Former Chairman of the Department of Psychiatry at Duke University School of Medicine and the task force that created DSM-IV, Alan Frances, MD, almost apologizes for helping to create false epidemics of attention deficit disorder, pediatric bipolar, and autism, in his March 1 LA Times editorial. To his credit, Dr. Frances warned us about psychiatric imperialism at least once before, with a June 26, 2009 article in Psychiatric Times.
But it's not a full apology. Those millions of children who were labeled and drugged according to the DSM since 1994 were "unintended consequences", which Frances' panel only brought about "inadvertently" despite their great and noble scientific efforts to avoid possible misuses of the system, their rigorous 3-stage procedures of empirical documentation, their transparent and inclusive blah, blah, blah, which was so explicitly accountable....
Just because all those kids were neurologically tampered with for no reason of real disease, just because their parents were defrauded, their bodies and minds altered without anyone's informed consent ... Well c'mon now, that's no reason to be harsh with a doctor, is it?
Frances speaks important truth to power when he writes, "Unfortunately, this therapeutic zeal creates an enormous blind spot to the great risks that come with overdiagnosis and unnecessary treatment. This is a societal issue that transcends psychiatry." He argues for caution against the forthcoming DSM-V, which he fears will make his own false-epidemic-creating work of two decades ago look positively benign by comparison.
He points out, "There can be no dramatic improvements in psychiatric diagnosis until we make a fundamental leap in our understanding of what causes mental disorders. The incredible recent advances in neuroscience, molecular biology, and brain imaging that have taught us so much about normal brain functioning are still not relevant to the clinical practicalities of everyday psychiatric diagnosis. The clearest evidence supporting this disappointing fact is that not even one biological test is ready for inclusion in the criteria sets for DSM-V."
This actually soft-pedals the more brutal truth, that after a full generation of empty promises, psychiatry has never learned to cure a single mental illness. They don't know what causes schizophrenia, or depression, or anything else, any better than they have ever known.
If Alan Frances wants to get right with his Hippocratic oath, I'm sorry, for my money he sure owes more than a half apology for inadvertent mistakes. He needs to be the guy who stops DSM-V cold. He needs to be a true hero.
An historical example I might recommend highly is that of Samuel Sewell, the only judge presiding at the Salem witch trials who later apologized. There are many parellels, actually.
Biographer Richard Francis writes in his introduction to Judge Sewell's Apology: The Salem Witch Trials & the Forming of an American Conscience, "An apology means repudiating an aspect of our past selves; in that way it's like a little suicide.... But there is another way of looking at it. Apology can be a creative act. It can liberate both the individual and his or her society. Apology frees you from the past and gives access to the future."
I hope we hear much more from Alan Frances and others in his shoes. And I sure pray for access to some future without this ... psychiatry.