The Human Disorder: DSM-V Fraught with Danger

Child with pill on his tongueThis past weekend, something happened that set the psychological world on its ear and caused many organizations and individuals to take up arms against one of the largest and most influential institutions in mental health. The new “enemy”? The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which was just approved with changes that have been vehemently opposed by many groups and individuals.

New diagnostic categories include disruptive mood dysregulation disorder, better known as temper tantrums. The forthcoming DSM also eliminates the exclusion for bereavement from depression. This means many more people will be eligible for diagnosis and will often be treated for things that fall well within the range of normalcy. The problem many people have with these changes stems from their belief that being human and having human experiences is not a disorder.

I can’t tell you how many times I have had sessions with clients who believe there is something wrong with them because they are having a perfectly normal and perfectly human reaction to life’s tragedies. Often, they are seeking a quick fix to alleviate their pain. I am really saddened at how our society—and not just in the realm of mental health—has worked to make being human undesirable. Anything less than the “ideal” is rejected.

Widening the Divide
“The Other” is a concept used to describe how individuals and groups differentiate themselves from other groups or individuals. “The Other” is seen as being inferior in some way, perhaps lacking some characteristic that normalizes. This is seen in race and cultural relationships, in bipartisan politics, and, I believe, in the use of diagnostic categories. That is not to say diagnosis is not valid at times, but the insurance-driven market of psychotherapy has created an environment in which a diagnosis is necessary for treatment, compelling therapists who accept insurance to swiftly diagnose clients.

A therapist, by slapping a label on the client, has minimized the humanity of “The Other” (in this case, the client). There is now a clear line between the therapist and the client; the therapist is the authority with the power to treat, while the client is the diagnosed or “mentally ill.” Often, treatment becomes about treating the diagnosis and less about the care of the person behind the label.

The Danger of Labels
The new additions to the DSM-V create even more opportunities to see our clients as “The Other” and less like fellow travelers on this journey of life. Noted existential psychologist Irvin Yalom states that “labels do violence to people,” and Kierkegaard said, “Once you label me, you negate me.” I, along with many others, fear the violence that will be done to those included in these new categories.

I believe the DSM-V changes can serve as a wake-up call, alerting each of us to the need for a life of celebrating our humanity … one where we learn to accept ourselves right where we are without judgment or criticism. Of course, that means we must take a stand against the dangers we are facing. Maurice Friedman said, “The great character who can awaken responsibility in others is one who acts from the whole of his or her substance and reacts in accordance with the uniqueness of every situation.” It is to those great characters that this piece is written; those who are willing to awaken responsibility in self and others. It is high time we get back to a psychology for the person—a psychology where we can practice loving others and ourselves just as we are, while always working to become that which we are capable of being.

One of the most amazing things about being human is that humans alone have the privilege of experiencing what we do—not just sorrow, suffering, pain, joy, and ecstasy, but everything in between. Let’s not waste any more time labeling and mislabeling our fellow man. Let’s begin the business of living.

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Lisa M. Vallejos, PhD, LPC, therapist in Denver, Colorado

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • fred

    December 8th, 2012 at 4:24 AM

    have never liked the concept of slapping a label on someone just for the sake of classifying one thing or another
    i kind of like that we are all fellow human beings on this life journey together
    if this version that so many professionals solicit advice and help from does more labeling than what makes many of them comfortable with, I am not sure I understand how the changes were passed and apporved in the first place

  • Ira Bindman

    December 9th, 2012 at 6:03 AM

    I agree that labels, as dictated by the new DSM V, move us away from a humanistic vision of our patients towards a more clinical and distant viewing. Insurance companies must have categories to determine how to fit patients into their payment matrix but it’s sad when we are caught up in that process too. Sometimes diagnosis codes are helpful, e.g., when working with a patient with borderline personality disorder it’s important to note what behaviors to watch out for. But on the whole, labels dehumanize our patients and make us less human too.

  • Theodore

    December 9th, 2012 at 3:55 PM

    I agree that labels do create a sense of a stigma, but don’t we sometimes need them to ensure that a patient is getting the proper diagnosis and treatment?

  • TP

    December 9th, 2012 at 9:46 PM

    We’re growing more and more uncomfortable with anything even slightly unpleasant. I am certain this is a result of such thinking. Throwing tantrums is a disorder now? Come on!

    Why can’t we accept ourselves as the imperfect beings we have always been? The idea is to live with those imperfections and learn from them, to see the light at the end of the tunnel and channelized out energy into getting to that end!

  • Dane

    December 10th, 2012 at 4:04 AM

    There has always been a danger with wrongly labeling people and allowing this label become who or what you think that they are. But this is nothing new with the new DSM-V. This problem has been around since the beginning of the science itself, but this is a human problem and not necessarily one perpetuated by the manual.

  • Lisa Vallejos

    December 10th, 2012 at 8:36 AM

    Hi everyone! Thanks for the discussion, I really appreciate it. To some of the points that were made: Theodore, there are absolutely sometimes when using the DSM is useful for patient care. However, this post is addressing the misuse and overuse of diagnostics.

    Dane: I suppose we could equate the DSM with a car/gun/money. If and of itself it is neither good or bad but it can be a tool of good or bad. The concern I have is that the ease of labeling people for reimbursement purposes will perpetuate a negative & unhealthy view of what is health in our society.

    Fred: Many people wonder how these changes passed. There were THOUSANDS of signatures gathered, petitions sent and many people who spoke out against the DSM-V’s proposed changes but they accepted them anyway.

  • Paul Leslie

    June 13th, 2013 at 5:09 PM

    Thank you for this post. I agree that labels do little to heal. The increase of labels seem to be more about a desire to see pathology in all aspects of clients’ lives in order to facilitate pharmaceutical interventions rather than viewing the journey of life as a challenge from which to grow.

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