BEYOND THE DSM

Copyright, Ruth Lampert, May, 2011


Since my retirement as a psychotherapist, I no longer write “professional” articles or books. However, there is a topic much in the current popular press which I would like to address; that is, the updating of the DSM (“Diagnostic and Statistical Manual”) which is the “Bible” for diagnosing mental disorders. It has been revised several times, and the latest version – DSM-V-TR is due for publication in May 2013.

So here are my suggestions/comments for nomenclature of mental disturbances which, in spite of their increasing prevalence, will probably continue to be omitted in new versions.

FOD – “Fear of Deletion.”

This disorder is characterized by an unreasonable panic which overwhelms the sufferer at the last moment before permanently deleting an e-mail from the file. Typically, the person is first aware of an annoying anxiety when the delete button is pushed for the first time, and the item goes to the “delete” file, where it remains until the e-mailer decides (or seriously considers) permanent deletion. After hitting “X” at this point, a small but ominous warning appears on the screen:

“Are you sure you want to delete this item?

This is the moment of truth, which triggers anxiety symptoms including rapid heartbeat, sweaty palms, dry mouth, etc. I personally experience this situation almost every day. I mean, I’m pretty sure I want to delete this old ad from Amazon, .but absolutely, positively forever? True, the time frame for the advertised special has already expired, but they might offer it again, and I might miss the second offer…

And that political controversy…even if the election is over, there will be more, or I might need to defend my choice to someone…you never know. And those confirmations of lunch dates – maybe I’ll need to look them up for tax purposes, and demonstrate that they were indeed business related and maybe I won’t be able to find the actual receipts, who knows? Anything can happen….

This syndrome is more likely to be seen in the elderly (I’ll let you define what that is) and sometimes results in so much stored material that the health of the computer, let alone of the computeree, may be threatened. There is no DSM for that that I know of.

Another disorder not officially noted is the OAO (“On-and-On”) syndrome. An example of this is the above description of FOD, which could have been covered in a sentence or two. This is also seem frequently, but not exclusively, in older patients, which is understandable because older people have more accumulated memories and opinions to draw on as they try to explain or describe something to someone. So far the most effective intervention is attendance at Onandonanonymous meetings. Although each person’s story tends to be interminable, it beats driving a friend or relative nuts. (This condition is not severe enough to warrant an entry in DSM.)

It should be noted that if OAO sufferers are undergoing psychotherapy, the treatment itself will probably go on and on, which some therapists think is a good idea as far as their financial welfare goes. You know who you are.

SCR, or “Sudden Cooking Resistance” is common in women who have been married 20 or more years, (not necessarily to the same man) though it may occur in those who have experienced fewer years of matrimony. While the appearance of symptoms is sudden, the condition may have been festering (simmering? More about puns later.) for many years. Typically, the first symptom is a slamming of kitchen cupboard doors, and a loud, explosive, shout of “I’VE COOKED ENOUGH! THAT’S IT! FROM NOW ON WE EAT OUT OR ORDER IN!” In advanced cases, “YOU LIKE HOMECOOKED FOOD SO MUCH? THEN YOU CAN COOK IT!” may be included.)

There is no cure for this condition, although in some mild cases the patient may find herself able to cook a light meal now and then, as long as someone else does the shopping and the cleaning up.

The CRS! Syndrome,” Can’t Remember S---!” is actually not a disorder, but rather a colorful way of describing the normal memory loss that occurs with aging. It may actually be beneficial in that it allows a healthy release of tension, and is often accompanied by laughter and many “Yeah, me too!” comments from contemporaries.
On the other hand – uh, what was I going to say here? Something about the damage that can be caused by forgetting a close relative’s birthday…Who was that now….. Damn, CRS.