On April 29, Thomas Insel, Director of NIMH, published a paper called Transforming Diagnosis. You can see it here.
Dr. Insel is critical of DSM:
“While DSM has been described as a ‘Bible’ for the field, it is, at best, a dictionary, creating a set of labels and defining each.”
“The weakness is its lack of validity.”
This has created quite a stir, in that it appears to support the position of those of us who have been criticizing the DSM on these kinds of grounds for decades. It also suggests a fundamental rift between the NIMH and the APA, two groups who up till now had appeared to be joined at the hip.
The article has generated a great deal of comment. So far, there’s been nothing from the APA.
Those of us who have been critical of psychiatry’s routine medicalization of all human problems and their widespread pushing of destructive “treatment,” have often focused on the DSM as the central target. This was a valid approach because DSM was the vehicle that the APA used to promote their spurious and destructive agenda.
Up till recently our efforts had been largely futile – like gnats attacking a battleship. But in the last five years or so there have been some important developments. Firstly, some heavy hitters from outside the mental health arena joined the fray (e.g. Robert Whitaker, Chris Lane, etc.). Secondly there have been some serious defections from the ranks of the believers.
But more important than either of these developments has been the growth of the survivor movement.
Psychiatry is under attack. Its spurious concepts are being unmasked, and its destructive practices are being exposed.
Just as politicians distance themselves from allies who become tainted with scandal, so the NIMH is distancing itself from the DSM and, by implication, from the APA.
But, and this is the critical point, the NIMH is emphatically not distancing itself from the medicalization of human problems, nor from the promotion of destructive “treatments.”
Here are some more quotes:
“NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.”
“Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.”
“Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior.”
In other words, human problems are caused by brain illnesses.
So what Dr. Insel is committing his agency to is twenty more years of futile research, looking for the Holy Grail – the putative brain illnesses that supposedly cause all emotional suffering and counterproductive habits. He is also committing his agency to ignoring the vast and growing body of legitimate research that demonstrates clearly that emotional and behavioral problems are best conceptualized (and alleviated) within an entirely different set of paradigms.
Another glaring feature of Dr. Insel’s article is that he presents the criticisms of DSM as if they were his ideas. There is no recognition that many of us on this side of the fence have been saying these things for years – sometimes decades.
And let’s not forget that it was Dr. Insel who played a lead role in the concepts that ultimately led to the promotion of SSRI’s in the treatment of depression and “OCD.”
If the NIMH want to promote serious, vital, and genuinely helpful research, I suggest that they start funding studies to explore the links between SSRI’s and suicide and homicide.
Meanwhile, nothing is going to change in the trenches. Psychiatrists will continue to promote their nonsensical concepts (depression is an illness just like diabetes) and push their dangerous products (you must take these pills for life). Victims will be lured in and damaged, sometimes irreparably, and the psychiatrists’ pharma buddies will continue to get rich and spread their corrupting rewards back to the pushers.
NIMH’s rejection of DSM is good news. It opens a rift in the bio-pharma-psychiatric bloc, and it represents a victory of sorts for those of us in the opposition. But we still have miles to go. We need to keep writing; keep speaking out; keep spreading the word.