"Only in psychiatry is the existence of physical disease determined
by APA presidential proclamations, by committee decisions, and even, by
a vote of the members of APA, not to mention the courts". - Peter Breggin,
"Some critics wonder if the multiplication of mental disorders has gone
too far, with the realm of abnormal encroaching on areas that were once
the province of individual choice, habit, eccentricity or lifestyle." -
Erica Goode, "Sick, or Just Quirky?"
"DSM-III represents a bold series of choices based on guess, taste,
prejudice, and hope ... few are based on fact or truth." - George Valiant,
"A Debate on DSM-III"
|This section is included because it is referenced in other of our pages.
The text below is taken directly from the Fourth Edition of the DSM-IV,
copyright 1994, printed in 1997. Realize that psychiatry seems to make
sense within it's own limited framework of nomenclature and definitions,
but then again so do all mythologies, and the fault with psychiatry is
not logical inconsistencies within the field, but severely flawed
basic assumptions about man, his mind, his behavior, life, the environment
and the relationships between these things. Psychiatric methods have been
and continue to be harmful to Man and society. They cannot even clearly
define basic concepts of their field such as "mental disorder" (see below).
DSM-IV: DIAGNOSTIC AND STATISTICAL
MANUAL OF MENTAL DISORDERS
Issues in the Use of DSM-IV
Limitations of the Categorical Approach
DSM-IV is a categorical classification that divides mental disorders
into types based on criteria sets with defining features. This naming of
categories is the traditional method of organizing and transmitting information
in everyday life and has been the fundamental approach used in all systems
of medical diagnosis. A categorical approach to classification works best
when all members of a diagnostic class are homogeneous, when there are
clear boundaries between classes, and when the different classes are mutually
exclusive. Nonetheless, the limitations of the categorical classification
system must be recognized.
In DSM-IV, there is no assumption that each category of mental
disorder is a completely discrete entity with absolute boundaries dividing
it from other mental disorders or from no mental disorder. There is also
no assumption that all individuals described as having the same mental
disorder are alike in all important ways. The clinician using DSM-IV
should therefore consider that individuals sharing a diagnosis are likely
to be heterogeneous even in regard to the defining features of the diagnosis
and that boundary cases will be difficult to diagnose in any but a probabilistic
fashion. This outlook allows greater flexibility in the use of the system,
encourages more specific attention to boundary cases, and emphasizes the
need to capture additional clinical information that goes beyond diagnosis.
In recognition of the heterogeneity of clinical presentations, DSM-IV
often includes polythetic criteria sets, in which the individual need only
present with a subset of items from a longer list (e.g., the diagnosis
of Borderline Personality Disorder requires only five out of nine items).
|A major problem with this is the application of modern psychiatric
methods consistently leads to different diagnosis and treatments
for the same patient by different psychiatrists! Why?
First, because the supposed disorders have unclear boundaries, are not
discrete entities, and people with the disorders don't necessarily have
similarities (in their own words). If botanists began saying things
like, "leaves are not that different from stems, and we can't clarify them
as different things really; a tree trunk is operationally like a branch
which is also structurally like a bud; let's call it a tree if it has 3
of these sub-categories of leaves, buds, branches, roots, and bark..",
there would be a very unusual and unworkable subject of botany. Let's be
real here. Leaves are leaves and trees are trees!
Second, because as a "profession" the psychiatrists tend to occupy the
"bottom" of the class of the medical schools judging by grades. They are
simply not as bright as other medical professionals, and this compounded
with an already very complex diagnostic subject results in divergent opinions,
diagnosis and treatments. This subject is very far from being a "science"
of any sort. I personally wouldn't place my well-being in the hands of
any of them. That's asking for trouble!
Psychiatry's failure to do a strict analysis, observation, and categorizing
of the functions of a mind has
resulted in 1) a failed subject of the mind, 2) absurd theories and practices
parading as "modern science", and 3) explanations like the above few paragraphs
in the DSM which explain in excruciating detail just WHY they can't
and don't need to be strict regarding distinct categories of the mind!
It was suggested that the DSM-IV Classification be organized following
a dimensional model rather than the categorical model used in DSM-III-R.
A dimensional system classifies clinical presentations based on quantification
of attributes rather than the assignment to categories and works best in
describing phenomena that are distributed continuously and that do not
have clear boundaries. Although dimensional systems increase reliability
and communicate more clinical information (because they report clinical
attributes that might be subthreshold in a categorical system), they also
have serious limitations and thus far have been less useful than categorical
systems in clinical practice and in stimulating research. Numerical dimensional
descriptions are much less familiar and vivid than are the categorical
names for mental disorders. Moreover, there is as yet no agreement on the
choice of the optimal dimensions to be used for classification purposes.
Nonetheless, it is possible that the increasing research on, and familiarity
with, dimensional systems may eventually result in their greater acceptance
both as a method of conveying clinical information and as a research tool.
Use of Clinical Judgment
DSM-IV is a classification of mental disorders that was developed
for use in clinical, educational, and research settings. The diagnostic
categories, criteria, and textual descriptions are meant to be employed
by individuals with appropriate clinical training and experience in diagnosis.
It is important that DSM-IV not be applied mechanically by untrained
individuals. The specific diagnostic criteria included in DSM-IV
are meant to serve as guidelines to be informed by clinical judgment and
are not meant to be used in a cookbook fashion. For example, the exercise
of clinical judgment may justify giving a certain diagnosis to an individual
even though the clinical presentation falls just short of meeting the full
criteria for the diagnosis as long as the symptoms that are present are
persistent and severe On the other hand, lack of familiarity with DSM-IV
or excessively flexible and idiosyncratic application of DSM-IV
criteria or conventions substantially reduces its utility as a common language
Use of DSM-IV in Forensic Settings
When the DSM-IV categories, criteria, and textual descriptions
are employed for forensic purposes, there are significant risks that diagnostic
information will be misused or misunderstood. These dangers arise because
of the imperfect fit between the questions of ultimate concern to the law
and the information contained in a clinical diagnosis. In most situations,
the clinical diagnosis of a DSM-IV mental disorder is not sufficient
to establish the existence for legal purposes of a "mental disorder," "mental
disability," "mental disease," or "mental defect." In determining whether
an individual meets a specified legal standard (e.g., for competence, criminal
responsibility, or disability), additional information is usually required
beyond that contained in the DSM-IV diagnosis. This might include
information about the individual's functional impairments and how these
impairments affect the particular abilities in question. It is precisely
because impairments, abilities, and disabilities vary widely within each
diagnostic category that assignment of a particular diagnosis does not
imply a specific level of impairment or disability.
|This is very interesting and telling, because it is usual to assume
when in a court of law, that the goal is to place the discovery of truth
above all else. Psychiatry's standard "bible" on disorders admittedly is
incapable of strict application in ascertaining whether a person actually
"has" any of these "disorders". The psychiatrist is apparently much more
comfortable under a "less stringent" environment where questions of truth
and actuality aren't relevant. Also, the law involves responsibility and
competence, two subjects admitted again to be out of the realm of psychiatry's
Responsibility and competence are two KEY aspects of any person - qualities
usually thought to derive from their basic inner personality or mind. Again,
psychiatry leaves this out of their provence. Psychiatry is a field dealing
largely in categorizing the problems
(what's wrong) with people, their environments and their minds. Psychiatry
NEVER deals with observing, initiating, developing or improving responsibility
or competence in anyone! Again, this seems very strange to me. A subject
dealing with Man and his mind, would and should strive to get familiar
with the basic functions and capabilities of Man and his mind, with a goal
to discover ways to help assist in expanding and improving these things.
It should be very obvious to anyone that measures taken to improve responsibility
and competence would have wide ramifications across the entire range of
things called by psychiatry to be "mental disorders". In other words, successful
methods to achieving increased competence and responsibility would have
a natural and necessary side effect of reducing any "mental disorders".
"Mental disorders" and "illnesses" are largely a failure to take
responsibility and exercise control over one's own mind, emotions, behavior
and environment. A valid subject of Man and his mind would involve
methods to do these things. Psychiatry does none of these things,
and actually initiates "solutions" which act in the opposite direction,
to reduce even further responsibility and control of one's own mind, behavior,
First, drugs, shock, lobotomy and involuntary commitment each act to
control and exert force on the individual, and reduce clarity
of awareness, perception, feelings, and everything needed to be fully responsible
and in control. These methods each dull the source of responsibility
- the person them self.
Second, the entire ideological
approach of psychiatry is one of "no-responsibility". How so? 1) "Oh, don't
feel bad Bill. In the old days you would have been told your perversions
were your own fault, but today we know it's just a mental illness and you
aren't to blame. There's nothing you can do about flashing those three
children except take your medication. You aren't responsible". 2) "The
criminal needs to be understood and not punished. Even murderers and rapists
actually are the victims of specific mental disorders. They suffer from
a condition just like cancer or arthritis. They can't stop their behavior
anymore than someone else could just decide for their cancer to go away.
We need to do more research on the chemical imbalance that causes the criminal
Responsibility and control are "mind" functions of the inner
personality. These need to be acknowledged, encouraged, and developed through
a true understanding of what these are. When they are, people are happier
and society is more sane and stable. Modern psychiatry has completely erased
these factors from the human equation. Their solution to everything is
drugs and shock. In fact, their approach attacks the idea of personal responsibility
and control as solutions. The only time you will here the terms responsibility
and control out of their mouths is when it involves "responsibility to
take your medication" and "controlling your urges to refuse to undergo
psychiatric treatment". In fact, they have even created a "mental disease"
for those people not wanting to go along with their stupid system and methods
- it's called "V15.81 Noncompliance With Treatment". How convenient! And
they call this "science". . .
Nonclinical decision makers should also be cautioned that a diagnosis does
not carry any necessary implications regarding the causes of the individual's
mental disorder or its associated impairments. Inclusion of a disorder
in the Classification (as in medicine generally) does not require that
there be knowledge about its etiology. Moreover, the fact that an
individual's presentation meets the criteria for a DSM-IV diagnosis
does not carry any necessary implication regarding the individual's degree
of control over the behaviors that may be associated with the disorder.
Even when diminished control over one's behavior is a feature of the disorder,
having the diagnosis in itself does not demonstrate that a particular individual
is (or was) unable to control his or her behavior at a particular time.
|These lines (in red) admit no understanding or dealing with actual
causes. The psychiatric field spends the majority of it's time 1) investigating
what's wrong with people and their minds, 2) categorizing these results,
and 3) prescribing drugs. There is no serious research to discover what
causes these situations and problems from a viewpoint of "mind"
or "mental". All research is directed at convincing the "profession" and
public that the various "conditions" are due to purely physiological causes
such as genetics and chemical imbalances in the brain. The research is
largely funded by groups and associations with direct ties to the major
drug companies who require acceptance of the notion that all mental illness
is due to biochemical causes (which they offer the solution to in the form
It must be noted that DSM-IV reflects a consensus
about the classification and diagnosis of mental disorders derived
at the time of its initial publication. New knowledge generated by research
or clinical experience will undoubtedly lead to an increased understanding
of the disorders included in DSM-IV, to the identification of new
disorders, and to the removal of some disorders in future classifications.
The text and criteria sets included in DSM-IV will require reconsideration
in light of evolving new information.
|The "consensus" is presented as a professional agreement based upon
incredibly scientific methods and modern advanced understanding. This is
simply hogwash. The "consensus" is largely the current agreement among
practicing psychiatrists of their own bias, miseducation, faulty logic
and invalid basic postulates of the subject of Man, his mind, and life.
he use of DSM-IV in forensic settings should be informed by an
awareness of the risks and limitations discussed above. When used appropriately,
diagnoses and diagnostic information can assist decision makers in their
determinations. For example, when the presence of a mental disorder is
the predicate for a subsequent legal determination (e.g., involuntary civil
commitment), the use of an established system of diagnosis enhances the
value and reliability of the determination. By providing a compendium based
on a review of the pertinent clinical and research literature, DSM-IV
may facilitate the legal decision makers' understanding of the relevant
characteristics of mental disorders. The literature related to diagnoses
also serves as a check on ungrounded speculation about mental disorders
and about the functioning of a particular individual. Finally, diagnostic
information regarding longitudinal course may improve decision making when
the legal issue concerns an individual's mental functioning at a past or
future point in time.
Ethnic and Cultural Considerations
Special efforts have been made in the preparation of DSM-IV to
incorporate an awareness that the manual is used in culturally diverse
populations in the United States and internationally. Clinicians are called
on to evaluate individuals from numerous different ethnic groups and cultural
backgrounds (including many who are recent immigrants). Diagnostic assessment
can be especially challenging when a clinician from one ethnic or cultural
group uses the DSM-IV Classification to evaluate an individual from
a different ethnic or cultural group. A clinician who is unfamiliar with
the nuances of an individual's cultural frame of reference may incorrectly
judge as psychopathology those normal variations in behavior, belief, or
experience that are particular to the individual's culture. For example,
certain religious practices or beliefs (e.g., hearing or seeing a deceased
relative during bereavement) may be misdiagnosed as manifestations of a
Psychotic Disorder. Applying Personality Disorder criteria across cultural
settings may be especially difficult because of the wide cultural variation
in concepts of self, styles of communication, and coping mechanisms.
|This is an excellent example of the absurdity of psychiatric classification
and diagnosis; in their own words no less! A person who hears or sees a
dead relative is NOT considered to have a "mental disease" in one culture,
because the culture accepts this phenomena. whereas in a culture that doesn't
accept the phenomena, the person is labeled with "psychosis". More importantly,
what if he really is hearing or seeing the dead! It makes no difference
to the psychiatrists.
The index for deciding is what does the culture consider normal and
acceptable? This basically says that whenever a society alters its
general attitude about any topic that any persons who falls outside of
the rigidly "normal" average of social acceptance will be labeled as "mentally
ill". This is not an oversimplification; this is exactly how psychiatry
operates. This entire approach involves enforcing conformity of thought
and behavior. Fit in, think and behave how you are supposed to or submit
to drugs or electric shock treatments. The key point is that the same exact
"mental" attitude in two different cultures gets two different diagnosis.
I can guarantee that if a person has cancer in America they will also have
it in South Africa! The same for any real physical disease.
The psychiatric "diseases" are a sham. See them for what they are and
refuse to contribute to the delusion. Read on for more psychiatric shenanigans.
The provision of a culture-specific section in the DSM-IV text,
the inclusion of a glossary of culture-bound syndromes, and the provision
of an outline for cultural formulation are designed to enhance the cross-cultural
applicability of DSM-IV. It is hoped that these new features will
increase sensitivity to variations in how mental disorders may be expressed
in different cultures and will reduce the possible effect of unintended
bias stemming from the clinician's own cultural background.
Use of DSM-IV in Treatment Planning
Making a DSM-IV diagnosis is only the first step in a comprehensive
evaluation. To formulate an adequate treatment plan, the clinician will
invariably require considerable additional information about the person
being evaluated beyond that required to make a DSM-IV diagnosis.
|What adequate treatment plan? This makes it sound like the psychiatrist
will spend time evaluating many possible alternatives for the disorder.
This is a complete joke. The psychiatrist has only one or two solutions
to offer. It's either drugs or electric shock. The drug companies state
clearly with their drug literature which drugs are for what DSM-IV
determined "illnesses". A psychiatrist is trained to believe
that you and your mind are 100% biochemical in nature, and to apply drugs
or shock as the ONLY solutions to whatever diagnosis you get labeled with.
A psychotherapist or counselor might attempt to deal with the mental
and emotional problems directly, working to increase personal responsibility
and control, but not a psychiatrist. Never! The psychiatrist is
trained completely and solely into a medical viewpoint of "mental disorders".
This is what they are and what they do. Don't look to find or expect anything
Distinction Between Mental Disorder and
General Medical Condition
The terms mental disorder and general medical condition are used throughout
this manual. The term mental disorder is explained above. The term general
medical condition is used merely as a convenient shorthand to refer to
conditions and disorders that are listed outside the "Mental and Behavioral
Disorders" chapter of ICD. It should be recognized that these are merely
terms of convenience and should not be taken to imply
that there is any fundamental distinction between mental disorders and
general medical conditions, that mental disorders are unrelated to physical
or biological factors or processes, or that general medical conditions
are unrelated to behavioral or psychosocial factors or processes.
|This is a required and necessary fundamental tenant of the modern
20th century religion known as psychiatry. It is an orthodox belief
system, largely false and misguided, parading as science. There are
major distinctions between mental conditions and physical conditions. There
are relationships between a mind, the body, behavior and social
factors. The authors of the DSM-IV labeled the notion of distinct
mental and physical causes as "a reductionistic
anachronism of mind/body dualism". The true reductionistic phenomena
is psychiatry's persistent demand that the mind doesn't exist as anything
unique of itself, and instead that it completely falls under the headings
"physical", "chemical" and "biological" as far as any theories or methods
The above section (in red) must be repeatedly promoted and put forward
as "truth" and "fact" by the psychiatric, medical and pharmaceutical fields
in a constant attempt to maintain the "party line" and elicit strong public
agreement. The current psychiatric drug "solution" would be impossible
without this agreement. Again, it is meaningless whether this is done out
of careful planning and intentional design, or whether it's the result
of stupidity, a collapsed educational system, miseducation and carelessness.
Either way it's happening, and the individual pays with personal mental
and spiritual deterioration, while society as a whole pays with increasing
crime, immorality, violence and a sabotaged educational
Read first hand for yourself and discover the true nature of psychiatry
as a very complicated modern mythology masquerading as "true science".
Where else would one find "coffee drinking" (292.9 Caffeine-Related Disorder)
turned into a mental illness! Smoking is now classified as a mental illness
also! You'll find it under category 305.10 Nicotine Dependence, and 292.0
Nicotine Withdrawal. Yes, smoking does have an addictive aspect. No, drug
addiction is not a mental illness! It's simply drug addiction - the reaction
physically and mentally to drug taking. "Withdrawal" is a physiological
reaction to stopping the taking of a drug. It is not a mental illness either!
Of course, more mental illnesses in the catalog (DSM-IV) justifies
more psychiatrists, government involvement, drugging of the public, electric
shock, brain surgery and involuntary commitment. It truly is a self perpetuating
leviathan. More "disorders" gives us more psychiatrists and increased funding
of psychiatry, which then gives us more "disorders", and round and round
published by the American Psychiatric Association
Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's
Normal by Paula J. Caplan, Ph.D.
Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders
by Herb Kutchins, Stuart A. Kirk
Myth of Mental Illness: Foundations of a Theory of Personal Conduct
by Thomas S. Szasz, M.D., Professor
Liberty, and Psychiatry : An Inquiry into the Social Uses of Mental Health
Practices by Thomas S. Szasz, M.D., Professor
Casebook: A Learning Companion to the Diagnostic and Statistical Manual
of Mental Disorders by Robert L. Spitzer, Miriam Gibbon, Andrew
E. Skodol, Michael B. First
Made Easy: The Clinician's Guide to Diagnosis by James Morrison
Criteria from DSM-IV (4th Ed) by John S. McIntyre
Back to Main DSM-IV Page
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Truth in all subjects...
|©Gene Zimmer 1999 ALL RIGHTS RESERVED