It’s Not My Fault…You Can Look it Up!

The new and improved "Diagnostic and Statistical Manual of Mental Disorders," the psychiatrist's Bible, is now out.  After a decade going over the latest scientific literature, consulting scores of international experts, the first draft of the fifth edition is out.  Anyone can read the draft, and even submit a comment, until April 20 of this year at dsm5.org.

But no worries.  You can breathe a huge sigh of relief.  Whatever it is you've done, or are doing, it's not your fault. 

You're just mentally ill.

In an editorial in the Times of London, Richard Morrison skewers the new text in light of its proclivity to treat every human foible and fancy as symptoms of an unstable mind.

So you lounge around every day on a sofa, watching trash on the television?  You're not lazy.  You apparently have "sluggish cognitive tempo disorder."

You like to complain about the weather, your boss, your in-laws or your neighbors?  You are most likely suffering from "negativistic personality disorder."

Do you find yourself offering some choice Anglo-Saxon insults at drivers who pull out in front of you without warning?  You might have "intermittent explosive disorder."

Mary Wylie, a senior editor of the Psychotherapy Networker, calls it "the one organizing principle standing between the mental health field and sheer diagnostic chaos."

Oh my.

Morrison suggests a new game.  One contestant confesses to some minor peccadillo, and then the other would have to dress it up in pretentious psychobabble. 

Spreading too much butter on your toast?  That's a clear case of "obsessional dairy product disorder." 

Finding it hard to get out of bed on cold Monday mornings?  You are obviously suffering from "compulsive duvet disorder."

Fuming because the subway train is down?  Careful, you're letting people see your "irritable tunnel syndrome." 

Constantly worrying that you have hopelessly overspent your credit card?  That's not your fault.  You have a "fixational impecuniary disorder."

I know, as does Morrison, that there is nothing funny about true mental illness.  But that isn't what's going on here.  Morrison is right in noting that what is becoming pervasive is "the abdication of responsibility for our own behavior.  If we can attribute all of our bad-tempered outbursts, insensitive comments and callous or cynical misdeeds to a medical condition, then we are absolved of carrying the can for our own conduct." 

Morrison carries this to its logical conclusion, which is the very notion of free choice, will-power and morality being rendered irrelevant.  We are merely creatures of our disorders.  We act the way we do because our conditions force us to behave that way. 

Morrison concludes by saying, "I don't say that psychiatrists should stop trying to find ways to unravel the perplexing knots of anguish, anger or nihilism inside the human mind.  But I wish they would stop giving healthy people excuses for behaving badly, when we are perfectly capable of holding back many of our worst impulses if we try hard enough.  As regularly used to happen in less feckless eras."

Don't like this?

Sorry, I probably just have "chronically misguided cultural assessment disorder."

Sources

To read the draft of DSM-5, log on to dsm5.org.

"It's not my fault, I just have irritable columnist syndrome," Richard Morrison, The Times (of London), Wednesday, February 17, 2010, Times 2, p. 5. 

"A diagnosis in the book has power to change lives," USA Today, Monday, March 8, 2010, p. 8D.