Can The DSM Be Wrong?

Wednesday, January 31, 2007 -dr.bomb

Quoted within the book "Resisting 12-Step Coercion" are DSM criteria on the diagnosis of substance dependency. What I've noticed is how utterly arbitrary and wrong its criteria are and the flaws inherent in pathologizing human functioning.

For the uninitiated, the DSM (Diagnostic and Statistical Manual of Mental Disorders) is a weighty tome used by psychiatrists and psychologists to patholigize common problems in living. In the context of substance addiction it falls far short as to an actual definition of what addiction (euphemized as "substance abuse") is. In lieu of any real diagnosis it has no choice but to pathologize the various sticky situations the currently addicted get themselves into.

As you'll see, the DSM entry for "Alcohol (Substance) Dependence" (quoted from pp.18-20 of "Resisting 12-Step Coercion") is rife with enough misunderstanding and outright lack of knowledge of what substance addiction is (much less how to quit) that it can be easily tailored to incarcerate any hedonist, no matter what substance or activity at hand they choose to engage within is getting themselves into trouble.

Alcohol (Substance) Dependence

The current (fourth) edition of the DSM notes, "The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that usually results in tolerance, withdrawal, and compulsive drug-taking behavior" (APA, 1994, p. 176). DSM-IV defines the Criteria for Substance Dependence as follows:

Unfortunately, as will be fully explained, these so-called cognitive, behavioral, and physiological symptoms are nothing more than normal human functioning involving typical problems in living when and after using recreational drugs. While I have no idea who specifically wrote the DSM I do know that the DSM is to shrinks as the Big Book is to Buchmanites: A sacred work which has done its share of damage towards the uninitiated who truly wanted to solve their problems but wound up becoming ensnared by its dogma instead.

A fact never mentioned within this section of the DSM is that intoxication, in and of itself, can lead to people doing really stupid and harmful things. For example, DUI is a clear-cut public safety issue, or endangering one's own children within their family. Outside of that, as long as other nonconsenting people or others' property isn't harmed then this is a bunch of nonsense.

A. a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

Why a 12-month period? Why not a thirteen-month period instead? Or six months? Or one? The simple answer is that this timeframe was arbitrarily chosen for those who enter the treatment system need to be diagnosed (follow the bouncing dollar sign for the RGM/ATI is a multi-billion dollar pro-addiction scam). You think that someone who gets into trouble while or after drinking or drugging is going to be diagnosed by the Therapeutic State as being perfectly normal? Nah! Indoctrination into being an Alcoholic or Addict is the role in store for these problem users to play.

Unlike those creeps who run such a system I'm willing to give the user the benefit of a doubt. Only they know for certain if they themselves have a problem or not. They need not be quizzed as though they are a bunch of simpletons. And, when they say that they've had enough I'll take 'em on their word over any sycophantic follower of the pro-addiction cult any day of the week.

In other words, unlike the brain-dead followers and apologists for the current system, I view these people as competent, intelligent and above all else, responsible for their own actions. And, if I don't no one else will; especially the users themselves.

Is it truly maladaptive behavior or just normal to the point that it baffles neo-prohibitionist headshrinkers? Most of the criteria can be found here to be perfectly normal. Since normalcy and human resilience to adversity (tolerance) has been pathologized here within the DSM, one could find a way to turn these criteria into a list for other problems of living for the sake of treating more "undesirables".

1. tolerance, as defined by either of the following: a. a need for markedly increased amounts of the substance to achieve intoxication or desired effect b. markedly diminished effect with continued use of the same amount of the substance

Tolerance is a poor word choice here. What's actually occurring is natural and normal human adaptation.

A good example are people who are employed in stinky surroundings, such as in the sanitation field. Initially, the person in the first few days is repulsed by the stench of the rotting and putrifying waste. Over time that person becomes so accustomed to the strong aromas that the person no longer notices it around themselves and goes about the task of cleaning it up.

Or, sadly, the desensitization of the public to violence in the corporate owned/subsidised mass media. Carnage abounds yet not many people within the immediate area bats an eye. It's become so commonplace that exposed flesh within the context of human sexuality is, oddly, the culprit deemed more offensive than a fatal cranial evisceration (a headshot, if you will).

If tolerance is to be defined as a disorder then every single human being, young and old, is guilty of possessing it. And yes, sometimes we humans have to tolerate some rather horrible stuff just to get what we want out of life. In other words, that's normal!

2. withdrawal, as manifested by either of the following: a. the characteristic withdrawal syndrome for the substance b. the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms

Here's where the DSM uses circular reasoning to attempt to explain something very simple: Deprivation. If one misses something that once gave them pleasure then of course one would feel deprived when that one thing is taken from them.

In other words, this point pathologizes simple want and need. The person knows what he or she wants but can't get it. That's not a "withdrawal symptom". That's normal!

Besides, remember when such things used to be called hangovers? Thanks to the Therapeutic State, scholarly-sounding jargon serves to obscure simple well-known ages-old wisdom. Not to helpful, mind you. These clueless charlatans want only to confuse people further for the sake of indoctrination into their wonderful little pro-addiction cult.

3. the substance is often taken in larger amounts or over a longer period than was intended

Again, this symptom is nothing more than natural human adaptation itself and merely a duplication of its first criteria. And, since alcohol and other recreational drugs are pleasure-producing by their very nature, one may grow to like them despite the risks and is willing to devote extra time using them. Again, perfectly normal.

Think about it this way: One takes a puff off a joint and enjoys the high. What's the difference between that and a drink? Actually, there is none short of the taboo distinction that the neo-prohibitionists have given marijuana. Recreational drugs are used as directed for the sake of pleasure. The so-called numbness one seeks to feel is pure pleasure itself. Perfectly normal.

4. there is a persistent desire or unsuccessful efforts to cut down or control substance use

That persistent desire or craving is nothing more than temptation itself. Since alcohol and other recreational drugs are also inhibitive by nature there will be that crossover point where one simply wants to spend some time in that nice, warm and comfy "home zone" of intoxication. Sometimes that time is longer than usual when the person wants to go beyond that zone. Still again, perfectly normal behavior.

People drink or drug simply because they like the feeling produced by their choice of intoxicants. Unfortunately, due to the dishonesty of the Therapeutic State and its invasion of human culture, that honesty is replaced by dishonesty that gives more and more excuses for recreational drug use. Tragically, those excuses are more acceptable to a desensitized population looking for the easy fix rather than taking the hit of temporary anguish via deprivation.

Goodness help us all if there's a successful "treatment" for desire. The truth is anyone can resist the temptation to use; the majority of those who have a problem do, in the end, quit on their own. No one else will do it for them short of having someone lock 'em up.

5. a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects

That sounds like a perfectly acceptable weekend of full-out hedonistic behavior. Nothing is wrong with any of that as long as no other nonconsenting persons or their property are harmed outside of the user's own actions and self. It's ultimately the user who knows the score, how to proceed in the score and to deal with any of the consequences of that score. Still, again, perfectly normal behavior.

6. important social, occupational, or recreational activities are given up or reduced because of substance use

Some people like reading an engrossing book far past their bedtime. Or writing. Or playing music. Or video games. Or browsing the Internet. Or maintaining an authentic anti-addiction website. Or any other activity that gives something of value back to the person partaking in that activity: Pleasure!

But who defines what those important social, occupational, or recreational activities should be in this context? Instead of siding with human competence and letting the user decide for themselves it's the neo-prohibitionist, a lackey behind the long-fought failure known as the "War On Some Drugs" posing as a therapist or counselor, who wants control over another human being. The general consensus of these know-it-alls is that the user is stupid or engaging in activities that are far more offensive to the "helper" than the "helped".

Wanting pleasure is okay. Enjoying pleasure, no matter how politically incorrect the activity may be, is okay. Wanting to feel good is perfectly normal!

7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
(APA, 1994, p. 181)

Here's where the excuse of someone "self-medicating" comes into play. This one point is the grand medical excuse for continued drug use against one's own better judgment that says to KNOCK IT OFF! After all, these professionals who authored the DSM must know something, right? Thus, instead of following their own intuition, the user who wants to quit is steered down the harrowing path of becoming one "in recovery" and distrusting their own intuition that says "QUIT!" in the process.

Many problems are indeed made worse through recreational drug use. It is, after all, the price to be paid for that pleasure. Certainly drinkers know they're wrecking their livers or that smokers are burning out their lungs. And, as I'm sure that this will offend many so-called "do-gooders" out there who would rather have a more intrusive government in the form of a Therapeutic State to supervise over others "for their own good". I just have to say it:

WHO CARES?!?!?

It's not my lungs the smoker is burning out. It's not my liver the drunk is dissolving. It's certainly not my veins being engraved or being injected with disease. In fact, I flat out just don't care about what the user does to themself as long as it doesn't immediately harm another nonconsenting person's being or property. Simply because...

IT'S NOT MY JOB TO CARE!!!!!

My role is simply to lay ALL the facts out in the open for public perusal; especially the fact that the system has failed.

The whole idea behind personal responsibility is looking out for #1: Your own ass. I care about myself and my own personal politics and ethics. I know where my own recreational drug use took me so I took moral action with those bad consequences of those activities in mind. Thus, I NEVER smoke or drink. I quit!

If the person is willing to play they're willing to pay. From monetary figures to the wages of death itself, it's ultimately the individual who has to weigh the risks. It's the individual user who has to choose whether they choose to care more for a life of freedom of addiction or the freedom to suffer for it as the bill comes in. That is the price of freedom itself.

It's the user who is taking the risks and who is willing to pay the price for their fixes. That is 100%, de facto, normalcy in regards to their freedom to use or not! The ultimate irony is that the Therapeutic State steers them into an obvious pro-addiction system where the user is forced to believe that they have some sort of mythological disease via freethought-sapping religious cult indoctrination.

DSM-IV then, on the same page, goes on to refine the diagnosis, providing the distinction, "With Physiological Dependence: evidence of tolerance or withdrawal" or "Without Physiological Dependence: no evidence of tolerance or withdrawal."

It isn't so much as a refinement but an obfuscation where the DSM has pathologized adaptation and deprivation. Instead of providing a bona-fide diagnosis it simply goes on to use others' authority, the criminal justice system as an example, to justify its shoddy definitions of diagnosis.

Alcohol (Substance) Abuse

DSM-IV notes, "The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances" (APA, 1994, p. 182).

The entire idea of "substance abuse" is ludicrous. After all, if it truly abuse when someone is using that recreational drug for the sake of pleasure? Indeed, that would be using it as directed and not abuse.

What the DSM is actually describing is gluttony. Sometimes people just love whatever it is to the point of making complete pigs of themselves. Within the context of abuse, the fix of choice is not what's being abused. The user may harm themselves or others but the fix doesn't know, much less comprehend abuse. It's an inanimate object that someone has to use or do first before it can do something.

The truth is that "substance abuse" is nothing more that a roundabout way of going about Buchmanism's First Step. After all, the users are powerless over obtaining and using their various fixes. Thus, responsibility is shifted away from the users and to their fixes. Thus, the culmination of neo-prohibition, a.k.a. the "War On Some Drugs".

It defines the Criteria for Substance Abuse as:

A. a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

As shown above the so-called maladaptive pattern is quite normal. And again there's that arbitrary 12-month period of time where one is to be diagnosed and then indoctrinated into the lie that they're once an Alcoholic or Addict and will always be one.

How come these experts have lost track of the ethics of the Hippocratic Oath? Or did they simply mindlessly parrot the words as a child would in elementary school regarding the Pledge of Allegiance?

1. recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household)

The user clearly knows that they may get fired, fail school or neglect their family. Again, that's the potential price to be paid for their pursuit of and engagement within that pleasurable activity. In regards to child neglect (clearly a situation where others' lives are endangered) the criminal justice system can take care of that matter. The rest is simply that person's own business and only they can weigh the benefits of their use (pleasure) versus the risks of job or education loss.

In other words, if you're hurting or endangering someone else and wind up with that on your criminal record then watch out!

2. recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

Again, the criminal justice system is better equipped in terms of protect the public rather than delegating such matters to a far more intrusive and dangerous entity: The pro-addiction know-nothing Therapeutic State.

Yet again, the only basis of this diagnosis is though one's own criminal record and nothing more.

3. recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)

This point is redundant and simply summarizes the above two points. It's merely included for the sake of fulfilling more than one criterion.

4. continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

Only the latter (physical fights) can result in legal action from the criminal justice system for it does involve harming another human being. Constant arguing over one's own incompetence-through-intoxication should merit swift legal action by the aggrieved: Separation right on up to divorce.

Again, just another legal peccadillo for the sake of fulfilling the other legality-based criteria for being diagnosed as a substance abuser (and just as redundant).

B. the symptoms have never met the criteria for Substance Dependence for this class of substance.
(APA, 1994, pp. 182 183)

Ahh, so there are different classifications! No doubt that such classifications are based more in the taboos of the neo-prohibitionist culture of the Therapeutic State than common sense itself.

And yet, if one were diagnosed within that 12-month period of time yet has resolved never to use again? Does the diagnosis take that into consideration? OF COURSE NOT! Again, if one realizes where this is heading, the diagnosis is merely a gateway to a fate worse than addiction itself: Entry into the RGM/ATI itself.

By then, once one has been labeled by the DSM, the RGM/ATI can care less. It goes from one system to another where simple addiction turns into a chronic problem. Fortified by more sacred lies, it's aided and abetted by a system filled with those who have NEVER solved their own problems in the first place!

Which leads back to the shrinks who claim to diagnose addiction. If they only realized how useless and harmful "treatment" is they'd reconsider letting the user decide on their own to continue or to quit. Ah, but that's the rub for the system simply doesn't know what quitting is.

The DSM? Authored by knowledgeable experts? It's safe to discard that notion for the more one examines the faulty logic employed by shrinks the more one realizes what a fraud psychiatry is as well. And not once within this entire screed did these so-called "experts" provide one iota of evidence of a pathological disease.

If you're addicted, QUIT! Anyone can do it. While the system has no faith in your ability and sees you more for the money you can bring into the system to further its participants' own careers, The ARID Site trusts that you can. Trust yourself!

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