DSM 5 Modern madness, a point of view -The Monthly – May 2013

August 1, 2013

I have just read the most sensible article on DSM 5 that I have yet seen.  I have posted a link to the article in ‘Publications’. This is from the May 2013 issue of The Monthly and is written by Professor Nick Haslam, professor of psychology at the University of Melbourne. I was particularly struck by his response to the naysayers. He writes “many of these revisions have drawn criticism, but the fiercest challenges have addressed the new ways in which DSM 5 might pathologise normal behaviour. This charge has been led by a psychiatrist, Alan Frances, primary architect of DSM IV. His new book, Saving Normal, was published a week before DSM 5. He is an incisive psychiatric critic of the new diagnostic regime. Many psychologists have also engaged seriously with DSM 5 despite deep concerns over diagnostic inflation and the neglect of social and cultural influences…. Other critics have been entirely dismissive. The British Psychological Society’s response to DSM 5 rejects the very idea of diagnosis. Clients should be assessed for specific problems, not assigned to categories, The Socirty objects to “the medicalisation of… natural and normal responses… which do not reflect illnesses so much is normal individual variation” – appointed repeats, mantra like, 37 times, even though DSM 5 never employs the concept of “illness”.

He takes to task other critics for attributing to DSM 5 opinion is that it has not expressed.

He makes the point that “it’s not obvious why people feel the need to save normality from psychiatry more than from dermatology. It is also not clear why entirely different principle should apply when we think about physical illnesses and mental disorders: the idea that one is objective and real and the other subjective and arbitrary smacks of an old-fashioned dualism.  Rheumatology, for example, like psychiatry, recognises more than 200 distinct conditions, this classification is in a state of flux. Two rheumatology researchers could have been writing about psychiatry when they recently observed that for most conditions “we do not understand their (causation), and there are no “gold standard”, unequivocal clinical and laboratory features to distinguish one disease from another or even from normality.”

He goes on to say “if DSM 5 adds to the ways in which personhood can be stripped and identity tainted, than it deserves all of its criticisms. Understood correctly, however, psychiatric diagnosis does nothing of the sort. Disorder does not define one’s identity or essence: diagnosing a person is not like identifying species. The disorder is not even an alien “thing” that a person has, like an illness. It is merely a set of very human characteristics that bring suffering and impairment. Normality is not defined by what DSM 5 leaves out.”

I urge you to read the article.


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