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New York - Bitterness [“Farbissen”] Might Become Sanctioned As A Mental Disorder

Published on: June 16, 2009 08:55 AM
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New York - No one could accuse the American Psychiatric Association of missing a strain of sourness in the country, or of failing to capitalize on its diagnostic potential. Having floated “Apathy Disorder” as a trial balloon, to see if it might garner enough support for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, the world’s diagnostic bible of mental illnesses, the organization has generated untold amounts of publicity and incredulity this week by debating at its convention whether bitterness should become a bona fide mental disorder.

Bitterness is “so common and so deeply destructive,” writes Shari Roan at the Los Angeles Times, “that some psychiatrists are urging it be identified as a mental illness under the name post-traumatic embitterment disorder.” “The disorder is modeled after post-traumatic stress disorder,” she continues, “because it too is a response to a trauma that endures. People with PTSD are left fearful and anxious. Embittered people are left seething for revenge.”

Now I grant that there’s a lot of anger and bitterness out there. How much of it should be attributed to the last Republican administration? The question straddles psychology and politics, I concede, but in the eyes of many Americans that administration managed in eight years to bring a largely healthy economy to its knees.

To many Americans, there are additional reasons for bitterness at that outcome. The Bush administration led the country into a protracted, illegal war, based on trumped-up evidence; ignored memos that said the country faced credible terrorist threats; locked up large numbers of suspects afterwards without trial or due process; lied to its citizens about the widespread use of torture; eliminated every sensible, necessary check on financial regulation to prevent a fiscal meltdown; mocked the facts of climate change; and sat on its hands as Hurricane Katrina devastated a large city.

Heaven knows, there are reasons enough to be bitter about the untold number of opportunities squandered, the problems that have escalated in their place, and the crises now with us that were once entirely avoidable.

But when justified anger at such incompetence is discussed as a sign of mental illness, it is borderline insulting, especially because half the reason for the discussion is to ensure that drug companies—anxious to prod their faltering revenues—can promise relief from the alleged disorder with yet more pharmaceuticals.

Imagine, if you will, the inevitable ads: “Think it’s just bitterness from job loss, foreclosure on your home, or that nonexistent pension for which you’ve been saving all your working years? It may be ‘post-traumatic embitterment disorder,’ a mental illness that some doctors think is due to a chemical imbalance . . .”

Nor, more seriously, is PTSD a solid model for comparison. A recent issue of Scientific American carried a detailed article on the growing need to “save Post-Traumatic Stress Disorder (PTSD) from itself.” The phrase was Robert Spitzer’s, architect of the third and fourth editions of the DSM. “As a diagnosis,” Richard J. McNally, a leading Harvard authority on trauma and memory, conceded with Spitzer, “PTSD has become so flabby and overstretched, so much a part of the culture, that we are almost certainly mistaking other problems for PTSD and thus mistreating them.”

In its discussion of post-traumatic embitterment disorder, the APA may have correctly gauged the mood of the country, but as usual it has ignored or shunted aside most of the explanatory context, to pathologize the individual in all of her or his frustrated grievance.

“They feel the world has treated them unfairly,” says Dr. Michael Linden, a German psychiatrist who labeled the behavior. “It’s one step more complex than anger. They’re angry plus helpless.”

Linden estimates that between 1% and 2% of the population is embittered, though he didn’t specify whether that percentage increased during or immediately after the Bush years. Perhaps he should. Others reviewing his work note that PTED includes “a high degree of comorbidity [and] diagnostic uncertainty . . . : 66% adjustment disorder, 40% dysthymia, 34% generalized anxiety disorder, 18% social phobia, 18% agoraphobia, and 16% personality disorder.”

But adjustment disorder, a highly elastic concept, is itself a capacious term to describe predictable, largely routine responses to stress. Why, then, is the APA discussing the inclusion of a new term that not only overlaps so strongly with existing “disorders,” but also has so many obvious, identifiable causes in the world?

Part of the incredulity the APA discussion has generated in the media and blogosphere is doubtless because bitterness strikes the person feeling it as a justified response to a social ill or personal wrong. It may be an exaggerated, distorted perception to which, Linden wisely notes, “revenge is not a treatment.” But just one of the many reasons for alarm here is the thought of the DSM, of all documents, trying with a few vague, open-ended criteria to legislate what is reasonable bitterness and what is not. (If you knew that “fear of eating alone in restaurants” and “avoidance of public restrooms” were both official symptoms of social anxiety disorder, among the most widely diagnosed of mental illnesses in the United States, you’d share my concern.)

These days, when many people approaching retirement open their 401(k) statements, they doubtless feel a bad twinge of “angry plus helpless.” How about making that frantic concern and impotent rage? Do we really want the DSM telling us that those feelings—including over the need to postpone retirement by up to a decade—could soon be a symptom of “post-traumatic embitterness disorder”? Wouldn’t that be comparable to rubbing salt in an already large wound?

Christopher Lane, the Pearce Miller Research Professor of Literature at Northwestern University, is the author most recently of Shyness: How Normal Behavior Became a Sickness.


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Read Comments (17)  —  Post Yours »

1

 Jun 16, 2009 at 08:03 AM Anonymous Says:

we can edit the "masilas yashorim" and by each pyrak we can add the the name to it, gavah will be part of bitterness disorder

2

 Jun 16, 2009 at 08:25 AM Anonymous Says:

So every bad behavior or "middah rah" is either a mental condition or somonene
else's fault and no one is responsible for his oown deeds, Great let's all celebrate.

3

 Jun 16, 2009 at 09:09 AM FVNMS Says:

It's not a disease, it's bad character. I have one cousin who I avoid like the plague, especially at simchas. She takes people hostage and kvetches about everyone and everything. Sometimes I can see her from across the room with her current victim; I don't even need to hear what she's saying but I KNOW she's at her best - her eyes are closed, her lips in a tight frown with her jowls exaggerated, shaking her head rapidly. I have forbidden my Rebbitzen from ever offering this woman a ride if I will be in the car. OY. May G-d help us all!

4

 Jun 16, 2009 at 10:31 AM Anonymous Says:

Reply to #3  
FVNMS Says:

It's not a disease, it's bad character. I have one cousin who I avoid like the plague, especially at simchas. She takes people hostage and kvetches about everyone and everything. Sometimes I can see her from across the room with her current victim; I don't even need to hear what she's saying but I KNOW she's at her best - her eyes are closed, her lips in a tight frown with her jowls exaggerated, shaking her head rapidly. I have forbidden my Rebbitzen from ever offering this woman a ride if I will be in the car. OY. May G-d help us all!

I know this will sound very difficult, and there may be times when you don't feel up to it, but listening to this woman and allowing her to express her bitter feelings may actually be an opportunity for you to do a great chesed. Chesed does not just involve money and hot suppers. Certainly to forbid someone from giving this person rides while you are in the car crosses a line. I am curious, how did your Rebbetzin react? I am not saying that you need to allow this woman to be critical of you in a personal manner, but if she just wants to 'kvetch' about what she feels bad about, try listening once in a while! She very likely does not have a lot of friends because of her behaviour. Maybe at the next simcha you can set aside a few minutes for Cousin Kvetch and then find an excuse to politely excuse yourself.

5

 Jun 16, 2009 at 10:06 AM SimchaB Says:

Pure genius, this prof managed to include an expansive diatribe of his feelings toward the Bush administration, into an article on psychiatric disorders. I think he has selective memory disorder.

6

 Jun 16, 2009 at 09:57 AM Anonymous Says:

Reply to #2  
Anonymous Says:

So every bad behavior or "middah rah" is either a mental condition or somonene
else's fault and no one is responsible for his oown deeds, Great let's all celebrate.

And even better to be able to blame everything on the president. This is absolutely absurd. To blame Bush for your own bad character? Sounds ridiculous to me.

If life didn't go exactly the way u pictured it, the solution is not to put the blame on other ppl like the president. Do some avoides hamidas and you'll be a happier person

7

 Jun 16, 2009 at 09:31 AM Jacob Says:

1 and 2 should get counseling.

8

 Jun 16, 2009 at 10:53 AM Anonymous Says:

While the article has a point, it is written by a deeply disgruntled liberal fanatic who got the disorder somewhere in the last eight years. come on, do you really think ppl got a disorder over the factr that we didn't find any WMD's in iraq, what does this proffessor think, we are stupid to buy this garbage? Job loses and the economy is the reason, and that loss has many "fathers" including many prominent democrats who got rich out of fennie and freddie mac, even when they knew that its destined for disaster. Yes, borrowing for ppl who couldn't repay, that is!!

9

 Jun 16, 2009 at 11:56 AM Shmilfke Says:

I guess they'll have to diagnose Marror and Chrain with the new bitterness disease new.

I'll stick to Romaine Lettuce next pesach so I don't catch "Bitternessitis"

10

 Jun 16, 2009 at 12:18 PM Anonymous Says:

this lady needs help

11

 Jun 16, 2009 at 03:14 PM New Yorker Says:

Wait a minute, Did anyone relize this article comes out of New York? How about our city and it's leaders? how are they making our life's any less stress full? Are they building more parking lots in our over crowded shopping areas so we don't circle blocks for hours burning gas? or they want to charge us for geting in to those blocks? Maybe rasing the bus/train fare is going to help? or cutting vouchers? Or more tax? or more tax? or you know what? maybe more tax? Yeah right Mr. Bush is making us all nervous, give me a break.

12

 Jun 16, 2009 at 04:13 PM FVNMS Says:

Reply to #4  
Anonymous Says:

I know this will sound very difficult, and there may be times when you don't feel up to it, but listening to this woman and allowing her to express her bitter feelings may actually be an opportunity for you to do a great chesed. Chesed does not just involve money and hot suppers. Certainly to forbid someone from giving this person rides while you are in the car crosses a line. I am curious, how did your Rebbetzin react? I am not saying that you need to allow this woman to be critical of you in a personal manner, but if she just wants to 'kvetch' about what she feels bad about, try listening once in a while! She very likely does not have a lot of friends because of her behaviour. Maybe at the next simcha you can set aside a few minutes for Cousin Kvetch and then find an excuse to politely excuse yourself.

Its never good to assume things. She doesn't have gehakte tzooris requiring a shoulder to cry on. She complains about other people, what they wear, how much money they spend, how they raise their children. Where's the chessed in that? The Mrs, btw, although trainloads more tolerant than I am, does not enjoy her company either. We won't leave her stranded - don't worry.

13

 Jun 16, 2009 at 08:13 PM Anonymous Says:

Reply to #3  
FVNMS Says:

It's not a disease, it's bad character. I have one cousin who I avoid like the plague, especially at simchas. She takes people hostage and kvetches about everyone and everything. Sometimes I can see her from across the room with her current victim; I don't even need to hear what she's saying but I KNOW she's at her best - her eyes are closed, her lips in a tight frown with her jowls exaggerated, shaking her head rapidly. I have forbidden my Rebbitzen from ever offering this woman a ride if I will be in the car. OY. May G-d help us all!

You have FORBIDDEN? Your REBBETZIN?? I find it hard to believe you are a rabbi. If you were really a Rabbi, maybe you could have succeeded in offering her a different perspective in life had you stopped to offer her a ride and used the time in the car to share words of wisdom with her.

14

 Jun 16, 2009 at 09:53 PM FVNMS Says:

Reply to #13  
Anonymous Says:

You have FORBIDDEN? Your REBBETZIN?? I find it hard to believe you are a rabbi. If you were really a Rabbi, maybe you could have succeeded in offering her a different perspective in life had you stopped to offer her a ride and used the time in the car to share words of wisdom with her.

I can't believe I'm replying to your post but lookie here - I am. No I am not a rabbi or close to being one... rebbitzen is a term of endearment for wife... husbands and wives don't forbid each other or command each other, so no need for your righteous indignation. It's a manner of speaking. Don't be a baby and react to words you don't like.

15

 Jun 16, 2009 at 11:34 PM Milhouse Says:

Reply to #14  
FVNMS Says:

I can't believe I'm replying to your post but lookie here - I am. No I am not a rabbi or close to being one... rebbitzen is a term of endearment for wife... husbands and wives don't forbid each other or command each other, so no need for your righteous indignation. It's a manner of speaking. Don't be a baby and react to words you don't like.

I don't know whether you did in fact forbid her to do this, but had you done so you would have been perfectly within your rights. Husbands and wives DO have the right to forbid each other certain things. Among the rights that husbands and wives enjoy is the right to veto visitors to their joint home, except in extraordinary circumstances; it seems to me that the car, at least while you're in it, falls under the same category, and you may bar this person from your car just as you may bar her from your home.

16

 Jun 17, 2009 at 08:28 AM FVNMS Says:

Reply to #15  
Milhouse Says:

I don't know whether you did in fact forbid her to do this, but had you done so you would have been perfectly within your rights. Husbands and wives DO have the right to forbid each other certain things. Among the rights that husbands and wives enjoy is the right to veto visitors to their joint home, except in extraordinary circumstances; it seems to me that the car, at least while you're in it, falls under the same category, and you may bar this person from your car just as you may bar her from your home.

See, Milhouse, that's why I love you. Redst tzim zach.

17

 Jun 17, 2009 at 03:18 PM Anonymous Says:

OY-If everyone who was Farbissen was considered mentally ill, there would be no one walking on the streets today!

18

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