Dsm V Disaster...

The Diagnostic and Statistical Manual of Mental Disorders (produced by the American Psychiatric Association, and hugely important in the funding, diagnosis and treatment of these disorders ) is being upgraded from DSM IV to V.

Disastrously, after 5 years wrangling, they have failed to agree on a section relating to personality disorders. These are widely acknowledged to be inadequately treated in DSM IV The basic issue seems to be that the working group has produced quite a complex set of diagnostic distinctions, which apparently will confuse a regular practitioner and the public. To me, this sounds like criticising the Standard Model in physics for having too many particles.

Relating to ILIASM, this has a negative impact on those with partners (or themselves) suffering from these disorders (BPD etc) because they will likely not get appropriate treatment or even diagnosed at all.

I'm also not clear what the status of Hypoactive Sexual Desire Disorder (HSDD aka low libido) in the update to the DSM, there has been an intense controversy regarding whether this should be categorised as a disorder and to what extent - because lack of desire is common in some stages of life, and in asexuals.  They are also making it gender neutral as far as possible.

Wikipedia gives a current summary, and this includes, for at least 6 months:

No interest/fantasies
No initiation, and not receptive to partner's attempts to initiate
Reduced pleasure in sex
Absent/reduced arousal in most encounters

And it must cause significant distress to the individual (no mention of the partner!), and not better diagnosed under something else.
hl42 hl42
51-55, M
6 Responses Dec 10, 2012

So your hypothesis is.....I am asking if I understand .....that a SM is an indicator of a mental attitude which in some cases can be changed ?

And the underlying mental issue(s) are not addressed ?

Some members here suffer from spouses with things like BPD (Borderline Personality Disorder). That has a huge impact on how their SM plays out and what can be done about it. To the extent that that label is accurate/useful/treatable makes a difference, and that's an example of what has not been properly addressed in the DSM-V.

Forgive me....SM .....it refers to what ?

Sexless marriage, title of this group... or ILIASM.

Why is this of importance to the author of this story ?

That is the willingness for psych literature to be accurate ?

Two reasons: first, from a personal point of view before I changed my SM, I came to realise that the bad labelling of conditions and just-so stories that prevail in popular culture, and in therapists who are beholden to the DSM for various reasons, are a contributory factor in making the SM acceptable and ineffective in treatment.

Second, in terms of helping others on this board, I am acutely aware that many here have spouses who have personality disorders and mental illness which is a major part of the SM. The inadequate treatment of these, and the failure of the DSM-V in this respect is not doing them or their spouses any favors. And being aware of this information might encourage a person to read some more original research so they can understand the dynamics and prognosis better and at least keep themselves safer, even if they cannot help their spouses.

I'm very much in agreement with you hl42. I've seen some vehement arguments here on ILIASM with people denying certain conditions exist or have any validity because they are not represented in the DSM-IV or are not considered to be "psychiatric conditions" in the DSM-IV. For example, there is no agreement about where (or even whether) "**** addiction" should be included. Hence there are those who argue that there is "no such thing". . . .

(This reminds me somewhat of the archaic definitions that Australia used to adopt for compensation to people who had been in accidents. For example: Loss of two limbs = disability; loss of one limb - you are fine!)

There is a strong thrust in some parts of the USA to move away from the diagnosis of "disability" - that is, to accept that everyone without exception is at some point on the spectrum of humanity and as such is "normal". Whilst this sounds nice philosophically, it is actually extremely likely to result in very serious discrimination. I can see why such a position might be very attractive politically - after all, if everyone (regardless of their condition or circumstances) is "normal", then there is NO need for any expenditure on special services (medical or otherwise)!!!

For better or worse, our Western societies take great note of these "official" classifications, and if these are missing, there will be no funding for anyone who might need help in one of these areas.

I guess anytime you mix money, politics, ideology and evidence together, it's the latter that comes out the loser. I'm in a state of fairly general perpetual dismay at the gap between what could "easily" be effectively done, and what actually happens (which is about short-termism to suit interest groups and the power elites).

So to that extent, I'd want to see useful distinctions in psychiatry that are based on decent science to get more established, so that it moves up the scale as a subject, and avoids the dumbing down stuff - but that is not what will happen I guess, at least as far as the money flows are concerned.

And of course, you know my skepticism about "**** addiction" - because it's been co-opted by those with money to make, and whose ideological position glorifies in lambasting the visual preferences of men. That's not to say I'd accept those who use **** over an intimate relationship with their spouse - I'd thrash them within an inch, or have them on the stocks.

Which last therapeutic intervention might well be far more effective than years of sessions or drugs..... (like the jackwagon commercial).

I do LOVE the image of the **** abuser being thrashed or in stocks!!! ROFL. May I suggest stocks . . . ? It is possible the thrashing could be just too much fun!!

On a more serious note, I concur with you wholeheartedly and share your "fairly general perpetual dismay". This issue is by no means the only one where self interest triumphs over good sense and reasonable decision making.

So we are not likely to see a diagnosis of some refuser being an "Authentic Arsehole" in this DSM tome to be released ????

How disappointing. That condition, along with "Frigid Money Grubbing ***** Disorder" and the common "Aloof Limpdick Syndrome" miss out too !!!!

Never mind, all such maladies will probably be listed under a cluster group ond day. Perhaps the title of said cluster group might be "Refuseritis" and all the "whys" ever seen on these pages will get a mention. It will be an awfully thick book.

Tread your own path.

Yeh, well I'm no lover of the quackery and $ involved in psychiatry, yet there is money and recognition involved, and I think it's overly cynical to dismiss instances where they are trying to make progress and get less witchcraft. And while the subject's still in its infancy IMO, I don't think it's right to dismiss progress which at least recognises more distinctions and gets less pseudo-science.

I'd also see it as a possible antidote to too-glib categorisations of people into over-simplistic labels.

And in these instances, I don't see anything wrong with distinguishing the symptoms and using these to predict behaviors - at least to the extent that you can then better protect yourself against them.

What you can be sure of, there won't be any support for those with partners exhibiting those AA behaviors.

Any possible treatment?

Treatment for the psychiatrists?!

For the suffers, probably not. For the indirect sufferers, postcode therapy.

As usual...:(