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Reading the DSM-5 Through Literature:
The Value of Subjective Knowing
Christine Marks
Defnitions of illness are constantly reframed and restructured, consolidated,
and streamlined in the feld of medicine. These types of reconceptualization
occur at the intersection of evolving “objective” medical knowledge, the sub-
jective experience of suffering, and the sociocultural contexts in which illnesses
materialize. Emerging from the gaps between medico-scientifc knowledge and
the experience of the patient, illness narratives (including fctional and nonfc-
tional representations of and by suffering individuals) highlight the narrative
forces at work in illness and often promote an understanding of illness as cul-
turally determined, constructed, and fexible. These alternative explanatory
models are particularly relevant to an understanding of physiologically unex-
plainable illnesses, which have challenged health care practitioners and patients
as they evade full objective description and demand a consideration of the
subjective dimensions of illness. Indeed, the term illness itself encompasses the
personal elements excluded by other terms such as disease or pathology, which
delineate clinical assortments of symptoms detached from subjective experience
(Couser, “Illness” 105). The uncertain etiology of medically invisible symp-
toms interferes with the goal of developing rigorous taxonomies of symptoms
and clearly defned labels for various illnesses. This places what the American
Psychiatric Association defnes as “somatic symptom disorder” and other bio-
logically invisible illnesses at the heart of a longstanding confict over the privi-
leging of physical evidence over psychological or invisible causes of illness.
© The Author(s) 2017
S.M. Hilger (ed.), New Directions in Literature and Medicine Studies,
DOI 10.1057/978-1-137-51988-7_9
C. Marks (*)
English Department, LaGuardia Community College CUNY,
Long Island City, NY 11101, USA
e-mail: cmarks@lagcc.cuny.edu