Why DSM Is Mostly False
27th August 2025
A decade ago, the fifth revision of DSM (the Diagnostic and Statistical Manual) was published by the American Psychiatric Association. This diagnostic system has been called the “Bible” of psychiatry. The metaphor suggests some cultural realities. It tends to be worshipped; some view it as the literal truth; it can inspire, but it can be used to suppress dissent. The problem is that DSM can’t be a Bible and science at the same time.
In this article, I examine what the DSM system is and what it isn’t. The brief summary is that it has become more like a religion, and less and less scientific. (Much of the source evidence for the details of the DSM-III history can be found in this book by Hannah Decker.)
Psychology is like economics, a shamanistic magic system masquerading as a science. All you need to know is how often either of them makes a prediction that comes true. A real science makes predictions that come true Every Single Time. Medical doctors, who also deal with chaotic complex badly-understood systems, at least don’t pretend that theirs is a science–it has scientific aspects, of course, but (again) it cannot make predictions that come true Every Single Time.