Audiobook14 hours
The Book of Woe: The DSM and the Unmaking of Psychiatry
Written by Gary Greenberg
Narrated by David Drummond
Rating: 4.5 out of 5 stars
4.5/5
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About this audiobook
For more than two years, author and psychotherapist Gary Greenberg has embedded himself in the war that broke out over the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM)-the American Psychiatric Association's compendium of mental illnesses and what Greenberg calls "the book of woe."
Since its debut in 1952, the book has been frequently revised, and with each revision, the "official" view on which psychological problems constitute mental illness. Homosexuality, for instance, was a mental illness until 1973, and Asperger's gained recognition in 1994 only to see its status challenged nearly twenty years later. Each revision has created controversy, but the DSM-5, the newest iteration, has shaken psychiatry to its foundations. The APA has taken fire from patients, mental health practitioners, and former members for extending the reach of psychiatry into daily life by encouraging doctors to diagnose more illnesses and prescribe more therapies-often medications whose efficacy is unknown and whose side effects are severe. Critics-including Greenberg-argue that the APA should not have the naming rights to psychological pain or to the hundreds of millions of dollars the organization earns, especially when even the DSM's staunchest defenders acknowledge that the disorders listed in the book are not real illnesses.
Greenberg's account of the history behind the DSM, which has grown from pamphlet-sized to encyclopedic since it was first published, and his behind-the-scenes reporting of the deeply flawed process by which the DSM-5 has been revised is both riveting and disturbing. Anyone who has received a diagnosis of mental disorder, filed a claim with an insurer, or just wondered whether daily troubles qualify as true illness should know how the DSM turns suffering into a commodity and the APA into its own biggest beneficiary. Invaluable and informative, The Book of Woe is bound to spark intense debate among expert and casual listeners alike.
Since its debut in 1952, the book has been frequently revised, and with each revision, the "official" view on which psychological problems constitute mental illness. Homosexuality, for instance, was a mental illness until 1973, and Asperger's gained recognition in 1994 only to see its status challenged nearly twenty years later. Each revision has created controversy, but the DSM-5, the newest iteration, has shaken psychiatry to its foundations. The APA has taken fire from patients, mental health practitioners, and former members for extending the reach of psychiatry into daily life by encouraging doctors to diagnose more illnesses and prescribe more therapies-often medications whose efficacy is unknown and whose side effects are severe. Critics-including Greenberg-argue that the APA should not have the naming rights to psychological pain or to the hundreds of millions of dollars the organization earns, especially when even the DSM's staunchest defenders acknowledge that the disorders listed in the book are not real illnesses.
Greenberg's account of the history behind the DSM, which has grown from pamphlet-sized to encyclopedic since it was first published, and his behind-the-scenes reporting of the deeply flawed process by which the DSM-5 has been revised is both riveting and disturbing. Anyone who has received a diagnosis of mental disorder, filed a claim with an insurer, or just wondered whether daily troubles qualify as true illness should know how the DSM turns suffering into a commodity and the APA into its own biggest beneficiary. Invaluable and informative, The Book of Woe is bound to spark intense debate among expert and casual listeners alike.
Author
Gary Greenberg
Gary Greenberg has a doctorate in psychology and has been a practising psychotherapist for more than twenty years. He is the author of The Self on the Shelf: Recovery Books and the Good Life and major articles for McSweeney's, The New Yorker and Harpers. He lives in Connecticut.
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Reviews for The Book of Woe
Rating: 4.666666666666667 out of 5 stars
4.5/5
9 ratings2 reviews
- Rating: 4 out of 5 stars4/5a cathartic read for me. it’s always nice to discover that others out there think some of the thoughts you do especially when they are against mainstream knowledge and belief. it feels a bit like finding a home.
Greenberg reports on the process of creating the new DSM-5: the 5th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. He is, himself, a psychotherapist rather than a psychiatrist and isn’t outright antipsychiatric as Allen Frances, one of the main players in his tale, believes him to be but, nevertheless, understands that the “illnesses” in the DSM do not represent medical diseases in any scientific sense.
the story he tells is one of intrigue, hubris, and self-deluded bumbling. the APA struggles to “fix” the problem of the previous DSMs by bringing in hard, neurological evidence and criteria for diagnosis. it doesn’t work but, despite this, the new DSM hurtles towards publication and dissemination.
mostly, you hear a black and white story where either people believe in mental illness and psychiatry’s role in helping people or you don’t believe in mential illness and think that the paradigm promulgated by psychiatrists is a kind of new priesthood, making up sins for modern, secular times. Greenberg’s book, however, brings nuance to this picture in various ways but mostly by outlining Allen Frances’s point of view that he’s against what they’re doing to create the DSM-5 because of the lack of empirical evidence for any of the “illnesses” listed in the book but yet isn’t antipsychiatric because the profession does lots of good by providing ways for people to think about their suffering. the placebo effect is central to psychiatry’s efficacy. and he wants it to stay that way. he doesn’t want it revealed that these “illnesses” are nothing more than socially defined problems.
it’s a great book to read whether you are for or against the APA and its ilk because it elucidates the process by which one of the most powerful book in history is revised. names and dates and quotes from those intimately involved are given openly. it reveals details on a mostly closed society and how it operates in the face of criticism. it brings questions to bear on the whole paradigm of mental illness apart from Thomas Szasz and his devotees’ well-known rants. an intimate look at an industry that has come to define us in very fundamental ways. - Rating: 4 out of 5 stars4/5This is a very insightful look at the attempt to classify disorders that have very few diagnostic tests or patterns, can vary considerably from individual to individual, and are often affected by circumstance. Perhaps more than any other diseases, those in the DSM are misunderstood, often misdiagnosed and treatment routinely falls down as a result.
At times, The Book of Woe was a little dry, but this is a serious and important volume; it's immensely difficult to prevent the knowledge and its implications from weighing heavy on one's mind. If you have any interest in the DSM, psychiatry or medicine in general, this is a must read eye-opener.