Allen Frances > Quotes

“The power to label is the power to destroy.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Loose diagnosis is causing a national drug overdose of medication. Six percent of our people are addicted to prescription drugs, and there are now more emergency room visits and deaths due to legal prescription drugs than to illegal street drugs.6”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Stigma takes many forms, comes from all directions, is sometimes blatantly overt, but can also be remarkably subtle. It is the cruel comment, the unkind smirk, the extrusion from the group, the lost job opportunity, the rejected marriage proposal, the ineligibility for life insurance, the inability to adopt a child or pilot a plane.

But it is also the reduced expectation, the helping hand when none is needed or wanted, the solicitous sympathy that one cannot really be expected to measure up.

And the secondary psychological and practical harms of having a mental disorder come only partly from how others see you. A great deal of the trouble comes from the change in how you see yourself: the sense of being damaged goods, feeling not normal or worthy, not a full fledged member of the group.

It is bad enough that stigma is so often associated with having a mental disorder, but the stigma that comes from being mislabeled with a fake diagnosis is a dead loss with absolutely no redeeming features.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Mental disorders should be diagnosed only when the presentation is clear-cut, severe, and clearly not going away on its own. The best way to deal with the everyday problems of living is to solve them directly or to wait them out, not to medicalize them with a psychiatric diagnosis or treat them with a pill.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Overcoming problems on your own normalizes the situation, teaches new skills, and brings you closer to the people who were helpful. Taking a pill labels you as different and sick, even if you really aren't. Medication is essential when needed to reestablish homeostasis for those who are suffering from real psychiatric disorder. Medication interferes with homeostasis for those who are suffering from the problems of everyday life.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“The great unspoken paradox of the arduous process of psychoanalysis is that the best patients are the ones who never really needed it in the first place. Abnormal”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“[W]e have far too much faith in pills, far too little trust in resilience, time, and homeostasis.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“[W]ay too much treatment is given to the normal "worried well" who are harmed by it; far too little help is available for those who are really ill and desperately need it. Two thirds of people with severe depression don't get treated for it, and many suffering with schizophrenia wind up in prisons. The writing is on the wall.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Taking a pill is passive. In contrast, psychotherapy puts the patient in charge by instilling new coping skills and attitudes toward life.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Patienthood can become a way of life and rationale for people who are struggling for other reasons.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“DSM definitions do not include personal and contextual factors such as whether the depressive symptoms are an understandable response to loss, a terrible life situation, psychological conflict or personality factors.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“ADHD is spreading like wildfire. It used to be confined to a small percentage of kids who had clear-cut problems that started at a very early age and caused them unmistakable difficulties in many situations. Then all manner of classroom disruption was medicalized and ADHD was applied so promiscuously that an amazing 10 percent of kids now qualify.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“The DSMs have a mixed record. They have served an extremely valuable function in improving the reliability of psychiatric diagnosis and in encouraging a revolution in psychiatric research. But they have also had the very harmful unintended consequence of triggering and helping to maintain a runaway diagnostic inflation that threatens normal and results in massive overtreatment with psychiatric medication.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“It is equally dangerous at either extreme - to have either an expanding concept of mental disorder that eliminates normal or to have an expanding concept of normal that eliminates mental disorder.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Time heals so well because many of our ills are short-term, situational, and self-limited - our bodies and our minds are programmed to be resilient without any active effort on our part.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Much of the increased prevalence of ADHD results from the “false positive” misidentification of kids who would be better off never receiving a diagnosis. Drug company marketing pressure often leads to unnecessary treatment with medications that can cause the harmful side effects of insomnia, loss of appetite, irritability, heart rhythm problems, and a variety of psychiatric symptoms.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“[T]he DSM alone does not establish standards. Physicians, other mental health workers, drug companies, advocacy groups, school systems, the courts, the Internet, and cable TV all get to vote on how the written word will actually be used and misused.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Because of diagnostic inflation, an excessive proportion of people have come to rely on antidepressants, antipsychotics, antiaxiety agents, sleeping pills, and pain meds.”
― Allen Frances

“To become a fad, a psychiatric diagnosis requires 3 preconditions: a pressing need, an engaging story, and influential prophets. The pressing need arises from the fact that disturbed and disturbing kids are very often encountered in clinical, school, and correctional settings. They suffered and cause suffering to those around them—making themselves noticeable to families, doctors, and teachers. Everyone feels enormous pressure to do something. Previous diagnoses (especially conduct or oppositional disorder) provided little hope and no call to action. In contrast, a diagnosis or childhood Bipolar Disorder creates a justification for medication and for expanded school services. The medications have broad and nonspecific effects that are often helpful in reducing anger, even if the diagnosis is inaccurate.”
― Allen Frances

“We should not have the ambition to label as mental disorder every inconvenient or distressing aspect of childhood.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“[M]onolithic opposition to psychiatry is far too undiscriminating in its broadside critique. Indeed, it seems to me equally impossible to be enthusiastically an uncritical psychiatric loyalist or a dedicated psychiatric debunker. Both positions miss the truth in their one-sided extremity. [...] The antipsychiatry movement, generalizing from worst cases [...], goes way overboard and condemns all of psychiatry. Their extremism would deprive those who really need treatment and can benefit greatly from it.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“[D]iagnosis needed to rest in order to let research catch up. It made no sense to keep rearranging the furniture of descriptive psychiatry, creating new diagnoses or altering the thresholds of existing ones, based only on the whims of the experts who happened to be in the room. [...] Changes in diagnoses should be few and far between until we gained much deeper understanding of what causes the mental disorders and how best to define and treat them.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“It is good to know and use the DSM definitions, but not to reify or worship them.31,32”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Utilitarianism provided the first, and remains the only practical, philosophic guidance on how and where to set a boundary between “normal” and “mental disorder.” The guiding assumptions are that “normal” has no universal meaning and can never be defined with precision by the spinning wheels of philosophical deduction—it is very much in the eye of the beholder and is changeable over time, place, and cultures. From this it follows that the boundary separating “normal” from “mental disorder” should be based not on abstract reasoning, but rather on the balance between the positive and the negative consequences that accrue from different choices. Always seek the “greatest good for the greatest number.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“It is comforting to see President Donald Trump as a crazy man, a one -off, an exception- not a reflection on us or on our democracy. But in ways I never anticipated, his rise was absolutely predictable and a mirror on our soul.”
― Allen Frances, Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump

“CBD has become the most inflated bubble in all of psychiatric diagnosis, with a remarkable fortyfold inflation in just one decade. CBD satisfied three essential preconditions for excessive popularity: a pressing need, influential prophets, and an engaging story.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“If there are just a few mental health clinicians in a developing country, only the most severely disturbed will appear mentally disordered—”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Elusive reality does not discourage Umpire Two. We don’t have to fully perceive or understand the underlying nature of our world to negotiate it well. Our senses and reasoning powers evolved as they did because they work just fine in the everyday, nonphilosophical business of survival. Mental constructs of reality are imperfect, but indispensable, ways to organize the otherwise bewildering phenomena of the world.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Some radical critics of psychiatry have seized on its definitional ambiguities to argue that the profession should not exist at all. They take the difficulty in finding a clear definition of mental disorder as evidence that the concept has no useful meaning - if mental disorders are not anatomically defined medical diseases, they must be "myths," and there is no real need to bother diagnosing them.
[...] This shibboleth can be believed only by armchair theorists with no real life experience in having, living with, or treating mental illness. However difficult to define, psychiatric disorder is an all-too-painful reality for those who suffer from it and for those who care about them.”
― Allen Frances, Saving Normal: An Insider's Revolt Against Out-Of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life

“Fourteen Ways To Tame Pharma

1. No more direct-to-consumer advertising on TV, in magazines, or on the internet

2. No more drug company-sponsored junkets, dinners, promotional gifts, or continuing medical education for doctors or medical students

3. No more financial support for medical professional organizations

4. No more beautiful salespeople congregating in the doctors' waiting room

5. No more free samples

6. No more off-label marketing

7. No more co-opting of thought leaders

8. No more drug company funding for the Food and Drug Administration

9. Bigger fines and criminal penalties for malfeasance that are directed against the executives as well as the companies

10. Shortened patent protection for companies that break the law

11. No more financial aid for consumer advocacy groups

12. No more disease-awareness campaigns

13. No more unlimited and undisclosed contributions to politicians

14. A three-year quarantine before politicians, staffers, and bureaucrats involved in setting or monitoring drug company regulations can join a drug company as officer or employee”
― Allen Frances