There’s No Science in the DSM
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There’s No Science in the DSM

There’s No Science in the DSM

January 31, 2012

The DSM-5 controversy continues, as more professionals and parents share their experiences and opinions regarding specific diagnostic changes and their impact on people’s lives. This is happening on the blogospere and in major media like The New York Times, which in the last ten days has had front page articles, op eds and letters on depression and ADHD and autism. 

The debate goes something like this: Fewer kids will get services if …; Medication is fine, but it’s not everything; But medication was a lifesaver for my kid; Is grieving a sign of depression? Always? If the criteria around grieving changes more people will be diagnosed with depression…and so on.

Lives are at stake, Long-term, no one knows the effects of the drugs that almost inevitably follow a diagnosis of, say, ADHD in a child. Short-term, parents and teachers want something to minimize the chaos they experience, whether that be a drug or special services their children become eligible for with a diagnosis. These are critically important practical policy issues.

But none of this has anything to do with science. The DSM-5 is not a scientific document. To portray it as one is a gigantic hoax. The debate that psychiatrists are having about this and that category of mental disorder is as scientific as a debate about how to classify the different languages spoken by aliens from space. They’re arguing about the very things they themselves made up! They’re debating the virtues of their map but they’re telling us they’re talking about our territory. Have they forgotten that what makes a map a map is the gap between it and the territory? Or are they deliberately disseminating misinformation to the public? Either way, it’s unethical (and takes a lot of chutzpah!).

Some of the experts now speaking say that the science has to get better, that we don’t yet know enough about the brain and biology. They’re just perpetuating the hoax. I’m all for discovering as much as we can about the brain. The men and women working in neuroscience are probably really good scientists—because their research doesn’t violate the brain. The brain is an organ and, from what I’ve read, it’s being studied in ways consistent with what an organ is.

But a person who doesn’t get out of bed? A 6 year-old boy who doesn’t sit still 6 hours a day? A 14 year-old girl who pulls her hair out? Each one of them has a brain, but they are not their brain. Their behavior, their emotional and relational lives, and their pain and distress are social, cultural activities that exist in the world. Relating to them as anything other than this is unscientific.

The notion of science I’m invoking is that it’s an exploratory enterprise that doesn’t violate the integrity of the thing being explored. Diagnosing “mental disorders” in human beings is both a scientific and a moral violation.

So let’s have some honesty in the DSM-5 debate. When it comes to emotional pain, science-talk doesn’t cure. But it does procure.

 

7 Comments
  • Signs of Depression
    Posted at 18:14h, 20 July

    does the natural therapies work at the advanced stages of depression???

  • Psychiatry_Scam_Exposed
    Posted at 19:40h, 12 May

    Psychiatry and big pharma is a complete scam.

  • loisholzman
    Posted at 00:09h, 13 February

    Agreed! Yet psychiatrists get paid a whole lote more than astrologists…

  • Randall Griffith
    Posted at 20:34h, 11 February

    To me, the seduction of the DSM is in the same category as that of astrology books that describe personalities under the stars/sun. Thanks for the great post.

  • loisholzman
    Posted at 13:14h, 08 February

    Thanks for your comment. I too believe in a whole approach.

  • Dee
    Posted at 14:04h, 06 February

    I agree with your sentiments in part. I do think we need to know more, and should have greater scientific backing to confirm the DSM’s diagnostic of mental disorders. However, we are our brains, just as we are our hearts, fingers, eyes and feet. I believe in the whole approach to psychology and therapy. The body, mind and environment are interconnected. If one is sick, the rest become infected. So a child that cannot sit for 6-hours may have a mental disorder/chemical imbalance that is contributing to the problem. Maybe its diet, which can impact mental health if inadequate. Maybe the child is board in school and the teacher need to use a different approach. Possibly providing adjustments to all three areas would help the child remain still for the 6-hours. And, what works for one may not be appropriate for another.

    The DSM does need work, clarification and specificity. Culture, beliefs about mental health, and family systems should be considered. We cannot look at individuals as just their brains, but everything that can impact the brain as well as how the brain impacts everything else. A person is a whole unit, not pieces of one, in my humble opinion.

    D. Reid

  • Robin
    Posted at 14:32h, 05 February

    The DSM is a political document and unfortunately one professionals are bound by if they want to get paid. Diagnoses have too much overlap, are too vague, don’t cover family systems or culture, and worst of all aren’t scientifically valid. All my opinion, of course.

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