Response to Dissociative Identity Disorder Letters From Martínez-Taboas et al. and Brand et al.

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To the EditorIt must be difficult to acknowledge that one has spent a great part of one’s career promoting an illusion, particularly one that has been destructive to patients’ lives. However, that is the position that the proponents of dissociative disorders find themselves in. The good news is that most psychiatrists ignored dissociative identity disorder, even at the height of the fad. The defeat of this idea helps to explain their furious onslaught on an article that only describes the current scientific consensus. The highly selective nature of their review of other published articles will be apparent to anyone who knows this literature.Unfortunately, neither Brand et al. nor Martinez-Taboas et al. have sufficient scientific training to be skeptical about one of the most absurd fads in the history of medicine. They are true believers, and that is what makes them dangerous. They fall back on personal attack, including the claim that I do not understand the impact of childhood abuse (despite my 20 years of research on the subject). Evidently, it has not occurred to them that the impact of adversity needs to be studied prospectively (or with independent validation), not by misguided therapists who insist that patients must have experienced abuse, whether they remember it or not.The larger tragedy is that once a category gets into DSM, it is almost impossible to remove it. When manufacturers produce defective products, they apologize for errors and carry out recalls. However, when psychiatrists invent diseases, and when they have friends in high places, they suffer no consequences other than long-term reputation. Our profession lacks oversight and regulation. The responsibility for this fiasco, which has done much to make our specialty look ridiculous, lies with the American Psychiatric Association and the editors of the various DSM editions, who allowed it to happen.

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