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DSM-IV-TR

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My wife reading in bed. And it wasn't because ...

My wife reading in bed. And it wasn’t because she was trying to get to sleep. (Photo credit: Wikipedia)

The DSM-IV-TR (The Diagnostic and Statistical Manual of Mental Disorders, Version IV with Text Revisions) is the most recent manual developed by the American Psychiatric Association, one used by health professionals to classify various psychological disorders, generally referred to as mental illnesses.

The DSM-IV-TR is used around the world, along with two other manuals (The ICD-10 produced by the World Health Organization and The Chinese Classification of Mental Disorders produced by the Chinese Society of Psychiatry).

Each diagnosis is number-coded and depending on the country, may be used by hospitals, clinics and insurance companies.

Some postmodern thinkers and particularly anti-psychiatry groups say that the DSM-IV-TR, along with its counterparts, constructs (as in creates) rather than classifies mental illnesses. For those unfamiliar with this idea, it might take a while to understand just what these thinkers are saying. But in a nutshell, postmodern critiques of the DSM-IV-TR argue that certain illnesses are, in a sense, created by the way that those with social power interpret unusual behaviors. In more common parlance, these thinkers say that those who benefit from the status quo tend to label certain people who behave differently from the social rules and expectations of the day.

These kinds of conceptual and historically based critiques of the DSM-IV-TR and of psychiatry, in general, tend to draw on the work of thinkers like Michel Foucault, Thomas Szaz, R. D. Laing, Ram Dass, David Lukoff, Stanislav Grof, L. Ron Hubbard (the founder of Scientology) and others.

Other critiques focus not so much on the issue of the DSM-IV-TR’s analytical validity but on the possibility of negligence by incompetent practitioners.

Debates also exist about the relation between psychiatric classification, on the one hand, and cultural, political and economic realities on the other hand, the most visible example being the link between pharmaceutical companies and the discipline of psychiatry, and a less visible example being political in-fighting among psychiatrists.

While some readily dismiss the DSM-IV-TR as a kind of 21st-century witch hunter’s manual,  we’d do well to remember that psychiatry (along with its diagnostic tools) is a developing science.¹ And human beings do live in a social and largely organizational world, and those who differ dramatically often do suffer, and in violent cases, cause others to suffer (or die).

The fact that psychiatry is a developing science is often overlooked or negatively construed by its more forceful critics, while embraced by its supporters. Regardless of one’s philosophical position on this point, sociologists will rightly note that the DSM-IV-TR still enjoys a high degree of societal legitimacy and legal power.

To this Ofer Zur, Ph.D. adds:

The DSM is a political not a scientific document. It pathologizes women, children, and minorities. It defines existentially normal behaviors as mental illnesses. It is a money making endeavor for psychiatry and other mental health professionals. It ‘dares’ to define what is normal and what is abnormal and who should be free or detained against their will…[one may find] a detailed critical article about the DSM at http://www.zurinstitute.com/dsmcritique.html » See in context

Related Posts » Corruption, Madness

¹ As I write this a new DSM V is currently being forged, among much debate and controversy. See http://en.wikipedia.org/wiki/DSM-5

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4 thoughts on “DSM-IV-TR

  1. The DSM is a political not a scientific document. It pathologizes women, children, and minorities. It defines existentially normal behaviors as mental illnesses. It is a money making endeavor for psychiatry and other mental health professionals. It ‘dares’ to define what is normal and what is abnormal and who should be free or detained against their will.
    Ofer Zur, Ph.D.
    Psychologist
    Zur Institute

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  2. I forgot to mention a detailed critical article about the DSM at http://www.zurinstitute.com/dsmcritique.html
    Ofer Zur, Ph.D.
    Zur Institute

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  3. While not a scientific document, it is true that the “DSM-IV-TR still enjoys a high degree of societal legitimacy and legal power”. Although it has become an integral part of the machinery that provides treatment under insurance rule and pharmaceutical company complicity, it is essentially unnecessary in providing treatment. As with all things, one must consider the process and end to which power is applied. As a document, the DSM can be used in helpful or harmful processes resulting in helpful or harmful ends. Nola Nordmarken, MFT, co-author with Dr. Zur of the article in critique of the DSM http://www.zurinstitute.com/dsmcritique.html

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  4. If you dig deep into the history of psychiatry, back into the 1960s, you will find that it virtually collapsed because it was anything but a science. It was more like a religion at the time. After the fiasco the DSM was developed to present the guise of psychiatry as science. It’s still not science. Nevertheless, the DSM must be applauded for making the bold assertion that religion is a mental disorder. We can no longer madness to sweep the world and endanger the human race and all live on earth from religious supremicism, fascism, abuse, and violence.

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