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.

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

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