Author Background
Allen Frances is a noted author of various research and books in the academic field. He was also among the task force that oversaw the growth of DSM-IV while serving in their full capacity as the Chair of Psychiatry at Duke University. Amid his retirement, he composed a literary article about his experiences and recorded them in Saving Normal.
Book Summary and Themes
In this book, the author focuses on what can be termed as the normal and abnormal mental disorders based on the French perspective and the history of mental health. Because of the prevalence of false positives in diagnosing mental health issues, much money is being wasted on treatments that are unnecessary and may even be detrimental to the patients receiving them. This book aims to raise awareness of current events on an international scale.
Dr. Frances’ primary objective is to raise awareness among the general public, medical experts, and clinicians about the widespread problem of incorrect diagnoses and the inappropriate use of treatment and medication for “normal” people. For instance, he says “we must take partial responsibility for the epidemics of autism, attention deficit, and adult bipolar disorder” (France, 2013, p. 139). Common suffering and pains are being labelled as mental diseases. Misleading diagnoses have been assigned to individuals by the field of psychiatry. Frances says that individuals are too concerned that they have the newly-described mental disorder whenever it is discussed.
The book also makes the case that the line between normality and mental illness is often misdiagnosed, which is a problem that needs to be addressed. Many people who are simply suffering could be wrongly diagnosed with a mental illness. Overdiagnosis of psychiatric conditions, according to Allen Frances, is due to the prevalence of online and social media interactions. The book’s best sections examine past, present, and future fads. The message of Saving Normal is that people should strive to recover their whole humanity.
Reflection
Overdiagnosis and the Misuse of the DSM
One of the key reactions to the book is how the author claims that people without mental disorders may be diagnosed using the DSM. The author argues that the DSM may be used to diagnose people who do not have a mental disease, using the term attention deficit hyperactivity disorder as an example (ADHD)(Frances, 2013). He contends that the signs of attention deficit hyperactivity disorder (ADHD), such as fidgetiness and wandering attention, are not necessarily indicative of a mental disability and are really fairly common among youngsters(Frances, 2013).
This idea of Frances is related to my future career as a Psychiatric-Mental Health Nurse Practitioner(PMHNP), as it equips me with knowledge of assessing signs of mental health disorders other than the common ones. Additionally, I totally agree with him that there is misdiagnosis of mental disorders, which has resulted in inappropriate medication, especially for youngsters. This is evidenced by the fact that one of my childhood friends was being medicalized for schizophrenia. Yet, their disorder was not related to the medication that was being provided.
Rationalizing Controversial Therapies and Their Potential Harms
I have also found Frances’ idea that DSM can be used to rationalize therapies with adverse side effects quite captivating and engaging. The author claims that there exists a history of links between electroconvulsive therapy (ECT), which he calls a controversial treatment, and memory loss and other serious adverse outcomes. He argues that the presence of Major Depressive Disorder (MDD) and other similar diagnoses in the DSM might be used to justify the administration of ECT despite the lack of data demonstrating its efficacy (Frances, 2013).
This idea by the author amazes me since I faced a challenging scenario at one point in my career. I was supposed to discover ways to rationalize various therapies, especially those with adverse side effects on a patient. It was a challenging experience as I could not identify the negative beliefs and irrational patterns in a patient despite them having undergone a DSM-5 diagnosis for trauma, personality, feeding, and stressor-related disorders. However, this book has immensely boosted my understanding of the subject, and my perspective on rationalizing therapies has changed.
Neglect of Preventive Mental Health Strategies in Modern Society
I think that Frances’ idea that the current society has neglected the best forms of mental disorder prevention is a reality. Many people are too engaged in their everyday activities and pay less attention to vital matters related to their mental stability. There is also a growing number of people who disregard physical exercise, proper diet, moderate alcohol consumption, and abstention from drugs and tobacco. For instance, the author says that “we neglect what are the best forms of prevention such as promoting exercise, proper diet, moderation in alcohol use, abstention from tobacco and drugs” (Frances, 2013, p. 73) are. Additionally, there is a proper setup and sponsorship to realize these beneficial and remarkable, cheap prevention measures that have been recommended.
Although Frances hopes that the idea of premature preventive medicine does not spread to the field of mental disorders, it seems that the situation is even worse. There have been higher rates of mental disorders in the recent past, which can be attributed to living under extreme pressures from a stressful and sped-up society. The author’s idea of neglecting cheap preventive measures of mental disorder reminds me of a particular speaker’s call for PMHNP nurses to ensure that they advise their patients accordingly on cheap measures of mental disorder prevention.
Organization, Clarity, and Accessibility of the Argument
The book is well-organized so that the reader can easily switch between themes and phrases, and it is free of terminology that is only understood by specific healthcare providers. With these basic features, I can easily recommend the book to others, especially my colleagues in the PMHNP career. The reader has definitions and the author’s interpretation of specific terms or concepts. The book offers sources for historical mental health facts and diagnoses and an understanding of the author’s viewpoints via descriptions of experiences and observations. The author’s tone is formal, as if in a one-on-one dialectical argument, and may be interpreted as having a bad view of the Diagnostic Statistical Manual.
Overall Evaluation and Relevance for Future Professionals
In conclusion, I would strongly recommend Frances’ book to the general public, medical experts, and clinicians who may have the urge to know more about the widespread problem of incorrect diagnoses for mental health disorders. With this book, they will be equipped with enough knowledge on how they can utilize cheap preventive measures against mental disorders while tracking their mental progress. Additionally, the book is an essential tool for those pursuing a Psychiatric-Mental Health Nurse Practitioner career, as it expands their thinking and discovery of common causes of misdiagnosis associated with their career. This helps them re-strategize their knowledge base to address this limitation and realize amicable solutions.
Reference
Frances, A. (2013). Saving normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma and the medicalization of ordinary life. Psychotherapy in Australia, 19(3), 14-18.