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Disorders are updated, but one is missing

Disorders are updated, but one is missing

A forthcoming new edition of my favorite book, the Diagnostic and Statistical Manual of Mental Disor

A forthcoming new edition of my favorite book, the Diagnostic and Statistical Manual of Mental Disorders, has gotten publicity recently with the disclosure of some of the changes it will contain, but frankly, ladies and gentlemen, the changes are nothing to get excited about. A tweak here, a tweak there.

Some types of what has been called bipolar disorder will now be called “temper dysregulation disorder with dysphoria.”

The age before which symptoms of Attention Deficit Hyperactivity Disorder must appear will be 12 rather than 7.

A new “binge-eating disorder” will be added.

Just fine-tuning, which is quite meaningless since all the definitions are arbitrary anyway, simply made up by the American Psychiatric Association. It’s not as if they are based on new scientific discoveries.

The standard for binge-eating disorder, for example, will be going on a food binge at least once a week for three months. You might ask, why not twice a week for two months, or three times a week for one month? What’s so special about once a week for three months? You wouldn’t get an answer because there is none.

“The scientific status of the main diseases … is fragile,” said Edward Shorter, a historian of psychiatry quoted in The New York Times, and it sure is.

Then too, some of the changes are merely euphemistic — substituting “substance abuse” for addiction, and “intellectual disability” for retardation.

What really strikes me is what is NOT in this supposedly comprehensive manual of derangement, with its hundreds of “dissociative disorders,” “mood disorders” and “somatoform disorders,” and what I especially have in mind is the religious disorder, which is not included nor is any hint of it included.

But think about it, ladies and gentlemen: What is the main type of lunacy afflicting the world right now? Is it not the conviction that one is serving an all-powerful invisible being by using one’s own body as a bomb to blow up other people who do not share one’s devotion to that invisible being?

Certainly that’s the type of lunacy I’m most aware of, and I’m aware of it every time I go through airport security or even courthouse security.

Then below the level of suicide bombers devoted to Allah and his Prophet, who must be the purest exemplars of the religious disorder, we have other religious fanatics — Islamic, Jewish, Christian, Hindu — who are so convinced of their mandate from higher invisible beings that they feel fully justified in hacking, burning, torturing, shooting, dispossessing or just disdaining people who swear allegiance to different invisible beings.

Now, the definition of a mental disorder, per the American Psychiatric Association, is that it must not be merely cultural but must be associated with distress, disability, or with “a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.” It must be “a manifestation of a behavioral, psychological, or biological dysfunction in the individual.”

Doesn’t the religious disorder fit that definition? Doesn’t it bring increased risk of death etc.? Isn’t it a dysfunction in the individual?

I think it is. The trouble is, too many people are afflicted with it, and they and their sympathizers have too much clout for American psychiatrists to dare call them nuts.

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