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A Great Literature Guide to the DSM-5 (2018)

von Eric Altschuler

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This text examines prominent individuals from great literature and their apparent mental disorders or diseases. It then investigates how those disorders and diseases meet the DSM-5 (Diagnostic and Statistical Manual-5) diagnostic criteria, and how the authors of these stories could have had enough knowledge to create characters who were suffering from mental illness hundreds of years before these illnesses were classified or defined.… (mehr)
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It's not what you know, it's how you learn it.

Perhaps a year ago, I found a book by Laura James called Tigger on the Couch: The neuroses, psychoses, disorders of our favourite childhood characters. It attempted to "diagnose" Tigger, Winnie the Pooh, Peter Pan, the Wizard of Oz, and others. The format of the book was a little fluffy, and more than a little repetitive, but the concept was a great way to describe psychological disorders -- after all, many literary characters essentially are their diagnosis, because they don't have to be compete people. So when I encountered a more knowledgeable author's attempt to try the same trick across a broader range of characters, I had to get it.

Sadly, I don't think the result is better than Tigger. For starters, the book is too short -- the main text is just 87 pages long. As a result, many, many important psychological concepts are left out.

What's more, I don't think author Altschuler really chooses his books and characters very well. An obvious example is using a story by Nicolai Gogol. Without in any way trying to deny Gogol's greatness as a writer, he is not an author who is really familiar to American or British readers. To include him while excluding such authors as Chaucer strikes me as ridiculous. C'mon, who doesn't want a diagnosis of the Pardoner? Even Shakespeare gets pretty short shrift -- we learn that Lady Macbeth has repressed memories, but do we ever study Iago's antisocial personality disorder, or the stupidity of Romeo and Juliet that is so extreme that it frankly strikes me as borderline intellectual disability?

And there is, of course, a problem with diagnosing a literary character, and that's that you can't get any more information than is in the book. And this makes it too easy to focus on one or two particular traits and ignore the rest. An obvious example of this is page 45, where Altschuler looks at Milne's "Winnie the Pooh" books and examines two different prior attempts to diagnose the characters there. He says he prefers one of the two -- yet the other is at least as reasonable. Pooh has Prader-Willi? Just because he's overweight? He certainly doesn't have some of the uglier traits of the condition.... And Eeyore has Major Depressive Disorder rather than Persistent Depressive Disorder? Have you ever encountered a scene where Eeyore is not down in the dumps?

There are also some historical errors. Page 50, for instance, says that no one knew of sleep paralysis until Dickens wrote about it. But English has an actual word for sleep paralysis: it's called being "hagridden." Similarly, page 13 claims no one knew about schizophrenia before 1800. Ever hear of Joan of Ark? The criteria for schizophrenia require various traits, one of which is hallucination or delusions (Criterion A). The classic example is hearing voices. She also had negative symptoms; people thought she was strange. By the unfair standards of the time, she didn't fit the social standards (Criterion B); she dressed funny. The delusions met the duration criterion (Criterion C). She didn't have a mood disorder -- she clearly was neither depressed nor manic. And she wasn't odd as a child, so she can't have had autism. Her symptoms developed in her late teens -- which is classic; schizophrenia almost always appears in the late teens or early to mid twenties.

I can't diagnose Joan; I can say that she met the criteria well enough for the sort of diagnosis in this book.

That's a lot of whining. There is good here with the bad. The claim that Sherlock Holmes had autism makes a lot of sense, e.g. And I was impressed with the idea the Dr. Jekyll had a substance abuse disorder rather than the obvious suggestion of simple dissociative identity disorder. But be prepared to take some of the material here with a grain of salt. Or maybe a grain or two of antipsychotic medication. ( )
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Bettina and I thank Benjamin and Daniel. We have discussed many of the stories and tales herein. Many more. L'dor vador.
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One of the many delights of being in medical research -- especially basic or "pure" research is that one gets to retreat from the "real world" with all its limitations and mind-numbing social arbitrariness.
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This text examines prominent individuals from great literature and their apparent mental disorders or diseases. It then investigates how those disorders and diseases meet the DSM-5 (Diagnostic and Statistical Manual-5) diagnostic criteria, and how the authors of these stories could have had enough knowledge to create characters who were suffering from mental illness hundreds of years before these illnesses were classified or defined.

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