July 2013
It's difficult to make a point with only words, as images, videos of people telling their stories have more impact. The creator of this film happens to have a website that goes far beyond specific criticism, and makes bizarre claims that the military industrial complex have implanted chips in individual brain--the mother of all conspiracy theories. In this film he dismisses the legitimate goal of psychiatry that does help suffering individuals. This is the challenge of the reader here and the public at large, to identify excesses of the psychiatric profession that require appropriate critiques. While this film is certainly not balanced, within the exaggerated hyperbole there are elements of truth, important truths that should be said. The DSM: Psychiatry's Deadliest Scam
As an example of cogent reasonable criticism, Dr. Allan Francis, who was the director of the previous version of the DSM-4 acknowledged that it had allowed a "false epidemic of a disease that didn't really exist, Childhood bi-polar psychosis" The damage done to the children by being so stigmatized and medicated was implied in his acknowledgement. Dr. Francis just yesterday on PBS brought up an issue that I have been writing about extensively. He said, "Now that I'm getting older and my memory is getting bad, they want to call it Mild Cognitive Impairment. First they turn childhood into a disease and now they are doing to getting old." Yes, that the point this writer has been making in articles such as, MCI or CRS, why the diagnosis of a decline of memory matters.
It's even worse, with a special psychiatric diagnosis to compete with MCI, as described by Francis in this essay:
3) The everyday forgetting characteristic of old age will now be misdiagnosed as Minor Neurocognitive Disorder, creating a huge false positive population of people who are not at special risk for dementia. Since there is no effective treatment for this 'condition' (or for dementia), the label provides absolutely no benefit (while creating great anxiety) even for those at true risk for later developing dementia. It is a dead loss for the many who will be mislabeled.
It's difficult to make a point with only words, as images, videos of people telling their stories have more impact. The creator of this film happens to have a website that goes far beyond specific criticism, and makes bizarre claims that the military industrial complex have implanted chips in individual brain--the mother of all conspiracy theories. In this film he dismisses the legitimate goal of psychiatry that does help suffering individuals. This is the challenge of the reader here and the public at large, to identify excesses of the psychiatric profession that require appropriate critiques. While this film is certainly not balanced, within the exaggerated hyperbole there are elements of truth, important truths that should be said. The DSM: Psychiatry's Deadliest Scam
As an example of cogent reasonable criticism, Dr. Allan Francis, who was the director of the previous version of the DSM-4 acknowledged that it had allowed a "false epidemic of a disease that didn't really exist, Childhood bi-polar psychosis" The damage done to the children by being so stigmatized and medicated was implied in his acknowledgement. Dr. Francis just yesterday on PBS brought up an issue that I have been writing about extensively. He said, "Now that I'm getting older and my memory is getting bad, they want to call it Mild Cognitive Impairment. First they turn childhood into a disease and now they are doing to getting old." Yes, that the point this writer has been making in articles such as, MCI or CRS, why the diagnosis of a decline of memory matters.
It's even worse, with a special psychiatric diagnosis to compete with MCI, as described by Francis in this essay:
3) The everyday forgetting characteristic of old age will now be misdiagnosed as Minor Neurocognitive Disorder, creating a huge false positive population of people who are not at special risk for dementia. Since there is no effective treatment for this 'condition' (or for dementia), the label provides absolutely no benefit (while creating great anxiety) even for those at true risk for later developing dementia. It is a dead loss for the many who will be mislabeled.
The greater distortion of Psychiatry is not the film, but is illustrated in the way the media, represented by Public Broadcasting System is reporting on the latest update of the publication that underpins these excesses. It did not get to the core of the issue, ignoring the rejection of the entire concept by the National Institute of Mental Health. Here's the email I sent to their ombudsman:
Re: May 20th Newshour on DSM-5
The DSM, Psychiatric Statistical Manual has been highly controversial since the first version in 1951, yet the segment on your highly respected national news presented a discussion of the latest version with two psychiatrists who did not convey the depth of this long simmering issues. There was the appearance of a debate between reflecting the two views, but it was far from it.
Dr. Michael First, who contributed to the book, started with this:
Well, the reason it's so important is, the DSM is the guidebook that is used by all mental health professionals. It's crucial to their ability to practice. It defines all of the psychiatric diagnoses. And the psychiatric diagnosis, arriving at a correct psychiatric diagnosis is the first step in trying to pick the best treatment for patients. So, it is something that has enormous influence on everybody's ability to provide the best treatment that's possible. Dr. Steven Hyman, former director of the National
Institute of Mental Health at NIH
Next is Dr. Steven Hyman, former director of the National Institute of Mental Health at NIMH
Well, I think it's critically important, as Dr. First said,
for diagnosis and for insurance reimbursement. But I think that the DSM is scientifically early. The brain gives up its secrets grudgingly. And we have to understand the DSM as a set of guidelines to diagnosis of often very serious disorders, but not as the bible of psychiatry. It is hardly meant to be by either the people who wrote it or in reality a perfect mirror of nature.
Both men agree that this document is necessary for Psychiatrists to practice their profession which is based on payment from insurers, and that it has influence of everybody's ability to provide treatment. They also agree that it is not a perfect mirror of nature, meaning the underlying neurological or interpersonal causes of the conditions that are described. Neither of them described the damage that is done by over diagnosis and treatment by drugs that have profoundly damaging side effects, and the financial incentives that many see as driving this; and furthermore how the DSM is the essential tool for this process.
What was also completely missing from this news broadcast was the major story, that the National Institute of Health on the day of release completely rejected its premise and value as the underlying document of the field of psychiatric medicine. This is the agency of the United States government that is charged with evaluating all areas of health care including research and practice, the very institution that gave Dr. Hyman, the hallmark of his authority to be the "opposing" view in this news story. And while the manual does include serious mental illness, it is much more than that, as among the hundreds of personality disorders that will be included as treatable conditions are behaviors that such as anger, agitation, insomnia, and other universals of human existence.
Lets look at what the current director of the HIMH, Thomas Insel, had to say about the DSM in a formal announcement on the day of its release:
The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
This rejection of the DSM, not only the current version but the entire approach, should have made headlines. Rather, Public Broadcasting System did not even convey an awareness of this rejection in their reporting on the new edition, which is something that should be rectified by another story that features the current director of the NIMH, explaining a new model of analysis of psychiatric nomenclature that has the benefit of being based on actual science.
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