Over the summer, a wrangle between eminent psychiatrists that had been brewing for months erupted in print. Startled readers of Psychiatric News saw the spectacle unfold in the journal’s normally less-dramatic pages. The bone of contention: whether the next revision of America’s psychiatric bible, the “Diagnostic and Statistical Manual of Mental Disorders,” should be done openly and transparently so mental health professionals and the public could follow along, or whether the debates should be held in secret.
One of the psychiatrists (former editor Robert Spitzer) wanted transparency; several others, including the president of the American Psychiatric Assn. and the man charged with overseeing the revisions (Darrel Regier), held out for secrecy. Hanging in the balance is whether, four years from now, a set of questionable behaviors with names such as “Apathy Disorder,” “Parental Alienation Syndrome,” “Premenstrual Dysphoric Disorder,” “Compulsive Buying Disorder,” “Internet Addiction” and “Relational Disorder” will be considered full-fledged psychiatric illnesses.
This may sound like an arcane, insignificant spat about nomenclature. But the manual is in fact terribly important, and the debates taking place have far-reaching consequences.
I have always said the psychiatrists and witch doctors have a lot in common.
Many psychiatrists and psychologists see themselves as the high priesthood of a secular society. They have already shown themselves more than willing to allow political correctness to affect if not determine their understanding of human “pathological” behavior. And they have also be more than willing to use their study of human behavior for manipulation and other purposes which test the already vague boundaries of the “ethics” of their respective professions.
The 1973 DSM removed homosexuality as a disorder. It is very revealing to read the history of that change and see the extent to which political pressure rather than new research led to the change. The strategy of intimidtion and personal attacks is similar to the process by which TEC has come to the verge of approving SSM.
Indeed. The DSM has invented diagnoses that have no basis in scientific fact, in the same way that CDOs have invented “equity” and value that has no rational financial basis.
The main purpose of the DSM system is to ensure that psychiatrists get paid for seeing a child or adult who is obnoxious, undisciplined, and who has parents who are idiots.
The diagnoses are made by voice or hand vote. The democratic method is used (all in favor of this diagnosis being a real disease say “Aye’) not the scientific method.
Busy family physicians take this mumbo jumbo seriously. This is how all of a sudden some 20% of kids nationwide have suddenly come down with psychiatric disease. If everybody didn’t realize (secretly) that this was complete BS we would have had an outcry, and folks would be jumping up and down shouting about the dread epidemic, far worse than AIDS that has struck down hordes of US school children. The NIH says nothing because it knows this is BS.
Isn’t it remarkable how deviant behavior is depathologized and normalized while rambunctious little boy behavior is pathologized and “abnormalized!”
Our definition of mental health is the ability to function well in the economy or prepare to do so. I’m serious. If you think at all about it, this is our culture’s bottom line definition of what it means to be “well” — social-economic competence!
The DSM surely has some highly questionable twists and turns, but at least it has some nuance.
Albany [#7]: Don’t forget receiving and giving sexual gratification.
The real issues with DSM are more than just political. There are also the questions of what can a mental health provider get paid for “treating” and how much control can be asserted over individuals’ behaviors. If characteristics that previously were considered as perhaps obnoxious but hardly pathological can now be termed as medical conditions (Oppositional Defiant Disorder, Social Anxiety Disorder, etc., etc., etc.) then insurance companies will have to pay for them, schools can urge (or compel in many cases) parents to medicate their children, and “providers” of just about any persuasion/degree of training can get richly compensated for treating them. A great deal all around! It’s just the poor saps who pay the bills or believe what they’re told who suffer…they and the chemical zombies (boys, mostly) who are the recipients of all this treatment.
While I have some differences with his analysis, I think Dr. Thomas Szasz is probably right about most of psychiatry/psychology.