This is a critical examination of the concepts behind the new DSM-5, the Diagnostic and Statistical Manual of the American Psychiatric Association, which is due out in the next few years. My case is that it will fail because it is based in very bad science. Bad science will not produce good psychiatry.
Here are some excerpts from the DSM-5 chapter of my book Humanizing Psychiatrists:
The DSM-5 “will continue the process of damaging psychiatry and reducing its importance in the world of mental health, to the point where it becomes a commodity and psychiatrists themselves become irrevelant.”
“Not even death is so clear that we can definitively operationalize its definition. In the field of mental disorder, which is murky and uncertain at best, this is even more true.”
“That is, the DSM nosology of mental disorder is driven by the need to find a series of specific, internally uniform clinical pictures as the surface manifestation of specific unseen biochemical lesions. ” “By answering the question of whether mental disorder is psychological or biological, we will ipso facto answer the question of whether the final nosology of mental disorder will be categorical or dimensional in form. Even though the Committee has not overtly embraced the reductionist, biological model of mental disorder, they have shifted the focus of thinking by implication.” (see chapter for details)
“Without specifiying their stance, they clearly imply that mind-body dualism is not scientific. This stance is completely unsupported by the literature, by philosophers, and by psychiatrists. The philosopher David Chalmers has outlined in great detail a convincing case for a rational (ie non spiritual) dualism.”
“If it emerges that the correct model of mental disorder is psychological in nature, and i have argued at length that it is, then the categorical model of DSM diagnosis will disappear as quickly as the psychoanalytic model did. Until this question is determined, openly and honestly, we are simply engaged in a vastly expensive exercise of drawing boxes in the sand, then watching impotently as the social winds blow them away.”