For those who know not, it is a compendium of psychiatric conditions that are reviewed with every edition with tthe latest edition being DSM-5 TR published by the American Psychiatric Association (APA).
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The DSM is supposed to be an instruction manual for identifying problems so you can match them with solutions. The way we study things to put them in the DSM does neither of those things.
It doesn’t identify problems because it thinks syndromally. In Medicine, sometimes it helps to start by describing symptoms so you can identify what parts of the body are not doing their jobs through process of elimination, but since we dont know much about how the brain does its job right, there’s no point to trying to find patterns in how it does its job wrong. Instead, the patterns we identify say more about how we think people should think or act (moral principles) than how brains are supposed to work (functional principles).
It doesn’t produce solutions because psychotherapies and medicines don’t operate on diagnoses, they instead operate on processes. Medicines modify neurotransmitter levels in various parts of the brain, which aren’t mentioned in the dsm at all, while psychotherapies address particular intentional behavioral or cognitive strategies, which generally aren’t targeted at specific diagnoses (with a couple of exceptions like DBT or TFCBT that mostly prove the rule).
The altenatives to a syndromal approach are either to start taking a purely neurological or neuriscientific approach to defining what a brain should/shouldnt be doing and ignoring what a mind should/shouldn’t be doing, or to focus our attention on psychological health instead of on deficit. In the last 20-30 years most or all of the popular psychotherapeutic approaches have been focusing less on finding what’s wrong/fixing it and more on figuring out what healthy is/promoting it. The dsm gets in the way of that way of thinking. That’s why people don’t like it.
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