Collapsing Personality Disorders

DSM5 will collapse Narcissistic, Paranoid, Schizoid, Dependent, and Histrionic personality disorders into a single category, with N/P/S/D/H characteristics.

Schizotypal, Antisocial, Borderline, Avoidant and Obsessive-Compulsive categories remain intact.

Clinicians are up in arms. They say each of these collapsed disorders have unique syndromes and shouldn’t be conflated. Maybe they’re right, but at first glance, from my experience, and I am not a professional, just someone who’s dealt with a lot of assholes, it seems that all the collapsed disorders can be put under the heading of “known asshole, various flavors.”

The diagnostic criteria overlap for a lot for the collapsed types. There is no agreed-on etiology, course or therapy for these types. 

I’m for listing the new category as “I’m an Asshole Disorder”.

The categories that the DSM5 keeps intact do have clear syndrome features, ones that the rest of us realize are abnormal. Think Sheldon from Big Bang Theory.

The collapsed categories are people like your boss, your contractor, that crazy bitch in the cube next to you….Being an asshole is not a psychiatric disorder, it’s a life strategy. Narcissism, neediness,  weirdness and attention-whoring need to be declassified. And that is what DSM5 is doing.

Clinicians are bitching because up till now they can milk treating assholes and now the DSM5 is rounding up all the assholes under one category and it’s going to be a lot harder to justify $200 an hour for asshole therapy under a single code.

BTW, therapy doesn’t fix assholes. Shocker.


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