NIMH Delivers A Kill Shot To DSM-5


From the article:

DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. (Thomas R. Insel, M.D., Director of the National Institute of Mental Health)

I think this is very good news. Notice how it changes the semiotics of mental illness. A better paradigm for mental illness is that intolerable stress causes a wide variety of symptoms in people. A major stressor of this type is, of course, interpersonal stress. FIML cannot by any stretch of the imagination fix all mental illness, but it can help suitable partners greatly reduce interpersonal stress.

Edit: Yesterday, I read reasonable objections to Insel’s statement to the effect that we are not able to obtain “laboratory measure(s),” or biological markers, for all mental illness. I completely agree with this objection.

The synthesis of the two points of view (Insel v/ the DSM) seems to me to be that drugs should only be very guardedly prescribed, if they are prescribed at all, in situations where there are no “laboratory measures” or biological markers (both are fairly vague terms).

Does interpersonal stress produce biological markers? I bet it does. Does interpersonal stress of the type that can probably be cured by FIML practice produce biological markers? I bet it does. But I also bet that it would be far better to try FIML, or something else, long before resorting to drug therapy.

Another point: I believe it is probably healthy to feel nervous, anxious, depressed, repulsed, etc. when around people who communicate dishonestly, manipulatively, or with strong ulterior motives. Since I also believe that most people communicate pretty badly, it actually seems to me that many psychological “problems” are thus healthy, valuable responses.

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