Send us Fan Mail

The DSM sits on so many office shelves like a permanent authority, but its history tells a different story: mental health diagnosis is a living document shaped by culture, politics, research, and plain old human error. We start with the DSM’s roots in 1952, originally designed for shared language in military and psychiatric hospital settings, and talk about how that origin still influences the myth that therapy is only for people in crisis instead of something you can use preventatively during big life transitions.

From there we track the huge pivot that comes with DSM-III in 1980, when psychoanalytic interpretation gives way to criteria and checklists. That structure can help clinicians communicate clearly and document responsibly, but it also raises hard questions about who gets defined by a label and what gets missed. We also name one of the most important corrections in DSM history: homosexuality being removed as a diagnosis in 1973, and why activism outside the therapy room changes what happens inside it.

We then fast-forward to DSM-5 (2013) and get into what’s shifted since then, including autism spectrum disorder and the lingering confusion around Asperger’s. We also unpack the weird, messy space where TikTok pop psychology collides with clinical reality: caffeine use disorder, internet gaming disorder, complex PTSD (CPTSD), rejection sensitive dysphoria (RSD) with ADHD, and what it means when clients come in using terms that feel real even when they aren’t officially recognized. Finally, we talk about newer updates like prolonged grief disorder (added in 2022) and the controversy around disruptive mood dysregulation disorder in kids.

If you like thoughtful therapist conversations with a little chaos and a lot of honesty, hit subscribe, share this with a friend or cohort, and leave a review so more people can find us. What DSM change do you think needs to happen next?

Support the show