Document Type

Letter to the Editor

Publication Date



Arts and Humanities


First paragraph:

In her review of Frederick Crews’s Freud: The Making of an Illusion Lisa Appignanesi argues that Freud’s talking cures, while not working miracles, were innocuous compared to the harm done under the regime of the American Psychiatric Association’s Diagnostic and Statistical Manual even now. While I share Lisa Appignanesi’s concern over the misapplication of diagnostic labels and the over-prescription of psychoactive drugs, it should be noted that the interpretive liberties taken by the psychoanalysts who ruled American psychiatry as late as the 1970’s had much to do with the rise of the DSM diagnostic system as we know it. Instituted in DSM-III in 1980, this system proclaimed an “atheoretical” stance toward etiology, in direct reproach of the psychoanalytic practice of etiological speculation. As Nancy Andreasen, a member of the DSM-III Task Force and later the editor-in-chief of the American Journal of Psychiatry, wrote in retrospect, it was the recognition “that the psychodynamic emphasis had gone too far, leading to diagnostic imprecision,” that led to the making of DSM-III.


This letter was sent to but not published by the New York Review of Books in reply to Lisa Appignanesi’s Oct. 26, 2017 review of Frederick Crews’s critical biography of Freud.

NB: The NYRB did not publish Crews’s letter in defense of his own book, either.


© 2017 Stewart Justman