Pathology, Self-diagnosis, and Psychology
Nov. 3rd, 2009 12:11 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
pandora_parrotSo, I run around a bunch of people that have rampant degrees of self-diagnosis of various psychological conditions. It's a behavior that some criticize severely, while others think it's part of a person's right to self-identity. I myself do this to some degree and think it very useful a lot of the time. However, I think this needs to be done with care, as it can lead to easy mis-diagnosis, excuses for bad behavior, and similar things.
Self-diagnosis seems to be one of the first steps towards self-acceptance and potential treatment/coping strategies. You read a list of conditions and they seem to be similar to you. So you start exploring it more fully. You learn about other symptoms that people with that condition express. You learn about coping mechanisms. You start to realize that you're not alone and that your symptoms aren't unusual. That you're not a fucked up, broken person, but just a person with this odd condition.
This process has been important for me in my self-diagnosis of being transsexual, having prosopagnosia, and having asperger's. In all three cases, my self-diagnosis and subsequent research lead to my finding new ways to cope with my condition and finding others to relate to about my experiences. It improved my self-esteem and my functionality in society. I've also found other people to relate my experiences to, creating a shared community of people sharing our issues and misery.
For some, the next step after self-diagnosis is to seek an official diagnosis. However, there is a degree to which this is problematic. In many cases, the criteria for diagnosing a psychological condition is constantly evolving and changing, receiving more input from people that are having related experiences. You are also dealing with the interpretation of those criteria from a person that may have bias. 60 years ago, getting a diagnosis of gender identity disorder required a person to perform stereotypical gender roles. The diagnostic criteria for aspeger's does not account well for adults that have developed coping mechanisms for overcoming their condition. There are hardly any doctors that actually look to diagnose people with prosopagnosia.
An official diagnosis carries with it a lot of weight. With it, you have access to resources and medical assistance that you otherwise would not have. A person with severe asperger's might be able to get access to things like disability or work-related support mechanisms. Transsexuals are able to get legal recognition of their gender and legally obtain hormones and necessary surgical procedures in the United States.
Additionally, having an official diagnosis gives you the advantage of having a more objective third party verify your own self-diagnosis. Or if not "objective," then well studied in these areas. It has a tendency to "legitimize" ones experiences.
You do, of course, run into issues where lay-person interpretations of concepts collide with medical definitions. Perhaps you run into an issue where the current official criteria for a condition does not match what how a particular community defines that criteria. For example, I associate with a number of people that identify as plural, using the language of "Multiple Personality Disorder" or "Dissociative Identity Disorder" to describe themselves and their experiences. However, I have yet to meet a single one of these individuals that actually matches the diagnostic criteria for these psychological conditions. The community I associate with uses a different set of criteria for defining their experiences than the medical community would. Yet the fact that both use the same language creates confusion.
Perhaps you run into a community where they are actively discussing changes to the diagnostic criteria. Aspergers is a great example of that. I just read an article where they are talking about removing the diagnosis of Asperger's altogether and talking about autism spectrum disorders as a general classification. And people are always trying to change the diagnostic criteria for gender identity disorder.
And then you get into more colloquial understandings of a concept. Many people misuse psychological conditions to describe themselves all the time. If you get a bit distracted by things, you might say you're ADD today. If you find yourself obsessing over a small detail, you might claim that you're being OCD. A person that has issues with socialization might be described as "being aspie." In each of these cases, people are using a term with a specific medical meaning to describe something that is merely a superficial aspect of the condition. Yet are these usages wrong, if they convey the right meaning in context?
You can even get into issues of extremely similar or related conditions that may not have an official or popularly understood name yet. A person with a social development disorder similar but unrelated to asperger's may have many of the same coping strategies and issues as an aspie person, but their condition is not identical. However, this person, without anything else to seek out, may reach out to the autism-spectrum community for support, coping strategies, etc.
Related to that, you've got issues that border on one another. ADD, OCD, DID, and ASD issues all have a lot in common in places, and if you've got the diagnostic criteria for one, chances are that you've got many of the symptoms of some of the others as well and can derive support from resources for those conditions, potentially.
Some people go so far as to argue that a condition which is similar to another is actually the same general issue at a different degree. Asperger's for example, is known as a minor form of autism. I imagine that, initially, it may not have been included under other forms of autism and thought to be a separate condition. The fact that they're talking about a general Autism Spectrum Disorder might actually mean that they're recognizing that aspie-like conditions exist along a spectrum of symptoms, all of which are related but present in different ways and degrees.
When definitions collide like this, what are people to do? Which definition trumps? Is it the definition a person uses for themself or their community? Is it the current medical definition? Is it the colloquial understanding of that definition? Is it the current medical definition coupled with suggested updates and changes? What is the actual definition that gets to be used and who gets to use it?
The battle over these terms can get very violent at times. People that have been officially diagnosed with Asperger's may find themselves feeling like someone else is misrepresenting their condition when they run around claiming that they're aspie without any medical diagnosis. Transsexuals that match a "classic transsexual" definition sometimes turn around and complain that transgender people that don't match that specific criteria are hurting their chances of getting support from society due to their confusing separate and distinct issues. People with a diagnosis may feel that people without one are confusing the issue and making it harder for them to get support. Some may even say that they are pretenders and fakes, making up their issues in an attempt to get attention or to seem interesting. I know of at least one person that has a major problem with me specifically because I claim to be aspie without an official diagnosis. (She calls "fake asperger's" ASS-burgers.)
I think that harmony can be found by looking beyond the terms themselves to see the meaning that people ascribe to those terms. I think furthermore it can be useful to see how a person's self-diagnosis may be useful to them, regardless of whether or not it matches a clinical criteria. If you understand that another person's "aspergers syndrome" is not the same as your own, but it does them good to describe themself that way, perhaps you can live and let live and allow people the space to figure themselves out and get help for their issues, regardless of whether or not they match a particular set of criteria for a term that you understand.
My first therapist never gave me an official diagnosis of gender identity disorder, but I assume that they must have without telling me, since they gave me access to HRT and stuff. I've only been tested for prosopagnosia as part of a study of such individuals, but the results seem "official" enough to call it an official diagnosis. I have yet to find a reason to seek an official diagnosis of Asperger's, as I don't see it having any benefit to doing so. However, if a reasonable criteria for adults were to be used, I do believe that I satisfy the diagnostic criteria for it, or at least would have at an earlier part of my life. I think this is especially true having run into people that *have* been officially diagnosed and discovering that many of my symptoms are even more severe than theirs in some ways.
But as for the rest of the psychological conditions that I sometimes consider and contemplate being applicable to me, I don't think I really qualify for the diagnostic criteria for any of them. They're ideas I may explore for a while to see if they match more exactly, and I may derive usefulness from them for a time, but at the end of the day, they don't seem to fully describe the experiences that I have, or I discover criteria for them that doesn't relate to my actual experience.
There is this danger, in self-diagnosis, to over-pathologize one's behavior. To find an explanation for every little behavior by pointing to some sort of personality defect or something. It can make a person feel less responsible for their bad behavior and social issues, and allow them to dismiss their problems as being the result of their condition. Additionally, focusing on a self-diagnosis can lead to a person masking their actual issues, such as a person that claims to be plural trying to cover up the fact that they have emotional maturity issues or are trying to avoid dealing with reality by creating a rich fantasy life to live in. Self-diagnosis should be done carefully and with awareness, recognizing that you are not a therapist and have not studied psychology. You should also be sensitive to those that have received official diagnoses, as you definitely don't want to colonize or trivialize someone else's real serious experience by making wild and unstudied claims about your own condition.
I think that it is important to give people the space to self-diagnose. It's a way of exploring oneself and figuring out what makes a person tick. When done carefully, it can lead to finding helpful resources for dealing with one's conditions and with the general world. It can also be done carelessly, in a way that harms, offends, or trivializes the experiences of people that suffer serious issues due to a particular condition. Harmony can be created between those that use clinical diagnostic criteria and those that use more fluffy, lay versions of these conditions by recognizing the important differences between the two groups and the distinctions in the way those terms are used.
Self-diagnosis seems to be one of the first steps towards self-acceptance and potential treatment/coping strategies. You read a list of conditions and they seem to be similar to you. So you start exploring it more fully. You learn about other symptoms that people with that condition express. You learn about coping mechanisms. You start to realize that you're not alone and that your symptoms aren't unusual. That you're not a fucked up, broken person, but just a person with this odd condition.
This process has been important for me in my self-diagnosis of being transsexual, having prosopagnosia, and having asperger's. In all three cases, my self-diagnosis and subsequent research lead to my finding new ways to cope with my condition and finding others to relate to about my experiences. It improved my self-esteem and my functionality in society. I've also found other people to relate my experiences to, creating a shared community of people sharing our issues and misery.
For some, the next step after self-diagnosis is to seek an official diagnosis. However, there is a degree to which this is problematic. In many cases, the criteria for diagnosing a psychological condition is constantly evolving and changing, receiving more input from people that are having related experiences. You are also dealing with the interpretation of those criteria from a person that may have bias. 60 years ago, getting a diagnosis of gender identity disorder required a person to perform stereotypical gender roles. The diagnostic criteria for aspeger's does not account well for adults that have developed coping mechanisms for overcoming their condition. There are hardly any doctors that actually look to diagnose people with prosopagnosia.
An official diagnosis carries with it a lot of weight. With it, you have access to resources and medical assistance that you otherwise would not have. A person with severe asperger's might be able to get access to things like disability or work-related support mechanisms. Transsexuals are able to get legal recognition of their gender and legally obtain hormones and necessary surgical procedures in the United States.
Additionally, having an official diagnosis gives you the advantage of having a more objective third party verify your own self-diagnosis. Or if not "objective," then well studied in these areas. It has a tendency to "legitimize" ones experiences.
You do, of course, run into issues where lay-person interpretations of concepts collide with medical definitions. Perhaps you run into an issue where the current official criteria for a condition does not match what how a particular community defines that criteria. For example, I associate with a number of people that identify as plural, using the language of "Multiple Personality Disorder" or "Dissociative Identity Disorder" to describe themselves and their experiences. However, I have yet to meet a single one of these individuals that actually matches the diagnostic criteria for these psychological conditions. The community I associate with uses a different set of criteria for defining their experiences than the medical community would. Yet the fact that both use the same language creates confusion.
Perhaps you run into a community where they are actively discussing changes to the diagnostic criteria. Aspergers is a great example of that. I just read an article where they are talking about removing the diagnosis of Asperger's altogether and talking about autism spectrum disorders as a general classification. And people are always trying to change the diagnostic criteria for gender identity disorder.
And then you get into more colloquial understandings of a concept. Many people misuse psychological conditions to describe themselves all the time. If you get a bit distracted by things, you might say you're ADD today. If you find yourself obsessing over a small detail, you might claim that you're being OCD. A person that has issues with socialization might be described as "being aspie." In each of these cases, people are using a term with a specific medical meaning to describe something that is merely a superficial aspect of the condition. Yet are these usages wrong, if they convey the right meaning in context?
You can even get into issues of extremely similar or related conditions that may not have an official or popularly understood name yet. A person with a social development disorder similar but unrelated to asperger's may have many of the same coping strategies and issues as an aspie person, but their condition is not identical. However, this person, without anything else to seek out, may reach out to the autism-spectrum community for support, coping strategies, etc.
Related to that, you've got issues that border on one another. ADD, OCD, DID, and ASD issues all have a lot in common in places, and if you've got the diagnostic criteria for one, chances are that you've got many of the symptoms of some of the others as well and can derive support from resources for those conditions, potentially.
Some people go so far as to argue that a condition which is similar to another is actually the same general issue at a different degree. Asperger's for example, is known as a minor form of autism. I imagine that, initially, it may not have been included under other forms of autism and thought to be a separate condition. The fact that they're talking about a general Autism Spectrum Disorder might actually mean that they're recognizing that aspie-like conditions exist along a spectrum of symptoms, all of which are related but present in different ways and degrees.
When definitions collide like this, what are people to do? Which definition trumps? Is it the definition a person uses for themself or their community? Is it the current medical definition? Is it the colloquial understanding of that definition? Is it the current medical definition coupled with suggested updates and changes? What is the actual definition that gets to be used and who gets to use it?
The battle over these terms can get very violent at times. People that have been officially diagnosed with Asperger's may find themselves feeling like someone else is misrepresenting their condition when they run around claiming that they're aspie without any medical diagnosis. Transsexuals that match a "classic transsexual" definition sometimes turn around and complain that transgender people that don't match that specific criteria are hurting their chances of getting support from society due to their confusing separate and distinct issues. People with a diagnosis may feel that people without one are confusing the issue and making it harder for them to get support. Some may even say that they are pretenders and fakes, making up their issues in an attempt to get attention or to seem interesting. I know of at least one person that has a major problem with me specifically because I claim to be aspie without an official diagnosis. (She calls "fake asperger's" ASS-burgers.)
I think that harmony can be found by looking beyond the terms themselves to see the meaning that people ascribe to those terms. I think furthermore it can be useful to see how a person's self-diagnosis may be useful to them, regardless of whether or not it matches a clinical criteria. If you understand that another person's "aspergers syndrome" is not the same as your own, but it does them good to describe themself that way, perhaps you can live and let live and allow people the space to figure themselves out and get help for their issues, regardless of whether or not they match a particular set of criteria for a term that you understand.
My first therapist never gave me an official diagnosis of gender identity disorder, but I assume that they must have without telling me, since they gave me access to HRT and stuff. I've only been tested for prosopagnosia as part of a study of such individuals, but the results seem "official" enough to call it an official diagnosis. I have yet to find a reason to seek an official diagnosis of Asperger's, as I don't see it having any benefit to doing so. However, if a reasonable criteria for adults were to be used, I do believe that I satisfy the diagnostic criteria for it, or at least would have at an earlier part of my life. I think this is especially true having run into people that *have* been officially diagnosed and discovering that many of my symptoms are even more severe than theirs in some ways.
But as for the rest of the psychological conditions that I sometimes consider and contemplate being applicable to me, I don't think I really qualify for the diagnostic criteria for any of them. They're ideas I may explore for a while to see if they match more exactly, and I may derive usefulness from them for a time, but at the end of the day, they don't seem to fully describe the experiences that I have, or I discover criteria for them that doesn't relate to my actual experience.
There is this danger, in self-diagnosis, to over-pathologize one's behavior. To find an explanation for every little behavior by pointing to some sort of personality defect or something. It can make a person feel less responsible for their bad behavior and social issues, and allow them to dismiss their problems as being the result of their condition. Additionally, focusing on a self-diagnosis can lead to a person masking their actual issues, such as a person that claims to be plural trying to cover up the fact that they have emotional maturity issues or are trying to avoid dealing with reality by creating a rich fantasy life to live in. Self-diagnosis should be done carefully and with awareness, recognizing that you are not a therapist and have not studied psychology. You should also be sensitive to those that have received official diagnoses, as you definitely don't want to colonize or trivialize someone else's real serious experience by making wild and unstudied claims about your own condition.
I think that it is important to give people the space to self-diagnose. It's a way of exploring oneself and figuring out what makes a person tick. When done carefully, it can lead to finding helpful resources for dealing with one's conditions and with the general world. It can also be done carelessly, in a way that harms, offends, or trivializes the experiences of people that suffer serious issues due to a particular condition. Harmony can be created between those that use clinical diagnostic criteria and those that use more fluffy, lay versions of these conditions by recognizing the important differences between the two groups and the distinctions in the way those terms are used.
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no subject
Date: 2009-11-04 12:09 am (UTC)I've known several people who had some kind of dissociation going on, some kind of plurality. Most of them didn't have any problem maintaining relationships, holding jobs, or keeping their lives going. So, no disorder.
One of the things they taught me in therapy school is that having an official diagnosis is only worthwhile to the extent that it opens up possibilities to help the client get his or her life together.
no subject
Date: 2009-11-04 12:14 am (UTC)The asperger's thing has given me inspiration for where to look for various elements of human interaction that I've been missing, but it's mostly a self-comfort thing. I don't feel bad about things like stimming, or responding to my environment in unusual ways, or simply having a lot of trouble with people's emotions.
I sometimes experience something plural-like, and other times, I don't. So I don't know whether or not I fully ID as it. It's useful sometimes to think about things that way, though.
it's only a disorder if it gives you serious problems.
So... all three of these conditions do, and all three are things that I've had to figure out how to handle, mostly on my own. The fact that I've figured out how to be functional, after many many many years of not being such, means... what... exactly? I no longer have these disorders?
This sort of disorder-based diagnosis system doesn't seem terribly helpful, sometimes.
no subject
Date: 2009-11-04 12:18 am (UTC)Condition != disorder.
no subject
Date: 2009-11-04 12:22 am (UTC)You may still have the constellation of symptoms, but they are not a disorder unless they get in the way of your life.
no subject
Date: 2009-11-04 12:34 am (UTC)When I've sought for resources on various things, they almost universally talk about people with disorders and such.
At the very least, there seems to be a pretty big disconnect between the way these terms are used outside the psychiatric community and within.
Just because I've figured out how to pass as a neurotypical human doesn't mean that I can't benefit from more instruction, support, and study on how to do this, for example. For someone with these issues, it could mean the difference between holding down a job and holding down a job while also having friends and a social life.
no subject
Date: 2009-11-04 12:38 am (UTC)No one in therapy (the kind I did) gets cut off because their oddities aren't Official Disorders. You can still get support and ideas from most of the places you'd look if you had an Official Diagnosis. You just won't get insurance to pay for it or the government to recognize it.
no subject
Date: 2009-11-04 12:40 am (UTC)I.e. I have no right to seek support for having asperger's since I don't have an official diagnosis, and wouldn't be able to get one since I've figured out how to be functional.
no subject
Date: 2009-11-04 12:43 am (UTC)In seriousness, though, I've yet to work with (or even meet) a therapist who isn't willing to sign off on a diagnosis if she thinks it will help her client, even if their difficulty isn't terribly severe.
no subject
Date: 2009-11-04 12:45 am (UTC)no subject
Date: 2009-11-04 02:08 am (UTC)no subject
Date: 2009-11-04 04:21 am (UTC)Well, okay, you probably don't. But I do.
no subject
Date: 2009-11-04 07:46 pm (UTC)no subject
Date: 2016-07-06 06:10 am (UTC)no subject
Date: 2009-11-04 04:54 am (UTC)It'd make an interesting research paper.
On the "no right to seek support for AS since you don't have an official diagnosis" belief, wtf does this person think an intake appointment is? Does she seriously think that a person can only get diagnosed AS if they don't have any idea what's causing them problems?
I mean, for my part, I went to an educational psychologist before I started grad school and said "I'm going to be going back to school, and I'm concerned about my study habits and think I might have ADD." He ran a bunch of tests and said "actually, this looks a lot more like a non-verbal learning disorder." Several years later, I went to a psych clinic to get help with some communication and social anxiety problems I was having, and mentioned the previous diagnosis to the psychiatrist who handled my intake appointment. His response? "Oh, 'non-verbal learning disorder' is educational-psychologist speak for Asperger's syndrome. The other problems you're describing fit that, too." The therapist assigned to me helped me work through the problems I was having with that in mind, so in that respect, having a name to hang on things helped -- but problems are still problems whether anyone's hung a name on them or not.
I think this person you're talking about has some weird issues about the medical establishment granting legitimacy to things.
no subject
Date: 2009-11-04 05:03 am (UTC)(One mark of a good therapist, IMO, is having a clear sense of what s/he can do to help a patient and when it's time for the therapist/patient relationship to conclude. A therapist's job, quite literally, is to help each patient along to the point where the patient no longer needs the therapist's help. That in and of itself was a huge warning flag, to me, with respect to the craptacular therapist that a mutual friend of ours got rooked by earlier this year.)
Anyway, part of the initial consultation and first couple of sessions would involve talking about the problems that you've already figured out coping strategies for (and any you haven't), and any diagnosis would be made on the basis of that. The fact that you've found coping strategies doesn't mean you're not coping, yanno?
I know this because Tyler knows this.
Date: 2009-11-04 09:20 am (UTC)One of the problems inherent with the sudden influx of AS claims is that so many people are trying to use their differences as an excuse to not take responsibility for their own actions. It doesn't matter if somebody is AS or merely socially awkward, being a member of society includes the intrinsic agreement to be responsible for one's actions. A disorder label (whether AS or something else) is not carte blanche to completely disregard the well-being of one's fellow people. Unfortunately, it is much easier to say "It's not my fault, I have (insert condition here) and can't help myself" than it is to be an adult and own up to one's own actions and statements. The real disorder -- the thing that is negatively affecting the quality of life -- isn't Asperger's, it's a growing apathy towards the concepts of growth and accountability.
It also has the side effect of trivializing the experiences of others who may be dealing with AS or even full-blown autism, making it even more difficult for people who really need help to get the help they need. But this is a lesser symptom compared to the overarching responsibility issues seen today.
Re: I know this because Tyler knows this.
Date: 2009-11-04 11:34 am (UTC)You know... Although I tend to agree with you, it brings up some interesting questions in my head about ableism. Is it ableism to expect or require someone with a disability to overcome their disabilities to behave "normally?" Can we consider so-called psychological conditions like depression, transsexuality, and aspeger's disabilities, even?
Re: I know this because Tyler knows this.
Date: 2009-11-04 08:29 pm (UTC)Can we consider so-called psychological conditions like depression, transsexuality, and aspeger's disabilities, even?
Some do consider them so, especially in cases of depression severe enough that the diagnosis was used as legal leverage in ADA suits. I don't know if either of the other two have been used for it, but if you can convince a judge or jury, knock yourself out. The real question is: Is the condition severe enough to make you a danger to yourself and others, or that it prevents you from performing daily tasks? Doesn't help much that there was a time when the above-mentioned were cause to be institutionalized, after all.
Is it ableism to expect or require someone with a disability to overcome their disabilities to behave "normally?"
This question, however, is slanted in a manner to incite.
There's a world of difference between "normal" and "being a productive member of society." As I mentioned before, a label, whether officially diagnosed or not, is not carte blanche to disregard the needs and safety of others. It is not ableism to require a person with violent compulsions to not attack other people. Or in layman's terms, "Your right to swing your fists ends where my nose begins."
Re: I know this because Tyler knows this.
Date: 2009-11-04 08:34 pm (UTC)Eh? Incite? Incite how? As I said before, I agree with you on this. I'm just exploring the concepts that your comment raise in my head, as I think there's more to this.
It is not ableism to require a person with violent compulsions to not attack other people.
True. But... let's take the example of stimming that many ASD people do. If you're not aware, that's some form of repetitive motion, often used by an ASD person to relax or something. Many ASD people stim in ways that are not socially acceptable, such as with hand flapping or odd hand movements. Is it ableism to expect them to not stim in public?
I.e. If you were to ask them to stop stimming, is it reasonable for them to say, "It's not my fault. I have ASD?"
Re: I know this because Tyler knows this.
Date: 2009-11-04 10:51 pm (UTC)"Inabilities, through courage, support and incentive, can be compensated so that they can even become greater abilities. When accounted for, an inability can provide a rich resource or a stimulus that can propel individuals toward higher achievement. Those who question what it is to be 'normal' often take the first step towards rejecting stigma. Only when one takes risks, confronts the consequences of ones acts, and takes on responsibility for the self as it were, can a person begin to 'transcend' traditional constraints and stigma....
In a post traditional society responsibility, whether the individual chooses to take it or not, is devolved onto the inner world more so than controlling the outer. Ignoring 'reality' whether by being 'lazy' in friendship, work, personal mental and physical well being, can ... lead to a feeling of personal meaninglessness and that life has nothing worthwhile to offer. Giddens (1991: 9) believes the latter is characteristic, and is a widespread, "fundamental psychic problem in circumstances of late modernity." The notion of responsibility, or the successful management of an individual's choices, has close associations with commitment or the creation of commitments. This has a close attachment with dignity of risk, reciprocity and interdependence. Commitment, whether to people or to life goals, allows individuals to better handle difficulties and cope with otherwise disturbing life patterns or events. Commitment also focuses on self-development and the capacity to sustain involvement in a series of tasks maintained over an extended period of time."
Barnes and Oliver cite problems with potential maximization. They claim that the 'process of adaptation' is expected of people with impairments in order to acclimatize and become 'normal' as possible. This pressure can add to an already hostile environment. On the other hand, those who 'overcome their disability' "are sanctified and held up as exemplars of individual will and effort, while the majority who do not are referred to as passive, apathetic or worse." (Barnes and Oliver, 1993; Reiser and Mason, 1990) Susan Wendell (1997: 271) refers to these people as 'disabled heroes': "people with visible disabilities who receive public attention because they accomplish things that are unusual even for the able-bodied." In addition, Lennard Davis (1996: 10) believes that the majority sees the disabled as individuals without abilities, social functions or status, and that those who 'perform successfully' somehow lose their disability.
The manufacturing of 'disabled heroes' creates a 'feel good' factor that is comforting to the able-bodied and largely perpetuates the myth that "science will eradicate the disabled body." (Davis, 1995: 40) The many who cannot meet the ideal set by 'disabled heroes' are the truly 'disabled' and abnormal. The fact that they are feared, stigmatized and excluded might be because they "symbolise failure to control the body and the failure of science and medicine to protect us all." (Wendell, 1997: 271)
no subject
Date: 2016-07-06 06:19 am (UTC)Re: I know this because Tyler knows this.
Date: 2016-07-06 06:13 am (UTC)Re: I know this because Tyler knows this.
Date: 2009-11-04 08:08 pm (UTC)Re: I know this because Tyler knows this.
Date: 2016-07-06 06:15 am (UTC)no subject
Date: 2009-11-04 12:18 am (UTC)This. Having an official diagnosis of Asperger's was basically "oh, that's nice" -- having a therapist who was ready, willing and able to help me address my social problems in terminology that made sense to me and figure out ways to cope with them was what really made a difference.
If a person has problems they need help with, "a therapist" isn't necessarily going to solve those problems -- it needs to be a therapist the person can connect with and who can help them figure out a suitable plan of action for solving them. I've run into far too many people pouring money down the therapy hole trying to deal with someone who just isn't cut out for assisting them in the way they need.
no subject
Date: 2009-11-04 12:21 am (UTC)What the researchers eventually came up with was that the details of the theory by which a therapist works is less important than the rapport between therapist and client.
no subject
Date: 2009-11-04 07:35 am (UTC)While I know this is the medical/clinical definition, I've just recently begun to really question this attitude. This particular post was where most of that insight came from, and it hasn't developed much: http://mantic-angel.livejournal.com/198277.html
Basically... you have a lot of categories, and they can all use assistance. You have the people that can "fake" functionality well enough to participate in society, the people who can function just fine as long as they have assistance, the people who would benefit from a more accomodating and accessable society (or at least health care)... all on top of the people who have a "genuine certifiable issue (tm)".
And right now, the current medical model is... pretty much focused just on that last category.
So... it feels sort of dismissive and trivializing to assert that definition, because... there are plenty of people who have issues, who have conditions, and even though they aren't "Disorders", they still benefit from all sorts of help and understanding.
no subject
Date: 2009-11-04 08:03 pm (UTC)One of the difficulties with the list of disorders is that there isn't a unified vision in the mental health care system. There are several different kinds of therapist, each with its own set of guidelines for care. There's the insurance industry, who have a vastly different set of priorities as to who needs what. And then there's the laws around government services, which exist more often to restrict access than to grant it.
The DSM categories exist, mainly, as a patchwork language for bringing all these diverse (and sometimes contradictory) forces together. It's far from perfect, and in some places it out-and-out sucks.
In my training, we discussed all the subtleties you bring up, and were encouraged to be flexible with the definitions in the best interests of the client. Our instructors were vocal in their opinion that "official diagnoses" were mainly only useful for insurance, and we should bear that in mind when trying to get/give our clients the help they need.
no subject
Date: 2009-11-05 05:53 am (UTC)no subject
Date: 2009-11-04 12:11 am (UTC)And that's just for situations where we have some idea what aspects of brain chemistry are involved. No such luck for Asperger's or DID, at least so far.
no subject
Date: 2009-11-04 01:53 am (UTC)I've been a dartboard for most of my childhood and adolescence. I wonder what would be involved in testing neurotransmitter levels in the first place; I tend to be leery of people who assume psychiatry is pure quackery, but know full well just how haphazard getting care can be...
no subject
Date: 2009-11-04 04:38 am (UTC)There is a blood test for serum serotonin levels, but it's not typically used for depression because the amount of serotonin in your system and what your brain is actually doing with it are two entirely different things. A person can have perfectly adequate amounts of serotonin in their brain, but if their brain is breaking it down (the "reuptake" in SSRI) too quickly, then depression is one common result.
That said, I know there's some way to test receptor saturation levels (e.g., the degree to which reuptake is being inhibited), because dose/saturation curves are published data. I just don't know how they measure it. Radiolabeling and an fMRI, maybe. I should really find out.
What I don't usually give psychiatrists any credit for, unless they can prove it to me otherwise, is understanding a goddamn thing about pharmacology. A lot of this has to do with how psych meds are marketed; drug A gets promoted as a "mood stabilizer", drug B gets promoted as an "antipsychotic", and half the time they affect the exact same set of receptors -- and the majority of psychiatrists don't know any better because they don't have enough biochemistry to read the dose-response graphs. (The other half of the time, drug A was marketed as a "mood stabilizer", but then its patent expired, so drug B, which is still on patent, gets promoted as a "mood stabilizer" too.)
Failure to understand basic psychopharmacology (http://thelastpsychiatrist.com/2007/07/the_most_important_article_on.html) often leads to really retarded combinations of medications (http://thelastpsychiatrist.com/2007/08/arent_two_antipsychotics_bette.html), and is why I make it a habit to do the math on my friends' med regimens if they'll let me. I know far too many people whose doctors just kept on stacking and stacking medications until they ended up with side effect profiles that were far worse than their original psych problems, including one person with tardive dyskinesia that's likely to be permanent. :-/
Relatedly,
no subject
Date: 2009-11-04 03:17 pm (UTC)no subject
Date: 2009-11-04 08:15 pm (UTC)Psychiatrists are M.D.s, and as such should have some training in pharmacology. MFTs and PsyDs aren't, though, and our training skips a lot of that (sadly, when I was in grad school, I was explaining the pharmacology to my instructors...). Further, lot of folks I know work not with psychiatrists, but with their MFTs and get scrips from their general practitioners, which further clouds the issue.
no subject
Date: 2009-11-04 01:50 am (UTC)People that have been officially diagnosed with Asperger's may find themselves feeling like someone else is misrepresenting their condition when they run around claiming that they're aspie without any medical diagnosis. Transsexuals that match a "classic transsexual" definition sometimes turn around and complain that transgender people that don't match that specific criteria are hurting their chances of getting support from society due to their confusing separate and distinct issues.
It's counteproductive, isn't it? The problem isn't the other people who claim your label, whatever one may think of them; it's the fact that the majority has seen fit to marginalize you on the basis of perceived group affinity. It's internalized prejudice, the idea that the majority isn't wrong to oppress, just wrong to oppress *you*...
no subject
Date: 2009-11-04 08:32 pm (UTC)You know my stance on this, so I won't bother to belabor the point (again).
Rather, let me say this:
Words have meaning. They are the symbols we use to communicate to each other. Distorting their meanings to suit whatever fantasy you are wanting to live out today debases that meaning, clouds communication and is in general a very bad idea.
no subject
Date: 2009-11-04 08:38 pm (UTC)I think that's actually one of the significant issues that I'm bringing up. what are the meanings of these terms and who decides them? What does it mean to have condition X, when condition X is ill defined, constantly changing, or defined differently by different groups of people?
Words certainly have meaning, but only within a specific and particular context. Deciding what contexts are the most legitimate is one of the questions that I'm trying to raise with this post.
Distorting their meanings to suit whatever fantasy you are wanting to live out today debases that meaning, clouds communication and is in general a very bad idea.
I certainly think there's value to this notion. I question the appropriateness, often, of some of the people that call themselves "plural" when in reality their experience is hardly even remotely similar to DID. I think the mental categorization concept can be useful, and I do think there are dissociative conditions that can result in something a lay person might describe as plurality, but these are not DID.
Once again, the issue comes back to: Who defines the meanings of those concepts?
no subject
Date: 2009-11-05 06:36 am (UTC)The condition we are talking about (Asperger's syndrome) has a well defined diagnostic criteria. You know this because I have told you the criteria in person. It is not "ill defined" nor is it "changing constantly".
The people who define it are the professionals who work on the DSM. This is their job. To be diagnosed, you have to meet the criteria. The lay-person claiming "Aspie status" (and make no mistake, these people wear it as a badge of honor [for reasons beyond me]) are almost always wrong.
I am not saying that they are not having difficulties, but Asperger's syndrome is VERY specific in its diagnosis and is statistically quite rare. Self-diagnosis does harm in that it keeps people from understanding what the real problem is and prevents them from working on those problems.
People that need help should get it, but burying your head in the sand with a handy "Oh, but I'm aspie" does no one any good, least of all the erstwhile aspie.
On a side note, "plural" does not equal DID. My own therapist uses the term Multiple Personality ORDER for plurality that is less traumatic than MPD or DID. Everyone has different sides. I am not the same person when I converse with you as I am at work, and neither of those are the same as the me talking to my dad. One way to look at that is "plural". I use it as an organizing tool for my own interior life.
no subject
Date: 2009-11-05 09:08 am (UTC)And yet the meanings of those symbols is constantly evolving. We are constantly adding new meanings to dictionaries as terms change in usage and definition. Different groups of people use various terms differently.
You know this because I have told you the criteria in person. It is not "ill defined" nor is it "changing constantly".
I just read an article about how the meaning of the term is changing for the DSM V. That they are, in fact, removing the term entirely from usage. That, to me, means "changing constantly," even if the meaning is only changing every few years when they update the DSM. Additionally, the conditions as specified can be vague in places. This is the case with most psychological conditions, from what I've been able to see.
The lay-person claiming "Aspie status" (and make no mistake, these people wear it as a badge of honor [for reasons beyond me]) are almost always wrong.
However, what does this prescribe for their behavior? Most people are not going to seek treatment for possible asperger's syndrome unless they first suspect it in themself. They must first "self-diagnose" before they are able to go to a therapist and say, "I think I might have aspergers" and talk about their particular constellation of symptoms.
From what I've seen, people don't seem to wear it as a badge of honor so much as they use it to help them with self-acceptance. Being on the autism spectrum is frustrating, difficult, and alienating from the rest of society. Being able to name it, claim it, and find support from others with it can be vital towards beginning to build self-esteem and handle one's life.
Asperger's syndrome is VERY specific in its diagnosis and is statistically quite rare.
From some of the articles I've been reading, the incidence of diagnosed Asperger's syndrome, and autism spectrum disorders in general, is increasing. It's not known whether this is due to some higher incidence of the condition in the general populace or if it has to do with improved awareness of the condition.
As for its specific conditions, part of what I'm going into in this essay is that there are more than likely psychological conditions that are significantly similar to Asperger's. If you look at the new information being suggested for the DSM V, they're talking about classifying the whole she-bang as Autism Spectrum Disorders in order to provide better treatment for individuals that might be "close" to asperger's, but not completely identical, and things like that. As the term implies, autism disorders are on a spectrum, and that means that the conditions vary from person to person.
To a lay person, an autism spectrum disorder that is almost identical to Asperger's IS Asperger's. And it appears that the medical community is starting to agree.
Self-diagnosis does harm in that it keeps people from understanding what the real problem is and prevents them from working on those problems.
And yet, for most psychological conditions that I've looked at, self-diagnosis is really the first step towards getting treatment of those issues. It's like you're trapped in this sort of no-man's land. You can't seek an official diagnosis of something unless you diagnose yourself, but to do so is to perform a task that you are poorly trained in and/or don't full understand.
I'm not saying you're wrong. Self-diagnosis of anything can mask a person's real problems if done improperly. But it can just as easily give a person the tools they need to overcome their actual problems and, if valuable, seek official diagnosis for something.
D. My own therapist uses the term Multiple Personality ORDER for plurality that is less traumatic than MPD or DID
Makes sense. Pesky words and everyone having their own definitions for things, eh?