My brother died unexpectedly several years ago. His death gave the grief that had been piling up for the last 10 years an acceptable outlet in a culture that would otherwise tell me to “cowboy up,” as my old boyfriend would say.

Luckily, in 2022, the American Psychiatric Association added “prolonged grief disorder” to its bible, The Diagnostic and Statistical Manual of Mental Disorders (DSM), noted the New York Times. This means that researchers and clinicians can now treat it with medical interventions such antidepressants and therapy. 

The Good News and the Bad News

The good news is that therapists can now use a DSM code and bill insurance for clients who would otherwise not be able to afford therapy. (My health insurance company, and the therapists who offer such counsel, label it “adjustment disorder.”)

The bad news is that now, something that is a natural part of life, has a pathological spin. My grief—and by association me—carries the label of a mental disorder. Sure, I know otherwise, but I can’t help but think that my psyche is soaking up a subtle message about my lack, as so many of patriarchy’s subtle messages preach. 

Is the DSM a Work of Fiction?

In Pathological: The True Story of Six Misdiagnoses (HarperCollins, 2022), Sarah Fey recounts her personal journey through multiple mental health disorder diagnoses. She also provides a history lesson on how the DSM came about, and the fiction of its “truths.” 

In her forties, Fay learned that the diagnoses she’d received— and all mental illnesses/mental health diagnoses—are not scientifically valid, she noted in an article in the March/April 2022 issue of Poets & Writers Magazine. Rather, such diagnoses are subjective and based on self-reported symptoms and a clinician’s opinion, notes Fay. 

I’m sure the folks who made up the DSM story were well intentioned. But biases are implicit; we’re not aware of them. And too often, they spin a tale that continues the larger story of the culture which, in patriarchy, is the “Something’s wrong with me,” story. 

Here’s the Whole Story of Grief 

Grief is painful and heart-wrenching and gut-ugly at times. But the story we tell about it is not one of pathology, as our culture would have us believe. Rather, it is a story, and an invitation, to enter one’s own unique personal mythology and remake some part of it, and oneself. It is, in fact, the ultimate Call to Adventure.

This is the work of the soul. This is also how the soul deepens and expands and is able to hold the entire breath of who we are and how we want to be in the next chapter—and at our own deaths. 

M. Carolyn Miller, MA, designs narrative- and game-based learning. She also writes and speaks about the power of story in our lives and world. www.cultureshape.com