There was a very interesting article in the New Yorker about the issue with the DSM. Turns out we now have research which shows that people get very attached to the little box they are put in by the DSM and that influences how their symptoms evolve. [0] Meanwhile, evidence seems to point out that "disorders" exist on mostly continuous scales with multifaceted issues and the relevance of having boxes is far from obvious.
> Turns out we now have research which shows that people get very attached to the little box they are put in by the DSM and that influences how their symptoms evolve.
After being diagnosed with something in the DSM - I experienced this myself, and have been very aware of the Heisenbergian side effects of labelling and observing something like this in a specific concrete way.
Common wisdom with some psychological diagnoses is that the symptoms often seem to get worse after diagnosis because you start to notice the problems more. But I think there is an "identity" element to this too as you elude to.
I think this is somewhat inevitable, but the question is, even though you may be subconsciously influenced by the diagnosis itself - is it still better to have such a diagnosis and to be able to work with that information - versus not?
From my own experience, I'm not quite sure - but I'd probably lean towards having the diagnosis still being the better option.
This is a trend I noticed lately. Being autistic is trendy for instance, people talk about it on social (!) networks, about their lives and all that, which is, if you believe what they are saying, is pretty much normal, save for a few personality quirks, like, well, most humans.
I may be wrong but the "little boxes" in the DSM are not supposed to be an identity. They are supposed to represent a pathology, essentially, if one of the boxes is checked, then you need help. Which box is an indication of what kind of help is the most appropriate: a drug? which one? counselling? hospitalization?
It may be a continuous scale, like most diseases really, but how much help you need has to be quantified in order to take action. That's what the "little boxes" are for, or at least, that's how I see it.
> They are supposed to represent a pathology, essentially
The diagnosis in the DCM are built very strangely. They are basically cluster of symptoms which are statistically seen to occur together in reports (which are necessarily self report the field being psychology).
It does for a somewhat arbitrary definition of what is a pathology. The DSM has a disproportionate impact on what is and isn’t covered by insurance in the US but isn’t overall a very good tool to decide what treatment is the best and I don’t think doctors base their recommendation on what people check or don’t check in the DSM.
> like most diseases really
Psychology is fairly unique in medicine in that we have very little idea of what’s the actual root cause of people mental disorders.
A "personality disorder" is also not static. The idea is that you work with it and heal aspects that make life (more) difficult for you, so you do not have the disorder any more. Not that you make it a part of your identity and demand others to accept your "unique style".
Being put in the convenient box is commonly the difference between getting social security payments or being thrown to the wolves. Of course people are attached to the little box when it determines much of your life.
