Pathologizing Normal Behavior?

by on

The DSM was first issued in 1952, during that liberating period that saw, for example, Kinsey’s reports on sexual behavior. The DSM in its various editions guides treatment decisions throughout North America and other continents.

The original DSM listed 106 disorders. This was pretty much carried over to the 1968 revision. However, the DSM III of 1980 jumped the number of categorized disorders to 265. A new edition in preparation by an American Psychiatric Association task force follows the 1980 and 2000 editions in many respects. The implications of classification are alarming.

Are more people suffering from mental disorders and emotional problems? According to the 1980 edition, the answer would appear to be 60 percent more.

But is this a true description of society? And what exactly defines a disorder? The Autumn issue of the U of T magazine accesses Professor Edward Shorter, Hannah Professor of the History of Medicine at the University of Toronto. Shorter’s concern is that actual diseases are lost in “a thicket of non-existent syndromes and disorders.” In other words, normal life may some day be regarded as a symptom.

Shorter goes on to say: “There isn’t any other discipline in medicine that depends on consensus for its scientific truths. Consensus really means horse-trading: I’ll give you this diagnosis if you’ll give me that diagnosis. That’s the way they do business in politics. That’s not the way you do business in science. The speed of light wasn’t determined by consensus.”

Shorter believes the current revision of the DSM, carries forth all the current shortcomings by not concentrating on well-established disorders, with clear organic underpinnings and biological causes, like classic melancholia. These, Shorter stresses, ought to be treated by psychiatrists; with the rest of what the DSM describes being handled by psychotherapists (psychologists, social workers, nurse practitioners).

Dr. Van Ornum has discussed the shortcomings of the DSM and its successor edition elsewhere in this blog. For Dr. Stefan de Schill, former director of research for AMHF, the issues raised were a lifelong concern.

Filed under: