Michael sez, "The American Psychiatric Association recently released a new version of its Diagnostic & Statistical Manual – basically a catalogue of the categories into which they divide suffering. This entertaining review treats the text as a sprawling dystopian novel."
If the novel has an overbearing literary influence, it's undoubtedly Jorge Luis Borges. The American Psychiatric Association takes his technique of lifting quotes from or writing faux-serious reviews for entirely imagined books and pushes it to the limit: Here, we have an entire book, something that purports to be a kind of encyclopedia of madness, a Library of Babel for the mind, containing everything that can possibly be wrong with a human being. Perhaps as an attempt to ward off the uncommitted reader, the novel begins with a lengthy account of the system of classifications used – one with an obvious debt to the Borgesian Celestial Emporium of Benevolent Knowledge, in which animals are exhaustively classified according to such sets as "those belonging to the Emperor," "those that, at a distance, resemble flies," and "those that are included in this classification."
Just as Borges's system groups animals by seemingly aleatory characteristics entirely divorced from their actual biological attributes, DSM-5 arranges its various strains of madness solely in terms of the behaviors exhibited. This is a recurring theme in the novel, while any consideration of the mind itself is entirely absent. In its place we're given diagnoses such as "frotteurism," "oppositional defiant disorder," and "caffeine intoxication disorder." That said, these classifications aren't arranged at random; rather, they follow a stately progression comparable to that of Dante's Divine Comedy, rising from the infernal pit of the body and its weaknesses (intellectual disabilities, motor tics) through our purgatorial interactions with the outside world (tobacco use, erectile dysfunction, kleptomania) and finally arriving in the limpid-blue heavens of our libidinal selves (delirium, personality disorders, sexual fetishism). It's unusual, and at times frustrating in its postmodern knowingness, but what is being told is first and foremost a story.
This is a story without any of the elements that are traditionally held to constitute a setting or a plot. A few characters make an appearance, but they are nameless, spectral shapes, ones that wander in and out of view as the story progresses, briefly embodying their various illnesses before vanishing as quickly as they came – figures comparable to the cacophony of voices in The Waste Land or the anonymously universal figures of Jose Saramago's Blindness. A sufferer of major depression and of hyperchondriasis might eventually be revealed to be the same person, but for the most part the boundaries between diagnoses keep the characters apart from one another, and there are only flashes. On one page we meet a hoarder, on the next a trichotillomaniac; he builds enormous "stacks of worthless objects," she idly pulls out her pubic hairs while watching television. But the two are never allowed to meet and see if they can work through their problems together.
Book of Lamentations [Sam Kriss/New Inquiry]