a conventional occupation…

Posted on Tuesday 3 April 2012


On Saturday, May 5, 2012, as thousands of psychiatrists congregate in Philadelphia for the American Psychiatric Association [APA] Annual Meeting, individuals with psychiatric labels and other supporters will converge in a global campaign to oppose the APA’s proposed new edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-5], scheduled for publication in May 2013.  Occupy the APA will include distinguished speakers from 10 a.m. to noon at Friends Center [1515 Cherry Street, Philadelphia]. A march at 1 p.m. from Friends Center will lead to the Pennsylvania Convention Center [12th and Arch Streets], where the group will protest beginning at 1:30 while the APA meets inside.

“This peaceful protest exposes the fact that the DSM-5 pushes the mental health industry to medicalize problems that aren’t medical, inevitably leading to over-prescription of psychiatric drugs – including for people experiencing natural human emotions,  such as grief and shyness,” said David Oaks, founder and director of MindFreedom International [MFI], which has worked for 26 years as an independent voice of survivors of psychiatric human rights violations. “We call for better ways to help individuals in extreme emotional distress.”

Other speakers criticizing the revised manual, considered the psychiatric industry’s bible, include Brent Robbins, Ph.D., Secretary of the Society for Humanistic Psychology, which has gathered more than 8,000 signatures from mental health professionals calling for “developing an alternative approach” to the DSM. Jim Gottstein, Esq., founder and president of the Alaska-based Law Project for Psychiatric Rights [PsychRights], will cross the country to speak. “The public mental health system is creating a huge class of chronic mental patients through forcing them to take ineffective yet extremely harmful drugs. As the APA gets ready to do even more harm with its proposed expansion of what constitutes mental illness, I want to be there in person to participate in the protest”…

I guess this was inevitable – a protest against the APA itself about the DSM-5 Task Force. Certainly, they were warned. Drs. Spitzer and Frances, people who had been with the DSM-modern from its birth in 1980 to the present, tried to tell them that what they are doing was a bad idea.

Here’s the thing. What they were planning just didn’t work out. Back when they started, they were gearing up to have the DSM-5 they’d long dreamed of – a DSM that was keyed to solid hard science with lab tests, biomarkers, genetic signatures, diagnostic neuroimaging, neuropathophysiology, and all the tools of mainstream medicine like translational science programs, measurement-based treatment algorithms, evidence-based diagnostic schemes, personalized medicine capabilities, and an armamentarium of psychopharmacologic agents. The trappings were all in place, the journals were filling with articles, but the expected neuroscience breakthroughs just didn’t materialize. For thirty years, they’ve been running on the hope that success was just-around-the-corner, but they just never got there. Even the drugs that occupied so much of their time and attention are turning out to be lackluster at best, with lots of adverse effects. And their pharmaceutical sponsors who have financed this enterprise for decades are moving on the greener pastures. Even worse, there has been an increasing drumbeat that much of academic psychiatry has either been corrupted or at least close enough to be tarnished.  What they were planning just didn’t work out – at all.

Back in 1980, that’s the way it had worked. An obscure DSM-II, primarily a code look-up book, became the DSM-III, the definitive word in Mental Illness organized along the descriptive lines of other medical nosologies, eliminating almost any mention of the mind or human psychology. It was a major paradigm shift. So the current members of the DSM-5 Task Force have spent their entire careers in an age of biologic and psychopharmacologic psychiatry. It’s all they’ve known, and the breakthrough-just-around-the-corner has just been part and parcel of the air they’ve always breathed. Likewise, the quiet alliance between academic psychiatry and the pharmaceutical industry has been like the mortar between the bricks – touching every surface.

The DSM-5 was going to create another paradigm shift. They were going to begin to put the biological substrate under the diagnostic categories and move us from simple syndrome descriptions to the level of scientific legitimacy on the way to the realm of biological causality. But here’s the thing. What they were planning just didn’t work out. So really, they’ve got nothing. They could fix problems [like MDD], or tweak areas where that other industry [insurance] is using the DSM to deny services, or do nothing. But they can’t seem to change gears and are making changes that gratuitously biologify or increase the indications for medication, which makes them look like there is a conflict of interest – a whole lot like there is a conflict of interest. They’re riding the breakthrough-just-around-the-corner meme at a time when nobody’s listening anymore. And they’re doing it in a time of weakness and well-deserved high levels of suspicion.

Here’s the thing. What they were planning just didn’t work out – at all…
hat tip to Soulful Sepulcher    
  1.  
    April 3, 2012 | 6:04 PM
     

    We need to change the way we fund studies. Psychiatry is not alone in the wishful thinking and self-promotion category. A lot of fields are publishing single studies and first attempts at developing technologies as if they were major breakthroughs and it was just a matter of time before their dreams come true.

    The “free market” is designed primarily for capitalists. Stockholders. Scientific studies should be free of the profit motive and should not be published
    for the purpose of raising stock values and creating false hopes or, worse yet, creating demand.

    The biological model is a money maker that could end up threatening the thirty percent or so of people who do find that the drugs outweigh the risks and improve their lives as it surely gives psychiatry the power to define people who don’t need the drugs and are harmed by them as “mentally ill”.

    Psychiatry often uses the courts to force people to take drugs that harm them. It is abuse of power based on a failed model and it has created an army of mental health professionals so full of hubris and delusion that they are often little more than organized drug pushers who make a living dehumanizing people who are overwhelmed with stress and pain. Mental health nurses, social workers, and even art therapists feel free to reduce people to mental disease labels and to reject everything the patients have to say about themselves and their lives in favor of an unsupported model. It is pathological the way these professionals routinely “interpret” everything a mental health patient says and does as “symptomatic”. Who “lacks insight” is pretty obvious, because these people are so sure of their own mental health that they can’t see how neurotic they are and often don’t pay heed to their own affect and apparent need to establish dominance whenever a patient disagrees with them and dares to speak about the actual burdens in their life.

    I know I’m talking a lot here, but during my first involuntary commitment in January, I got a huge dose of condescending speech and behavior from people who kept insisting that they were there to “help” me. Total strangers were so convinced that they knew me better than I and my friend of thirteen years know me that they were absolutely blind to the delusional nature of their beliefs. It’s a real comfort for me to find voices that challenge this institutionalized abuse. Thank you.

  2.  
    April 3, 2012 | 7:13 PM
     

    I hope we move from the “Decade of the Brain” to the “Century of Recovery.”

    And if there are a few psychiatrists who want to join in, great.
    If not, the movement will continue anyway.

    Duane

  3.  
    April 4, 2012 | 12:59 AM
     

    Many thanks for the hat tip doc! and for posting the article. I think it would be interesting to see some psychiatrists boycott and go to “the other side” and protest, but alas, I doubt that will happen!

  4.  
    April 4, 2012 | 1:46 PM
     

    On blogs here and there, and from my personal correspondence, there are psychiatrists who are questioning the medication paradigm and trying to figure out how they can practice ethically and help people as they always intended.

    I sure hope they take the course they might suggest to patients who feel isolated and develop social contacts who support their views! Going to an event like this would be a way they could meet doctors of like mind.

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