After more than two years of deliberation, the suggestions from thirteen expert groups that have been working on the next edition of the Diagnostic and Statistical Manual of Mental Disorders (used to diagnose recognized psychological disorders) are now available online.
The new volume, known as DSM-V and scheduled for publication in 2013, has become a focus of controversy. Psychiatrists who led previous revisions of the manual are among those who have criticised its proposals. In particular, they have warned that some of the changes under consideration could cause millions more people to be given potentially risky psychoactive drugs.
During an appointment with her psychiatrist, the psychiatrist asks Ms. Smith questions based on criteria in his revised copy of the DSM-V.
Doctor asks: “Has your interest in sex been reduced or absent in the past 6 months?”
Smith answers: “In the past six months I’d say so, yes.”
Smith thinks: Work is crazy, the gears on my bike are busted, and I bet my friend that I can finish Infinite Jest this year. Sex is great, but nothing turns me on like sleep.
Doctor: “What about your sexual thoughts? Erotic fantasies?”
Smith: “Yes, I’ve noticed a drop in the number of fantasies I’ve had since about mid-2007.”
Ever since George Clooney took up with that cocktail waitress, Sarah Larson or something, I haven’t been hot for him in the same way. It’s a power thing, isn’t it? He is at the top of the food chain in Hollywood, and he’s preying on krill. So deeply unsexy.
Doctor: “Have you initiated sex in the past 6 months?”
Smith: “No, I haven’t. Sometimes I even say no.”
Honestly? If I initiated sex, I’d have a broken vagina. I know a man’s libido is supposed to peak at 18, but apparently that peak can plateau for the rest of his life.
Doctor: “Do you get as much pleasure from sex as you used too?”
Smith: “Hard to say. There have been times when I just go through the motions.”
I love my partner, but at the end of most days I am all used up. So yes, I fake orgasms. What can I say? When Harry Met Sally was a seminal film for me. I’m good at it too. Bet a sucka like you can’t tell the difference.
Doctor: “Are you stimulated by other things, a movie you’ve seen?”
Smith: “What do you mean, erotica? I’m not really interested.”
Serious? What, like porn? Am I supposed to be turned on by a woman with a sad face and hair extensions? I can’t help but think of her circumstances. And what’s my alternative? Teenage vampires?
Doctor: “Do you notice physical changes during sex? Are they absent or reduced?”
Smith: “I’d guess I’d have to say absent.”
What does that mean, like a lady boner?
Ms. Smith’s diagnosis is confirmed: Sexual Interest/Arousal Disorder.
She displays a lack of sexual interest/arousal of at least 6 months duration and meets at least 4 of the criteria:
2 – Absent/reduced sexual/erotic thoughts or fantasies
3 – No initiation of sexual activity and is not receptive to a partner’s attempts to initiate
4 – Absent/reduced sexual excitement/pleasure during sexual activity (on at least 75% or more of sexual encounters)
5 – Desire is not triggered by any sexual/erotic stimulus e.g., written, verbal, visual, etc.
6 – Absent/reduced genital and/or nongenital physical changes during sexual activity (on at least 75% or more of sexual encounters)
Smith thinks: Is there a pill for that?
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