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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.

In the wake of the new study by Dutch researcher Lex Wunderink, it is time for psychiatry to do the right thing and acknowledge that, if it wants to do best by its patients, it must change its protocols for using antipsychotics. The current standard of care, which—in practice—involves continual use of antipsychotics for all patients diagnosed with a psychotic disorder, clearly reduces the opportunity for long-term functional recovery.

As noted in Anatomy of an Epidemic, the prognosis for someone experiencing psychosis is far better in developing countries than in industrialized countries. Robert Whitaker and others posit that this is due to the treatment models used in the developing world, as well as to debility and chronicity caused by psychiatric drugs themselves. I think it's also important to explore traditional tribal and village based models of helping people experiencing psychosis and examine why they may be effective. Do these traditional societies know something we don't?

Everywhere you turn, you see “OCD, ASD, MDD, ADD, ADHD, BPD, GAD, PD, SAD, PTSD, NPD," etc. The problem is not limited to this acronym soup, but the pseudo diagnoses they represent. Patients today get stained by the specious medical diagnoses of biological psychiatry. And furthermore they are brainwashed to believe that these fictitious brain ‘diseases’ are genetic. Biological psychiatry treats people like they are mechanical objects, renaming them almost as they are re-branding products. The one I like the best is the renaming of ‘manic-depressive’ to ‘bipolar.’ Instead of a name which accurately describes the states of suffering, it was turned into something mechanical — a battery with two poles. We’ve gone from something human to something Frankensteinian.

Three-and-a-half years ago I quit my career as a psychotherapist. I’d done it for ten years in New York City and had given it my all. It was a career that chose me, loudly, when I was 27 years old. I learned a huge amount from it and I believe I was helpful to a lot of people. It also represented a vital stage in my life. But then the time came to leave. That also came as a sort of revelation.

I learned of the Hiawatha Asylum for Insane Indians in 2001 through the paper, “Wild Indians,” by psychiatric survivor and activist Pemina Yellow Bird. Pemina movingly described the notorious history of this federal facility which operated from 1899 to 1933. When I finished reading, I searched up Pemina’s email address, and we began a series of lengthy virtual exchanges that helped galvanize my spirit through the many emerging battles with IHS’s psychiatric labeling and medicating approach to treating Yakama reactions to oppression, and the related psychosocial stress. In short, I began to fight back.

As awareness spreads about there being something wrong with existing approaches to “psychosis” aka “madness.” Interest grows in exploring what to do instead. One meeting place for exploring this question of “what to do” will be the ISPS conference in NYC in March 2015, which is titled “An International Dialogue on Relationship and Experience in Psychosis.” This conference promises to stand out in terms of the variety of voices,  perspectives, approaches and traditions that it will bring together to focus on the deeper issue of how helpers can best understand and interact with those experiencing what is called psychosis.

In a 2013 edition of the Journal of the History of Biology, Norbert Wetzel and I published an article on the Swiss-German psychiatric geneticist Ernst Rüdin (1874-1952) and his close colleagues, and how their work and crimes in the Nazi era have been discussed or ignored by contemporary psychiatric genetic writers and researchers. Here I would like to summarize the main points we raised in that article, and to make several additional observations. Whether Rüdin reluctantly aided and helped implement the “euthanasia” killing program in support of the war effort, or more likely, that he saw it as the crowning achievement of his decades of psychiatric genetic research based on racial hygienic (eugenic) principles, is an issue that may be decided in the future.

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?

To create his theory of relativity, Einstein had to see things differently. He used imagination and empathy to come to know a new 'reality' of existence. In this essay, we delve deeply into the nature of human experiences that lead to public concern and discover ourselves in a whole new realm.

In a recent commentary, University of Toronto historian Edward Shorter laments the efforts of people like myself in states like Texas who have successfully put limits on shocking children in order to induce grand mal convulsions. His argument is that we who have fought against this are denying children a benevolent medical treatment. In order to understand why Shorter’s plea to use electroshock on children is so egregious, we need to know what it does to children’s brains, which means a look at the science.

On a national Canadian radio show on Sunday (April 26), former APA president Jeffrey Lieberman called me a "menace to society" for my writings on the long-term effects of psychiatric medications (and other writings.) He said there was abundant evidence that psychiatric medications improved long-term outcomes for various psychiatric disorders. And so now we would like to issue a challenge: Dr. Lieberman, please point out these studies for us.

...but how realistic is it to expect that the biological skew of Western psychiatry can be sustainably changed one small step at a time?

When former NIMH chief Dr. Thomas Insel speaks, people listen. Dr. Insel famously criticized the DSM a couple of years ago for its lack of reliability. He notably broke ranks with the APA by saying there were no bio-markers, blood tests, genetic tests or imaging tests that could verify or establish a DSM diagnosis of schizophrenia, bipolar or schizoaffective disorder. However in a new article he announces research that claims to have found bona-fide physiological markers that identify specific "biotypes" of psychosis. This system could, purportedly, identify a person as possessing a specific biotype of psychosis, instead of a DSM-category diagnosis.

There are 50 Spiritist psychiatric hospitals in Brazil, offering inpatient and outpatient services that utilize an integrative approach to recovery, stressing the spiritual alongside physical and emotional therapies. Few people outside Brazil know of them. This article describes their philosophy, successes, as well as the treatments they use—and how they are a valuable resource for sensitives, creatives, and visionaries.

In the autumn of 1996, my son was seventeen when he told me one day on the way home from school: “I don’t know what’s happening, I can’t find my old self again.” He’d had a seemingly marvelous summer staying with family in Mexico, fishing and learning to surf. He’d achieved nearly a full scholarship for his junior year at a Boston private school. However, one teacher had observed that, in class, he “sometimes seems to be out of touch and unable to focus his mind.”

I've figured out there are five types of mental health advocates. We need to respect all five types of motivations and viewpoints in order to support or combat their agendas. The question for us, is how can we each of us maximize our own impact to share awareness of this situation and then impact change? The answer is that each of us has to work from our own passions and interests and talents and skills and motivations.

Editor's Note: After Allen Frances and Robert Whitaker spoke recently at the Society for Ethical Psychology and Psychiatry conference in Los Angeles, where they had a brief debate, Frances wrote to Whitaker suggesting that they should continue this debate in print. They do so here. Whitaker’s response follows Frances' post.

I have hopes for the field of psychiatry. I hope the field will redeem itself, and redeem its practitioners, because they do have clinical skill and the opportunity to learn more and grow. Many of them, I believe, were just taught bad science, influenced and infiltrated by Big Pharma.

Many people who have never been severely depressed might ask, “Why would anybody want to kill themselves?” After all, taking one’s life goes directly against the survival instinct that nature has programmed us with. For example, if you were walking across the street and saw a car coming towards you − your first instinct would be to jump out of its path. Yet, when the brain becomes overwhelmed with chronic, intense pain that seems to have no end, then suicide becomes not only a rational choice, but a compelling option. After all, if you are faced with the prospect of being in eternal hell, then taking your own life seems like an act of self-love, not an act of self-detruction.

I worked for ten-and-a-half years as a psychotherapist, nine of them licensed and one-and-a-half as a social work intern. For the last four years I have worked as a filmmaker. I have considered of late turning in my therapy license (an LCSW), and, if I were to return to the psychological helping profession, to do so as a life coach—unlicensed and outside the system. But is this wise?

Inside of the clamorous jails, in the single beds of locked in-patient psychiatric units, and in the noisy streets and quiet homes across this country there are people who have no voice. They have been rendered mute by terrible conditions; physical and emotional abuse, incarceration with dangerous criminals, numbing medication and threats of long term hospitalization. Whether their inability to communicate their fears, their desperation, and their frustration comes from an early history of abuse that traumatizes them into silence or is imposed by an environment that punishes expression of feelings, the results are the same. They are voiceless at a critical time in their lives.

In a bold and unprecedented move for any professional body, the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, issued a Position Statement today calling for the end of the unevidenced biomedical model implied by psychiatric diagnosis. In brief, the argument is that the so-called ‘functional’ diagnoses – schizophrenia, bipolar disorder, personality disorder, ADHD and so on - are not scientifically valid categories and are often damaging in practice.

On December 23, I wrote a post called DSM-5 - Dimensional Diagnoses - More Conflicts of Interest?  In the article I sketched out the role of David Kupfer, MD, in promoting the concept of dimensional assessment in DSM-5, and I speculated that at least part of his motivation in this regard might have stemmed from the fact that he is a major shareholder in a company that is developing a computerized assessment instrument. The article precipitated a fairly lengthy debate in the comments section. The discussion was wide ranging, and some of the issues addressed were fundamental to the entire psychiatric debate, in particular: whether or not psychiatry is based on valid science.

The Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and Schizophrenia. The central theme of the paper is that the condition known as psychosis is better understood as a response to adverse life events rather than as a symptom of neurological pathology. The paper was wide-ranging and insightful and, predictably, drew support from most of us on this side of the issue and criticism from psychiatry.  Section 12 of the paper is headed "Medication" and under the subheading "Key Points" you'll find this quote: "[Antipsychotic] drugs appear to have a general rather than a specific effect: there is little evidence that they are correcting an underlying biochemical abnormality."