Taking a narrative turn in psychiatry
A little over 30 years into its life journey, modern scientific psychiatry seems to be heading into a dark wood. Last year the US National Institute of Mental Health (NIMH) withdrew its support for the Diagnostic and Statistical Manual (DSM), which has often been called the “bible of psychiatry”.
Pharmaceutical companies are to some extent pulling back from psychiatric research and drug development. Activists, journalists, and academics from various perspectives are criticising psychiatric research, diagnoses, and treatments. Psychiatry, it seems, has gone astray from the road it set out on during the late 20th century and now seems to be veering into Dante's “arduous wilderness”.
All of this is personal for me; modern scientific psychiatry emerged around the same time I became a psychiatrist. In 1980, just a few years before I entered my residency at George Washington University, the American Psychiatric Association published—with much fanfare—the third edition of DSM. Leading psychiatrists at the time hailed DSM-3 as a revolutionary book that would lead to considerable modernisation of psychiatric diagnoses and treatment. It heralded a major shift away from psychoanalysis towards a more scientific approach to psychiatry. Unconscious conflicts, childhood traumas, and talk therapy gave way to broken brains, neurochemical imbalances, and psychopharmacological treatments. It seemed this tide of “modernisation” would go on indefinitely: more drugs would be developed, there would be more advances in neurological research, and the wave of scientific psychiatry would keep flowing forward. Instead, 34 years after the “revolutionary” DSM-3 was published, psychiatry has run into doubt, criticism, and uncertainty.
Read full article on the website of "The Lancet" press: here