The Selling of DSM
The Rhetoric of Science in Psychiatry
When it was first published in 1980, the Diagnostic and Statistical Manual of Mental Disorders, Third Edition—universally known as DSM-III—embodied a radical new method for identifying psychiatric illness. Kirk and Kutchins challenge the general understanding about the research data and the process that led to the peer acceptance of DSM-III. Their original and controversial reconstruction of that moment concentrates on how a small group of researchers interpreted their findings about a specific problem—psychiatric reliability—to promote their beliefs about mental illness and to challenge the then-dominant Freudian paradigm.
“Kirk and Kutchins provide a detailed and thoroughly documented critique of the development process of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), and of the resulting product. The authors' contention that DSM-III does not provide a diagnostic/classification system of high scientific credibility is a recurrent theme, and problems of diagnostic unreliability, in particular, are emphasized. But, more than the product, it is the process through which DSM-III was developed that comes in for detailed description and commentary. The role of Robert Spitzer, head of the DSM-III Task Force, and the extent to which he alledgedly permitted political as well as scientific considerations to influence the DSM-III development are the book's dominant themes. Serious concerns by dynamically oriented psychiatrists are documented; and from outside psychiatry, the American Psychological Association objections to the medical model and to the definition of mental disorders as a subset of medical disorders are noted. Recommended for undergraduate and graduate psychology collections and for medical libraries.”
—P. G. Romine, Choice
“Like the Zuni, whose intricate classification system projected their clan-based social order onto the natural world, modern psychiatry uses its classification system to embed its professional authority in the very definition of mental I llness. The official psychiatric nosology, published in the American Psychiatric Association’s Diagnostic and Statistical Manual, 3d edition (DSM-III), is thus both an instrument of professional dominance and the focus of resistance on the part of dominated mental health workers. The Selling of DSM is one such act of resistance, but one that offers a penetrating analysis of the political and rhetorical strategies by which the DSM-III was instituted. . . . This book is a critique of the field of mental health services that will help workers in that area take a more critical and reflexive stance toward DSM-III, IV, and beyond. For those interested in the sociology of psychiatry or the professions, it offers a fascinating, but decidedly partial, case study.”
—Daniel Breslau, Contemporary Sociology
"The Selling of DSM is a well-documented expose of the pretense that psychiatric diagnoses are the names of genuine diseases and of the authentication of this fraud by an unholy alliance of the media, the government, and psychiatry. I recommend this book to anyone concerned about the catastrophic economic and moral consequences of psychiatrizing the human predicament."
—Thomas Szasz, M.D., State Universityof New York, Health Science Center, Syracuse
"The book is fascinating, hard hitting, and well documented....Kirk and Kutchins describe the interlocked scientific and political issues clearly, precisely, and thoroughly. They show, convincingly, that DSM does not provide the diagnostic reliability its backers claim... .Kirk and Kutchins' judgments and interpretations are harsh, but also genuine. Supporters of DSM will recognize the events, structures, and processes described...."
—John Mirowsky, Department of Sociology, University of Illinois at Urbana-Champaign
"These authors have offered the reader their courage and their scholarship in this important book. Their analysis of the icon of DSM is both incisive and balanced, and it should provide all mental health practitioners fuel for thought and public debate."
—Carol H. Meyer, School of Social Work, Columbia University