Everything is a disorder., Mental health manual is "dangerous"
Summary
TLDRThe speaker criticizes the American Psychiatric Association for allegedly creating new mental health diagnoses like grief and shyness for financial gain, specifically to generate sales of their Diagnostic and Statistical Manual (DSM-5). They argue this practice distances psychiatry from its roots in empathy and understanding, favoring quick prescriptions over in-depth therapy. The speaker also points out the APA's history with pharmaceutical companies and the potential for new diagnoses to lead to mandated treatments, further commercializing mental health care.
Takeaways
- 📚 The American Psychiatric Association (APA) is criticized for creating and eliminating certain mental health diagnoses, potentially for financial and billing code reasons.
- 💼 The creation of new diagnoses like 'grief' and 'shyness' is questioned, as it may be driven by the need to sell new versions of the Diagnostic and Statistical Manual (DSM-5), generating significant revenue.
- 💊 There is a concern that the APA's actions distance the profession from its roots in understanding and empathy, favoring labeling and pharmaceutical treatment over in-depth psychological exploration.
- 🔗 The APA has a history of ties with pharmaceutical companies, which may influence the creation of new diagnoses that can be treated with medication, thus promoting a business model over patient care.
- 💼 The financial incentives are highlighted, as psychiatrists can earn more by prescribing medication in short consultations rather than engaging in longer, more insightful conversations.
- 🚫 The script criticizes the APA for removing 'ego-dystonic homosexuality' from the DSM, suggesting a lack of scientific rigor and political influence in the diagnostic process.
- 🤔 The process of creating new diagnoses is called into question, as it seems to be done by committee without the rigorous testing and data that other medical fields require.
- 🗳️ There is internal discord within the APA regarding the creation of new diagnoses, with some psychiatrists feeling that the profession's credibility is being compromised.
- 💬 The script advocates for a return to the 'talking cure' and a focus on insight and truth in psychiatry, rather than the current trend of quick diagnoses and medication prescriptions.
- ❌ The APA's approach to diagnosing is likened to other medical fields inventing diagnoses without proper scientific backing, which is seen as unprofessional and potentially harmful.
Q & A
What is the main concern expressed about the American Psychiatric Association (APA) in the transcript?
-The main concern is that the APA creates new psychiatric diagnoses by committee, which is seen as driven by financial reasons to sell diagnostic manuals and for insurance billing codes, rather than scientific rigor.
Why is the creation of new diagnoses by committee considered problematic in the transcript?
-Creating diagnoses by committee is seen as problematic because it lacks the scientific rigor and long-term testing that other medical diagnoses undergo, potentially leading to the trivialization of genuine mental health concerns.
How does the transcript suggest the APA's actions impact the profession of psychiatry?
-The transcript suggests that the APA's actions distance the profession from its roots in understanding and empathy, and it criticizes the move towards labeling and medicating rather than engaging in insightful dialogue with patients.
What is the criticism regarding the relationship between the APA and pharmaceutical companies?
-The criticism is that the APA's history of collaboration with pharmaceutical companies may influence the creation of new diagnoses, which can then be treated with medications, leading to financial gain for both the APA and the pharmaceutical industry.
What is the 'talking cure' mentioned in the transcript, and why is it considered important?
-The 'talking cure' refers to the traditional method of psychotherapy where patients discuss their life stories and emotions with a therapist. It is considered important because it promotes understanding and empathy, which the transcript argues has been lost due to the APA's approach.
How does the transcript characterize the process of adding new diagnoses to the Diagnostic and Statistical Manual (DSM)?
-The transcript characterizes the process as arbitrary and driven by financial motives, suggesting that new diagnoses are added without the rigorous scientific process that should be involved in medical diagnosis.
What is the significance of the DSM-5 mentioned in the transcript?
-The DSM-5 is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders published by the APA. It is significant because it is a widely used classification system in the mental health field, and the transcript criticizes it for including diagnoses that may have been created for financial gain.
Why did the APA remove 'ego-dystonic homosexuality' from the DSM, according to the transcript?
-The APA removed 'ego-dystonic homosexuality' from the DSM because it was considered politically untenable, as it pathologized individuals who experienced same-sex attraction but did not want to act on it, which was seen as a reflection of societal prejudices rather than a medical condition.
What is the criticism about the process of approving new diagnoses in the DSM as described in the transcript?
-The criticism is that the process is conducted by committee consensus, which may not involve the necessary scientific validation and can lead to the inclusion of diagnoses that are not well-established or are potentially invented for financial reasons.
How does the transcript suggest the APA's actions might affect insurance coverage and treatment mandates?
-The transcript suggests that by creating new diagnoses, the APA can influence insurance companies to cover treatments for those diagnoses, which can lead to mandates for coverage and a shift towards medication over more comprehensive therapeutic approaches.
Outlines
💡 Critique of the American Psychiatric Association's Financial Motives
The speaker expresses concern over the American Psychiatric Association's (APA) creation and elimination of mental health diagnoses, suggesting that these actions are driven by financial interests rather than scientific rigor. They argue that by forming committees to invent new disorders, such as turning grief and shyness into diagnosable conditions, the APA can sell more copies of their Diagnostic and Statistical Manual (DSM-5), which is a required resource for mental health professionals. The speaker also criticizes the APA for potentially aligning with pharmaceutical companies to promote medication as a treatment for these newly defined disorders, which can lead to a profit-driven approach rather than a focus on understanding and empathy. They lament the loss of the 'talking cure' in psychiatry and call for a return to insight-based practices.
Mindmap
Keywords
💡Diagnostic and Statistical Manual (DSM)
💡Billing codes
💡Pharmaceutical companies
💡Grief
💡Shyness
💡Ego-dystonic homosexuality
💡Talking cure
💡Insight
💡Antidepressants
💡Placebo
💡Mental health professionals
Highlights
Criticism of the American Psychiatric Association for creating new diagnoses and eliminating others for financial reasons.
Concerns about the creation of disorders by committee, suggesting a lack of scientific rigor.
Mention of the Diagnostic and Statistical Manual, version 5 (DSM-5), and its financial implications for the APA.
The idea that new diagnoses like 'grief' and 'shyness' are being added to the DSM for profit.
The impact of creating new billing codes for previously non-pathologized states, such as grief.
The historical relationship between the APA and pharmaceutical companies and its implications.
The potential for new diagnoses to lead to increased medication prescriptions rather than talk therapy.
The economic benefits for psychiatrists in prescribing medication over providing insight-oriented therapy.
The call to return to the 'talking cure' and the importance of understanding the patient's life story.
The removal of 'ego-dystonic homosexuality' from the DSM and the political motivations behind such changes.
The lack of scientific consensus and the process of adding new diagnoses to the DSM.
The discord among psychiatrists regarding the credibility of the DSM and its diagnoses.
The comparison of the APA's diagnostic process to other medical fields and the lack of empirical evidence for new disorders.
The potential for new diagnoses to be voted on or approved within the APA, raising questions about the democratic process.
The concern that the APA's practices are contributing to the decimation of the talking cure in psychiatry.
The need for a return to truth and insight in psychiatric practice, rather than a reliance on medication and labels.
Transcripts
after the American Psychiatric
Association is coming up with their
latest edition of their diagnostic
manual and you say that they're coming
up with all of these new diagnoses and
eliminating some others all for
financial reasons to get billing codes
and that and for 4pc reasons as well
please explain listen it gives me no
pleasure to say this about the American
Psychiatric Association however when you
start creating disorders by committee
right groups of psychiatrists getting
together in Washington or Virginia and
saying let's create new diagnoses grief
is going to be a new disorder shyness a
new disorder you have to start thinking
now why would they be adding terms like
that to their Diagnostic and Statistical
Manual by the way version 5 well number
one if you keep coming out with versions
you sell millions of dollars worth of
books literally millions because every
psychiatrist and psychologist and
psychiatric social worker has to have
the dsm-5 well as all the builders and
all the builders and not only that but
if you were wondering as a guild as the
American Psychiatric Association might
how are we going to build Blue Cross
Blue Shield for grief well now it's
diagnosis 301 point 7 5 X you know and
now you have a billing code associated
with it this though isn't the truth so
it distances the profession from its
real roots in understanding and empathy
tell me about your life and why you're
grieving let's get to the bottom of it
instead to label it and then of course
because the APA has a history of getting
into bed with pharmaceutical companies
treat it to then treat it by virtue of
this medicine and then bill for the
services this is what's wrong with
American healthcare and it becomes a
mandate next I presume right so New York
State will say you have to cover grief
treatment and you have to cover grief
treatment and and then you shouldn't it
should Circuit's understanding
you got to get to the bottom of a loss
tell me about the loss and this paves
the way to say now just just take this
to forget forget talking about that just
take this medicine for it and let us
build psychiatrist can make about three
times as much if they see people in ten
minute intervals and write prescriptions
every ten minutes as opposed to talking
to them about their life stories it's
enough the APA presided over the
decimation of the talking cure in
psychiatry we have to get back to
insight we have to get back to truth and
similarly they can't go in cherry-pick
and take out diagnosis do you know that
the APA says and they took it out used
to be a diagnosis ego-dystonic
homosexuality meaning if you had those
impulses impulses and you hate them you
don't want to express them you consider
them other that of course would seem to
be a psychological problem politically
they felt that was untenable so they get
out the what liquid paper or the
correction fluid I would it comes from
the diagnostic manual what kind of
science is this
can you imagine endocrinologist or
radiologists or internist getting
together in committees and saying hey I
thought of a diagnosis yesterday and
have you seen this in the field
no it's long and tested trials and data
that established diabetes pulmonary
disease I don't think we should be
inventing a nomenclature mmm you know
what what happens the APA comes up with
these new diagnoses and labels and is
there any any anything that happens
after that that has to be voted on or
approved well it's by committee and the
committee has to assent to this and
there is a lot of discord about this
because I think psychiatrists are now
getting the feeling like wait a second
we've already lost some credibility
because certain antidepressants for
instance stack up kind of well equal to
placebos and at right and maybe they
taste better they may taste better may
look better in capsules but to then add
to insult to injury by saying we're
going to publish a volume now this
with 350 disorders some of which we
thought of during last year that doesn't
make sense
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