Cultural imperialism of the DSM

There is certainly no lack of critiques being levied at the DSM-5 these days. In an interesting review of the American Psychiatric Association’s purple tome for the London Review of Books, Ian Hacking likens the whole concept of a diagnostic manual acting as the foundation of a bureaucratic mental health care system to “cultural imperialism”:

Mental disorders have to be identifiable by means of the DSM, because the US is the biggest market for medications. Partly to avoid ethics committees, and partly to keep a global net in place, the gene-hunters often go to impoverished places. In one case, a French drug company wanted DNA from bipolar patients. There was an underfunded mental hospital in Argentina, but it was psychodynamic in practice. Bipolar disorder is Kraepelinian, not Freudian, and so the hospital had no patients diagnosed as bipolar. The drug company made an offer the hospital could not refuse. So it reclassified its patients to DSM standards; doctors rethought and the patients experienced the symptoms in new ways. Such are the mechanisms of cultural imperialism.

Read the full story.


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