Saving Normal


Book Description

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.




The Book of Woe


Book Description

“Gary Greenberg has become the Dante of our psychiatric age, and the DSM-5 is his Inferno.” —Errol Morris Since its debut in 1952, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has set down the “official” view on what constitutes mental illness. Homosexuality, for instance, was a mental illness until 1973. Each revision has created controversy, but the DSM-5 has taken fire for encouraging doctors to diagnose more illnesses—and to prescribe sometimes unnecessary or harmful medications. Respected author and practicing psychotherapist Gary Greenberg embedded himself in the war that broke out over the fifth edition, and returned with an unsettling tale. Exposing the deeply flawed process behind the DSM-5’s compilation, The Book of Woe reveals how the manual turns suffering into a commodity—and made the APA its own biggest beneficiary.




Reclaming Childhood


Book Description




Back to Normal


Book Description

A veteran clinical psychologist exposes why doctors, teachers, and parents incorrectly diagnose healthy American children with serious psychiatric conditions. In recent years there has been an alarming rise in the number of American children and youth assigned a mental health diagnosis. Current data from the Centers for Disease Control reveal a 41 percent increase in rates of ADHD diagnoses over the past decade and a forty-fold spike in bipolar disorder diagnoses. Similarly, diagnoses of autism spectrum disorder, once considered, has increased by 78 percent since 2002. Dr. Enrico Gnaulati, a clinical psychologist specializing in childhood and adolescent therapy and assessment, has witnessed firsthand the push to diagnose these disorders in youngsters. Drawing both on his own clinical experience and on cutting-edge research, with Back to Normal he has written the definitive account of why our kids are being dramatically overdiagnosed—and how parents and professionals can distinguish between true psychiatric disorders and normal childhood reactions to stressful life situations. Gnaulati begins with the complex web of factors that have led to our current crisis. These include questionable education and training practices that cloud mental health professionals’ ability to distinguish normal from abnormal behavior in children, monetary incentives favoring prescriptions, check-list diagnosing, and high-stakes testing in schools. We’ve also developed an increasingly casual attitude about labeling kids and putting them on psychiatric drugs. So how do we differentiate between a child with, say, Asperger’s syndrome and a child who is simply introverted, brainy, and single-minded? As Gnaulati notes, many of the symptoms associated with these disorders are similar to everyday childhood behaviors. In the second half of the book Gnaulati tells detailed stories of wrongly diagnosed kids, providing parents and others with information about the developmental, temperamental, and environmentally driven symptoms that to a casual or untrained eye can mimic a psychiatric disorder. These stories also reveal how nonmedical interventions, whether in the therapist’s office or through changes made at home, can help children. Back to Normal reminds us of the normalcy of children’s seemingly abnormal behavior. It will give parents of struggling children hope, perspective, and direction. And it will make everyone who deals with children question the changes in our society that have contributed to the astonishing increase in childhood psychiatric diagnoses.




Big Pharma


Book Description

Pharmaceutical medicine is very, very big business. The top ten players earned more than $200 billion in 2003. One drug, Pfizer's cholesterol pill Lipitor, had sales of more than $9 billion. This kind of money buys an awful lot of friends among doctors and politicians. Most of those involved in the formulation of public health policy seems happy with the present system. The trouble is that the public is starting to have doubts. There is a growing sense that the vast profits of drug companies and their control of the research agenda might not be that good for our health. Jacky Law takes the reader on a journey through the pharmaceutical business and shows how the public is quite right to be concerned about conventional medicine, as it has developed since the late 1970s. She tells a story of spectacular regulatory failure, phenomenally high prices, betrayal of the public interest and a growing awareness among ordinary people that things could be very different. Sophisticated marketing and public relations, not scientific excellence, have helped corporations to preside unchallenged over matters of life and death. It is time, Law argues, for us to take responsibility for our health, not as passive consumers of pharmaceutical medicine, but as informed citizens.




Essentials of Psychiatric Diagnosis, Revised Edition


Book Description

Grounded in author Allen Frances's extensive clinical experience, this comprehensive yet concise guide helps the busy clinician find the right psychiatric diagnosis and avoid the many pitfalls that lead to errors. Covering every disorder routinely encountered in clinical practice, Frances provides the ICD-9-CM and ICD-10-CM (where feasible) codes required for billing, a useful screening question, a colorful descriptive prototype, lucid diagnostic tips, and a discussion of other disorders that must be ruled out. The book closes with an index of the most common presenting symptoms, listing possible diagnoses that must be considered for each. Frances was instrumental in the development of past editions of the DSM and provides helpful cautions on questionable aspects of DSM-5. The revised edition features ICD-10-CM codes where feasible throughout the chapters, plus a Crosswalk to ICD-10-CM Codes in the Appendix. The Appendix, links to further coding resources, and periodic updates can also be accessed online (www.guilford.com/frances_updates).




Saving Max


Book Description

Max Parkman is perfect in his mother's eyes. Until he's accused of murder. Attorney Danielle Parkman can't deny her son's behavior has been getting worse—drugs and violent outbursts have become a frightening routine. But when she receives the diagnosis from a top-notch adolescent psychiatric facility that Max is deeply disturbed—and dangerous—it seems too devastating to accept. Until she finds Max, weapon in hand, at the bedside of a fellow patient who has been brutally stabbed to death. Separated from Max and trapped in a maelstrom of doubt and fear, Danielle's mothering instincts snap sharply into focus. The justice system is bearing down on her son, so she must use her years of legal experience to find out the truth, no matter what that might be. But has she, too, lost touch with reality? Is her son truly a killer? Previously published.




Twilight of American Sanity


Book Description

“Unravel[s] the national psyche that brought our politics to this moment.” — Evan Osnos, The New Yorker A landmark book, from “one of the world’s most prominent psychiatrists” (The Atlantic): Allen Frances analyzes the nation, viewing the rise of Donald J. Trump as darkly symptomatic of a deeper societal distress that must be understood if we are to move forward. Equally challenging and profound, Twilight of American Sanity “joins a small shelf of essential titles—Arlie Hochschild’s Strangers in Their Own Land is another—that help explain why and how the Trump presidency happened” (Kirkus). It is comforting to see President Donald Trump as a crazy man, a one-off, an exception—not a reflection on us or our democracy. But in ways I never anticipated, his rise was absolutely predictable and a mirror on our soul. … What does it say about us, that we elected someone so manifestly unfit and unprepared to determine mankind’s future? Trump is a symptom of a world in distress, not its sole cause. Blaming him for all our troubles misses the deeper, underlying societal sickness that made possible his unlikely ascent. Calling Trump crazy allows us to avoid confronting the craziness in our society—if we want to get sane, we must first gain insight about ourselves. Simply put: Trump isn’t crazy, but our society is. —from TWILIGHT OF AMERICAN SANITY More than three years in the making: the world's leading expert on psychiatric diagnosis, past leader of the American Psychiatric Association’s DSM (“the bible of psychology”), and author of the influential international bestseller on the medicalization of ordinary life, Saving Normal, draws upon his vast experience to deliver a powerful critique of modern American society’s collective slide away from sanity and offers an urgently needed prescription for reclaiming our bearings. Widely cited in recent months as the man who quite literally wrote the diagnostic criteria for narcissism, Allen Frances, M.D., has been at the center of the debate surrounding President Trump’s mental state—quoted in Evan Osnos’s May 2017 New Yorker article (“How Trump Could Get Fired”) and publishing a much-shared opinion letter in the New York Times (“An Eminent Psychiatrist Demurs on Trump’s Mental State”). Frances argues that Trump is "bad, not mad"--and that the real question to wrestle with is how we as a country could have chosen him as our leader. Twilight of American Sanity is an essential work for understanding our national crisis.




Saving Talk Therapy


Book Description

A hard-hitting critique of how managed care and the selective use of science to privilege quick-fix therapies have undermined in-depth psychotherapy—to the detriment of patients and practitioners In recent decades there has been a decline in the quality and availability of psychotherapy in America that has gone largely unnoticed—even though rates of anxiety, depression, and suicide are on the rise. In Saving Talk Therapy, master therapist Dr. Enrico Gnaulati presents powerful case studies from his practice to remind patients and therapists alike how and why traditional talk therapy works and, using cutting-edge research findings, unpacks the problematic incentives in our health-care system and in academic psychology that explain its decline. Beginning with a discussion of the historical development of talk therapy, Dr. Gnaulati goes on to dissect the factors that have undermined it. Psychotropic drugs, if no longer thought of as a magical cure, are still over-prescribed and shunt health-care dollars to drug corporations. Managed-care companies and mental health “carve outs” send health-care dollars to administrators, drive many practitioners away, and over-burden those who remain. And drawing back the curtains on CBT (cognitive behavior therapy), Dr. Gnaulati shows that while it might be effective in the research lab, its findings are of limited use for the people’s complex, real-world emotional problems. Saving Talk Therapy is a passionate and deeply researched case for in-depth, personally transformative psychotherapy that incorporates the benefits of an evidence-based approach and psychotropic drugs without over-relying on them.




Saving Babies?


Book Description

Introduction: the consequences of newborn screening -- The expansion of newborn screening -- Patients-in-waiting -- Shifting disease ontologies -- Is my baby normal? -- The limits of prevention -- Does expanded newborn screening save lives? -- Conclusion: the future of expanded newborn screening