Saving Normal

Mental health and what is normal.

DSM 5 Boycotts and Petitions

Too many, too sectarian

There are already about a dozen different DSM 5 petitions and boycotts out there. This is completely understandable- there is lots in DSM 5 to be angry at or frightened about.

Unfortunately, though, this is not a case of more the merrier. Fragmentation into a number of small protests will greatly reduce their aggregate impact.

One unified, inclusive boycott with 200,000 signers would render DSM 5 much less dangerous. A dozen boycotts with 20,000 signers will likely not provide nearly as much protection.

Why all the splinter groups? The many people who oppose DSM 5 do so for a whole variety of very different reasons and have so far pursued their own independent agendas- rather than coming together under one unified and inclusive banner.

No surprise there- it is human nature to disagree and to follow divergent paths. But regrettable- we sorely need the clear warning about DSM 5 that only a really effective boycott could provide.

My name has been used without permission in a way that might imply I support the positions taken in one of the recently launched boycotts. This is not the case- it is premised on what seems to me to be a far too one sided and excessively negative view of psychiatric diagnosis.

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My view is that psychiatric diagnoses can cause great harm when it is used badly and expanded beyond its competence. But used well, psychiatric diagnosis is essential and sometimes life saving.

I think it is equally a mistake to blindly and fully support psychiatric diagnosis or to blindly and fully oppose it.

DSM 5 calls for a reckless expansion that will harm the people who are mislabeled; an ideologically worded boycott calls for a reckless discarding of psychiatric diagnosis even for people whose welfare depends upon it. Both extremes are reckless and risky.

I await and would enthusiastically support a DSM 5 boycott statement that was brief, inclusive, and non sectarian. Any new boycott must unify the diverse opposition, not further fragment what is already a very fragmented field. It must seek to actually make a difference- not just make a point.

APA is counting on having a captive audience that feels forced into using DSM 5. A successful boycott would free that audience. But to be successful it must include all opponents to DSM 5, not just the most radical.

I am now on twitter at @AllenFrancesMD

Allen Frances, MD

Author of Saving Normal and Essentials of Psychiatric Diagnosis

Allen Frances, M.D., was chair of the DSM-IV Task Force and is currently professor emeritus at Duke.

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