Category Archives: Diagnostic and Statistical Manual of Mental Disorders

Isolation hospitals for Muslim fanatics

screen-shot-2016-09-14-at-04-33-49No one in Europe, writes Dalrymple,

has the faintest idea how to react—at least within the bounds of decency—to the alarming propensity of young Muslim citizens to become partisans of violence and terrorism.

There is a tendency to think of ‘radicalisation’ as

a kind of disease, one that will appear in the next edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, offering the hope of some technical procedure—pills, perhaps, or psychosurgery?—that will cure it.

Dalrymple asks:

Is Islamic extremism a disease, whose ideas (if they deserve to be called such) are like infectious agents? Should those infected be treated in isolation hospitals in the hope that the disease will burn itself out? Prevention is better than cure, of course, but what is the vaccine that immunises people against this disease?

Sinister side of Harley Street

Waste of everyone's time

Waste of everyone’s time

In 1960, the doctor-barrister John Havard’s The Detection of Secret Homicide came out, while in 1962 the schoolteacher-novelist Anthony Burgess published A Clockwork Orange, about adolescent violence.

The two themes are combined, Dalrymple writes, in Pamela Hansford Johnson’s An Error of Judgement (1962), in which the patient-narrator consults William Setter, a Harley Street specialist, about

simultaneous pain in his right shoulder and the back of his left knee. Setter tells him he could have a cardiograph if he wanted but this would be a waste of everybody’s time. Having paid his four guineas, the patient-narrator is reassured and feels better. Payment is a wonderful placebo.

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Get over it

Setter

starts a club in Soho where he acts in a Mephistophelean manner to bring strangely assorted people together in a discussion group. He decides to give up medicine in the middle of his career, which was certain to have ended in a knighthood.

Johnson’s novel

casts light on the prescribing habits of the time. When the narrator’s mother-in-law dies, Setter prescribes Dexedrine for the narrator’s wife to help her get over her grief quicker than the Diagnostic and Statistical Manual of the American Psychiatric Association can say depression.

Setter prescribes phenobarbitone three times a day for a young man called Sammy Underwood,

That'll quieten him down

That’ll quieten him down

presumably to quieten him down, for Sammy is not epileptic.

Setter

suspects Sammy of being responsible for the kicking to death of an old inebriate woman.

Sammy is guilty and confesses to Setter,

who comes to the conclusion that Sammy is so lacking in remorse, contrition and conscience that he is likely to do it again. So for the public good and because he has always enjoyed inflicting harm (it is one of his reasons for having gone into medicine in the first place), Setter decides to kill him.

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Just what the doctor ordered

Sammy complains of insomnia

and Setter suggests that he ask his own doctor for some sodium amytal to help. He then suggests a small bottle of brandy to be taken with the pills just to make sure he gets a good night’s sleep, though with the stern warning that Sammy should take no more, absolutely no more, than four-fifths of the bottle.

Setter’s

secret homicide goes undetected.

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Arachnophobia

It's not quite what the British people agreed to in the 1975 referendumFor years, writes Dalrymple,

doubt about the wisdom of a European project (whose end can only be seen as through a glass, darkly) was attributed by its enthusiasts to a quirk, one that combined some of the features of

  • mental debility
  • arachnophobia
  • borderline personality disorder

One would not be surprised to learn that the European Union had sent lobbyists to Washington to have Euroscepticism included as a category in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

By now, though,

even the most convinced European projectors must have noticed that their project is not going swimmingly.

But

the projectors suggest that the solution to the difficulties is the granting of even more powers to themselves or people like them, that is to say those who conjured up the difficulties.

Morbid conditions

are never equally distributed geographically, and Euroscepticism was originally a predominantly British disease, an amusing consequence of our insularity; but it is spreading throughout Europe. The débâcle of the common currency, which will no doubt have a dénouement but not necessarily a solution, has lowered the estimate of the union in the eyes of practically all member populations.

What if the results of referenda turn out unfavourably?

The history of the union suggests that they will either be ignored or that there will be more referenda until the population gets the answer right: the European variant of African post-colonial democracy, that is to say one man, one vote, once.

And people like Habermas, Van Rompuy, Barroso et al.

are capable of boring the people of Europe into submission. You can bamboozle people so long as politics does not really interest them because their lives are going along quietly and smoothly, and they do not pay it much attention.

But

once their attention is caught by such things as unemployment, evaporation of  their savings, constantly increasing taxes and collapsing living standards, more precision will be needed.

Words that

connote human solidarity but denote bureaucratically administered and enforced transfer payments — on a scale that make Marshall Aid look like pocket money — will no longer suffice.

Openness, says Dalrymple,

is not the same thing as the incontinent abandonment of character, any more than hospitality is the indiscriminate welcoming, without any exclusion, of all and sundry into one’s home.

Multiculturalism as an official doctrine,

complete with enforcing bureaucracies, undermines the rule of law because it seeks to divide people, formalise their cultural differences and enclose them in moral and intellectual ghettoes. The rule of law requires a common cultural understanding, not merely the means of repression to enforce a legal code. Once that cultural understanding is lost, all that remains is repression, effective or ineffective, and experienced as alien and unjust. Nothing remains but conflict or surrender.

Supranational courts cannot supply the want of a national understanding, for two reasons:

  1. They are designed to escape any national tradition, as Rousseau knew Man, but not men. Just as the European Central Bank could set interest rates adapted to none of the member countries’ economic needs, so a supranational court or organisation can produce rulings that correspond to no one’s traditions, principles, requirements or interests.
  2. Supranational organisations, unlike international ones, escape the kind of checks and balances that can operate on a national scale. In the French press the need for such checks and balances is not even mentioned, probably because it is not thought to exist. In Napoleonic tradition, every problem is conceived as an administrative one; and even as the scant legitimacy among the French population of Europe seeps away, so it is proposed that the powers of a European administrative class be increased.

Dalrymple’s Disease

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The disease, also known as Dalrymple Syndrome, is included in the manual

This crushing book-buying illness

Dalrymple has long been a victim of a malady that few observers have spoken of (possibly out of embarrassment, though the patient himself is often unaware of, or indifferent to, the condition), one that is far less common than it was but which is still occasionally diagnosed in not wholly statistically insignificant numbers, namely book-purchasing disorder.

The layman is all too apt to dismiss the illness as merely nauseating and hateful to the onlooker, but it is important to recognise that members of the book-buying disorder community are suffering from a severe, apparently intractable, condition or affliction that requires to be understood and treated non-judgmentally.

Sadly exhibiting one of the characteristic symptoms, Dalrymple openly tells an interviewer that he

cannot walk by a bookstore without buying a book.

Bibliopsychosis

Dalrymple's bedroom

Dalrymple’s bedroom

Dalrymple Disorder is included in the Diagnostic and Statistical Manual of Mental Disorders, with the hoarding of second-hand or antiquarian books being recognised as a psychosis for which therapy is urgently needed. (Penetration disorder, impulse-control disorder, gambling disorder, racism, caffeine-induced sleep disorder, homophobia, occupational defiant disorder, mother-in-law relational disorder, hypoactive sexual desire disorder, Islamophobia, hyperactive sexual desire disorder, sexism, and alternating hypoactive-hyperactive sexual desire disorder, are also set out in the manual.)

Dalrymple is required to undergo lengthy treatment for his book-buying disorder and

must stay in therapy, so that the doctor keeps getting paid.

What is book-hoarding disorder? US medical authorities have described it as follows.

Dalrymple's garage

Dalrymple’s garage

Book-hoarding disorder is characterized by the persistent difficulty in discarding or parting with books, regardless of the value others, such as spouses or other family members, may attribute to them.

The book-hoarding behaviours (focal sepsis may be present), collectively known loosely as Dalrymple’s Disease,

usually have harmful effects—emotional, neurophysiological, social, political, gastrointestinal, ethical, dental (halitosis is often severe), environmental, financial, theological, paranormal and legal—for the person suffering from the disorder and their spouse (or spouses, up to four, if the sufferer is a male Muslim) or other family members.

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Dalrymple’s WC

For people who hoard books,

the quantity of their collected volumes (the quality will not be discussed here) sets them apart from people with normal book-collecting behaviors.

They obsessively accumulate a large number of books

that often fill up or clutter active living areas of the home or workplace to the extent that the active living areas’ intended use (dining, laundry, defæcation, gardening, table-tennis, bathing, baseball, DIY, micturition, off-road parking, television viewing, copulation, social gatherings, food preparation, etc.) becomes supererogatory and is severely constrained or precluded, with adverse effects for spouses, other family members, friends, work colleagues, visiting representatives of city and federal authorities, etc.

Dalrymple's dining-room

Corner of Dalrymple’s dining-room

Distressing

Symptoms of the bibliomanic frenzy

cause clinically significant distress or impairment in social, technological, eschatological, educational, sexual, vocational, ecclesiastical, uro-genital, occupational, horticultural, supernatural, teleological or other important areas of functioning including maintaining a minimally adequate living environment for self, spouse and/or others.

While some people who hoard books, such as Dalrymple, may not appear particularly distressed by their behaviours,

their behaviors can be deeply distressing to large numbers of other people, such as spouses, other family members, mailmen, district attorneys, electricians, infantrymen, landlords, Black Panthers, fire-fighters, mom-and-pop store owners, Klansmen, bellhops, veterinary surgeons, burglars, used-automobile salespersons, leaders of the LGBT community, lumberjacks, Vietnam vets, railroad employees, ISIS soldiers, narcotics officers, plumbers, persons of color, Jehovah’s Witnesses, cleaners, sheriffs or their deputies, satanists, electrical contractors, professional gamblers, gardeners, racists, neighbors, intimate-apparel vendors, double-glazing salespersons, and city and federal authorities.

Book-hoarding compulsion

A section of Dalrymple's kitchen

Section of Dalrymple’s kitchen

can often be quite severe and even threatening.

Beyond the highly negative mental impact of BPD,

the accumulation of old, flaking, dirty, dusty, greasy, moldy and often frankly disgusting volumes creates a public safety and health issue by overwhelming people’s homes and giving rise to serious and potentially deadly fall and fire hazards, especially in the fall or winter, when the compulsion is at its most acute.

Treatment

screen-shot-2016-11-06-at-14-12-45Indicated treatment modalities where mild to moderate Dalrymple’s Disease is diagnosed include:

  • frontal leucotomy: nerve pathways in bibliobrain lobes are severed — with dispatch and some force — from those in other regions
  • Metrazol-induced convulsion therapy: sharp anti-bibliomanic shocks are administered, giving rise to uncontrollable convulsions
  • insulin coma therapy (Insulinschockbehandlung): the patient is turned hypoglycemic with repeated injected insulin, causing repeated vomiting and loss of control of the bowels, also unbearable cramps, so that book-hoarding becomes not just unpleasant but painful in the extreme

    Staircase in the Dalrymple house

    Staircase in the Dalrymple house

Dalrymple's drawing-room

Part of Dalrymple’s drawing-room

Not only are we all guilty, we are all mad

Screen Shot 2013-04-05 at 01.44.48Dalrymple reports that according to the Diagnostic and Statistical Manual of the American Psychiatric Association,

people in North America and Europe suffer from an average of about two-and-a-half psychiatric conditions a year. This suggests that either we are all mad or the American Psychiatric Association is mad (though with a shrewd eye to the main chance).

Po-faced superstition

Screen Shot 2013-11-09 at 01.18.43Common sense, says Dalrymple, is

the quality that psychiatrists, perhaps more than any other kind of doctor, need. The lack of common sense [of the Diagnostic and Statistical Manual of Mental Disorders] would be amusing were it not destined to be taken with superstitious seriousness by psychiatrists…as well as by insurers and lawyers. If the DSM-5 reflects the American Psychiatric Association’s views, then that organisation clearly views humanity with Swiftian distaste. And that distaste is motivated, one suspects, by the hope of an endless supply of patients.

All-pervasive lunacy

Screen Shot 2013-04-05 at 01.44.48Dalrymple says he doubts, after publication next month of the fifth edition of the APA’s Diagnostic and Statistical Manual, that it will be possible any longer to find anyone, anywhere, who is not suffering from some form of mental illness.