Saturday, October 12, 2013

"The Book of Woe" - A critical look at the DSM-5

Scientific American    This is a landmark book about a landmark book. Psychotherapist and author Greenberg first took on the Diagnostic and Statistical Manual (DSM) in a blistering article in Wired in 2010. The Book of Woe is the nearly 400-page update, whose release coincided with the May 2013 release of the DSM-5, the fifth edition of the bible of mental health, which first appeared in 1952.

Relying heavily on interviews with distinguished insiders in the psychiatric establishment, Greenberg paints a picture so compelling and bleak that it could easily send the vulnerable reader into therapy. The basic message is this: everyone in the mental health profession knows full well that the DSM is a work of fiction—that the hundreds of “disorders” described therein are just labels for fuzzy, overlapping clusters of symptoms and that we have never found a definitive biological marker for even one of those disorders. Mental health professionals pretend that the disorders are real, but they're not, period.[...]

Psychiatrists are in the business of pathologizing and throwing drugs at everyday problems, and given the money at stake, perhaps nothing can stop this trend.


  1. A very interesting article. The involvement of Pharme and drug sales, shows there is some shochad - bribery which can blind even the greatest scientists.

  2. You could be Tom Insel, who is neither an antipsychiatrist nor a Jesuit of any spatial orientation, who is, in fact, America’s psychiatrist in chief. “Whatever we’ve been doing for five decades 22 ,” he told me, “it ain’t working. And when I look at the numbers— the number of suicides, number of disabilities, mortality data— it’s abysmal, and it’s not getting any better. All of the ways in which we’ve approached these illnesses, and with a lot of people working very hard, the outcomes we’ve got to point to are pretty bleak”— especially, he added, compared with the “extraordinary” progress in other fields, such as the 70 percent drop in mortality from cardiovascular disease since he went to medical school or the steep reductions in deaths from auto accidents and homicides. “There are some people for whom some of what we do is enormously helpful, ” he said. But even so, “we don’t know which treatments are working for which people.” And this litany of failure, he said, “gets us back to your interest in nosology. Maybe we just need to rethink this whole approach.” That’s what Pliny Earle said in 1886, and what Thomas Salmon said in 1917, and George Raines in 1951, and Robert Spitzer in 1978, and Steve Hyman in 2000: that without a working nosology, psychiatry is a failure, that the current nosology (whatever it is) is sadly lacking, that the profession needs a new paradigm

    Greenberg, Gary (2013-05-02). The Book of Woe: The DSM and the Unmaking of Psychiatry (pp. 351-352). Penguin Group US. Kindle Edition.

  3. I am in agreement. See further discussion at

    "I have long maintained openly that the categories laid out in the DSM are made up and not very useful for actually helping the people who suffer from the disorders therein. The only part I disagree with above is that 'mental health professionals pretend that the disorders are real'..."


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