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The fight over the new psychiatric manual, DSM-V, has escalated. The conflict is due to an underlying flaw in the manual's conception. Rather than tracing human activity in terms of its impact for people's lives, it instead attempts to list each separate manifestation of abnormal functioning. This is madness. Read More
makes great sense to me
It's not the substance or behavior to which one is compulsively attracted that matters, it's the nature of the compulsion itself and its effects on a person's well-being. Of course, like most truly intelligent ideas, this one has little chance of being adopted by the DSM-V. As you suggest, financial interests have taken control of this process, as well as so many others, from politics, to national security, to medicine.
I don't suggest financial interests drive the DSM.
That's Frances' and Lane's claim, and that it is true in many areas of diagnostics and treatment. But it is America's kooky cultural ethos towards, drug, alcohol, and addiction that drives DSM in those areas.
Behavioral addictions, the DSM, and sentinent beings
Though I'd love to agree, I think the notion that all people recognize that addictions outside of substance dependence can occur is simply false. I've had endless comments on my writing, which leads me to believe that you have as well Dr. Peele, from readers who think that addiction (or dependence) is a concocted condition, made up by clinicians who want work and pharmaceutical companies who want money.
The is no doubt that behavioral addictions exist and that the "once and addict, always an addict" motto is simply wrong. Even if the exceptions are relatively rare, they exist, and claiming they don't traps people in stigmatized roles forever, even making it impossible for them to escape (the familiar self-fulfilling prophecy idea).
Addiction is a tricky, developing, and context-dependent condition, which makes identifying it perfectly extremely difficult. I think we should keep trying, but I believe that a more spectrum-based, contextually aware, way of thinking about it is necessary.
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