MAKING US CRAZY

Rating:
Summary: Important Book, if not always an easy read
Review: For those of us who eagerly consume critiques of the mental health industry, this book is not necessarily what we have come to expect. I often expect what amounts to a quick adrenalin rush, with horror stories of abuse by the system driving me to the barricades. Kutchins and Kirk do not provide a quick rush, nor even a quick read. But when you find yourself on the barricades, they do give you the ammunition.

This is a very detailed social/political history of the DSM, in and out of committee meetings and individual correspondence, providing the evidence of the point made so well by others such as Kaplan: that the DSM is in fact a political document, evolving to suit conflicting political and financial interests. More than a story of good guys and bad guys, much of this history includes the sad moral of unintended consequences, as in the fight to get PTSD into the DSM.

I teach undergraduate psychology, and I applaud the authors' coherent explanations of technical issues such as reliablity and validity of assessment. My teaching experience informs me that this is a tedious exercise for most students, and, I assume, for the educated lay readership to whom Kutchins and Kirk appeal. But it is critical to the central theme of the story: the misuse of the aura of science to mask a fundamentally political process.

Are there victims and villains of this process? Of course, and they are the usual villains: a system of managed care, and a variety of bureaucracies and agencies pursuing government funding, grants and influence based on ultimately manipulated numbers. And the usual victims: the over-labelled, over-prescribed and stigmatized recipients of "care".

The story wanders through so many mazes that a reader may lose the thread: PTSD, homosexuality, female masochism, borderline personality disorder. Each story differs in who started the process of getting a diagnosis in or out of the DSM, the motivation for doing so, the outcome of the fight, and the specific consequences. Fortunately, the authors provide an excellent summary in the last chapter, and weave those threads back together.

More than once in reading this book, I found myself thinking that every political or social issue fight needs its policy wonks. Kutchins and Kirk may be our wonks.

Rating:
Summary: Important Book, if not always an easy read
Review: For those of us who eagerly consume critiques of the mental health industry, this book is not necessarily what we have come to expect. I often expect what amounts to a quick adrenalin rush, with horror stories of abuse by the system driving me to the barricades. Kutchins and Kirk do not provide a quick rush, nor even a quick read. But when you find yourself on the barricades, they do give you the ammunition.

This is a very detailed social/political history of the DSM, in and out of committee meetings and individual correspondence, providing the evidence of the point made so well by others such as Kaplan: that the DSM is in fact a political document, evolving to suit conflicting political and financial interests. More than a story of good guys and bad guys, much of this history includes the sad moral of unintended consequences, as in the fight to get PTSD into the DSM.

I teach undergraduate psychology, and I applaud the authors' coherent explanations of technical issues such as reliablity and validity of assessment. My teaching experience informs me that this is a tedious exercise for most students, and, I assume, for the educated lay readership to whom Kutchins and Kirk appeal. But it is critical to the central theme of the story: the misuse of the aura of science to mask a fundamentally political process.

Are there victims and villains of this process? Of course, and they are the usual villains: a system of managed care, and a variety of bureaucracies and agencies pursuing government funding, grants and influence based on ultimately manipulated numbers. And the usual victims: the over-labelled, over-prescribed and stigmatized recipients of "care".

The story wanders through so many mazes that a reader may lose the thread: PTSD, homosexuality, female masochism, borderline personality disorder. Each story differs in who started the process of getting a diagnosis in or out of the DSM, the motivation for doing so, the outcome of the fight, and the specific consequences. Fortunately, the authors provide an excellent summary in the last chapter, and weave those threads back together.

More than once in reading this book, I found myself thinking that every political or social issue fight needs its policy wonks. Kutchins and Kirk may be our wonks.

Rating:
Summary: The Only Book I've ever Returned
Review: I'm a big fan of Thomas Szasz; I enjoy the work of Peter Breggin; I am certainly a critic of modern psychiatry, the pathologizing of behavior, and labeling. HOWEVER, this is not a good book.

If there is a good book out there on the DSM, I would like to read it. This just isn't it.

For instance, there are a couple good points regarding Borderline Personality Disorder. However, it is buried in a chapter that attempts to assert that BPD was invented to free therapists from responsibility when they have sex with their patients.

Mostly, I just kept thinking "SO?" or "What's the point? ". I'm a psychiatric social worker, I use the DSM frequently, and I don't like it.

I would like to read a well-written book on the subject.

This just ISN'T it.

Rating:
Summary: weak arguments for a nonexistent point
Review: While there is nothing wrong with intelligent criticism, I could find very little in this book. Sadly, there are mental health professionals who abuse their positions and behave unethically, as there are in every other profession. That does not mean we should throw out the DSM because people have misused it.

It is also true that there has been bias arising from cultural ignorance, sexism, etc. And yes, politics is sometimes involved in decisions. Which profession has been immune from these things? In general, the mental health profession has been trying to increase professionals' understanding of cultural contexts for behavior through coursework and changes in the new DSM-IV-TR.

Even though this book sometimes includes actual material from the DSM, it basically misrepesents the facts about mental disorders. For example, it says a person can be diagnosed with major depression simply because he or she has trouble sleeping. While sleep disturbance may be a symptom of depression, someone who knows what she/he is doing knows that it may not be depression at all. Depression involves much more than that. The DSM is not perfect, and indeed a few classifications are questionable, such as schizoid personality disorder (extreme introversion). I am not sure whether that one is truly a disorder. The authors say that the DSM patholgizes everyday behavior. Does spending an hour or more every day washing one's hands over and over(obsessive compulsive disorder) seem like everyday behavior?

This book is weak and pointless, a disappointing attempt at criticism.