The Dysfunctional USSA

Patriotic young man with a flag, NYC 1967
Diane Arbus

If this country were a patient in one of our horrifically insufficient mental institutions the entire nation would be diagnosed as beyond severely disturbed.

Today the latest article which describes the Dangerous New Psychiatric Bible (DSM-5) was finalized for 2013. It is against this background that one must come to see this place as an open-air psyche ward, where the inmates are running the institutions and the government of this country.

The Board of Trustees of the American Psychiatric Association has given its final approval to a deeply flawed DSM-5 containing many changes that seem clearly unsafe and scientifically unsound. My best advice to clinicians, to the press, and to the general public — be sceptical and don’t follow DSM-5 blindly down a road likely to lead to massive over-diagnosis and harmful over-medication. Just ignore the 10 changes that make no sense.

“1) Disruptive Mood Dysregulation Disorder: DSM-5 will turn temper tantrums into a mental disorder — a puzzling decision based on the work of only one research group. We have no idea how this untested new diagnosis will play out in real life practice settings, but my fear is that it will exacerbate, not relieve, the already excessive and inappropriate use of medication in young children. During the past two decades, child psychiatry has already provoked three fads — a tripling of Attention Deficit Disorder, a more than 20-times increase in Autistic Disorder, and a 40-times increase in childhood Bipolar Disorder. The field should have felt chastened by this sorry track record and should engage itself now in the crucial task of educating practitioners and the public about the difficulty of accurately diagnosing children and the risks of over-medicating them. DSM-5 should not be adding a new disorder likely to result in a new fad and even more inappropriate medication use in vulnerable children.

2) Normal grief will become Major Depressive Disorder, thus medicalizing and trivializing our expectable and necessary emotional reactions to the loss of a loved one and substituting pills and superficial medical rituals for the deep consolations of family, friends, religion, and the resiliency that comes with time and the acceptance of the limitations of life.

3) The everyday forgetting characteristic of old age will now be misdiagnosed as Minor Neurocognitive Disorder, creating a huge false positive population of people who are not at special risk for dementia. Since there is no effective treatment for this ‘condition’ (or for dementia), the label provides absolutely no benefit (while creating great anxiety) even for those at true risk for later developing dementia. It is a dead loss for the many who will be mislabelled.

4) DSM-5 will likely trigger a fad of Adult Attention Deficit Disorder leading to widespread misuse of stimulant drugs for performance enhancement and recreation and contributing to the already large illegal secondary market in diverted prescription drugs.

5) Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM-5 has instead turned it into a psychiatric illness called Binge Eating Disorder.

6) The changes in the DSM-5 definition of autism will result in lowered rates — 10 percent according to estimates by the DSM-5 work group, perhaps 50 percent according to outside research groups. This reduction can be seen as beneficial in the sense that the diagnosis of autism will be more accurate and specific — but advocates understandably fear a disruption in needed school services. Here the DSM-5 problem is not so much a bad decision, but the misleading promises that it will have no impact on rates of disorder or of service delivery. School services should be tied more to educational need, less to a controversial psychiatric diagnosis created for clinical (not educational) purposes and whose rate is so sensitive to small changes in definition and assessment.

7) First time substance abusers will be lump definitionally in with hard-core addicts despite their very different treatment needs and prognosis and the stigma this will cause.

8) DSM-5 has created a slippery slope by introducing the concept of Behavioural Addictions that eventually can spread to make a mental disorder of everything we like to do a lot. Watch out for careless over-diagnosis of Internet and sex addiction and the development of lucrative treatment programs to exploit these new markets.

9) DSM-5 obscures the already fuzzy boundary been Generalized Anxiety Disorder and the worries of everyday life. Small changes in definition can create millions of anxious new ‘patients’ and expand the already widespread practice of inappropriately prescribing addicting anti-anxiety medications.

10) DSM-5 has opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings.

DSM-5 has dropped its pretension to being a paradigm shift in psychiatric diagnosis and instead (in a dramatic 180 degree turn) now makes the equally misleading claim that it is a conservative document that will have minimal impact on the rates of psychiatric diagnosis and in the consequent provision of inappropriate treatment. This is an untenable claim that DSM-5 cannot possibly support because, for completely unfathomable reasons, it never took the simple and inexpensive step of actually studying the impact of DSM on rates in real world settings.

Except for autism, all the DSM-5 changes loosen diagnosis and threaten to turn our current diagnostic inflation into diagnostic hyperinflation. Painful experience with previous DSMs teaches that if anything in the diagnostic system can be misused and turned into a fad, it will be. Many millions of people with normal grief, gluttony, distractibility, worries, reactions to stress, the temper tantrums of childhood, the forgetting of old age, and ‘behavioral addictions’ will soon be mislabelled as psychiatrically sick and given inappropriate treatment.

People with real psychiatric problems that can be reliably diagnosed and effectively treated are already badly short changed. DSM-5 will make this worse by diverting attention and scarce resources away from the really ill and toward people with the everyday problems of life who will be harmed, not helped, when they are mislabelled as mentally ill.

Our patients deserve better, society deserves better, and the mental health professions deserve better. Caring for the mentally ill is a noble and effective profession. But we have to know our limits and stay within them.” (1)

DSM-5 violates the most sacred (and most frequently ignored) tenet in medicine — First Do No Harm! That’s why this is such a sad moment.

From Holland comes this “news”.

“Amsterdam is to create “Scum villages” where nuisance neighbors and anti-social tenants will be exiled from the city and re-housed in caravans or containers with “minimal services” under constant police supervision.

The new punishment housing camps have been dubbed “scum villages” because the plan echoes a proposal from Geert Wilders, the leader of a populist Dutch Right-wing party, for special units to deal with persistent troublemakers.

“Repeat offenders should be forcibly removed from their neighborhood and sent to a village for scum,” he suggested last year. “Put all the trash together.”

Whilst denying that the new projects would be punishment camps for “scum”, a spokesman for the city mayor stressed that the special residential units would aim to enforce good behavior.

k): The Thought POLICE made it BIGTIME in Holland

“The aim is not to reward people who behave badly with a new five-room home with a south-facing garden. This is supposed to be a deterrent,” he said.

The tough approach taken by Mr van der Laan appears to jar with Amsterdam’s famous tolerance for prostitution and soft drugs but reflects hardening attitudes to routine anti-social behavior that falls short of criminality.

There are already several small-scale trial projects in the Netherlands, including in Amsterdam, where 10 shipping container homes have been set aside for persistent offenders, living under 24-hour supervision from social workers and police.

k): Ah Yes, but who will watch the perverted watch-dogs?

Under the new policy, from January next year, victims will no longer have to move to escape their tormentors, who will be moved to the new units.

A team of district “harassment directors” have already been appointed to spot signals of problems and to gather reports of nuisance tenants.

k): Apparently spy-cameras are just NOT ENOUGH for the sanctimonious Dutch

The Dutch Parool newspaper observed that the policy was not a new one. In the 19th century, troublemakers were moved to special villages in Drenthe and Overijssel outside Amsterdam. The villages were rarely successful, becoming sink estates for the lawless.

k): The whole point of having a society is to communicate with one another, not to dictate to anyone who differs from your own way of seeing the world. If these people were over here, maybe they could be charged by Psychiatric-police with being psychotic for wanting to CONTROL all aspects of everyone else’s life.

“We have learned from the past,” said the mayor’s spokesman. “A neighborhood can deal with one problem family but if there are more the situation escalates.” (2)

Between the collapse of psychiatry and the death of society here, as well as in ‘other places’ it seems that people have lost the ability to even tend to themselves or to others without resorting to any of the various “STATE APPROVED METHODS” whenever anyone is troubled by anything now. Every single aspect of life is now monitored, regulated, charged and punished or PROSECUTED for attempting to live a routinely unusual but happy life,,,

The longer this goes unchecked, the worse it will get wherever you live and no matter what you believe in (because there will ALWAYS BE SOMEONE WHO WILL VEHEMENTLY DISSAPROVE OF WHATEVER YOU END UP DOING.

It used to be that countries only had one police force. Today we have virtually all kinds of POLICE for every known or suspected imaginary-crime, in every category of daily life. This is being done in such a way that there can be NO ESCAPE FROM THE POLICE STATE no matter where you are or how you want to live…

Billions of People are now living in Police-States all around the planet: What would happen if those people begin to FIGHT BACK?

But what happens to the planet if they don’t!

Jim Kirwan

1) Dangerous New Psychiatric Bible (DSM-5) Finalized for 2013

2) Amsterdam to Create Scum Villages


Back to top


All images are © kirwan, all rights are reserved (unless otherwise noted).