Appendix 41 - The DSM

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

One commentator felt that the thrust of Rosenhan's argument was that diagnostic labeling is a process, "fraught with error and one both countertherapeutic and dehumanizing."[467]

"The dream of reason did not take power into account" - The Social Transformation of American Medicine

The American Psychiatric Association claims that in publishing the DSM, in providing such ready-made diagnostic pigeon holes for people, more time could be allocated to caring for the patients. Critics are skeptical.

From "A Critique of DSM-III" published in Research in Law, Deviance and Social Control:

It is disingenuous to claim that DSM['s]... purpose is to free the clinician for a more caring relationship with the patient, when its whole weight is towards the totalization of an objectifying and dehumanizing attitude.... The existing official practice is an inhuman sham.

It is simply laughable to think that a document so redolent in technocratic power, and so stunningly devoid of any of the texture that goes into actually listening to people, will encourage the student to set aside 'free time' for caring clinical relationships.... Given DSM... as a tool, the young doctor will have a handy incentive not to undertake the often painful task of recognizing the other - and of recognizing one's self in this other called patient.

[Animists] ascribed personal shape and motivation to the constellation of the heavens.... Today's psychodiagnosticians do the reverse: they project inanimate, thing-like qualities into the person and call it science.

The Malleus [Maleficorum, a handbook used to diagnose witches centuries ago] was perhaps the first distinct precursor to the DSM... - a systematic compendium of forms of deviance, artfully constructed by men who were considered representatives of order and reason, and who devised their system to enforce submission to the prevailing reality principle.

In sum, DSM... provides the necessary linkage for the insertion of madness into the political-economic process. It brings madness to the level of the commodity. And it allows psychiatry to play the servile role of rationalizing this process while permitting it to preen itself for its liberal and scientific attitude. And above all, it perpetuates the very alienation that psychiatric practice is intended to heal.[468]



[467] Millon, T. "Reflections on Rosenhan's 'On Being Sane in Insane Places.'" Journal of Abnormal Psychiatry 84(1975):456-461.

[468] Kovel, J. "A Critique of DSM-III." Research in Law, Deviance and Social Control 9(1988):127-146.



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