In eight years, you will be sick.
Or, rather, your relationships will be sick. Not sick, as in take two
aspirins and call in the morning. But sick, as in the mental illness of a
relationship between two people.
This is how it would work: Sparring spouses seek counseling, where they are
diagnosed with "relational disorder," meaning the relationship is causing
problems, not the people.
Relational disorder -- RD in the inevitable shorthand -- is not a recognized
mental illness. Yet. If two psychiatrists convince enough people, RD could
be added to the American Psychiatric Association's Diagnostic and
Statistical Manual -- DSM to those in the biz -- that mental health
professionals consult to diagnose mental and emotional disturbances. DSM's
fifth edition, however, isn't due out until 2010, so we've got eight years
until most of our relationships could be deemed sick.
Leading the charge, reports The Washington Post, are Michael First of
Columbia University, editor of the previous DSM, and David Reiss of George
Washington University. They and some colleagues say that people often go for
psychiatric help because of troubled relationships, and improving said
relationships can improve depression and physical problems. Thus RD.
If accepted, this new illness would initially apply only to families, so
someone could be considered perfectly healthy except for that always
difficult relationship with mom, dad or spouse. Siblings are considered the
next big category.
At a recent APA meeting, First insisted family relationships are his only
target, which is a little like saying Big Tobacco would be the only industry
targeted for its cash potential.
Peers who think there should actually be a medical component to psychiatry
worry about the potential for expansion. Consider the possibilities;
strained relationships do abound.
What student doesn't encounter a disliked teacher or jerk coach? Who hasn't
worked for someone who makes repeatedly banging one's head against a brick
wall preferable to daily interaction? Ever supervised someone who defines
irksome? How about the co-worker who stabs everyone in the back before their
back is even turned around?
Annoying, insecure, arrogant, stupid -- insert your adjective -- people are an
unfortunate and often numbingly awful fact of life. Should RD be legitimized
as an illness, it will surely creep into areas now accepted as the realities
of sharing space with imperfect people and all our foibles.
Now we cope, grumble, move on, consume adult beverages with equally tortured
souls, whatever. In the future, it'll be similar stuff, only with the
addition of a RD note from the doctor prescribing counseling for the sick
relationship. Surely some law will follow to ensure that both parties
appear, because, well, how to counsel a relationship if only one side shows
up?
RD represents a huge break from the medical model of psychiatry, so you see
why some oppose this proposed new classification: After years of trying to
educate professionals, the public and insurance companies that mental
illness is a real disorder caused by a real brain imbalance, RD would label
relationships themselves as the problem. Not so medical.
But First and Reiss don't worry about such technicalities. Please, they're
doctors. As the Post writes, they "argue that whether the new classification
fits the (medical) model is less important than whether it can help people."
Ah. Such altruism.
Or, just maybe, opportunity.
A passing thought only, but could the potential for research into sickly
relationships, new drugs and insurance coverage that allows more bickering
moms and daughters to pursue "help" propel the quest to include RD as a
completely new category of mental illness? Pathology casts a wide net in our
culture, particularly when attached to dollar signs.
So, the abusive husband or father isn't a pathetic excuse for a man, but
someone who doesn't function well with his target. The controlling mother
isn't in need of someone telling her to lay off but rather in need of
treatment for whatever ailing relationship she's trying to control. The
bratty child isn't a spoiled heathen in need of actual authority but rather
the other half of a mentally ill relationship. DonŐt forget the drugs.
Relationships often need a lot of help to survive and thrive, but they
aren't mentally ill.
I'll reserve judgment about those who would classify them as such.
Tresa McBee is a columnist at the Northwest Arkansas Times. She
can be reached at
tresam@nwarktimes.com.
