Text size:

  • Small
  • Normal
  • Large

Five hundred ways to say you're crazy, just not over the phone

What we consider psychiatric disorders depends on time, place and context. But the creation of new disorders is far more common than the removal of 'outdated diagnoses'.

I recently left the bright blue skies of Abu Dhabi for an ice-bound UK. Waiting for a taxi at the airport in the bitter winter cold, I began to shiver uncontrollably. I had forgotten how cold cold actually gets.

A taxi finally arrived: "Where to, mate?" chirped the pathologically happy driver. Chattering teeth rendered my response incomprehensible: "Verr verr verrr please." The driver stared bemusedly trying to work out whether I was a foreigner, crazy, or both. Regaining control of my facial muscles at last, I made myself understood: "The Lowry Hotel please."

The purpose of my visit was to present a paper at the Division of Clinical Psychology's annual conference. My paper was rather ironically titled "Sunshine and sadness: 25-hydroxyvitamin D and depressive symptoms in the UAE". The conference went without a hitch, papers were generally well received and psychologists gossiped, networked and drank coffee.

All was well, that is, until the final day of the conference when it was hijacked by protesters. An invited keynote speaker, Professor Kenneth Zucker from the University of Toronto, was fiercely heckled during his speech. I've never encountered anything like this at a conference, so what exactly was the offence?

Prof Zucker is an authority on gender identity disorder. He views this condition as a mental disorder, arguing that it should carry a psychiatric diagnosis in the upcoming 2012 revision of the American Psychiatric Association's diagnostic system, the DSM-5. The DSM is often referred to as psychiatry's "bible", and contains descriptions of all of mankind's mental health woes.

The problem with psychiatric disorders, however, is that they are often socially constructed: one man's disorder may be another's lifestyle choice. In the US, for example, up until 1971 homosexuality was considered a psychiatric disorder, for which "reparative interventions" were offered. And Prof Zucker is at the heart of a noisy debate about gender identity disorder.

What we consider psychiatric disorders depends on time, place and context. But the creation of new disorders is far more common than the removal of "outdated diagnoses". Since the 1950s, the number of disorders listed in the DSM has grown from 60 to more than 400. The new version will probably give us at least 500 ways to say "you're crazy".

If I was involved in its development, I'd focus on the social changes brought about by the information revolution. My hypothetical, and mildly satirical, category of psychiatric illnesses would be called communication technology disorders, or CTDs for short.

My first candidate for the new CTD category would be "phantom phone friend disorder", an illness characterised by pretending to receive or make phone calls. Sufferers can often spend hours in pseudo conversation with non-existent people. Such behaviour also extends to messages, and sufferers will pretend to type out messages, or repetitively reread old ones.

My next hypothetical disorder is "obsessive compulsive message checking", characterised by intrusive thoughts focused on the receipt of important messages. These thoughts lead to repetitive and excessive message checking.

Checking behaviours are compulsive, as sufferers check for messages at inappropriate times, often leading to interpersonal conflicts and relational discord. It's often associated with depression especially when most messages received are banking transaction receipts or unsolicited spam.

A final proposed CTD is "narcissistic volume disorder". This disorder is characterised by insisting on speaking in an extremely loud voice when making or receiving phone calls in public. The volume narcissist appears to delight in excessive gesticulation, laughter and over-disclosure of personal information over the telephone.

While such behaviours cause little distress to the narcissist, other people in the vicinity often suffer severe migraines and are forced to vacate public premises.

My make-believe disorders might caricature reality, but this is not too far from how psychiatric taxonomy works. Perhaps psychiatry's insistence on a categorical system based on a dated medical model is the actual problem. The whole system may be in need of a radical rethink rather than just a revision.

 

Dr Justin Thomas is an assistant professor at Zayed University Abu Dhabi

Back to the top

More articles


Editor's Picks

 A supporter of India’s ruling Congress Party wears a mask of leader Rahul Gandhi during a rally in Mumbai, India. Kevin Frayer / Getty

Best photography from around the world, April 21

The National View's photo editors pick the best images of the day from around the world.

 Bloom Properties' Al Bateen Waterfront project in Abu Dhabi. Photo courtesy Bloom Properties

Bloom Properties starts work on Al Bateen Waterfront project

The development will feature 225 residential apartments of one to four bedrooms, a 200-room five-star hotel with 57 serviced apartments, and a 3,000 square metre retail space

 David Moyes has led Manchester United to seventh in the Premier League, six points behind sixth-placed Tottenham. Alex Livesey / Getty Images

Manchester United require ‘radical surgery’ from top to bottom

'Moyes is not a bad manager ... However, he is doing a spectacularly bad job at United' writes Richard Jolly of Manchester United, arguing wholesale changes at the club are now necessary.

 Marina Square apartments Reem Island: Q1 2% rise. Studio - Dh65-68,000. 1BR - Dh75-95,000. 2BR - Dh110-145,000. 3BR - Dh170-190,000. Q1 2013-Q1 2014 no change. Sammy Dallal / The National

In pictures: Where Abu Dhabi rents have risen and fallen, Q1 2014

Find out how rental prices in the prime locations in Abu Dhabi have altered during the first three months of the year and the current rates you will pay according to data provided by Asteco.

 Jia Ruhan sang as a guest singer in famous pianist Robert Wells's concert 'rockabilly-medley' in November 2012. Handout

Meet the pop star who is key to China’s superpower ambitions

Before Beijing can achieve its ambitions to be a superpower it will need to become a respected soft power. That's where Jia Ruhan comes in.

 Screen shot from Vin Deisel's facebook page of he and Michelle Rodriguez in Abu Dhabi for the filming of Fast & Furious 7. April 2014

Fast & Furious in Abu Dhabi, a social media frenzy

Fast & Furious 7 wraps up an eventful and much-anticipated week of filming in the capital. Let's take a look at what went on via the key players' social media, while they were enjoying the delights of the desert.

Events

To add your event to The National listings, click here

Get the most from The National