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I have been writing about the DSM process which isn’t always easy to do because the head of DSM-5, David Kupfer, MD, runs a pretty tight ship with his committee members, making them sign confidentiality agreements and not take any notes. Well since he said that there would be a “paradigm shift” and the sky is the limit for coming up with new diagnoses, there has been a lot of interest in the process.
I recently wrote about the editorial by Allen Frances MD, head of DSM-4, criticizing the current process of DSM-5, and now there is a nasty response from the DSM-5 group, authored by Alan Schatzberg MD, James Scully MD, David Kupfer MD, and David Regier MD, that psychiatry blogger Daniel Carlat MD offered to edit for them to make it more respectful. Lol. A blogger offering to help the leaders of academic psychiatry tone down their language. Lol again.
I mean the damn editorial hasn’t even been published yet.
In their response to Frances Kupfer et al make dubious claims that “attorneys” had advised them to have committee members sign confidentiality agreements to protect “intellectual property”. They also charge Frances (as well as Robert Spitzer MD, who founded DSM and has been making the email rounds with criticism of the current process) with greed in wanting to retain royalties from a book he wrote about DSM-4 which would become outdated after the release of DSM-5. I mean anyone in the business knows that book royalties pale in comparison to the hundreds of thousands of dollars to be had doing pharmaceutical industry consulting and speaking. In fact one could even argue that doing things like editing books (which have essentially no revenue, because hardly anyone buys them) is a feather in the cap that helps you get those more lucrative gigs.
One of the diagnoses on the table is Female Sexual Dysfunction (FSD), a “disease” that if accepted would surely drive the drug companies to “identify and treat” these poor lassies with drugs like the testosterone patch (see “Wow A Drug To Have Sex Once More a Month? Sign Me Up!“) or Viagra or whatever psychotropic they could drug out of the medicine cabinet.
Turns out the medicalizing women’s sexuality may not be such a good idea. There is a long and jaded history of evil meddling by medical doctors in this area. The publication of the book Feminine Forever, whose thesis was that post-menopausal women become shriveled asexual crones due to an estrogen deficiency led doctors to put an entire generation of post-menopausal women on hormone replacement therapy (HRT), which in turn was later found to have caused tens of thousands of deaths from heart attack and other problems.
Then there were Masters & Johnson, the famous sex research team who concluded that women had more frequent orgasms than men.
Masters & Johnson on Meet the Press
This “research” however was based on looking through peep holes at brothels, and later their “research sessions” they conducted with each other. Virginia Johnson was Dr. William Masters secretary, and they “partnered” to have sex on a nightly basis for “research” purposes for years. Their report on 67 patients with unwanted homosexuality showing a 70% conversion to heterosexuality using “conversion therapy” was later disclosed as a fraud when noone could find any evidence of the patients. This bizarre “research team” should hardly be taken seriously about women’s orgasms.
Turns out that the DSM-4 has ‘Female Hypoactive Sexual Desire Disorder’ and ‘Female Hypo Orgasmic Disorder’ (I mean did the guy try going down on her?) as well as Dyspaerunia (painful sex). As a recent editorial pointed out, maybe the 43% of women with some type of so-called sexual dysfunction are acting “appropriately”.
I mean, maybe they’re with jerks and don’t feel like doing it?
The American Journal of Psychiatry has been soliciting editorials on the DSM-5 process. Too bad they rejected the editorial by Robert Spitzer MD who founded the DSM, and for FSD they have only this lame piece by a trio of MDs whose pharma disclosures read like a phone book. Lol. Sort of.
Ray Moynihan had a good piece in bmj on FSD (“FSD: The Making of a Disease”) in which he outlines how industry has moved in a serious way to pour cash in the “research and education” of this newly minted disorder, the rife conflicts of interest in the field, and the attempt by drug companies to medicalize female sexuality.
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lol lol lol fantastic stuff here
**‘Female Hypo Orgasmic Disorder’ (I mean did the guy try going down on her?)** Ha ha ha!!! Right Dr. Bremner! Many men think about 1 thing only that’s their OWN orgasm. I imagine there’s tremdous lack of orgasms in the women mated with selfish men. ***I mean, maybe they’re with jerks and don’t feel like doing it?*** Yup.
DSM V feels like collusion with pharma to me. Love your blog Dr. B.
my first therapist made out I was psychologically impaired for my lack of orgasms that started when I took an SSRI and (much later) disappeared when I stopped the SSRI…believe me she is still on my shit list…she also told me the weight gain was my fault even though I was thin before neuroleptics and again, now the weight falls off, since I stopped taking the crap.
and hell yeah women have more orgasms…ever hear of a multiple orgasm..if you count the lucky ones of us who’ve experienced those it’s possible to rack the number up in one sexual encounter!!! ha!
given I missed out on orgasm for many years due to psych meds…I still have a lot of catching up to do…
neuroleptics mess with orgasm too…though that is not as widely recognized…
will all the women on these drugs that impede orgasm get this labeling too?? iatrogenisis again being called mental illness…
Very informative post, Doug.
So now it is not frigidity, but female sexual arousal disorder. Just as with men, it is no longer impotence, but the Pfizer-created phrase, ‘erectile dysfunction’.
Below is a link that explores the Western world’s attempts to medicalize female sexuality and stimulation.
Ultimately, the author states what I believe to be accurate- that with this particular human function. That the western world would rather medicalize such disorders and dysfunctions, instead of exploring the source, the etiology, of what may be outside of what is considered normal limits and responses.
http://www.archive.org/stream/FemaleOrgasm/WomensOrgasm_djvu.txt
Female sexual dysfunction is generally a result of:
Insecurity
Issues from years of religious teaching that sex is dirty (the effect continues into marriage)
Over burdened with children and domestic responsibilities
An abusive and/or neglegent parnter
A partner with a small penis or poor performance
Busy or unhealthy lifestyle
Or any combination of these
Women do not need a medication, they need a break from an oppressive society. Money would be better spent resolving the issue of small or crooked penises.
Angela,
you’re being rather oppressive of men suggesting that small penises are a problem…a loving man interested in pleasing his partner does not need a large penis.
Moreover, Angela, some women cannot focus well enough on the act to reach orgasm. They are too distractible, sensorily defensive (a filtering issue), etc. Women with ADHD often experience their first orgasm (not to mention enjoyable physical intimacy) after taking a stimulant medication.
They wouldn’t support your opinion that women do not need a medication. They do, and that’s their right.
Dan, why do you prefer a globally pejorative term like “impotence” over the more biologically accurate “erectile dysfunction”?
And why do you call it “medicalizing” when this kind of research means that more people who have these problems can find help for them — without being called “frigid,” for petesakes?
Seems awfully uncompassionate to me.
Dan, why you prefer a globally pejorative term like “impotence” over the more biologically accurate “erectile dysfunction”?
And why do you call it “medicalizing” when this kind of research means that more people who have these problems can find help for them — without being called “frigid,” for petesakes?
Seems awfully uncompassionate to me.
You think psychiatrists practice projection as much as the patients we treat? Keep up the heat on these assholes who pretend to represent and embolden the principles of responsible psychiatry.
I hope you will let the following comment be printed, because it is how I feel and should reflect what at least one psychiatrist thinks of this DSM V crap:
I hope Schatzberg and his cronies get so exposed for their fraudulant actions that it brings down the APA once and for all. These are fucking greedy, insensitive, devious, and dangerous old men and women who exemplify the sociopaths which pervade the alleged leadership that psychiatry really shouldn’t tolerate as KOLs defining diagnosis and treatment in the first place; forensic psychiatry be damned as a specialty for thinking this Axis II shit should be accessed for care.
I hope you allow this to be printed, and thank you for your efforts. I get a sense Dr Dan C is starting to develop some more intestinal fortitude, maybe thanks to you and some other outspoken yet completely appropriate critics!
Skillsnotpills (never to be signed again by my former alias)
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