"Fashionable" Psychological Problems

Factual Questions
21

Um, and who was the first person with MPD/DID? Did a therapist come up with the idea and encourage it? Bet is was discovered, became popular, and THEN treatment got misapplied.

Sorry, SwimmingRiddles, I know people (two, anyway) who had MPD/DID way before anyone published any books on the subject, and it is a real condition, not just caused by hypnosis and suggestion (otherwise, how did they have personality switching DECADES before they started therapy, or ever heard of MPD?). Trauma can do some strange things, and it isn’t all the therapist’s fault. (Yes, some people were messed up by stupid therapists, but far from all of them.) That brain of yours can come up with some really creative ways to handle trauma, and DID is one of them. Fortunately therapeutic standards have been applied to treatment, so you don’t get a lot of the false memory thing anymore.

Personally, I think trends of these things are half suddenly finding out that that stupid/annoying/crazy/frustrating/frightening thing that happens to you might be TREATABLE… and half what is hot to DIAGNOSE (okay, people talk about it more if it is hot to HAVE). The disorders exist on their own, the trick is whether the doctor you see has ever heard of it, has a clue how to diagnose it, or can differentiate it from anything else in the same general category. If a doctor just came back from a great seminar on Social Anxiety Disorder, they may well be predisposed to classify someone with a panic disorder or agoraphobia as SAD, especially if it has been a while since they looked up the symptoms of panic disorders. Maybe they get lucky and the treatment for them all overlaps, and the person improves… then the next person with a panic disorder comes in, and the previous success leads to another SAD diagnosis. The label just became popular, not the disease. Society decides what is labeled just ‘eccentric’ or ‘just get over it’, too.

How about this kid? Never does the homework, doesn’t pay attention in class, solitary, brings inappropriate materials to school, appears to be depressed, scores lower than average on classroom tests and higher than average on standardized tests, can’t focus on any kind of math problems, turns in substandard work, acts bizarre at times… problem child? Maybe ADD? illiterate? depression? learning disorder? or maybe 3 standard deviations above the mean IQ, bored to tears and can’t see the point of trying anymore? Could be bad parenting, though. Or abuse at home. But ADD is hot, and the parents won’t sue you (or ignore you) for telling them to take parenting classes, and child abuse is too hard to prove - professionally risky. What’s the real problem? Profoundly gifted IQ, history of abuse, parenting/discipline problems, and dyslexia. Quick, better give him some Ritalin, or try some behavioral modification techniques. Heck, if it helps, that proves that it was ADD. And shaving a woman’s head was a cure for hysteria, too (hysteria included strange behaviors such as insisting on being allowed to go to college).

I think a lot of normal variations are getting treated as pathological because it is SAFER, simpler, and quicker to do that than find or fix the real problem(s). And a lot of things that are real problems but could previously be hidden (in misery) are now being treated effectively.

Oh, and DID is still out there, it just isn’t hot in the news, partly because therapists got sued for diagnosing it (malpractice!) so they tend to keep really quiet about it. And since it isn’t hot, people diagnosed with it go quietly about their business, taking leave from work without specifying the details to their co-workers, and spend their evenings in therapy. Nobody wants to hear about it, if it isn’t cool anymore, even if someone still has it. it fades to the background. Hey, women still get faint, especially during pregnancy, but we’re taught to sit down and put our heads between our knees until the feeling passes, rather than standing there waiting for the darkness to close in, hoping someone will leap to our aid. Nobody wants to catch us, and it is more embarassing than ‘ladylike’.

Next decade we’ll have another hot set of diagnoses, and the ones that are hot today will become ordinary and boring (or vaguely embarassing), or too touchy to approach.

22

So many things to respond to…let me get some quick ones out of the way:

1.) Yep ODD (Oppositional Defiant Disorder) is a technical way of simply saying the kid is a jerk.

2.) Most of the disorders talked about (ADHD) for example are WAY overdiagnosed.

3.) Yep some of them don’t exist…Repressed memories for the most part are largely distorted/fictitious…quite often implanted by a therapist on a suggestable client.

4.) with some exceptions, most psychological disorders are NOT due to problems in brain chemistry. Social Anxiety is one of them…the problems are essentially due to some weakness in personality or character. Paxil and other SSRIs (Selective Serotonin Reuptake Inhibiters, like PRozac) might help somewhat, but they do not CURE Social Anxiety, they mere mask it, alcohol would pretty much do the same thing. This is sort of like taking a cough suppressant for pneumonia. the problems with this approach is people never actually learn coping skills necessary for dealing with actual problems.

5.) Most psychotropic medications have long term effects. Prozac, Paxil, etc…cause long term reductions in serotonin production UNLESS you are actually endogenously depressed (only 33% of cases of clinical depression). So if you have social anxiety, or depression due to a situational event (breakup of relationship, etc.) and you take an SSRI (Paxil, PRozac) for a long period of time, your brain adjusts PERMANENTLY, by producing less serotonin. IF you try to stop taking the medication you will then suffer symptoms of depression. Again this effect is PERMANENT, even if you stop using the SSRI.

6.) People like to hear that they have a “disease” because they can then rationalize that they are the “victim” and things are not their fault. Alcoholism for example is a serious problem…but there is no empirical evidence to support a “disease” theory of alcoholism. In fact there is a wealth to suggest most alcoholics suffer from personality related problems (Borderline and Antisocial personalities being the big 2). ADHD is another one…it is better to hear that your child has a disease rather than they are just lazy or slow, right? Even depression is sometimes used as an excuse. It is sometimes “fashionable” to claim to have depression, thus when you do crabby things it is not your fault. Most depressed clients do not have brain chemistry problems (though a minority do) but rather have excessive stress, personality deficits or problems with coping skills. “Battered Wife Syndrome” is another…women who slay their husbands then claim to have been beated (in the absence of any actual evidence most often) in order to avoid punishment. Again, women who are beaten by their husbands (or the reverse) do NOT kill their husbands. Psychopaths kill their husbands (by similar token having been abused as a child does not excuse the behavior of wife-beaters themselves)

7.) Yes there may be a difference between being shy and pathologically avoiding social situations. This still does not mean that brain chemistry is to blaim. Some people just have severe personality related problems. It sucks, but such is life.

8.) If you think drug companies such as the ones that make Paxil, etc, have your best interest as their #1 priority, you are being naive.

So yes, getting a psychological diagnosis often is fashionable because if provides an easy rationalization for our behavior, and absolves us of responsibility. But, ultimately, less we have an ACTUAL brain/neurological problem such as those noted in schizophrenia, Bipolar, etc…what you do is your responsibility

23

How old are they? Sybil was published in 1973, so if your friends got it “DECADES” before this, that would be a pretty long time ago. Also, “Before the publication of Sybil in 1973 and the 1976 television movie starring Sally Fields as Sybil, there had been only about 75 reported cases of MPD. Since Sybil there have some 40,000 diagnoses of MPD, mostly in North America.” This is from the Skeptic’s Dictionary at http://www.skepdic.com/mpd.html . So your two friends were among the 75 cases total?

The problem as I see it with the MPD/DID diagnosis is that it would be so subjective to observe it even if it really existed. For example, sometimes I’m in a good mood, and sometimes not. Are these two personalities manifesting themselves? My wife complains that I can’t remember what she told me last night - was it because she was talking to one of my alters?

The existence of MPD/DID would be a extraordinarily amazing thing, even considering that the brain always does amazing things. I’d require pretty strong evidence that it does exist to accept it. But there is no convincing evidence.

24

hedra wrote:

Your friends must be pretty old. MPD became pop culture in 1973 with the publication of Sybil. But even before that, it had been floating around in the literature under various names for the past century. The relevant question is when were your friends diagnosed?

Actually, memory doesn’t work this way, and it is the terapist’s fault for not knowing this. You may wish to read Searching for Memory – the brain, the mind and the past by Daniel Schacter.

False memory continues to be a problem, because therapies continue to be based on this erroneous notion of memory that you have mentioned.

There is very little of this stuff your therapist won’t have heard of. The danger is that you might end up with a therapist who has been to a seminar about one of these disorders and will consequently be inclined to see your case as an instance of it. You may wish to read “Crazy” Therapies: What are they? Do they work? by Margaret Singer and Janja Lalich.

Precisely the problem with hysteria is that the label becomes the disease.

And requires more expensive therapy.

25

Sybil - the 1973 book and the 1976 film - were not the first popular accounting of multiple personalities. Who can forget Joanne Woodward’s riveting performance in The Three Faces of Eve, which was a mid-to-late fifties movie?

26

One would be 65 this year, and was showing personality switching behavior in 1962, 1967 and 1972, as an adult, and has recollection of doing so as a child. (Not some constant cycling around all the time, either) The other is older, but I don’t know her exact age.

there’s a wide range of dissociative behaviors, really. And yes they are a neurosis, not a psychosis, so they are really forms of post traumatic stress, not chemical imbalance, and they are treated best with learning how to cope with the things that stress you out that much. Lots of talking, and working out things you tried to avoid dealing with, and such. Also, dissociative tendencies seem to be somewhat genetic, or at least family-related (as in, chances are if your parents couldn’t cope, they didn’t teach YOU how to, either). Basically people cope (or don’t) in different ways, and not all that many are going to end up DID or even generally dissociative. But some DO.

So, if you have large portions of your personality (and skill sets) shift (not just memory loss - that could be you weren’t listening with enough focus to remember), you could have DID. Or another personality disorder, maybe. for instance, you can cook like a wizard almost all the time, then you smell a whif of perfume, and suddenly you can’t even boil water without burning yourself, and you look at the spice rack in terror, wondering how the hell you turn this slab of meat into something edible. A whole system goes off-line. You can’t even remember how much salt to add to the water you want to cook pasta in. You can’t remember cooking, but you know you’ve done it before, you can remember accepting compliments for a meal. This isn’t not remembering what your wife said, it is more like not remembering that you are married.

Full-blown DID involves memory loss between individual ‘alters’ in many cases, but also pretty often, there is internal watching going on, and a lot of talking. Voices in the head sounds like a psychosis, but funny, drugs that stop other types of voices DON’T work. the non-specific form of dissociation can have alters, too, though they kind of show up and disappear as skill sets and attitudes, without a black-out. that is the ‘normal’ basis of DID.

Spin the concept of DID, and what you have is s symbol system - your subconscious loves symbols, and using a ‘personality’ symbol set to handle stress is not all that striking. It is an extreme form of code-switching - you know, where you drop your back-country accent when talking to your boss? Code-switching is any behavior (commonly linguistic, but applies everywhere) where you apply a set of behaviors to a specific circumstance, status, location, and set of relationships. You (probably) don’t belch and put your hand down your pants at work, right? That’s code-switching. take it a step farther. Your mind has symbolically identified a particular event/thought/feeling/situation as stressful in a particular way. In order to handle that stress, a certain set of skills and personality traits seem to be effective. Everyone does this - code-switching for anxiety - your sense of humor gets out of hand, right? or you get pushy, or obstinate, or submissive, or whatever. Now magnify the stress, and repeat it, on an immature mind (trauma after a certain age pretty much never develops into DID). Now you have a strong pattern - I NEED this skill/personality set to deal with this feeling/situation. So it gets reserved for that situation. Most people end up with a mild or temporary use of the process - you get stressed, and suddenly you are all thumbs, because that isn’t a personality/skill your mind is pulling to the fore. But when it is pushed to the extreme, you can’t get to that skill set by just calling it up - it isn’t at your command anymore. Ta-da. DID. You can’t just retreive the memory or skill, because it is reserved for a special case. In severe cases, all the associated memories get reserved with it.

Is it ALL that hard to think this actually happens? it does, really.

27

Discussions gotten a little over my head, but I’ll thrash around momentarily. I believe a significant problem is that certain people desire to have clinical name put upon all less than perfect behavior. And once the name has been assigned, that opens the door to self-victimization, secondary gain - it is not an exaggeration to say that people apply for and at times receive governmental benefits, or ADA coverage, with “questionable” diagnoses such as these. The borderline cases, and the wholesale assignment of diagnoses, are a disservice towards the unfortunate folks who are really affected by these condition. Contrast situational from clinical depression, for example.

Help, I’m going under!

Blub

28

Bricker wrote:

Good point. 1957 – http://us.imdb.com/Title?0051077

Again, it makes a big difference when your friends were diagnosed. If it were before 1973, then they are among the 50 or so known cases from that time. And the one friend would constitute a very rare report of MPD manifesting in childhood – and I mean rare even at the modern rate of diagnosis.

But you go on to explain the theory, which is already in question, and your only argument in support of it amounts to, “Sounds plausible to me!” The problem still remains that it is based on a myth about how memory works and there is overwhelming evidence that it is brought on by confabulation between a therapist and a patient.

29

It seems to me these are (mostly)problems of societies that have too much time and money and freedom… In a society like China you are too worried with making it day by day and your social and family bonds are very strong so you do what you are expected to do whether it scares you or not. That means the “sickness” cannot develop. It seems those people have a much lower incidence of this type of problem…

30

[[- - - Attention Deficit Disorder is another recent “addition”, suspected by many of being a misdiagnosis of other problems such as hyperactivity, or of nothing at all. Analysis of parental expectations is beginning to play a part in diagnosis.]]

Yes, it can be mis-diagnosed and is probably over-diagnosed but ADHD is a real neurological disorder with organic causes. And Ritalin is appropriate therapy for many cases. It is not a “new” diagnosis, either. It’s been described at least as far back as the 1940s with names like “minimal brain disfunction.”

31

Avalongod said:

This raises a really interesting question, and will doom this thread to GD any minute now. Is there anything wrong with treating “defects in personality” with medication?

I am sympathetic to both points of view.

The “yes” side is supported by my inate distaste for self-deception. People that shell out money for homeopathic remidies because they “can’t hurt” bug me, and I feel an urge to lecture them that can only be controlled due to years of experience regarding its inability to make any difference at all. I really detest quacks who make a living with sham therpy or sham medical treatments.

My other main objection is that such drugs are often applied to things that really ought not be described as defects: non-conformity, antisociability. There was a memorable exchange of letters in Dear Abby a few months back: a woman had written in expressing that she really didn’t enjoy going to large social events but had problems convincing her friends that she really did prefer to stay home. Another woman proptly wrote back expressing her opinion that the first woman was probably clinicly depressed and just didn’t know she was miserable, and that the right pills would fix that right up. As a person who resents almost any social occasion that interferes with staying home staring mindlessly at a computer screen, I would hate to be labled as suffering from a disease, or being labled “miserable” when I am really happy as a pig in the mud. I feel that the glory of human society is the incredible variation that exisits among people. I would hate to see that eradicated in some sort of misguided attempt to make poeple happy.
The “no” side, on the other had, has a certain pragmatic appeal, especially when you consider people who are truely disfunctional. A person with severe social anxiety often can’t suport themselves (think 35-year old still living in the parental garage). In such a case, if a pill can get that person functional, I can’t quite see condemning it on the grounds that “the underlying problem hasen’t been addressed”. In a phrase, who cares? It is the symptom in a case like this, not the cause, that is the problem anyway.

A good example would be nicotiene replacement therapy. For myself, at least, I am fully prepared to attribute my severe addiction to cigarettes to a weak and feeble personality. I could never have quit smoking without the crutch of the patch. From the point of view Avalongod is espousing, I think that it would be morally prefrable for me to still be smoking. From this rather puritanical standpoint smoking would be my continual punnishment for my weakness.

In the Elaine Showalter book Johnny Angel cites (which is a really terrific book, by the way) part of her argument is that CFS, fibromylasia, Gulf War syndrom, etc., are not caused by biological factors, and are in fact different manifestations of the same disorder that caused hysteria in ninetheenth certury middle-class women (And shellshock in early 20th century soldier, for that matter). However, she is careful to point out that labeling these disorders as psychosomatic is not the same as dismissing them as “faked”; the fact that something is pyschosomatic does not mean that it is in anyway under the subconcious control of the victim.

So what we have are a bundle of disorders that are likely pyschosomatic but which in some cases respond (and in some cases respond very well) to chemical treatment of the symptoms. In many cases we do not have any effective mechanism to deal with the causes; The “talking cure” really can’t be held out as a substitute because it is a)prohibitly expensive for many b) is so imperfectly understood and misapplied that it in many cases creates more problems than it solves, and c) even when it desen’t hurt, often dosen’t help, or helps less than treating the symptoms with drugs would. Under these circumstances, is there any moral reason to decline the chemical treatment and stay miserable and unemployed?

32

Okay, okay, so I’m describing the process from a first person perspective - the way memory works for ME, thanks. I don’t think memory is a snapshot, or at least not in full color - it is a constant reconstruction. However, I think that parts can be stored in such a way that they are not constantly brought up, or are brought up but are ignored as irrelevant even when anyone else would find them relevant, so FUNCTIONALLY, you aren’t remembering them, because you are discarding them. And I have been told about things that others remember, that I don’t remember, and I have STILL not remembered - memory isn’t a perfect storage device, even when you have a ‘key’. Technical definition aside, I know what I’ve experienced, and I know what I’ve discussed with others… and no I’m not DID, but I’ve had dissociative events that DO work ‘like that’ - emotion split from time, split from circumstance, even sensory parts separated, and all that separated from direct access except by triggers - like smelling bread and suddenly remembering the way sun looked on the tiles in your kitchen as a child. If someone had ASKED you what the tiles looked like, you wouldn’t have been able to recall - but a trigger sent you straight to that info, and if you ask your mom, she’ll agree to all or most of your recollection. Whatever the technical mechanism, that is how it is perceived. Who cares if technically you forgot that you remembered, or if you were pathologically avoiding thinking about the subject, or whatever the ‘real’ mechanism was, the result is the same experience in the ‘first person’.

I’ll have to look into your cites but I’d like to see peer review or journal refs, too. Is the idea that memory cannot possibly be repressed and/or separated now the common understanding? Or, as with my perspective, is that the perspective of one side, at a particular point in time? The latest I read about our understanding of memory was about 4 years ago (1996), and then it seemed clear that we weren’t even close to understanding how memory works, and it was also likely that no one model would apply - different people seemed to think and remember in different ways, different researchers were coming up with a variety of answers. I’ll accept being wrong, but I still know what I experienced. WITHOUT therapy thanks, or ever having seen the movies or books before the experiences (I was rather young at the time). I hesitate to think we know it all about ‘how memory works’ - but again, I’ll have to look into the cites.

And if using hypnosis can CAUSE DID, cannot it be caused NOT using hypnosis or anything else? I find it strange to think that hypnosis or therapeutic malpractice is the ONLY method for creating an experience. Also, I’m not satisfied that the causal relationships identified by those who say DID is just False Memory Disorder are really causal - correlation doesn’t make for causality, and I have yet to see a real clinical study showing a causal relationship. Johnny Angel, can you cite your ‘overwhelming evidence’? The latest I’ve read suggests that ‘unproven’ is far more likely. If I’m out of date, your cite will certainly help. I’d especailly like to know if there is a professional concensus on this, or if there are simply competing viewpoints, both discounting the research of the other.

Also, I mispoke/typed - the ‘switching’ in the case I mentioned was new alter creation, not switching between existing alters in childhood. Thought I said that, but it wasn’t clear at all. My bad.

Diagnosis was slow with the one I know the most detail on - she was still probably in the first 100 or so, not the first 50. I had completely forgotten about the earlier movie, so I stand corrected on that.

So, I will back up a step until I’ve read the refs.

I think characterizing MPD/DID as a false disorder is misleading, if not directly hurtful to those ‘who have it’. One way or another, these people sought therapy for a reason. Their lives were ALREADY falling apart, they were feeling crazy, they were ceasing to function normally, they were having strange flashbacks, or reacting well out of norm. I’ve talked to one who was contemplating suicide because of the havoc in her life, only to find a vast releif once diagnosed - there was a name for what was wrong with her, she FIT the description, and there was something that could be done to help, and wonder of wonders, it actually HELPED. If popular images of MPD/DID causes people to use the concept as a tool to handle their particular problem, and treating it as DID resolved the issue when other approaches in the past had failed, doesn’t that make it fundamentally a valid diagnosis and treatment? (and if the journal references to it go back so far, doesn’t that make it seem more likely to actually exist independant of popular culture?)

Both the older women I know and one of the two younger ones who were diagnosed DID have ‘integrated’, learned to cope and process, and gone from barely functional to indistinguishable from everyone else (and the other is at least not suicidal anymore). Even if memory ‘technically’ doesn’t work like that, it seems to have functionally worked like that for them (and the 65-year old has an admission from her father that he did indeed do the things she remembers). That seems to my laymans eye to make it a valid diagnosis and treatment. Oh, and I will try to find my cites, but I beleive that the ‘invalidity’ of MPD/DID is not settled by any means even in the therapeutic community. There are researchers who believe it does work that way, and ones that don’t. There are researchers who say ‘memory is a scientific process that we understand’ and others who say memory is far from being understood, and we learn new things about it all the time. Clearly the non-professionals also are divided. Oh, well. Guess we’ll have to wait another decade or two to see if we are then laughing about Dissociation, PTSD, and other currently popular diagnoses, and what new ideas about memory and trauma processing exist.

Thanks for the refs, they sound like fascinating reading. Maybe I’ll learn something. If you come up with peer review or journal refs (or even have a link to a site listing them, so you don’t have to go digging around) I’ll gladly take those, too. One thing I hate is finding out I’m wrong after I’ve gone off in a particular direction - so sooner I delve into what you have to offer, sooner I get my (potential) foot out of my mouth.

33

REplying to Mandajoe:

Just wanted to clarify that I was not suggesting we should not treat personality deficits at all (such as your nicotine addiction). But rather we should address the actual underlying problem…i.e. the personality deficit itself, rather than masking it with Prozac, Paxil, etc. In many circumstances taking a psychotropic medication does not solve the problem, and the minute one goes off the medication the problems resurface. Social anxiety is another example…would it not be better to teach the person social skills, (assuming they were unhappy in the first place) or get the the root of some of their distorted cognitions? Sure it takes more effort, but doping oneself up is just a lazy quickfix and does not actually solve the problem.

34

Avalongod said:

It is easy to say his, but point of my post was that we often cannot address the underlying probelem. Therepy is the only device we have that even attepmts this, and as I said before, it is prohibitivly expensive and ineffective for many. It is also ineffecient–what portion of the population can afford to be disfunctional for three years until the therapy gets to the “root” of the problem? It is all well and good to suggest we teach people “social skills”, but the “root” of thw problem in social anxiety disorder is apparently much deeper than that: people who have good “social skills” can develop it–the problem is not ignorance, but something more tenacious. If all we have to treat pnumonia with is cough syrup, shouldn’t we take it and at least ease the symptoms until medical science comes up with something more effective?

So stay on the medication for the rest of your life. It is cheaper than dirt, and effective, without serious side effects.

I don’t think you know it, but this line makes you sound like a troll. You need to remember that this is a public board, and many people reading this are on Prozac or Paxil or something similair. Without knowing anything else about them, you just called them all lazy dopers to thier faces. You probably ought to apologize.

As I tried to get across above, no amount of effort seems to be effective in getting to the “root” of these problems. It would be niice if it worked that way, but it dosen’t. A shut-in is not trapped in the house because they are too lazy to make an effort.

There is a second role that anti-depressants can play which makes them useful on a temporary basis for many people: emotional instability can work as a vicious cycle–severe emotional turbulance in and of itself is suffecient to unbalence a person to the point that they can not deal with the causes of said turbulance. If I am so stressed out about my relationship with my mother that I am constanly having panic attacks, dealing with those panic attacks will consume all of my resources, leaving me with no time or strengh to deal with the problems with my mother. Drugs can serve a very useful purpose in cases like this.

Causes are also often unidentifiable: people go through periods of extreme depression, say, even though they cannot isolate any reason for it; they can come out of these same depressions for no apparent reason at all. The “root” is nowhere to be found, and thus cannot be dealt with.

35

Social Blindness Disorder (SBD). This is the disease which is supposed to be responsible for people not understanding how extreme social anxiety could be an actual problem. Opponents of this diagnosis claim that people suffering from SBD are just ignorant, self-righteous trolls who can’t be bothered to read psychological case studies.

Symptoms of Social Blindness Disorder:

  • Refering to prescribed pharmaceuticals as “dope”
  • Thinking serious agoraphobia can be cured by “adjusting and dealing with it” or “learning social skills”
  • Making unsupported claims about how selective serotonin reuptake inhibitors permanently reduce serotonin production

A report written by the renowned Dr. Thisiz Satire describes one of them most extreme documented cases. In this case, the patient babbled incoherently about the “hypochondriacs” he saw in a hospital. Dr. Satire quoted the patient at length,

Clearly this is an extreme case, but the question remains … is this a real disease? If so, should it be treated with electroconvulsive therapy, or with transorbital lobotomy? If not, what is to be done with the self-described “victims” of SBD?

36

I met a woman with MPD. I was in group therapy and she happened to be in my group. She dominated the group time, and I couldn’t follow what she was saying at all. I suspected that she had MPD. Later, it was confirmed. I can’t remember how many different personalities she had, but it was over 30. IMO, she had no business in group therapy yet. She still needed serious one-on-one therapy with a skilled therapist.

Years later I went to individual therapy during my pregnancy. I was told that I had disassociative spells and depression. It was helpful that this (disassociative spells) was pointed out to me. Now when I feel “outside myself” (or far away from myself), I concentrate on staying and confronting the feeling/situation that sparks it. It’s not easy.

I was taking Wellbutrin for the depression, though I initially objected to it. My therapist’s intention was that the meds would help alleviate the symptoms of depression until we could get at the root of the problem. By taking the meds, I could get through a session without breaking down or disassociating. I made tremendous progress quickly. Three months after my son was born, I was able to stop taking the meds.

My depression and disassociative spells were/are personality flaws. Chemical imbalance - I don’t know. But I do know that while I was on the meds, my migraines were almost nonexistant. The bottom line is: the meds helped me function until the problems could be addressed. Before this last encounter with a therapist, I had never heard of disassociative disorders. BTW, hedra, your description was right on the money.

I do think that docs (GPs and FPs especially) overdiagnose panic attacks, depression, ADHD, etc. and push pills. I think the responsible thing to do is to refer the patient to a therapist/psychiatrist/qualified professional who can decide what course of action is most appropriate for the patient. A prescription alone does not always cure these ailments.

Social anxiety is very real. Part of the reason for my alcoholism (also genetic predisposition, and an allergy to gluten (love that beer, whiskey, and scotch)) was that I felt like I could actually function in a social situation after a few drinks. Not that I am a shut-in or anything, but I am horribly shy and uncomfortable with strangers. Now, I don’t think that in my case popping a few pills is the best thing for me to do. But for someone who cannot venture outside of his/her own house, it’s not a bad idea.

My $.02 on this issue.

37

After having read the many posts here with interest and a few with amusement, I have to ask the following: How many of you ‘learned’ people are psychiatrists or psychologists? Anybody even sport an MSW? In the psychiatric field at all?

Also, from what I can recall about a report out over a decade ago, the popular pastime of women fainting was in actuality due to the restrictive corsets of the era. Not to long back, on a FOX network show, I saw the woman with the worlds smallest waist – and her ‘selfish’ smug physician husband who encouraged her activity. She strapped on a corset after wearing special training devices and while in garb, had a waist so small that one could essentially place it in both hands with fingers touching. It was assured that no harm was being done to her and X-rays produced but nothing was said about continued use of the once popular device. (I found the results somewhat horrific in appearance, actually more cartoonish than pleasant.)

The obvious restriction of her abdominal contents, especially the intestines, followed by the compression of the lower sections of her ribs and lungs could not be good. While in the device, she spoke, but seemed somewhat short of breath. The massive compression would have restricted the blood flow through her liver, spleen, large and small intestines and pancreas. Add too that the restriction placed on her breathing and it is no wonder that ‘fancy’ ladies of past eras fainted when upset. Now the restrictions were not as radical, though I do recall reading books where the husband of a woman, in such an era, was delighted to be able to put both hands about her waist, in most average ladies of the era, had slightly larger waists than the current ‘champion.’

Now factor in the fact that ladies of that era, as of yet unexposed to the influences of the coming styles from France – which would pop up after WW2 – were more rubinesque in form than today’s styles. Squashing them in corsets was not healthy.

Shyness.

I would not hesitate to consider this a ‘social disease’ because I have observed people and children so painfully shy that they would panic if they had to approach a somewhat large cluster of peers. When I was a kid, I recall normal, outgoing children who seemed fine, if a bit ‘kind,’ until they had to go to school. By the time they reached third grade, they were shy, quiet and introverted among classmates and terrified almost into illness when having to perform in the usual (and unnecessary) play. As they grew older, the condition became very apparent around members of the opposite sex and if they were no aggressive enough to physically fight those who challenged them, I have noticed some graduating high school with grades too low for their observed intelligence, going into low pay jobs and avoiding promotions beyond a certain level and often remaining ‘virginal’ until in their 20s and often having unsatisfactory opposite sex relationships.

From what I have directly noticed, such people seem to drift towards drugs and alcohol within their twenties and many will have entered psychotherapy before reaching 40. Having known several such people, I have been impressed with their remarkable depth of feeling, creativity, perception, intelligence and abilities shown mainly to those within a very small group of close, nonthreatening friends. However even as adults, their ‘shyness’ hampered their lives and careers and often resulted in damage to their ego systems to the extend that they would privately consider themselves inferior to almost everyone.

Such people often appear with depression, anxiety effective disorders, OCB, and often a condition known as a ‘maladjustment to adult society.’

Apparently, they are born with the condition, for most will express the observation that they knew they were different from most for as far back as they can recall, most will have had good relationships with kids of their age group up until after several years of grade school. (Intimidation by aggressive ‘bullies’ seems to bring the shyness out much faster, especially if the child cannot fight back. Often, this condition prevents them from fighting back, causing them to feel almost crippling terror at the thought or possibility of being physically dominated and abused by another child.) (SIDENOTE: Some such children, later in preadolescent life, having gotten into fights, have stated that the beating was not as bad as the aggressors posturing, shouting, verbal abuse and verbal challenging BUT even knowing this, still became terrified if ‘bullied.’

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[[Just wanted to clarify that I was not suggesting we should not treat personality deficits at all (such as your
nicotine addiction). But rather we should address the actual underlying problem…i.e. the personality deficit
itself, rather than masking it with Prozac, Paxil, etc. In many circumstances taking a psychotropic medication
does not solve the problem, and the minute one goes off the medication the problems resurface.]]

There is more and more evidence that many of these “personality deficits” have organic/chemical origins. That’s not to say that counseling should not accompany medications, but I’m just sayin’…

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hedra wrote:

But this is functionally indistinguishable from imagination, so that we have no way of distinguishing what are buried memories being brought out and what are confabulations being constructed ad hoc.

So long as you don’t believe that there is any such thing as a perfectly accurate memory which can be brought out by hypnosis or therapy, then we’re not disagreeing by much. The claim is not that `memory cannot possibly be repressed.’ It’s that there isn’t any sufficient evidence that the mind works that way. It violates Occam’s Razor in the first place, and in the second place it rationalizes therapies which have proven dangerous.

It certainly doesn’t have to be the only way. It is enough that hypnosis and MPD therapy are liable to lead to problems. Confabulation, in principle, can happen to anyone and under a variety of circumstances. The mind makes things up to fill in gaps in its memory. But therapy is a rarefied situation in which confabulations can arise much more easily, and have the potential to be disastrous to the patient.

To the extent that people suffer from it, it’s real. The problem is not whether people are really suffering – they are. The problem is that most likely they went to the psychiatrist with minor issues and came out with horrid confabulated memories, and neuroses which render them disfunctional.

However, on the topic of the thread, there is something to be said for psychological malingering. For every person who has a genuine problem, there will be many others who mostly want the benefit of being able to excuse assholish behavior by claiming a psychological disfunction. You’ve probably met a few. Personally, I take claims about mental illnesses with a grain of salt, and I certainly don’t accept them as excuses. That’s the issue that’s frustrating people. People who have disfunctions get to excuse themselves, and villify you if you don’t excuse them. But people without them don’t have the luxury of demanding forgiveness for their faults – they have to accept that they have done wrong.

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Boy I need to pay attention to these posts a bit more.

Someone asked about credentials so here are mine. MS in psyche thus far, three years teaching psyche, and working on the dissertation in Clinical Psyche. Don’t claim that makes me an expert but I am familiar with the literature.

To respond (using the literature) to a couple of comments.

1.) Someone spoke of “three years in therapy”…most empirically valid treatments of choice nowadays are designed to take 6-8 weeks. Welcome to the world of HMOs.

2.) Actually the evidence to support a biochemical cause of personality related problems, and most psychological problems (including social anxiety, although I am not sure why we keep harping on that) are VERY weak.

3.) BUT to talk about social anxiety…the literature is actually pretty clear that not EVERYONE is succeptible to it unlike one poster suggested. Social phobia is clearly linked with social skills problems. Not saying you personally have social skills problems, but the link has been established.

4.) Actually psychotropic medications DO have serious long term side effects for those who do not have a legitimate biochemical imbalance…including inducing a biochemical imbalance.

5.) The whole point of this thread was that some people would like to believe they are victims of a disease than to believe that they are responsible for their own problems. For some people this is the case (Schizophrenics, bipolar, etc.) But for most people that come to therapy (and yes I have seen hundreds of clients) the cause lies elsewhere.

6.) Someone said I am essentially a troll for not holding people’s hands and telling them their problems are not their fault. Actually I am concerned about people’s well being because taking SSRIs when you don’t need them can be detrimental. But I am not going to water down what scientific evidence suggests. I am aware people reading these posts might not be hearing what they want to, but awareness of personal responsibility is often the cornerstone to psychological wellness. Some people prefer to play the victim to the hilt though. Your choice.

:slight_smile: