Dsm Live Quotes

Dissociative symptoms—primarily depersonalization and derealization—are elements in other DSM-IV disorders, including schizophrenia and borderline personality disorder, and in the neurologic syndrome of temporal lobe epilepsy, also called complex partial seizures. In this latter disorder, there are often florid symptoms of depersonalization and realization, but most amnesia symptoms derive from difficulties with focused attention rather than forgetting previously learned information.

The forward to the landmark 1980 DSM III was appropriately modest and acknowledged that this diagnostic system was imprecise. So imprecise that it never should be used for forensic or insurance purposes. As we will see that modesty was tragically short lived.

Mental disorders should be diagnosed only when the presentation is clear-cut, severe, and clearly not going away on its own. The best way to deal with the everyday problems of living is to solve them directly or to wait them out, not to medicalize them with a psychiatric diagnosis or treat them with a pill.

The foreword to the landmark 1980 DSM-III was appropriately modest and acknowledged that this diagnostic system was imprecise—so imprecise that it never should be used for forensic or insurance purposes.8 As we will see, that modesty was tragically short-lived.

The SCID-D-R's standard for "distinct identities or personality states" (DSM-IV, p. 487) is: "Persistent manifestations of the presence of different personalities, as indicated by at least four of the following: a) ongoing dialogues between different people; b) acting or feeling that the different people inside of him/her take control of his/her behavior or speech; c) characteristic visual image that is associated with the other person, distinct from the subject; d) characteristic age associated with the different people inside of him/her; e) feeling that the different people inside of him/her have different memories, behaviors, and feelings; f) feeling that the different people inside of him/her are separate from his/her personality and have lives of their own" (Steinberg, 1994, p. 106). [The author believes that it is of considerable importance that none of the SCID-D-R's six criteria for "distinct personalities or personality states" are observable signs; each of the six is a subjective symptom or experience that must be reported to the test administrator. This striking fact supports the contention that assessment of dissociation should be based on subjective symptoms rather than signs (Dell, 2006b. 2009b).]

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.

Prior to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of Dissociative Identity Disorder had been referred to as Multiple Personality Disorder. The renaming of this diagnosis has caused quite a bit of confusion among professionals and those who live with DID. Because dissociation describes the process by which DID begins to develop, rather than the actual outcome of this process (the formation of various personalities), this new term may be a bit unclear. We know that the diagnosis is DID and that DID is what people say we have. We’d just like to point out that words sometimes do not describe what we live with. For people like us, DID is just a step on the way to where we live—a place with many of us inside! We just want people who have little ones and bigger ones living inside to know that the title Dissociative Identity Disorder sounds like something other than how we see ourselves—we think it is about us having different personalities. Regardless of the term, it is clear that, in general, the different personalities develop as a reaction to severe trauma. When the person dissociates, they leave their body to get away from the pain or trauma. When this defense is not strong enough to protect the person, different personalities emerge to handle the experience. These personalities allow the child to survive: when the child is being harmed or experiencing traumatic episodes, the other personalities take the pain and/ or watch the bad things. This allows these children to return to their body after the bad things have happened without any awareness of what has occurred. They do this to create different ways to make sense of the harm inflicted upon them; it is their survival mechanism.

[O]ur inner lives are too important to leave in the hands of doctors [,] because they don't know as much about us as they claim, because a full account of human nature is beyond their ken.

The grief exception revealed something that the authors of the DSM—the distillation of mainstream psychiatric thinking—were deeply uncomfortable with. They had been forced to admit, in their own official manual, that it’s reasonable—and perhaps even necessary—to show the symptoms of depression, in one set of circumstances. But once you’ve conceded that,4 it invites an obvious follow-up question. Why is a death the only event that can happen in life where depression is a reasonable response? Why not if your husband has left you after thirty years of marriage? Why not if you are trapped for the next thirty years in a meaningless job you hate? Why not if you have ended up homeless and you are living under a bridge? If it’s reasonable in one set of circumstances, could there also be other circumstances where it is also reasonable?

Maybe, abnormal is not defined by a list of ettiquette rules you don't follow or even the symptoms listed in the DSM manual. Maybe, it isn't defined by a person's anger or how they react to prolonged emotional, physical, psychological or sexual abuse. Maybe, it isn't in the rituals people do to cope when they are hurt, lost or confused. Maybe, abnormal is found not in how we live or even in how we survive. Maybe, abnormal is something as simple as going against choosing the right. Maybe, madness is in the things we do that goes against the very nature of all that is good and true. Maybe, just maybe, normal is something as simple as not hurting someone for your own gain.

Do You Have DID? Determining if you have DID isn’t as easy as it sounds. In fact, many clinicians and psychotherapists have such difficulty figuring out whether or not people have DID that it typically takes them several years to provide an accurate diagnosis. Because many of the symptoms of DID overlap with other psychological diagnoses, as well as normal occurrences such as forgetfulness or talking to yourself, there is a great deal of confusion in making the diagnosis of DID. Although this section will provide you with information which may help you determine if you have DID, it is a good idea to consult with a professional in the mental health field so that you can have further confirmation of your findings.

The DSM-5 defines depression as a person having multiple symptoms, which may include a depressed mood, loss of energy, diminished ability to concentrate, changes in appetite, and decreased interest or pleasure in normally enjoyable activities, for more than a two-week period. It also states that depression is disruptive, meaning that a person’s decreased mood is interfering with their ability to comfortably live their lives. A person with depression may have a lot of trouble getting out of bed in the morning, finishing basic tasks, or connecting with friends and family. One of my patients once described depression to me as what happens when life loses its color—and I think that’s a very illuminating description.

it me, or do these names seem fabricated? Could you match each of these names with its literary mate or author? Rat Crancer (probably a gumshoe). Powder D. Coulter. Weymouth Crumpler (longtime friend of Little Miss Muffett). Pansy Hines. Donald Dumbleton (wouldn’t you know, he had a timothy-head screwdriver in his esophagus). Alice Dalrymple. Zadie Smallwood. Mrs. L. Stretch. Myrtle Yonders (sister of Thistle Near). Anna Skeen (I think she appears in Gertrude Stein’s Three Lives). Florabelle Sledge (an oxymoronish personage). Sister Mary Octave. Waldo Intermill. Evelyn Marie Loveless. Irma Erben (William Wilson’s cousin and Humbert Humbert’s wife). Linnwood Wheeloff (hadn’t Henry James made a place for him in The Americans?), and the incomparably unbelievable Sister Mary Pica—“pica” being the DSM-IV descriptor for disordered swallowing.

Mental health is an enormous business; in the United States, more money is spent on mental health conditions than any other medical specialty, with an estimated $201 billion spent in 2013 alone and an estimated increase to $280 billion by 2020 (Substance Abuse and Mental Health Services Administration, 2014). More than half of the budget for the American Psychiatric Association is income received directly from pharmaceutical companies, and drug-makers are the most frequent and largest donors of mental health advocacy groups (see, e.g., Harris, 2009). Speaking and consulting gigs for the pharmaceutical industry can earn psychiatrists up to $1 million or more in direct fees per year,4 and at least 70% of the professionals making up the task force for the DSM were tied to pharmaceutical companies (Cosgrove & Krimsky, 2012), raising concerns about corporate interests reflected in practice and policy and accusations of disease mongering (Moynihan, Heath, & Henry, 2002). The incentive for ensuring the medical and biological framework for conceptualizing problems in living is huge.

Some radical critics of psychiatry have seized on its definitional ambiguities to argue that the profession should not exist at all. They take the difficulty in finding a clear definition of mental disorder as evidence that the concept has no useful meaning - if mental disorders are not anatomically defined medical diseases, they must be "myths," and there is no real need to bother diagnosing them. [...] This shibboleth can be believed only by armchair theorists with no real life experience in having, living with, or treating mental illness. However difficult to define, psychiatric disorder is an all-too-painful reality for those who suffer from it and for those who care about them.