The ambiguity between mental disorder and normality puts into question which disorders should be included in the DSM and who receives diagnosis
- The right hemisphere cares about the meaning of language, whereas the left cares more about having control of language “meaningless hypertrophy of language”
Mental disorder and and normality are too ambiguous to distinguish between, and not having a useful definition of mental disorder creates a gaping hole at the center of psychiatric classification, resulting in two unanswered conundrums: how to decide which disorders to include in the diagnostic manual and how to decide whether a given individual has a mental disorder. Binge eating was once considered a sin; should it now be a psychiatric disorder? Is the forgetting of old age an illness or just old age? Is having sex with a teenager just a crime or also a sign of craziness? And in evaluating any given person, we lack a general definition of mental disorder to help us decide whether they are normal or a patient, mad or bad.
The mental disorders included in DSM-5 have not gained their official status through any rational process of elimination. They made it into the system and have survived because of practical necessity, historical accident, gradual accretion, precedent, and inertia—not because they met some independent set of abstract and universal definitional criteria.
No surprise then that the DSM disorders are something of a hodgepodge, not internally consistent or mutually exclusive. Some mental disorders describe short-term states, others lifelong personality; some reflect inner misery, others bad behavior; some represent problems rarely or never seen in normals, others are just slight accentuations of the everyday; some reflect too little self-control, others too much; some are intrinsic to the person, others are culturally determined; some begin early in infancy, others emerge only late in life; some affect thought, others emotions, behaviors, interpersonal relations; some seem more biological, others more psychological or social; some are supported by thousands of research studies, others by a mere handful; some may clearly belong in DSM, others could have been left out and perhaps should be eliminated; some are clearly defined, others not; and there are complex permutations of all of these possible differences.
References
- Frances, Allen. (2013). Saving Normal CHAPTER 1. What’s Normal and What’s Not? (p. 31). New York, NY: HarperCollins.
Metadata
Type:🔴 Tags: Psychiatry / Philosophy / Semantics Status:☀️