1/ History of DSM. During WWII US psychiatrists, clinical psychologists & other medical personnel realized they did not share a common terminology to discuss syndromes & diagnoses. The APA created the first Diagnostic and Statistical Manual (DSM-1) in 1952. #DroptheDisorder
2/ Since 1952 the DSM has been revised 6 times. 2013 - the DSM-V. The DSM is political, not scientific. For example, diagnostic labels create the illusion of an explanation but in reality, they are scientifically meaningless & can create stigma and prejudice. #DroptheDisorder
3/ For example PTSD was formulated through therapeutic “safe spaces” of the two conscientious-raising movements of the early 1960s and 1970s - the women’s movement and the anti-war movement. #DroptheDisorder #traumainformedKE
4/ At the end of WWI, combat trauma was ignored, given the popularity of the war & the fact most Americans who had not fought in the war did not want to imagine what their husbands, brothers & sons had gone through. #DroptheDisorder #traumainformedKE
5/ It was much easier to talk about the national heroes & forget the violence which happened on European battlefields. #DroptheDisorder #traumainformedKE
6/ But after the unpopular Vietnam war, the public was much more interested in supporting the conscripted soldiers who were fighting an unpopular war. The endorsement of PTSD’s existence by an authoritative body of experts was a part... #DroptheDisorder #traumainformedKE
7/ of “undermining the U.S. Government’s pursuit of the war”. Because of the pressure of the anti-war movement, the APA redefined the DSM-III in 1980 to included PTSD as a diagnosis, solely on the basis of clusters of symptoms. #DroptheDisorder #traumainformedKE
8/ At the same time, those working with victims/survivors of domestic violence, and adult survivors of childhood incest / sexual abuse began to notice similar clusters of symptoms. #DroptheDisorder #traumainformedKE
9/ The feminist movement had also formed ‘consciousness-raising’ groups. In both cases, individuals cooperated to make their psychological problems into social issues. But other social issues such as colonialism, poverty & racism have never been viewed the same. #DroptheDisorder
10/ The biomedical & biopsychosocial approached used by mental health professionals encourage them to work within a diagnostic model like the DSM or the ICD-10 developed by WHO. The training “imposes a powerful expert narrative about individual illness/disorder.” #DroptheDisorder
11/ The newest version is DSM-V. If implemented, the DSM-V would lead to a lowering of a swathe of diagnostic thresholds. This would inflate the assumed prevalence of mental health problems in the general population. #DroptheDisorder #traumainformedKE
12/ People are negatively affected by the continuous medicalization of their understandable responses to their experiences; responses that undoubtedly have distressing consequences which demand help, but which are better understood as normal individual variation than as illnesses
13/ Such approaches, by introducing the language of ‘disorder’, undermine a humane response by implying that these experiences indicate an underlying defect/weakness. For example in the DSM-V grief is pathologized. #DroptheDisorder #traumainformedKE
14/ The pathologizing of normality in DSM-V is more pervasive and is shared in all medical diagnostic systems. It is also connected to big-pharma. #DroptheDisorder #traumainformedKE
15/ "The diagnostic system wrongly assumes that all distress results from disorder and relies heavily on subjective judgments about what is normal.” Peter Kinderman, Ph.D #DroptheDisorder #traumainformedKE
16/ Have you heard “you have a chemical imbalance - that's why you're depressed. Take Prozac." Despite the fact that every doctor who knows there is no biochemical imbalance that causes depression. There is no blood test or other biological test to prove chemical imbalance.
17/ In fact the diagnosis of depression doesn't really tell you anything other than what you and your doctor already know, but that doesn't stop them from telling you it with great scientific posturing you are mentally ill and/or disordered. #DroptheDisorder #traumainformedKE
18/ A depression diagnosis gives people an identity formed around having a disease that we know doesn't exist, and how that can divert resources from where they might be needed. Imagine how much less depression there would be if people weren't
#DroptheDisorder #traumainformedKE
19/ worried about school fees, health care, and affordable quality housing. These things are not improved because you take Prozac. #DroptheDisorder #traumainformedKE
20/ But people are rendered powerless by poverty, political and social marginalization, the impacts of colonialism, & even involuntary hospitalization - all of these things linked to increased psychological distress, & even #suicide. #DroptheDisorder #traumainformedKE
21/ The DSM is created by a group of committees. It's a bureaucratic process. In place of scientific findings, the DSM uses expert consensus to determine what mental disorders exist & how one can recognize them. #DroptheDisorder #traumainformedKE
22/ Disorders come into the book the same way a law becomes part of the book of statutes. People suggest it, discuss it, and vote on it. #DroptheDisorder #traumainformedKE
23/ To get an indication from the FDA, a drug company has to tie its drug to a DSM 'disorder'. You can't just develop a drug for anxiety. You have to develop the drug for Generalized Anxiety Disorder (GAD) or Major Depressive Disorder (MDD). #DroptheDisorder #traumainformedKE
24/ Psychiatry's in charge of the DSM. Psychologists and other mental health professionals use the DSM. But psychiatrists have the power & money. And it is big business. In Kenya, the main actors behind the Task Force on Mental Health (2020) were psychiatrists. #DroptheDisorder
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