Saturday, June 1, 2013

Saving Normal

Saving Normal

Adult Nonfiction
"...We need to grieve the loss of loved ones or we would never
fully love them. We need to worry about the consequences of our
actions or those actions will get us into trouble. We need to order
our environments or chaos will ensue. Illness lurks only at the far
extremes, distant from the golden mean. Most of what we do, we do for
good reason. Most of us are normal."
Allen Frances, M. D. brings us those words of reassurance at the
end of his anything but reassuring book, Saving Normal. He wrote it
to warn us of the dangers of the overdiagnosing of psychiatric
disorders and consequent overmedication. Due to a convergence of the
publication of the Diagnostic and Statistical Manual of Mental
Disorders-5 (DSM5), big pharma finding big profits in advertising
directly to customers and incentivizing doctors, and the existence of
fads in diagnoses, this already rampant frenzy has the potential to
become even more rabid. The "worried well", folks who are often
dealing with situational loss and stress and would get well on their
own, are slapped with stigmatizing diagnoses and pills with serious
side effects. This depletes resources, leaving sufferers who really
do need these treatments less able to access them. Can we say lose-
If you're anything like me you see evidence of this in day to
day life. A celebrity in a tv spot tells you there's a one in eighty
something chance your child will turn out to be autistic. An adult
friend announces that meds for adult ADHD have made her life a whole
lot better. But her flat affect makes you wonder. Men who have an
off night or two or even don't want to face that prospect are urged to
chat with their doctors about Viagara. What the Hell? Yes, there are
people who suffer from psychiatric illnesses and do need meds. But
this darn many? I don't think so.
Frances knows whereof he speaks. He has insider info. He
chaired the DSM-IV task force. His book quite lucidly and
systematically explains why it is so darn hard to define either
normalcy or deviance, the balancing act with its conflicting dangers
of under and overdiagnosing, the hazards of diagnostic inflation, and
psychiatric diagnostic fads of the past, present, and potential future.
Frances takes the risk in writing this book that people will use
it to totally discredit psychiatry. He believes that it has a very
important place in treating those who need it to lead functional and
rewarding lives. Meds also. But when everyday people are
overdiagnosed and medicated, when the predictable stresses and losses
of life are handled with pills rather than social support, when the
pool of the normal dries up to a mere puddle, he thinks we have ample
reason for concern.
If what I have written in this review rings true you will
certainly want to read the book. A whole lot of us need to if there
is to be any hope of reversing the disturbing trends Frances so
eloquently describes.
On a personal note, it is a lovely late spring evening to read outside
on my swing. A nice little breeze breaks up the humidity. Birds and
insects serenade. The air is scented with lilacs.
A great big shout out goes out to all who fight against the
overdiagnosing and medicating of America.
Julia Emily Hathaway

Sent from my iPod

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