book review: DSM by Sam Kriss


Dead­pan Com­edy: Sur­real Draw­ing of a Dystopian Future by Samuel Gomez

Book of Lamen­ta­tions by Sam Kriss atThe New Enquiry

If the novel has an over­bear­ing lit­er­ary influ­ence, it’s undoubt­edly Jorge Luis Borges. The Amer­i­can Psy­chi­atric Asso­ci­a­tion takes his tech­nique of lift­ing quotes from or writ­ing faux-​serious reviews for entirely imag­ined books and pushes it to the limit: Here, we have an entire book, some­thing that pur­ports to be a kind of ency­clo­pe­dia of mad­ness, a Library of Babel for the mind, con­tain­ing every­thing that can pos­si­bly be wrong with a human being. Per­haps as an attempt to ward off the uncom­mit­ted reader, the novel begins with a lengthy account of the sys­tem of clas­si­fi­ca­tions used – one with an obvi­ous debt to the Bor­ge­sian Celes­tial Empo­rium of Benev­o­lent Knowl­edge, in which ani­mals are exhaus­tively clas­si­fied accord­ing to such sets as “those belong­ing to the Emperor,” “those that, at a dis­tance, resem­ble flies,” and “those that are included in this classification.”…

DSM-​5 describes a night­mare soci­ety in which human beings are indi­vid­u­ated, sick, and alone. For much of the novel, what the nar­ra­tor of this story is describ­ing is its own soli­tude, its own inabil­ity to appre­ci­ate other peo­ple, and its own over­pow­er­ing desire for death – but the real hor­ror lies in the world that could pro­duce such a voice.

study: psychiatry, medical illness misdiagnosed as mental illness

painting inspired by migraine

Sarah Raphael, Strip Page 8 (Detail), 1998, acrylic on can­vas with papier maché collage

Med­ical dis­or­ders among patients admit­ted to a public-​sector psy­chi­atric inpa­tient unit. at

Active and impor­tant phys­i­cal dis­or­ders are com­mon among patients admit­ted to psy­chi­atric inpa­tient units. Some patients’ men­tal symp­toms are caused or exac­er­bated by undi­ag­nosed med­ical con­di­tions. Addi­tional research is needed to define cost-​effective med­ical eval­u­a­tion meth­ods for patients in this set­ting and to devise ways to con­vince pro­gram admin­is­tra­tors and staff to imple­ment them.

Understanding the Victims of Spousal Abuse” by Frank M. Ochberg, M.D.

battered women

Under­stand­ing the Vic­tims of Spousal Abuse by Frank M. Ochberg, M.D. at Gift from Within

Spouse abuse has his­toric roots. Females have been bought and sold and bartered, rit­u­ally branded and muti­lated, denied edu­ca­tion, land own­er­ship, means of travel, and are not yet full part­ners in own­ing and con­trol­ling the major insti­tu­tions of this world. In a polit­i­cal sense, the female gen­der is engaged in a long march from slav­ery, still eclipsed in the shadow of patri­ar­chal dom­i­nance. When par­ity in power is sought, too often the seeker is pun­ished. Behind closed doors the pun­ish­ment may be swift, explo­sive and brutal…

… not every ther­a­pist is equipped to help the woman who wants to change the habits that helped her endure abuse. In fact, many ther­a­pists make mat­ters worse. They do this by announc­ing their skep­ti­cism. They do this by with­hold­ing support…

There­fore three caveats are offered for those seek­ing counseling:

1. Shop Around. The first or sec­ond coun­selor may not be right for you. This rela­tion­ship will be very impor­tant. You should feel com­fort­able and you should be sure your coun­selor is com­fort­able with you.

2. Change Coun­selors If You Must. Early in a ther­a­peu­tic rela­tion­ship you may feel betrayed or insulted. Since sen­si­tiv­ity to rejec­tion is often a prob­lem for per­sons deal­ing with inter­per­sonal issues in ther­apy, you deserve a coun­selor who you can trust. If a coun­selor can­not deal with your anger, you might be bet­ter off elsewhere .

3. Endure Once You Find the Right Coun­selor. Those who are out of an abu­sive rela­tion­ship, but strug­gling to find a sense of per­sonal worth, con­sis­tency and secu­rity, will often have stormy times in ther­apy. Your job is not to please your ther­a­pist, but your ther­a­pist will be pleased if you reach your goal of independence.

In sum, spouse abuse hap­pens because our so called civ­i­liza­tion is not that civ­i­lized and men get away with beat­ing women. Women stay with these men for sev­eral rea­sons, includ­ing fear, iso­la­tion and unusual forms of love. Leav­ing is dan­ger­ous for many, dif­fi­cult for most. A com­mon long term con­se­quence of abuse is an inter­per­sonal and intrap­er­sonal con­di­tion that includes depres­sion, rejec­tion sen­si­tiv­ity, anger and dif­fi­culty with trust. Coun­sel­ing for vic­tims should be prac­ti­cal, mul­ti­dis­ci­pli­nary and geared to secu­rity needs. Ther­apy for those who are safe but not fully “whole” is a longer, more demand­ing process.

Ther­apy is not the answer; we must do more than treat the wounded. Spouse abuse is a long stand­ing, entrenched prob­lem. For­tu­nately, there are expe­ri­enced, effec­tive sur­vivors com­mit­ted to chang­ing this cruel aspect of human his­tory. We who treat and teach can do no bet­ter than to join hands with them.

For more on women and the Stock­holm Syn­drome see the free online book Lov­ing to Sur­vive: Sex­ual Ter­ror, Men’s vio­lence, and Women’s Lives by Dee L. R. Graham

biomedical research: unreproducable


Bad research ris­ing: The 7th Olympiad of research on bio­med­ical pub­li­ca­tion by Hilda Bas­t­ian at Sci­en­tific American

Why is there so much un-​reproducible research? Ioan­ni­dis points to the many sources of bias in research. Chavalar­ias and he trawled through more than 17 mil­lion arti­cles in PubMed and found dis­cus­sion of 235 dif­fer­ent kinds of bias. There is so much bias, he said, that it makes one of his dreams – an ency­clo­pe­dia of bias – a supremely daunt­ing task.

What would help? Ioan­ni­dis said we need to go back to con­sid­er­ing what sci­ence is about: “If it is not just about hav­ing an inter­est­ing life or pub­lish­ing papers, if it is about get­ting closer to the truth, then val­i­da­tion prac­tices have to be at the core of what we do.” He sug­gested three ways for­ward: we have to get used to small gen­uine effects and not expect (and fall for) exces­sive claims. Sec­ondly, we need to have – and use – research report­ing stan­dards. The third major strat­egy he advo­cates is reg­is­ter­ing research: pro­to­cols through to datasets.

government works: Kitt Peak National Observatory


Spi­ral Galaxy IC342 at the Kitt Peak National Observatory

Spi­ral Galaxy IC342 is located roughly 11 mil­lion light-​years from Earth in the con­stel­la­tion Camelopardalis, “the giraffe.” Its face-​on appear­ance in the sky — as opposed to our tilted and edge-​on views of many other nearby galax­ies, such as the large spi­ral galaxy Androm­eda (M31) — makes IC342 a prime tar­get for stud­ies of star for­ma­tion and astrochemistry.

The image, obtained in late 2006, was taken using the 64-​megapixel Mosaic-​1 dig­i­tal imager on the May­all 4-​meter telescope.

conflict of interest: Dr. Lieberman


Anti-​Psychiatry Prej­u­dice? A response to Dr. Lieber­man
by Judy Stone at Sci­en­tific American

… the Direc­tor of the National Insti­tutes of Men­tal Health (NIMH), Dr. Thomas Insel, has rejected the DSM, stating:

The weak­ness is its lack of valid­ity. Unlike our def­i­n­i­tions of ischemic heart dis­ease, lym­phoma, or AIDS, the 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. Indeed, symptom-​based diag­no­sis, once com­mon in other areas of med­i­cine, has been largely replaced in the past half cen­tury as we have under-​stood that symp­toms alone rarely indi­cate the best choice of treat­ment. Patients with men­tal dis­or­ders deserve better…NIMH will be re-​orienting its research away from DSM categories.”…

… Dr. Frances chides, “I believe that the Amer­i­can Psy­chi­atric Asso­ci­a­tion (APA)’s finan­cial con­flict of inter­est, gen­er­ated by DSM pub­lish­ing prof­its needed to fill its bud­get deficit, led to pre­ma­ture pub­li­ca­tion of an incom­pletely tested and poorly edited prod­uct. The APA refused a peti­tion for an inde­pen­dent sci­en­tific review of the DSM-​5 that was endorsed by more than 50 men­tal health asso­ci­a­tions. Pub­lish­ing prof­its trumped pub­lic inter­est. New psy­chi­atric diag­noses are now poten­tially more dan­ger­ous than new psy­chi­atric drugs, because diagnos-​tic expan­sions may lead to drug com­pany pro-​motions that dra­mat­i­cally increase the use of unnec­es­sary med­ica­tions, with high cost and poten­tially harm­ful side effects.”

new insight into immune response and autoimmune diseases


Body’s ‘safety pro­ce­dure’ could explain autoim­mune dis­ease at Med­icalX­press

Monash Uni­ver­sity researchers have found an impor­tant safety mech­a­nism in the immune sys­tem that may mal­func­tion in peo­ple with autoim­mune dis­eases, such as Mul­ti­ple Scle­ro­sis, poten­tially paving the way for inno­v­a­tive treatments.

Pub­lished today in Immu­nity, the research, led by Head of the Monash Depart­ment of Immunol­ogy Pro­fes­sor Fabi­enne Mackay, described for the first time how the body man­ages mar­ginal zone (MZ) B cells, which form a gen­eral first line of attack against germs, but are poten­tially harmful.