Causation Theories

The Economist, in its upcoming edition, says of the DSM "No other major branch of medicine has such a single text, with so much...

I think it’s helpful to see the psychiatric/pharmaceutical complex as being somewhat analogous to one of those large inflatable giants that you sometimes see hovering over car lot sales. Sure, it looks big and powerful, and it really is so long as “we the people” buy its propaganda and its drugs and continue feeding it billions of dollars and continue “bowing down” to its “almighty wisdom.” But its entire foundation consists of a model that simply doesn’t fit the research evidence at all, and quite frankly is propped up by many outright lies.

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.

Imagine being able to live harmoniously amongst others without fear. I cannot. Cannot imagine it even a little bit. What can be created for people in my camp? People who are sensitive and had so much trauma in childhood that life among others is highly stressful, scary and worrisome? I'm allowing myself sanctuary-time alone, quiet time, time to write… yet… will things ever be different? Will I ever find my niche in this world, where I feel safe and able, valued and worthwhile, loved, adored and comfortable? I have no idea.

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.

It is time for a new understanding of suicidal feelings and actions. Perhaps a more open dialogue, without fear of sirens and police and involuntary hospitalizations, would have made a difference for one young man here in Asheville last month. Perhaps more public local conversation would have saved some of the 45 lives we lost here in Buncombe County in 2010. Perhaps a more public and safe national conversation would have saved some of the 22 veterans who died from suicide every day in 2010.

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.

As the medical director of a community mental health center, my colleagues look to me for guidance on how to approach the new edition of the DSM. How many should we buy? How much time should be devoted to staff training? This is my answer.

When Thomas Szasz’s name comes up in debates over defining mental illness, it is fairly common to hear people say something along the lines of, “Well, he made some good points, but he was just too extreme.” Yet I am struck by how conversations about DSM-5, being released this month, make the crisp arguments Szasz consistently offered for 50 years just as timely as ever. I’d even go so far as to suggest that a large number of counselors, psychologists, social workers, and psychiatrists pretty much agree with the main tenets of Szasz’s argument, despite their ongoing disclaimers.

Susan Salasin created this video about the role of trauma in the lives of those who are labeled seriously mentally ill. She collaborated with...

Psych meds can not only put weight on regardless of how you otherwise care for yourself, they also tend to make people feel gravely lethargic and vaguely sick all the time. I could not exercise as I had before. Could not. It doesn't matter how much mental health professionals try to tell us that if we just exercised we'd be okay in the face of neurotoxic drugs that cause weight gain, because the fact is the drugs impede that capacity. This is not widely appreciated or understood and people on psych meds are again traumatized and made to feel guilty for something that is truly outside of their control as long as they are taking these medications.

Suicidal torment is magnified by the loss of hope. People in life-or-death survival conditions, such as being lost in the wilderness or being held prisoner of war, will dream and plan for the future in order to make their present conditions tolerable. The critically ill heart patient expresses his faith in his upcoming surgery by making a date to play golf six weeks after the operation. But the depressed person sees no viable future. There is nothing to look forward to, no dreams to fulfill, only the never-ending hell of the eternal present.

For everyone who goes on psychiatric drugs, the reason comes back to power imbalances in their personal life. Women who's husbands “make all of the money” and have an unequal share of the power, kids who's parents have power over them—frequently people who have less money and security, therefore less platform for authority than those around them. Mental illness is not in fact an illness but an unequal division of power and sense of security in a social group.

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 that’s not enough, those who believe that science will ultimately explain madness can always rely on the media to fawn at their feet.

British researchers find that a 10% increase in pain medication resulted in a dramatic reduction in the use of antipsychotic and other medications. “When...

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,...

Military.com reports that doctors from the Department of Veterans' Affairs are continuing to prescribe tranquilizers such as Valium and Xanax despite the VA's guidelines...

I hope this will be of help to people who hear voices and their friends and supporters. I also hope it will be helpful to the voices which are parts of many people's lives. Many voices I have come across and the people that hear them are convinced that their voices are spiritual in nature. I take an agnostic position on this, and therefore endeavour to respect different spiritual understandings. My intention is not to explain all voices psychologically but to help people make peace with their voices so they can get on with their lives.

I am returning to the subject of psychological formulation after rather a lengthy gap, during which controversy about the forthcoming 5^th edition of DSM has continued to grow – sign the petition ‘Stop the Insanity’ at  www.dsm5response.com if you share others’ concerns about the creeping medicalisation of everyday life and the risks that it poses.

A few months ago I had the great honor of speaking with Kofi Annan, former secretary general of the United Nations, after a talk he had given locally here in Washington, DC. We spoke about eCPR and there was a moment that I will remember for the rest of my life. He looked deep into my eyes and said, “We are in the same line of work. We are peacemakers.” It was a profound statement that inspired me to think more about eCPR as a tool of peacemaking.

The label of schizophrenia has a chilling ring. It carries with it the suggestion of a wrecked and wretched life. It is also a diagnosis that is notoriously difficult to shed. For this reason, the diagnosis of schizophrenia should not be applied lightly and not without a thorough understanding of the patient’s family and wider circumstances.

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 International DSM-5 Response Committee, sponsored by Division 32 of the American Psychological Association — the Society for Humanistic Psychology — 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

As most readers are aware, it is widely believed that both within and without of psychiatry genetic factors play an important role in causing major psychiatric disorders such as schizophrenia, bipolar disorder, major depression, ADHD, autism, anxiety, and even post-traumatic stress disorder (PTSD). Twin studies provide the main pillar of support for this belief which is often, though mistakenly, presented as a scientific fact.

I attended Milt Greek’s educational opportunity at Cooper Riis’ The Farm last February 25, 2013 and it was especially fortuitous for me. What I was able to glean from the presentation, in short, was that it shook me up.