Another DSM-5 critique

DSM-5* launches on the 22nd of this month and the ripples of its drop could be tsunami-sized for some communities. We’ve written previously about DSM-5 controversy here and here.  The Wired article that we linked to was written by psychotherapist Gary Greenberg, who offers a harsh critique of the new DSM — and any DSM and psychiatry as a whole — in his new work The Book of Woe: The DSM and the Unmaking of Psychiatry. I haven’t read the book yet, but The Atlantic has an interview with Greenberg: The Real Problems with Psychiatry. It’s worth a critical read, along with the comments on the interview.

I agree with several of Greenberg’s points, perhaps the ones in which he’s most in sync with Allen Frances, but on others his approach is so antithetical to medical anthropology that I was arguing aloud as I read them. Consider his lack of distinction between illness, disease, and disorder and sentences like, “If they don’t have real diseases, they don’t belong in real medicine.” If he’s so opposed to the APA being the judge of psychiatric diagnostic criteria, I wonder whom he would appoint to be the arbiter distinguishing real from non-real diseases or even real from non-real medicine.

As I read the piece, I wondered if perhaps Greenberg was just not a good interviewee. Though other things he’s written have a cynical edge, the tone seemed off and there were inconsistencies. According to Greenberg’s website, he didn’t know that the format of the Atlantic piece was going to be Q&A with verbatim quotes, and he admits that he “said some pretty intemperate things… but only a couple are embarrassing.”  Ah, that makes more sense. I’ll have to take a look at the book to get a better understanding of his arguments.

*  The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition.

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