Letter to the New Yorker magazine published 2-7-05
Alex Spiegel's "The Dictionary of a Disorder" summarizes well many of the reasons I left the active practice of psychiatry seven years ago after fourteen years of practice (board certified). It was primarily because of the "collective fantasy that the DSM was a genuine scientific tool". As pretend science, the DSM-III & IV were desperate attempts for psychiatry to legitimize itself within the field of medicine. One of the fatal flaws of the DSM was to decontextualize human behavior, as if it could be described in a pristine state of isolation, carved out of the lived experience in which it is embedded. In this endeavor, the profession of psychiatry could not see that it was deluding itself, by assuming the validity of their categories exists a priori and by not considering how psychiatrists know what they know. With such elaborate descriptions of "abnormal behaviors", the DSM's continues the process of the medicalization of many social problems and personal idiosyncrasies, leaving the mental health professional wondering what constitutes normal behavior.
Since the DSM committee members have historically been predominantly M.D.'s, (excluding Ph.D., M.S.W. or other degrees of mental health professionals), male, white, Judeo-Christian and American, the document they produce in a large part reflects their own values. In a blatant display of hubris, the creators of the DSM presume it to apply to all cultures, races and countries of the world. Dr. Spitzer and his profession failed to learn from the central scientific insights of the quantum mechanics revolution of the 20th century, namely, the inherent connection of the observer to the observed, and that describing an object is the act of creating it.
Hunter Yost M.D.
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