Jul. 1st, 2009

greensword: (i see right through you)
There is, apparently, a heated debate surrounding the creation of the DSM-V. For those of you who didn't grow up with a copy of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in your home - it is a sort of general consensus of psychiatrists as to which different mental disorders exist and how they should be diagnosed.

It sounds relatively innocuous, until you start thinking about the fundamental questions that lie beneath. What is a mental disorder, and what is just a different way of thinking and behaving? Where is the line between legitimizing suffering and medicalizing otherness? What does mental "illness" even mean?

The DSM weighs heavily in these discussions. Clinicians, health insurance companies, and others use the DSM as a guidebook to deciding what they will recognize, treat, and pay for. The debate going on now has real impact.

The DSM has been controversial in the past. Until 1973, it listed homosexuality as a mental disorder, and it currently lists several provocative disorders, including Gender Identity Disorder, Hypoactive Sexual Desire Disorder, and Oppositional Defiant Disorder. The debate over whether or not these particular disorders should legitimately be included brings up all those fundamental questions.

The current criticisms being leveled at those compiling DSM-V (we currently use DSM-IV) fall along two major lines. First, apparently there is too much secrecy in the process. Whereas all previous revisions have been completely open, contributors to this revision had to sign a confidentiality agreement. Given that more than half of the contributors have financial ties to the pharmaceutical industry, that's a little troubling.

Secondly, the head of this revision has called for a "paradigm shift" in the way we think about mental disorders. The person who headed up the previous revision, Allen Frances, is one of the most vocal critics. He warns how in the past, reclassification of disorders such as ADD and autism created "epidemics" in the population and how with pharmaceutical pressure to create more and more disorders that can be medicated, the danger is even more great. The new version is apparently going to focus more attention on prodromal patients - i.e. people presenting with pre-clinical, more mild symptoms. I think it's great to try and catch small problems before they become big ones - we do this with physical health all the time - but like Frances I worry this is little more than a ploy to net more patients for the pharmaceuticals.

Anyway, what do you all think?
greensword: (bitch please)
While I'm procrastinating...

I saw this piece on women playwrights and theater about a week ago. I don't know if those without a nytimes subscription can read it, but here's an excerpt:

When more than 160 playwrights and producers, most of them female, filed into a Midtown Manhattan theater Monday night, they expected to hear some concrete evidence that women who are authors have a tougher time getting their work staged than men. And they did. But they also heard that women who are artistic directors and literary managers are the ones to blame.


I grew increasingly more grumpy as I read the story, which details a study that asked male and female artistic directors to rate identical scripts with male and female names attached. The surprising finding (at least, the one reported by the NY Times and others in the media) was that female artistic directors were the ones giving lower ratings to women.

Here's the real deal:

The questions about the likely reception of a play intend to measure customer discrimination (by the audience, in this case) and co-worker discrimination (by the actors). They are not measures of what the respondent himself or herself thinks about the play... All it means is that they believe the audience and the workers in the theater are less accepting of female playwrights than of male playwrights. Male respondents don't believe this, but then they don't have the same life experiences as the female respondents...

Suppose you come and interview me about authors, say, and ask me to tell which ones I think are really good and what their future prospects might be. And I give you some female and some male names of writers I like and regard as equally good and then tell you that the female ones have not as great prospects as the male ones. Then you go out and write that THIS PROVES I'M THE REASON FOR THEIR NOT-SO-GREAT PROSPECTS! That's pretty much how this whole thing works: To notice discrimination is to be guilty of it.


Sexism is alive and well in theater... and in journalism.

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