Turn on, Tune in, Drop out

Well, I don’t know about the drop out part. But if you turn on your radio and tune in to Science Friday, an NPR show, today at 215, you will hear Tom Insel, head of NIMH, Jeff Lieberman, president of the APA, and me talk about whatever Ira Flatow wants us to talk about.


Insel and Lieberman reprise their rendition of Kumbaya, attributing their differences to a division of labor–the NIMH does research, which needs to detach itself from DSM, while the DSM is for clinicians, who need it.

Insel and Lieberman will team up to defend psychiatry against antipsychiatrists like me. But they will be very nice about it.

I will try to explain  why I am not an antipsychiatrist, which is sort of like explaining that you don’t beat your wife. I will also be very nice about it.

Insel and Lieberman will say that I indict the DSM because its diagnoses don’t have any biology to them, but that this is a straw man argument. They will point out that many medical diagnoses are like DSM diagnoses, and that it is unreasonable to hold psychiatry to a standard that the rest of medicine does not meet.

I will try to explain that I never said I think biology is a necessary condition for determining that a particular suffering is a disease. I will then try to explain that nonetheless the biology thing is the myth that gives us confidence in what doctors tell us, and that the DSM is an attempt to command confidence by suggesting that psychiatry knows more than it does. I will try to invoke history, the way that the DSM-III was a response to a crisis of confidence. I may even  invoke David Brooks, who accused psychiatry of having Physics Envy. But I probably won’t get far, since this is a hard one to get into NPR-=sound-bite shape.

They will say that we can’t do without the DSM, for the sake of the patients.

I will say that this is what people in bad marriages say all the time–that it’s bad but must be preserved for th sake of the children. I will allow that sometimes the parents are right, and sometimes they are wrong.

We will agree that psychiatry has a long way to go.

And, most important, I will talk about “my book” as often as possible.


7 Responses to “Turn on, Tune in, Drop out”

  1. Choo says:

    Greenberg got owned.

  2. gary says:

    Maybe, but I think it was more like rented.

  3. Great stuff. Fascinating conversation. Time ran out right when things began to get interesting. Ira tried to stoke the flames but the 2 establishment guests had to appear establishmentesque so no real banter ensued.

    Gary, I’m reading your book and it’s absolutely brilliant and fair. I swear I feel like my IQ goes up 20 points every time I read your work. Thanks for that.

    Psychiatry appears too self-important & comfortably installed in the healthcare infrastructure now for any of us to really expect an introspective reflection from within. I’m afraid history won’t be any kinder to them about what they’re doing now than when they classified Homosexuality as a mental disorder just 40 years ago. Internet Use Disorder will be laughable in 10 years time as technologies like Google Glass get embedded in our everyday activities. They’ll have to remove it and do the whole “we’ve gotten better” bit. If we’re lucky they might have one bio-marker to tout that they should be in medicine. And they’ll add a new one, like Exercise Induced Binge Drinking.

  4. This is really something. When Fox News throws the DSM 5 under the bus, things get interesting: http://www.foxnews.com/health/2013/05/30/caffeine-withdrawal-made-up-condition-included-in-dsm-5/

    What about Incandescent Lightbulb Hoarding Disorder..?

  5. Hello Gary,
    Great job on Science Friday yesterday; you gave a straight-up challenge to the validity of the DSM diagnoses. This is a critical issue since the validity of the medical model advanced by the DSM informs most of mental health care.
    I am not a good public speaker so I admire your patience and delivery during the broadcast. However, Dr. Lieberman (or Dr. Insel) made a surprising announcement that was hard to accept; he stated that scientists have recently discovered the beginnings of biological markers for mental “disorders.” I don’t believe these “discoveries” will endure the test of time any better than other pseudoscience that previously supported a biological or genetic foundation for mental distress. Moreover, I disagree with the value of psychotropic drugs; while I’m not against medicating emotional emergencies, psychotropic medications have problematic side effects. Besides the well known physical side effects, psychotropic drugs cause physical fatigue and a mental fogging that inhibit the ability to solve real problems that cause mental distress.
    Thanks again for challenging the validity of the DSM.
    Best regards, Steve Spiegel

  6. Lisa says:

    I missed your NPR interview but your Layna Berman interview (on the Your Own Health and Fitness radio show) was an excellent, in depth and hard hitting examination of the issues. I look forward to reading your book.

  7. Bought the book a couple of days ago, and am enjoying reading it. Brilliantly written; as someone who struggles with severe depression, I’ve laughed so much reading the book, I thought for a minute I was cured. Thanks for the relief! Has done more for me than a pile of Zoloft.

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