The Book of Woe

The Book of Woe
Gary Greenberg

The Diagnostic and Statistical Manual of Mental Disorders (or DSM) is known as the Bible of Psychiatry, and has been called by one leading light in the field (Jeffrey Lieberman, in his history of psychiatry Shrinks) perhaps “the most influential book written in the past century.” This it may well be, but Gary Greenberg, who was closely involved in the preparation of its fifth edition (published in 2013) has a more critical take, seeing it as “all clothes and no emperor.” What he means by this is that it is a nosology divorced from the reality of mental illness, a compendium of symptoms without a clear understanding of the disease (if such an understanding is even possible). The shift from mind to brain holds out promise for the further medicalization of mental illness, but the mind abides in all its elusive complexity. Mental illness will always have a cultural context and social dimension, and there will be no keeping the dirty business of business, not to mention politics, out of our collective book of woe.