DSM-V as Dystopian Fantasy

DSM-V as Dystopian Fantasy

Really interesting and clever article…reviews the DSM-V , suggesting that the gradual transformation of human variance into pathology is a dystopian vision. I think it really picks up in the last half of the essay, where it challenges the categorization of human experience into little pigeonholes and asks what a normal human could be now that all behavioral variance has been pathologized.

Perhaps we live in this dystopia?

There has been medicalization of all personal problems, particularly in a post-Prozac world. Depression, obsession, hallucination–all have been transformed from unstoppable curses to internal problems through a better understanding of the underlying biology. While this process has allowed for the development of treatment for people who cannot function with their behavioral irregularity, this greater ability to intervene has resulted in intervention in ever less aberrant behaviors. A timely example here is the massive increase in production of methylphenidate to treat ADD/ADHD.

The localization of behavioral problems to internal biology somehow shifts the responsibility for the ailment within the person: it is your neurotransmitter imbalance, your brain structure, your strange behavior which is the problem. But one idea which I will frequently address on this blog is the notion of the extended self. We currently tend to think of ourselves in either spirit-centric or brain-centric terms–there is a something located inside of us which allows us to think and feel and move.

However, there is another crucial aspect to the self: the environment which surrounds each individual. We know that the brain is a plastic (that is, rapidly changeable) organ. All incoming stimulus–be it chemical, visual, acoustic, somatic–leave a distinct impression of variable permanence on neural tissue. These impressions can change brain function drastically over very long periods of time, particularly if a strong impression is left at a younger age, where the brain’s plasticity is more pronounced. Perhaps, then some of the ailments suggested by the DSM-V can be attributed to environmental influence on a person.

Another question present in this article are to what extent strange behaviors should be identified as pathological. To what extent is ‘strange’ behavior simply an expression of an individual’s personality? With concepts of disease and normality so unclear, where do we draw the line between quirks and disease? If we all aspire to some ill-defined perfect norm, certainly nothing but frustration lies in the future.