My personal favorite absurd thing that got said at the APA convention: a statistician on the DSM task force said, “The DSM guides diagnoses. It doesn’t define disorders.”
Say what?
First of all, why can’t it do both? Come to think of it, doesn’t it have to do both? Unless they’re thinking of it like the Field Guide to the Birds, in which someone else’s taxonomy is taken for granted and then the book helps guide you in identifying whether that bird is a blue-footed booby or a grey-crested tit. Which, I think, is exactly what they wish were the case. But it’s not, and that is why they;ve spent, as they’re so fond of reminding all of us, ten years and 25 million dollars, wrangling over which disorders exist and how to define them. And really, if the DSM doesn’t define disorders, then who exactly does? God? Webster’s Collegiate? Google?
Second, and more important, why waste time trying to cover over the fact that you’re producing an authoritative document? I don’t think the APA has thought this one through all the way. This same statistician also repeated the party line about how the DSM is a living, breathing document. (Which sounds a little scary to me; I have visions of a book storming down city streets, eating cars and stomping on buildings.) Can’t you just see this in court, the defense having just proved that its client suffers PTSD, as defined int he DSM. and the prosecutor quoting the authors of the DSM saying that the book doesn’t define disorder and that it’s not a Bible, but a living breathing document? Or school systems holding off on providing services because the APA says the DSM is still being beta-tested?
I don’t blame them for trying to have it both ways: the authority of medicine and the flexibility demanded by the complex human mind. But really, you can’t square that circle, and the closer they try to move toward this brain-based account of subjectiv e suffering, the more they’re going to have to try,.
