As most of us in the mental health field know, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) has replaced the revised DSM-IV as American psychiatry's one and only tool for diagnosis. Just about all social workers I know love to debate and play with this thing. I have spent twenty-five years in the treatment field, and have never read one. How could I work so long in the field, and not bow to the supremacy of such a powerful, all knowing tool?
Surprisingly the lead editor of the DSM-IV, Dr. AllenFrancis has come out saying in an interview in Wired Magazine: "there is no definition of mental disorder. It's bullshit, I mean, you can't define it." He has also recently written a book called Saving Normal: An insider's revolt against out-of-control diagnosis, DSM-5, Big Pharma, and the medicalization of everyday life.
We have been told that the DSM-5 will revolutionize diagnosis and treatment. However, Dr. Francis suggests that there were problems with the new manual, suggesting in an article in CCHR International: it "contains errors that went unnoticed or were outright ignored. Quality control was minimal; nobody but the team developing it saw it till it was finished. There were conflicts of interest-e.g. friends of Big Pharma CEOs on the task force-that influenced the development of new diagnoses and changes to old ones." He further predicts that this will lead to "epidemics and fads of certain new and expanded diagnoses that become applied to smaller and smaller differences from 'normal,' until normal disappears and nearly everyone is diagnosable with something." As if previous manuals had not done the same thing.
In twenty-five years working with chronic mental illness I have rarely looked at a client's diagnosis. I found that if I did, it colored the way that I looked at that person, in fact, made it difficult to see that person for who they were. Rather than seeing diagnosable symptoms, I saw rather fear, insecurity, anger, profound sadness, and often difficulty believing what the rest of us believed. This is not unusual for any of us. This stance helped me treat this client as a person with the same rights, hopes and deams as the rest of us.
I am concerned that more and more of us submit to diagnosis with the hope that something, anything from pills with horrendous side-effects to electro-shock therapy will allow us to feel better. I have known people on as many as thirty medications, or who have submitted to a series of shock treatments who say it doesn't help, I still feel so sad.
As usual most of this is smoke and mirrors. We are not fixing anyone with these methods. Healing comes from within. Western medicine and psychiatry are dismal failures in so many areas. Why else would so many of us turn to alternatives, such as Buddhism, Traditional Chinese Medicine and Mindfulness?
Mindfulness and Mindfulness based therapies such as Acceptance and Commitment Therapy suggest that difficult thoughts, feelings and memories cannot be banished, rather our thinking is often habitual and unproductive. We are often hopelessly caught up in believing what we think to be true, and real; when at best our thinking is nothing but an attempt to surmise what we are experiencing. For example, if you have ever tried to explain how you loved someone, only to realize what a poor, and impossible attempt it was.
Mindfulness teaches us to simply notice our thoughts for what they are- words and pictures; to put space between these thoughts in an effort to realize that these images exist in a background of silence, and that this silence is what we truly are, silent and at peace.
I am concerned that so many of us think badly of ourselves in so many habitual and destructive ways. Imagine that we could just take a step back from these beliefs and for once see the totality of our truth. We are not our beliefs, our wayward behaviours, the lies. We are much more that this, and nothing. We are the silence within which plays out our experience. This experience can be whatever you would like it to be. You simply choose.