CHANGES TO DSM

I note in the papers that they are getting ready to start the ‘review’ process for the “Diagnostic and Statistical Manual” (DSM), that handbook used by the mental health professional community (actually a broad spectrum of practitioners extending from major world-class researchers through clinical providers such as psychiatrists and Ph. D. level psychologists, and on down into a rather broad array of less-trained ‘providers’ and ‘advocates’).

A couple of points are in order for the SO community to keep an eye on.

First, as was noted in my most recent Shanley Post (“Important New Shanley”, January 30th), it is by no means established that merely by being included in an edition of the DSM a diagnosis is professionally endorsed at the highest levels to be a valid entity. And as you can see in that Post, courts – including the US Supreme Court – have said so.

The ‘process’ is not so much one of rigorous scientific testing of a proposed ‘diagnosis’ and ‘disease’ as it is political wrangling between those who advocate and those who doubt its usefulness and validity.

It’s not as if you have a damaged bone or organ that can be clearly demonstrated to examiners, such as is the case with purely medical or surgical cases. You are dealing with a range of ‘mental’ diseases and problems that on their most biologically-evident end include biologically-involved symptoms that can be seen on various scans or include symptoms and behavioral patterns that cannot be faked (not to put too fine a point on it) and whose connection to a causal organic dysfunction can be established for all competent observers to confirm.

But on the lower end, as I have often said, you start getting into the “spectral evidence” realm with a lot of these less empirically grounded diagnoses and maladies: You get problems that only the sufferer can ‘know’ and ‘feel’. The ‘repressed memory’ and ‘dissociative amnesia’ diagnoses go in this direction, as does the extension of Post-Traumatic Stress Disorder symptoms from combat troops and survivors of natural disasters to persons claiming sexual abuse at some point in their past.

You also wind up with a lot of maladies and diagnoses that seem curiously topical when looked at in the context of trends and events in the wider culture”. A classic example is ADHD, which was discovered – curiously enough – just about the time parents in this country were spending less time with their children. It is not at all beyond the realm of reasonable explanation that children’s lack of attention has somewhat to do with the absence of sufficient parental attention and the structuring – providing a Trellis, as it were – for the child’s attention and energies.

And of course, the drug-business that has grown up around such drugs as Ritalin and Adderall adds another curious variable. It is becoming increasingly evident that long-term use of these powerful psychoactive drugs – whether by indulgent prescribers or through improper acquisition or use by the patient – creates serious secondary problems of its own.

Among the ‘new’ diagnoses that this or that coalition wants to see included as an official malady are the following, as the article notes: those kids who throw a few too many tantrums will suffer from “temper dysregulation with dysphoria”. And I bet there are a lot of such kids out there at this point, although they may just be really unhappy that their parents aren’t around enough. Or they’re fed up with brilliant-baby videos.

Much more ominously, teenagers who don’t seem to fit into the conventional mold could wind up stuck with the label of “psychosis risk syndrome”. You can see right off – and the SO community will be especially alert to this usage – the inclusion of the term “risk”: once again, in a therapeutic setting such a term rightly indicates to the staff and therapeutic team that they keep a sharp eye out so as to make timely and appropriate treatment interventions.

But when you start throwing this around, deploying it, in non-therapeutic settings then we get closer and closer to the Communist praxis of declaring ‘non-conformist’ individuals, whose nonconformity becomes inconvenient to the Correct visions of the regime, to be ‘mentally ill’ and locked away for re-education or ‘therapy’. The Boomers and the children (now adults) that they have raised are turning against the Sixties!

BUT it has become all too typical that the still-engorging Regulatory-Preventive and Prosecutory State has – under the guise of ‘sensitivity’ – begun applying this medical-psychological therapy term in the realms of civil and criminal law. The result is that you can find yourself labeled as a ‘risk’ or a ‘potential risk’ in the matter of some particularly ‘popular’ or trendy concern, and on the basis of little more than a therapist’s spectral opinion could wind up in the clutches of a police-power that claims a ‘responsibility’ to keep the public ‘safe’ by simply grabbing you, declaring you unwell, and locking you away. This is precisely the government gambit in the Comstock case, whose Oral Arguments I have recently examined on this site.

More specifically of concern to the SO community is this proposed ‘diagnosis’, and I quote the article directly: “Men who are too interested in sex face being labeled as suffering from ‘hypersexual disorder’”.

This is not the camel’s nose under the tent; this is the whole business end of a very large and omnivorous constrictor snake.

Note that the article doesn’t even bother with the fig-leaf of the gender-nonspecific “persons”: this is going to be a disease that “men” have. And, if it gets voted in at the official horse-trading session, then you won’t have long to wait before it will be decried as a “public health emergency”, so that the government can “quarantine” you, as if you had TB or the plague. Again, this is precisely what the government is trying to do in the Comstock case.

Note also that ‘hypersexual’ is a rather substantially subjective call – the ‘hyper’ is in the eye of the beholder. And if that beholder is paid by the government, or is a disciple of a particular movement or philosophy (anti-male, anti-violence, pro-victim, or a host of other possibilities – and no disrespect intended here) then you can find yourself in deep and troubled waters verrrry quickly.

I recall encountering one gentleman in his later 40s some years ago whom they wanted to ‘confine’ in a ‘facility’ merely because he had mentioned – to a therapist – that he masturbated once a day. They said he had a “Personality Disorder – Not Otherwise Specified’ – meaning that it wasn’t even in the DSM list; but the DSM had helpfully – and shrewdly – included the ‘NOS’ category for anyone a therapist had bad feelings about (or against) but couldn’t find a ‘diagnosis’ for. That sort of thing.

And note finally that this rather quiet little diagnosis could be precisely the thing to fill that conceptual and legal hole that legislators and prosecutors have been dancing around for decades now: there is no ‘sex offense’ diagnosis.

And I can guarantee you that even if this thing gets voted in as an ‘official’ diagnosis, there still won’t be an equally official ‘cure’ for it, hence no real ‘therapy’, hence you will wind up being ‘confined’ with a ‘disease’ for which there exists no treatment, no therapy, no cure – but you won’t be able to gain release until you are cured. Do you see where this sort of thing can go, quickly and quietly but lethally?

Oy.

You can be tempted to think that the only thing that could save the country is that the currency does collapse or the government goes broke so that the money for all these schemes and gambits will disappear, and all their pomps and works and ‘advocates’ with them. But that’s not constructive and I don’t recommend it.

The article says, honestly enough, that the outcome of this horse-trading "will help shape which emotions, behaviors, thoughts and personality traits society considers part of the natural spectrum of the human persona and which are considered pathological, requiring treatment and possibly criminal punishment".

There are worlds contained in that statement. And dark ones.

Clearly, a lot of 'maleness' is included (and I most certainly do not support the unripe functioning of the stereotypical 'Animal House' male).

And clearly, the government - especially in that 'criminal punishment' aspect but even in the 'public health emergency' aspect as well - is now going to have even more 'official therapeutic' support for sitting in judgment on the very personalities of the Citizens. Which, by the by, it used to be the job of parents in the family setting to establish - without inviting in through the front door the police (or 'therapeutic') authority of the government.

This is the Regulatory-Preventive Nanny State taken to yet another ominous level. Not that this wasn't all a very real possibility when the country - and the government - first started down this dark road. (Which may yet prove, for a Constitutional Republic and certainly for the Framers' vision of the Constitutional Republic and its Citizenry, the road to the Little Big Horn.)

The article says that these proposed diagnoses will be put up on the internet for public comment, so I’ll do some looking around. But I know that many of you are far more net-savvy than I am so have a field day with this.

You won’t be wasting your time.