I have started out with a few examples in each zone. I would like to be exhaustive here so send me your favorite one liners about the profession or your most hated psychiatrist and I will try to place it on the heat map. Just a heads up, no personal attacks or identifiers will be tolerated. It may be hard to believe but this is nothing personal. I hope to provide a simple graphical solution to the question of what is and what is not appropriate psychiatric criticism.
I also thought about a couple of reasons why this is important. Several years ago a friend of mine called me up and asked me a question about the American Board of Psychiatry and Neurology. He wanted to know what year it was incorporated. I told him I thought it was on my certificate and I would call him later. When I got home I looked at the certificate and sure enough it read: "Incorporated 1934". I called him with the information and asked him why that was important. He is a social worker and told me that he was at a major DSM training course attended by social workers and the speaker (who was not a psychiatrist) suggested that psychiatry was such an illegitimate field that they were not even one of the original specialties and decided to form the ABPN later in order to seem more legitimate. And this was a guy who was teaching a DSM course! In another similar session, the presenter (also not a psychiatrist) compared the validity of psychiatric diagnoses referring to the Robins and Guze criteria to the validity of drapetomania. For anyone not familiar with this definition, it refers to the idea by a 19th century quack that a slave running away is somehow a mental illness. It really has no connection at all to the idea that there are valid mental illnesses that can be diagnosed and treated. And yet here we have a professional making this comparison. The term was also used in a periodical that is valued for its intellectual appeal, but the interview is embarrassing to read especially the tortured attempt to connect it to DSM-5. My speculation is that the people who use this term have an additional agenda. It is clear that there are are many uses of the loose application of this rhetoric and gaining political advantage is often an overlooked one.
As I look at my initial attempt, I am realizing that I need to figure out a way to group all of the statements at the top firmly in the red zone so that none of them touch the transition area to the green zone.
George Dawson, MD, DFAPA
Supplementary 1:
Here is a working list to consider (click to enlarge all graphics on this page). This is the second version and as of today (2/16/2014) no outside suggestions. The image below is formatted to print or store as a single 8.5 x 11 inch page:
