While finishing up graduate school, I managed to get myself involved in a very interesting IT development program, a program that in 1985, envisioned and produced computers and software not unlike those we use today.
Though my job was hardly exotic—developing documentation for new users of software—I got to use what was then some pretty exotic software and rub elbows with a lot of really brilliant people, many of them computer programmers. These were the kind of people that are so bright that no one seems to care if they come barefoot to work at noontime, drink Cokes in place of meals, or demonstrate almost no skill with English grammar or sentence structure.
None of that mattered at the time—we were building the future and, in my own hopelessly clean-cut way, I was one of these geeks, charged with translating their programming magic into software products that made sense enough that even a freshman could use them. Here, the flow of new inventions and claims was such that obsolescence was the only sure thing. And so it was that a major piece of developmental software was retired, replaced by a new and more effective piece of developmental software. So too was its brilliant inventor, who left the project and was “kicked upstairs” to a major computer maker’s development laboratory.
When we said bid farewell to our departing colleague, our director gave him a very unusual gift: a chunk of log with an arrow stuck into it. This unusual honor was explained thus: “You,” said the director to our colleague, “have been a true pioneer in the field. And you can always tell a true pioneer because he’s got an arrow in his back.” And so, we colleagues honored our friend — the guy who was so far out in front that the future had to attack him from behind.
This story came to mind recently as I considered the tumult surrounding the release of the DSM-5, which some speculate may be the last of its kind, given the decision by the National Institutes of Mental Health Director Tom Insel to shift future research away from symptom-based DSM categories to an evolving set of “Research Domain Criteria” (RDoC).
It is hard to think of any recent endeavor or group that has been the target of more critical, derisive, and even deserved arrows than the DSM-5 and its developers. Yet, for all the limitations that critics now see in the DSM approach, we owe its developers, then and now, a debt of thanks. In their determination to take the DSM approach through this fifth revision, the latest DSM team did its job, producing for the field an aging, but still viable framework—the best that we are likely to see for some years to come.
As with all human discoveries, much is learned when a theoretical framework is formulated, more when it is tested, and often the most when it is seen to fail. The DSM’s critics certainly have won the right to try and do better in setting a new diagnostic standard for the field. But in time, they will answer to history too. As surely as time marches on, those who are shooting the arrows today will become the “shootees” of tomorrow.
And, we’ll remember some of them as true pioneers, too, though for what, we can only imagine.
We’ll have to wait and see.