Longer observation (20): Limitations of the DSM-5: Whether or not the newest edition (Fifth Edition) of the Diagnostic and Statistic Manual for mental illnesses is an improvement over the Fourth Edition is being debated within the mental health professional community. Which ever side of the debate we find ourselves on, perhaps we will agree that any attempt to categorize mental illnesses has inherent limitations. We use the image of a building with windows to demonstrate the point.

 Here is a window


Imagine a group of people jostling each other to look in. Each wants to come up with the best description of what is inside. Each does the best he or she can and writes it down (or photographs it). The descriptions are compared, and there is a dispute about which is the most accurate. They are gathered into a book which is published for general and professional use.



As soon as the book is published there is an outcry because all the descriptions came from the experts looking only into one window. What about this second window? Looking in that window would, at the very least, give another view of the same things, but it might even give a view into another room that wasn't even glimpsed by the first group. And so the group (or another group) moves over to the second window and describes what they see there. They compare it and contrast it with what they saw through the first window, and they come up with descriptions that, they hope do justice to both view points. And another edition is published and used.



But the critics are up in arms again. "Great!" they say, "At best we now have a description from two windows! But what about all the others!" And so a new edition is worked on and eventually published. And there are arguments about whether this edition is superior to the previous editions.

But no matter how many editions are published, no matter how many windows are peered into, there will always be objections. One objection is that viewing something from a window is not like being in the room, and so even if there were a perfect description of what is seen from all the windows, there will always be dimensions that an outsider's view can never sense or grasp.

But even more, 


We can not really understand what is going on in any room or rooms in the house without understanding the layout of the whole house and the fact that the house is situated in an environment, in the world itself.

This is no reason to give up trying to describe the content of a room or rooms of the building, but it is a reason for feeling humble before the vastness of what we are trying to understand.