The American Psychiatric Association‘s Diagnostic and Statistical Manual of Mental Disorders has always been a strange mix of bigotry and pointless essentialism. Homosexuality was included as a mental disorder in the DSM until 1974, and “Gender Identity Disorder” remains there today. Many of the disorders simply make illnesses out of personality traits: I’ve never been able to understand how “having” Antisocial Personality Disorder is any different from being a really nasty person, for example.
I wouldn’t normally have a problem with some group of learned weirdos making a list of personality traits they find disorderly, except the DSM is used around the world to forcibly “treat” people and can provide a defence or mitigation in court.
The upcoming DSM-V, due in 2012, looks set to be the wackiest yet:
The APA isn’t just deciding the fate of shopaholics; it’s also debating whether overuse of the Internet, “excessive” sexual activity, apathy, and even prolonged bitterness should be viewed, quite seriously, as brain “disorders.” If you spend hours online, have sex more frequently than aging psychiatrists, and moan incessantly that the federal government can’t account for all its TARP funds, take heed: You may soon be classed among the 48 million Americans the APA already considers mentally ill.
Quite how the association will decide when normal kvetching becomes a sickness—or reasonable amounts of sex become excessive—is still anyone’s guess. Behind the APA’s doors in Arlington, Va., the fine points of the debate are creating quite a few headaches. And they’re also causing a rather public dust-up.
To linger anxiously, even bitterly, over job loss is all too human. To sigh with despair over precipitous declines in one’s retirement account is also perfectly understandable. But if the APA includes post-traumatic embitterment disorder in the next edition of its diagnostic bible, it will be because a small group of mental-health professionals believes the public shouldn’t dwell on such matters for too long.
I’m with Thomas Szasz: viewing personality traits which are unwanted by the individual or inconvenient to others as mental illnesses is thoroughly wrongheaded. I’m all for using pharmaceuticals to improve your own mental functioning – based on your own understanding of what constitutes improvement – but there is no such thing as a normal and healthy personality from which individuals can depart and be declared abnormal.