Blog des AK Psychiatriekritik der NFJ Berlin

Tag: DSM5

The Great “Crazy” Cover-up: Harm Results from Rewriting the History of DSM

I have been immersed in the field of psychiatric diagnosis – and resistance to it – for more than a quarter of a century. In the late 1980s, I was a consultant to two committees appointed by DSM-IV Task Force head Allen Frances to decide what DSM-IV should contain. I resigned from those committees after two years because I was appalled by the way I saw that good scientific research was often being ignored, distorted, or lied about and the way that junk science was being used as though it were of high quality . . . if that suited the aims of those in charge. I also resigned because I was increasingly learning that giving someone a psychiatric label was extremely unlikely to reduce their suffering but carried serious risks of harm, and when I had reported these concerns and examples of harm to those at the top, they had ignored or even publicly misrepresented the facts. I wrote about what I learned from my insider’s position in my book, They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal (Caplan, 1995).

From about 2009 until DSM-5 was published in 2013, there was massive coverage in popular and professional media about outcries against DSM-5. The outcries were largely based on the assumption that it would represent a break with DSM-IV (published in 1994 and minimally altered for a 2000 edition), which was seriously misrepresented as having been solidly scientific, helpful, and – for all but a tiny number of its hundreds of categories –  not harmful.  The rewriting of history has continued in publications since DSM-5 appeared, so that there has been a massive and damaging rewriting of history, and it lends a legitimacy to DSM and other diagnoses in general, when, in fact, the recurring problem is that psychiatric disorders have never been validated, in fact not even shown to be reliable.



DSM-5 Boycott Enters 2nd Phase: A Primer for the NO-DSM Diagnosis Campaign

I.  DSM-5 Boycott: Yes, the boycott of the DSM-5 continues. I can’t tell you how many fewer DSMs have so far been purchased as a result of the boycott; and conversations I have had with professionals in New York’s public mental health system lead me to believe that the great majority continue to accept the validity of the biomedical model and the centrality of psychoactive medications in the treatment of persons caught up in the public system. Perhaps that’s the most important argument in support of the boycott’s continuation – we have so many more folks to reach.

To date, 2136 persons have endorsed our boycott statement; little more than 4,000 individuals supported the petition of the International DSM-5 Response Committee, composed in the main by members of the Clinical Psychology Division of the British Psychological Society and Division 32 of the American Psychological Association. Approximately 2000 Spanish and French professionals, psychoanalysts for the most part, also signed petitions opposing the sale of the DSM-5 . . . in sum, little more than 8000 persons in the U.S. and Western Europe, a comparatively miniscule number when one considers the millions of DSMs the American Psychiatric Association anticipated selling.


DSM-5: Diagnosing for Status and Money Summary Critique of the DSM-5


Because most undergraduate, graduate and postgraduate courses relatively uncritically present the DSM as an objective scientific document, this summary focuses exclusively on the critical view. It neither provides a complete analysis of psychiatric diagnosis nor denies that the DSM, if used cautiously and appropriately, can be useful, nor does it advocate against psychiatric diagnostic.

The primary goal of this web page is to promote critical thinking in psychology and psychiatry by presenting a controversial critique of psychiatric diagnosis. The following summary was inspired by the work of both Allen Frances, M.D., chair of the DSM-IV task force, Dr. Paula Caplan, and the writing cited in the Selected Bibliography at the end of this page.


DSM-5 Writing Mistakes Will Cause Great Confusion

There are two very different kinds of mistakes that any DSM can make — bad conceptual choices or bad writing. The big conceptual botches in DSM-5 have been discussed extensively elsewhere and won’t be covered again here. These are things like the new diagnoses (e.g. Mild Neurocognitive, Disruptive Mood Dysregulation, Binge Eating, Behavioral Addictions) and the reduced thresholds for existing ones (e.g. removing the Bereavement Exclusion for Major Depressive Disorder).

Our focus now will be on the fact that DSM-5 is filled with glaring mistakes in wording and coding. The devil often lurks in these very small details. I have learned through painful experience not to underestimate the potential mischief caused by seemingly tiny word changes.

Crazy Like Us: How the U.S. Exports Its Models of Illness

The fears of many European psychiatrists may soon be realized. Earlier this week, Psychiatric News reported that the American Psychiatric Association has begun petitioning the various agencies overseeing changes to the ICD, or International Classification of Diseases, to request that they adopt its most-controversial changes in DSM-5.