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Tue February 12, 2013
OnWords: Disorder Is Often Quite Orderly
The word “disorder” gets thrown around a lot in diagnostic circles, but it rarely accurately describes what's going on.
The new manual for diagnosing mental problems, the DSM-V, has stirred up controversy in the mental health field for a variety of reasons, but one of the most contentious is the way it would potentially expand such things as grief, overeating, and everyday anxiety into categories of behavioral disorder.
Disorder seems to imply that there is no way to follow the problem or mental state, that it has no identifiable psychological cause. But the origins of these syndromes and their progression are actually quite ordered and easy to follow if you ignore the sometimes disordered communication patterns associated with them.
For example, someone who is hearing voices that he interprets as coming from the CIA has very good reasons for acting paranoid. Likewise, someone who is undergoing extreme grief and trying to make sense of her life without a loved one has quite logical and well-ordered reasons for believing her life is over; her life as she knew it before her loss certainly is.
Probably the least accurate of these so-called disorders is “obsessive compulsive disorder.” The behaviors we associate with this condition are by definition highly structured, ritualistic and predictable—the very opposite of disorder.
It may very well be that having these conditions leads people to lead disordered lives or lives that are quite different than those of the majority, but if we fail to see the often clear and frequently powerful internal logic of mental disorders, we can miss what's at the heart of people's psychological distress, and we can overlook what they really need to reclaim their lives and minds.