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Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life Hardcover – May 14, 2013


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Editorial Reviews

From Booklist

*Starred Review* The Diagnostic and Statistical Manual (DSM), produced by the American Psychiatric Association, is considered the bible of psychiatry. It establishes the border between normalcy and mental disorder. Despite its usefulness, one prominent psychiatrist laments that the DSM has become too influential. The definition of normal seems to be steadily shrinking. Frances served as head of the task force that issued the fourth DSM. He worries that the new DSM-5 (which cost $25 million to produce) will further inflate psychiatric diagnosis, resulting in additional overmedication. Already, 20 percent of American adults take one drug or more for a psychiatric condition. About 11 percent of adults used antidepressants in 2010. And prescriptions for antipsychotic medicines have doubled in a decade. Frances frets that the DSM-5 will spawn faddish diagnoses—much like its predecessor, which created false epidemics of attention deficit, autism, and childhood bipolar disorder. This time around, look out for Disruptive Mood Dysregulation Disorder, which morphs temper tantrums into a mental illness, and Minor Neurocognitive Disorder, which turns the forgetfulness of aging into a mental disorder. With ­Solomon-like wisdom, Frances justly doles out blame and offers reasonable remedies. His decree: don’t medicalize human difference; celebrate it. --Tony Miksanek

Review

“Frances delves deeply into the history of mental illness, makes his arguements crisply, and has good personal stories to tell. He’s articulate and learned. ... He’s in favor of not medicating, and thus muffling, all the offbeat pain and beauty out of existance. ... [A] piece of intellectual skywriting.” (Dwight Garner, New York Times)

“An extraordinarily candid and important book. Allen Frances has written a fascinating account of the apparent explosion in psychiatric disorders in the United States. (MARCIA ANGELL, M. D., Senior Lecturer in Social Medicine at Harvard Medical School, and former Editor-in-Chief, New England Journal of Medicine)

Saving Normal is a riveting and important book, written with great flair and precise passion. This is a book every psychiatrist, every general practitioner, every student swallowing meds--in fact everyone--needs to read.” (Dr. LISA APPIGNANESI, Chair of the Freud Museum, London, and author of Mad, Bad and Sad)

“Frances is largely credited with spearheading the anti-DSM-5 efforts.” (CNN.com)

Saving Normal is a clear, convincing, and essential discussion of the twin epidemics facing modern psychiatry: under-treatment of the truly ill and overtreatment of the basically well. It holds immense potential to improve patients’ lives.” (JOSH BAZELL, M.D., New York Times bestselling author of Beat the Reaper: A Novel)

“Few are as well-equipped as Frances to map the dynamic field of psychiatry, and his rendering of its shifting contours is timely, crucial, and insightful--as are his solutions for navigating it.” (Publishers Weekly)

“With Solomon-like wisdom, Frances justly doles out blame and offers reasonable remedies. His decree: don’t medicalize human difference; celebrate it.” (Booklist (starred review))

“A valuable assessment. ... A no-holds-barred critique.” (Kirkus Reviews)

“An indispensable guide for professional and lay readers” (Library Journal)

“Allen Frances’s book is fascinating. ... Entertaining.” (Metapsychology)

“Authoritative. ... Valuable. ... This is a detailed, nicely constructed account by a highly qualified and well-connected psychiatrist with intimate knowledge of the process. The book is clearly written and surprisingly easy reading.” (The Royal Australian and New Zealand College of Psychiatrists)
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Product Details

  • Hardcover: 336 pages
  • Publisher: William Morrow; 1 edition (May 14, 2013)
  • Language: English
  • ISBN-10: 0062229257
  • ISBN-13: 978-0062229250
  • Product Dimensions: 6 x 1.1 x 9 inches
  • Shipping Weight: 1.1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.4 out of 5 stars  See all reviews (99 customer reviews)
  • Amazon Best Sellers Rank: #167,381 in Books (See Top 100 in Books)

More About the Author

Allen Frances, MD, is a clinician, educator, researcher, and leading authority on psychiatric diagnosis. He chaired the DSM-IV Task Force, was a member of the Task Force that prepared DSM-III-R, and wrote the final version of the Personality Disorders section in DSM-III. The author of hundreds of papers and more than a dozen books, Dr. Frances is Professor Emeritus and former Chair of the Department of Psychiatry and Behavioral Sciences at Duke University. He blogs frequently on Huffington Post, Psychology Today, and Education Update.

Customer Reviews

4.4 out of 5 stars

Most Helpful Customer Reviews

76 of 79 people found the following review helpful By tired doc on May 14, 2013
Format: Hardcover
Dr. Alan Francis is a scholarly thoughtful physician whose career has been focused upon psychiatric diagnosis. His work at Columbia dn then Duke allowed him to see a broad range of psychiatric disorders and engage in a lively professional debate among other psychiatrists about the nature,causes,and treatments of psychiatric disorders. Given his experience,this book is far more than a critique of DSM5. It is a very practical guide to psychiatric diagnosis. Issue such as "normality" are often ignored by all mental health professionals. His chapter on this topic is worth the book itself. A must read by all mental health practitioners.
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37 of 39 people found the following review helpful By Lita Perna VINE VOICE on July 3, 2013
Format: Hardcover
Saving Normal, written by Allen Frances, Chair of the DSM-IV Task Force should be bundled and sold with every edition of the DSM V.

Dr Frances, who has worked for 20 years on the updated editions of the DSM, including DSM-III, DSM-IIIR and DSM-IV is not an outsider. He knows what he is talking about. And he is sounding the alarm.

He believes that those who desperately need psychiatric help are being neglected while others who don't need it are given diagnoses when there's nothing `wrong' with them and their issues are transitory.

Saving Normal should required reading for every therapist who diagnoses clients and for every client or potential client/patient who plans on using their health insurance benefits for mental health concerns or treatment.

In Saving Normal, Dr Frances warns about the mislabeling and diagnosing of normal problems and issues in daily living, as mental illness; he cautions about false diagnoses and potentially harmful and unnecessary prescriptions of psychotropic medications.

`Loose diagnosis' he says, `is causing a national drug overdose of medication.'

This diagnostic inflation impacts millions of people who are receiving unnecessary treatment and who believe they are suffering with a mental illness, when they are not.

Dr. Frances explores the creation of the first DSM, what's normal and what's not, psychiatric fads of the past and present (notably Attention Deficit Disorder, Childhood Bipolar Disorder, Autism, Bipolar II and shyness, diagnosed as `Social Phobia.) and the impact and influence of drug manufacturers on doctors and diagnoses.

Dr. Frances talks about how labels have changed.
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28 of 32 people found the following review helpful By a reader on June 16, 2013
Format: Hardcover
As a practicing physician and medical school professor, I hope this book is widely read. The influence of drug companies on physicians' education has grown alarmingly in the 30 years i have practiced. Dr. Frances has hit the nail on the head with this wise book. Much of what is being taught in the psychiatry rotations is that every fluctuation in mood, every worry, every moment of sadness or anger or fatigue is pathological and needs a pill. To paraphrase Eisenhower, it is alarming that nearly 50% of us are below average!
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18 of 20 people found the following review helpful By Rodney Timbrook on June 17, 2013
Format: Kindle Edition Verified Purchase
As a psychologist, I tend to be skeptical about many things. I think that Dr. Frances raised many important issues facing psychiatry and the American public in his fairly well-written and easy to read book. While at times he takes a rather biased view in favor of psychiatry and the medical approach to treating mental disorders, he balances his obvious bias with well-stated and well thought out criticisms of psychiatry, medicine, and the healthcare industry. For psychologists, I would highly recommend this book.
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20 of 23 people found the following review helpful By Frank Zacharias on June 7, 2013
Format: Kindle Edition Verified Purchase
An expert who disagrees with the majority of his peers. My take on this issue is simply the fact that "money talks". These people who wrote DSM5 have a financial interest in connection with big pharma. It is an unfortunate fact that men can be bought. In the end the money comes from us - patients, rate and tax payers, and workers. Read the book and hopefully you will become more discerning.
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22 of 26 people found the following review helpful By FRITTS on May 26, 2013
Format: Hardcover Verified Purchase
I saw Allen Frances on tv. At first I thought he disapproved of psychiatric medications altogether. The book explains how too many prescriptions are given to people who don't need them, not given to people who do, and how diagnosis should be made.
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16 of 19 people found the following review helpful By Susan M. Rosenberg on June 7, 2013
Format: Kindle Edition Verified Purchase
This world renowned psychiatrist, Dr. Allen Frances, has written a powerful book which describes some new diagnoses in the new DSM 5 Manual. These diagnoses could be normal feelings after a loss of a loved one or ADD for a child somewhat younger in his grade who just has not caught up to his classmates yet. Overmedication is discussed as well as unqualified people such as educators making diagnoses that should be left to psychiatrists. An illuminating read!
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6 of 6 people found the following review helpful By Connor H on February 9, 2014
Format: Hardcover
This is a topic that I find quite interesting as a BA psychology graduate with plans for PhD work. I don't think we give nearly enough attention to the classification and diagnosis of psychopathology, but rather accept the status quo. For that I credit Dr. Frances for writing this book.

It is usually easier to say what one doesn't like about something, and I do have a few criticisms. For one, I would have liked more detailed criticisms of specific disorders, and perhaps an expounding on alternative methods of classification (dimensional vs categorical, etc). Instead Dr Frances tends to pretty much say the same things over and over again in slightly different ways; "over diagnosis is harmful, certain disorders are being over diagnosed more than others, the drug companies are in need or reform, and most people don't need to have a diagnosis." Most of which I actually agree with, at least somewhat. But I think Dr. Frances could have expanded on topics of interest more instead of carving the book in to MANY little sections saying the same thing. My second criticism is that he focuses on psychiatry (which makes sense, since he is a psychiatrist) and tends to either misrepresent or undervalue other mental health professionals and researchers. At one point he equates psychologists to being people that give out IQ tests and epidemiological research methods as being done by clueless undergraduates. This is a bit silly, I think, since clinical psychologists often have much more training in diagnosis than psychiatrists, and diagnosis in general is done by many different health professionals. But I understand we all have our biases based on our experiences, including me.

What I did like about the book is that it at least attempts to broach a needed subject.
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Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life
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