6/CHRONICLESnFreud was a man. So was Jung. Sonwere Adler and Sullivan, to say nothingnof Rollo May and Carl Rogers.nPerhaps that explains why psychiatristsnand feminists are at odds over how tondefine the mentally ill. In 1983 thenAmerican Psychiatric Associationncommissioned a special Work Groupnto update and revise the Association’snDiagnostic and Statistical Manualn(DSM-III), the official catalog of recognizednforms of mental illness. Anpreliminary draft of the revised manualn(DSM-III-R) is now out, and, accordingnto National Public Radio,nleading feminists don’t like it.nOne of the oflFending recommendadonsnin DSM-III-R is the proposal thatnPremenstrual Dysphoric Disorder benrecognized as a new category of mentalnillness. The working draft is careful tonpoint out that for most women theirnnatural cycles cause “little distressnand … no effect on social or occupationalnfunctioning” and that PremenstrualnDysphoric Disorder was to bendiagnosed only in cases of “clinicallynsignificant emotional and behavioralnsymptoms” that include “marked distressnor marked impairment in socialnor occupational functioning” and onlynwhen such symptoms persist “during anmajority of menstrual cycles in thenpast year.” Still, feminists are enragednby the very idea that women quanwomen are subject to a mental afflictionnfrom which men are exempt.nFeminists are likewise up in armsnover the recommendation that a “MasochisticnPersonality Disorder” be recognizednin the case of an individualnfilled with “feelings of martyrdom”nand inclined to voluntarily remain “innrelationships in which others exploit,nabuse, or take advantage of him ornher.” Such a diagnostic syndrome isnunacceptable to feminists, who feelnthat it will be used against womennabused and victimized by their husbandsnor lovers.nIn a telephone conversation withnChronicles recently, John Blamphin,nDirector of Public Relations for thenAmerican Psychiatric Association, ex­nCULTURAL REVOLUTIONSnpressed surprise at the attacks on thenproposed new manual, especially sincenthe APA Work Group had already metnwith concerned women’s groups,nheard their complaints, and “agreednwith many of them.” Blamphin didnsay, however, that feminists had beenn”very strong in opposition” to the proposednrevisions all along and haveneven threatened legal action againstnthe APA if the proposed revisions arenaccepted. To many observers, suchncoercive tactics suggest paranoiac orneven authoritarian personalities.nBut feminists aren’t the only onesnwho want to influence the rewriting ofnDSM-III. In the same sort of crazynalliance inspired by the war againstnpornography, traditional Christiansnare joining feminists in protesting thenrecognition of “Paraphilic Rapism” asna mental illness characterized by “acts,nfantasies, or other stimuli involvingncoercing or forcing a non-consentingnperson to engage in oral, vaginal, ornanal intercourse.” Christians insistnthat this is not mental illness but sin;nfeminists prefer to label it a crime or anviolation of rights. In response to objections,nthe APA has apparently decidednon “dropping the term ‘rapism’nand reformulation of the criteria to benmade under the title of ParaphilicnCoercive Disorder.”nAlso applying strong pressure tonthose revising DSM-III are homosexualngroups angered that the 1980 editionndefined as mentally ill any person whon”complains that heterosexual arousalnis persistentiy absent or weak” or whonexperiences “homosexual arousal” asn”a persistent source of distress.”n(DSM-III does not stigmatize thosenwho are cheerful and uncomplainingnhomosexuals.) The gay rights crowdnhas not yet succeeded in removingn”Ego-dystonic Homosexuality” fromnthe catalog of psychiatric illnesses, butnthey have apparently persuaded thenAPA to add “a stronger statementnabout the controversial nature of thendiagnosis.”nThe APA hopes that the new manualn(to be published in early 1987) willnnnreflect all “scientific data” now available.nYet at a meeting last December,nthe APA held open the possibility thatnbefore final publication of DSM-III-Rnthe Work Group might “determinenthat although adequate scientific supportnfor inclusion [of some revisions]nexisted, other implications were sonoverriding that inclusion would not benappropriate at this time.” The unnamedn”other implications” are nondoubt the strong political pressures ofnfeminists, homosexuals, and othersndetermined to stamp their own agendanon the official list of mental illnesses.nDSM-III-R raises another seriousnquestion about psychiatry. On the onenhand, the manual lists clearly documentablendisorders, whose symptomsnand causes have a physiological basenand are therefore medically treatable.nOn the other hand, the APA is addingnto the list of neuroses, for which symptomsnare vague and treatment a matternof taste. Thomas Szasz has becomenpersona non grata by pointing out hownmuch money is spent on studying andntreating middle-class “blues” undernfancy names and how little is spent onnactual mental illnesses like schizophrenia.n(Is it possible that the disparitynis explained by the fact that neuroticsnoften have wealth and power whilenpsychotics are just plain sick?) Thenfuture for serious psychiatrists clearlynlies in medicine—they are M.D.’sn—rather than in psychoanalytic voodoo.nAs long as psychiatrists devotenthemselves to the anxieties of the richnand famous, they will be subject to thenwhims of pressure groups.nThe Soviets are ahead of us inndiscovering the political power availablento those who can define mentalnhealth. To the degree that the UnitednStates also becomes an ideologicalnstate, American psychiatrists will wieldnmore and more power as our truenlegislators, judges, and policemen.nWho knows? Before long, smart PAC’snmay discover that dominance in thenhalls of Congress is far less decisiventhan control over the gates of Bedlam.n