The Book of Woe

The DSM and the Unmaking of Psychiatry

De: Gary Greenberg

Narrado por: David Drummond

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 (APA) 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 has changed. Homosexuality, for instance, was a mental illness until 1973, and Asperger's gained recognition in 1994 only to see its status challenged nearly 20 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.

©2013 Gary Greenberg (P)2013 Tantor

A dishy take on psychiatry's diagnostic charade

This scintillating narrative exposes the absurd game of inside baseball that was played, while America's psychiatric heavyweights sought to create a more perfect collection of sham diagnoses. The audio version is well acted, and highly recommended if you like schadenfreude.

interesting book....

This book was good. Among other books I've read, it helped connect other points from other perspectives. All in all it was a good book. May listen to again in the future to refresh and reflect....

Psychiatry a pastime for only dummies.

Amazing. Inspiring. Earth shattering. Mind altering. Perspective breaking information that can literally have you at the edge of your seat both begging for more and asking to be done with it. This book touched me in a truly hard place. I am a direct descendent of Robert spitter. But everything in this book is 100% right. And the perspective itself I think is infallible. This book if in enough people's hands. Can change the world. Will it? I don't know. I can only speak from my experience as I prepare myself to read and listen again. To be captivated by experience and moved by the only thing that should move this world, truth!!!

Pathological history of the DSM & mental illness

I am a clinical psychotherapist with over 50,000 hours of direct contact clinical experience. My clinical orientation is primarily object relations and psychodynamics. I have been a state clinical supervisor for over 25 yers andI lecture on diagnosis and treatment strategies. I am only reviewing this book on the sections associated with psychopathology and not neurological disorders.

This book clearly describes the failure of the DSM due to it's stubborn commitment to a symptom based diagnostic system.

I attended a lecture by one of the top professionals at the Beck Institute on the use of CBT in the treatment of the Borderline Personality Disorder. (DSM-4 criteria) She started by stating (I paraphrase): With Borderlines, CBT therapy is 100% effective, 50% of the time. She also stated that a colleague was advocating that the Borderline category had 3 subsets within the symptom profile. Dependent, Anti-Social, and Spectrum. In my opinion, a great majority of Borderlines are actually non-criminal Anti-social personality disorders. CBT is useless with this population. This is not a failure of CBT...it's a failure of the diagnostic system that is unable to differentiate significantly different personality structures sharing the same diagnosis. Thus the high failure rate with this population.

This is just one simple example of the failure of a symptom based diagnostic system.

I highly recommend this book. It was easy to listen to, and the information was enlightening. He reveals the pressure and influence of the pharmaceutical companies as well as the flexible ethics of many of the influential psychiatrists working on the diagnostic categories.

Finally.....the elimination of the Asperger's diagnostic criteria was highly questionable. The amount of information on Asperger's available to the general public has been muted by the lack of support by the APA. Shame.

This book is well worth the read. Thank-you Gary Greenberg.

The Book of Whoa!

What would have made The Book of Woe better?

The fact that Gary Greenberg is only a psychotherapist and not a psychiatrist immediately raises the red flags that he has his own agenda to promote. He does. He has divorced himself from the whole sorry mess and does not use any codes or bill insurance companies. He does say that he tries to be benevolent in his billing scale. He further advocates for boys who want to be girls and vice versa and helps his patients to rationalize whatever behavior they choose.

Would you ever listen to anything by Gary Greenberg again?

No

Would you be willing to try another one of David Drummond’s performances?

Yes

What character would you cut from The Book of Woe?

This question is not really applicable to this book, but I suppose that I would have found the book more acceptable, if he hadn't pushed his own agenda so obviously.

Any additional comments?

I agree wholeheartedly that the DSM-5 is a book that no one really needs to buy and that the entire practice of psychiatry and psychology is pseudoscience.

Author's rage

I thought the book was unscholarly and reflected that the author seemed to have an axe to grind. This criticism is despite agreement with the author's point of view.

Slams the DSM, while barely indulging solutions

It's bureaucratic history lesson at best and a problematic slam poetry essay at worst.

Disappointment

This could be a very good book, and quite accurate, if the writer (and narrator) weren't so dramatic. Greenberg clearly has an axe to grind, so his approach is very slanted. Most clinicians (I am one) know there are many many flaws in DSM IV and 5; we work around it. But Greenberg takes it too literally. There are some issues ("diagnosis" needed for insurance, drug companies exploitation) but in general, i day-to-day clinical practice, DSM is not a "bible" nor a main ingredient.
As a result, Greenberg intends an anti-psychiatry screen rather than a balanced critique of DSM, and the profession. Its not fair, nor accurate; it is a one-sided approach.