New Scientist recently published an article1 describing the conflict that has emerged in American psychiatry over the upcoming revised version of the DSM (Diagnostic and Statistical Manual of Mental Disorders), frequently referred to as psychiatry’s bible.
From my point of view, disagreement over the diagnostic approach employed by the DSM is decades overdue. I initially encountered the DSM2 in the ‘80s when I was working on my master’s degree. My master’s thesis examined how (and how much) the media influence an individual’s perceptions and eventual behavior, so I took a mix of graduate-level classes in communications, psychiatry, sociology and several other areas. Even at that time, the DSM already was used almost universally as the resource for diagnosing psychiatric disorders.
What struck (and bothered) me from my first encounter with the DSM was the process through which it diagnosed disorders — it diagnosed an individual’s illness solely on the basis of the symptoms observed. In other words, the root cause of any psychiatric ailment was irrelevant when making a diagnosis. And since diagnosis drives treatment, that meant that treatments were being prescribed on the basis of symptoms, not underlying causes. Read the rest of this entry »
- Psychiatry’s civil war, New Scientist, 12 Dec. 2009 [↩]
- In those days, it was DSM-IIIR, meaning the revised third edition of the manual. [↩]
That tongue-in-cheek speech has always resonated with me because of the kernel of truth in it. To a large degree, America was founded and initially populated by people who didn’t fit in anywhere else. The Pilgrims and their spiritual brethren came here because they wanted to worship and express beliefs in religions that were outside the mainstream (and frequently outside the law in their native European countries). Others with strong streaks of individualism came here seeking riches or adventure — things that were increasingly tough to find in the more developed and more tightly governed nations they left behind. These were the individuals who would develop into everything from cowboys to industrialists. 
