Here’s my problem with the remarks of Dr. Thomas R. Insel, director of the National Institute of Mental Health, regarding the DSM (see http://www.nytimes.com/2013/05/07/health/psychiatrys-new-guide-falls-short-experts-say.html?smid=pl-share). Yes, we know much more than we once did about the organic contribution to mental illness and more of this knowledge needs to find its way into the DSM. At the same time, our recognition of and curiosity about the social, economic, and political dimensions of mental illness have atrophied. We live in an extraordinary violent world made more violent by the ever widening gulfs isolating different communities from one another. These divisions are not removed or healed merely because we are now bound ever more tightly around one another by the smooth, featureless immaterial value form of the commodity. Rather does this social and economic mediator invite us to credit our differences to features – race, ethnicity, gender, gender preference, economic condition – about which we can do nothing; suggesting that the only solution is that we disappear, either actually or psychically. To reduce social and/or psychological pathology to organic causes is naive, adolescent and even, dare I say, infantile insofar as it seeks to simplify what is extraordinarily complex. Dr. Insel should know better, but my guess is that he does not or cannot; which must suggest a diagnosis.