Book review
Saving Normal: An Insider’s Revolt Against Out-
of-Control Psychiatric Diagnosis, DSM-5, Big
Pharma and the Medicalization of Ordinary Life
Allen Frances
Philosophy in Action 2.5: Sapere Aude
Faculty of Health, Medicine and Life Sciences
(FHML)
Bachelor Health Sciences
Author: Anna Tóth
Student number: i6188813
Tutor: Dr. Dorothee Horstkötter
Specialization: GGZ
Word count: 1687
, Core argument of Saving Normal by Allen Frances
Allen Frances is an American psychiatrist, chairman of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV) and writer of the book; Saving Normal: An Insider’s
Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma and the
Medicalization of Ordinary Life. This book provides a different look on the DSM and warns
about the expanding boundary of psychiatry, which causes a diagnostic inflation and
swallows op normality. The DSM, considered as the “Bible” for psychiatric diagnosis, is an
American manual that psychiatrists use to detect and describe mental disorders. In this book
he criticizes the latest edition of the DSM, the DSM-V (published in 2013).
People, including myself, often blindly accept information from a therapist. Therapists often
do this themselves by taking information that has been prepared. Psychologists and
psychiatrists use the DSM to make and trace diagnoses. However, it is often not looked at
how the DSM is set up and what consequences may arise from certain diagnoses. Dr.
Frances’ his focus is on raising awareness through showing the shortcomings of the DSM and
the dangers of the Big Pharma. He wants to make the people aware that the things described
in the DSM ‘determines all sorts of important things that have an enormous impact on
people’s lives’ (page 3). The DSM ensures that everything that could be explained mentally
is labeled and thus new diseases arise. However, the question is who determines what is
considered as "normal" and what is "abnormal"? Normal cannot be defined (easily). The
realm of the ‘normal’ is shrinking rapidly, as psychiatry has expanded and pushed the
boundaries in recent years. The DSM sets the boundaries between abnormal and normal
behavior. Dr. Frances writes ‘the boundaries demarcating the different disorders are ever so
much fuzzier in real life than they appear to be on paper. There is really nothing magical or
preordained about any of the DSM thresholds— shades of gray exist between their seemingly
black and white cutoff points. Psychiatric diagnosis still relies exclusively on fallible
subjective judgments rather than objective biological tests.’ (page 34). He states that the
DSM should just be seen as one small part of an overall evaluation. Unfortunately, the DSM
has been far too dominating the field in a way it was never intended to be. This leads to
psychiatrists who often misdiagnose because of the DSM criteria. The DSM-V added new
diagnoses that turned everyday anxieties, forgetting and bad eating habits into mental
disorders. These things should not be diagnosed because time or other problem-solving
measures will solve this “problems” by themselves. Dr. Frances states that this new manual
will turn our current diagnostic inflation into a hyperinflation.
1
Saving Normal: An Insider’s Revolt Against Out-
of-Control Psychiatric Diagnosis, DSM-5, Big
Pharma and the Medicalization of Ordinary Life
Allen Frances
Philosophy in Action 2.5: Sapere Aude
Faculty of Health, Medicine and Life Sciences
(FHML)
Bachelor Health Sciences
Author: Anna Tóth
Student number: i6188813
Tutor: Dr. Dorothee Horstkötter
Specialization: GGZ
Word count: 1687
, Core argument of Saving Normal by Allen Frances
Allen Frances is an American psychiatrist, chairman of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV) and writer of the book; Saving Normal: An Insider’s
Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma and the
Medicalization of Ordinary Life. This book provides a different look on the DSM and warns
about the expanding boundary of psychiatry, which causes a diagnostic inflation and
swallows op normality. The DSM, considered as the “Bible” for psychiatric diagnosis, is an
American manual that psychiatrists use to detect and describe mental disorders. In this book
he criticizes the latest edition of the DSM, the DSM-V (published in 2013).
People, including myself, often blindly accept information from a therapist. Therapists often
do this themselves by taking information that has been prepared. Psychologists and
psychiatrists use the DSM to make and trace diagnoses. However, it is often not looked at
how the DSM is set up and what consequences may arise from certain diagnoses. Dr.
Frances’ his focus is on raising awareness through showing the shortcomings of the DSM and
the dangers of the Big Pharma. He wants to make the people aware that the things described
in the DSM ‘determines all sorts of important things that have an enormous impact on
people’s lives’ (page 3). The DSM ensures that everything that could be explained mentally
is labeled and thus new diseases arise. However, the question is who determines what is
considered as "normal" and what is "abnormal"? Normal cannot be defined (easily). The
realm of the ‘normal’ is shrinking rapidly, as psychiatry has expanded and pushed the
boundaries in recent years. The DSM sets the boundaries between abnormal and normal
behavior. Dr. Frances writes ‘the boundaries demarcating the different disorders are ever so
much fuzzier in real life than they appear to be on paper. There is really nothing magical or
preordained about any of the DSM thresholds— shades of gray exist between their seemingly
black and white cutoff points. Psychiatric diagnosis still relies exclusively on fallible
subjective judgments rather than objective biological tests.’ (page 34). He states that the
DSM should just be seen as one small part of an overall evaluation. Unfortunately, the DSM
has been far too dominating the field in a way it was never intended to be. This leads to
psychiatrists who often misdiagnose because of the DSM criteria. The DSM-V added new
diagnoses that turned everyday anxieties, forgetting and bad eating habits into mental
disorders. These things should not be diagnosed because time or other problem-solving
measures will solve this “problems” by themselves. Dr. Frances states that this new manual
will turn our current diagnostic inflation into a hyperinflation.
1
