By Kingwell, Mark
Queen's Quarterly , Vol. 110, No. 4
The alphabet offers a bare scheme of order, and so exerts a peculiar fascination when sustained thought is too much to contemplate. It promises sense where there may be mere arrangement--dangerous, but hard to resist.
Six years ago, when Bruce Mau Design in Toronto asked me to consider an alphabetical encyclopedia on the idea of freedom, I leapt at the idea. Mau had already collaborated with the Dutch architect Rem Koolhaas on S, M, L, XL, an alphabetical meditation on size, a hipster's visual encyclopedia. I wanted The Alphabet of Freedom to be the same thing, only deeper. I quickly constructed a list of keywords that would appear in it, each letter entry to be a miniature essay in the triumphs, reversals, and ironies of the human quest for freedom.
Not surprisingly, the thought of completing this project, begun with such optimism, soon became oppressive and weighty--in a word, unfree. Like many over-ambitious encyclopedic projects before it, The Alphabet of Freedom had to be abandoned. As a final act of homage to alphabetical ambition, however, here is the single completed entry: "D." Maybe appropriately, this little essay attempts to undermine the authority of yet another mad encyclopedia of the human mind, the one of medical pathology. Madness meets madness.
THE NEWEST, fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, known in the North American psychiatric trade as DSM-IV, was published in 1994. It lists 374 separate forms of mental illness--up from 297 in the previous edition, published in 1987. Indeed, over the years of its history the manual, and the psychiatric profession that uses it, exhibit an almost parabolic curve of rising taste for new disorders. In 1840, for instance, when the phrase "mental illness" had not yet entered the vocabulary, the US census acknowledged just a single form of madness, "idiocy/insanity," and failed even to provide a definition of it, relying instead on presumed common sense and the sort of thinking operative in the common law's long-standing M'Naughten Rule (dating from an 1843 political assassination case) which specifies legal insanity as "the inability to know the difference between right and wrong." In the 1880 US census, the number of listed mental disorders had jumped to seven: mania, melancholia, monomania, paresis, dementia, dipsomania, and, a little incongruously to modern eyes, epilepsy.
Since that time the disputed categories of mental illness have proliferated beyond all reason. The first DSM appeared in 1952, listing 26 classifiable mental disorders, all understood to be reactions to observable causes. By 1968, when DSM-II was published, this strong causal link was broken, never to be reforged, and the list of mental illnesses began to mushroom. As ever, the issues of inclusion and exclusion were strongly influenced by social trends and the background of cultural assumptions. Though the revised version of the second edition, DSM-II (1974), famously banished homosexuality from the list of mental disturbances, for example, ending decades of social engineering disguised as psychiatry, DSM-III (1980) reintroduced the "disease" as something called "ego-dystonic homosexuality," which is defined as the state of feeling bad because you are homosexual. Depending on your point of view, that is either politicized nonsense or a scientific recognition that such a condition is the reasonable response to social disapproval of a deviant sexual preference.
We now have so many mental illnesses that are diagnosable--and hence treatable under private medical insurance schemes--that the manual includes such things as frotteurism (the irresistible desire to sexually touch and tub against fellow passengers on mass transit--and who among us can honestly deny feeling some slight touch of that disorder now and then?); particularistic fugue states (travel in foreign lands, often under assumed names); bad writing, together with its close cousin, poor handwriting; coffee drinking, including coffee nerves, bad coffee nerves, and, ironically if not nonsensically, inability to sleep after drinking too much coffee. …