March 6, 2011


me+ME: Suzy Chapman clarifies the DSM-5

Suzy Chapman owns and maintains two of the finest sites relating to ME and to the DSM-5. Here they are with their own titles and links:

These are two carefully maintained sites with much material and many links about the topics they are concerned with, and but one proviso, which I only make because some have insisted on making this clear on forums for patients with ME: To appreciate the value of these sites, you need to be willing and able to think rationally.

I learned a lot from these sites, including that Ms. Chapman has a fine mind and an excellent prose style.

To turn to the DSM-5, first by clarifying some terminology: "The DSM" (<- Wikipedia), in the words the Wikipedia gives to the subject, from which I quote the first four paragraphs, minus some links, is this:

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, and policy makers.

The DSM has attracted controversy and criticism as well as praise. There have been five revisions since it was first published in 1952, gradually including more mental disorders, although some have been removed and are no longer considered to be mental disorders, most notably homosexuality.

The manual evolved from systems for collecting census and psychiatric hospital statistics, and from a manual developed by the US Army, and was dramatically revised in 1980. The last major revision was the fourth edition ("DSM-IV"), published in 1994, although a "text revision" was produced in 2000. The fifth edition ("DSM-5") is currently in consultation, planning and preparation, due for publication in May 2013.

ICD-10 Chapter V: Mental and behavioural disorders, part of the International Classification of Diseases produced by the World Health Organization (WHO), is another commonly used guide, more so in Europe and other parts of the world. The coding system used in the DSM-IV is designed to correspond with the codes used in the ICD, although not all codes may match at all times because the two publications are not revised synchronously

The latest news is that the public revision period scheduled for May of this year - when "the public" i.e. those to be diagnosed by the DSM, to be treated according to its terms, and to pay their psychiatrists or psychotherapists for it - has been postponed to August/September of 2011:

The first of these links is to dr. Frances' blogs; the second from the quote there to Suzy Chapman's DSM-5 site.

Why is this important for persons with ME, and indeed important for anyone who is interested in rational and moral medical science? Here are links to some of my answers in Nederlog, preceded by three links to others explaining it:

Next, here is a list of Nederlogs I wrote about the DSM-5, followed by a note on prurience (yes, you read that well) - and the reason to list these items I wrote on the subject is to have them in one place, also for myself, in case I want to use them.

First in 2010:

  • On the DSM-5TM
    This is a fine quoted exposition by Suzy Chapman plus 21 notes by me
  • Brit. Jn. Psychiatry: 78% of the British are not sane
    This is a review of an article in the BJP argueing the title, with help of the DSM-IV. (In case you missed the logical point: It follows most normal folks are insane - if the DSM-IV makes sense, to be sure, but that's a proviso few make, and that far fewer know how to make rationally.)
  • More about psychiatry
    Mostly about what this elderly psychologist thinks about psychiatry.
  • Feynman vs Wessely
    From Feynman - a genius in physics - "Cargo Cult Science", against pseudoscientists, including Wessely and the editors of the DSM-5.
  • McCulloch vs. Wessely
    From McCulloch, who started out as a medical doctor and psychiatrist, and ended as one of the founders of neuroscience and cybernetics, who was much abhorred by the standards and contents of psychiatry of his day.
  • Morningstar shines a bright light on postmodernism
    A good article on postmodernism (pomo), which is one of the mainstays of the DSM-5 and the Wessely school in pseudoscientific psychiatry, and a major liability for the continuance of civilization in the West.
  • More on postmodernism + logic
    My own take on the rise of pomo and its great dangers, and what intelligent persons can do to prevent it taking hold of their ways of thinking, speaking and writing (for yes: It is doublespeak, it is totalitarian, it is dangerous nonsense put forward by a bunch of terribles simplificateurs to an "academic audience" that is the least gifted and least intelligent, on average, of any "academic audience" ever, since the Western universities were "democratically" levelled in the late sixties and early seventies.
  • Psychiatry, psychology, CBT, GET, DSM-5 and XMRV
    This only is about the DSM-5 in passing, but mentions the Greenberg article linked above.

Then in 2011:

  • DSM-5
    Rather a lot more including my extensive comments on the Spiegel interview for radio linked above.
  • More on the APA's mockery of medicine and morality
    More fundamental objections to the APA's DSM-5, including its policies of (i) excluding virtually everyone from criticizing, commenting and indeed seeing what's happening behind the scenes and (ii) reinventing psychiatry in an editorial committee on the basis of a postmodernistic irrationalism that seeks to attribute to any disease a somatic and a psychological dimension (which is not rational science but irrational theology: The APA as would be doctors of the soul, like reverend ministers). [See below on prurience.]
  • More on the APA and the DSM-5
    More of the same, with a fine comment by Suzy Chapman.
  • On natural philosophy, philosophy of science, and psychiatry
    My own take of it all, as a logical philosopher and psychologist: Here you find many relevant texts mentioned.
  • me+ME: More on Freud and psychiatry
    Considerably more on the failings of modern psychiatry (sadistic maltreatment of children in France) and the moral and intellectual failings of Freud and Charcot, with links to Richard Webster's site and publications on Freud (who really was a fraud, though I should add drs. Frances and Spitzer disagree with me on this).
  • The gentle art of bullshitting the public for money
    On the subject, with reference to a book by philosopher Frankfurt on the subject of bullshitting, which is what the DSM-5 is, like much of psychiatry, psychotherapy, psychobabble, like much of religion and politics
  • More on bullshitting
    My own bullshitprotector mentioned and shown in use viz. mathematical logic.
  • More on the DSM-5
    Only briefly about the DSM-5 but with fine links, illustrations and quotations

As you may validly infer without having read any of these: I did write a fair amount on the DSM-5 since September 2010, and indeed rather a lot of it was downloaded or at least read a lot, and in particular

Here is the note I placed today at the start of that nicely argued text:

Note of March 6, 2011:

As it happens, this text ended with a rather famous picture of Freud with a cigar - who famously said "Sometimes a cigar is just a cigar" i.e. not what he in others would call a penis symbol - that was photoshopped to him holding a penis.

As it also happens, this is a file that, perhaps because of its title, was read a lot, it seems, but hardly ever downloaded. I had already provided a version without this Freud picture, but will today switch them, as I must infer that most of the readers of this text, very probably for the most part psychiatrists or psychologists, are too prurient to appreciate a bawdy visual joke on Freud.

My explanation? Here it is, in two parts:

A. As I explain in a note to More on the APA's mockery of medicine and morality:

For those whose consciences are clean or Christian, or who simply are prurient or in love with authorities: The Father of Psychoanalysis can be seen in an unbowdlerized version picture: Plus Freud (and Fliess?), that may not be fit for family-viewing.

I wouldn't want my arguments not considered for prurient reasons.... ()

B. But personally I think that Freud was a fraud ever since I read ca. 1968 Patrick Mullahy's "Oedipus - Myth and Complex", which is a fair summary of psychiatry up to the 1960ies, and which convinced me immediately upon reading it that Freud, and indeed Jung, Ranke and quite a few other Leading Psychiatrists were frauds - which I still think, but with much more evidence than I had then, that also includes a cursory reading of Freud's correspondence with his friend Wilhelm Fliess, with whom he also shared a passion for cocaine, that seemed to explain to me fairly well why Sigmund didn't sleep with his wife after age 42.

Anyway... my readers need not agree with me, and indeed I know a few whose intelligence is considerable and who are qualified academically in psychology or medicine, and who look upon Freud with more sympathy and admiration than I do.

But I do think that he was a fraud, though, and that his particular kind of bullshit did much harm, and also that he had no moral or rational right to present it as if it were science, even if he believed in his nonsense, which I personally can't believe, because I can see Freud was a clever man, but not honest with it. (**)


(*) As it happens "APA" also abbreviates the American Psychologists', Poolplayers', Planning and Physiotherapy Associations - among others.

(**) And I should add that ever since 1968 I have been at least a little amazed that so few folks saw through him - but then again (i) it really is a matter of nous and character and (ii) history shows that many intelligent folks have believed lots of nonsense, apparently for no better reasan than because most in their environments believed it.

P.S. Corrections have to be made later, if any.

As to ME/CFS (that I prefer to call ME):

1. Anthony Komaroff

Ten discoveries about the biology of CFS (pdf)

3. Hillary Johnson

The Why

4. Consensus (many M.D.s) Canadian Consensus Government Report on ME (pdf)
5. Eleanor Stein

Clinical Guidelines for Psychiatrists (pdf)

6. William Clifford The Ethics of Belief
7. Paul Lutus

Is Psychology a Science?

8. Malcolm Hooper Magical Medicine (pdf)

Short descriptions:

1. Ten reasons why ME/CFS is a real disease by a professor of medicine of Harvard.
2. Long essay by a professor emeritus of medical chemistry about maltreatment of ME.
3. Explanation of what's happening around ME by an investigative journalist.
4. Report to Canadian Government on ME, by many medical experts.
5. Advice to psychiatrist by a psychiatrist who understands ME is an organic disease
6. English mathematical genius on one's responsibilities in the matter of one's beliefs:
   "it is wrong always, everywhere, and for anyone, to believe anything uponinsufficient evidence".
7. A space- and computer-scientist takes a look at psychology.
8. Malcolm Hooper puts things together status 2010.

    "Ah me! alas, pain, pain ever, forever!

No change, no pause, no hope! Yet I endure.
I ask the Earth, have not the mountains felt?
I ask yon Heaven, the all-beholding Sun,
Has it not seen? The Sea, in storm or calm,
Heaven's ever-changing Shadow, spread below,
Have its deaf waves not heard my agony?
Ah me! alas, pain, pain ever, forever!
     - (Shelley, "Prometheus Unbound") 

    "It was from this time that I developed my way of judging the Chinese by dividing them into two kinds: one humane and one not. "
     - (Jung Chang)


See also: ME -Documentation and ME - Resources

Maarten Maartensz (M.A. psy, B.A. phi)

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