Dodge the DSM and Its True Believers!
A mental health diagnosis may be harmful to your health and happiness.
Posted January 8, 2017
Socked in due to blizzard conditions in Norfolk, Virginia, it seemed like a good time to reflect and peruse my bookshelf for some unread books. Instead, I saw a few that I have read that caused me to think about how much my views of my profession have changed over the years.
From Faith to Shame
It was September in Chicago, Illinois 1983 when I entered graduate school to become a clinical psychologist and was required to learn the history of and the ins and outs of the Diagnostic and Statistical Manual, commonly called the DSM. The DSM is the “definitive” source for diagnosing mental health conditions. Insurance companies require healthcare professionals of all persuasions to use it, if they want to be reimbursed for their clinical work.
In the 1980s, I took seriously what was in the DSM, as well as what my professors had to say about it. Today, I want nothing to do with the DSM. Allow me to explain.
While I’ve always felt at least a tad uncomfortable with the DSM, at first this was due primarily to a lack of confidence about my ability to adequately serve my clients by appropriately deciphering the diagnostic criteria of disorders that contained overlapping symptoms. Eventually, I grew to be embarrassed by the absurdity of the manual’s content, its intent, and my less-than-immediate realization that it lacks the degree of scientific rigor it pretends to reflect.
Sad State of Mental Health
But such harsh self-criticism may not be in order. Sadly, many, if not most, mental health clinicians and physicians still “believe” the DSM is a source of sound authority for distinguishing between those who suffer temporary slings and arrows of life and those whose distress and dysfunction represent legitimate disease processes. This is not true.
There’s an abundance of reasons to run from anyone who believes in the DSM, and evidence to suggest that doing so may be good for your mental health and your bank account. When I think about summarizing such, I almost become too agitated to begin. So, allow me to draw your attention to three sources of such enlightenment that hold down a special place in my library.
Good (and Important) Reads
1. Saving Normal: An Insider's Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life by Dr. Allen Frances. As described on the Amazon website, this book was written by "the most powerful psychiatrist in America" (New York Times) and "the man who wrote the book on mental illness" (Wired), a deeply fascinating and urgently important critique of the widespread medicalization of normality. As Frances, a man who was once responsible for chairing the committee that produced an earlier version of the DSM, says, the most recent edition (DSM-5, published in 2013) turns the problem of diagnostic inflation to hyperinflation. The net effect is that stigmatizing healthy people as mentally ill “leads to unnecessary, harmful medications, the narrowing of horizons, misallocation of medical resources, and draining of the budgets of families and the nation. We also shift responsibility for our mental well-being away from our own naturally resilient and self-healing brains, which have kept us sane for hundreds of thousands of years, and into the hands of "Big Pharma," who are reaping multi-billion-dollar profits.”
2. The Book of Woe: The DSM and the Unmaking of Psychiatry by Gary Greenberg. Amazingly, journalist and psychotherapist Gary Greenberg was able to spend two years documenting behind-the-scenes events that led to publication of the latest edition of the DSM—the DSM-5. Greenberg’s conclusion was that the American Psychiatric Association “should not have the naming rights to psychological pain or to the hundreds of millions of dollars the organization earns, especially when even the DSM’s staunchest defenders acknowledge that the disorders listed in the book are not real illnesses,” according to the book’s description on Amazon.
3. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illnesses by Robert Whitaker. Long before most, Whitaker documented (with the sort of scientific rigor that those who created recent editions of the DSM lacked) that America’s approach to mental illnesses is not only misguided but actually makes people sicker. As explained in the beginning of the book, Whitaker discovered this horrific reality quite by accident. It was his outrage over depriving hospitalized patients from their drugs to test newer ones that led him to discover the harmful nature of almost all psychiatric drugs in use today. The evidence is compelling. These drugs ensure schizophrenia becomes a chronic condition; early and aggressive treatment of depression too often leads to a host of other more serious mental health problems; and long-term treatment of ADHD with stimulants can induce more serious bi-polar symptoms in children and young adults.
Creating a Paradigm Shift
Any one of these three books will knock your socks off. Reading them could be depressing...except that today (alas!) there is a movement afoot to create a new mental health treatment paradigm that offers better care to those who suffer emotional distress and dysfunction. For starters, see Whitaker’s highly acclaimed website, www.madinamerica.com, which is filled with inspiring stories of people who have recovered and are recovering from long-term use of psychiatric labels and drugs.
If you are a mental health professional, in treatment with mental health professional, or taking psychiatric drugs to treat a mental health condition please do yourself this favor. Stock up: make sure you have at least one of these books ready to read this winter.
Reading a book by Whitaker, Greenberg, or Frances will give your emotions a workout. Each has a different writing style, but any one of them is likely to send you on an emotional roller coaster ride and lead you to discover just how emotionally resilient the human spirit can be. If you’re not a book reader, then you might want to start your journey by visiting the Mad in America website.
In any event, surround yourself with supportive people. This is the best buffer against and cure for the pangs of emotional distress and dysfunction.
Frances, A. (2013). Saving normal: An insider's revolt against out-of-control psychiatric diagnosis, DSM-5, Big Pharma, and the medicalization of ordinary life. New York, NY: William Morrow.
Greenberg, Gary (2013). The Book of Woe: The DSM and the Unmaking of Psychiatry. New York, NY: Blue Rider Press.
Whitaker, Robert (2010). Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illnesses. New York, NY: Broadway Books.