The Book of Woe: the DSM and the unmaking of psychiatry

by Gary Greenberg

a society’s revulsion had found expression in the official diagnostic manual of a medical profession, where it gained the imprimatur not of a church or a state, but of science. When doctors said homosexuality was a disease, that was not an opinion, let alone bigotry. It was a fact. When they wrote that fact down in the DSM, it was not a denunciation. It was a diagnosis.

The diagnostic enterprise hinges on an optimistic notion: that disease is part of a natural world that only awaits our understanding.

It reflects what is best about us: our desire to understand ourselves and one another, to use knowledge to relieve suffering, even if it results in a kind of reductionism that insults our sense of ourselves as unfathomably complex and even transcendent creatures. It also reflects what is worst—the desire to control, to manipulate, to turn others’ vulnerabilities to our advantage.