Psychiatrist Glen Simblett reflects on what DSM diagnosis might mean in the consulting room and offers the unusual metaphor of dance to think about how we might best help people.
In 1980 the mental health industry invented a new diagnostic label, one of many, for the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM III). The American Psychiatric Association (APA) presented DSM III to the world as a scientific revolution in psychiatric understanding. If people suffering emotional distress had accepted the APA’s statements about the new manual, they would have rejoiced that such a wealthy and powerful organisation had put its energies into making sense of psychological suffering. The vast majority of people receiving one of these new labels had experienced great trauma – sexual abuse, extreme life events and repeated abuses of power. Quite a progressive move by the APA then: understanding the effects of power on people. Psychiatrists could show care, understanding, and perhaps even provide a sense of solidarity to people who were marginalised. Unfortunately, in 1980 the APA willed Borderline Personality Disorder into being. The APA’s idea of empathy and understanding led to vast numbers of survivors of abuse being labelled as disordered individuals.