Customer Reviews

Making Us Crazy

5 star:		(4)
4 star:		(1)
3 star:		(0)
2 star:		(0)
1 star:		(2)

 

 

For those of us who eagerly consume critiques of the mental health industry, this book is not necessarily what we have come to expect. I often expect what amounts to a quick adrenalin rush, with horror stories of abuse by the system driving me to the barricades. Kutchins and Kirk do not provide a quick rush, nor even a quick read. But when you find yourself on the barricades, they do give you the ammunition.

This is a very detailed social/political history of the DSM, in and out of committee meetings and individual correspondence, providing the evidence of the point made so well by others such as Kaplan: that the DSM is in fact a political document, evolving to suit conflicting political and financial interests. More than a story of good guys and bad guys, much of this history includes the sad moral of unintended consequences, as in the fight to get PTSD into the DSM.

I teach undergraduate psychology, and I applaud the authors' coherent explanations of technical issues such as reliablity and validity of assessment. My teaching experience informs me that this is a tedious exercise for most students, and, I assume, for the educated lay readership to whom Kutchins and Kirk appeal. But it is critical to the central theme of the story: the misuse of the aura of science to mask a fundamentally political process.

Are there victims and villains of this process? Of course, and they are the usual villains: a system of managed care, and a variety of bureaucracies and agencies pursuing government funding, grants and influence based on ultimately manipulated numbers. And the usual victims: the over-labelled, over-prescribed and stigmatized recipients of "care".

The story wanders through so many mazes that a reader may lose the thread: PTSD, homosexuality, female masochism, borderline personality disorder. Each story differs in who started the process of getting a diagnosis in or out of the DSM, the motivation for doing so, the outcome of the fight, and the specific consequences. Fortunately, the authors provide an excellent summary in the last chapter, and weave those threads back together.

More than once in reading this book, I found myself thinking that every political or social issue fight needs its policy wonks. Kutchins and Kirk may be our wonks.

This expose represents the most thorough documentation that psychiatry is a psuedo-science to date. The proof that psychiatry is no more (and possibly much less) than the mere sum of its internal politics is amply provided by the authors in the form of personal correspondance between the brightest minds and most powerful leaders of the discipline. For the impatient or the semi-literate, a long, slow read lies ahead. For those with an eye for detail, prepare to witness the unraveling of the most influential scientific institution in America, decades in the making. According to this book shouting matches, voting, back door meetings and boycotts were the "data" that came to comprise what most people believe is a scientific definition of mental illness, the DSM-IV in a process that better resembles the way a legsilature works as opposed to scientific research. The authors take great care to not inflate the value of their findings. The book is written by a journalist and a social worker and was not vetted or peer reviewed by Scientologists, angry parents of drugged kids, or psychiatrists--and this provides the most convincing evidence of its overall credibility. Really, this is a rare work of valid, honest journalism covering a subject that is mostly the domain of anonymous hotheads and arrogant "experts" all of whom are making claims without evidence in service of their own personal or professional objectives. In this sea of muckety-muck, this book is an island of reason.

Those who give this book a one star rating most likely have interests that are being threatened. Drug company representatives? Drug prescribers? So, pull down the average rating and reduce the number of people who buy it. It's what the republicans try to do to Al Franken's books.

The book conveys facts in a neutral, understated tone, and from those facts develops reasonable beliefs. Which ideas did you disagree with? That the diagnostic categories lack reliability and validity? That DSM has been shaped more by special interests than by science? That the criteria for each diagnosis are purely arbitrary?

Read the book. You'll think twice about letting someone you care about be diagnosed.

I read this book to flesh out my own background in the history of the DSM for a History of Psychology class that I am teaching. I found the book insightful, informative, and well written. I would recommend it to anyone who has interest in the politics behind the creation of the DSM.

I'm a big fan of Thomas Szasz; I enjoy the work of Peter Breggin; I am certainly a critic of modern psychiatry, the pathologizing of behavior, and labeling. HOWEVER, this is not a good book.

If there is a good book out there on the DSM, I would like to read it. This just isn't it.

For instance, there are a couple good points regarding Borderline Personality Disorder. However, it is buried in a chapter that attempts to assert that BPD was invented to free therapists from responsibility when they have sex with their patients.

Mostly, I just kept thinking "SO?" or "What's the point? ". I'm a psychiatric social worker, I use the DSM frequently, and I don't like it.

I would like to read a well-written book on the subject.

This just ISN'T it.

While there is nothing wrong with intelligent criticism, I could find very little in this book. Sadly, there are mental health professionals who abuse their positions and behave unethically, as there are in every other profession. That does not mean we should throw out the DSM because people have misused it.

It is also true that there has been bias arising from cultural ignorance, sexism, etc. And yes, politics is sometimes involved in decisions. Which profession has been immune from these things? In general, the mental health profession has been trying to increase professionals' understanding of cultural contexts for behavior through coursework and changes in the new DSM-IV-TR.

Even though this book sometimes includes actual material from the DSM, it basically misrepesents the facts about mental disorders. For example, it says a person can be diagnosed with major depression simply because he or she has trouble sleeping. While sleep disturbance may be a symptom of depression, someone who knows what she/he is doing knows that it may not be depression at all. Depression involves much more than that. The DSM is not perfect, and indeed a few classifications are questionable, such as schizoid personality disorder (extreme introversion). I am not sure whether that one is truly a disorder. The authors say that the DSM patholgizes everyday behavior. Does spending an hour or more every day washing one's hands over and over(obsessive compulsive disorder) seem like everyday behavior?

This book is weak and pointless, a disappointing attempt at criticism.

Mim Udovitch must not have liked the chapter on homesexuality. His review perpetuates the psych profession's stigma that it is nothing less than cleverly disguised argumentum ad hominem.

The DSM-IV states not all therapists are honest, but presumes them to be. The DSM-IV also presumes, like the Romans, that death is final. I still haven't found any reference to consciousness.

It becomes obvious after spending time in another culture that today's mental health professionals have no work experience with anyone outside their own peer group. Every new edition of the APA's DSM or the World Health Organization's ICD denies the implication of misdiagnosis based on previous volumes. The media has not reported , but I would like to know how the lawsuit resulted in an Oregon case in which a Mexican was falsely imprisoned in a hospital for two years because mental health couldn't understand his Native American dialect. Too often this is the matter, especially in small towns where the vanity of authority and status are less likely to be questioned. The APA cannot police itself well enough to prevent itself from becoming modern inquisitors in our new state religion-socialism. History repeats itself because human nature never changes. No profession is an island in a universe with only one absolute.

Defining ourselves without losing the meaning in the nomenclature we use is, true, 'a conceptual issue;' a big one. DSM-IV Guidebook points this out in a shallow knowledge compromise between a happy child ('naive realism') and Thomas Szasz ('heuristically barren solipsism') by labeling themselves as 'Umpire No. 2.' (No. 6 must have caught them watching through a keyhole.)

Paul Twitchell wrote 'conciousness was the only state worth consideration.' Wrong thinkers consistantly try to define consciousness as and with labels of behaviour. Authors and educators Kirk and Kutchins give us a brief outline of how pervasive this is within the mental health community.

The easiest description of consciousness for me was delivered by Rebazar Tarz in Twitchell's "Dialogues with the Master." In the chapter on Maya, Queen of Illusion, Mr. Tarz describes the actinic characteristics of consciousness in a comparison of Einstein's and Shankacharya's Theories of Relativity. Tarzs said 'each individual has within him the wave-energy qualities of GOD; matter being bottled waves and radiation, unbottled. We only focus on the atom's radiation and not its source.'

He says, "Radiation moves like water and breaks up into grains (light-quanta). Mind makes the world, but it doesn't always have to be a world in which the strong prey upon the weak. When we see GOD everywhere, there is no obstacle and radiation is not obstructed. Relativity means the observer can change his system of references to create his paradise.'

Making Us Crazy:DSM:The Psychiatric Bible points out how DSM has become such a tool for the APA. It is unlikely a cat would throw itself into a pen of dogs, though it is possible a human might take his own life to change his experience by changing the material image he projects of himself from his own mind. Bunyon's "Pilgrim's Progress" neatly describes how Christian met the challenge of literally changing his references which every professional could use for a lesson themselves.

Some references: Robertson's Short History of Freethought, anything by Hartshorne and Reese, Scapegoat volume 9 of Frasier's Golden Bough, Feynman's QED and Surely You're Joking..., Korzybski's Science and Sanity and Klemp's Art of Dreaming (if you haven't gotten it in your sleep). John Ryan Clark