The association has no clear definition of the cutoff between normal and pathological responses to life’s letdowns. To those of us following the debates as closely as the association will allow, it’s apparent that the DSM revisions have become a train wreck. The problem is, everyone involved has signed a contract promising not to share publicly what’s going on.
Back in 1952, when the APA’s diagnostic manual first appeared, it was a thin, spiral-bound edition that offered sketches of such ’50s-sounding traits as passive-aggressive personality disorder, emotionally unstable personality disorder, and inadequate personality disorder. It was seen more as a guide to psychiatry than as a chapter-and-verse authority on everything pertaining to mental health…
“In its effort to increase diagnostic sensitivity,” Spitzer and Frances conclude, the DSM-V task force “has been insensitive to the great risks of false positives, of medicalizing normality, and of trivializing the whole concept of psychiatric diagnosis.”
[Every behavior known to man can be taken to a pathological extreme. The drive to name them all (then classify and publicize) strikes me as a professional preoccupation. "I'm an expert in Associative Rhetorical Disorder." Who cares if shrinks want to name everything under the sun, and then some? The Manual may become less useful, but psychiatry is nothing if not a personal profession. We can allow the Manual to get out of hand, so long as its readers don't take it too seriously, don't try to fit us too neatly into predetermined disorders. As usual, Jonah Lehrer says it best: "The brain... rarely obeys our neat schematics and categories. Human behavior is a smear, a spectrum." I'm inclined to believe that most psychiatrists appreciate this, even the ones who specialize in treating shopaholics. -Ed.]
Douglas Faneuil is the founder of Living Proof Productions, a not-for-profit devoted to suicide prevention based in New York City. He also designs database solutions for companies throughout the Northeast.