Why Psychiatry Needs Therapy
28th February 2010
To flip through the latest draft of the American Psychiatric Association’s Diagnostic and Statistical Manual, in the works for seven years now, is to see the discipline’s floundering writ large. Psychiatry seems to have lost its way in a forest of poorly verified diagnoses and ineffectual medications. Patients who seek psychiatric help today for mood disorders stand a good chance of being diagnosed with a disease that doesn’t exist and treated with a medication little more effective than a placebo.
My view is that psychiatry is a pseudo-science, like astrology, in which the principles of the discipline bear no causal relationship to the real world and its operations. To the extent that it actually accomplishes anything at all, it is because of incorporation of real scientific fields like medicine.
Jerry Pournelle says:
DSM has, in my judgment, far too often been influenced by the pharmaceutical industry, and used to justify payments from insurance; it is, in my judgment, one of the many reasons for the high costs of health care, since “mental health” coverage is now generally required in state mandated healthcare insurance policies as one of the “minimum” requirements. As to the conflicts between the Freudian analyst based theories of mental disorder and the behavior-based medical theories that generally prescribed chemical treatment, that was just beginning when I left psychology graduate school. Of course my emphasis in psychology was in engineering and human factors on the one hand, and mathematical and statistical analysis using tests and measurements on the other, so I am hardly an expert on abnormal psychology.
I am very glad that the DSM did not exist when I was growing up. I would almost certainly have been diagnosed with a disorder that could only be cured by drugs. As it happens, I was “cured” by being forced to learn a modicum of self-discipline.