I have avoided using psychiatric language to describe the personalities and autocratic actions of old friends who have acted badly, but I can’t resist making a suggestion for the next DSM, the official bible of psychiatric diagnosis, since it already contains diagnoses like “temper dysregulation disorder with dysphoria” – an affliction of young children and adolescents who unfairly blame their parents for their own inability to control their little fucking tempers and then get depressed about it.

I guess the thing to do is create a list of signs, symptoms, if you will, that define this personality disorder, or perhaps, to give it a bit more gravitas, dysorder?

Authoritarian Personality Dysorder, diagnostic criteria

1) An unshakable belief that there is always only one right answer to every question. A concomitant belief that your answer is always the right one.

2) An absolute entitlement to be obeyed without question.

3) The perception that criticism of any kind, even mild questioning, is defiance.

4) An entitlement to do whatever is necessary to punish defiance and enforce obedience.

5) A belief that every action you take to maintain absolute dominance over others is fully justified, in fact, righteous, perfect and unassailable.

6) The firm conviction that compromise of any kind is humiliation. A request from a loved one to compromise is treason, a capital offense.

Of course, it is easy enough to dismiss this new diagnostic category as simply a restatement of others, among them American Asshole Disorder, Fucking Dickhead Disorder, Narcissistic Personality Disorder, Oppositional Defiance Disorder, etc.

Psychiatrist Bessel van der Kolk, in The Body Keeps the Score, describes his work with trauma patients. Most patients’ psychiatric diagnoses appeared to flow directly from their attempts to deal with trauma. For example, a child who is regularly raped by a highly respectable parent may display signs of Temper Dysregulation Disorder with Dysphoria. It is pretty natural for a child abused this way to be angry, irritable and depressed.

When van der Kolk proposed new diagnostic criteria for some childhood diagnoses, and an approach that included identifying possible trauma as the root of the behavioral disturbance, he got a curt letter from the august board that revises the DSM informing him that he seemed to have pulled this provocative idea out of his own ass, without copious clinical trial data to back it up. His own work continues to show the value of addressing the actual underlying traumatic injury, while the DSM continues to diagnose these behavioral disturbances the same way.

We note that until 1973, the DSM listed homosexuality as a diagnostic category of mental illness/personality disorder. The first DSM, published in 1952, listed it as a mental illness. In DSM-II, published in 1968, being gay was still considered deviant, but it was now a personality disorder rather than a mental illness. It took pressure from gays who did not agree with being diagnosed by the American Psychiatric Association either way, and others who agreed with them, before a 1973 vote to remove homosexuality as a diagnosable disorder. Just to say, none of these diagnostic categories, most based strictly on a list of observable symptoms, are carved in stone.

So why not have Authoritarian Personality Dysorder added to the next DSM? Probably because the authoritarian personalities who always preside over such decisions would be fucking furious, dysregulated and dysphoric.

For this and other reasons, I refrain from using the popular, descriptive term “narcissist” to describe the characters in this story who cannot be wrong, cannot accept responsibility for hurtful behavior, and will kill you to prove that they are as blameless, with intentions always as perfect as those of the original authors of the DSM.

Now, if you’ll excuse me, I’m going to try to give myself some at home electro-convulsive therapy as I wait for my next intake appointment at the mental health clinic where a skilled therapist has been highly recommended to me.