I have an article in the latest (Jan 2011) issue of Wired. It’s about the attempt to create a DSM-5. The process I witnessed makes the worst sausage factory look like a cupcake plant. You can read the article “The Book of Woe” in Wired, which I hear will be online soon–I’ll post the link. (Or you could buy the magazine, because much as information might want to be free, writers and editors want to eat.)
Anyway, a few items didn’t make it into the story. A couple of them are illustrative of just how hunkered down the American Psychiatric Association is, how doggedly determined the organization is to control the flow of information about the DSM, and how bad they are at doing it.
The story is largely about a group of unlikely DSM-5 dissidents–unlikely because they’re about as mainstream as psychiatrists get. Bob Spitzer and Al FRances, editors of the most recent revisions, Michael First, who was responsible for much of the criterion-writing in DSM-IV, and other long time psychiatric stalwarts are up in arms about DSM-5. About a year after they started their assault, the APA convened a committee to oversee the process–which was one of the suggestions the dissidents were making. The committee determined that the process was behind schedule and in disarray and thus publication of DSM-5 needed to be delayed by a year. When the APA heard from the factchecker that we were reporting that they had postponed publication in response to the dissidents the pr flack there insisted this was incorrect, that they had other reasons for convening the committee and for the delay, and that the timing was coincidental.
I guess you can’t blame them for this. Well, actually I think you can. What possible good does it do them to deny something so obvious? Clearly, it’s about pretending that the dissenters aren’t bothering them, that they’re so wrong they aren’t even worth listening to, and that just because the APA followed their suggestions, that doesn’t mean they were right. Which is such a ham-handed move. It reeks of petty squabble, of schoolyard brawl, of turf war.
Especially when you consider that the APA trustee who headed the oversight committee told me, on the record, that the committee was formed in order to address the concerns raised by Spitzer and Frances and the rest. She said it flat-out and unprompted, in passing really. I lucked out there–not being much of a reporter I didn’t even think to ask about something so obvious. So I didn’t even take note of it, and I’ll bet she didn’t either. I only remembered it when the APA started insisting that it wasn’t the case.
For various reasons, the magazine didn’t publish this part of the story, just let the APA “insist” that they weren’t listening, which is as stupid a strategy as one can imagine. Talk about drawing attention to yourselves in the wrong way! The APA can’t even get their propaganda straight.
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I’m in the middle of the article now (and, unable to link to it, am sending people here instead) and enjoying it muchly. Nice work.
Excellent article. What a mess!
Brilliant article.
You seem unconvinced about the current way of thinking about mental health.
It seems to me that there is a decision at the root of psychiatry about whether a person can handle being responsible for themselves or whether they need to be treated as if they are just a mal-functioning brain, and until psychiatrists take on the full weight of this momentous decision and stop hiding behind their own definitions, they will be forever anxious about the foundation of their profession.
It’s all made worse by the paradox that is caused by calling something that is clearly not a disease in the normal sense a disease.
My very imprecise thoughts here: http://bit.ly/hbaEIs
Excellent article. I especially liked the two quotes:
– “So what would you say was the value of the diagnosis?”
– “I got paid.”
and
“We have a dragons world here. But you wouldn’t want to be without a map.”
Both sides summarised perfectly.