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by JumpCrisscross 2165 days ago
> Mental Illness as defined by the DSM as not thriving

Isn’t that a two-system measure? The person. And their society.

A gay man in Tehran won’t thrive, but the solution isn’t medicating him into submission.

3 comments

Yes. From page 20 of the DSM,

> Definition of mental disorder

> A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.

> Isn’t that a two-system measure?

Usually, three, because the specific “not thriving” criteria usually have a degree of subjectivity, so it's patient/society/clinician.

Yes, it is, and that's precisely why the removal of homosexuality from the DSM (in 1974) was not a sign of the DSM's authors giving into cultural pressures - it was a combination of the authors avoiding the cultural pressures that had caused the previous edition to list it, plus a realization (after scientific study) that the problem wasn't with the person, it was with their society.

The nature of the scientific method is that we learn new things over time, and the nature of society is that we are all subject to various kinds of cultural pressures, most of which we don't even recognize. The meta-level goal of the DSM - describing those disorders which prevent someone from thriving and are properly treated by psychiatrists - seems sound, even if each edition always needs to be succeeded by a new one.