Sausages and Legislation

…and the diagnostic categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM) all have one thing in common: You will be seriously disgusted if you look too closely at how any of them are made.

In a Los Angeles Times article, Christopher Lane, a Northwestern University professor, describes an ongoing controversy among psychiatrists as to whether the next revision of the DSM should be open for public discussion or whether it should be a secretive, closed-door process. Lane writes:


Hanging in the balance is whether, four years from now, a set of questionable behaviors with names such as "Apathy Disorder," "Parental Alienation Syndrome," "Premenstrual Dysphoric Disorder," "Compulsive Buying Disorder," "Internet Addiction" and "Relational Disorder" will be considered full-fledged psychiatric illnesses.

This may sound like an arcane, insignificant spat about nomenclature. But the manual is in fact terribly important, and the debates taking place have far-reaching consequences...

...Because large numbers of countries, including the United States, treat the DSM as gospel, it's no exaggeration to say that minor changes and additions have powerful ripple effects on mental health diagnoses around the world.

Behind the dispute about transparency is the question of whether the vague, open-ended terms being discussed even come close to describing real psychiatric disorders.


Lane writes that he is concerned about the lack of solid science, the lack of proper oversight, and the need for a vigorous debate about the validity of any proposed disorders. He describes, in scary detail, the chaotic and scientifically unsupported discussion that went into the creation of new diagnostic labels in previous editions.

This is how I see it: At present, we live in a society where large numbers of our citizens, without any say in the matter, have been assigned mental disorder classifications on the basis of scientifically questionable and often biased research studies. We face widespread prejudice and discrimination as a result of these arbitrary classifications and the resulting stereotypes. Our psychiatric emperors and their drug-company courtiers wield vast power over our lives, while their scientific nakedness usually goes unmentioned. It's time for concerned citizens to put an end to the ugly and morally indefensible caste system that they have created in secret.