Where is its mind? What the battle over it’s ‘bible’ says about psychiatry

Is the time up for the notion that mental “illness” can be categorised and fixed with drugs? A wry reflective artivle about Elliot Spritzer, whose brainchild it was to collate a handy guide to diagnosis- to make it easier, more reliavble, became the monster we now call the DSM. Undergoing its fifth revision, the DSM is requiring psyhiatry to examine the very process it has used to establish itself as a legitimate discipline of modern “medicine”.


Top Story in Globe & Mail, 10 July 2011 by Ian Brown

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It’s possible, looking back on Robert Spitzer’s life as one of the most influential psychiatrists of the 20th century, to conclude that he had a genius for turning grudges into career moves.

 He then became a psychoanalyst. And when talk therapy didn’t cure his patients fast enough, he created the modern Diagnostic and Statistical Manual of Mental Disorders, the bulky tome that revolutionized psychiatry and drove the last nail into Sigmund Freud’s coffin.

But revenge has a way of biting back. A new group of psychiatrists is now under fire as they try to prepare the latest edition of the DSM, the Sears Catalogue of mental illness, used by more than 28,000 psychiatrists to diagnose their patients’ afflictions.

The controversy over the proposed DSM-5 is forcing psychiatry to analyze its own issues – its fervid embrace of drugs; its enthusiastic use of genetics and brain imaging to expand existing diagnostic categories, perhaps prematurely; and the limits of its ability to understand the human mind.

This may, in turn, open the door again, at least a little, to talk therapy and Dr. Spitzer’s old enemy, the unconscious. For the failing notion that mental illness can be crisply categorized and fixed with drugs – an idea Dr. Spitzer helped to invent, and that then dominated mental health for 30 years – it seems the time, as the shrinks like to say, is up.

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