Thursday, March 25, 2010

"DSM-5 and sexual disorders: Just say no"

Psychology urged to oppose psychiatric monopoly



Perilous forensic consequences

"DSM-5 sexual disorders make no sense"



"Paraphilic Coercive Disorder"


"Hypersexuality Disorder"

Related article:

Hat tips: Ken Pope, Andrew H.
Graphics credit: Raul Crimson (Creative Commons license 2.0)


  1. Daniel GrantMarch 26, 2010

    Not only am I concerned about the impact of some of the DSM-5 changes to adults but What about the impact on/to adolescents. I work in a Juvenile detention center and 80+% of the individuals who have issues with anger and have seen a psychiatrist prior to detention have been diagnosed with bipolar disorder and begun on 2,3 or more medications for this disorder. After careful evaluation and observation in the facility we most often document a pattern of behavior related to conduct disorder and sometimes including Intermittent explosive disorder but do not find symptoms related to bipolar disorder. Depending on the severity of the behavior we may use a single medication. Most often we find the anger is related to limit setting. This is a problem with an existing diagnosis which makes it difficult to try to get the youth to become responsible for his own behavior. We also get a number of youth charged with a sex related crime. As the research with adolescents on your website has shown most often this is not a repeated behavior and is treatable but with the changes in DSM-5 these youth would most likely be given one of the proposed psychiatric disorders and treated by society and the courts counter to what research has shown. I refer those interested in adolescene and development to the work of Laurence Steinberg.

  2. The concept of mental illness was invented to explain the unusual and disturbing actions of individuals at a time when better and more valid explanations were not generally available. The mental illness explanations also legitimized the incarceration and mistreatment of these individuals.

    The concept of mental illness is exactly analogous to the concept of witchcraft, which was invented in pre-scientific times to explain adverse phenomena such as crop failures and epidemics.

    The problem is not DSM 5. The problem is DSM. The psychiatric-pharmaceutical consortium has succeeded in promoting the false and spurious notion that virtually every human problem is a mental illness and needs to be “treated” by drugs.

    Perhaps the most profound tragedy in this sordid affair is the embracing by professional psychology of this spurious and destructive conceptual framework. Psychology is the science of human behavior! Yet our professional associations and individual members have endorsed DSM as if it were the Holy Grail. A large portion of our licensing exam is based on DSM, which is a bit like requiring Ag majors to know the signs of witchcraft and the various methods witches use to destroy crops.

    What we don’t need is more psychological involvement and input into DSM 5. What we need is to exit stage. Psychology needs to distance itself from the so-called mental health field and begin developing areas of expertise and methods of effective intervention in the very many behavioral problem areas that beset the human race, e.g. crime, obesity, addiction, exploitation, discrimination, traffic accidents, poverty, pollution, war, etc., etc..

    Philip Hickey, PhD

  3. Dr. Hickey.

    Your comment is the perfect illustration of what I mean when I say that psychology has sociology envy. Psychology is not the science of human behavior; that’s sociology. Psychology is the study of the human mind. For me the DSM is the perfect symbol of how far psychology and psychiatry has wandered off into the sociological realm.

    All the classical psychologists where medical doctors (William James, William Wundt, Carl Jung, etc). But they did not see psychology as mental medicine; they saw medicine as applied philosophy. All three of the psychologists I mentioned were explicit on that point. The original purpose of medicine and psychology was to provide concrete data to illustrate and justify traditional philosophical conclusions. This is why, to this day, a PhD is a Doctorate in Philosophy (in field X).

    I agree with you that mental illness is a failed construct but that’s because I don’t think that medicine and human behavior was ever intended to be the focus of psychology at all. Put another way, my problem with “mental illness” as a construct is not the mental part but the illness part because illness has come to be defined exclusively in a cultural normative sense. Again, that’s not because I don’t believe that people can’t be physically ill or engage in behavior that is inconsistent with cultural norms. It’s that I don’t recognize the treatment of the body or the treatment of non-normative human behavior as the practice of psychology; the former is medicine and the later is sociology.

    It’s interesting that you and I would both like to see the DSM in the trash can but for the exact opposite reasons. I guess the enemy of my enemy is still my friend.

  4. I strongly disagree with Diamond that diagnosis means "inherent medicalization, biological bias" etc. The problem is misdiagnosis, and losing sight of the problems with diagnosis.

    I'm also a little concerned at the idea of psychologists riding to the rescue of the mental health field at the expense of psychiatry because the last time that happened it didn't end well (Freudianism - OK, he was a neurologist, but he wrote psychology).

    Balance is everything...


Real Time Web Analytics