Life is Not a Mental Disorder

07/13/2010 01:36 pm ET | Updated Nov 17, 2011
  • Ronald Ricker Physician, Psychiatrist, Psychoanalyst, Social Critic, Founder and Director of The Linden Center

The Bible (or really any religious text) can be made to say and mean anything the author wishes.

The "Bible" of psychiatry, that fabled and hoary text, the DSM-IV-TR (Diagnostic Statistical Manual of Mental Disorders written by the American Psychiatric Association), is no different. Conceived as an instrument to identify and help heal disorders of the mind, it has morphed as to both form and function. Too often, psychiatrists wield the DSM-IV-TR like a blunt instrument, desperate in their drive to assign names to supposed "mental conditions" and thus to be able to assign numbers to these "conditions." Discover a new widely inclusive "condition," give it a name and number and you have a winner: One more brick in the wall of sicknesses.

DSM-IV-TR is very large book. We have lots of diagnoses, the number rapidly growing. We need lots of page room. Aside from blank pages, Chapter Heading Pages, and long lists of Contributors, etc., DSM-IV-TR is chuck full of diagnoses, with detailed descriptions and code numbers for each diagnosis. This book is 952 pages long. It weighs 4.8 pounds.

There is an odd situation in DSM-IV-TR. Really odd. In its entirety, all 952 pages, there is no "No Disorder" option. Therefore, everyone is seen by DSM-IV-TR as sick, the only question being from which sickness(es) they suffer. The annual physical checkup many of us get, usually, unless there is something wrong, ends with "everything is fine." This, apparently, doesn't exist in mental health.

I have always felt that I was a crummy writer, starting from college and thereafter (including medical school, internship, National Institute of Mental Health, Psychiatric Residency). However, in writing this poorly written piece, while trudging through DSM-IV-TR, I found 315.2 - "Disorder of Written Expression." It was an AH-HA moment. I may be a crummy writer, but it's because I have a disease. Criteria, according to DSM-IV-TR, for this disease (315.2) are 3:

  • a) Writing skills below those expected given the person's chronological age, measured intelligence and age appropriate education;
  • b) The disturbance in criterion A significantly interferes with academic achievement or activities of daily living that require the composition of written texts (e.g, writing grammatically correct sentences and organized paragraphs);
  • c) If a sensory deficit is present, the difficulties in writing skills are in excesses of those usually associated with it.

Had I been told that I had Disorder of Written Expression (315.2), I would have been talking to psychiatrists. I have been seeking help from the wrong people -- friends, teachers, editors, other writers, newspaper columnists, professors, etc.

Well, I hadn't talked to the right people. I've pretty much thrown in the towel on this writing thing. Given up. This writing is so bad, I'm not even writing this article, because I can't. My writing partner, Dr. Nicolino, does not have "Disorders of Written Expression" (315.2). I tricked her into partnering with me. There's a diagnosis for "tricking a good writer to pair with a crummy writer," but I don't have the time to look through DSM-IV-TR to find it and its code, and besides, co-factors of "Disorders of Written Expression" (315.2), are "Reading Disorder" (315.oo) and "Mathematics Disorder" (315.5), all three of which will make it hard or impossible to find the code for "tricking a good writer." Actually, I'm blind lucky to have found "Disorders of Written Expression" (315.2) in the first place because of my other disabilities. It's clear that I've turned sociopath. There is a fancy-named diagnosis, with a number for that too. For the same reasons, I'm not going to look for those.

We have a diagnosis for everything and every body. I have heard people, thought to be treehugging new agers, who think that medicine is directed to illness not health. They have an excellent point. We don't aim to make people healthy or even allow as to how they may be healthy, but we call them sick.

The above, laughter aside, is all too pathetically accurate. There really is no place in DSM-IV-TR for "no psychiatric problem." If one wanted to push the case, the absence of the chance to be wrong invalidates all of DSM-IV-TR. Any scientific experiment has to have the chance to be wrong in order to have the chance to be right. I can't be just a crummy writer, but have to have a disease, label and numbered.

Crummy writing is not a mental disorder and neither is life.