Psychiatrist: grief deserves dignity, not its own diagnosis as a disease

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One of the most frequent critics of the revision of psychiatry’s “bible,” the Diagnostic and Statistical Manual (or DSM, now going on DSM-V), is Allen Frances, M.D., who chaired the DSM-IV Task Force and is currently professor emeritus at Duke.  He writes on a “DSM-5 in Distress” blog on the Psychology Today website.

In his latest post, he addresses “the proposed medicalization of normal grief into a mental disorder.”

He cites an article written by Dr. Joanne Cacciatore, “a researcher at Arizona State University and the founder of the MISS Foundation- a nonprofit organization providing services to grieving families whose children have died or are dying.” Excerpt of what she wrote:

“I have long opposed the DSM-5 suggestion to remove the bereavement  exclusion, but chose to remain silent because I simply could not believe it had any chance of making it into the final version of the manual. It made no sense that DSM-5 would allow providers to diagnose a serious mental disease—Major Depressive Disorder—when people are having nothing more than the perfectly normal symptoms of grief.

I decided to speak now because it appears almost certain that DSM-5 will actually go forward with this poorly conceived proposal to pathologize the authentic human experience of sorrow.”

Frances summarizes:

Previously, DSM-5 has brushed off the many thoughtful and spirited criticisms mounted by experts in the field disputing its interpretation of the scientific literature as it relates to the diagnostic issues involved in grief. DSM-5 has equally shrugged off the criticisms coming from the broader field of medicine- as expressed in the Lancet. And DSM-5 has responded testily and ineffectually to the unanimous ridicule it has received in the world press.

Long ago, the APA (American Psychiatric Association) should have realized that this suggestion needs a quick and decisive rejection—instead it turned a blind eye to all previous warnings. Now APA faces a far more serious and undeniable opposition—a spontaneous revolt by the large community of the bereaved. They soundly reject the DSM 5 proposal and refuse to allow themselves to be misdiagnosed by it. It has now come down to DSM 5 against the world. How long can APA depart from common sense and continue in the folly of medicalizing normal grief? I hope that APA will finally hear Dr. Cacciatore’s plea and act swiftly on it.

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