BEYOND THE ADVANCED PSYCHIATRIC SOCIETY- A COLLECTIVE RESEARCH/ OLTRE LA SOCIETA' PSICHIATRICA AVANZATA- UNA RICERCA COLLETTIVA


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giovedì 3 novembre 2011

Planh per la morte di un giovane re [GC, 1988]



italianista e dialettologo
era lì tutto l’errore
non avere mai visto New York con i capelli al [vento
o le pianure del Midwest
o le Marina Towers-
ricordare un altro mondo (in absentia)
volere e non potere cantare ab joi
non avere mai letto fantascienza
spostarsi sempre, ma per rimanere su un [terreno sempre più  limitato       
& quanta solitudine
corpi decomposti per le strade, nelle prove [dei film, in un canneto lungo un fiume;
ucciso dal nulla,
dal nulla
Teògnide spiantato (raffinerie a Mègara)
pensando di essersi perso una volta per [sempre
e non che bisogna riperdersi volta dopo volta, [change with the times-
ucciso dal sublime linguaggio degli avi,
dalle cortine di pizzo  abbassate, dalle tazzine [anni ‘20
& dalla madre & da una gioventù in Friuli
& non avere imparato
la baia di Kingstown verso sera
& non avere imparato
la violenza dei frammenti di corpo
sognando di vivere in una torre vicino ad un [lago
invecchiare, adattarsi
non ci sono vittime innocenti.


non ci sono vittime innocenti
guardo con attenzione gli ippocastani alla [finestra
sotto il vento, il clima alterato, il buco [d’ozono,
aspetto la notte, lo splendente reticolo di luci
che significano morte
per incidente o elettrocuzione o attentato o [avvelenamento
bombe solitudine silenzio
amo questa Italia
how do you think it feels
come ci si sente
alcuni sono arrivati a qualcosa
altri no
non ci sono vittime innocenti.

perdonami.

ti penso.

abbi pietà di me.

Hardt/ Negri IMPERIO 1: 'MILITANTE' [2000, P. 355-357]






   En la era posmoderna, a medida que la figura del pueblo se disuelve, es el militante quien mejor expresa la vida de la multitud: el agente de la producción biopolítica y la resistencia contra el Imperio. Cuando hablamos del militante, no pensamos en algo parecido al triste, ascético agente de la Tercera Internacional cuya alma estaba profundamente permeada por la razón de Estado soviética, de igual modo que la voluntad del Papa estaba embebida en los corazones de los caballeros de la Sociedad de Jesús.  No estamos pensando en nada como eso ni en nadie que actúe sobre la base del deber y la disciplina, que pretenda que sus acciones se deduzcan de un plan ideal.
Por el contrario, nos referimos a alguien más parecido a los combatientes comunistas y libertadores de las revoluciones del siglo veinte, los intelectuales que fueron perseguidos y exiliados en el transcurso de las luchas antifascistas, los republicanos de la Guerra Civil española y los movimientos de resistencia europeos, y los guerreros de la libertad de todas las guerras anticoloniales y anti-imperialistas. Un ejemplo prototípico de esta figura revolucionaria es el agitador militante de los Trabajadores Industriales del Mundo. El Wobbly construyó asociaciones entre la gente trabajadora de abajo, mediante continua agitación, y al organizarlos posibilitó el desarrollo del pensamiento utópico y el conocimiento revolucionario. El militante fue el actor fundamental de la "larga marcha" de la emancipación del trabajo desde el siglo diecinueve hasta el veinte, la singularidad creativa de aquel movimiento
colectivo gigantesco que fue la lucha de la clase trabajadora.
   En todo este largo período, la actividad del militante consistió, primero, en prácticas de resistencia en la fábrica y la sociedad contra la explotación capitalista. Consistió también, mediante y más allá de la resistencia, en la construcción colectiva y el ejercicio de un contrapoder capaz de destruir el poder del capitalismo, y oponerse a él con un programa alternativo de gobierno. En oposición al cinismo de la burguesía, a la alienación monetaria, a la expropiación de la vida, a la explotación del trabajo, a la colonización de los afectos, el militante organizó la lucha. La insurrección fue el orgulloso emblema del militante. Este militante fue repetidamente martirizado en la trágica historia de las luchas comunistas. A veces, aunque no a menudo, la estructura normal del Estado de derecho fue suficiente para las tareas represivas requeridas para destruir al contrapoder. Sin embargo, cuando no fueron suficientes, se invitó a los fascistas y los guardianes blancos del terror de Estado, o a las mafias negras al servicio de los capitalismos "democráticos", a prestar su ayuda para reforzar las estructuras represivas legales.
   Hoy, tras tantas victorias capitalistas, luego que las esperanzas socialistas se han marchitado en la desilusión, y luego de que la violencia capitalista contra el trabajo se ha solidificado bajo el nombre del ultraliberalismo, ¿porqué aún emergen instancias de militancia, porqué se han profundizado las resistencias y porqué reemerge continuamente la lucha, con nuevo vigor? 
   Debemos decir que esta nueva militancia no repite, simplemente, las fórmulas organizativas de la antigua clase trabajadora revolucionaria. Hoy el militante no puede ni siquiera pretender ser un representante, ni aún de las necesidades humanas fundamentales de los explotados. El militante político revolucionario actual, por el contrario, debe redescubrir la que ha sido siempre su propia forma: no la actividad representativa sino la constituyente. Hoy la militancia es una actividad innovadora, constructiva y positiva. Esta es la forma en la
que nosotros y todos aquellos que se rebelan contra el mando del capital hoy nos reconocemos como militantes. Los militantes resisten el comando imperial de un modo creativo. En otras palabras, la resistencia está unida inmediatamente con
una inversión constitutiva en la esfera biopolítica y con la formación de aparatos cooperativos de producción y comunidad. Aquí está la fuerte novedad de la militancia actual: repite las virtudes de la acción insurreccional de doscientos años de experiencia subversiva, pero al mismo tiempo está unido a un nuevo mundo, un mundo que no tiene exterior. Sólo conoce un interior, una participación vital e ineludible en el conjunto de estructuras sociales, sin posibilidad de trascenderlas. Este interior es la cooperación productiva de la intelectualidad de masas y las redes afectivas, la productividad de la biopolítica posmoderna. Esta militancia transforma la resistencia en contrapoder y cambia la rebelión en un proyecto de amor.
   Hay una antigua leyenda que puede servir para ilustrar la vida futura de la militancia comunista: la de San Francisco de Asís. Consideremos su obra.  Para denunciar la pobreza de la multitud adoptó esa condición común y descubrió allí el poder ontológico de una nueva sociedad. El militante comunista hace lo mismo, identificando en la condición común de la multitud su enorme riqueza. Francisco, oponiéndose al naciente capitalismo, rechazó toda disciplina instrumental, y en oposición a la mortificación de la carne (en la pobreza y el orden constituido) sostuvo una vida gozosa, incluyendo a todos los seres y a la naturaleza, los animales, la hermana luna, el hermano sol, las aves del campo, los pobres y explotados humanos, juntos contra la voluntad del poder y la corrupción. 
   Una vez más, en la posmodernidad nos hallamos en la situación de Francisco, levantando contra la miseria del poder la alegría de ser. Esta es una revolución que ningún poder logrará controlar-porque biopoder y comunismo, cooperación y revolución, permanecen juntos, en amor, simplicidad, y también inocencia. Esta es la irreprimible alegría y gozo de ser comunistas.

mercoledì 2 novembre 2011

Hardt/ Negri EMPIRE 1: 'MILITANT' [2000, pp 411-413]




   In the postmodern era, as the figure of the people dissolves, the militant is the one who best expresses the life of the multitude: the agent of biopolitical production and resistance against Empire. When we speak of the militant, we are not thinking of anything like the sad, ascetic agent of the Third International whose soul was deeply permeated by Soviet state reason, the same way the will of the pope was embedded in the hearts of the knights of the Society of Jesus. We are thinking of nothing like that and of no one who acts on the basis of duty and discipline, who pretends his or her actions are deduced from an ideal plan. We are referring, on the contrary, to something more like the communist and liberatory combatants of the twentieth-century revolutions, the intellectuals who were persecuted and
exiled in the course of anti-fascist struggles, the republicans of the Spanish civil war and the European resistance movements, and the freedom fighters of all the anticolonial and anti-imperialist wars. A prototypical example of this revolutionary figure is the militant agitator of the Industrial Workers of the World. The Wobbly constructed associations among working people from below, through continuous agitation, and while organizing them gave rise to utopian thought and revolutionary knowledge. The militant was the fundamental actor of the ‘‘long march’’ of the emancipation of labor from the nineteenth to the twentieth centuries, the creative singularity of that gigantic collective movement that was working-class struggle.
   Across this long period, the activity of the militant consisted, first of all, in practices of resistance in the factory and in society against capitalist exploitation. It consisted also, through and beyond resistance, in the collective construction and exercise of a counterpower capable of destructuring the power of capitalism and opposing it with an alternative program of government.
In opposition to the cynicism of the bourgeoisie, to monetary alienation, to the expropriation of life, to the exploitation of labor, to the colonization of the affects, and so on, the militant organized the struggle. Insurrection was the proud emblem of the militant. This militant was repeatedly martyred in the tragic history of communist struggles. Sometimes, but not often, the
normal structures of the rights state were sufficient for the repressive tasks required to destroy the counterpower. When they were not sufficient, however, the fascists and the white guards of state terror, or rather the black mafias in the service of ‘‘democratic’’ capitalisms, were invited to lend a hand to
reinforce the legal repressive structures.
   Today, after so many capitalist victories, after socialist hopes have withered in disillusionment, and after capitalist violence against labor has been solidified under the name of ultra-liberalism, why is it that instances of militancy still arise, why have resistances deepened, and why does struggle continually reemerge with new vigor? We should say right away that this
new militancy does not simply repeat the organizational formulas of the old revolutionary working class. Today the militant cannot even pretend to be a representative, even of the fundamental human needs of the exploited.
   Revolutionary political militancy today, on the contrary, must rediscover what has always been its proper form: not representational but constituent activity. Militancy today is a positive, constructive, and innovative activity. This is the form in which we and all those who revolt against the rule of capital recognize ourselves as militants today. Militants resist imperial
command in a creative way. In other words, resistance is linked immediately with a constitutive investment in the biopolitical realm and to the formation of cooperative apparatuses of production and community. Here is the strong novelty of militancy today: it repeats the virtues of insurrectional action 
of two hundred years of subversive experience, but at the same time it is linked to a new world, a world that knows no outside. It knows only an inside, a vital and ineluctable participation in the set of social structures, with no possibility of transcending them. This inside is the productive cooperation of mass intellectuality and affective networks, the productivity of postmodern biopolitics. This militancy makes resistance into counterpower and makes rebellion into a project of love.
   There is an ancient legend that might serve to illuminate the future life of communist militancy: that of Saint Francis of Assisi. Consider his work. To denounce the poverty of the multitude he adopted that common condition and discovered there the ontological power of a new society. The communist militant does the same, identifying in the common condition of the multitude its enormous wealth. Francis in opposition to nascent capitalism refused every instrumental discipline, and in opposition to the mortification of the flesh (in poverty and in the constituted order) he posed a joyous life including all of being and nature, the animals, sister moon, brother sun, the birds of the field, the poor and exploited humans, together against the
will of power and corruption. Once again in postmodernity we find ourselves in Francis’s situation, posing against the misery of power the joy of being.
   This is a revolution that no power will control—because biopower and communism, cooperation and revolution remain together, in love, simplicity,and also innocence. This is the irrepressible lightness and joy of being communist.





LINK: IVAN FASSIO: "Cronache dell’Esistenza dal Mondo delle Macchine. La Luce Verde dell’Apocalisse di Jean Paul Charles"





http://www.cinquepezzifacili.it/cronache-dellesistenza-dal-mondo-delle-macchine-la-luce-verde-dellapocalisse-di-jean-paul-charles




Apocalypse Green. In mostra a Torino dal 2 al 6 novembre 2011


[vedi 
http://gconse.blogspot.com/2011/10/apocalypse-green-e-altro-jean-paul.html ]

martedì 1 novembre 2011

'lettera aperta al DSM 5'/ DSM 5 petition (da Pietro Barbetta)


A tutti i destinatari, psicologi, medici, familiari di pazienti, pazienti, studenti di psicologia, di psicoterapia,di psichiatria. Il sito sopra indicato permette di firmare per inpedire l'uscita del DSM 5 così come impostato. Il testo, in inglese, indica alcuni elementi chiave  d'insoddisfazione da parte di molti operatori. Non è il migliore dei testi possibili, tuttavia ognuno di voi, al momento della firma può scrivere (in inglese) le ragioni del proprio dissenso riguardo ai metodi e ai contenuti di questa nuova (possibile) edizione.
(da pietro barbetta)



 QUESTO E' IL TESTO DELLA PETIZIONE (ANDARE AL LINK SE SI VUOLE FIRMARE):

To the DSM-5 Task Force and the American Psychiatric Association: As you are aware, the DSM is a central component of the research, education, and practice of most licensed psychologists in the United States. Psychologists are not only consumers and utilizers of the manual, but we are also producers of seminal research on DSM-defined disorder categories and their empirical correlates. Practicing psychologists in both private and public service utilize the DSM to conceptualize, communicate, and support their clinical work. For these reasons, we believe that the development and revision of DSM diagnoses should include the contribution of psychologists, not only as select individuals on a committee, but as a professional community. We have therefore decided to offer the below response to DSM-5 development. This document was composed in recognition of, and with sensitivity to, the longstanding and congenial relationship between American psychologists and our psychiatrist colleagues. Overview Though we admire various efforts of the DSM-5 Task Force, especially efforts to update the manual according to new empirical research, we have substantial reservations about a number of the proposed changes that are presented on www.dsm5.org. As we will detail below, we are concerned about the lowering of diagnostic thresholds for multiple disorder categories, about the introduction of disorders that may lead to inappropriate medical treatment of vulnerable populations, and about specific proposals that appear to lack empirical grounding. In addition, we question proposed changes to the definition(s) of mental disorder that deemphasize sociocultural variation while placing more emphasis on biological theory. In light of the growing empirical evidence that neurobiology does not fully account for the emergence of mental distress, as well as new longitudinal studies revealing long-term hazards of standard neurobiological (psychotropic) treatment, we believe that these changes pose substantial risks to patients/clients, practitioners, and the mental health professions in general. Given the changes currently taking place in the profession and science of psychiatry, as well as the developing empirical landscape from which psychiatric knowledge is drawn, we believe that it is important to make our opinions known at this particular historical moment. As stated at the conclusion of this letter, we believe that it is time for psychiatry and psychology collaboratively to explore the possibility of developing an alternative approach to the conceptualization of emotional distress. We believe that the risks posed by DSM-5, as outlined below, only highlight the need for a descriptive and empirical approach that is unencumbered by previous deductive and theoretical models. In more detail, our response to DSM-5 is as follows: Advances Made by the DSM-5 Task Force We applaud certain efforts of the DSM-5 Task Force, most notably efforts to resolve the widening gap between the current manual and the growing body of scientific knowledge on psychological distress. In particular, we appreciate the efforts of the Task Force to address limitations to the validity of the current categorical system, including the high rates of comorbidity and Not Otherwise Specified (NOS) diagnoses, as well as the taxonomic failure to establish ‘zones of rarity’ between purported disorder entities (Kendell & Jablensky, 2003). We agree with the APA/DSM-5 Task Force statement that, from a systemic perspective, "The DSM-III categorical diagnoses with operational criteria were a major advance for our field, but they are now holding us back because the system has not kept up with current thinking. Clinicians complain that the current DSM-IV system poorly reflects the clinical realities of their patients. Researchers are skeptical that the existing DSM categories represent a valid basis for scientific investigations, and accumulating evidence supports this skepticism." (Schatzberg, Scully, Kupfer, & Regier, 2009) As researchers and clinicians, we appreciate the attempt to address these problems. However, we have serious reservations about the proposed means for doing so. Again, we are concerned about the potential consequences of the new manual for patients and consumers; for psychiatrists, psychologists, and other practitioners; and for forensics, health insurance practice, and public policy. Our specific reservations are as follows: Lowering of Diagnostic Thresholds The proposal to lower diagnostic thresholds is scientifically premature and holds numerous risks. Diagnostic sensitivity is particularly important given the established limitations and side-effects of popular antipsychotic medications. Increasing the number of people who qualify for a diagnosis may lead to excessive medicalization and stigmatization of transitive, even normative distress. As suggested by the Chair of DSM-IV Task Force Allen Frances (2010), among others, the lowering of diagnostic thresholds poses the epidemiological risk of triggering false-positive epidemics. We are particularly concerned about: • “Attenuated Psychosis Syndrome,” which describes experiences common in the general population, and which was developed from a “risk” concept with strikingly low predictive validity for conversion to full psychosis. • The proposed removal of Major Depressive Disorder’s bereavement exclusion, which currently prevents the pathologization of grief, a normal life process. • The reduction in the number of criteria necessary for the diagnosis of Attention Deficit Disorder, a diagnosis that is already subject to epidemiological inflation. • The reduction in symptomatic duration and the number of necessary criteria for the diagnosis of Generalized Anxiety Disorder. Though we also have faith in the perspicacity of clinicians, we believe that expertise in clinical decision-making is not ubiquitous amongst practitioners and, more importantly, cannot prevent epidemiological trends that arise from societal and institutional processes. We believe that the protection of society, including the prevention of false epidemics, should be prioritized above nomenclatural exploration. Vulnerable Populations We are also gravely concerned about the introduction of disorder categories that risk misuse in particularly vulnerable populations. For example, Mild Neurocognitive Disorder might be diagnosed in elderly with expected cognitive decline, especially in memory functions. Additionally, children and adolescents will be particularly susceptible to receiving a diagnosis of Disruptive Mood Dysregulation Disorder or Attenuated Psychosis Syndrome. Neither of these newly proposed disorders have a solid basis in the clinical research literature, and both may result in treatment with neuroleptics, which, as growing evidence suggests, have particularly dangerous side-effects (see below)—as well as a history of inappropriate prescriptions to vulnerable populations, such as children and the elderly Sociocultural Variation The DSM-5 has proposed to change the Definition of a Mental Disorder such that DSM-IV’s Feature E: “Neither deviant behavior (e.g., political, religious, or sexual) nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual,” will instead read “[A mental disorder is a behavioral or psychological syndrome or pattern] [t]hat is not primarily a result of social deviance or conflicts with society.” The latter version fails to explicitly state that deviant behavior and primary conflicts between the individual and society are not mental disorders. Instead, the new proposal focuses on whether mental disorder is a “result” of deviance/social conflicts. Taken literally, DSM-5’s version suggests that mental disorder may be the result of these factors so long as they are not “primarily” the cause. In other words, this change will require the clinician to draw on subjective etiological theory to make a judgment about the cause of presenting problems. It will further require the clinician to make a hierarchical decision about the primacy of these causal factors, which will then (partially) determine whether mental disorder is said to be present. Given lack of consensus as to the “primary” causes of mental distress, this proposed change may result in the labeling of sociopolitical deviance as mental disorder. Revisions to Existing Disorder Groupings Several new proposals with little empirical basis also warrant hesitation: • As mentioned above, Attenuated Psychosis Syndrome and Disruptive Mood Dysregulation Disorder (DMDD) have questionable diagnostic validity, and the research on these purported disorders is relatively recent and sparse. • The proposed overhaul of the Personality Disorders is perplexing. It appears to be a complex and idiosyncratic combined categorical-dimensional system that is only loosely based on extant scientific research. It is particularly concerning that a member of the Personality Disorders Workgroup has publicly described the proposals as “a disappointing and confusing mixture of innovation and preservation of the status quo that is inconsistent, lacks coherence, is impractical, and, in places, is incompatible with empirical facts” (Livesley, 2010), and that, similarly, Chair of DSM-III Task Force Robert Spitzer has stated that, of all of the problematic proposals, “Probably the most problematic is the revision of personality disorders, where they’ve made major changes; and the changes are not all supported by any empirical basis.” • The Conditions Proposed by Outside Sources that are under consideration for DSM-5 contain several unsubstantiated and questionable disorder categories. For example, “Apathy Syndrome,” “Internet Addiction Disorder,” and “Parental Alienation Syndrome” have virtually no basis in the empirical literature. New Emphasis on Medico-Physiological Theory Advances in neuroscience, genetics, and psychophysiology have greatly enhanced our understanding of psychological distress. The neurobiological revolution has been incredibly useful in conceptualizing the conditions with which we work. Yet, even after “the decade of the brain,” not one biological marker (“biomarker”) can reliably substantiate a DSM diagnostic category. In addition, empirical studies of etiology are often inconclusive, at best pointing to a diathesis-stress model with multiple (and multifactorial) determinants and correlates. Despite this fact, proposed changes to certain DSM-5 disorder categories and to the general definition of mental disorder subtly accentuate biological theory. In the absence of compelling evidence, we are concerned that these reconceptualizations of mental disorder as primarily medical phenomena may have scientific, socioeconomic, and forensic consequences. New emphasis on biological theory can be found in the following DSM-5 proposals: • The first of DSM-5’s proposed revisions to the Definition of a Mental Disorder transforms DSM-IV’s versatile Criterion D: “A manifestation of a behavioral, psychological, or biological dysfunction in the individual” into a newly collapsed Criterion B: [A behavioral or psychological syndrome] “That reflects an underlying psychobiological dysfunction.” The new definition states that all mental disorders represent underlying biological dysfunction. We believe that there is insufficient empirical evidence for this claim. • The change in Criterion H under “Other Considerations” for the Definition of a Mental Disorder adds a comparison between medical disorders and mental disorders with no discussion of the differences between the two. Specifically, the qualifying phrase “No definition adequately specifies precise boundaries for the concept of ‘mental disorder’” was changed to “No definition perfectly specifies precise boundaries for the concept of either ’medical disorder’ or ‘mental/psychiatric disorder’.” This effectively transforms a statement meant to clarify the conceptual limitations of mental disorder into a statement equating medical and mental phenomena. • We are puzzled by the proposals to “De-emphasize medically unexplained symptoms” in Somatic Symptom Disorders (SSDs) and to reclassify Factitious Disorder as an SSD. The SSD Workgroup explains: “…because of the implicit mind-body dualism and the unreliability of assessments of ‘medically unexplained symptoms,’ these symptoms are no longer emphasized as core features of many of these disorders.” We do not agree that hypothesizing a medical explanation for these symptoms will resolve the philosophical problem of Cartesian dualism inherent in the concept of “mental illness.” Further, merging the medico-physical with the psychological eradicates the conceptual and historical basis for somatoform phenomena, which are by definition somatic symptoms that are not traceable to known medical conditions. Though such a redefinition may appear to lend these symptoms a solid medico-physiological foundation, we believe that the lack of empirical evidence for this foundation may lead to practitioner confusion, as might the stated comparison between these disorders and research on cancer, cardiovascular, and respiratory diseases. • The proposed reclassification of Attention Deficit/Hyperactivity Disorder (ADHD) from Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence to the new grouping “Neurodevelopmental Disorders” seems to suggests that that ADHD has a definitive neurological basis. This change, in combination with the proposal to lower the diagnostic threshold for this category as described above, poses high risk of exacerbating the extant over-medicalization and over-diagnosis of this disorder category. • A recent publication by the Task Force, The Conceptual Evolution of DSM-5 (Regier, Narrow, Kuhl, & Kupfer, 2011), states that the primary goal of DSM-5 is “to produce diagnostic criteria and disorder categories that keep pace with advances in neuroscience.” We believe that the primary goal of DSM-5 should be to keep pace with advances in all types of empirical knowledge (e.g., psychological, social, cultural, etc.). Taken together, these proposed changes seem to depart from DSM’s 30-year “atheoretical” stance in favor of a pathophysiological model. This move appears to overlook growing disenchantment with strict neurobiological theories of mental disorder (e.g., “chemical imbalance” theories such as the dopamine theory of schizophrenia and the serotonin theory of depression), as well as the general failure of the neo-Kraepelinian model for validating psychiatric illness. Or in the words of the Task Force: “…epidemiological, neurobiological, cross-cultural, and basic behavioral research conducted since DSM-IV has suggested that demonstrating construct validity for many of these strict diagnostic categories (as envisioned most notably by Robins and Guze) will remain an elusive goal” (Kendler, Kupfer, Narrow, Phillips, & Fawcett, 2009, p. 1). We thus believe that a move towards biological theory directly contradicts evidence that psychopathology, unlike medical pathology, cannot be reduced to pathognomonic physiological signs or even multiple biomarkers. Further, growing evidence suggests that though psychotropic medications do not necessarily correct putative chemical imbalances, they do pose substantial iatrogenic hazards. For example, the increasingly popular neuroleptic (antipsychotic) medications, though helpful for many people in the short term, pose the long-term risks of obesity, diabetes, movement disorders, cognitive decline, worsening of psychotic symptoms, reduction in brain volume, and shortened lifespan (Ho, Andreasen, Ziebell, Pierson, & Magnotta, 2011; Whitaker, 2002, 2010). Indeed, though neurobiology may not fully explain the etiology of DSM-defined disorders, mounting longitudinal evidence suggests that the brain is dramatically altered over the course of psychiatric treatment. Conclusions In sum, we have serious reservations about the proposed content of the future DSM-5, as we believe that the new proposals pose the risk of exacerbating longstanding problems with the current system. Many of our reservations, including some of the problems described above, have already been articulated in the formal response to DSM-5 issued by the British Psychological Society (BPS, 2011) and in the email communication of the American Counseling Association (ACA) to Allen Frances (Frances, 2011b). In light of the above-listed reservations concerning DSM-5’s proposed changes, we hereby voice agreement with BPS that: • “…clients and the general public are negatively affected by the continued and continuous medicalization of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.” • “The putative diagnoses presented in DSM-V are clearly based largely on social norms, with 'symptoms' that all rely on subjective judgments, with little confirmatory physical 'signs' or evidence of biological causation. The criteria are not value-free, but rather reflect current normative social expectations.” • “… [taxonomic] systems such as this are based on identifying problems as located within individuals. This misses the relational context of problems and the undeniable social causation of many such problems.” • There is a need for “a revision of the way mental distress is thought about, starting with recognition of the overwhelming evidence that it is on a spectrum with 'normal' experience” and the fact that strongly evidenced causal factors include “psychosocial factors such as poverty, unemployment and trauma.” • An ideal empirical system for classification would not be based on past theory but rather would “ begin from the bottom up – starting with specific experiences, problems or ‘symptoms’ or ‘complaints’.” The present DSM-5 development period may provide a unique opportunity to address these dilemmas, especially given the Task Force’s willingness to reconceptualize the general architecture of psychiatric taxonomy. However, we believe that the proposals presented on www.dsm5.org are more likely to exacerbate rather than mitigate these longstanding problems. We share BPS’s hopes for a more inductive, descriptive approach in the future, and we join BPS in offering participation and guidance in the revision process. References American Psychiatric Association (2011). DSM-5 Development. Retrieved from http://www.dsm5.org/Pages/Default.aspx British Psychological Society. (2011) Response to the American Psychiatric Association: DSM-5 development. Retrieved from http://apps.bps.org.uk/_publicationfiles/consultation-responses/DSM-5%202011%20-%20BPS%20response.pdf Compton, M. T. (2008). Advances in the early detection and prevention of schizophrenia. Medscape Psychiatry & Mental Health. Retrieved from http://www.medscape.org/viewarticle/575910 Frances, A. (2010). The first draft of DSM-V. BMJ. Retrieved from http://www.bmj.com/ content/340/bmj.c1168.full Frances, A. (2011a). DSM-5 approves new fad diagnosis for child psychiatry: Antipsychotic use likely to rise. Psychiatric Times. Retrieved from http://www.psychiatrictimes.com/ display/article/10168/1912195 Frances, A. (2011b). Who needs DSM-5? A strong warning comes from professional counselors [Web log message]. Psychology Today. Retrieved from http://www.psychologytoday. com/blog/dsm5-in-distress/201106/who-needs-dsm-5 Hanssen, M., Bak, M., Bijl, R., Vollebergh, W., & van Os, J. (2005). The incidence and outcome of subclinical psychotic experiences in the general population. British Journal of Clinical Psychology, 44, 181-191. Ho, B-C., Andreasen, N. C., Ziebell, S., Pierson, R., & Magnotta, V. (2011). Long-term antipsychotic treatment and brain volumes. Archives of General Psychiatry, 68, 128-137. Johns, L. C., & van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21, 1125-1141. Kendell, R., & Jablensky, A. (2003). Distinguishing between the validity and utility of psychiatric diagnoses. The American Journal of Psychiatry, 160, 4-11. Kendler, K., Kupfer, D., Narrow, W., Phillips, K., & Fawcett, J. (2009, October 21). Guidelines for making changes to DSM-V. Retrieved August 30, 2011, from http://www.dsm5.org/ProgressReports/Documents/Guidelines-for-Making-Changes-to-DSM_1.pdf Livesley, W. J. (2010). Confusion and incoherence in the classification of Personality Disorder: Commentary on the preliminary proposals for DSM-5. Psychological Injury and Law, 3, 304-313. Moran, M. (2009). DSM-V developers weigh adding psychosis risk. Psychiatric News Online. Retrieved from http://pn.psychiatryonline.org/content/44/16/5.1.full Regier, D. A., Narrow, W. E., Kuhl, E. A., & Kupfer, D. J. (2011). The conceptual evolution of DSM-5. Arlington, VA: American Psychiatric Publishing. Schatzberg, A. F., Scully, J. H., Kupfer, D. J., & Regier, D. A. (2009). Setting the record straight: A response to Frances commentary on DSM-V. Psychiatric Times, 26. Retrieved from http://www.psychiatrictimes.com/dsm/content/article/10168/1425806 Whitaker, R. (2002). Mad in America. Cambridge, MA: Basic Books. Also see http://www. madinamerica.com/madinamerica.com/Schizophrenia.html Whitaker, R. (2010). Anatomy of an epidemic. New York, NY: Random House.

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