The Making of Dsm-Iii(r): A Diagnostic Manual's Conquest of American Psychiatry

In 1973, the American Psychiatric Association decided to publish a revised edition of their Diagnostic and Statistical Manual (DSM). There was great hope that a new manual would display psychiatry as a scientific field and aid in combating the attacks of an aggressive anti-psychiatry movement that had persisted for more than a decade. The Making of DSM-III� is a book about the manual that resulted in 1980-DSM-III-a far-reaching revisionist work that created a revolution in American psychiatry. Its development precipitated a historic clash between the DSM-III Task Force--a group of descriptive, empirically oriented psychiatrists and psychologists--and the psychoanalysts the Task Force was determined to dethrone from their dominance in American psychiatry. DSM-III also inaugurated an era in which it and the diagnostic manuals that followed played enormous roles in the daily lives of persons and organizations all over the world, for the DSMs have been translated into many languages. The radical revision process was led by the psychiatrist Robert L. Spitzer, a many-talented man of great determination, energy, and tactical skills, arguably the most influential psychiatrist of the second half of the 20th Century. Spitzer created as major a change in descriptive psychiatry and classification as had the renowned German psychiatrist Emil Kraepelin, almost a century earlier. Kraepelin had been the epochal delineator of dementia praecox from manic-depressive illness, the forerunners of modern schizophrenia and bipolar disorder. In her book, Hannah Decker portrays the many internal and external battles that roiled the creation of DSM-III and analyzes both its positive achievements and significant drawbacks. She also astutely explores the deleterious effects of the violent swings in scientific orientation that have dominated psychiatry over the past 200 years and are still alive today. Decker has written a revealing and exciting book that is based on archival sources never before used as well as extensive interviews with the psychiatrists and psychologists who have brought into being the psychiatry we know today.

About the Author :
Hannah S. Decker is a cultural historian of psychiatry and Professor of History at the University of Houston. She is also Adjunct Professor in Medical History in the Menninger Dept. of Psychiatry at the Baylor College of Medicine and an Adjunct Faculty Member at the Center for Psychoanalytic Studies (Houston). Her publications include Freud in Germany: Revolution and Reaction in Science, 1893-1907 and Freud, Dora, and Vienna 1900. In 2007 she received the Carlson Award from the Cornell University Medical College for "extraordinary contributions to the history of psychiatry and psychoanalysis." She is married and has two grown children.

Review :
"In writing her magisterial history of DSM III, Hannah Decker has colorfully captured all the personal dramas, the institutional hijinks, the underlying forces, and the pervasive cultural implications. Born of a process that was never smooth or pretty, DSM III was nonetheless a turning point not only for psychiatry but also for how we see ourselves as individuals and as a society. A joy for historians, a must for clinicians, an eye opener for patients, and a great read for anyone." -- Allen Frances, MD, Head of the Task Force for DSM-IV and Professor Emeritus and Former Chair of the Department of Psychiatry, Duke University "[This] is a landmark work in the history of psychiatry. DSM-III both produced and reflected profound changes in the field of psychiatry whose import-for better and for worse-still reverberates. To my knowledge, this is the first book-length treatise documenting in extra-ordinary detail the process-warts and all-of the making of a psychiatric classification...In fine detail, the author helps us understand why the makers of DSM-III could not come up with a good working definition of 'mental illness, ' and even a good working definition of the term they eventually used, 'Mental Disorder.' Tensions among biological, cultural, psychodynamic, and sociological perspectives are an important part of the story of what is so complex, enriching and frustrating in psychiatry... The Making of DSM-III� will remain a perennial guide to understanding much of the complexity of the field of mental health and mental illness." -- Bennett Simon, MD, Clinical Professor of Psychiatry, Harvard Medical School "Decker beautifully details psychiatry's major shift of modern times. She describes very clearly for the reader the science, the culture, and the politics that produced the foundation of present-day psychiatry." -- Roger Peele MD, Secretary, American Psychiatric Association and Member DSM-5 Task Force "Everyone is aware of the significance of the publication of DSM 5 and its capacity to make and break both research and treatment programs. We know this because of the earthquake that was DSM III. Hannah Decker's book brings out how momentous this earthquake was and just what a contested field mental health is. Her account will be widely read and vigorously debated." -- David Healy, MD, FRCPsych, Author of Pharmageddon, Professor of Psychiatry, University of Cardiff, Wales "Dr. Decker's work is important in understanding the context and controversies that surround the DSM, which continue to this day with the recent release of DSM-V. This book will be of interest to people interested in the history of medicine and psychiatry, clinicians and researchers in any mental health discipline, and anyone who is interested in ongoing debates about the field of psychiatry." -- Debbie Sorensen, New Books in Psychology "This book is the most objective and well-documented history of DSM-III; it deserves wide readership." --Acta Psychiatrica Scandinavica "The DSM - lll grew out of a conscious plan to help the field of psychiatry become more medically oriented. The story about the personalities of the people who made this happen and the politics surrounding the acceptance of DSM - III by the American Psychiatric Association makes for fascinating reading. Hannah Decker is an historian, and the research for this work is comprehensive. The writing is flawless. The photographs of the protagonists are wonderful. People interested in field of psychiatry can gain an excellent historical appreciation of this rapidly evolving field by reading this magnificent book by Hannah Decker." --Eugene H. Rubin, MD, PhD, Professor of Psychiatry and Vice Chair for Education, Department of Psychiatry, Washington University in St. Louis - School of Medicine "...very engaging." --The Journal of Nervous and Mental Disease "Decker offers a refreshing dose of realism about how these manuals have been developed, explaining why decisions were made, but presenting them forthrightly as decisions rather than discoveries." --Metapsychology