Behavior: Battling over Masochism

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Spitzer's rebuttal: "They have never developed a category. It's easy to say it's chaotic and mock the use of the computer, but that's how a committee works. You put it on the screen so everybody can see it." He spoke in the aggrieved tones of a man who has just spent five hours bending over backward and is now being attacked anyway. Hanging in the air was the belief that masochism exists but henceforth no woman will ever be diagnosed as suffering from it because the women's movement would be disappointed. Some of the women even doubt that a masochistic personality exists. Garfinkel believes there "simply is no research" to prove it. Walker thinks the group should "junk the whole thing." "Basically," said the beleaguered Spitzer, the feminists are "against what we are trying to do ... They are so enmeshed in spouse abuse that they can't focus on what we see as a problem--that there are people whose pain and suffering can't be explained by objective reality."

Richard Simons, a Colorado psychoanalyst and writer on masochism who attended the session, agreed with Spitzer. "It's not scientifically valid to throw out a category merely because it might be misused," he said. Otherwise, Simons seemed to embrace the entire feminist position. Psychiatrists confronting battered women should not sit around pondering categories, he said. They should get out of their chairs and get the woman some physical protection. "The first thing you do is protect life and limb. A psychiatrist has that responsibility like anyone else." But in the current climate, could a psychiatrist find that a battered woman actually had masochistic symptoms? Admitted Simons: "You could do it, but only in your mind."

Agility has long been the name of the game in defining diagnostic categories. In 1973 the psychiatrists placated a powerful gay lobby by deciding that homosexuality, "per se," is not a mental disorder. This left in limbo those homosexuals who are dissatisfied with their condition. So the association created "ego-dystonic homosexuality," the world's first mental disorder that is only a disorder if the afflicted person thinks it is. DSM-III, published in 1980, officially listed tobacco dependence and transsexualism as disorders. "Tobacco dependence" may have been discovered to be a special disorder, worthy of its own category, so that smokers could collect from insurance companies for therapy. When "transsexualism," or discomfort about one's anatomic gender and the desire to change, was made an official disorder, Psychiatrist Thomas Szasz derisively claimed to be suffering from "transchronologism" because he was dissatisfied with his current age and wanted to be younger.

Next week Spitzer and some of his colleagues will address two more highly charged issues, both of intense interest to feminists: proposed categories for premenstrual syndrome and for men who rape compulsively. Feminists, aghast at the possibility of a legal defense built around the new disorder of "paraphilic rapism," are likely to see that it remains no category at all. --By John Leo