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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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)