I'm O.K. You're O.K. We're Not O.K.

What makes the proposed diagnosis controversial, aside from the possibility that it could be applied to every living American, is the question of how the "patient" will be defined. A relationship can't make an appointment. Only the individuals in it can. But if only one of them shows up at the clinic, how do you effectively treat the relationship? And if they both come, what if only one feels poorly? For First and his like-minded colleagues, these are sticky issues but solvable ones. They point out that psychiatry deals every day with similar dilemmas and ambiguities. "To me," says First, "the bottom line is treating people. If this is something that can improve people's lives, that's worth the conceptual murkiness."

When a psychiatric disorder makes its debut, patients and doctors join the ticket line first, but eventually the lawyers queue up too. That's when the trouble tends to start. For America's attorneys, who might be said to specialize already in Relational Disorders--in creating them and making them worse--the prospect of such a fuzzy diagnosis must look like a row of cherries on a slot machine. By clouding the notion of personal responsibility even as the classification opens up vast new realms of mutual and collective liability, RD, as it will inevitably be referred to on daytime-TV talk shows, may generate even more in legal fees and damage awards than in insurance reimbursements.

Whatever happens, it won't happen right away. DSM-V will not be published before 2010, giving us plenty of time to ponder the wisdom of formally recognizing a new disease that people can prevent only by living alone in locked rooms that don't have telephones. Maybe the first Relational Disorder that we should be concerned about is the one between psychiatry and the public. --Reported by Sora Song/New York