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BITWASTES_DSM

                                             October  30, 2021
                                             December 28, 2021

                                                   BITWASTES
   
Some of the better material in David Auerbach's
"Bitwise: A Life in Code" (2018), revolves     
around psychotherapy-- for someone of his               
generation he was unusually well-placed to     
observe it.  He comes at it with a viewpoint   
that's on the edges of the inside: both his    
parents were psychotherapists, and he himself        
had some (relatively minor) episodes of               
something like anxiety attacks.                
                
His interest in systems of categorization of human
beings-- and the way computers change the way we use
them-- ties in well with this:


                                           (p. 120)

    "The DSM notoriously uses a criterial system to
    determine diagnoses: one need not possess *all* the
    markers of a disorder to be diagnosed with it, only
    *enough* of them.  Many disorders entail having '5 of
    the following 7' or 'at least 4 of the following 10'
    behaviors or tendencies listed."

    "This did not fit any conception I had of what a
    disease was, nor did it fit psychiatry as my parents
    had described it to me.  More importantly, it did not
    even fit any conception I had of what a *taxonomy*
    was."

        Auerbach is talking about his younger
        self's attitudes here, which might or
        might not reflect his present day
        attitudes, but this seems like an odd        Why young Auerbach
        thing to say about "taxonomy": he            was hung up on some
        evidently expected a hard-edged set of       need for rigid, well
        categories that perfectly reflects the       defined taxonomy is
        one true underlying reality...               the interesting point
                                                     here, one which I
        Whatever problems I have with the DSM,       don't think Auerbach
        this would not be one of them: as I          ever addresses.
        understand it there's strong evidence
        that things like a checklist-based
        system of diagnosis can perform quite    MEDIUM_SPEED
        well...

    "These checklists didn't function well as overall
    rubrics; some of them, at least to my
    preadolescent self, seemed random.  I was hardly a
    good judge of personality at that point, and the
    way symptoms and behaviors were arranged and
    listed seemed puzzling, if not entirely arbitrary.
    I presumed that there was some expert logic that
    explained why it was *these* diseases that people
    had or did not have."


    "The DSM-II notoriously classified homosexuality as
    a mental disorder, listing it alongside other
    'Sexual Deviations' such as sadism, masochism, and
    transvestitism.  Other artificats included
    'neurasthenia', 'psychotic depressive reaction', and
    'involutional melancholia'.  The homosexuality
    classification was rectified in 1973, thanks to an
    effort led by the quantitatively oriented
    psychiatrist Robert Spitzer, but it was increasingly
    clear that many of the other categories, while less
    controversial, were terminally vague, overlapping,
    and sometimes incoherent."


Auerbach's parents on the DSM:

    "They explained that clinical assessments were not
    made by such criteria, but by the reasonable
    judgment of adults like themselves who wouldn't
    diagnose people as crazy just because they ticked
    off the right number of boxes under a DSM category.
    So what, I asked, was the purpose of these
    categories?  Getting paid, they told me."










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