Doctors Consider Diagnosis for ‘Ill’ Relationships: “Some of the nation’s top psychiatrists are advocating the creation of an entirely new category of mental illness that could profoundly alter the practice of psychiatry and result in tens of thousands of families being diagnosed with a psychiatric disorder.

In a monograph being circulated by the American Psychiatric Association (APA), the doctors recommend that a category called “Relational Disorders” be added to the next edition of the Diagnostic and Statistical Manual (DSM), which is the psychiatric profession’s official guide for defining emotional and mental illnesses.” Washington Post [thanks, Norton] This is a perfect illustration of how diagnostic categories and, in fact, the very nature of diagnosis, have expanded and contracted to meet secondary agendas throughout the history of psychiatric classification. It will never fly, but it clearly represents a response to psychiatrists’ diminishing market share in mental health as well as an internal conceptual struggle between the biological and nonbiological schools of thought in the profession. The difference between identifying problematic relationships as causes of psychiatric difficulties and labelling the relationships themselves as psychopathology opens the door to pathologizing all sorts of social problems. However, there is another sense in which this is a valiant effort. Shifting insurance coverage and research protocols to diagnoses which reside in a relationshipo, or a system of people (e.g. a family system), as the family systems theorists have been doing for years, removes some of the stigma imposed on the ‘identified patient’ in the system. I’m looking forward to the debate.