Quick Reference to the DSM-IV-TR
American Psychiatric Association

Certain books are keystones.

The Bible is a singular meeting point for philosophy, literature and religion. All the humanities seem to intertwine within the collected works of William Shakespeare. Dante's "Divine Comedy" neatly blends poetic expression and political philosophy with medieval Christian theology.

And the "Quick Reference Guide to the Diagnostic Criteria from DSM-IV-TR" is the meeting point of psychology, psychiatry and the law.

Saying "he's crazy!" is one thing. It's a broad-brush, subjective, personal assessment. It may resonate. It may even be true. But it's just a simple word, hurled into the ongoing vortex of simple words that make up everyday conversations.

But when you say "I suspect he is suffering from a generalized form of social anxiety disorder," your words have clout. If you've got the right college degree, you've put someone's life into a whole new box.

The DSM-IV-TR contains almost every mental complaint, illness and condition known to modern science, with wildcard allowances for the creative new stuff our minds are capable of belching forth. Known in full as "the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders," it's published by the American Psychiatric Association, and used as a handbook for diagnosing mental illness. This little book is powerful.

It's full of secrets, which proper schooling can probably unravel. Why did "elective mutism" (a consistent failure to speak in specific social situations) get changed to "selective mutism?" Why is "female orgasmic disorder" more accurate than "inhibited female orgasm?" And where did "hypersomnia," insomnia's super-cool cousin, come from?

And who decided that rubbing one's genital region against the hindquarters of others in a public and inappropriate manner deserves its own condition, known as "frotteurism"? Outside of Tokyo's subway system, are there really that many people suffering from this condition?

It seems a few consistent sufferers of a mental illness can create a whole new label.

With its endless lists of clinically accurate conditions and symptoms, this little silver book is a chilling tour through the various things that can go wrong with our minds. It's a lot like OSHA's safety page — it has detailed, ultra-rational descriptions of horrible things that can happen to people.

When the mind is given an anatomically perfect skeleton of something tragic, the imagination needs to do very little work to paint on the flesh of a person in pain. Reading the DSM-IV-TR is no picnic.

The book is insidious. It gets you thinking about your friendships and relationships. "I just poured my heart out to her, but she didn't react at all. But the whole episode had surprisingly little impact on me. Am I suffering from histrionic personality disorder? Or is she just schizoid? Or are we just equally sick — and complementary?"

Probably neither, you sick fuck. Put down the book, and forget about its contents. It's not for us non-professionals to read, or contemplate.

This damn thing can drive you insane.

— James Norton (jrnorton@flakmag.com)