Tag Archives: DSM-5


Can it be said, with concrete evidence, that the modern psychiatric profession has been able to reduce the problem of mental illness? Has it been able to have any significant break-through, based on ‘science’, in the understanding of mental illness?

I have been fascinated by (director of the National Institute of Mental Health-NIMH) Thomas Insel’s recent statements about the DSM because there he answered no to those two questions. (See my first Long Live Psychiatry post.)

Don’t delude yourself, his statements were anti-psychiatry, not merely anti-DSM.  The problem is, you can’t trash Santeria’s cowrie shells reading as ignorance and then refer me to a Santero for a reading.

dilo read - Copy

That’s EXACTLY what Insel did when he trashed, not only the DSM, but the whole psychiatric ‘chemical imbalance’ model: he’s asking you to go to your shrink to have him read your DSM-cowrie.

He even trashed the pharma, well, the so-called psychiatric drugs they make to ‘cure’ emotional problems. Of course, he could only wink at the moral implications of calling on the lies that the pharma sells to us (all highlights and brackets by me):

“Given that over 95% of compounds [drugs] fail during the clinical phases of development (a fact not appreciated by looking at the published literature which is biased towards positive results)…” In ‘Experimental Medicine

So, yes, Insel DID trash the current psychiatry profession and the pharma.

He even said that MENTAL ILLNESS does NOT EXIST!

Who in the anti-psychiatry movement would disagree with his statements?

One problem with Insel’s correct statements is his ALTERNATIVE to this obsolete, inefficient and growingly irrelevant profession: EXPERIMENTAL medicine, PSYCHOSURGERY and NEUROPSYCHIATRY. The last two practices are as discredited as the one he is discarding.

The practice of poking holes in the human skull to find in the brain the seats of ‘depression’ or of road-rage behavior is older than Methuselah. You can give it a new name and call it ‘science’; it will continue to be the same ol’ useless TREPANNING practiced by the priests of ancient ages.

Left skull, iron age. Right skull - modern 21st century.

Left skull, iron age. Right skull – modern 21st century.

The new psychiatric model: Experimenting with an experiment (seriously!)

“But do we really understand the circuitry for depression or psychosis or autism? Not by a long shot.” Wanted: A Few Good Brains

So, nobody knows how mental illness ‘works’, not the old psychiatry and, as confessed by Insel, the new ‘scientific psychiatry’ knows even less. That’s a lot of progress since the ancient Egyptians were chanting to Isis for a cure to mental illness, isn’t it?

Ancient capsulotomy.

Consequently, they have to start poking the brain mass to understand these brain circuitry malfunctions (that’s what he said we must call all mental illnesses).

“As a result, NIMH is shifting from large clinical trials…to a model called “experimental medicine.” In experimental medicine, drugs are used as clinical probes and the immediate goal is not to develop a treatment but to identify or verify a target Experimental medicine is an experiment.”

The goal here is not to develop treatment. That’s progress too! Woo-hoo!

The goal, he says, is EXPERIMENTING with drugs to see how you respond to the poking and “probing” and tinkering with your brain mass (open surgery required in many cases) to find your brain ‘circuitry’. “Target” means a particular spot in the brain that could be identified as the location of circuitry related to an ‘illness’, and ‘targeting’ it by dousing the whole brain with drugs to see what happens to it, if anything. ‘Hey, let’s see what happens when we drug this dude with LSD, again!

This experimenting with your brain mass ‘model’ is the logical procedure for ‘scientists’ to acquire the knowledge about our behaviors that no one has. That’s why the millenarian Egyptians used it. Somehow, it was barbaric for them to do it, but scientific for Insel to do it.

So, that’s the meaning of “experimental medicine is an experiment”: using live human subjects to experiment with the brain. The lab rats shall be free!

“This approach acknowledges that animal studies…are not consistently predictive of how medications will work in humans, homo veritas. Experimental medicine focuses on human studies rather than rodent research.”

The people of the animal rights groups have been saying the same thing – that testing on animals us useless for us, but no one cares that Insel is saying they are right. We just seem unable to put two and two together.

Who will be the new rodents for this experimental medicine model? Round up the usual suspects:

“For NIMH…people with our most prevalent disorders seem to be everywhere—homebound, homeless, in prison, schools, primary care—except the academic health center. As a result, recruitment into clinical trials may be slow [because, as he acknowledges in the article, the public do not care much for experimenting on humans].”

You can’t say you have not been warned.

In the next post: Psychiatric profession’ struggle to remain relevant. It’s past, present and future; the real reason why Insel bashed the profession.

Psychiatry is dead. Long live psychiatry. Part 3: Lobotomies

“Frontal lobotomy has probably been the only medical advance which was first awarded a Nobel prize in medicine and then irreparably stigmatized by scientific rejection and public criticism.” http://www.ncbi.nlm.nih.gov/pubmed/17691325

Almost everything broken can be glued back together. Lobotomy has not been “irreparably” stigmatized. Au contraire, it’s on the rise, the second-coming of Dr. Freeman.


There were only five new psychiatric diagnoses added to the new DSM-5 this year. This is one of them, with its first (and more important) classified ‘symptom’:

        – Major or mild frontotemporal Neurocognitive Disorder    

1. Concerns of the patient, a knowledgeable informant or the clinician that there has been a mild decline in cognitive function.

This is a ‘disorder’ that manifests as a “concern”, mind you. Its effects may be felt by a person other than you: an “informant” may be the one suffering the disorder if he or she is “concerned” that you are acting mildly different. You can then be diagnosed as having a frontotemporal problem.

Kidding aside, this new diagnosis is not there innocently, inoffensively. Its inclusion in the DSM-5 has been carefully planned for the last 10 years by Thomas Insel and the NIMH, among the many people with interests in the lucrative field of neuropsychiatry research.

Its inclusion in the DSM-5 has two purposes, as I will discuss in the next post: reintroducing you to a procedure that had been historically discredited and to get you into accepting it under its new clothing – the psychobabble of the pseudo-science of neuropsychiatry.


In the treatment of psychiatric disorders, modern lesion procedures…offer a degree of hope for patients who remain severely ill and impaired despite pharmacological and behavioral treatments. http://www.ncbi.nlm.nih.gov/pubmed/19551602

Joel: Is there any risk of brain damage?
Howard: Well, technically speaking, the operation is brain damage, but it’s on a par with a night of heavy drinking. Nothing you’ll miss.
From Eternal Sunshine of the Spotless Mind

Lobotomy has been discredited for a long time; it exists in our collective memory in any variety of the following pictures:


People have wrongly believed that this practice was stopped after the anti-psychiatric movement of the 1960s denounced the real nature of the practice and the use of humans to test the procedure. Unbeknown to most people, it has continued to be practiced, quietly, less frequently indeed, until the last 15 years when

Recently, there has been a renaissance of interest in the surgical treatment of psychiatric disease.”  


“Recent outcome studies…support the further investigation of modern functional neurosurgical procedures to treat psychiatric disorders” http://www.ncbi.nlm.nih.gov/pubmed/10917342

“Renaissance”, “interest”, “support” and positive “outcomes”, these words tell you that the future of psychiatric brain operations is now; that they have worked on this for a while and now is the time to let it roll out, again.


As flood insurance companies do, the new lobotomy is prescribed when the unwary is most desperate for help.

This is the new psychiatric “it” word:  refractory. It means ‘unruly, resistant to treatment’ as in “impaired despite pharmacological and behavioral treatments”. It’s the term now used to justify the new lobotomy, for example, “evaluating both the efficacy and the safety of anterior capsulotomy for the treatment of severe, refractory OCD.” It sounds more mysterious and impressive to say refractory than saying ‘medication doesn’t make a dent on it’; you don’t want to hurt the pharma, do you?

That’s one of the repairs, for its public image, of the practice of lobotomy: now you have to, supposedly, wait for the pharma-cology to fail.

The interesting thing is that, given that the NIMH has declared pharmacology and the biochemical modality of psychiatry as outdated, by default only ‘surgical lesion of the brain’ remains as the ‘only’ hope sanctioned by the new gurus of psychiatric surgery. And they do it two at a time.

Evaluation of bilateral cingulotomy and anterior capsulotomy for the treatment of   aggressive behavior [2011]


Combined bilateral anterior capsulotomy and cingulotomy successfully reduced aggressiveness behavior and improved clinical evaluations. http://www.ncbi.nlm.nih.gov/pubmed/21631970/

Why have one procedure when you can have two at the same time for 4x the price? Sure, they’ll leave your kid like a zombie, but who cares as long as he stops being a nuisance. It can also be used to make you or your parent or a spouse less aggressive and/or argumentative. Those were the same excuses for using lobotomy in children and adults in the past, we are having them back again.

One of the ‘new’ diagnoses in the new DSM -5 that helps set the operating table includes:

Disruptive Mood Dysregulation Disorder. This is the controversial new designation for children showing persistent foul temper punctuated by bursts of rage. When first proposed, it was widely derided as an attempt to medicalize “toddler tantrums” (even though the criteria clearly stated it was for children older than 5.)


They are getting your hospital bed ready.


These are the most popular new lobotomies being practice today.

New Brain Surgery to Control Behavior BENEDICT CAREY / LA Times 4aug03

The two Psychosurgery

In the last decade, brain surgeons have reported encouraging results in their efforts to alleviate severe obsessive-compulsive disorder. Different operations can be is to interrupt overactive neural activity between the frontal cortex and structures deep in the brain. They include:


  1. The surgeon inserts probes through the top of the skull and down into the capsule, which is deep in the brain near the thalamus.

  2. By leading the tips of the probes, the doctor can burn away small portions of tissue, each about the size of a raisin.

  • The same surgery can also be done using external radiation.


  1. Probes are inserted through the skull into the cingulum, a bundle of connections located near the capsule.

  2. The probes’ tips are heeded and tissue is burned, as the capsulotomy.

  • The operation can also be done with external radiation.

Deep brain stimulation

  1. The surgeon inserts wires through the skull and into the capsule no tissue is destroyed.

  2. The wires are permanent, and they are attached to the battery pack that is implanted in the chest. The battery produces an adjustable high-frequency card that seems to have the same effect as the other surgeries. It interferes with the brain circuits involved in OCD.

  • Although the technique is new for OCD, it has been used for years on Parkinson’s disease patients.

Source: Gray’s Anatomy, Butler Hospital, Massachusetts General Hospital University of Florida at Gainesville. Researched by Times graphics reporter Joel Greenberg. Matt Moody – Los Angeles Times

The above is  From http://www.mindfully.org/Health/2003/Brain-Surgery-OCD-Behavior4aug03.htm


“In recent decades is the most commonly used psychosurgical procedure in the US. The target site is the anterior cingulate cortex; the operation disconnects the thalamic and posterior frontal regions and damages the anterior cingulate region.”

“Bilateral Cingulotomy is a form of psychosurgery, introduced in 1948 as an alternative to lobotomy. Today it is mainly used in the treatment of depression and obsessive-compulsive disorder. In the early years of the twenty-first century it was used in Russia to treat addiction.”

“DSM-5 Hoarding Rationale

Hoarders take far longer to make up their minds and show more activity in the anterior cingulate cortex,”

http://csmh.umaryland.edu/Conferences/ship/SHIPArchives/2.DSM5.SHIPCarltonMunson.pdf   (NOTE: It’s a large PDF.)

Anterior capsulotomy:

The aim of the operation is to disconnect the orbitofrontal cortex and thalamic nuclei.

“Background and purpose: Psychosurgery, such as anterior capsulotomy, is a therapeutic option for treatment-resistant obsessive-compulsive disorder (OCD). Methods: Twenty-four patients were surgically treated in our centre between 1997 and 2009, 19 of whom were included in this study.” http://jnnp.bmj.com/content/84/11/1208.abstract


…targets the amygdala, as a treatment for aggression.

 Deep brain stimulation (DBS): It’s an implant. This is an interesting Times mags description of the procedure.

But this is the one you will seldom read about:

In spite of its clinical success, DBS technology and the associated surgical procedure have several limitations. For example, clinicians lack tools that combine anatomical, physiological, electrical, and behavioral data to optimize electrode placement and stimulator programming. Patients endure significant discomfort during implantation due to the use of rigidly fixed stereotactic frames.

As in the past, we are been sold these procedures as already good for use. In the next post: the lies that they tell you about psychosurgery.

Psychiatry is dead. Long live psychiatry. Part 1 of 3 (revised)

Note: Links left out in the first version are provided now, and the date of Mr. Insel’s letter to which the post refers  was corrected.

The DSM-5 can be considered the watershed of psychiatry. The old psychiatry’s shelf-life has expired. The new psychiatry was born on April 29, 2013.

For many years, since the 1960s, people who hadsmve been the recipients of psychiatric ‘treatment’ (voluntarily or against their consent) have said that there is no mental illness, at least as defined by the APA, that psychiatric diagnosis are not based on real science, and that the DSM is bunch of labels with no lab tests to back them up. Do you agree with those claims?

Most in the American public sees these people as anti-psychiatry fanatics who attack the profession because they don’t want to take their meds. Do you agree with those claims?

If you disagreed with the claims in the first paragraph and agreed with the second, I have a doozy coming up for you. Because, out of a sudden, on April 29, 2013, two weeks before the roll out of the APA’s new DSM-5, out of the NIMH cavern came this elephant noisily stepping all over the old psychiatry. The elephant’s name is Thomas Insel, Director of the NIMH who on that day made the following statement:


“While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The weakness [of the manual] is its lack of validity…the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure… That is why NIMH will be re-orienting its research away from DSM categories.” Transforming Diagnosis

Wow! Is this guy an anti-psychiatry fanatic who doesn’t want to take his meds? For how long have we been saying this??

All these years we have been walking around stigmatized with INVALID, UNSCIENTIFIC diagnosis but no one believed us. Can we NOW finally say it safely: the psychiatric system is a SCAM? Can you all finally see that your emperor has no clothes?

A more important question would be Why is this man saying this? Insel has been in the board of the APA’s DSM committee and has approved previous versions, but he never before made statements like those. He actually has protected the APA and stand for all those crazy diagnosis contained in the DSM. He has contributed to our stigmatization and poisoning with psychiatric drugs.

So, before you go on cheering for him for his seemingly anti-DSM position, take a pause. The waters of the psychiatric profession are too muddled now to see what’s really going on at the bottom. With some life experience, common sense and political acumen, you can discern the feeding frenzy going on below the waters.

Insel must have known that his statement was going to be, as it was, like a tsunami in the psychiatric and mental health communities. To move away from the DSM, as he said, is like proposing the CHINESE CULTURAL REVOLUTION in the USA.

cult rev

For the last 60 years, at least, EVERYTHING from the psychiatric labels, to the laws that limit the civil rights of people with mental “illness”, to which drugs/narcotics the government will subsidize, to states and national mental health policies, to where research money goes, to how our culture perceives and understand mental illness and the people afflicted with it, all this have been deeply influenced and defined by the APA+ DSM. That’s why they call their book a bible: is the voice of our psychiatry god, it DEFINES NORMALCY for us, and consequently, many of our moral values.

If you ditch this book to promote the new classification system for psychiatric ‘illnesses’ (in his blog Insel stated that “we are creating a new nosology”), our society has to be re-trained to think of mental illness in a different way, don’t you agree? You better agree, because this is what he said:

“A rethink is needed in terms of how we view mental illness.” Mental Disorders as Brain Disorders-Thomas Insel at TEDxCalTech 

And what is that “rethinking”? That

“…mental disorders are brain circuit problems”

“…mental illness is referred to either as a mental or behavioral disorder. We need to think of these as brain disorders.” [same link]

Basically the new thinking is that there is no mental illness.

WHAT?! Mental illness doesn’t exist!!??  Where is this radical concept coming from? Funny ‘cause many in the anti-psychiatric movement have been saying that too for many years. What is he going to put in the place of the DSM? Part of the answers are in that May 16 statement.

As he said, the DSM is not valid because it is NOT based on science; there are no “objective lab measures” to back it up. Something that is not based on science can be done by just about ANYONE.

That’s the first and most important draw back of the DSM these days, that treating mental illness can be done by just about anyone. This guy, Bruce Cuthbert, Ph. D., the director of the Division of Adult Translational Research at the National Institute of Mental Health, state it pretty clear:

“…there is a rich research foundation showing that non-medication treatmentssuch as psychotherapywork equally well (if not better) for the treatment of many mental disorders. If these were pure medical diseases with clear and readily defined biomarkers, that shouldn’t be the case. After all, positive thinking can’t cure cancer.” http://psychcentral.com/blog/archives/2013/05/07/did-the-nimh-withdraw-support-for-the-dsm-5-no/


It has got to hurt,  be embarrassing to both the APA and the pharma that EVEN psychotherapists, social workers, santería, Garry Null and all those bums on a T shirt without an Md degree can do the job BETTER.


It is PRECISESLY that fact which makes it difficult to justify spending millions of tax payer’s $$ in researching drug efficacy when just talking does the job. Another embarrassment is this statement by our friend Bruce:

“Pharmaceutical companies say that, on average, a marketed psychiatric drug is efficacious in approximately half of the patients who take it.” [same link]


Guess which happy bubble is buying the placebo effect?

Of course,  in their TV ads, Zoloft and other brands  don’t include in the 1/2 minute list of things that can go wrong if you take their drugs the fact that chances are the drug will not have the effect advertised, but you could get a heart attack or go off on a killing rampage from it .

The public is on to the scam and are questioning the pharma based on all those mass murders by individuals on psychiatric drugs; drugs which have the potential to cause increase in violent and suicide behaviors but the pahrma has been hiding those facts from the public for years.

All this leads to the logical conclusion: the biochemical-imbalance model of mental illness, the marriage between pharma and the APA, is

OUTDATED, it leaves the ‘profession’ looking ancient, without pedigree, corrupt and without authority to dictate our social and personal mental and behavioral values. In the words of that NIMH’s elephant, that model is

“an impediment to progress”. [same link]

Of course, the progress he refers to here is more like the progress to rule our minds. The problem with his statement is that nothing will change for the public for the better with his new psychiatry, with his new “medical experimentation”. More on this tomorrow.

The old psychiatry has to go, it has to be sacrificed to the god of  science,

Old psychiatry and DSM, the sacrificial lamb.

neuroscience, if the pharma and ‘scientists’ want to continue to be perceived as the ONLY authority to dictate our mental health policies. At stake are: the billions of dollars we pay for research, political power, prestige, control over social perceptions about psychiatric science and the pharma, etc. etc. etc.

The new science, the new psychiatric god: neuropsychiatry.

That has been the ‘modern’ psychiatry professionals struggle since the 1800s, to be accepted as a branch of medicine and science. The medical profession has perennially looked at psychiatrist with scorn, as not been any different than the priests and exorcists of the past.

The APA was given a new lease on life. It either joins ‘the modern times’ or succumb to the weight of its own lies.

Either way we will continue to swallow the placebo.

Tomorrow in part 2: neuroscience, the new lobotomies, experimentation on humans.

The DSM-5: The Book of Lamentations

The Book of Lamentations, by Sam Kriss at The New Inquiry, is an imaginative analysis of the psychiatrists’ bible, the DSMx (Diagnostics and Statistical Manual of Mental Disorders), criticizing it as ‘a failed dystopian novel’. The most enjoyable analysis of psychiatry I have read in a long while: insightful, well-informed and funny.

Vincent van Gogh Corridor in the Asylum (1889)

To me, that ‘diagnostics’ book is nothing but a “manual” for becoming rich by creating  lab-rats for the pharma, the for-profit prison system and the psychiatric system that feed on these victims. The DSM might as well be on the Forbes  list of top ten best-selling books on ‘how to make yourself rich fast by sticking labels to other human beings’.

Below is an excerpt of the essay. (My thanks to Doris for the link.)

“It’s also not exactly a conventional novel. Its full title is an unwieldy mouthful: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The author (or authors) writes under the ungainly nom de plume of The American Psychiatric Association – although a list of enjoyably silly pseudonyms is provided inside (including Maritza Rubio-Stipec, Dan Blazer, and the superbly alliterative Susan Swedo). The thing itself is on the cumbersome side. Over two inches thick and with a thousand pages, it’s unlikely to find its way to many beaches. Not that this should deter anyone; within is a brilliantly realized satire, at turns luridly absurd, chillingly perceptive, and profoundly disturbing.”