10 November 2009
Simon Baron-Cohen complains about the possible removal of Asperger’s Syndrome from The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. Asperger’s is not regarded as sufficiently different from classic autism. The APA book defines mental illness for the world and, crucially, for insurance companies. This has always been an alarmingly subjective business. As Baron-Cohen points out, it is not yet possible to define a mental illness in terms of its causes, only in terms of its symptoms and symptoms, especially mental ones, are slippery things. I am not, to my knowledge, mentally ill. But I have just been reading Melanie Klein – brilliant – and she seemed to nail me on a number of counts. In fact, I suspect she nails most of us. That amounts to a character study, not a diagnosis, and no treatment is required, certainly not prolonged encounters with Gabriel Byrne. Yet, doubtless, I could get hold of the APA ‘bible’ and find something wrong with me. At the other end of the spectrum, however, lies Asperger’s, a real and terrible condition. But there it is, symptom-defined like everything else and subject to the kind of re-ordering to which Baron-Cohen is objecting. Mental illness remains a curiously weightless conception.