TODAY'S TOPIC:

D.S.M: Color It
52 Years Old

by
Natalia J. Garland

Print Version

My introduction to social work began during the days of the D.S.M.-III. I remember that D.S.M. as though it were yesterday. It was like a citrus grove filled with lemons and oranges, just oozing with Vitamin C. It provided such good nutrition for the dedicated worker and eternal student.

For those who may have never seen the D.S.M.-III, I'm referring to the color of its cover--bright yellow-green. And, of course, D.S.M. is short for Diagnostic and Statistical Manual of Mental Disorders. It's the book which we mental health workers use to officially diagnose our patients and thereby obtain insurance reimbursement. The D.S.M. has a definite practical use. But does it have any other value?

It seems there have always been polarized views regarding the D.S.M. Some people find it a useful tool that gives us a common clinical language and diagnostic categories so that we can communicate with one another. Others find it a constraining system that unnecessarily and inaccurately labels our patients.

When I first opened the D.S.M.-III back in the 1980's, it gave me safe passage into a new world. I thrived on studying lists of symptoms and learning how to make a differential diagnosis. I longed to own copies of the D.S.M.-I and D.S.M.-II. I searched in the used bookstores, asked my co-workers, but nobody had ever seen the 'I' and 'II' versions. And nobody was interested. I was looked upon as an anomaly. What did I care! I was feeding myself a delicious intellectual food which I picked from the lush foilage of my citrus grove.

Then, the D.S.M.-III-R was published. Oh, goody goody! More diagnostic treats! I rushed right out to buy the paperback version and its matching Casebook. Although, rather expensive, I'll admit. The color of the D.S.M.-III-R was ocean-blue. Its contents were like rare proteins in the midst of plentiful waters. It held exotic wonders for my adventuresome mind. How I loved to splish and splash in its depths.

Let me take a moment to give you the time-frame for all the D.S.M.'s. The D.S.M. has been around for fifty-two years. Here's when each one was published:

That's a lot of D.S.M.'s. By the time the D.S.M.-IV was published, I began to feel the financial burden. For the first time, I did not buy my own copy to study and cherish. I began using the workplace copy to simply flip through the pages and look up diagnostic code numbers for which my memory had no capacity. Besides, the cover of the D.S.M.-IV was a deep burgundy. It was unexciting from the beginning. Burgundy is the color of wine: very inappropriate, don't you think? I became nostalgic for my youthful days of ocean-blue and yellow-green.

Fortunately for color-sensitive people like myself, the burgundy model had a short lifespan. In a mere six years it was gone. The next D.S.M. was destined to outshine the whole bunch.

The D.S.M.-IV-TR sped in like a sleek, silver sports car. Breathtaking beauty. A cure for the mid-life crisis. Just what I needed to make me wipe the smudges off my eyeglasses and start studying again. Yes, I can see clearly now.

I see, for example, as I'm sure you do too, that despite improvements, human emotions are difficult to categorize neatly. I am already looking forward to the D.S.M.-V. We desperately need diagnostic categories for co-dependency, chronic anger, cross-addiction, and hoarding. There are experts in these fields who have made worthy contributions to our knowledge, and I hope their voices will be heard at the D.S.M.-V editing table. Who knows, if the color is right, I might even buy my own paperback copy. (Written 04/07/03 - Revised: 12/01/03, 11/05/07: bibliography available.)

Until we meet again..............stay sane.