Excerpt:
Sometimes a book is more than just a book: it is an occasion for high anxiety. For instance, in just a few days, the American Psychiatric Association will unveil the fifth edition of its handbook of diagnoses, the Diagnostic and Statistical Manual of Mental Disorders. More than a few – patients and professionals and caregivers – are upset with what they expect to find there. In today’s guest blog, psychiatric nurse practitioner Nina Gaby examines how the controversy might play out in one family:
...Appendices become sections. Axes morph. Spectrums of quirk. Structure disintegrates. What is already less science than art becomes even more subjective. The world as she knows it is crumbling. 992 pages. Releases to the big shots on May 18...Controversy has overshadowed common sense. She takes it personally.
It has done away with the Multi-Axial System. Axes 1-5 initially provided a template on which to place symptoms, psychosocial stressors; quantifying functioning and listing criteria, stuff that people hate to hear, but clinicians rely on. We have only moments to evaluate, diagnose, develop a treatment plan, and find a billable code. You don’t like being reduced to numbers? Okay, says the older sister, then pay for it yourself. Personality still takes on blame, but has lost its own axis. (Is it scrim or lens? the older sister snorts.) The proposed windmills of domain and level and trait, internet process addictions and other tasty problems will reside for the next decade, unreimbursed, in the nether land of Section 3. Others have died altogether.
Bereavement, Excoriation, Hoarding, Asperger’s. No, yes, yes, no.
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Medical advice from Bertie Wooster
"Jeeves," I said at the breakfast table, "I've got spots on my chest."-from Levi Stahl at Ivebeenreadinglately Blog
"Indeed, sir?"
"Pink."
"Indeed, sir?"
"I don't like them."
"A very understandable prejudice, sir. Might I enquire if they itch?"
"Sort of."
"I would not advocate scratching them."
"I disagree with you. You have to take a firm line with spots. Remember what the poet said."
"Sir?"
"The poet Ogden Nash. The poem he wrote defending the practice of scratching. Who was Barbara Frietchie, Jeeves?"
"A lady of some prominence in the American war between the states, sir."
"A woman of strong character? One you could rely on?"
"So I have always understood, sir."
"Well, here's what the poet Nash wrote. 'I'm greatly attached to Barbara Frietchie. I'll bet she scratche when she was itchy.' But I shall not be content with scratching. I shall place myself in the hands of a competent doctor."
"A very prudent decision, sir."
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