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Tuesday, May 31, 2011

Is The DSM High?

  Inclusion of new diagnoses into the DSM always involves much thought and debate, or at least it should, as a diagnosis can determine treatment and even involuntary commitment of individuals. 


  A most controversial addition will hit the DSM-V, slated for release in 2013. A new term, called Paraphillic Coercive Disorder, will be added to the Appendix of conditions that need more research but are not considered official diseases yet. This concession was made as members of the medical community are at odds with each other as to whether PCD is an actual psychiatric condition. 


  Well, what is PCD? It is, in essence, a term applied to serial rapists. ("The person has clinically significant distress or impairment in important areas of functioning, or has sought sexual stimulation from forcing sex on three or more nonconsenting persons on separate occasions.") You see, many states have laws stating that sexual predators can be hospitalized indefinitely in mental facilities after they have served their prison sentences. The Supreme Court has ruled that the person must have an actual disorder (other than being a selfish, evil fuck) that makes them dangerous in order to be held. Thus far, such offenders are held under a vague classification which is being legally challenged as punitive and unconstitutional, so well-meaning, but otherwise incorrect folks have tried to invent a disease in order to lock rapists up. 


  I have a mental illness and so do millions of other human beings, people who have consciences and wouldn't consider harming another person. The difference between psychosis and psychopathy lies in one's ability to feel, and mentally ill people most certainly have a full spectrum of human emotions- in fact, it's usually amplified. Lumping people who want and need psychiatric intervention with those who live to service their narcissistic desires by attacking others undermines the integrity of the entire psychiatric profession and those with actual illnesses that are present through no fault of their own. Additionally, it laughs in the face of traumatized victims and offers yet another new defense to a reprehensible crime.


  I agree that serial rapists should be incarcerated, and for very long periods, followed by closely-monitored parole. However, admitting them into hospitals where they will have an all-you-can-eat buffet of vulnerable prey is most certainly not the way to go. Individuals with serious mental illnesses have enough to deal with without being housed with sexual predators, who are highly aware that what they are doing is wrong and have no desire to change. 


  While it's unfortunate that convicted sex offenders are in our midst, it's absolutely unconstitutional to hold someone past the term of his or her determined sentence. Moreover, it is an insult to good people to coalesce  the ill with the depraved. The psychiatric community needs to stop excusing horrendous voluntary behaviour at the behest of law enforcement agencies and should issue a resounding no to even considering this ridiculous proposal.


  Regardless of the reasoning, under no circumstances should the term serial rapist be sugar-coated. 


  Be well.

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