The Evolution Revolution

Forced treatment is the big secret in the mental health “care” world today. Once upon a time, not that long ago, there was only one form of mental health treatment available, and that was it.

The American Psychiatric Association in fact grew out of the Association of Medical Superintendents of American Institutes for the Insane. Where once you had the heads of what were then called Lunatic Asylums, now you have an association of professional pill pushers.

The big lie is that the pills they are pushing, and whose usage they are promulgating, are good for people, and not people in general, but specific people. People diagnosed with a “mental disorder”. This diagnosis is thought to make the people who have been given one somehow different from the general run of humanity and, therefore, in need of the fix that comes with a drug.

The truth is that mental health treatment is about social control. We have this law that permits confinement of anybody acting oddly on the grounds that they may cause harm to themselves or others. It would be a serious mistake, albeit a common one, to assume that people are held in psychiatric institutions because they are dangerous.

People in mental hospitals are not there because they were given a trial by jury. Usually they are there because they were given a hearing by judge, attorney, and psychiatrist in which judicial opinion subordinates itself to the whims of professional bias and procedural habit. Mental health commitment hearings, in other words, in the present day and age, are little more than kangaroo courts.

Drugs can’t fix people. Drugs can damage people. Drugs can’t straighten out faulty logic. Education can teach logical deduction. Drugs can’t supply insight. Drugs generally mask a problem rather than correct it. Masking a problem is not dealing with it, and coming  up with a solution to it.

Waiving independence in order to be treated by the mental health authorities, usually as a charity case, is not the best course of action to take as a rule. Doing so often involves forfeiting rights we think of as basic to our species. This revelation may take time to register and resonate, but it should come in time.

Yes, Virginia, there is life beyond the confines of the Mental Health clinic. One is not bound to the human services system the way a rat can be restricted to its track through a maze.  The thing is that that system shares many similarities with a rat maze. If it didn’t, researchers wouldn’t be studying rats with the idea of better understanding human behavior. I would strongly suggest that if success in the world is at all important to you, you should abandon the maze.

The irony found in the heading of this post comes with the realization that more complex organisms evolved from less complex organisms. The butterfly in a display frame is not a butterfly in flight. Our capacity expands to the extent that we learn to escape those boxes that other people would try to contain us within. Quite apart from biological limitations, and barring extreme circumstances, we have minds that allow us this advance and that departure.

Pre-psychosis In The News

Attenuated psychosis syndrome, alternately called psychosis risk syndrome, pre-psychosis and prodromal disorder is going into section 3 of the DSM-5. This is the section for disorder labels that need more review, and which will not be reimbursable. The bad news is that it is in the DSM at all, and being in the DSM, it’s going to be considered as a disorder. The good news is that it is not an “official” disorder label, insurance companies are under no obligation to pay for it, and so its not likely to explode into an epidemic next year.

Researchers, it seems, much less fastidious than DSM revisers, are intent in studying people afflicted with this fictitious and elusive label. The latest rage in pseudo-scientific discoveries concerns this nebulous early stage in the development of psychosis. An article in the Detroit Free Press, Schizophrenia may give early warning signs, is typical.

Researchers in Chapel Hill looked at brain scans of 42 children, some as young as 9, who had close relatives with schizophrenia. They saw that many of the children already had areas of the brain that were “hyper-activated” in response to emotional stimulation and tasks that required decision-making, said Aysenil Belger, associate professor of psychiatry at the UNC School of Medicine and lead author of the study.

Now whether psychiatrized families actually think differently from non-psychiatrized families is anyone’s guess, and it could always be the topic for additional research should anybody choose to go there.

People who have a parent or sibling with schizophrenia are about 10 times more likely to develop the disease than those who do not. Signs of the illness typically begin in the late teens to mid-20s. These include declines in memory, intelligence and other brain functions that indicate a weakening in the brain’s processing abilities. More advanced symptoms may include paranoid beliefs and hallucinations.

Perhaps this sounds like an astonishing figure until you realize that it actually means 1 in 10 people rather than 1 in 100 people.  This is to say that among the 1 in 100 people that get described as psychotic, 1 in 10 of their closest relatives could also be so described. Unlike in the rest of the world where the rate stays more or less at 1 %. 1 in 10 means that chances are, if you are in a family haunted by the phenomenon of psychosis in one of its members, 9 out of 10 of it’s members most probably wouldn’t be described as psychotic anyway.

“Of all the people who seem to have compromised circuitry in their brain, if we come back and image them in later years, some may be moving toward the cluster of symptoms for schizophrenia while others may have other types of deficits,” such as bipolar disorder or attention deficit disorder, Belger said.

The article goes on to add, “Still others may avoid serious disorders altogether”, but the damage has been done. If you were an agent of the inquisition, let’s say, looking for witches, you are not going to be questioning the existence of witches. If you want to find fault in anyone, or anything, no problem. Just conduct a fault finding mission. If you are out to praise those people, well, hunting for future “mental illnesses” is just not the way to do so.

I think these researchers have better things to be doing with their time. We really have a problem when the DSM starts predicting disorders in people.  Ignoring any fork in the pathway that may lead to dysfunction, from functionality, is a major shortcoming, I would imagine. Ditto, in the case of paths that lead to folly from reason and wisdom. You are postulating that mental and emotional disturbances are a matter of predestination, and I imagine such leaps of faith belong in the realm of superstition rather than in the realm of scientific inquiry and skepticism.

This doesn’t mean that pre-psychosis isn’t going to make it’s way as a reimbursable disorder in a future edition of the DSM. I imagine, if things continue going the way they are going, it will. There is a lot of nonsense in the DSM. I would say maybe 100 % of the DSM is sheer nonsense. All the same, quite literally, even a listing as a category for diagnosis won’t make future psychosis a real disorder in present time.

Bringing the war in the classroom home to your doorstep

Did somebody say it’s jungle out there? It isn’t a jungle, it’s a war zone, especially in the public school system. Among the new disorders in the DSM-5, such as adult ADHD (attention deficit hyperactivity disorder) , you will also find childhood PTSD (post traumatic stress disorder) listed.

Just read between the lines on the first paragraph of this ABC News report, Psychiatry ‘Bible’ DSM-5 Will Add PTSD for Preschoolers, and imagine millions, perhaps billions, of shell-shocked kiddies returning home from their school day.

 When the new Diagnostic and Statistical Manual of Mental Disorders, DSM-5, is published in May, a small section could alter the lives of millions of children.

Not to be alarmed, despite this potential sharp rise in the number of children labeled ‘off their rocking horses’, mental health professionals tell us they’ve got treatment, and that this treatment can be effective.

Small children develop PTSD at the same rate as adults — one in four — and the number of potential sufferers is vast, said Dr. Judith Cohen, a psychiatry professor at Drexel University’s College of Medicine.

I imagine we could just give children signs on their first day of class, basing children numbers on adult numbers, of course. Numbers, you know, don’t change. 1/4th of the students would receive a sign that read PTSD, and 3/4th of the students would receive signs that read NORMAL. The students with the signs that said PTSD could then automatically be enrolled in a treatment plan.

And yet because existing DSM criteria doesn’t apply to young children, and because of society’s tendency to idealize children as resilient, pre-schoolers aren’t getting the diagnoses they desperately need, [vice chairman of Child and Adolescent Psychiatry at Tulane University, Dr. Charles] Zeanah [Jr.] said.

Children are idealized as resilient. Oh, that explains it! We don’t have the time to offer classes to parents, teachers, and children in ‘how to be more resilience’ then I guess. Notice, they desperately need diagnoses, too. You think so?

If you will excuse me, I think I’ve had enough of this nonsense, and so I think I’m going to return to my bunker for a little blissful shuteye. The prospect of a nation of shell-shocked children is just a little much for me to face head-on alone at the moment. I’ve got my own patch of green pasture that needs tending.

My Rant Against The Mental Illness Labeling Industry

Fuck psychiatry! I’m sick of system shit. I’m so sick of system shit that I got out of the system. I don’t need to be a shrink, and I don’t need to be a patient. I don’t even need to be a patient shrink, or a shrink patient. I don’t need to be one or another specialist on a continuum in a rich variety of turncoat categories. I’m not overseeing adult children mental patients in one capacity or another. I guess that makes me irresponsible, but that’s not the way I see it. I’d say that makes me responsible. I’ve ousted myself from the 6 % category of people that need supervising, as well as from the glorified adult baby sitter category that does the supervising.

I now exist among the roughly 75 % of population who have no need for the mental health system whatsoever except perhaps in so far as it applies to other people. I will work with a portion of the 6 %, but that is only to dismantle this monstrosity we’ve created. It is a monstrosity that embodies and includes that 6 %. There is no us and them dichotomy here. There is only this monstrosity in the corner of the world that the rest of us do our best to ignore.  If you think about it, it’s not such a big snorting elephant of a monstrosity as some of us might imagine it to be, it’s really just a tiny pink one.

I cringe every time I hear people talk about educating people about “mental illness”. The only people talking about doing this educating are people with a personal stake in mental health treatment. Talking about “mental illness” has become a way of selling “mental illness”. “Mental illness” is not, and never has been, a fact, it’s an idea. The profession never had a real grip on what it was dealing with. The mental health professional has no interest in becoming alarmed at the rate of people labeled “mentally ill”. “Mental illness” labeling is his or her bread and butter. The more people receiving a “seriously mentally ill” label there are, the more secure his or her job status becomes.

This leads us naturally enough to the condemned by biology theory that is so readily adopted by our professionals. It’s a matter of convenience mostly. 6 % of the population have not become good automatons. They aren’t, and they never were, human beings, not fully functioning human beings anyway. Human beings can become good automatons, according to theory, and be content with a mindless 9 to 5 sort of thing. They are broken machines, and it’s the computing function of the machine that is most broken. So we’ve got our warehouses, and our ill equipped repair people, to deal with the matter. Given that the design was poor, they say, don’t blame the repair folk for not being able to fix the automaton.

There is not much point in going there if you’ve managed to get away from it. The people talking about the people who are defectively designed are, of course, not the people defectively designed themselves. No, they are the people who determine which people are defectively designed, and which people are effectively designed; they couldn’t do so, or so goes the theory, if they were defectively designed. Imagine the difficulties involved in becoming disentangled from that illusion. Illusion it is, but it isn’t the only thing going, so excuse me while I eject myself from the entire argument. Significance, as I see it, is sometimes a matter of rejecting insignificance. I feel much better knowing I’m not contributing to the problem, even if not contributing to the problem is not likely to win me any awards.

Repercussions from the Sandy Hook tragedy slight in Florida

It looks like Florida may not suffer as extensively from the fallout over the Newtown Connecticut massacre as some other states. The Palm Beach Post headline,  State May Shrink Mental Health Spending, doesn’t tell the whole story.

Despite a growth in the state’s anticipated revenue for the first time in six years, Gov. Rick Scott’s proposed 2013-2014 budget does not include any increase for mental health services. Neither Scott nor GOP legislative leaders mentioned the issue as a priority on the opening day of the legislative session Tuesday. And lawmakers appear split on the only two proposals in play — mandatory mental health screening of elementary school students and extending the observation period for patients who are involuntarily committed by law enforcement or health officials.

The problem concerns these two pieces of legislation that I hope our legislators will have the common sense and decency to table or vote down. Busting school children for “mental illness” is what mandatory mental health screening is all about and, frankly, if there’s one thing we don’t need, that is it. Labeling children “mentally ill”, and putting them on powerful pharmaceuticals, is not good for their educations, nor is it good for their futures. Extending the Baker Act would be a completely absurd, unnecessary, and as far as humanity goes, a wasteful thing to do.

Thankfully, given our republican controlled legislature, as bad as things are, these representatives are not in hurry to make them worse. Praised be the tightwad when the spending he isn’t spending on is repressive and draconian legislation.

The issue with spending is that it could, if it were used for something else besides busting people for “mental illness”, reduce mental health spending in the state anyway.

More than half of Florida’s mental health spending goes to hospitalization. Other states, on average, spend less than 30 percent on hospitalization, said Florida Council for Community Mental Health President Bob Sharpe.

Hospitalization is very costly. Keeping people out of the state hospital system through building a statewide community mental health care system is one way to potentially save a lot of money.

As for the Baker Act…

DCF estimates that 35,000 out of 110,770 people held under the Baker Act last year had been Baker Acted before. Sharpe points to at least one man who was Baker Acted 100 times in a single year, meaning he was hospitalized nearly the entire year.

It would seem that one person would have a pretty good case for suing the state, if he had any legal rights to stand on at all, which apparently, as a mental patient, he doesn’t.  On the other hand, when the state can Baker Act one person 100 times in the course of a single year, there is certainly no reason to extend the Baker Act. It seems institutions here have that power already.

Reversing the damage as treatment paradigm

Attention deficit hyperactivity disorder (ADHD), a disease that didn’t officially exist until 1980, has been astoundingly successful at making drug companies happy. Just look at outcomes. Pasted at the bottom of much of the recent ADHD bad news is something like the following from a USA Today article, Childhood ADHD often can linger into adulthood.

Among those age 27 who had been diagnosed with ADHD as children:

– 37.5% had no ADHD and no psychiatric disorders

– 33.2% had no ADHD and one or more psychiatric disorders

– 23.7% had ADHD and one or more psychiatric disorders

– 5.6% had ADHD and no psychiatric disorders

ADHD is said to affect roughly 9 % of the adolescent male population, and somewhat less for the adolescent female population, in the USA.

Conventional wisdom has gone completely bonkers in finding these statistics a motive for increasing mental health spending. Increased mental health focus and funding will mean an increased ADHD rate, and given that increase, an increase in the diagnostic labels that accompany it.

Mental health treatment IS the problem when that treatment is a matter of encouraging children not to seek the self-reliance and financial independence that comes with adulthood. Mental health treatment essentially represents providing much disincentive to the process of growing up. What do we get out of this treatment? An oxymoron, ‘adult children’.

The recovery rates for people with what are typically thought of as much more serious disorders–schizophrenia, bipolar disorder, and major depressive disorder–parallel the recovery rates for ADHD. They might be a little worse, 10 % or so, but not much.

The reasons for these bad outcomes are two-fold. First, the major form of treatment is with ineffective and often harmful psychiatric drugs. Although these drugs may be effective for the short term, in the long term their effects are disastrously debilitating. Second, you’ve got a dependency system that instead of ushering people back into the real world of everyday life cripples them forever.

We will start with the expression “burden to society” and go from there. The question remains, how does society “unburden” itself of this problem it has produced for itself? Well, one thing is certain, it doesn’t “unburden” itself of the “burden” by making the “burden” an industry. This is essentially what we have today. We have a mental health treatment system that is involved primarily in the manufacture of more and more cases of “mental illness”.

I don’t encourage people to go and seek mental health treatment. I don’t encourage them to do so because in so doing they stand a good chance of losing many of their basic rights as citizens. “Stigma” is not in the hearts and minds of their fellow human beings. “Stigma” is in laws and mental health treatment records that make up the hearts and minds of their fellow human beings. Records that will follow them around to the end of their days.

Just Wait Until “Adult ADHD” Rates Catch Up

Attention deficit hyperactivity disorder (ADHD) rates are going up. Hardly a shocking finding. If you invent a disease, disease rates are likely to go up rather than down without an effective way to expose you, and with you, it. As reported in Psychiatric Annals, Rate of ADHD diagnosis increased in past decade, researchers looking at trends among 842,830 schoolchildren aged 5 to 11 found the following.

According to the researchers, rates of ADHD diagnosis were 2.5% in 2001 vs. 3.1% in 2010, a relative increase of 24%. During the same period, the rate of ADHD diagnosis increased among whites (4.7% to 5.6%; RR=1.3; 95% CI, 1.2-1.4), blacks (2.6% to 4.1%; RR=1.7; 95% CI, 1.5-1.9) and Hispanics (1.7% to 2.5%; RR=1.6; 95% CI, 1.5-1.7). Rates of diagnosis among Asian/Pacific Islander and other racial groups remained unchanged.

We’re more hyperactive then in 2010 than we were in 2001, that is to say, that boys will be boys, and not only will boys be boys, but girls will be girls. Confused? You’re not alone. Or to be more on target, children will be children.

The rate increase among blacks was largely due to a growing number of girls with an ADHD diagnosis (RR=1.9; 95% CI, 1.5-2.3). Boys were more likely than girls to be diagnosed with ADHD, but study results indicated that the sex gap may be closing among blacks. The researchers also observed a much higher rate of ADHD diagnosis among children living in high-income ($70,000 per year or more) households (P<.001).

Just imagine, sex equality in pathology. Things must be improving for folks of color out there, wouldn’t you say? Or, maybe not. The good news is the arrival of the spoiled brat syndrome so you folks out there in the ghetto don’t have to feel like you’re alone in your misery. Or, maybe not. Mommy and daddy uptown can buy success for junior, can’t they? …Oh, well…Them’s the breaks.

“Although the reasons for increasing ADHD rates are not well understood, contributing factors may include heightened ADHD awareness among parents and physicians, increased use of screening and other preventive services, and variability in surveillance methods among institutions,” the researchers wrote.

Okay dokey. If awareness induces contagion, no wonder they say ‘ignorance is bliss’. Screening for figurative disease is going to increase the incidence of figurative disease. Undoubtedly. Calling screening and miseducation preventive is the real kicker though. Rates go up, and you’re preventing. Oh, yeah? Uh huh. Alluding to surveillance is more to the point. This isn’t about letting children be children, this is about training the next generation of corporate bureaucrats, and maybe, just maybe, we’ve got better things to be doing in the first place.

One factor  not listed, although the authors did mention not having any published ties to pharmaceutical companies, is the influence of drug markets on this increase. I can’t imagine it doesn’t have anything to do with stimulant, and the miscalled ‘performance enhancing’, drug sales, does it? Check out stock exchange figures sometime. I reckon, if anything, ADHD treatment drug makers aren’t suffering. The wall street party goes on and on, even if from here on out at a tightly guarded secret location.

Missing ‘The Psyche’ In Psychiatry

I came across in this Information About Psychiatry blog a post, Origins of the words Psychology and Psychiatry, on the word origin of the specialty beginning with a sentence on psychology.

The word psychology first appeared in the English language in the 17th century and derives from psyche (soul) and ology (study of).

Closing with a paragraph on psychiatry.

Later, in 1808 the word “psychiatry” was coined by Johann Christian Reil. This word means “doctoring the soul”, coming from psyche (soul) and iatros (doctor). This new word allowed psychiatrists to take matters of the soul away from religion and into their own, incapable hands.

It was quite fascinating to think that the second half of the word psychiatry seemed to have the same root as the first half of one of my favorite words, iatrogenic, or doctor caused. Used in a sentence: Psychiatry is the source of much iatrogenic illness found in the world today.

The base of iatrogenic, according to Mosby’s Medical Dictionary.

Etymology: Gk, iatros, physician, genein, to produce.

Soul, in this instance, often translates interpretively into mind, and the word mind in its origins is related to memory.

I know of people who see conventional twenty-first century psychiatric practice as ‘soul killing’ or fostering ‘soul death’. This has to be ironic as the psychiatrist was initially viewed as a person who would be a healer of souls.

Much of this direction away from the original slant of psychiatrist has come with the ascendancy of biological psychiatry. Biological psychiatry sees human problems primarily in terms of brain dysfunction, and it does not tend to look to psyche or consciousness for the source of, or the solution to, those problems.

Re-translating psychobabble into bio-babble certainly hasn’t increased the success rate for the field. In fact, the biological approach to problems in living seems resigned to a belief that subtle birth defects are the source of psychiatric disorders.

One has to point out, time and time again, that there is very little concrete proof for a biological basis to psychiatric problems. There has been, on the other hand, much heavy-handed theorizing and thoroughly biased verbiage expended to bolster such a faith.

Specialty Specialist Word Usage Timeline

psychology 1653

mad doctor 1703

psychologist 1727

psychiatry 1846

alienist 1864

psychiatrist 1890

shrink 1966

Mutants are taking over? Really? You think…

Psychiatry is full of it, and some of the latest “discoveries” in the field indicate just how full of it psychiatry happens to be. Take this report, New Genetic Mutations May Keep Some Mental Disorders From Dying Out, at PsychCentral. The post concerns a study suggesting that because mental patients have fewer children and “mental illness”, the label, isn’t dying out, we’re seeing genetic mutations…

People with certain mental disorders, such as schizophrenia and autism, tend to have fewer children than the average person, suggesting that these disorders persist not because of heredity, but because of new genetic mutations, according to a new study.

Or, and this isn’t stated, because we’re not dealing with a heritable condition. In other words, it’s a matter of the decisions people make in their lives and not so much the genes their parents gave them.

People in the psychiatric system exist within a social context, and it’s this social context that is not being looked at so much.

The findings shed light on a longstanding puzzle in psychiatry: How do the genes linked with some mental health disorders persist in the human population, if people with those disorders tend to have fewer children?

I would suggest that the issue is a matter of supply and demand. If mental health professionals had fewer children, there wouldn’t be such a demand for nut cases.

No doubt some Swedish researcher somewhere along the way was impacted by the SciFi movie The Andromeda Strain, and nothing can be the same since.

For example, schizophrenia is extremely heritable, so it would make sense that it becomes more rare over time. But the disorder seems to persist in 1 percent of the population, which suggests that new mutations are occurring quickly enough for it to remain consistent, said [researcher Robert] Power.

Correction, bias has it that schizophrenia is extremely heritable despite all the evidence that would indicate otherwise. If it’s not genes, it must be genes. This is biological psychiatry to the core. Nobody is saying look to social and environmental factors, nobody is saying that, but maybe somebody should.

When you are selling disease it is convenient to pretend you are selling something else, like health, because people wouldn’t tend to buy disease on its demerits alone.

The researchers note that some people with mental disorders may take medication that affects fertility, or they may have been hospitalized at some point during their reproductive years, and these factors may have influenced the results.

Or they may be facing prejudice in what is referred to as the competition for suitable, if desirable is too strong a word, partners. One scapegoat doesn’t reproduce. Two scapegoats do reproduce, but they hardly do so well as the goat with his harem in the herd.

Allen Frances And The DSM-5

Allen Frances, Duke University psychiatry professor emeritus, isn’t so much a critic of the Diagnostic and Statistical Manual of Mental Disorders as he is a critic of the DSM revision process. Apparently he has a love/hate relationship with the manual itself. He doesn’t object to the DSM, psychiatry’s label bible, so much as he objects to what he sees as a rushed and flawed job that could result in a shoddy product. He objects to a process that he thinks will produce a lower quality product than a more thorough going process would produce.

He himself was one of the architects of the DSM-IV. The DSM-IV was notorious for raising the “mental illness” rate throughout the world. The DSM-5 is expected to smooth out a few more of the wrinkles in the DSM-IV. Although current criticism of the DSM revision process may make the DSM-5 less of an open Pandora’s Box, or contagion zone, than no criticism whatsoever would, the publication of the DSM-5 is expected to raise the rate of mental illness around the world substantially again. Make no mistake about it; what is going on here, with the hoopla surrounding the revision and publication of this manual, is the selling of “mental illness”!

His latest jabs at this process on his Huffington Post blog have been aimed at the price tag. A recent blog post of his bore the title, DSM-5 Costs $25 Million, Putting APA in a Financial Hole. The DSM-5 has cost 5x the amount already that the DSM-IV cost. The APA is in the hole right now because of this price tag.

The American Psychiatric Association just reported a surprisingly large yearly deficit of $350,000. This was caused by reduced publishing profits, poor attendance at its annual meeting, rapidly declining membership, and wasteful spending on DSM-5. APA reserves are now below “the recommended amount for a non-profit (reserves equal to a year’s operating expenses).”

$350,000 in the hole to be exact because of a multi-million dollar revision process owing in part to the objections of critics such as Allen Frances.

APA has already spent an astounding $25 million on DSM-5. I can’t imagine where all that money went. As I recall it, DSM-IV cost about $5 million, and more than half of this came from outside research grants. Even if the DSM-5 product were made of gold instead of lead, $25 million would be wildly out of proportion. The rampant disorganization of DSM-5 must have caused colossal waste. One obvious example is the $3 million spent on the useless DSM-5 field trial, with its irrelevant questions, poorly conceived design, and embarrassing results.

The DSM-5 was due to be published in 2012. Because of the objections of many psychologists and the likes of Allen Frances publication was suspended for a year. The revisers of the DSM-5 are also going out of their way to get input from interested parties. Actually, and to be more precise, the revisers are busy at damage controll by giving the appearance of giving an ear to critics for public relations purposes. The upper echelon of the APA don’t want democracy. Dialogue is not what coming up with “mental disorder” labels is all about. There is, for example, no No Mental Disorder Not Otherwise Specified category in the manual.

If stage one were field testing, stage two is quality control. Stage one a disaster, in his view; he sees quality control as the issue in a more recent post, Follow The Money, on these monetary difficulties lost to the DSM-5 revision process.

APA was faced with 2 choices: 1) go ahead with Stage 2 to clean up the mess; or 2) declare Stage 2 unnecessary and publish a poorly edited, unreliable, and untested DSM-5. APA chose the second option and is rushing toward a forced, premature birth of DSM-5.

Actually, as pointed out above, publication had been suspended earlier, and so this would entail suspending publication yet again. This suspension proposed by Allen Frances also begs the issue of the rising tab and the debt. If the DSM-5 revision has cost $25,000,000 already, continuing to haggle over the minutae and specifics of “mental disorder” labels is not going to bring this tab down.

Since there is no pressing need to publish the DSM-5 quickly, let’s follow the money. The APA budget depends heavily on the huge publishing profits generated by its DSM monopoly. APA needs the money badly. It is losing paying members; other sources of funding are also on a downward trend; and its budget projections require a big May 2013 injection of DSM-5 cash.

Is there a pressing need to publish the DSM-5 at all? Oh, yeah! The money! The patients? Well, they’re going to rot anyway, and so we might as well take advantage of them and their plight. What can they do?

As someone with a history of activism in the psychiatric survivor movement, I have objections to the DSM-I through 5. Our problem stems precisely from the fact that these psychiatrists, with their medical degrees, and their drug company ties, are putting professional interests ahead of their patients’ health. These medical doctors are putting their own standing above the health of their patients to the detriment of their patients’ health. Allen Frances, the retired psychiatry professor, is as guilty as any of them.

Allen Frances is playing a double game. If he has to settle for a shoddy product, to him it’s better than no product at all. This product could be “medicalizing normal”, as he puts it, right and left. This represents a glitch the next edition can potentially clear up. He can immediately start projecting his wishes onto a revision of the DSM-6. He may not be alive then, but his followers can continue to opt for a little more rigor in the revision efforts. I just don’t see how any amount of rigor is going to resolve the basic lack of real science you’ve got in the DSM. There is no real science involved in the selection of “disease” labels by committee.

We don’t really have a potentially bad edition of a good book going on here. We just have another bad edition of a bad book that was a bad idea to start with. The DSM should be scrapped altogether for other approaches that don’t owe so much to biological bias and drug industry profiteering. Lives are on the line, and as long as the current toxic paradigm, supported by the DSM, is in operation, more of those lives are going to be lost. The APA can find other ways to fund its nefarious activities. The DSM is basically fraud, but unfortunately it’s a fraud that it appears is going to continue for some time to come. Again, and emphatically, it should be scrapped entirely!