Being Diagnosed Quotes

Used in combination with genomics, AI could help pharma companies to develop new drugs for rare diseases. The rarer a disease is, the smaller the market is and so the less likely it is to have been addressed. Big pharma is hesitant to take on the high development costs for new drugs if there’s no sign of a return on investment. Biological processes are complex, and that means that they lead to multidimensional data that human beings struggle to wrap their heads around. The good news is that AI is the perfect tool to spot patterns in this kind of data.

Irony and cynicism were just what the U.S. hypocrisy of the fifties and sixties called for. That’s what made the early postmodernists great artists. The great thing about irony is that it splits things apart, gets up above them so we can see the flaws and hypocrisies and duplicates. The virtuous always triumph? Ward Cleaver is the prototypical fifties father? "Sure." Sarcasm, parody, absurdism and irony are great ways to strip off stuff’s mask and show the unpleasant reality behind it. The problem is that once the rules of art are debunked, and once the unpleasant realities the irony diagnoses are revealed and diagnosed, "then" what do we do? Irony’s useful for debunking illusions, but most of the illusion-debunking in the U.S. has now been done and redone. Once everybody knows that equality of opportunity is bunk and Mike Brady’s bunk and Just Say No is bunk, now what do we do? All we seem to want to do is keep ridiculing the stuff. Postmodern irony and cynicism’s become an end in itself, a measure of hip sophistication and literary savvy. Few artists dare to try to talk about ways of working toward redeeming what’s wrong, because they’ll look sentimental and naive to all the weary ironists. Irony’s gone from liberating to enslaving. There’s some great essay somewhere that has a line about irony being the song of the prisoner who’s come to love his cage.

focus on clarifying what is being observed, felt, and needed rather than on diagnosing and judging,

When he first said my diagnosis, I couldn't believe it. There must be another PTSD than post-traumatic stress disorder, I thought. I have only heard of war veterans who have served on the front lines and seen the horrors of battle being diagnosed with PTSD. I am a Beverly Hills housewife, not a soldier. I can't have PTSD. Well, I was wrong. Housewives can get PTSD, too, and yours, truly did.

I've been diagnosed as being bi-polar but so have Florence Nightingale and King David...which kinda leaves me in pretty dam good company...if I must say so.

Well,” she said, getting more comfortable, “Here’s what I’ve got so far. I’m going to college and getting a Ph.D. in being awesome. That’s a thing, right? Everyone will call me Dr. Kitten and pay me megabucks to diagnose all their problems. Because, of course, I will have all the answers.

A psychiatrist would diagnose Jolene—and possibly every member of Cade Chase’s team—as having a benign form of psychosis. Benign, because she had not experienced a psychotic break. She was far short of being psychotic, but only because her brain and soul allowed her to manage her dissociative behavior well. The unconscious guides such people.

As they climbed it, the various Healers called out to them, diagnosing odd complaints and suggesting horrible remedies. Ron was seriously affronted when a medieval wizard called out that he clearly had a bad case of spattergroit. “And what’s that supposed to be?” he asked angrily, as the Healer pursued him through six more portraits, shoving the occupants out of the way. “ ’Tis a most grievous affliction of the skin, young master, that will leave you pockmarked and more gruesome even than you are now —” “Watch who you’re calling gruesome!” said Ron, his ears turning red. “The only remedy is to take the liver of a toad, bind it tight about your throat, stand naked by the full moon in a barrel of eels’ eyes —” “I have not got spattergroit!” “But the unsightly blemishes upon your visage, young master —” “They’re freckles!” said Ron furiously.

Eighty two percent of the traumatized children seen in the National Child Traumatic Stress Network do not meet diagnostic criteria for PTSD.15 Because they often are shut down, suspicious, or aggressive they now receive pseudoscientific diagnoses such as “oppositional defiant disorder,” meaning “This kid hates my guts and won’t do anything I tell him to do,” or “disruptive mood dysregulation disorder,” meaning he has temper tantrums. Having as many problems as they do, these kids accumulate numerous diagnoses over time. Before they reach their twenties, many patients have been given four, five, six, or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as the method of management du jour: medications, behavioral modification, or exposure therapy. These rarely work and often cause more damage.

It's not easy to diagnose because depending where the endometrial deposits are, the symptoms can be quite different. It's an unrecognized problem among teenage girls, and it's something that every young woman who has painful menstruation should be aware of ... it's a condition that is curable if it's caught early. If not, if it's allowed to run on, it can cause infertility, and it can really mess up your life. [Author Hilary Mantel on being asked about being a writer with endometriosis, Nov 2012 NPR interview]

That dead-eyed anhedonia is but a remora on the ventral flank of the true predator, the Great White Shark of pain. Authorities term this condition clinical depression or involutional depression or unipolar dysphoria. Instead of just an incapacity for feeling, a deadening of soul, the predator-grade depression Kate Gompert always feels as she Withdraws from secret marijuana is itself a feeling. It goes by many names — anguish, despair, torment, or q.v. Burton's melancholia or Yevtuschenko's more authoritative psychotic depression — but Kate Gompert, down in the trenches with the thing itself, knows it simply as It. It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self's most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency — sitting or standing, doing or resting, speaking or keeping silent, living or dying — are not just unpleasant but literally horrible. It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Inability To Identify is also an integral part of It. If a person in physical pain has a hard time attending to anything except that pain, a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell. Everything is part of the problem, and there is no solution. It is a hell for one. The authoritative term psychotic depression makes Kate Gompert feel especially lonely. Specifically the psychotic part. Think of it this way. Two people are screaming in pain. One of them is being tortured with electric current. The other is not. The screamer who's being tortured with electric current is not psychotic: her screams are circumstantially appropriate. The screaming person who's not being tortured, however, is psychotic, since the outside parties making the diagnoses can see no electrodes or measurable amperage. One of the least pleasant things about being psychotically depressed on a ward full of psychotically depressed patients is coming to see that none of them is really psychotic, that their screams are entirely appropriate to certain circumstances part of whose special charm is that they are undetectable by any outside party. Thus the loneliness: it's a closed circuit: the current is both applied and received from within.

I know being diagnosed with ADHD looks different for all of us, but if you’ve ever had a hard time explaining why you leave literally everything until the last minute, why you feel out of control, why your tongue feels like it doesn’t belong in in your mouth when the music is too loud, or any of the countless other things we feel that are apart of ADHD, you might see yourself in Done and Dusted.

the same paranoia that was a symptom of the illness would prevent its ever being diagnosed and treated.

We need a revolution in the research and the practice of medicine, and we need it yesterday. We need to train doctors to listen to women, and to recognise that their inability to diagnose a woman may not be because she is lying or being hysterical: the problem may be the gender data gaps in their knowledge. It’s time to stop dismissing women, and start saving them.

The core predicament of medicine - the thing that makes being a patient so wrenching, being a doctor so difficult, and being a part of society that pays the bills they run up so vexing - is uncertainty. With all that we know nowadays about people and diseases and how to diagnose and treat them, it can be hard to see this, hard to grasp how deeply uncertainty runs. As a doctor, you come to find, however, that the struggle in caring for people is more often with what you do not know than what you do. Medicine's ground state is uncertainty. And wisdom - for both the patients and doctors - is defined by how one copes with it.

Until we accept that our children have much more of a risk of being sexually abused than drowning in a pool, being struck by a car, stricken with cancer, hurt by a vaccination, or diagnosed with ebola, we contribute to a culture of panic and ignorance.

The love object occupies the thoughts of the person diagnosed as 'in love' all the time despite the probability that very little is actually known about it. To it are ascribed all qualities considered by the obsessed as good, regardless of whether the object in question possesses those qualities in any degree. Expectations are set up which no human being could fulfill. Thus the object chosen plays a special role in relation to the go of the obsessed, who decided that he or she is the right or the only person for him. In the case of a male this notion may sanction a degree of directly aggressive behavior either in pursuing the object or driving off competition.

He had also gone through a bad divorce, become estranged from his only daughter and been diagnosed with skin cancer, but he insisted that all of that, however painful, was secondary to the sudden realization that it was mathematics—not nuclear weapons, computers, biological warfare or our climate Armageddon—which was changing our world to the point where, in a couple of decades at most, we would simply not be able to grasp what being human really meant.

Postmodernism's specifically academic appeal comes from its being another in the sequence of all-purpose "unmasking" strategies that offer a way to criticize the intellectual efforts of others not by engaging with them on the ground, but by diagnosing them from a superior vantage point and charging them with inadequate self-awareness. Logical positivism and Marxism were used by academics in this way, and postmodernist relativism is a natural successor in the role. [The Sleep of Reason]

After being diagnose as bi-polar...I feel that laughter is the best medicine for all. I find that I can't write humorously and be depressed at the same time.:)

On the train, the tears come, and I don’t care if people are watching me; for all they know, my dog might have been run over. I might have been diagnosed with a terminal illness. I might be a barren, divorced, soon-to-be-homeless alcoholic.

Boys’ aggressiveness is increasingly being treated as a medical problem, particularly in schools, a trend that has led to the diagnosing and medicating of boys whose problem may really be that they have been traumatized and influenced by exposure to violence and abuse at home. Treating these boys as though they have a chemical problem not only overlooks the distress they are in but also reinforces their belief that they are “out of control” or “sick,” rather than helping them to recognize that they are making bad choices based on destructive values. I have sometimes heard adults telling girls that they should be flattered by boys’ invasive or aggressive behavior “because it means they really like you,” an approach that prepares both boys and girls to confuse love with abuse and socializes girls to feel helpless.

What do you think it’s like, Father?” “What what’s like?” “Being crazy. Mentally ill.” “Well, they never know they’re ill, do they? You can’t diagnose yourself with the same organ that has the disease, just like you can’t see your own eyeball. So, I suppose you just feel normal and the rest of the world seems to go crazy around you.

By listening to the “unspoken voice” of my body and allowing it to do what it needed to do; by not stopping the shaking, by “tracking” my inner sensations, while also allowing the completion of the defensive and orienting responses; and by feeling the “survival emotions” of rage and terror without becoming overwhelmed, I came through mercifully unscathed, both physically and emotionally. I was not only thankful; I was humbled and grateful to find that I could use my method for my own salvation. While some people are able to recover from such trauma on their own, many individuals do not. Tens of thousands of soldiers are experiencing the extreme stress and horror of war. Then too, there are the devastating occurrences of rape, sexual abuse and assault. Many of us, however, have been overwhelmed by much more “ordinary” events such as surgeries or invasive medical procedures. Orthopedic patients in a recent study, for example, showed a 52% occurrence of being diagnosed with full-on PTSD following surgery. Other traumas include falls, serious illnesses, abandonment, receiving shocking or tragic news, witnessing violence and getting into an auto accident; all can lead to PTSD. These and many other fairly common experiences are all potentially traumatizing. The inability to rebound from such events, or to be helped adequately to recover by professionals, can subject us to PTSD—along with a myriad of physical and emotional symptoms.

The science on the subject is pretty clear: according to the New England Journal of Medicine, rape is about four times more likely to result in diagnosable PTSD than combat. Think about that for a moment—being raped is four times more psychologically disturbing than going off to a war and being shot at and blown up. And because there are currently no enduring cultural narratives that allow women to look upon their survival as somehow heroic or honorable, the potential for enduring damage is even greater.

... but as with so may diagnoses it is, in the end, the symptoms that matter, not the cause, because this is what being alive means, this is what being a person means, to be sickened by an illness known as you.

Hershey Pennsylvania was self-proclaimed as the “Sweetest Place On Earth,” but less advertised than chocolate, it was also home to one of the state’s largest Children’s Hospitals. The streets lined with Hershey Kiss–shaped streetlamps that led excited children and families on vacation to chocolate tour rides and rollercoasters were the same exact streets that led anxious children and families to x-rays and MRIs on the worsts days of their lives. Chocolate was being created on the same street that childhood diseases were being diagnosed. And that was life. The sweetest of sensations and the deepest of devastations live next door to each other.

In less than a year, the magic of being diagnosed had begun to wear off, and my bipolar disorder no longer felt like a story hook. It felt like a part of me I wasn't sure I wanted to sit with anymore. So the further away I got from the diagnosis and all that had led up to it, the more I downplayed the extremes or made them punchlines I could use before anybody else could. I came to resent the head tilts and looks of surprise that go hand in hand with sharing what I'd come to see as a particularly unglamorous part of my life. If this was what interesting was, I didn't want it anymore. I hadn't counted on the most interesting people not being able to opt out. I didn't want to be the woman who does everything despite her bipolar disorder. I wanted to be the woman who has many complexities, her bipolar disorder being just one of them. (You know, a person).

Even sleep offered no respite from my mental disorders. There was Nightmare Disorder, which is diagnosed when the sufferer dreams of being "pursued or declared a failure." All my nightmares involve someone chasing me down the street while yelling, "You're a failure!

That’s one bad thing about being a paramedic and a victim. You’ve seen it all and can diagnose yourself. He figures he doesn’t have long to live.

Many menopausal women are now being diagnosed with AD/HD for the first time because previously developed coping skills that hid the symptoms are compromised once the estrogen changes exacerbate the symptoms.

What if, instead of being diagnosed—being called mentally ill—what if I had been able to receive care for its own sake. To be in distress, to ask for care, to receive it. What if there were space in this world for care.

You know, all poetry may be a cry of generalised love, for this, or that, or the universe - which must be loved in its particularity, not its generality, but for its universal life in every minute particular. I have always supposed it to be a cry of ;unsatisfied love; - and so it may be indeed - for satisfaction may surfeit it and so it may die. I know many poets who write only when in an exalted state of mind which they compare to ;being in love;,when they do not simply state, that they are in love, that they seek love - for this fresh damsel - or that lively young woman - in order to find a fresh metaphor, or a new bright vision of things in themselves. And to tell you the truth, I have always believed I could diagnose this state of ;being in love; which they regard as ;most particular;, as inspired by item, one pair of black eyes or indifferent blue, ;item;, one graceful attitude of body or mind, ;item;, one female history of some twenty-two years from, shall we say 1821-1844 – I have always believed this ;in love; to be of something of the most abstract masking itself under the particular forms of both lover and beloved. And Poet who assumes and informs both.

The evidence that women are being let down by the medical establishment is overwhelming. The bodies, symptoms and diseases that affect half the world’s population are being dismissed, disbelieved and ignored. And it’s all a result of the data gap combined with the still prevalent belief, in the face of all the evidence that we do have, that men are the default humans. They are not. They are, to state the obvious, just men. And data collected on them does not, cannot, and should not, apply to women. We need a revolution in the research and the practice of medicine, and we need it yesterday. We need to train doctors to listen to women, and to recognise that their inability to diagnose a woman may not be because she is lying or being hysterical: the problem may be the gender data gaps in their knowledge. It’s time to stop dismissing women, and start saving them.

Classifying depression as an illness serves the psychiatric community and pharmaceutical corporations well; it also soothes the frightened, guilty, indifferent, busy, sadistic, and unschooled. To understand depression as a call for life-changes is not profitable. Stagnation is not a medical term. The 17.5 million Americans diagnosed as suffering a major depression in 1997 were mostly damned. (Psychobiological examinations confuse cause and symptom.) Deficient serotonergic functioning, ventral prefrontal cerebral cortex, dis-inhibition of impulsive-aggressive behavior, blah blah blah: the medical lexicon boils emotion from human being. Go take a drug, the doctor says. Pain is a biochemical phenomenon. Erase all memory.

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact. But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

The survivor movements were also challenging the notion of a dysfunctional family as the cause and culture of abuse, rather than being one of the many places where abuse nested. This notion, which in the 1990s and early 1980s was the dominant understanding of professionals characterised the sex abuser as a pathetic person who had been denied sex and warmth by his wife, who in turn denied warmth to her daughters. Out of this dysfunctional triad grew the far-too-cosy incest dyad. Simply diagnosed, relying on the signs: alcoholic father, cold distant mother, provocative daughter. Simply resolved, because everyone would want to stop, to return to the functioning family where mum and dad had sex and daughter concentrated on her exams. Professionals really believed for a while that sex offenders would want to stop what they were doing. They thought if abuse were decriminalised, abusers would seek help. The survivors knew different. P5

Anyone who is truly crazy, in my book, wouldn't be able to understand the dialectic of crazy and not-crazy. Listen, I've worked for the pharmaceutical companies, they have a vested belief in making you believe that if you have a chemical imbalance you need them to be 'cured' of your current issues and personality. Indefinitely. Imagine diagnosing personality only in terms of its negative aspects. Does this strike you as a strategy designed for health? The only way to deal with a problem is to fucking deal with it. Get inside what positive motivation, what intention, makes you behave in the way you are... and how you could maybe satisfy that need in a healthier or at least more agreeable manner. America wants quick, easy and painless; being a real person is slow, difficult and very messy.

To function in society, you need to believe that you’re safe. We all know it’s a lie, but it’s a lie you need to believe to survive. Realistically, everybody knows that they’ll die one day. Everybody knows that, every second, around the world, people are getting killed, and assaulted, and robbed, and hurt. At this very moment, people are losing their kids, being run over, getting diagnosed with terminal illnesses. We’re living in a motherfucking horror movie, but most people can convince themselves that they’re safe. And they go about their lives, thinking about money, and their annoying neighbours, and celebrity gossip, like any of that fucking matters.

Fire children are often told to "settle down", "be still", or - even worse - diagnosed with ADD when they may simply have a very energetic disposition from being a Fire element.

The main character in Done and Dusted is named Emmy. Emmy and I don’t have that much in common, but like me, Emmy, has ADHD. The differences in the way our brains work can be subtle, but it doesn’t mean that they don’t exist or make an impact on the way we live our lives. I know being diagnosed with ADHD looks different for all of us, but if you’ve ever had a hard time explaining why you leave literally everything until the last minute, why you feel out of control, why your tongue feels like it doesn’t belong in in your mouth when the music is too loud, or any of the countless other things we feel that are apart of ADHD, you might see yourself in Done and Dusted. Emmy and I are right there with you. Happy reading, Lyla

But when a doctor among them refused to cast his vote—his reasonable justification being that he’d made no professional examination of Elizabeth and could hardly diagnose her based on hearsay

Don't you just love the army? They take a fellow who's been turned into a catatonic mute by being shelled from here to Christmas and say he's not yet been properly diagnosed but he seems a bit nervous.

Often those objecting to the diagnosis will be using their objections to conceal an emotional agenda. They may be angry with the person being diagnosed. They may resent him for all his past sins, and they don’t want to see him get off with just a diagnosis. They want punishment. So they will grow angry at the notion of ADD, and try to discredit it. At these moments it is best to stay with the science, to stay with the facts we have about ADD.

I have another scan this week," I say lightly, hoping to reassure my loved ones that it is safe to rejoin my orbit. There is always another scan, because this is my reality. But the people I know are often busy contending with mildly painful ambition and the possibility of reward. I try to begrudge them nothing, except I'm not alongside them anymore. In the meantime, I have been hunkering down with old medical supplies and swelling resentment. I tried— haven't I tried? — to avoid fights and remember birthdays. I showed up for dance recitals and listened to weight-loss dreams and kept the granularity of my medical treatments in soft focus. A person like that would be easier to love, I reasoned. I try a small experiment and stop calling my regular rotation of friends and family, hoping that they will call me back on their own. _This is not a test. This is not a test._ The phone goes quiet, except for a handful of calls. I feel heavy with strange new grief. Is it bitter or unkind to want everyone to remember what I can't forget? Who wants to be confronted with the reality that we are all a breath away from a problem that could alter our lives completely? A friend with a very sick child said it best: I'm everyone's inspiration and and no one's friend. I am asked all the time to say that, given what I've gained in perspective, I would never go back. Who would want to know the truth? Before was better.

The experience of psychological trauma, as is typically diagnosed (posttraumatic stress disorder [PTSD]), has at least some of the following symptoms: • Reliving the trauma: This can happen through nightmares, flashbacks, or reexperiencing as a result of being in the presence of stimuli reminiscent of the traumatic event. • Efforts to avoid thoughts or feelings that are associated with the trauma. • Efforts to avoid activities or situations that arouse memories of the trauma. • Inability to remember some important aspect of the trauma (psychogenic amnesia). • Marked reduced interest in important activities. • Feeling of a lack of interest or expulsion by others. • Limited affect; such as inability to cherish loving feelings. • A feeling of not having any future (foreshortened future); not expecting to have a career, get married, have children, or live a long life. • Hypervigilance (heightened sensitivity to possible traumatic stimuli).

When I came here, diagnosed as a schizophrenic, you spent days, months, talking to me and treating me as a human being. I was getting used to the life I’d decided to lead, to the other reality I’d created, but you wouldn’t let me. I hated you, and now I love you.

Cancer is another forbidden or “whisper” topic. I read about a writer named Emily McDowell who said the worst part of being diagnosed with lymphoma wasn’t feeling sick from chemo or losing her hair. “It was the loneliness and isolation I felt when many of my close friends and family members disappeared because they didn’t know what to say, or said the absolute wrong thing without realizing it.” In response, Emily created “empathy cards.” I love them all but these two are my favorites, making me want to laugh and cry simultaneously.

In the economic sphere too, the ability to hold a hammer or press a button is becoming less valuable than before. In the past, there were many things only humans could do. But now robots and computers are catching up, and may soon outperform humans in most tasks. True, computers function very differently from humans, and it seems unlikely that computers will become humanlike any time soon. In particular, it doesn’t seem that computers are about to gain consciousness, and to start experiencing emotions and sensations. Over the last decades there has been an immense advance in computer intelligence, but there has been exactly zero advance in computer consciousness. As far as we know, computers in 2016 are no more conscious than their prototypes in the 1950s. However, we are on the brink of a momentous revolution. Humans are in danger of losing their value, because intelligence is decoupling from consciousness. Until today, high intelligence always went hand in hand with a developed consciousness. Only conscious beings could perform tasks that required a lot of intelligence, such as playing chess, driving cars, diagnosing diseases or identifying terrorists. However, we are now developing new types of non-conscious intelligence that can perform such tasks far better than humans. For all these tasks are based on pattern recognition, and non-conscious algorithms may soon excel human consciousness in recognising patterns. This raises a novel question: which of the two is really important, intelligence or consciousness? As long as they went hand in hand, debating their relative value was just a pastime for philosophers. But in the twenty-first century, this is becoming an urgent political and economic issue. And it is sobering to realise that, at least for armies and corporations, the answer is straightforward: intelligence is mandatory but consciousness is optional.

When he wrote back, he pretended to be his old self, he lied his way into sanity. For fear of his psychiatrist who was also their censor, they could never be sensual, or even emotional. His was considered a modern, enlightened prison, despite its Victorian chill. He had been diagnosed, with clinical precision, as morbidly oversexed, and in need of help as well as correction. He was not to be stimulated. Some letters—both his and hers—were confiscated for some timid expression of affection. So they wrote about literature, and used characters as codes. All those books, those happy or tragic couples they had never met to discuss! Tristan and Isolde the Duke Orsino and Olivia (and Malvolio too), Troilus and Criseyde, Once, in despair, he referred to Prometheus, chained to a rock, his liver devoured daily by a vulture. Sometimes she was patient Griselde. Mention of “a quiet corner in a library” was a code for sexual ecstasy. They charted the daily round too, in boring, loving detail. He described the prison routine in every aspect, but he never told her of its stupidity. That was plain enough. He never told her that he feared he might go under. That too was clear. She never wrote that she loved him, though she would have if she thought it would get through. But he knew it. She told him she had cut herself off from her family. She would never speak to her parents, brother or sister again. He followed closely all her steps along the way toward her nurse’s qualification. When she wrote, “I went to the library today to get the anatomy book I told you about. I found a quiet corner and pretended to read,” he knew she was feeding on the same memories that consumed him “They sat down, looked at each other, smiled and looked away. Robbie and Cecilia had been making love for years—by post. In their coded exchanges they had drawn close, but how artificial that closeness seemed now as they embarked on their small talk, their helpless catechism of polite query and response. As the distance opened up between them, they understood how far they had run ahead of themselves in their letters. This moment had been imagined and desired for too long, and could not measure up. He had been out of the world, and lacked the confidence to step back and reach for the larger thought. I love you, and you saved my life. He asked about her lodgings. She told him. “And do you get along all right with your landlady?” He could think of nothing better, and feared the silence that might come down, and the awkwardness that would be a prelude to her telling him that it had been nice to meet up again. Now she must be getting back to work. Everything they had, rested on a few minutes in a library years ago. Was it too frail? She could easily slip back into being a kind of sister. Was she disappointed? He had lost weight. He had shrunk in every sense. Prison made him despise himself, while she looked as adorable as he remembered her, especially in a nurse’s uniform. But she was miserably nervous too, incapable of stepping around the inanities. Instead, she was trying to be lighthearted about her landlady’s temper. After a few more such exchanges, she really was looking at the little watch that hung above her left breast, and telling him that her lunch break would soon be over.

Every year, new uses for deep brain stimulation are being found. In fact, nearly all the major disorders of the brain are being reexamined in light of this and other new brain-scanning technologies. This promises to be an exciting new area for diagnosing and even treating illnesses.

Keeping high-volume procedures within general hospitals allows hospitals to subsidize the unique, low-volume specialized capabilities that are so central to the value proposition of their solution shops- being able to diagnose and embark on a therapy for anything that might be wrong.

Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor and patient. As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask “Why me?” (Answer: Why not me?) I knew a lot about medical care, complications, and treatment algorithms. I quickly learned from my oncologist and my own study that stage IV lung cancer today was a disease whose story might be changing, like AIDS in the late 1980s: still a rapidly fatal illness but with emerging therapies that were, for the first time, providing years of life. While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient. It didn’t tell Lucy and me whether we should go ahead and have a child, or what it meant to nurture a new life while mine faded. Nor did it tell me whether to fight for my career, to reclaim the ambitions I had single-mindedly pursued for so long, but without the surety of the time to complete them. Like my own patients, I had to face my mortality and try to understand what made my life worth living—and I needed Emma’s help to do so. Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one. —

...I have always believed I cd diagnose this state of being in love, which they regard as most particular, as inspired by item, one pair of black eyes or indifferent blue, item, one graceful attitude of body or mind, item, one female history of some twenty-two years from, shall we say, 1821-1844--I have always believed this in love to be something of the most abstract masking itself under the particular forms of both lover and beloved. And Poet, who assumes and informs both. I wd have told you--no, I do tell you--friendship is rarer, more idiosyncratic, more individual and in every way more durable than this Love.

DSM-5 is not 'the bible of psychiatry' but a practical manual for everyday work. Psychiatric diagnosis is primarily a way of communicating. That function is essential but pragmatic—categories of illness can be useful without necessarily being 'true.' The DSM system is a rough-and-ready classification that brings some degree of order to chaos. It describes categories of disorder that are poorly understood and that will be replaced with time. Moreover, current diagnoses are syndromes that mask the presence of true diseases. They are symptomatic variants of broader processes or arbitrary cut-off points on a continuum.

If a doctor has worked through the problem well, there’s a very good chance that one of these possible diagnoses will be right. The rest though, by definition, will be wrong. We are regularly wrong in the pursuit of being right. … The question we are taught to ask ourselves is, if it isn’t that, what else could it be?

I met Autistics who’d at first been diagnosed with things like Borderline Personality Disorder, Oppositional Defiant Disorder, or Narcissistic Personality Disorder. I also found scores of transgender and gender-nonconforming Autistic people like me, who had always felt “different” both because of their gender and their neurotype. In each of these people’s lives, being Autistic was a source of uniqueness and beauty. But the ableism around them had been a fount of incredible alienation and pain. Most had floundered for decades before discovering who they truly were. And nearly all of them were finding it very difficult to take their long-worn masks off.

Nostalgia was diagnosed [as a medical illness] at a time when art and science had not yet entirely severed their umbilical ties and when the mind and body internal and external well-being were treated together...Our progeny well might poeticize depression and see it as a global atmospheric condition, immune to treatment with Prozac.

By contrast, moderate identity alteration differs from its milder countepart in that the alterations are not always under the person's control. In addition, moderate identity alteration does not always manifest the presence of distinct alter personalities. Someone who experiences moderate identity alteration may present with mood changes and behaviors that they perceive as uncontrollable. Patients with nondissociative psychiatric disorders (e.g., manic depressive illness) may report moderate alterations in behavior/demeanor that they cannot control; for example, one patient diagnosed as manic depressive mentioned being bothered by his inability to "keep his mind from racing" (SCID-D interview, unpublished transcript). However, these alterations do not coalesce around distinct personalities. Similarly, individuals who have borderline personality disorder tend to fluctuate rapidly between radically different behaviors and moods; however, these changes do not involve different names, memories, preferences, distinct ages, or amnesia for past events.

am so sick of it. All of it. I’m sick of my dad and his it’s-your-fault-for-wearing-a-skirt-that’s-too-short BS. I’m sick of people acting like I’m crazy. Anytime a woman gets mad or sad or emotional, boom, let’s put a big stamp on that feeling that says it isn’t valid. That it’s maybe even pathological. You know as many as 70 percent of women got diagnosed as hysterical by certain doctors back in the day? But what if none of them were Crazy Bitches? What if they were just tired? Tired of pretending everything was okay when it wasn’t, and living in a world that was designed to be against them, and being told to smile through the knife wounds. Maybe pretending to be okay in the middle of a tornado is the truly crazy thing.

You and I were made for connection, to be emotionally attached to others. It’s a well-known fact that physical touch is crucial for us as human beings, not just for emotional health but for our very survival. Studies show that the elderly die sooner if they don’t have physical touch. Babies are more likely to be diagnosed with “failure to thrive” if they’re not touched. One

Debbie Nathan blames the early symptoms on pernicious anemia yet explains their supposed remission by Shirley’s being out of contact with Dr. Wilbur for those 9 years. But Dr. Wilbur never diagnosed a dissociative disorder in 1945. Nathan does not seem to recognize the implausibility of Dr. Wilbur creating via suggestion a complex dissociative disorder in five sessions, particularly when the doctor herself did not diagnose it. Nathan attributes Shirley’s postintegration improvement in functioning to being out of contact with Dr. Wilbur rather than to the therapy. But the pernicious anemia continued to be undiagnosed and untreated during that time period, so any symptoms due to it should have continued rather than showing an improvement that coincided with psychotherapy with Dr. Wilbur. Debbie Nathan’s thesis is self-contradictory.

On the train, the tears come, and I don’t care if people are watching me; for all they know, my dog might have been run over. I might have been diagnosed with a terminal illness. I might be a barren, divorced, soon-to-be-homeless alcoholic. It’s ridiculous, when I think about it. How did I find myself here? I wonder where it started, my decline; I wonder at what point I could have halted it. Where did I take the wrong turn?

Nostalgia was diagnosed at a time when art and science had not yet entirely severed their umbilical ties and when the mind and body—internal and external well-being—were treated together. This was a diagnosis of a poetic science—and we should not smile condescendingly on the diligent Swiss doctors. Our progeny well might poeticize depression and see it as a metaphor for a global atmospheric condition, immune to treatment with Prozac.

As we are aware, the effect of the vagus nerve is to slow the level of inflammation and keep it in check. If we are sending repeated messages of inflammation over a long time, we are essentially training the vagus nerve to stop having its positive anti-inflammatory effect. This is why it is most common for people to begin experiencing and receiving diagnoses of these autoimmune conditions in their 30s and 40s. After 30+ years of inflammatory signals, the vagus nerve has been trained to stop functioning as an anti-inflammatory intervention. Between the ages of 35 and 40, the vagus tone has decreased significantly and the anti-inflammatory signals stop being sent out. These conditions often arise following the stress of pregnancy, having children, and lacking sleep during the first years of a child’s life—all of which are stressors that decrease vagus nerve function.

We live in a culture that has monetized and commercialized “well-being” and “health” to such an extent that concern for our physical health has grown into an often unmanageable worry. We seek answers, diagnoses, and treatments from questionable sources, such as the omnipresent “Dr. Google.” We stress and fret about our health, which ironically, has a negative impact on the very part of ourselves that we are trying so diligently to protect.

Self-diagnosed adolescent trans boys – natal females – started to fill up GIDS’s waiting room with similar stories, haircuts, even names – ‘one after another after another’. They’d talk about their favourite trans YouTubers, many having adopted the same name, and how they aspired to be like them in the future. Given how complicated these young people appeared to be, could something else be going on that explained this, something other than them all being trans?

For nearly a hundred years, psychiatry has been striving to apply medical model thinking to psychiatric disorders. In this model, the symptoms besieging patients are sorted into specific disease entities and the causes then identified and removed. For doctors of internal medicine, this works. In the case of diabetes mellitus, for example, the symptoms of urinary frequency, fatigue, and confusion often lead to suspicion of the underlying cause, which is confirmed by blood sugar monitoring and then treated by insulin replacement. But psychiatric symptoms are much harder to sort into diagnoses. People with depression sometimes become paranoid. People with schizophrenia sometimes become depressed. Some people who hear voices have no other symptoms whatsoever, and others who hear voices also fall victim to terrible mood swings. Thus far, the hope that psychiatry would be able to identify homogeneous disease states, uncover the biological underpinnings, and remedy them has been largely a barren one. Kappler's symptoms, however, evolved when the hope for psychiatry's becoming a true medical specialty was bright to the point of being blinding. Over the years he would collect over a dozen diagnoses and cavalierly take a myriad of medicines, but no one would be able to bring him close to confronting the past he had disowned, to stand a chance of making peace with it and, ultimately, overcoming it. (46)

We continue drinking unchecked, often overlooking the danger of addiction, because we have come to believe alcoholism can only happen to other people. By the time we realize we have a problem, we are faced with self-diagnosing a fatal and incurable illness or admitting to being weak-willed and lacking self-control. We tend to avoid this horrific diagnosis until things have gotten so out of control we can no longer avoid the problem. In some ways this approach has defined alcoholism as a disease of denial.

There I was, in black and white. My entire being of weirdness, easily explained with bullet points listed under both “Signs of Adult AD(H)D” and “Signs of Adult Giftedness.” Double trouble. Twice fucked, as I like to say. Getting diagnosed was definitely a mixed blessing for me. On one hand there was a nicely packaged reason for all of the things I felt were wrong with me. On the other hand, it was comparable to a mental-health death sentence. I used to say to my mom, “It shouldn’t be this hard…it isn’t this hard for other people…this isn’t normal.” I used to think I could just fix myself away with my little self-improvement plans. I still do, actually—a different one every week, but getting that diagnosis meant I could do all of the self-improvement plans available in the universe, and I would still come out as messed up as I went in. No improvements for me. Sorry, Charlie. Shit out of luck, my friend. I’ve always felt misunderstood. Though I was never at a loss for friends, I was always told I was weird, which I was totally OK with. Weird

Or what about attention deficit disorder, and the litany of negative, even catastrophic associations it carries? Fifteen years ago, it barely existed, but today it's being diagnosed left, right, and sideways. I'm not suggesting that some kids don't have it, or can't benefit from treatment, but ADD (and the fear of our children being diagnosed with it) has saturated our culture like a virus. And the result, of course, is millions of parents buying their children drugs. A parent's internal monologue may go something like this: If my child doesn't take Ritalin, or Adderal or Concerta, he won't be able to concentrate in school. He'll fall behind. His grades will suffer. He'll be marginalized by his peers. He'll begin hanging out with other low-performing kids. He won't get into college. He'll drift from job to job. He may even end up in jail. All because I didn't address his ADD when he was in kindergarten. Fear, in my experience, spreads faster than anything else - and the ads for those drugs have done a very nice job scaring the pants off us.

Do you know a Psychopath? You do not know me; but after reading my memoir you will know me a little better and you will have had the experience of safely getting into the mind and life of a young psychopath in training. Critics have written: It is a powerful and unusual memoir; brutal and raw. A Psychopath In Training: In 1997 psychiatrist’s contracted by the Correctional Service and the National Parole Board wrote in their final report, before I was released back into the community, they had diagnosed me to be a psychopath. A Psychopath: How does one become a Psychopath? After of the death of my young mother, when I was fourteen, I became a ward of the state and forced into the care and custody of the Catholic Christian Brothers at St. John’s Catholic Training School for Boys until after I turned sixteen. Since then I have been incarcerated over seventeen years in various prisons, institutions and juvenile detention centres. I have been interviewed and treated by so many prison psychiatrists and psychologists I should be called the professional. In my youth I have experienced almost every kind of sleaze, sex and violence humans can inflict on each other. I had to learn the hard way on how to identify and deal with the people who were the dangerous psychopath’s in my life and the proof I succeeded is; I am still alive. My book cover depicts what is coming out of the government foster homes and prisons today: Our communities and our police forces are not at all prepared for the dangerous psychopaths being churned out. Are you ready? You and the educators alike can learn from my memoir.

There is a growing Awareness in the medical community that a lot of what has been diagnosed and treated as depression among older people may instead be a natural process of reorientation. Whether we attribute it to cellular-biochemical mechanisms, or psychodynamics, or spiritual processes, there’s a kind of drawing-inward that seems to be part of the process of aging. Not a paranoid drawing-inward; not being afraid of the world. Just a kind of deepening. I think it’s probably the nearness of death that leads many people to want to reflect on what life is all about.

That's the beauty of discipline. It trumps everything. A lot of us are born with minimal talent, unhappy in our own skin and with the genetic makeup with which we were born. We have fucked-up parents, grow up bullied and abused, or are diagnosed with learning disabilities. We hate our hometown, our teachers, our families, and damn near everything about ourselves. We wish we could be born again as some other motherfucker in some other time and place. Well, I am proof that rebirth is possible through discipline, which is the only thing capable of altering your DNA. It is the skeleton key that can get you past all the gatekeepers and into each and every room you wish to enter. Even the ones built to keep you the fuck out! ... Discipline builds mental endurance because when effort is your main priority, you stop looking for everything to be enjoyable. Our phones and social media have turned too many of us inside out with envy and greed as we get inundated with other people's success, their new cars and houses, big contracts, resort vacations, and romantic getaways. We see how much fun everyone else is having and feel like the world is passing us by, so we bitch about it and then wonder why we are not where we want to be. When you become disciplined, you don't have time for that bullshit. p140

AUTHOR’S NOTE Dear reader: This story was inspired by an event that happened when I was eight years old. At the time, I was living in upstate New York. It was winter, and my dad and his best friend, “Uncle Bob,” decided to take my older brother, me, and Uncle Bob’s two boys for a hike in the Adirondacks. When we left that morning, the weather was crisp and clear, but somewhere near the top of the trail, the temperature dropped abruptly, the sky opened, and we found ourselves caught in a torrential, freezing blizzard. My dad and Uncle Bob were worried we wouldn’t make it down. We weren’t dressed for that kind of cold, and we were hours from the base. Using a rock, Uncle Bob broke the window of an abandoned hunting cabin to get us out of the storm. My dad volunteered to run down for help, leaving my brother Jeff and me to wait with Uncle Bob and his boys. My recollection of the hours we spent waiting for help to arrive is somewhat vague except for my visceral memory of the cold: my body shivering uncontrollably and my mind unable to think straight. The four of us kids sat on a wooden bench that stretched the length of the small cabin, and Uncle Bob knelt on the floor in front of us. I remember his boys being scared and crying and Uncle Bob talking a lot, telling them it was going to be okay and that “Uncle Jerry” would be back soon. As he soothed their fear, he moved back and forth between them, removing their gloves and boots and rubbing each of their hands and feet in turn. Jeff and I sat beside them, silent. I took my cue from my brother. He didn’t complain, so neither did I. Perhaps this is why Uncle Bob never thought to rub our fingers and toes. Perhaps he didn’t realize we, too, were suffering. It’s a generous view, one that as an adult with children of my own I have a hard time accepting. Had the situation been reversed, my dad never would have ignored Uncle Bob’s sons. He might even have tended to them more than he did his own kids, knowing how scared they would have been being there without their parents. Near dusk, a rescue jeep arrived, and we were shuttled down the mountain to waiting paramedics. Uncle Bob’s boys were fine—cold and exhausted, hungry and thirsty, but otherwise unharmed. I was diagnosed with frostnip on my fingers, which it turned out was not so bad. It hurt as my hands were warmed back to life, but as soon as the circulation was restored, I was fine. Jeff, on the other hand, had first-degree frostbite. His gloves needed to be cut from his fingers, and the skin beneath was chafed, white, and blistered. It was horrible to see, and I remember thinking how much it must have hurt, the damage so much worse than my own. No one, including my parents, ever asked Jeff or me what happened in the cabin or questioned why we were injured and Uncle Bob’s boys were not, and Uncle Bob and Aunt Karen continued to be my parents’ best friends. This past winter, I went skiing with my two children, and as we rode the chairlift, my memory of that day returned. I was struck by how callous and uncaring Uncle Bob, a man I’d known my whole life and who I believed loved us, had been and also how unashamed he was after. I remember him laughing with the sheriff, like the whole thing was this great big adventure that had fortunately turned out okay. I think he even viewed himself as sort of a hero, boasting about how he’d broken the window and about his smart thinking to lead us to the cabin in the first place. When he got home, he probably told Karen about rubbing their sons’ hands and feet and about how he’d consoled them and never let them get scared. I looked at my own children beside me, and a shudder ran down my spine as I thought about all the times I had entrusted them to other people in the same way my dad had entrusted us to Uncle Bob, counting on the same naive presumption that a tacit agreement existed for my children to be cared for equally to their own.

I didn’t like the way Elgie was talking. Thanks to Victims Against Victimhood, I have grown expert at detecting the signs of being victimized by emotional abuse: confusion, withdrawal, negotiating reality, self-reproach. At VAV, we don’t help newcomers, we CRUSH them. C: Confirm their reality. R: Reveal our own abuse. U: Unite them with VAV. S: Say sayonara to abuse. H: Have a nice life! I launched into the saga of Barry’s failed businesses, his trips to Vegas, his Intermittent Explosive Disorder (which was never diagnosed, but which I’m convinced he suffers from), and finally how I found the strength to divorce him, but not before he successfully drained our life savings.

Thank God for pain. Most of life's blessings, in my experience, are potential curses. And vice versa. So it is with physical pain. Acute short term physical pain, whether mild or severe, is virtually always a blessing. It is a signal that something is wrong with the body, something that needs attention. Without that signals our lives would quite quickly become devastated. But pain is useful ONLY as a signal that something is wrong, be it a broken ankle, a burn or a cinder in the eye. Once the problem is diagnosed and is being appropriately treated, there is no reason for the signal to continue. Pain has lost its utility. If the pain does continue, the blessing has become a curse.

the system being employed at the children’s hospital down the street from my grad-school apartment made the Victorian approach look relatively benign. The modern system featured not only highly aggressive cosmetic genital surgeries in infancy for children born with “socially inappropriate” genital variations like big clitorises, but also the withholding of diagnoses from patients and parents out of fear that they couldn’t handle the truth. It treated boys born with small penises as hopeless cases who “had” to be castrated and sex-changed into girls, and it assumed that the ultimate ability of girls to reproduce as mothers should take precedence over all else, including the ability to someday experience orgasm.

At the dinner table... CALVIN, looking like an x-ray version of himself: Bombarded by high energy photons, Calvin is transformed into a living x-ray. CALVIN: Although this condition will facilitate future medical diagnoses, it does make Calvin's presence at the dinner table a disgusting ordeal. CALVIN: Everyone can see Calvin's food being ground into mushy pulp and swallowed! At this moment, Calvin chews up a large spoonful of creamed corn! CALVIN'S DAD, leaning in at the dinner table: For gosh sakes, close your mouth when you chew!! You think we want to SEE that? CALVIN, physically back to normal, except that his mouth is open amazingly wide, with full view of his current mouthful: MKGHH! SMACK! BLAGHKH!

Messiah thought back, his mind floating back in time to the day he’d taken Mo to Stepping Stone Falls to let her high come down. That morning. He’d found out that morning. He had been diagnosed with cancer. It was the biggest reason he had warned Morgan that he would never be able to stay. That he would hurt her. That they would never be. There was no future with him. No wedding. No growing old together. He knew that it would hurt her to only have him for a little while, but that small moment of time that they had carved out was the best days of his life. Those days outweighed every ounce of pain he had ever felt. He looked at his illness as a blessing, because he would have never crossed the line with Morgan if he hadn’t been diagnosed that day. Hearing that he was sick made him want to risk what little time he had left on her. Messiah couldn’t allow himself to die without indulging in an angel. Morgan had been his biggest blessing and he had been her biggest curse. She would never know how sorry he was. He would never be able to tell her. “It’s been awhile. About a year or so,” he said. “You’re 180 pounds. According to your records from your doctors in Michigan, you were 225 at your last visit. You know what that means, right? They should have told you what to look for. The signs. You should have…” “I know,” he said. “I was busy living. I didn’t want to take the time out to die. I found a girl to love me for a little while. It was worth it.” Messiah stepped down and the woman looked at him in stun.

ADHD is crazy, actually. My brain, how fast it moves at any given moment—that the hyperactivity, it’s not me bouncing off walls, it’s a thousand thoughts each minute bouncing off the walls in my head. And there are parts of it that are wonderful, I notice things other people don’t, I’m detail-oriented, I pick up patterns well, I think I’m quite clever, truthfully. I like how I think. I wasn’t sad when they diagnosed me with it, it made a lot of things about me make sense, and about us and how I am and how I can be and why—it answered a lot. It can be bad though. It can be a waterboarding of thoughts. Just—cloth over my brain’s face, and all the thoughts in the world being poured over my mouth and nose and you can’t breathe because if you do you’ll choke on them—

I have two settings as a dad: normal and special mode. Normal mode is used with my eldest son, aged eight. It involves all the regular dad stuff, such as knowing the answers to every possible question, teaching him to ride his bike and generally being hands-on and involved. Special mode is quite different. All of the skills of normal mode apply, and then some. Special mode involves enormous powers of endurance, negotiation, problem solving, vigilance, strength, forbearance, deciphering, arbitration and above all, patience. To be honest, I’m a bit rubbish at all of those things but I strive for them nonetheless, because special mode is required for my youngest son, aged five and diagnosed as high functioning autistic. The two styles of parenting could not be more different.

Let’s take a quick look at what a psychopath is. Although the American Psychiatric Association (APA) no longer uses this term, much of the rest of the world does. The APA has incorporated the term psychopath and sociopath within a broader definition designated as antisocial personality disorder. Even within the APA, there is wide disagreement as to what these terms actually mean. The most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) is an American handbook for mental health professionals. It lists different categories of mental disorders and the criteria for diagnosing them, according to the publishing organization, the American Psychiatric Association. The APA defines antisocial personality disorder, which would include Lobaczewski’s psychopathic personality disorder, as a pervasive pattern of disregard for the violation of the rights of others occurring since age fifteen years, as indicated by three or more of the following:   1.     Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest. 2.     Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. 3.     Impulsivity or failure to plan ahead. 4.     Aggressiveness, as indicated by repeated physical fights or assaults. 5.     Reckless disregard for the safety of self or others. 6.     Consistent irresponsibility. 7.     Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Fifty years ago, I published a study2 devoted to a specific type of depression I had diagnosed in cases of young patients suffering from what I called “unemployment neurosis.” And I could show that this neurosis really originated in a twofold erroneous identification: being jobless was equated with being useless, and being useless was equated with having a meaningless life. Consequently, whenever I succeeded in persuading the patients to volunteer in youth organizations, adult education, public libraries and the like—in other words, as soon as they could fill their abundant free time with some sort of unpaid but meaningful activity—their depression disappeared although their economic situation had not changed and their hunger was the same. The truth is that man does not live by welfare alone.

Fifty years ago, I published a study devoted to a specific type of depression I had diagnosed in cases of young patients suffering from what I called "unemployment neurosis." And I could show that this neurosis really originated in a twofold erroneous identification: being jobless was equated with being useless, and being useless was equated with having a meaningless life. Consequently, whenever I succeeded in persuading the patients to volunteer in youth organizations, adult education, public libraries and the like - in other words, as soon as they could fill their abundant free time with some sort of unpaid but meaningful activity - their depression disappeared although their economic situation had not changed and their hunger was the same. The truth is that man does not live by welfare alone

Some researchers, such as psychologist Jean Twenge, say this new world where compliments are better than sex and pizza, in which the self-enhancing bias has been unchained and allowed to gorge unfettered, has led to a new normal in which the positive illusions of several generations have now mutated into full-blown narcissism. In her book The Narcissism Epidemic, Twenge says her research shows that since the mid-1980s, clinically defined narcissism rates in the United States have increased in the population at the same rate as obesity. She used the same test used by psychiatrists to test for narcissism in patients and found that, in 2006, one in four U.S. college students tested positive. That’s real narcissism, the kind that leads to diagnoses of personality disorders. In her estimation, this is a dangerous trend, and it shows signs of acceleration. Narcissistic overconfidence crosses a line, says Twenge, and taints those things improved by a skosh of confidence. Over that line, you become less concerned with the well-being of others, more materialistic, and obsessed with status in addition to losing all the restraint normally preventing you from tragically overestimating your ability to manage or even survive risky situations. In her book, Twenge connects this trend to the housing market crash of the mid-2000s and the stark increase in reality programming during that same decade. According to Twenge, the drive to be famous for nothing went from being strange to predictable thanks to a generation or two of people raised by parents who artificially boosted self-esteem to ’roidtastic levels and then released them into a culture filled with new technologies that emerged right when those people needed them most to prop up their self-enhancement biases. By the time Twenge’s research was published, reality programming had spent twenty years perfecting itself, and the modern stars of those shows represent a tiny portion of the population who not only want to be on those shows, but who also know what they are getting into and still want to participate. Producers with the experience to know who will provide the best television entertainment to millions then cull that small group. The result is a new generation of celebrities with positive illusions so robust and potent that the narcissistic overconfidence of the modern American teenager by comparison is now much easier to see as normal.

To imagine an end to caste in America, we need only look at the history of Germany. It is living proof that if a caste system—the twelve-year reign of the Nazis—can be created, it can be dismantled. We make a serious error when we fail to see the overlap between our country and others, the common vulnerability in human programming, what the political theorist Hannah Arendt called “the banality of evil.” “It’s all too easy to imagine that the Third Reich was a bizarre aberration,” wrote the philosopher David Livingstone Smith, who has studied cultures of dehumanization. “It’s tempting to imagine that the Germans were (or are) a uniquely cruel and bloodthirsty people. But these diagnoses are dangerously wrong. What’s most disturbing about the Nazi phenomenon is not that the Nazis were madmen or monsters. It’s that they were ordinary human beings.

In particular, I think of the mass of people who are today unemployed. Fifty years ago, I published a studyfn3 devoted to a specific type of depression I had diagnosed in cases of young patients suffering from what I called “unemployment neurosis.” And I could show that this neurosis really originated in a twofold erroneous identification: being jobless was equated with being useless, and being useless was equated with having a meaningless life. Consequently, whenever I succeeded in persuading the patients to volunteer in youth organizations, adult education, public libraries and the like—in other words, as soon as they could fill their abundant free time with some sort of unpaid but meaningful activity—their depression disappeared although their economic situation had not changed and their hunger was the same. The truth is that man does not live by welfare alone.

Critical examination of the lives and beliefs of gurus demonstrates that our psychiatric labels and our conceptions of what is or is not mental illness are woefully inadequate. How for example does one distinguish an unorthodox or bizarre faith from delusion? Gurus are isolated people, dependent upon their disciples with no possibility of being disciplined by a church or criticised by contemporaries. They are above the law. The guru usurps the place of god. Whether gurus have suffered from manic depressive illness, schizophrenia or any other form of recognised diagnosable mental illness is interesting, but ultimately unimportant. What distinguishes gurus from more orthodox teachers is not their manic depressive mood swings, not their thought disorders, not their delusional beliefs, not their hallucinatory visions, not their mystical states of ecstasy. It is their narcissism.

Criteria for Diagnosing Borderline Personality Disorder 1. Frantic efforts to avoid being or feeling abandoned by loved ones. 2. Instability in relationships, including a tendency to idealize and then become disillusioned with relationships. 3. Problems with an unstable sense of self, self-image, or identity. 4. Impulsivity in at least two areas (other than suicidal behavior) that are potentially damaging, such as excessive spending, risky sex, substance abuse, or binge eating. 5. Recurrent suicidal behavior, including thoughts, attempts, or threats of suicide, as well as intentional self-harm that may or may not be life-threatening. 6. Mood swings, including intense negative mood, irritability, and anxiety. Moods usually last a few hours and rarely more than a few days. 7. Chronic feelings of emptiness. 8. Problems controlling intense anger and angry behavior. 9. Transient, stress-related paranoid thoughts or severe dissociation.

Predominantly inattentive type Perhaps the majority of girls with AD/HD fall into the primarily inattentive type, and are most likely to go undiagnosed. Generally, these girls are more compliant than disruptive and get by rather passively in the academic arena. They may be hypoactive or lethargic. In the extreme, they may even seem narcoleptic. Because they do not appear to stray from cultural norms, they will rarely come to the attention of their teacher. Early report cards of an inattentive type girl may read, "She is such a sweet little girl. She must try harder to speak up in class." She is often a shy daydreamer who avoids drawing attention to herself. Fearful of expressing herself in class, she is concerned that she will be ridiculed or wrong. She often feels awkward, and may nervously twirl the ends of her hair. Her preferred seating position is in the rear of the classroom. She may appear to be listening to the teacher, even when she has drifted off and her thoughts are far away. These girls avoid challenges, are easily discouraged, and tend to give up quickly. Their lack of confidence in themselves is reflected in their failure excuses, such as, "I can't," "It's too hard," or "I used to know it, but I can't remember it now." The inattentive girl is likely to be disorganized, forgetful, and often anxious about her school work. Teachers may be frustrated because she does not finish class work on time. She may mistakenly be judged as less bright than she really is. These girls are reluctant to volunteer for a project orjoin a group of peers at recess. They worry that other children will humiliate them if they make a mistake, which they are sure they will. Indeed, one of their greatest fears is being called on in class; they may stare down at their book to avoid eye contact with the teacher, hoping that the teacher will forget they exist for the moment. Because interactions with the teacher are often anxiety-ridden, these girls may have trouble expressing themselves, even when they know the answer. Sometimes, it is concluded that they have problems with central auditory processing or expressive language skills. More likely, their anxiety interferes with their concentration, temporarily reducing their capacity to both speak and listen. Generally, these girls don't experience this problem around family or close friends, where they are more relaxed. Inattentive type girls with a high IQ and no learning disabilities will be diagnosed with AD/HD very late, if ever. These bright girls have the ability and the resources to compensate for their cognitive challenges, but it's a mixed blessing. Their psychological distress is internalized, making it less obvious, but no less damaging. Some of these girls will go unnoticed until college or beyond, and many are never diagnosed they are left to live with chronic stress that may develop into anxiety and depression as their exhausting, hidden efforts to succeed take their toll. Issues

Specifically, participants were asked to describe their relationship with each parent using the following scale: “very close,” “warm and friendly,” “tolerant,” or “strained and cold.” Ninety-one percent of participants who stated that their relationship with their mother was tolerant or strained were diagnosed with a significant health issue (such as cancer, coronary artery disease, hypertension, etc.) in midlife, compared with 45 percent of participants—less than half—who reported that their relationship with their mothers was warm or close. Similar numbers were reported for participants who described their relationship with their fathers. Eighty-two percent of the participants who reported tolerant or strained relationships with their fathers had significant health issues in midlife, compared with 50 percent of those who had warm or close relationships with their fathers. If participants had a strained relationship with both parents, the results were startling: 100 percent had significant health issues, versus 47 percent of those who described their relationships with their parents as being warm and close.1

the new “affirmative-care” standard of mental health professionals is a different matter entirely. It surpasses sympathy and leaps straight to demanding that mental health professionals adopt their patients’ beliefs of being in the “wrong body.” Affirmative therapy compels therapists to endorse a falsehood: not that a teenage girl feels more comfortable presenting as a boy—but that she actually is a boy. This is not a subtle distinction, and it isn’t just a matter of humoring a patient. The whole course of appropriate treatment hinges on whether doctors view the patient as a biological girl suffering mental distress or a boy in a girl’s body. But the “affirmative-care” standard, which chooses between these diagnoses before the patient is even examined, has been adopted by nearly every medical accrediting organization. The American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American Psychological Association, and the Pediatric Endocrine Society have all endorsed “gender-affirming care” as the standard for treating patients who self-identify as “transgender” or self-diagnose as “gender dysphoric.

After gathering evidence on this for decades, Alan concluded that “none of what I originally believed turned out to be true,” and a “clear majority” of the kids who were later diagnosed “were not born to be ADHD. They developed these problems in reaction to their circumstances.” There was one crucial question, Alan said, that held the key to whether parents overcame these problems—one that seemed to me to tell us a lot about Sami’s work: Is there somebody giving you support? The families they studied sometimes got help from people around them. It usually wasn’t from a professional—they just found a supportive partner, or a group of friends. When their social support went up in this way, they found “the children are less likely to have problems at the next stage.” Why would this be? Alan wrote: “Parents experiencing less stress can be more responsive to their infants; then infants can become more secure.” This effect was so large that “the strongest predictor of positive change was an increase in social support available to the parents during the intervening years.” Social support is, I reflected, the main thing Sami provides to families whose children struggle with attention.

Western medicine’s love of drawing people into diagnostic categories and applying disease names to small differences and minor bodily changes is not specific to functional disorders – it is a general trend. Pre-diabetes, polycystic ovaries, some cancers and many more conditions have all been subject to the problem of over-inclusive diagnosis. My biggest concern in this regard is the degree to which many people are wholly unaware of the subjective nature of the medical classification of disease. If a person is told they have this or that disorder, they assume it must be right. The Latin names we give to things and the shiny scanning machines make it look as if there is more authority than actually exists. To a certain extent, Sienna pursued each diagnosis she was given, but other people have diagnoses thrust upon them, having no idea that there might be anything controversial about it – and having no idea that they have a choice. Western medicine’s hold on people, and its sense of being systematic and accurate, makes it a powerful force in the transmission of cultural concepts of what constitutes wellness or ill health. But Western medicine is just as enslaved to fads and trends as any other tradition of medicine.

IN THE PAST, when dying was typically a more precipitous process, we did not have to think about a question like this. Though some diseases and conditions had a drawn-out natural history—tuberculosis is the classic example—without the intervention of modern medicine, with its scans to diagnose problems early and its treatments to extend life, the interval between recognizing that you had a life-threatening ailment and dying was commonly a matter of days or weeks. Consider how our presidents died before the modern era. George Washington developed a throat infection at home on December 13, 1799, that killed him by the next evening. John Quincy Adams, Millard Fillmore, and Andrew Johnson all succumbed to strokes and died within two days. Rutherford Hayes had a heart attack and died three days later. Others did have a longer course: James Monroe and Andrew Jackson died from progressive and far longer-lasting (and highly dreaded) tubercular consumption. Ulysses Grant’s oral cancer took a year to kill him. But, as end-of-life researcher Joanne Lynn has observed, people generally experienced life-threatening illness the way they experienced bad weather—as something that struck with little warning. And you either got through it or you didn’t.

I began to see that the stronger a therapy emphasized feelings, self-esteem, and self-confidence, the more dependent the therapist was upon his providing for the patient ongoing, unconditional, positive regard. The more self-esteem was the end, the more the means, in the form of the patient’s efforts, had to appear blameless in the face of failure. In this paradigm, accuracy and comparison must continually be sacrificed to acceptance and compassion; which often results in the escalation of bizarre behavior and bizarre diagnoses. The bizarre behavior results from us taking credit for everything that is positive and assigning blame elsewhere for anything negative. Because of this skewed positive-feedback loop between our judged actions and our beliefs, we systematically become more and more adapted to ourselves, our feelings, and our inaccurate solitary thinking; and less and less adapted to the environment that we share with our fellows. The resultant behavior, such as crying, depression, displays of temper, high-risk behavior, or romantic ventures, or abandonment of personal responsibilities, which seem either compulsory, necessary, or intelligent to us, will begin to appear more and more irrational to others. The bizarre diagnoses occur because, in some cases, if a ‘cause disease’ (excuse from blame) does not exist, it has to be 'discovered’ (invented). Psychiatry has expanded its diagnoses of mental disease every year to include 'illnesses’ like kleptomania and frotteurism [now frotteuristic disorder in the DSM-V]. (Do you know what frotteurism is? It is a mental disorder that causes people, usually men, to surreptitiously fondle women’s breasts or genitals in crowded situations such as elevators and subways.) The problem with the escalation of these kinds of diagnoses is that either we can become so adapted to our thinking and feelings instead of our environment that we will become dissociated from the whole idea that we have a problem at all; or at least, the more we become blameless, the more we become helpless in the face of our problems, thinking our problems need to be 'fixed’ by outside help before we can move forward on our own. For 2,000 years of Western culture our problems existed in the human power struggle constantly being waged between our principles and our primal impulses. In the last fifty years we have unprincipled ourselves and become what I call 'psychologized.’ Now the power struggle is between the 'expert’ and the 'disorder.’ Since the rise of psychiatry and psychology as the moral compass, we don’t talk about moral imperatives anymore, we talk about coping mechanisms. We are not living our lives by principles so much as we are living our lives by mental health diagnoses. This is not working because it very subtly undermines our solid sense of self.

I’m the living dead. I feel no connection to any other human. I have no friends and I don’t really care much about my family any longer. I feel no love for them. I can feel no joy. I’m incapable of feeling physical pleasure. There’s nothing to ever look forward to as a result. I don’t miss anyone or anything. I eat because I feel hunger pangs, but no food tastes like anything I like. I wear a mask when I’m with other people but it’s been slipping lately. I can’t find the energy to hide the heavy weight of survival and its effect on me. I’m exhausted all the time from the effort of just making it through the day. This depression has made a mockery of my memory. It’s in tatters. I have no good memories to sustain me. My past is gone. My present is horrid. My future looks like more of the same. In a way, I’m a man without time. Certainly, there’s no meaning in my life. What meaning can there be without even a millisecond of joy? Ah, scratch that. Let’s even put aside joy and shoot for lower. How about a moment of being content? Nope. Not a chance. I see other people, normal people, who can enjoy themselves. I hear people laughing at something on TV. It makes me cock my head and wonder what that’s like. I’m sure at sometime in my past, I had to have had a wonderful belly laugh. I must have laughed so hard once or twice that my face hurt. Those memories are gone though. Now, the whole concept of “funny” is dead. I stopped going to movies a long time ago. Sitting in a theater crowded with people, every one of them having a better time than you, is incredibly damaging. I wasn’t able to focus for that long anyway. Probably for the best. Sometimes I fear the thought of being normal again. I think I wouldn’t know how to act. How would I handle being able to feel? Gosh it would be nice to feel again. Anything but this terrible, suffocating pain. The sorrow and the misery is so visceral, I find myself clenching my jaw. It physically hurts me. Then I realize that it’s silly to worry about that. You see, in spite of all the meds, the ketamine infusions and other treatments, I’m not getting better. I’m getting worse. I was diagnosed 7 years ago but I’m sure I was suffering for longer. Of course, I can’t remember that, but depression is something that crept up on me. It’s silent and oppressive. I don’t even remember what made me think about going to see someone. But I did and it was a pretty clear diagnosis. So, now what? I keep waking up every morning unfortunately. I don’t fear death any more. That’s for sure. I’ve made some money for the couple of decades I’ve been working and put it away in retirement accounts. I think about how if I was dead that others I once cared for would get that money. Maybe it could at least help them. I don’t know that I’ll ever need it. Even if I don’t end it myself, depression takes a toll on the body. My life expectancy is estimated to be 14 years lower as a result according to the NIH. It won’t be fast enough though. I’m just an empty biological machine that doesn’t know that my soul is gone. My humanity is no more

The crime was discovered when Trina became pregnant. As is often the case, the correctional officer was fired but not criminally prosecuted. Trina remained imprisoned and gave birth to a son. Like hundreds of women who give birth while in prison, Trina was completely unprepared for the stress of childbirth. She delivered her baby while handcuffed to a bed. It wasn’t until 2008 that most states abandoned the practice of shackling or handcuffing incarcerated women during delivery. Trina’s baby boy was taken away from her and placed in foster care. After this series of events—the fire, the imprisonment, the rape, the traumatic birth, and then the seizure of her son—Trina’s mental health deteriorated further. Over the years, she became less functional and more mentally disabled. Her body began to spasm and quiver uncontrollably, until she required a cane and then a wheelchair. By the time she had turned thirty, prison doctors diagnosed her with multiple sclerosis, intellectual disability, and mental illness related to trauma. Trina had filed a civil suit against the officer who raped her, and the jury awarded her a judgment of $62,000. The guard appealed, and the Court reversed the verdict because the correctional officer had not been permitted to tell the jury that Trina was in prison for murder. Consequently, Trina never received any financial aid or services from the state to compensate her for being violently raped by one of its “correctional” officers. In 2014, Trina turned fifty-two. She has been in prison for thirty-eight years. She is one of nearly five hundred people in Pennsylvania who have been condemned to mandatory life imprisonment without parole for crimes they were accused of committing when they were between the ages of thirteen and seventeen. It is the largest population of child offenders condemned to die in prison in any single jurisdiction in the world.

I remember being asked at a conference, "If you could be cured of HIV today, but when the disease left your body, it took with it all the strength, unconditional love, compassion, endurance, and empowerment that you have acquired since being diagnosed, would you still agree to being cured?" I thought really long and hard about my answer and with tears in my eyes I proudly held my head up and replied, "No.