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Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life [Hardcover]

Allen Frances
5.0 out of 5 stars  See all reviews (1 customer review)
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Book Description

20 May 2013

From "the most powerful psychiatrist in America" (New York Times) and "the man who wrote the book on mental illness" (Wired), a deeply fascinating and urgently important critique of the widespread medicalization of normality

Anyone living a full, rich life experiences ups and downs, stresses, disappointments, sorrows, and setbacks. These challenges are a normal part of being human, and they should not be treated as psychiatric disease. However, today millions of people who are really no more than "worried well" are being diagnosed as having a mental disorder and are receiving unnecessary treatment. In Saving Normal, Allen Frances, one of the world's most influential psychiatrists, warns that mislabeling everyday problems as mental illness has shocking implications for individuals and society: stigmatizing a healthy person as mentally ill leads to unnecessary, harmful medications, the narrowing of horizons, misallocation of medical resources, and draining of the budgets of families and the nation. We also shift responsibility for our mental well-being away from our own naturally resilient and self-healing brains, which have kept us sane for hundreds of thousands of years, and into the hands of "Big Pharma," who are reaping multi-billion-dollar profits.

Frances cautions that the new edition of the "bible of psychiatry," the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), will turn our current diagnostic inflation into hyperinflation by converting millions of "normal" people into "mental patients." Alarmingly, in DSM-5, normal grief will become "Major Depressive Disorder"; the forgetting seen in old age is "Mild Neurocognitive Disorder"; temper tantrums are "Disruptive Mood Dysregulation Disorder"; worrying about a medical illness is "Somatic Symptom Disorder"; gluttony is "Binge Eating Disorder"; and most of us will qualify for adult "Attention Deficit Disorder." What's more, all of these newly invented conditions will worsen the cruel paradox of the mental health industry: those who desperately need psychiatric help are left shamefully neglected, while the "worried well" are given the bulk of the treatment, often at their own detriment.

Masterfully charting the history of psychiatric fads throughout history, Frances argues that whenever we arbitrarily label another aspect of the human condition a "disease," we further chip away at our human adaptability and diversity, dulling the full palette of what is normal and losing something fundamental of ourselves in the process. Saving Normal is a call to all of us to reclaim the full measure of our humanity.


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Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life + The Intelligent Clinician's Guide to the DSM-5 + Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
Price For All Three: 114.16

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Product details

  • Hardcover: 336 pages
  • Publisher: William Morrow; 1 edition (20 May 2013)
  • Language: English
  • ISBN-10: 0062229257
  • ISBN-13: 978-0062229250
  • Product Dimensions: 23.6 x 16.4 x 2.9 cm
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
  • Amazon Bestsellers Rank: 169,851 in Books (See Top 100 in Books)

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Review

“Frances delves deeply into the history of mental illness, makes his arguements crisply, and has good personal stories to tell. He’s articulate and learned. ... He’s in favor of not medicating, and thus muffling, all the offbeat pain and beauty out of existance. ... [A] piece of intellectual skywriting.” (Dwight Garner, New York Times)

“An extraordinarily candid and important book. Allen Frances has written a fascinating account of the apparent explosion in psychiatric disorders in the United States. (MARCIA ANGELL, M. D., Senior Lecturer in Social Medicine at Harvard Medical School, and former Editor-in-Chief, New England Journal of Medicine)

Saving Normal is a riveting and important book, written with great flair and precise passion. This is a book every psychiatrist, every general practitioner, every student swallowing meds--in fact everyone--needs to read.” (Dr. LISA APPIGNANESI, Chair of the Freud Museum, London, and author of Mad, Bad and Sad)

“Frances is largely credited with spearheading the anti-DSM-5 efforts.” (CNN.com)

Saving Normal is a clear, convincing, and essential discussion of the twin epidemics facing modern psychiatry: under-treatment of the truly ill and overtreatment of the basically well. It holds immense potential to improve patients’ lives.” (JOSH BAZELL, M.D., New York Times bestselling author of Beat the Reaper: A Novel)

“Few are as well-equipped as Frances to map the dynamic field of psychiatry, and his rendering of its shifting contours is timely, crucial, and insightful--as are his solutions for navigating it.” (Publishers Weekly)

“With Solomon-like wisdom, Frances justly doles out blame and offers reasonable remedies. His decree: don’t medicalize human difference; celebrate it.” (Booklist (starred review))

“A valuable assessment. ... A no-holds-barred critique.” (Kirkus Reviews)

“An indispensable guide for professional and lay readers” (Library Journal)

“Allen Frances’s book is fascinating. ... Entertaining.” (Metapsychology)

“Authoritative. ... Valuable. ... This is a detailed, nicely constructed account by a highly qualified and well-connected psychiatrist with intimate knowledge of the process. The book is clearly written and surprisingly easy reading.” (The Royal Australian and New Zealand College of Psychiatrists)

About the Author

Allen Frances, M.D., was the chairman of the DSM-IV Task Force and part of the leadership group for DSM-III and DSM-III-R. He is professor emeritus and former chair of the Department of Psychiatry and Behavioral Science at Duke University School of Medicine. He lives in Coronado, California, and travels and lectures extensively worldwide.


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Most Helpful Customer Reviews
Format:Hardcover|Verified Purchase
Despite his protestations, the author seems to have played a major part in creating the problem of diagnostic hyperinflation in mental illness. The DSM (Diagnosis and Statistical Manual) is psychiatry's bible in terms of defining what is and what is not a mental illness. The author chaired the task force that created the DSM 4. This has only just been superseded by the DSM 5 which the book brilliantly critiques.
The author cites as evidence for diagnostic hyperinflation (amongst many other statistics) the fact that about half of Americans will be diagnosed with a mental health problem during their lifetime. Of course, this situation pertained under the DSM that he chaired the production of. The DSM 5 has only just been released and so cannot be blamed for this sort of historical fact.
No doubt the DSM 5 will make things much worse and Frances explains why.
Frances is a fantastic writer, hugely erudite and very entertaining.
It's great that he has come over from the dark side!
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Most Helpful Customer Reviews on Amazon.com (beta)
Amazon.com: 4.3 out of 5 stars  61 reviews
70 of 70 people found the following review helpful
5.0 out of 5 stars This is the best review of psychiatric diagnostic issues available 14 May 2013
By tired doc - Published on Amazon.com
Format:Hardcover
Dr. Alan Francis is a scholarly thoughtful physician whose career has been focused upon psychiatric diagnosis. His work at Columbia dn then Duke allowed him to see a broad range of psychiatric disorders and engage in a lively professional debate among other psychiatrists about the nature,causes,and treatments of psychiatric disorders. Given his experience,this book is far more than a critique of DSM5. It is a very practical guide to psychiatric diagnosis. Issue such as "normality" are often ignored by all mental health professionals. His chapter on this topic is worth the book itself. A must read by all mental health practitioners.
27 of 27 people found the following review helpful
5.0 out of 5 stars Essential :DSM Examined 3 July 2013
By Lita Perna - Published on Amazon.com
Format:Hardcover
Saving Normal, written by Allen Frances, Chair of the DSM-IV Task Force should be bundled and sold with every edition of the DSM V.

Dr Frances, who has worked for 20 years on the updated editions of the DSM, including DSM-III, DSM-IIIR and DSM-IV is not an outsider. He knows what he is talking about. And he is sounding the alarm.

He believes that those who desperately need psychiatric help are being neglected while others who don't need it are given diagnoses when there's nothing `wrong' with them and their issues are transitory.

Saving Normal should required reading for every therapist who diagnoses clients and for every client or potential client/patient who plans on using their health insurance benefits for mental health concerns or treatment.

In Saving Normal, Dr Frances warns about the mislabeling and diagnosing of normal problems and issues in daily living, as mental illness; he cautions about false diagnoses and potentially harmful and unnecessary prescriptions of psychotropic medications.

`Loose diagnosis' he says, `is causing a national drug overdose of medication.'

This diagnostic inflation impacts millions of people who are receiving unnecessary treatment and who believe they are suffering with a mental illness, when they are not.

Dr. Frances explores the creation of the first DSM, what's normal and what's not, psychiatric fads of the past and present (notably Attention Deficit Disorder, Childhood Bipolar Disorder, Autism, Bipolar II and shyness, diagnosed as `Social Phobia.) and the impact and influence of drug manufacturers on doctors and diagnoses.

Dr. Frances talks about how labels have changed.

He gives an example of ADHD, (now diagnosed in 10% of children) which used to be diagnosed in only a small number of children. He says ADHD is spreading like `wildfire'.

After the publication of the DSM-IV, several new and expensive drugs to treat ADHD came on the market. There was heavy drug company marketing to doctors.

He attributes the increased diagnosis of ADHD to wording changes in the DSM-IV, drug company marketing, advertising to the general public, extensive media coverage, pressure from parents and teachers to control unruly children and extra services for diagnosed kids.

There was once no such thing as Childhood Bipolar Disorder (CBD). Now, according to Dr. Frances, it has become the `most inflated bubble in all of psychiatric diagnosis with a fortyfold inflation in just one decade.'

Bipolar II was added for the sake of more accurate diagnosis but wound up doubling the instance of it. The doctor believes the addition of Bipolar II has led to misleading drug company marketing and unnecessary medication for many unipolar patients who have been diagnosed as bipolar.

He focuses on the DSM V; how the reliability of field trials was compromised and unacceptable due to a rush to get to publication.

`The essential stage two step of quality control was surreptitiously cancelled and a premature DSM-5 was rushed to the printers to get sales moving and cash registers ringing.'

Dr Frances believes that the current DSM-5 will hyperinflate diagnoses and turn millions of `normal' people into mental patients.

For instance, normal grief will be diagnosed a Major Depressive Disorder; temper tantrums, Disruptive Mood Dysregulation Disorder...the list goes on.

Unless you elect to pay out-of- pocket for counseling or therapy you will probably get a diagnosis and a treatment plan; the days of talking things out or personal exploration are a thing of the past.

You should know that therapists cannot bill your insurance company if you don't have a diagnosis. The insurance company only reimburses therapists if you're given a diagnosis .You will get a mental health diagnosis if you plan on using your health insurance.

I strongly urge those considering seeing a therapist to read this book.

I strongly urge therapists to read this book. If you're questioning your jump-through-hoops to get reimbursed and the mandatory diagnosing required by your involvement with insurance companies; if you're questioning the future and the direction of your practice, this book is essential reading.
24 of 24 people found the following review helpful
5.0 out of 5 stars Should be required reading for medical students 16 Jun 2013
By a reader - Published on Amazon.com
Format:Hardcover
As a practicing physician and medical school professor, I hope this book is widely read. The influence of drug companies on physicians' education has grown alarmingly in the 30 years i have practiced. Dr. Frances has hit the nail on the head with this wise book. Much of what is being taught in the psychiatry rotations is that every fluctuation in mood, every worry, every moment of sadness or anger or fatigue is pathological and needs a pill. To paraphrase Eisenhower, it is alarming that nearly 50% of us are below average!
18 of 18 people found the following review helpful
5.0 out of 5 stars Definitely a must read 7 Jun 2013
By Frank Zacharias - Published on Amazon.com
Format:Kindle Edition|Verified Purchase
An expert who disagrees with the majority of his peers. My take on this issue is simply the fact that "money talks". These people who wrote DSM5 have a financial interest in connection with big pharma. It is an unfortunate fact that men can be bought. In the end the money comes from us - patients, rate and tax payers, and workers. Read the book and hopefully you will become more discerning.
21 of 22 people found the following review helpful
5.0 out of 5 stars INFORMATIVE 26 May 2013
By FRITTS - Published on Amazon.com
Format:Hardcover|Verified Purchase
I saw Allen Frances on tv. At first I thought he disapproved of psychiatric medications altogether. The book explains how too many prescriptions are given to people who don't need them, not given to people who do, and how diagnosis should be made.
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