1. "How psychiatry went
2. "German psychiatry murder of mental patients"
3. "We're all mad here"
4. "British psychologists find
fault with DSM-V"
5. "Delusions of Progress: Psychiatry's Diagnostic Model"
I am still paying back my walk of over three weeks ago, so I
am still not
feeling very well. But it may be improving some - and "the proof" is
that there are today two essays by me, for the previous one of today is
The present one is about the DSM-5, Actually, I am quite tired with it,
but now that the DSM-5 is
out, and does not get
"a fair press", it may be reported some. This last fact also does me
some good, and I'll report five
comments (although the second is more historical).
Note that I give the original titles and the links to
in my section titles.
psychiatry went crazy"
This is by Carol Tavris, and it was published on May 17, 2013,
with the subtitle "The "bible" of psychiatric diagnoses shapes-and
deforms-both treatment and policy". Here are its first two
paragraphs, plus two more.
The Diagnostic and
Statistical Manual of Mental Disorders is often called the "Bible" of
psychiatric diagnosis, and the term is apt. The DSM consists of
instructions from on high; readers usually disagree in their
interpretations of the text; and believing it is an act of faith.
At least the Bible lists
only 10 Commandments; the DSM grows by leaps and bounds with every
revision. The first edition, published by the American Psychiatric
Association in 1952, was a spiral-bound pamphlet that described 11
categories of mental disorder, including brain syndromes, personality
problems and psychotic disorders. (The final category, "Nondiagnostic
Terms for the Hospital Record," contained Dead on Admission, the one
diagnosis that psychiatrists have ever agreed on.) The DSM-II (1968)
made homosexuality a mental disorder, a decision revoked by vote in
1973. In the general excitement about that progressive decision, few
noted that voting didn't seem to be the most scientific way of
determining mental illness. Narcissistic Personality Disorder was voted
out in 1968 and voted back in 1980; where did it go for 12 years?
Doctors don't vote on whether pneumonia is a disease.
But the DSM has grown too
powerful to ignore; it is the linchpin of the pharmaceutical-medical
complex. Adding more disorders allows doctors to be compensated for
treating any kind of problem, from garden-variety sorrow to
incapacitating depression. Drug companies encourage new disorders so
that they can create medications or repackage old ones: Prozac, when
its patent expired, was renamed Sarafem to treat "Premenstrual
Dysphoric Disorder." PMDD had been relegated to the kids' table (that
is, an appendix) in the DSM-IV, thanks to protests by women clinicians
who wondered why menstrual symptoms constitute a "mental disorder"
when, say, Hypertestosterone Hostility Disorder is nowhere to be found.
Alas, PMDD has moved to the adults' table in the DSM-5. HHD is still
Readers of both "The Book of
Woe" and "Saving Normal" will learn why the goal of "precision
medicine" in mental health is a mirage. The DSM committees already
tried their damnedest to support their diagnoses with neuroscience or
biomarkers, but no lab tests yet exist for depression, schizophrenia,
bipolar or obsessive-compulsive disorder, or, for that matter, any
other mental disorders. Efforts to find explanations in genes,
neurotransmitters, "chemical imbalances" or brain circuits have, Dr.
Frances writes, "turned out to be naïve and illusory."
psychiatry murder of mental patients"
following is not a review of the DSM-5. This is a 20 years old
review by Peter Breggin MD, himself a critical psychiatrisr,
who outlines psychiatry's role in organizing concentration camps.
This is a pdf of 4.3
MB, and I merely give the abstract here plus the first paragraph:
"German psychiatrists proposed the exterminati on of mental
patients before Hitler came to power. Then in Nazi Germany, organized
psychiatry implemented involuntary eugenical sterilizatio n and
euthanasia, ultimately killing up to 100,000 German mental patients.
The six psychiatric euthanasia centers utilized medical professionals,
fake death certificates, gas chambers disguised as showers, and the
mass burning of corpses.
Psychiatrists from the euthanasia program also participated in the
first formalized murders in the concentration camps. Inmates were
"diagnosed" on euthanasia forms and sent to the psychiatric euthanasia
centers. These facilities later provided the training, personnel and
technology for the larger extermination camps.
Medical observers from the United States and Germany at the Nuremberg
trials concluded that the holocaust might not have taken place without
psychiatry. This paper summarizes psychiatric participation in events
leading to the holocaust, and analyzes the underlying psychiatric
principles that anticipated, encouraged, and paved the way for the Nazi
"Psychiatry played a key role in the events that unfolded in Nazi
leading up to the mass murder of the Jews and other groups considered
alien to the German state. According to many observe rs at the
Nuremberg trials, psychiatry was the "entering wedge"  into the
holocaust and the tragedy might not have taken place without the
profession's active leadership. This paper summarizes psychiatry's role
and attempts to answer the question, "What psychiatric principles could
have led to these abuses?" "
all mad here"
This is by Dr. Allen
Frances, published on May 19, 2013, in the New York Post.
I offer you the first two paragraps, plus three more:
Human nature doesn’t
change that fast, but the labels used to describe it can follow fickle
fashions. The vehicle of today’s fashion shift is the publication
yesterday of the fifth edition of the “Diagnostic and Statistical
Manual of Mental Disorders,” the official compendium of psychiatric
DSM 5 has added many new
mental disorders that include many symptoms and behaviors previously
accepted as simply part of the human condition. The resulting
overdiagnosis of mental disorder will have many harmful unintended
consequences — the misuse of medication, unnecessary stigma, high
costs, misallocated resources, narrowed expectations, a reduced sense
of personal responsibility, and the misapprehension that we are all
becoming sick individuals living in an increasingly sick society.
Why all the these daffy
DSM 5 diagnoses reducing the large pool of normal into a small puddle?
This is a classic case of psychiatric experts run riot — overvaluing
their pet areas of research and making their mark by getting them
included in the diagnostic system. Poorly tested research concepts have
been given a diagnostic status they simply don’t deserve. And we, the
public, are the guinea pigs in what amounts to a public health
patients, beware. Getting a psychiatric diagnosis can be a life
changing moment that provides great benefits if it is accurate, great
harms when it is not. The care exercised should be equivalent to
picking a spouse or buying a house. Instead, 80% of psychiatric
diagnoses are made by harried primary care physicians with little
training, in seven minutes visits that are brought to a quick end with
the provision of a “free” sample of medication courtesy of a kindly
Nothing is free. My
advice: Never accept a psychiatric diagnosis or pill offered this
psychologists find fault with DSM-V"
This is by Alexander
Reed Kelly. I found it on truthdig.com and reproduce its first
three paragraphs (and record it should be "DSM-5"):
"England’s Division of
Clinical Psychology, which represents more than 10,000 practitioners,
has criticized the latest edition of the field’s leading diagnostic
manual for its categorizing of normal behaviors—such as shyness in
children and depression after the death of a loved one—as medical
problems treatable with drugs.
The debate centers on
whether behaviors that are clinically labeled as disorders have either
biological or social sources, or some combination of the two. The fifth
edition of the Diagnostic and Statistical Manual, published this month,
treats mental health as a biological issue.
The British group is
calling for a shift in the way mental health is viewed and treated,
saying that practitioners of psychology should look for personal and
social causes of perceived aberrations rather than behaving as if they
were doctors of physical medicine."
of Progress: Psychiatry's Diagnostic Model"
This is from a long
piece by Andrew Scull, published on May 19, 2013. I will try to
quote from it so as to preserve part of it:
Certainly Gary Greenberg
(a PhD psychotherapist) and Michael Taylor (who prefers to call himself
a neuropsychiatrist) think it is not. Their respective analyses of the DSM
project are equally scathing, though they approach the problem of
mental illness from opposing points of view. Greenberg is deeply
skeptical of psychiatry’s claim “that psychological suffering is best
understood as medical illness.” Taylor, on the other hand, regards
Freud as a fraud, disdains the notion that mental illness has any
meaning, or has its roots in meaning, or could possibly be treated by
addressing psychological issues. For him, mental symptoms are so much
epiphenomenal noise, the surface manifestations of the disordered
brain, which is the sole and singular source of mental troubles.
Greenberg, by contrast, views the attempt to reduce human woes to
defective brains as what philosophers call a category mistake (he does
seem willing to cede a place for biology in the genesis of some kinds
of mental disturbance, but insists this remains speculative, not
scientific). Taylor minces no words when expressing his disdain for
psychotherapeutics, and psychoanalysis in particular. He uses such
adjectives as “baseless,” “silly,” “useless,” and “destructive,” and
truculently asserts that “if psychodynamic therapies were medications,
their support by the U.S. psychiatric establishment would be a scandal.”
Both men, though, see the
DSM as a disaster — a psychiatry built upon such
foundations as a rickety, unsafe, unscientific enterprise that faces
looming catastrophe. And as weird as it is to see two such narcissistic
know-it-alls (see DSM IV TR diagnosis 301.81, Narcissistic
Personality Disorder) agreeing on anything, in view of their completely
divergent starting points and competing grandiose senses of
self-importance, they may well be right.
OK... and note that both
Greenberg and Taylor attack the DSM-5, but from opposite directions.
Here is Scull on the previous two DSMs, that in my opinion are
almost as bad as the DSM-5
This shift to a
psychiatric world dominated by a book — or rather, to an
anti-intellectual collection of categories jammed between two covers —
can be dated quite precisely. The publication of DSM III in
1980 ushered in our so-called neo-Kraepelinian world (an era named
after the fin-de-siècle German psychiatrist who first distinguished
between dementia praecox — later renamed schizophrenia — and
manic-depressive psychosis). Each of the ensuing revisions of
psychiatry’s manual has codified its own fundamental approach to the
universe of mental disorder, and that approach has come to dominate our
understanding of mental illness. Not entirely by coincidence, a few
years after the appearance of DSM III, the psychoanalytic
hegemony in American psychiatry collapsed, to be replaced by an
emphasis on biology, neuroscience, and drugs.
Actually, this seems a bit
over the top, although simultaneously it is quite fair in fact, for a
reason Mr Scull indicates himself:
But if validity was to be
set aside, reliability was not to be jettisoned. Reliability is the
statistically demonstrable ability of any two clinicians confronted
with the same patient to assign him or her the same diagnostic
category. This was where Spitzer and his team concentrated their
efforts.To accomplish their ends, the DSM III task force
adopted a “tick the boxes” approach to assigning illness labels. Find
any six from a list of 10 symptoms, and voilà, a schizophrenic. Why
six? Well, as Spitzer later put it, that felt about right. How many
categories of illness to accept, and which ones? Here, too, there was
much politicking at work
Note how totally insane
psychiatry has gotten here - or has always been: There is no
validity to almost any of their diagnoses - and even the reliability
that the same diagnosis is made is very arbitrary and tenuous.
Also, note as to these "any six from a list of 10 symptoms": There are e.g. these elementary
combinations, quoted from my own DSM-5: Question 1 of "The six most essential
questions in psychiatric diagnosis, from a year ago:
The following table
suffices with instances of in how many ways x things can be taken out
of y things, with x <= y, and 1 of x always in x ways and x of x in
dangerous nonsense of the x out of y diagnostic schema
|2 of 3=3
||2 of 4=6
||2 of 5=10
||2 of 6=15
||2 of 7=21
||2 of 8=28
||2 of 9=36
||2 of 10
||3 of 4=4
||3 of 5=10
||3 of 6=20
||3 of 7=35
||3 of 8=56
||3 of 9=84
||4 of 5=5
||4 of 6=15
||4 of 7=35
||4 of 8=70
||4 of 10
||5 of 6=6
||5 of 7=21
||5 of 8=56
||5 of 10
||6 of 7=7
||6 of 8=28
||6 of 9=84
||6 of 10
||7 of 8=8
||7 of 9=36
||7 of 10
||8 of 9=9
||8 of 10
|9 of 10
But this is merely a hopefully instructive
aside, as to the number of distinct ways in which one
can have an ailment "X" on any diagnostic schema that is written around
the "x out of y" attributes: 6 out of 10 (a common couple of figures in
the DSM) in fact defines 210 different
ways of having that ?same?
"ailment" defined by 6 out of 10 attributes.
And there is nothing else but this
schema: Only the numbers differ.
Then again psychiatrists just do not care,
by and large, and probably also, in vast majority, do not understand
- and no, you cannot trust liars to speak the truth in public:
The architects of DSM
III and DSM IV, men who had built their careers on this
very approach, launched an increasingly fierce attack on the work of
their successors. Robert Spitzer began the assault, but he was ailing
with a bad case of Parkinson’s disease. Soon Allen Frances, who had
retired to Southern California to take care of his wife, took up the
cause. (..) For orthodox psychiatrists, it was a deeply
embarrassing spectacle. It is one thing to be attacked by Tom Cruise
and the Scientologists, quite another to come under withering assault
from one’s own. Wounded, the leaders of American psychiatry struck back
with ad hominem attacks, alleging that Spitzer and Frances were
clinging to past glories, and going so far as to suggest that the
latter, by far the more energetic of the two, was motivated by the
potential loss of $10,000 a year in royalties he still collected from
DSM IV. (Left unmentioned was how dependent their professional
association had become on the multimillions in royalties a new edition
promised to provide.)
In fact, those who accused
Frances profited themselves far more, as Mr Scully also makes
clear later, but did not say so, of course. We have arrived at
one of Mr. Scully's - very safe - conclusions:
All this suggests a
profession in crisis.
Here Mr. Scully is
discussing Dr. Taylor's opinions:
It is hard, however, to
know quite where to locate the missing Age of Gold. Certainly it did
not exist when Taylor joined the profession in the 1960s, the last
decade of a psychoanalytic dominance he deplores. Nor can it be found,
as he is at pains to make clear, in the years since.
[A] political rather than a scientific document […] [T]he
process was and is very much like congress writing legislation. The
procedure is messy and the results are wanting. Instead of “earmarks”
we have new never validated labels and distinctions, such as shared
psychotic disorder, identity disorder, schizophreniform disorder,
bipolar I, II, III as separate diseases, and many other “bridges to
proliferated, but not because of any advances in the profession’s
scientific understanding of mental illness.
“The explosion of
diagnoses […] is a fabrication of the political process […] The
pharmaceutical industry adores the explosion of conditions, because as
‘medical diagnoses’ the DSM categories provide the rationale
for prescribing drugs.”
Apart from locating an
unfindable place when psychiatry was a science, the quotations are OK.
Now I'll cut some quotes, to go to the end of Scully's piece:
If all these shenanigans
.. that I have mostly left
provide ample support for
Taylor’s claim that his profession is in crisis, the rot does not stop
Here is the main secret:
antidepressant drugs routinely rank among the top five most profitable
classes of prescription drugs on the planet, and, as always, the great
bulk of those profits are earned in the United States. In pursuit of
them, the multinational drug industry has been ruthless and
unscrupulous. There has been much talk in recent years about
evidence-based medicine, but for such an approach to work, the evidence
has to be what it seems.
Or worse - and correctly: "evidence based
"science"" = "pseudoscience".
Here is a part of the reason why (and see dr. Healy's website for much
more on this):
And it is not. The drug
companies own the double-blind controlled trials on which we rely to
assess the worth of new medications lock, stock, and barrel. They own
the data. They manipulate the data. They conceal the data they don’t
like and that are at odds with their self-interest. Their public
relations flacks ghostwrite scientific papers that then appear in even
the most prestigious medical journals — Journal
of the American Medical Association, New England Journal of
Medicine, The Lancet — with the names of the most
prominent academic researchers appended. Data about side effects, even
fatal side effects, are suppressed and hidden, and then see the light
of day only through the discovery process provided by class-action
lawsuits. Meanwhile, direct-to-consumer advertising increasingly drives
drug sales, and neither physicians nor their patients seem to grasp or
act upon the difference between statistical significance and clinical
I'll end with quoting
Greenberg reports of the
[Its] income from the drug industry, which amounted to more
than $19 million in 2006, had shrunk to $11 million by 2009, and was
projected to fall even more [….] [In addition] journal advertising by
the drug companies was off by 50 percent from its 2006 high.
What would happen if [psychiatrists] told you that they
don’t know what illness (if any)
is causing your anxiety or depression, or agitation, and then, if they
thought it was warranted, told you that there are drugs that might help (although they don’t really know why or at
what cost to your brain, or whether you will be able to stop taking
them if you want to; nor can they
guarantee that you (or your child) won’t become obese or diabetic, or
die early), and offer you a prescription [for these substances].