DSM

A month ago, I published a critique of specific terminology of DSM-5.  Like countless others, I have serious concerns about the overpathologizing of normal behaviors that appears to be occurring over the past few decades.  The potential consequences of this trend have been widely articulated in many circles, and have raised a serious question, “What is normal?” But while this has been occurring in both psychiatric and lay arenas, another movement has been gaining significant support.  It is the idea that mental illness (or disease) is a fabrication, and as Sera Davidow quoted E. Fuller Torrey in her recent moving article, “Mental illness does not exist, and neither does mental health.”

In just two decades, pointing out the pseudoscience of the DSM has gone from being an “extremist slur of radical anti-psychiatrists” to a mainstream proposition from the former chairs of both the DSM-3 and DSM-4 taskforces and the director of NIMH. In addition to the pathologizing of normal behaviors, another explanation for the epidemic — the adverse effects of psychiatric medications — is also evolving from radical to mainstream, thanks primarily to the efforts of Robert Whitaker and his book Anatomy of an Epidemic. While diagnostic expansionism and Big Pharma certainly deserve a large share of the blame for this epidemic, there is another reason.

While a great deal of the excitement about advances in psychological treatments comes from the potential for research in neuroscience to unlock the secrets of the brain, many mental health experts would like to temper this enthusiasm. A special issue of the Behavior Therapist released this month calls into question the predominant conception of mental illnesses as brain disorders.

A new article suggests counselors and psychotherapists are dissatisfied with current diagnostic systems and outlines some potential alternatives.

Robert Whitaker notes on Al Jazeera's "Inside Story" that a helpful diagnostic text must be both reliable and valid, and the DSM is neither...

Neuroscience researchers find no differences in brain connectivity between children with diagnoses of autism, ADHD, and those with no diagnoses.

Kev Harding argues against conceptualizations of therapy as a ‘cure’ to an ‘illness’ and instead offers alternative approaches.

Dr. Raskin discusses psychotherapists’ dissatisfaction with current psychiatric diagnostic systems and explores alternatives.

A new study systematically explores critical reactions to the DSM-5 and identifies unifying themes.

The American Journal of Psychiatry (January, 2103) recently published a series of articles that analyzed the outcomes of the field trials that were conducted by the DSM-5 Task Force, to determine the inter-rater reliability of the multiple diagnostic categories that will comprise the DSM-5. A table below tracks the downward progression of inter-rater reliability from DSM-III through DSM-5.

Derek Summerfield, consultant psychiatrist at South London and Maudsley National Health Service Foundation Trust, challenges the assumption that Western depression is a universal condition.

“The voices, they tell me they gonna kill me, and it’s my fault.” “Sometimes, when we hear voices, they just reflect our own anxieties, sometimes they can echo things we’ve been told in the past. When the voices tell you that they’re going to kill you, does that echo anything you may have been told in the past?” I ask.

As co-chair of the Diagnostic Summit Committee of the Society for Humanistic Psychology, I am pleased to announce that today we officially launch the Global Summit on Diagnostic Alternatives (DxSummit.org), an online platform for rethinking mental health. Our goal is to provide a place for a collegial and rigorous discussion of alternative ways to conceptualize and practice diagnosis. Today's launch is marked by the appearance of our first eight posts. These posts come from a variety of prominent people in the field, each offering a unique perspective on the current state of diagnosis and where we might take things as we move forward.

There has been a lot of talk lately about neuroscience and the future of the medical model of "mental illness." It was made clear, in NIMH director Thomas Insel’s statement, that the DSM is a system of identification and classification of what are deemed disorders within our human experience. This isn’t exactly news to the vast majority of people who have spent even a little bit of time thinking about whether or not psychiatric diagnosis makes sense.

‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another. Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong - scientifically, professionally, and ethically. The DSM debate presents us with a unique opportunity to put some of this right, by working with service users towards a more helpful understanding of how and why they come to experience extreme forms of emotional distress.

The latest issue of the journal Behavioral and Brain Sciences features several prominent researchers arguing that mental health concerns are not “brain disorders.”

-A special issue of Public Affairs Quarterly examines "the moral and political implications" of the Diagnostic and Statistical Manual of Mental Disorders.

Attempting to locate the mechanisms of psychiatric disorder is a step in the wrong direction and fails to challenge potentially unjust social practices.

Study uncovers teachers’ attitudes surrounding ADHD medication use and examines the influence of race and social class on teacher beliefs.

In "The Order of Things", Michel Foucault, the great French philosopher cites a ‘certain Chinese encyclopedia’ that notes ‘animals are divided into: (a) belonging to the Emperor, (b) embalmed, (c) tame, (d) suckling pigs, (e) sirens, (f) fabulous, (g) stray dogs, (h) included in the present classification, (i) frenzied, (j) innumerable, (k) drawn with a very fine camelhair brush, (l) et cetera, (m) having just broken the water pitcher, (n) that from a long way off look like flies’.

More than a year on from the release of DSM-5, a Medscape survey found that just under half of clinicians had switched to using the new manual. Most non-users cited practical reasons, typically explaining that the health care system where they work has not yet changed over to the DSM-5. Many, however, said that they had concerns about the reliability of the DSM, which at least partially accounted for their non-use. Throughout the controversies that surrounded the development and launch of the DSM-5 reliability has been a contested issue: the APA has insisted that the DSM-5 is very reliable, others have expressed doubts. Here I reconsider the issues: What is reliability? Does it matter? What did the DSM-5 field trials show?

Researchers detect disparity between white and African American patients diagnosed with schizophrenia when symptoms of a mood disorder are present.

In a new report, the United Nations Special Rapporteur on the right to health, Dr. Dainius Pūras, calls for a move away from the biomedical model and “excessive use of psychotropic medicines.”

What makes the DSM so pernicious is that it is a cultural document whose influence transcends not only psychiatric practice but also the Western civilization from which it originates. Each revision of the DSM rescripts and reimagines how we make sense of our experiences, reinterprets what thoughts, feelings and behaviors are socially sanctioned, and ultimately what it means to be human.

The safety of our children is a sacred obligation we strive to preserve. Anything or anyone that harms them becomes the object of our...