The New Definition of a Mental Disorder

Is it an improvement or another attempt to name a non-existing thing?

Posted Jul 23, 2013

No one really doubts the phenomena of birds and bees. But to call birds and bees miracles and to create a miracle-maker god who created them is a certain kind of leap. No one really doubts the phenomena of sadness and worry. But to call them symptoms of mental disorders is the same kind of leap. We make gods and mental disorders in the same way, by using real phenomena as “proof” of the existence of non-existing things.

Part of the joy and ease of this creating is that you can define the non-existing thing any way you like. Who is to say if a god is or isn’t friendly, spiteful, eternal, or taking a personal interest in you if there is no real thing involved? Who is to say if a mental disorder is the same or different from a brain disorder, the same or different for a Jungian, a Freudian, or a drug dispenser, the same or different from unwanted thoughts or behaviors, if there is no real thing involved? It ought to be the case that those making the claim for a non-existing thing should have to prove its existence, but in real life the burden always falls on the whistle-blower.

See how easy the definers of non-existing mental disorders have it. First they define it one way, as they did in the DSM-4: “A mental disorder is a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.”

Then, under pressure by skeptics as to whether this definition made sense, they redefined mental disorders in this new way, in the recently released DSM-5:

"A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."

The very idea that you can radically change the definition of something without anything in the real world changing and with no new increases in knowledge or understanding is remarkable, until you realize that the thing being defined does not exist. It is completely easy—effortless, really—to change the definition of something that does not exist to suit your current purposes.

Certainly one could scrutinize the changes. A mental disorder is a psychological thing, or maybe it isn’t. A mental disorder is a biological thing, or maybe it isn’t. You can rail against your society unless you have a “dysfunction,” at which point your railing is a mental disorder. You can have a conflict with your politicians unless you have a “dysfunction,” at which point you are a mental deviant.

The question is not, “What is the best definition of a mental disorder?” The question is not, “Is the DSM-5 definition of a mental disorder better than the DSM-IV definition of a mental disorder?” The question is, “Do mental disorders exist?” The phenomena certainly exist. The birds and bees exist; pain and suffering exist. But birds do not prove the existence of gods and pain does not prove the existence of mental disorders.

The phenomena itself confounds us and it would be lovely to create gods and mental disorders to explain them. But, being non-existent, gods and mental disorders explain nothing. Let us move on and do better.