Causation Theories

In these days with limited access to mental health facilities, and when in-patient or out patient treatment might be focused on invasive treatments and not on recovery, you may be tempted to "provide sanctuary" for a friend or family member who is experiencing serious mental health challenges. Many of you have probably already done this.

If you’ve been paying attention the last two years, you’ve seen the new DSM-5, as well as its predecessors, taking a beating from a variety of critics pre- and post-publication. Most have begun by noting the lack of construct validity of DSM’s diagnoses, dating from the landmark DSM-IIIR in 1987. Given the absence of scientific evidence to support their existence, these diagnoses were less likely to represent the neurobiological phenomena claimed by the DSMs’ several authors than to be products of their collective imaginations.

When we share our stories publicly, whether in speaking, writing, or another art form, we acknowledge we are part of something bigger. We are aware we aren't the only ones who have been abused or witnessed abuse, or who are scared to let go of our ancestral shame and fear. We are, rather, part of an entire generation, an entire society that is moving away from silence, blame and abuse. In sharing our stories, we instantly recover from a big hunk of loneliness, loneliness that might not be so easily resolved sitting in a room across from a professional, with a few non-offensive art pieces on the walls. We acknowledge that every single one of us who experiences physical or emotional symptoms is holding onto things for others, in our bodies, and together, word by word, we can break free.

If we believe that emotional problems are primarily disorders of the brain, then perhaps taking a “fill-in-the-blank” medical history is sufficient. However, if we believe that emotional crises and dis-ease are problems that exist between people, in our sticky or not-so-sticky web of relationships, then whether families, survivors and those in crisis can heal together is a much more relevant, if still complicated, question. Perhaps the most honest answer to this question is: “It depends..."

Just as the American Psychiatric Association's (APA) long-delayed DSM5 was about to launch, the director of NIMH, Dr Thomas Insel, provoked a flurry of acrimony when he mentioned in his blog that his organisation intended to move away from the ideas behind DSM: “Patients with mental disorders deserve better... NIMH will be re-orienting its research away from DSM categories... we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system”. It now seems Insel's comments had more to do with NIMH funding needs than points of principle.

I live a slow paced life. I meditate every morning, refuse to get a smart phone (yet), and it takes me generous amounts of time to do things. This isn't because I am “stupid” or slow to get things. Sometimes I wonder how others get so much done each day - yet the quality and vibration of what I do is unique. It needs time. How does this relate with psychiatric drugs? Psych drugs are rooted in impatience, urgency, emergency.

In the film Avatar, scientists are keen to exploit the moon planet Pandora which is inhabited by 10-foot-tall blue humanoids called Na'vi.  To do so they create Na'vi human hybrids called “Avatars” which are controlled from afar by genetically matched humans. When the scientists decide to destroy the eco-system of the planet to gain access to valuable minerals, war breaks out between the humans and the Na'vi. At this point the main character, Jake, who operates an Avatar, has to choose whose side he is on.  Eventually Jake's life is saved and transformed by the Tree of Souls, which the humans are trying to destroy. Why are Avatars in the news again? The latest innovation from psychiatric research is using computer-generated avatars to help people who hear aggressive voices.

In the film Avatar scientists are keen to exploit the moon planet Pandora, which is inhabited by 10-foot-tall blue humanoids called Na'vi. To do so they create Na'vi human hybrids called “Avatars” which are controlled from afar by genetically matched humans. When the scientists decide to destroy the eco-system of the planet to gain access to valuable minerals, war breaks out between the humans and the Na'vi. At this point the main character, Jake, who operates an Avatar, has to choose whose side he is on. Eventually Jake's life is saved and transformed by the Tree of Souls, which the humans are trying to destroy. Why are Avatars in the news again? The latest innovation from psychiatric research is using computer generated avatars to help people who hear aggressive voices.

Researchers from Columbia University and the New York State Psychiatric Institute test the behavioral effects of SSRIs on Pavlovian fear conditioning in rats, and...

The Association for Psychological Science (APS) was founded twenty years ago by psychologists and neuroscientists who were dismayed by trends in the American Psychological Association (APA). The APA had lost its old single-minded focus on the search for empirically based answers to psychological questions. This may have followed from the fact that the APA’s membership encompassed an ever-larger percentage of practicing psychologists with many immediate, practical concerns. Yet it is these very clinicians who are in such dire need of empirically validated procedures. It might be time to summarize newer empirical literature that challenges the assumption that the mere expression of emotion is helpful.

Why all the fuss over DSM-5? Why did Robert Spitzer, the editor of DSM-III, begin to protest about the “secrecy” surrounding its production as early as 2007? Why did Allen Frances, editor of DSM-IV, begin in 2009 to challenge the American Psychiatric Association’s (APA) announced goal that when making DSM-5 “everything is on the table”? Why did he dispute the APA’s position that there had been enough progress in neuroscience to call for a “paradigm shift”, and why did Frances and others go on to protest repeatedly what they viewed as DSM-5’s “medicalization of normality?”

Gary Greenberg gets a chance to engage with Thomas Insel and Jeffrey Lieberman on the risks and benefits associated with psychiatric diagnosis and the...

This is not just about pregnancy loss and motherhood. This is reflective of how we treat many people who have experienced pain and are expressing it in ways not immediately relatable to those around them. It is about how we as a society may contribute to some of the truly awful things that happen not by failing to properly screen and assess, but by quite successfully fostering fear and alienation.

Greetings, MIA readers. Would you like to write your own review of the DSM-5 (even if you haven’t read it, never mind bought it.) I’ve done neither, but I’ve read, talked, written enough about it to have an opinion. Write your own review of the DSM-5 on Amazon …Here's the link

I've just returned from a meeting of 17 activists self-identified as users or survivors of psychiatry, or people with psychosocial disabilities, from all over the world. Literally all over the world. An international gathering of human rights defenders that makes me proud to be among them. It was a meeting where I felt heard and acknowledged and able to fully give what I had to give - to offer it up along with everyone else's contributions for the common deliberation. I gave all and received all in return.

You never know what you’re going to accomplish when you start something. Who could have predicted that Tom Insel and NIMH would throw the APA and the DSM under the bus? My guess is that two factors played a big part in NIMH’s decision. First, the unceasing barrage of criticism directed at the DSM – its lack of construct validity; its declining inter-rater reliability – had damaged its credibility beyond repair. On top of that, thirty years of DSM-based research had produced no biomarkers.

Robert Whitaker notes on Al Jazeera's "Inside Story" that a helpful diagnostic text must be both reliable and valid, and the DSM is neither...

The Critical Psychiatry Network is concerned with the way the controversy over the publication of DSM-5 is being portrayed in the media and by some academic psychiatrists. The issues raised by the DSM are complex and require careful and studied consideration. There are two aspects in particular that concern us. These relate to the portrayal of the controversy as a guild dispute, and the polarisation of the debate as one of nurture versus nature.

Americans have increasingly lost community and autonomy, and have acquired instead the tyranny of institutionalization: domination by gigantic, impersonal, bureaucratic, standardized entities — visible in large corporations, the workplace, health care, schools, and much of our lives. This institutionalization has made many Americans feel small, isolated, helpless, scared, inattentive, bored, angry, alienated, and depressed.

Jeffrey Lieberman, incoming president of the APA, responds to criticism of the DSM and psychiatry, saying "it’s important to understand the difference between thoughtful,...

People in roles of power in the mental health system often don’t realize how much complicity they have in actually creating the symptoms they claim are biologically-based in individuals with psychiatric labels.

The recent furore surrounding publication of the new DSM has provided a much-needed opportunity to discuss and debate crucial issues about how we make sense of, and respond to, experiences of madness and distress. Many psychiatrists, psychologists and other mental health professionals have expressed their dismay about the dominance and inadequacy of a biomedical model of mental illness. Whilst we share these concerns, welcome these debates and support colleagues that are willing to take a stand, The Hearing Voices Network believes that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system.

Schizophrenia Bulletin publishes a review of published articles that finds the use of schizophrenia subtypes (Catatonic, Disorganized, Paranoid, Residual & Undifferentiated), "while widely used...

Monica Cassani promises to add to Beyond Meds' chronicle, today and for the next week or so, of emerging coverage on the DSM rollout....

Tomorrow, May 18, the American Psychiatric Association kicks off its 166th annual conference. That same day, its new DSM-5 will be officially published. Given the occurrences of the past couple of weeks, which I’ll review briefly below, some members of the APA might wish tomorrow’s events would go unnoticed. But they won’t.