Mad Flies and Bad Science
Tension mounts across the ideological divide as D-Day (DSM-5 Day) approaches. The APA has powerful allies on its side. President Obama has just launched Decade of the Brain 2 with the announcement two weeks ago that heralds the arrival of BRAIN ( Brain Research through Advances in Innovative Neurotechnologies). If thatâs not enough, those who believe that science will ultimately explain madness can always rely on the media to fawn at their feet.
“The D.S.M. and the Nature of Disease”
Gary Greenburg writes in the New Yorker that "The D.S.M. has enormous impact on the public health. It determines which conditions insurers will cover,...
Using Formulation to Change Team Cultures
I am returning to the subject of psychological formulation after rather a lengthy gap, during which controversy about the forthcoming 5th edition of DSM has continued to grow â sign the petition âStop the Insanityâ at www.dsm5response.com if you share othersâ concerns about the creeping medicalisation of everyday life and the risks that it poses.
The DSM-5 Field Trials: Inter-Rater Reliability Ratings Take a Nose Dive
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.
The Petition Against DSM-5
The International DSM-5 Response Committee, sponsored by Division 32 of the American Psychological Association â the Society for Humanistic Psychology â now has an online petition against the DSM-5. This is a truly international effort. Please support the petition by signing it at http://dsm5response.com
Diagnosis Dilemma
Not long ago I had a conversation with a psychiatrist. He told me about a diagnostic dilemma heâd run up against at work; When a judge makes an unfunded treatment mandate as part of her judgment, she pressures the doctor to make a âpayableâ psychiatric diagnosis. If the doctor stretches the truth out of sympathy and provides an inaccurate but payable diagnosis so that his patient can have access to medical care and money to live on, he is committing fraud that can mean heavy fines and incarceration for himself.
The Politics of Systems Change: Lessons Learned from the Launch of the DSM-5 Boycott
Machiavelli had it right. âThere is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success than to take the lead in the introduction of a new order to things.â Ever since we launched our DSM-5 Boycott three weeks ago, weâve received support from organizations and individuals but have become entangled in more wrangling than I ever would have anticipated.
Psychiatric Survivors Speak Up: Harm From Psychiatric Diagnosis, and a Start on Solutions
Clinical and research psychologist Paula Caplan presents a keynote address entitled "Psychiatric Survivors Speak Up: Harm From Psychiatric Diagnosis, and a Start on Solutions" at the 2012 National Association for Rights Protection and Advocacy (NARPA) Conference in Cincinnati, Ohio.
Scapegoating Persons Labelled Mentally Ill: The Politics of Marginalization
Scapegoating is an ancient human practice that probably dates from the time the first human beings decided to circle their huts -- what we fondly term the dawn of civilization. When things got tense in the compound, penalties got handed out to one or more individuals or families, those usually at the low end of the pole, the politically powerless or vulnerable.
The Problem with PTSD
âThe voices, they tell me they gonna kill me, and itâs my fault.â
âSometimes, when we hear voices, they just reflect our own anxieties, sometimes they can echo things weâve been told in the past. When the voices tell you that theyâre going to kill you, does that echo anything you may have been told in the past?â I ask.
More Thinking about Alternatives to Psychiatric Diagnosis
In my last post, I argued that the single most damaging effect of psychiatric diagnosis is loss of meaning. By ruthlessly divesting experiences of their personal, social and cultural significance, diagnosis turns âpeople with problemsâ into âpatients with illnesses.â Horrifying stories of trauma, abuse, discrimination and deprivation are sealed off behind a pseudo-medical label as the individual is launched on what is often a lifelong journey of disability, exclusion and despair.
“As Diagnostic Thresholds Are Lowered, Being Normal Ends Up Being as Difficult as Being...
"We are in the process of turning the disease into the norm and where the normal becomes the exception. If this continues, we will...
“Drop the Language of Disorder”
Peter Kinderman, John Read, Joanna Moncrieff and Richard Bentall write, in Evidence-Based Mental Health this month, that "While some people find a name or...
From Psychiatry and Psychotherapyâs Grand Delusion Toward Constructions of a Post-Therapeutic State
by Eugene Epstein, Manfred Wiesner, and Lothar Duda
Over the past 50 years, the psychiatric and psychotherapeutic discourses of the western first world have infiltrated...
“Last Plea To DSM-5: Save Grief From the Drug Companies”
Allen Frances, writing in the Huffington Post, calls the decision in the forthcoming DSM-5Â to call grief in the bereaved a disorder as soon as...
Thinking about Alternatives to Psychiatric Diagnosis
I want to follow up my first post by outlining the principles of possible alternatives to psychiatric diagnosis â that is, alternatives in addition to the most obvious one, which is simply to stop diagnosing people.
Time to Abolish Psychiatric Diagnosis?
âDiagnosingâ someone with a devastating label such as âschizophreniaâ or âpersonality disorderâ is one of the most damaging things one human being can do to another. Re-defining someoneâs 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.
Why Paul Steinberg Has It All Wrong (and Should Stop Seeing Patients)
(This commentary originally ran on Beyond Meds)
In his New York Times op-ed entitled âOur Failed Approach to Schizophreniaâ Paul Steinberg, a psychiatrist in private practice, proposes we...
Boycott The DSM-5: Anachronistic Before Its Time
When plans for the DSM-5 were first announced about ten years ago, most folksâ reaction was âWhy?â. Many of us asked that same question several times as the publication date for the new tome kept on getting pushed back. Finally, the curtain enshrouding the DSM-5 Task Force and its several committees began to part and proposed revisions/additions began to appear on its website. To our dismay, we found our question answered.
Psychiatry Beyond the Current Paradigm, and DSM-5
Recently, two more waves of criticism have broken onto the beach of opinion concerning mental health services and practice. Allen Frances has mourned approval of DSM-5 in his Psychology Today blog and the British Journal of Psychiatry has published a paper by members of the UK Critical Psychiatry Network. What is notable about both of these is that they give further voice to criticism of conventional mental health services by those who have spent years providing and researching them.
Suckling Pigs, Stray Dogs, and Psychiatric Diagnoses
In "The Order of Things", Michel Foucault, the great French philosopher cites a âcertain Chinese encyclopediaâ that notes âanimals 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 fliesâ.
“Multigenerational Poverty”
The practice of medicine in our country is being swallowed whole by a snake. The snake started with the poor, the black, the brown; the already disenfranchised of the deep south and inner cities many years ago. It was an easy sell to the better-off taxpayers. Who wants to give up money to take care of poor people?
All Quiet on the DSM Front
1 Boring Old Man write on the silent treatment echoing from the DSM-5 battlefront.
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Psychiatric Diagnosis as Subjective Opinion Rather than Science
An opinion article by a survivor of forced hospitalization writes in The Irish Times argues that the 30% reduction in involuntary detentions in Ireland...
“Grief is Good News for Pharmaceutical Companies”
The U.K.'s Guardian writes today that "the proposal by the American Psychiatric Association to create a new illness â prolonged grief disorder â and...