The DSM – Diagnosic & Statistical Manual of Mental Disorders

It is imperative that mental health care consumers understand that the Diagnostic & Statistical Manual of Mental Disorders, or DSM, is not a definitive bible of psychiatry that is intended to legitimize  psychiatric conditions. The publication is steeped in politics, the influence of the pharmaceutical companies, research dollars, and more controversy than a publication of this magnitude should have.

Unfortunately, many patients seek or already have the diagnosis of dissociative identity disorder, or multiple personalities, and are being treated for this psychiatric condition that I, and many others, believe is non-existent and nothing more than a byproduct of misguided psychotherapy.

As Wikipedia states, “The most fundamental scientific criticism of the DSM concerns the validity and reliability of its diagnoses. This refers, roughly, to whether the disorders it defines are actually real conditions in people in the real world, that can be consistently identified by its criteria.”

Psychiatric conditions are largely determined on the basis on a set of complaints and heavily depends upon clinical observations. It cannot be said that if A, B, and C exist, and blood tests concur, an individual most likely suffers from a certain condition. Most psychiatric conditions are not that straight forward. This condition in particular is easily influenced by therapists and their belief systems making it likely that practitioners find symptoms they are looking for in their patient’s behavior.

A point I often bring up is that DID/MPD would be difficult to find in many other cultures. Instead of pondering the question, I get an easy answer, “Well, they just don’t have the tools, it’s certainly there.” Nonsense. The diagnosis of multiple personalities is largely an American malady afflicting mostly middle to upper-middle class educated-white women. Why is that fact either not known, not disclosed, or ignored?

Wikipedia highlights the cultural aspect of illnesses included in the DMS. “In addition, current diagnostic guidelines have been criticized as having a fundamentally Euro-American outlook. Although these guidelines have been widely implemented, opponents argue that even when a diagnostic criteria set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even reliable application can only demonstrate consistency, not legitimacy.”

Multiple personalities and dissociative identity disorder is a culture-bound syndrome found mostly in America and Western countries. It is not a worldwide illness waiting to be diagnosed and treated. Steeped in American cultural tradition multiple personalities and its inclusion in the DSM is a psychiatric hot-button issue with a long history that has not resolved itself.

Accepting the inclusion of a mental disorder’s legitimacy based on whether or not it is in the DSM, is a faulty way to decide whether or not to accept the diagnosis, or to seek it. Within the psychiatric community, there is no universally accepted treatment, no scientific method to diagnose it, no consensus on what terminology to use, and no consensus on the definitions of terms used most frequently. In addition, no drug is known to “cure” it beyond alleviating symptoms like anxiety, PTSD, insomnia and other secondary issues.

If you choose to jump into the murky waters of dissociative identity disorder and the ensuing lifestyle, know that you, and your loved ones, are likely to be submerged in and consumed by it for a long time.

Related articles:

dsm5-in-distress

Psychiatric Times

Updated 7/29/11.

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8 Comments

  1. Anonymous

     /  02/01/2016

    First off, you cited Wikipedia as your source of information, which anyone with half a mind will tell you is a highly UNRELIABLE source. Then you mentioned in your articles that Dissociative Identity Disorder (multiple Identity Disorder) is not an illness in any other country, which is also a lie. It’s one thing to have sound arguments with scientific proof backed by legitimate studies in order to prove a point, but it is another to say “we say this” or “experts say this” yet have nothing to show for it. I have kindly attached a few articles for your reading, and reference.

    Fujii, Y., Suzuki, K., Sato, T., Muraka, Y., & Takahashi, T. (1998). Multiple Personality Disorder in Japan. Psychiatry and Clinical Neurosciences, 52, 299-302

    Maldonado, J. R., Butler, L. D., & Spiegel, D. (2002). Treatments for dissociative disorders. In A Guide to Treatments That Work (2nd Ed.). New York: Oxford University Press.

    Dissociative Identity Disorder: An Australian Series
    Aust N Z J Psychiatry December 1998 32: 794-804,

    http://psychcentral.com/lib/dispelling-myths-about-dissociative-identity-disorder/

    As a student of Psychology, I look forward to the possibility of coming across your name again in regards to some psychological illness. It is only through the doubts and the questioning can we begin to understand that which is unknown, and there is nothing a good psychologist likes more, than to make known that which is unknown. Good luck.

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    • Hi Anonymous, Thank you for your comments.

      I use wiki as a starting resource at times. I agree it isn’t always reliable that’s why I do more research to confirm wiki.

      The resources you left were published in the 90’S. About as out of date as possible unless you are seeking an historical perspective. Psych Central is a bust IMHO. Unreliable info and completely unable to report a rounded view of MPD/DID.

      I don’t think any source should be ignored. It’s a good idea to read all angles of these issues.

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  2. Anonymous

     /  01/26/2012

    Very well put, I believe in the credibility of the DSM. I rely on this module for a lot of my educational research. On the other hand, I feel that there should be more research before the DSM includes personality disorders as a diagnostic category. Accepting the inclusion of a mental disorder’s legitimacy based on whether or not it is in the DSM, is an unreliable way to decide whether or not to acknowledge the diagnosis, or to seek it. Inside the society of psychiatry, there is no unanimous acknowledged treatment, no precise way to diagnose it, no unanimous terminology or unanimous definitions of terms to use, and no definitions of terms used most frequently. Another factor is no drug has been found effective for a cure. The drugs used today are used to alleviate the symptoms. I agree with the opponents that argue that even when a diagnostic criteria set is accepted across different cultures, it does not necessarily indicate that the underlying constructs have any validity within those cultures; even valid relevance might only demonstrate consistency, not legitimacy. I most emphatically feel that there is a need for implementing more education in cross-cultural psychiatry.

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    • Thank you for voicing your opinions, Anonymous.

      You said you rely on the DSM and find it credible, yet you went on to list very serious criticisms of it. How can the two opposing views of this book work?

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      Reply
    • @Anonymous. I know I replied, but the reply fairy stole it.

      I fully understand the need for a manual in any profession to help diagnose illness. The DSM has gotten political and every hang-nail has a diagnostic category and code.

      The biggest problem I see is that patients think, wrongly, that this bible of psychiatry has more meaning than it does.

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  3. Sue

     /  08/02/2011

    My husband was diagnosed with DID a little over a year ago and our lives (and marriage) have been slowly unraveling. I should have listened to my inner voice when his therapist used a bogus diagnosis because our insurance wouldn’t pay for DID. Can you say insurance fraud? My husband is so far gone in his mental disorder now to realize his therapist is a bottom feeder. We are both victims.

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    • Oh Sue, I’m sorry to learn of your troubles. Insurance fraud? Could be. When you say your husband is far gone in his “disorder” do you mean the multiple personalities? Remembering abuse, or what?

      Yes, you are both victims. How can I help? You can check out the reading list on this blog, and I can get more if it will help.

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  4. Anonymous

     /  02/07/2011

    BRAVO! Indeed, the DSM is a largely unscientific and dangerous cookbook, and there has been effort in the past to have the highly questionable “diagnoses” of the “dissociative disorders” REMOVED. Politics probably prevailed and I imagine DSM V will continue to provided ignorant, poorly trained, heavily indoctrinated and biased “therapists” (e.g., ISSTD members and “trauma therapists”) with the means to damage more lives via the misinformation in the “bible” of their industry.

    It is of serious importance that the United States, in particular, is increasingly over-represented in numbers of “diagnosed” cases of “DID” and other “dissociative disorders.” There seem to be conflicting conclusions among various studies (no surprise), but certainly one can find numerous publications claiming all sorts of correlations, including that “dissociative disorder diagnoses” are far more prevalent among females, that “dissociative disorders” are often “co-morbid” with any number of other “DSM-defined disorders,” the criteria necessary and sufficient for “diagnosing dissociative disorders” are poorly substantiated by valid science, etc.

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