Same Mental Disorder Quotes

Killing yourself slowly is still killing yourself. Wanting to die is not the same as wanting to come home. Recovery is hard work. Not wanting to die is hard work.

The good part about having a mental disorder is having a valid reason for all the stupid things we do because of a damaged prefrontal cortex. However, the best part is seeing someone completely sane do the exact same things, without a valid excuse. This is the great equalizer of God and his little gift for all us crazy people to enjoy.

I've invaded the walls of the asylums with my ink pen. The way they look at mental illness won't be the same again

It is growing up different. It is extreme hypersensitivity. It is a bottomless pit of feeling you're failing, but three days later, you feel you can do anything, only to end the week where you began. It is not learning from your mistakes. It is distrusting people because you have been hurt enough. It is moments of knowing your pain is self inflicted, followed by blaming the world. It is wanting to listen, but you just can’t anymore because your life has been to full of people that have judged you. It is fighting to be right; so for once in your life someone will respect and hear you for a change. It is a tiring life of endless games with people, in order to seek stimulus. It is a hyper focus, so intense about what bothers you, that you can’t pay attention to anything else, for very long. It is a never-ending routine of forgetting things. It is a boredom and lack of contentment that keeps you running into the arms of anyone that has enough patience to stick around. It wears you out. It wears everyone out. It makes you question God’s plan. You misinterpret everything, and you allow your creative mind to fill the gaps with the same old chains that bind you. It narrows your vision of who you let into your life. It is speaking and acting without thinking. It is disconnecting from the ones you love because your mind has taken you back to what you can’t let go of. It is risk taking, thrill seeking and moodiness that never ends. You hang your hope on “signs” and abandon reason for remedy. It is devotion to the gifts and talents you have been given, that provide temporary relief. It is the latching onto the acceptance of others---like a scared child abandoned on a sidewalk. It is a drive that has no end, and without “focus” it takes you nowhere. It is the deepest anger when someone you love hurts you, and the greatest love when they don't. It is beauty when it has purpose. It is agony when it doesn’t. It is called Attention Deficit Disorder.

Creativity is paradoxical. To create, a person must have knowledge but forget the knowledge, must see unexpected connections in things but not have a mental disorder, must work hard but spend time doing nothing as information incubates, must create many ideas yet most of them are useless, must look at the same thing as everyone else, yet see something different, must desire success but embrace failure, must be persistent but not stubborn, and must listen to experts but know how to disregard them." [Twelve Things You Were Not Taught in School About Creative Thinking (The Creativity Post, December 6, 2011)]

I’ve found that it’s of some help to think of one’s moods and feelings about the world as being similar to weather. Here are some obvious things about the weather: It's real. You can't change it by wishing it away. If it's dark and rainy, it really is dark and rainy, and you can't alter it. It might be dark and rainy for two weeks in a row. BUT it will be sunny one day. It isn't under one's control when the sun comes out, but come out it will. One day. It really is the same with one's moods, I think. The wrong approach is to believe that they are illusions. Depression, anxiety, listlessness - these are all are real as the weather - AND EQUALLY NOT UNDER ONE'S CONTROL. Not one's fault. BUT They will pass: really they will. In the same way that one really has to accept the weather, one has to accept how one feels about life sometimes, "Today is a really crap day," is a perfectly realistic approach. It's all about finding a kind of mental umbrella. "Hey-ho, it's raining inside; it isn't my fault and there's nothing I can do about it, but sit it out. But the sun may well come out tomorrow, and when it does I shall take full advantage.

Just to let you know I don't post my books and things on the net in hopes of being rich. The reason is. "I am a person with Bipolar Disorder" and they're are a lot of great minds on the "Famous Bipolar" list that died penniless. If I do the same it's no big deal but having a form of mental Illness I would love to get my name on the Bipolar list also one day. Preferably while I'm still living so I can make sure they spelled it right

No two eating disorders are the same. No two individuals are the same. No two paths to recovery are the same. But everyone's strength to reach recovery IS the same.

It's feeling full of everything and empty of it all at the same time. This is mental illness.

Eating disorders are insidious and subtly manipulative. The behaviors that initially feel like relief are the same ones that will eventually ruin you.

As it stands, the diagnostic criteria for depression are so loose that two people with absolutely no symptoms in common can both end up with the same unitary diagnosis of depression. For this reason especially, the concept of depression as a mental disorder has been charged with being little more than a socially constructed dustbin for all manner of human suffering.

Healing requires you to be vulnerable and strong at the same time.

Coping with any death is traumatic; suicide compounds the anguish because we are forced to deal with two traumatic events at the same time. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the level of stress resulting from the suicide of a loved one is ranked as catastrophic–equivalent to that of a concentration camp experience.

But what shall we say, when an individual discovers a revelation addressed to himself alone, on the same vast sheet of record. In such a case, it could only be the symptom of a highly disordered mental state, when a man, rendered morbidly self-contemplative by long, intense, and secret pain, had extended his egotism over the whole expanse of nature, until the firmament itself should appear no more than a fitting page for his soul's history and fate.

Whereas an Otaku is a true connoisseur of the culture, showing the same reverence and respectful distance which any true expert shows to their chosen field of expertise, the Weeaboo is like a socially awkward adolescent, ineptly trying to gain the social acceptance of Japanese people — because their unfortunate mental disorder has caused them to believe they are, in fact, Japanese.

Let me stop here and correct a very common misconception: personality disorders are not the same classification of mental health disorders, such as Bipolar Disorder or Major Depressive Disorder.

As a therapist, I have many avenues in which to learn about DID, but I hear exactly the opposite from clients and others who are struggling to understand their own existence. When I talk to them about the need to let supportive people into their lives, I always get a variation of the same answer. "It is not safe. They won't understand." My goal here is to provide a small piece of that gigantic puzzle of understanding. If this book helps someone with DID start a conversation with a supportive friend or family member, understanding will be increased.

The movement of descent and discovery begins at the moment you consciously become dissatisfied with life. Contrary to most professional opinion, this gnawing dissatisfaction with life is not a sign of "mental illness," nor an indication of poor social adjustment, nor a character disorder. For concealed within this basic unhappiness with life and existence is the embryo of a growing intelligence, a special intelligence usually buried under the immense weight of social shams. A person who is beginning to sense the suffering of life is, at the same time, beginning to awaken to deeper realities, truer realities. For suffering smashes to pieces the complacency of our normal fictions about reality, and forces us to become alive in a special sense—to see carefully, to feel deeply, to touch ourselves and our worlds in ways we have heretofore avoided. It has been said, and truly I think, that suffering is the first grace. In a special sense, suffering is almost a time of rejoicing, for it marks the birth of creative insight. But only in a special sense. Some people cling to their suffering as a mother to its child, carrying it as a burden they dare not set down. They do not face suffering with awareness, but rather clutch at their suffering, secretly transfixed with the spasms of martyrdom. Suffering should neither be denied awareness, avoided, despised, not glorified, clung to, dramatized. The emergence of suffering is not so much good as it is a good sign, an indication that one is starting to realize that life lived outside unity consciousness is ultimately painful, distressing, and sorrowful. The life of boundaries is a life of battles—of fear, anxiety, pain, and finally death. It is only through all manner of numbing compensations, distractions, and enchantments that we agree not to question our illusory boundaries, the root cause of the endless wheel of agony. But sooner or later, if we are not rendered totally insensitive, our defensive compensations begin to fail their soothing and concealing purpose. As a consequence, we begin to suffer in one way or another, because our awareness is finally directed toward the conflict-ridden nature of our false boundaries and the fragmented life supported by them.

Basically, everything that happens in our life is our fault and ours alone. A lot of people go through the same difficulties we went through, and they react completely differently. We looked for the easiest way out: a separate reality

Schizo. It didn't matter how many times Dr. Gill compared it to a disease or physical disability, it wasn't the same thing. It just wasn't. I had schizophrenia. If I saw two guys on the sidewalk, one in a wheelchair and one talking talking to himself, which would I rush to open a door for, and which would I cross the road to avoid?

As much as the left fashions themselves as being progressive, they’re not. In reality, today’s leftist movement is made in much the same way as a sausage—it’s a blend of fascist, communist, and socialist ideologies from twentieth-century Europe, with a pinch of Nazism, all ground together, yet retaining the flavor of its various parts.

Being trauma informed must include respecting and honouring the fact that what is learned from the experience of trauma is a kind of knowledge, in the same way that what we learn about trauma is knowledge. In both cases, what is known is contextual and deeply nuanced.

Somehow the disorder hooks into all kinds of fears and insecurities in many clinicians. The flamboyance of the multiple, her intelligence and ability to conceptualize the disorder, coupled with suicidal impulses of various orders of seriousness, all seem to mask for many therapists the underlying pain, dependency, and need that are very much part of the process. In many ways, a professional dealing with a multiple in crisis is in the same position as a parent dealing with a two-year-old or with an adolescent's acting-out behavior. (236)

Black-and-white thinking is the addict's mentality, which can be a bar to recovery when one is still active. But an addict who finds the willingness can then rely on the same trait to stay clean: "Just don't drink," they say in AA. How's that going to work for an addicted eater? Food addicts have to take the tiger out of the cage three times a day. I've read that some drinkers have tried "controlled drinking," and it hasn't been very successful. Eaters don't just have to try it; they must practice it to survive. Having a food plan is an attempt to address that, and having clear boundaries is a key to its working. But the comfort of all or nothing is just out of reach. ... I'm saying that food addicts, unlike alcoholics and may others, have both to try for perfection and to accept that perfection is unattainable, and that the only tool left is a wholesome discipline. The problem is, if we had any clue about wholesome discipline, we wouldn't be addicts.

In the 1980s, research on post traumatic stress disorder in Vietnam veterans was regarded as important, noble, and useful. When the same researchers looked at the same problem in children who had been sexually abused, a tremendous controversy ensued a controversy that persists to this day. There were those who disputed the extent and severity of the sexual abuse that had been uncovered.

In the same way that the women's movement of the seventies and eighties brought rape and incest into public consciousness, we can do the same with the causes and reality of dissociation and multiplicity.

I had a bizarre rapport with this mirror and spent a lot of time gazing into the glass to see who was there. Sometimes it looked like me. At other times, I could see someone similar but different in the reflection. A few times, I caught the switch in mid-stare, my expression re-forming like melting rubber, the creases and features of my face softening or hardening until the mutation was complete. Jekyll to Hyde, or Hyde to Jekyll. I felt my inner core change at the same time. I would feel more confident or less confident; mature or childlike; freezing cold or sticky hot, a state that would drive Mum mad as I escaped to the bathroom where I would remain for two hours scrubbing my skin until it was raw. The change was triggered by different emotions: on hearing a particular piece of music; the sight of my father, the smell of his brand of aftershave. I would pick up a book with the certainty that I had not read it before and hear the words as I read them like an echo inside my head. Like Alice in the Lewis Carroll story, I slipped into the depths of the looking glass and couldn’t be sure if it was me standing there or an impostor, a lookalike. I felt fully awake most of the time, but sometimes while I was awake it felt as if I were dreaming. In this dream state I didn’t feel like me, the real me. I felt numb. My fingers prickled. My eyes in the mirror’s reflection were glazed like the eyes of a mannequin in a shop window, my colour, my shape, but without light or focus. These changes were described by Dr Purvis as mood swings and by Mother as floods, but I knew better. All teenagers are moody when it suits them. My Switches could take place when I was alone, transforming me from a bright sixteen-year-old doing her homework into a sobbing child curled on the bed staring at the wall. The weeping fit would pass and I would drag myself back to the mirror expecting to see a child version of myself. ‘Who are you?’ I’d ask. I could hear the words; it sounded like me but it wasn’t me. I’d watch my lips moving and say it again, ‘Who are you?

Mind you, I cannot swear that my story is true. It may have been a dream; or worse, a symptom of some severe mental disorder. But I believe it is true. After all, how are we to know what things there are on earth? Strange monstrosities still exist, and foul, incredible perversions. Every war, each new geographical or scientific discovery, brings to light some new bit of ghastly evidence that the world is not altogether the same place we fondly imagine it to be. Sometimes peculiar incidents occur which hint of utter madness. How can we be sure that our smug conceptions of reality actually exist? To one man in a million dreadful knowledge is revealed, and the rest of us remain mercifully ignorant. There have been travelers who never came back, and research workers who disappeared. Some of those who did return were deemed mad because of what they told, and others sensibly concealed the wisdom that had so horribly been revealed. Blind as we are, we know a little of what lurks beneath our normal life. There have been tales of sea serpents and creatures of the deep; legends of dwarfs and giants; records of queer medical horrors and unnatural births. Stunted nightmares of men's personalities have blossomed into being under the awful stimulus of war, or pestilence, or famine. There have been cannibals, necrophiles, and ghouls; loathsome rites of worship and sacrifice; maniacal murders, and blasphemous crimes. When I think, then, of what I saw and heard, and compare it with certain other grotesque and unbelievable authenticities, I begin to fear for my reason. ("The Mannikin")

Cheryl was aided in her search by the Internet. Each time she remembered a name that seemed to be important in her life, she tried to look up that person on the World Wide Web. The names and pictures Cheryl found were at once familiar and yet not part of her conscious memory: Dr. Sidney Gottlieb, Dr. Louis 'Jolly' West, Dr. Ewen Cameron, Dr. Martin Orne and others had information by and about them on the Web. Soon, she began looking up sites related to childhood incest and found that some of the survivor sites mentioned the same names, though in the context of experiments performed on small children. Again, some names were familiar. Then Cheryl began remembering what turned out to be triggers from old programmes. 'The song, "The Green, Green Grass of home" kept running through my mind. I remembered that my father sang it as well. It all made no sense until I remembered that the last line of the song tells of being buried six feet under that green, green grass. Suddenly, it came to me that this was a suicide programme of the government. 'I went crazy. I felt that my body would explode unless I released some of the pressure I felt within, so I grabbed a [pair ofl scissors and cut myself with the blade so I bled. In my distracted state, I was certain that the bleeding would let the pressure out. I didn't know Lynn had felt the same way years earlier. I just knew I had to do it Cheryl says. She had some barbiturates and other medicine in the house. 'One particularly despondent night, I took several pills. It wasn't exactly a suicide try, though the pills could have killed me. Instead, I kept thinking that I would give myself a fifty-fifty chance of waking up the next morning. Maybe the pills would kill me. Maybe the dose would not be lethal. It was all up to God. I began taking pills each night. Each-morning I kept awakening.

Fracturing of the psyche is said to be conducive to creating the phenomenon that has been termed sleeper assassins. According to such theories, the first psychiatrists employed to master mind control studied mental patients who had been diagnosed with Multiple Personality Disorder, which medical science has since renamed Dissociative Identity Disorder. Many of those psychiatrists are said to have been Paperclip Nazi doctors who were brought to the US after conducting radical psychiatric experiments on patients during the Holocaust – the same doctors whose victims not only included Jews, Gyspies, political agitators and homosexuals, but also the mentally ill.

I have called this mental defect the Lucretius problem, after the Latin poetic philosopher who wrote that the fool believes that the tallest mountain in the world will be equal to the tallest one he has observed. We consider the biggest object of any kind that we have seen in our lives or hear about as the largest item that can possibly exist. And we have been doing this for millenia. In Pharaonic Egypt, which happens to be the first complete top-down nation-state managed by bureaucrats, scribes tracked the high-water mark of the Nile and used it as an estimate for a future worst-case scenario. The same can be seen in the Fukushima nuclear reactor, which experienced a catastrophic failure in 2011 when a tsunami struck. It had been built to withstand the worst past historical earthquake, with the builders not imagining much worse--and not thinking that the worst past event had to be a surprise, as it had no precedent. Likewise, the former chairman of the Federal Reserve, Fragilista Doctor Alan Greenspan, in his apology to Congress offered the classic "It never happened before." Well, nature, unlike Fragilista Greenspan, prepares for what has not happened before, assuming worse harm is possible.

It is comic that a mentally disordered man picks up any piece of granite and carries it around because he thinks it is money, and in the same way it is comic that Don Juan has 1,003 mistresses, for the number simply indicates that they have no value. Therefore, one should stay within one’s means in the use of the word "love".

Rikki looked over at me. “Why now?" she asked, looking back at Arly. “Why is this happening now?" "Hard to say." Arly [therapist] replied. "DID usually gets diagnosed in adulthood. Something happens that triggers the alters to come out. When Cam's father died and he came in to help his brother run the family business he was in close contact with his mother again. Maybe it was seeing Kyle around the same age when some of the abuse happened. Cam was sick for a long time and finally got better. Maybe he wasn't strong enough until now to handle this. It's probably a combination of things. But it sure looks like some of the abuse Cam experienced involved his mother. And sexual abuse by the mother is considered to he one of the most traumatic forms of abuse. In some ways it's the ultimate betrayal.

I had to accept that there was something wrong with me and stop making excuses for my behavior. A mental disorder is not like a physical one. My mind and I are not one and the same. I don’t trust myself all the time, but I am working on that. I’m working to rewire my brain.

Pain is pain She lost her baby Her life fell apart Everyone was there for her lending a helping hand all the time On the other side she failed her final school year It hurt her so much People didn't support her as she drowned in her pain and failure You see it really doesn't matter what caused your pain It's all the same my dear So never feel why is she crying over a failing year awhile I lost my baby Don't ever compare Pain is pain Maybe a different reason But pain is pain

It didn't matter that so much of what they said made logical sense- or that I couldn't find any more plausible alternatives. I didn't have multiple personalities, I just didn't - and that was that. And then one day, several years after our first meeting, I walked out of Professor Morton's room and thought. What if he's right? What if there are multiple personalities living in this same body? Suddenly, for the first time in my life. the whole world began to make perfect sense to me.

To the men and women who changed Cheryl Hersha's life, she was a continuation of the research that had first been conducted in the late nineteenth and early twentieth centuries by Dr. Morton Prince. He encountered a woman named Miss Beauchamp, a nursing student who was referred to the psychiatrist because of health problems. As he worked with her, Prince discovered that she had four separate personalities (dissociated ego states) that existed independently of one another within the same body. Though he tried, Dr. Prince never understood Miss Beauchamp, nor was he able to help her. When he died, his wife had the woman committed to an insane asylum for the rest of her life. However, Prince's careful documentation of Beauchamp's symptoms, actions and family history (extreme child abuse beginning before the age of seven) provided information needed to develop the techniques for contemporary, routinely successful treatment of what would be called Multiple Personality Disorder.

I resolved to come right to the point. "Hello," I said as coldly as possible, "we've got to talk." "Yes, Bob," he said quietly, "what's on your mind?" I shut my eyes for a moment, letting the raging frustration well up inside, then stared angrily at the psychiatrist. "Look, I've been religious about this recovery business. I go to AA meetings daily and to your sessions twice a week. I know it's good that I've stopped drinking. But every other aspect of my life feels the same as it did before. No, it's worse. I hate my life. I hate myself." Suddenly I felt a slight warmth in my face, blinked my eyes a bit, and then stared at him. "Bob, I'm afraid our time's up," Smith said in a matter-of-fact style. "Time's up?" I exclaimed. "I just got here." "No." He shook his head, glancing at his clock. "It's been fifty minutes. You don't remember anything?" "I remember everything. I was just telling you that these sessions don't seem to be working for me." Smith paused to choose his words very carefully. "Do you know a very angry boy named 'Tommy'?" "No," I said in bewilderment, "except for my cousin Tommy whom I haven't seen in twenty years..." "No." He stopped me short. "This Tommy's not your cousin. I spent this last fifty minutes talking with another Tommy. He's full of anger. And he's inside of you." "You're kidding?" "No, I'm not. Look. I want to take a little time to think over what happened today. And don't worry about this. I'll set up an emergency session with you tomorrow. We'll deal with it then." Robert This is Robert speaking. Today I'm the only personality who is strongly visible inside and outside. My own term for such an MPD role is dominant personality. Fifteen years ago, I rarely appeared on the outside, though I had considerable influence on the inside; back then, I was what one might call a "recessive personality." My passage from "recessive" to "dominant" is a key part of our story; be patient, you'll learn lots more about me later on. Indeed, since you will meet all eleven personalities who once roamed about, it gets a bit complex in the first half of this book; but don't worry, you don't have to remember them all, and it gets sorted out in the last half of the book. You may be wondering -- if not "Robert," who, then, was the dominant MPD personality back in the 1980s and earlier? His name was "Bob," and his dominance amounted to a long reign, from the early 1960s to the early 1990s. Since "Robert B. Oxnam" was born in 1942, you can see that "Bob" was in command from early to middle adulthood. Although he was the dominant MPD personality for thirty years, Bob did not have a clue that he was afflicted by multiple personality disorder until 1990, the very last year of his dominance. That was the fateful moment when Bob first heard that he had an "angry boy named Tommy" inside of him. How, you might ask, can someone have MPD for half a lifetime without knowing it? And even if he didn't know it, didn't others around him spot it? To outsiders, this is one of the most perplexing aspects of MPD. Multiple personality is an extreme disorder, and yet it can go undetected for decades, by the patient, by family and close friends, even by trained therapists. Part of the explanation is the very nature of the disorder itself: MPD thrives on secrecy because the dissociative individual is repressing a terrible inner secret. The MPD individual becomes so skilled in hiding from himself that he becomes a specialist, often unknowingly, in hiding from others. Part of the explanation is rooted in outside observers: MPD often manifests itself in other behaviors, frequently addiction and emotional outbursts, which are wrongly seen as the "real problem." The fact of the matter is that Bob did not see himself as the dominant personality inside Robert B. Oxnam. Instead, he saw himself as a whole person. In his mind, Bob was merely a nickname for Bob Oxnam, Robert Oxnam, Dr. Robert B. Oxnam, PhD.

The implication that the change in nomenclature from “Multiple Personality Disorder” to “Dissociative Identity Disorder” means the condition has been repudiated and “dropped” from the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association is false and misleading. Many if not most diagnostic entities have been renamed or have had their names modified as psychiatry changes in its conceptualizations and classifications of mental illnesses. When the DSM decided to go with “Dissociative Identity Disorder” it put “(formerly multiple personality disorder)” right after the new name to signify that it was the same condition. It’s right there on page 526 of DSM-IV-R. There have been four different names for this condition in the DSMs over the course of my career. I was part of the group that developed and wrote successive descriptions and diagnostic criteria for this condition for DSM-III-R, DSM–IV, and DSM-IV-TR. While some patients have been hurt by the impact of material that proves to be inaccurate, there is no evidence that scientifically demonstrates the prevalence of such events. Most material alleged to be false has been disputed by someone, but has not been proven false. Finally, however intriguing the idea of encouraging forgetting troubling material may seem, there is no evidence that it is either effective or safe as a general approach to treatment. There is considerable belief that when such material is put out of mind, it creates symptoms indirectly, from “behind the scenes.” Ironically, such efforts purport to cure some dissociative phenomena by encouraging others, such as Dissociative Amnesia.

During this hour in the waking streets I felt at ease, at peace; my body, which I despised, operated like a machine. I was spaced out, the catchphrase my friends at school used to describe their first experiments with marijuana and booze. This buzzword perfectly described a picture in my mind of me, Alice, hovering just below the ceiling like a balloon and looking down at my own small bed where a big man lay heavily on a little girl I couldn’t quite see or recognize. It wasn’t me. I was spaced out on the ceiling. I had that same spacey feeling when I cooked for my father, which I still did, though less often. I made omelettes, of course. I cracked a couple of eggs into a bowl, and as I reached for the butter dish, I always had an odd sensation in my hands and arms. My fingers prickled; it didn’t feel like me but someone else cutting off a great chunk of greasy butter and putting it into the pan. I’d add a large amount of salt — I knew what it did to your blood pressure, and I mumbled curses as I whisked the brew. When I poured the slop into the hot butter and shuffled the frying pan over the burner, it didn’t look like my hand holding the frying-pan handle and I am sure it was someone else’s eyes that watched the eggs bubble and brown. As I dropped two slices of wholemeal bread in the toaster, I would observe myself as if from across the room and, with tingling hands gripping the spatula, folded the omelette so it looked like an apple envelope. My alien hands would flip the omelette on to a plate and I’d spread the remainder of the butter on the toast when the two slices of bread leapt from the toaster. ‘Delicious,’ he’d say, commenting on the food before even trying it.

Disorders of the mind are just as serious and can be just as debilitating as those that affect the body.  They can also vary greatly: most cause greater suffering inwardly, but others do outwardly.  Some show obvious symptoms, while others are more hidden.  But because it affects the mind, even though mental disorder prevalence rates are high, many people either do not see the need or delay seeking help, often for many years.  As a result, mental health problems are not given anywhere near the same level of importance as physical ailments, despite the growing awareness

Like the DSM-V, the RDoC framework conceptualizes mental illnesses solely as brain disorders. This means that future research funding will explore the brain circuits “and other neurobiological measures” that underlie mental problems. Insel sees this as a first step toward the sort of “precision medicine that has transformed cancer diagnosis and treatment.” Mental illness, however, is not at all like cancer: Humans are social animals, and mental problems involve not being able to get along with other people, not fitting in, not belonging, and in general not being able to get on the same wavelength.

Abhed, my father had called heredity-"indivisible." There is an old trope in popular culture of the "crazy genius," a mind split between madness and brilliance, oscillating between the two states at the throw of a single switch. But Rajesh had no switch. There was no split or oscillation, no pendulum. The magic and the mania were perfectly contiguous-bordering kingdoms with no passports. They were part of the same whole, indivisible. "We of the craft are all crazy," Lord Byron, the high priest of crazies, wrote. "Some are affected by gaiety, others by melancholy, but all are more or less touched." Versions of this story have been tool, over and over, with bipolar disease, with some variants of schizophrenia, and with rare cases of autism; all are "more or less touched." It is tempting to romanticize psychotic illness, so let me emphasize that the men and women with these mental disorders experience paralyzing cognitive, social, and psychological disturbances that send gashes of devastation through their lives. But also indubitably, some patients with these syndromes possess exceptional and unusual abilities. The effervescence of bipolar disease has long been linked to extraordinary creativity; at times, the heightened creative impulse is manifest during the throes of mania.

ME/CFS is not synonymous with depression or other psychiatric illnesses. The belief by some that they are the same has caused much con- fusion in the past, and inappropriate treatment. Nonpsychotic depression (major depression and dysthymia), anxiety disorders and somatization disorders are not diagnostically exclusionary, but may cause significant symptom overlap. Careful attention to the timing and correlation of symptoms, and a search for those characteristics of the symptoms that help to differentiate between diagnoses may be informative, e.g., exercise will tend to ameliorate depression whereas excessive exercise tends to have an adverse effect on ME/CFS patients.

There were other strange signals and signs. Another day, suddenly felt an almost overwhelming urge to travel to Balitmore. I wanted to 'kidnap' a helicoper fly it there if I didn't drive the there', she explains. 'I had no idea where I was to go, only that I was certain I would know my destination as I encountered signs and certain landmarks along the way. I was not even certain who I was to meet, or what my mission was, but I felt I must go.' Beginning to heal by this time with Talbon's help, she resisted that urge. Yet she sensed she would be summoned for three more Cat Woman missions: two in 1999 and one in 2000. As for the code words for activating her, those had been erased from Cheryl's conscious memory. Buried deep in her unconscious mind, however, the words, when called up, cause her to react as her programmers want her to. Though she can't remember the activation codes, Cheryl knows her handlers said the same things every time. 'I'm working on unblocking the words in therapy. Once I know what the words are, I can learn how to stop their effect on me. I did it already when I learned the control code. Standing in front of a mirror, I said the control code words over and over until I was completely desensitised to them. That's what I have to do for the activation code words... but I have not been able to recall all of them as yet.' Dr. Talbon was struck by another very important thing. 'It all hung together. The stories Cheryl told - even though it was upsetting to think people could do stuff like that - they were not disjointed. They were not repetitive in terms of "I've heard this before". It was not just trying consciously or unconsciously to get attention. She'd really processed them out and was done with them. She didn't come up with it again [after telling the story once and dealing with it]. Once it was done, it was done. And I think that was probably the biggest factor for me in her believability. I got no sense that she was using these stories to make herself a really interesting person to me so I'd really want to work with her, or something.

Many wish to believe that the odd is not so odd, the bizarre not so bizarre, and there is little changing of minds once they are set. There are only so many ways to understand the strange and disordered. The Greeks imagined gods to explain what they themselves could not. It is human nature to invent reasons for why the mind shatters, hope plummets, or the will to live dies. Scientific explanations are complicated and, for many, less humanly satisfying than visionary or religious ones. They are also less interesting than explanations based on planetary misalignment, toxins, or childhoods gone awry. There is a disturbing gap between what scientists and doctors know about mental illness and what most people believe.

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.

So what came first, do you reckon, the horrible thoughts forcing you to carry out rituals like a junkie, or the need to make people laugh? Or maybe they’re two sides of the same coin. The vivid imagination causing thoughts which make you want to cry is the same imagination that can find humour in situations other people would call ‘mundane’…” “It’s occurred to me, yes.” “Oh, it’s more than occurred to you, Nicky boy. You’re an intelligent man who has an affliction which affects your mind, so you’ve definitely thought about it. A lot, I bet. I’d like to tell you something Nicky, but I want to make sure I’ve got your full attention. Do I?” “Yes,” I replied in spite of myself. He leaned even closer, as if we were either co-conspirators in some scheme or lovers about to kiss. “We’re all victims. All of us. Victims of our own minds...

Among DID individuals, the sharing of conscious awareness between alters exists in varying degrees. I have seen cases where there has appeared to be no amnestic barriers between individual alters, where the host and alters appeared to be fully cognizant of each other. On the other hand, I have seen cases where the host was absolutely unaware of any alters despite clear evidence of their presence. In those cases, while the host was not aware of the alters, there were alters with an awareness of the host as well as having some limited awareness of at least a few other alters. So, according to my experience, there is a spectrum of shared consciousness in DID patients. From a therapeutic point of view, while treatment of patients without amnestic barriers differs in some ways from treatment of those with such barriers, the fundamental goal of therapy is the same: to support the healing of the early childhood trauma that gave rise to the dissociation and its attendant alters. Good DID therapy involves promoting co­-consciousness. With co-­consciousness, it is possible to begin teaching the patient’s system the value of cooperation among the alters. Enjoin them to emulate the spirit of a champion football team, with each member utilizing their full potential and working together to achieve a common goal. Returning to the patients that seemed to lack amnestic barriers, it is important to understand that such co-consciousness did not mean that the host and alters were well-­coordinated or living in harmony. If they were all in harmony, there would be no “dis­ease.” There would be little likelihood of a need or even desire for psychiatric intervention. It is when there is conflict between the host and/or among alters that treatment is needed.

The power of format creates opportunities for manipulation, which people with an axe to grind know how to exploit. Slovic and his colleagues cite an article that states that “approximately 1,000 homicides a year are committed nationwide by seriously mentally ill individuals who are not taking their medication.” Another way of expressing the same fact is that “1,000 out of 273,000,000 Americans will die in this manner each year.” Another is that “the annual likelihood of being killed by such an individual is approximately 0.00036%.” Still another: “1,000 Americans will die in this manner each year, or less than one-thirtieth the number who will die of suicide and about one-fourth the number who will die of laryngeal cancer.” Slovic points out that “these advocates are quite open about their motivation: they want to frighten the general public about violence by people with mental disorder, in the hope that this fear will translate into increased funding for mental health services.

If two people with no symptoms in common can both receive the same diagnosis of schizophrenia, then what is the value of that label in describing their symptoms, deciding their treatment, or predicting their outcome, and would it not be more useful simply to describe their problems as they actually are? And if schizophrenia does not exist in nature, then how can researchers possibly find its cause or correlates? If psychiatric research has made so little progress in recent decades, it is in large part because everyone has been barking up the wrong tree. It is not a question of getting a bigger and better scanner, but of going right back to the drawing board. What’s more, medical-type labels can be as harmful as they are hollow. By reducing rich, varied, and complex human experiences to nothing more than a mental disorder, they not only sideline and trivialize those experiences but also imply an underlying defect that then serves as a pseudo-explanation for the person’s disturbed behaviour. This demeans and disempowers the person, who is deterred from identifying and addressing the important life problems that underlie his distress.

Obsessive-compulsive personality disorder (OCPD) is unhelpfully named, since it is not particularly closely related to the better known obsessive-compulsive disorder (OCD). It does not tend to co-occur with obsessive-compulsive disorder, or even run in the same families. Obsessive-compulsive disorder is an anxiety disorder, in which the sufferer feels compelled to repeat particular thoughts or actions, such as checking or hand-washing. As an anxious condition, it belongs to the same family as depression and generalized anxiety disorder, and thus is related to high Neuroticism and responds to some extent to serotonergic antidepressant medications. Some people have even seen obsessive-compulsive disorder as a low Conscientiousness problem, since the affected individual cannot inhibit the checking or washing response in rather the same manner as the alcoholic cannot inhibit his desire to drink. Whether this is the right characterization or not, it is clear that OCPD is a very different type of problem.16 What, then, does OCPD entail? Psychiatrists define it as ‘a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts’.

The approach adopted by Daniel Stern and the followers of John Bowlby still appears to gain only peripheral attention in psychoanalytic circles, perhaps because by his theory of initial attachment Bowlby exploded a taboo. By linking the causes of antisocial behavior with the absence of a resilient attachment to the mother, he was flying in the face of Freud’s drive theory. But my conviction is that we have to go a step further than Bowlby went. We are dealing here not just with antisocial behavior and so-called narcissistic disorders but with the inescapable realization that denying and repressing our childhood traumas means reducing our capacity to think and conspiring to erect barriers in our minds. Brain research has succeeded in uncovering the biological foundations of the denial phenomenon. But the consequences, the impact on our mentality, have not yet been adequately contemplated. No one appears to be interested in examining how insensitivity to the suffering of children–a phenomenon found the world over–is bound up with a form of mental paralysis that has its roots in childhood. As children, we learn to suppress and deny natural feelings and to believe sincerely that the cuffs and blows we receive are for our own good and do us no lasting injury. Our brains, furnished with this false information, then instruct us to raise our own children by the same methods, telling them that it is good for them just as it was good for us.

To Greg, who had suffered from bouts of depression throughout his life, this seemed like a terrible approach. In seeking treatment for his depression, he—along with millions of others around the world—had found that cognitive behavioral therapy (CBT) was the most effective solution. CBT teaches you to notice when you are engaging in various “cognitive distortions,” such as “catastrophizing” (If I fail this quiz, I’ll fail the class and be kicked out of school, and then I’ll never get a job . . .) and “negative filtering” (only paying attention to negative feedback instead of noticing praise as well). These distorted and irrational thought patterns are hallmarks of depression and anxiety disorders. We are not saying that students are never in real physical danger, or that their claims about injustice are usually cognitive distortions. We are saying that even when students are reacting to real problems, they are more likely than previous generations to engage in thought patterns that make those problems seem more threatening, which makes them harder to solve. An important discovery by early CBT researchers was that if people learn to stop thinking this way, their depression and anxiety usually subside. For this reason, Greg was troubled when he noticed that some students’ reactions to speech on college campuses exhibited exactly the same distortions that he had learned to rebut in his own therapy. Where had students learned these bad mental habits? Wouldn’t these cognitive distortions make students more anxious and depressed?

Just how important a close moment-to-moment connection between mother and infant can be was illustrated by a cleverly designed study, known as the “double TV experiment,” in which infants and mothers interacted via a closed-circuit television system. In separate rooms, infant and mother observed each other and, on “live feed,” communicated by means of the universal infant-mother language: gestures, sounds, smiles, facial expressions. The infants were happy during this phase of the experiment. “When the infants were unknowingly replayed the ‘happy responses’ from the mother recorded from the prior minute,” writes the UCLA child psychiatrist Daniel J. Siegel, “they still became as profoundly distressed as infants do in the classic ‘flat face’ experiments in which mothers-in-person gave no facial emotional response to their infant’s bid for attunement.” Why were the infants distressed despite the sight of their mothers’ happy and friendly faces? Because happy and friendly are not enough. What they needed were signals that the mother is aligned with, responsive to and participating in their mental states from moment to moment. All that was lacking in the instant video replay, during which infants saw their mother’s face unresponsive to the messages they, the infants, were sending out. This sharing of emotional spaces is called attunement. Emotional stress on the mother interferes with infant brain development because it tends to interfere with the attunement contact. Attunement is necessary for the normal development of the brain pathways and neurochemical apparatus of attention and emotional selfregulation. It is a finely calibrated process requiring that the parent remain herself in a relatively nonstressed, non-anxious, nondepressed state of mind. Its clearest expression is the rapturous mutual gaze infant and mother direct at each other, locked in a private and special emotional realm, from which, at that moment, the rest of the world is as completely excluded as from the womb. Attunement does not mean mechanically imitating the infant. It cannot be simulated, even with the best of goodwill. As we all know, there are differences between a real smile and a staged smile. The muscles of smiling are exactly the same in each case, but the signals that set the smile muscles to work do not come from the same centers in the brain. As a consequence, those muscles respond differently to the signals, depending on their origin. This is why only very good actors can mimic a genuine, heartfelt smile. The attunement process is far too subtle to be maintained by a simple act of will on the part of the parent. Infants, particularly sensitive infants, intuit the difference between a parent’s real psychological states and her attempts to soothe and protect the infant by means of feigned emotional expressions. A loving parent who is feeling depressed or anxious may try to hide that fact from the infant, but the effort is futile. In fact, it is much easier to fool an adult with forced emotion than a baby. The emotional sensory radar of the infant has not yet been scrambled. It reads feelings clearly. They cannot be hidden from the infant behind a screen of words, or camouflaged by well-meant but forced gestures. It is unfortunate but true that we grow far more stupid than that by the time we reach adulthood.

Depression” is a problematic word. We all believe we know what it means because we toss it off so easily: “Oh, I’m depressed; I got a run in my stocking.” At the same time, when we are describing severe psychopathology, we presume that because the word is descriptive, it offers a definition as well. We move to the next step and presume that because we can take a picture of the brain and “see” depression, it therefore is real. It has been occurring to me more and more, not just from these conversations, but also from my work, that when the brain is in clearly different states—and the Diagnostic and Statistical Manual of Mental Disorders80 says they are the same pathology—maybe our definition of the psychopathology is too broad. We need to redefine the nature of suffering to understand how it may be a condition more like dukkha, instead of a disease with a physiological cause as specific as something like a brain lesion. That is not to deny that true psychopathology exists, or that the patients I take care of do not suffer from a brain disease. I believe very strongly that they do. But I also see patients who, with focused attention and by acquiring new skill sets, can bring themselves out of it in the same way that William James did when he decided to focus his attention from inside to outside. The ability to focus attention means your brain is in a different state. Maybe we ought to understand those as different definitions of illness. What I’ve learned from all of you is that maybe we have to start making those distinctions more strongly. That will allow us to focus attention on how to handle ourselves in a world with natural levels of suffering, and help us not stigmatize people who don’t have the brain capacity to even start. Those are two separate items.

In a sample of 125 Canadians convicted of homicide, 27% scored as psychopaths with the recommended cutoff on a standard scale (Woodworth and Porter, 2002; see also Haritos-Fatouros, 1995). However, in a broad stratified sample of 496 prisoners in England and Wales convicted of many offenses, violent and non-violent, Coid et al. (2009b) found that only 7.7% of men and 1.9% of women scored above the standard cutoff for psychopathy, and among all prisoners there was no correlation between psychopathy and any particular type of crime; psychopathy scores were not specifically associated with violent crimes. In a study of 416 German prisoners, 7% were categorized as psychopaths; just 8.8% of the 217 convicted of violent offenses were categorized as psychopaths (Ullrich et al., 2003). In an Iranian stratified sample of 351 prisoners, just 12% of violent offenders met the usual criterion of psychopathy; percentages of psychopaths among those convicted of other types of crime were the same or higher (Assadi et al., 2006). Given that the prevalence of psychopathy in the general population is estimated (with great uncertainty) at less than 1% (Coid et al., 2009a), it is clear that psychopaths commit far more than their share of violent crimes, but most crimes are not committed by psychopaths, nor do psychopaths perpetrate most violence of other kinds. Two cohort studies confirm this. In Finland from 1984 to 1991, 97% of 1,037 homicides were “solved,” and the court required a psychiatric evaluation by a neutral expert if it deemed that there was any possibility that the crime had been affected by a mental disorder, so 70% of the accused were examined. Men with antisocial personality disorder committed 11% of all homicides committed by men; women with antisocial personality disorder committed 13% of all homicides committed by women (Eronen et al., 1996). Men and women with all personality disorders combined committed 34% and 36% of homicides, respectively; alcoholics committed a similar proportion. More generally, mental disorders of all kinds together account for only a small minority of crimes. In a national cohort of all Danes, the 2.2% of men who were ever hospitalized for a mental disorder committed 10% of all violent crimes by males for which convictions were registered; for the 2.6% of women ever hospitalized, it was 16% of all violent crimes (Brennan et al., 2000).

As the result of some observations I have made in recent years, I propose to add two new and previously undescribed varieties to the various forms of insanity with fixed ideas, whose underlying phenomenology is essentially phobic. The two new terms I would like to put forth, following the nomenclature currently accepted by leading clinicians, are dysmorphophobia and taphephobia. The first condition consists of the sudden appearance and fixation in the consciousness of the idea of one’s own deformity; the individual fears that he has become deformed (dysmorphos) or might become deformed, and experiences at this thought a feeling of an inexpressible disaster… The ideas of being ugly are not, in themselves, morbid; in fact, they occur to many people in perfect mental health, awakening however only the emotions normally felt when this possibility is contemplated. But, when one of these ideas occupies someone’s attention repeatedly on the same day, and aggressively and persistently returns to monopolise his attention, refusing to remit by any conscious effort; and when in particular the emotion accompanying it becomes one of fear, distress, anxiety, and anguish, compelling the individual to modify his behaviour and to act in a pre-determined and fixed way, then the psychological phenomena has gone beyond the bounds of normal, and may validly be considered to have entered the realm of psychopathology. The dysmorphophobic, indeed, is a veritably unhappy individual, who in the midst of his daily affairs, in conversations, while reading, at table, in fact anywhere and at any hour of the day, is suddenly overcome by the fear of some deformity that might have developed in his body without his noticing it. He fears having or developing a compressed, flattened forehead, a ridiculous nose, crooked legs, etc., so that he constantly peers in the mirror, feels his forehead, measures the length of his nose, examines the tiniest defects in his skin, or measures the proportions of his trunk and the straightness of his limbs, and only after a certain period of time, having convinced himself that this has not happened, is able to free himself from the state of pain and anguish the attack put him in. But should no mirror be at hand, or should he be prevented from quieting his doubts in some way or other with rituals or movements of the most outlandish kinds, the way a rhypophobic who cannot get water to wash himself might, the attack does not end very quickly, but may reach a very painful intensity, even to the point of weeping and desperation.

Meanwhile, scientists are studying certain drugs that may erase traumatic memories that continue to haunt and disturb us. In 2009, Dutch scientists, led by Dr. Merel Kindt, announced that they had found new uses for an old drug called propranolol, which could act like a “miracle” drug to ease the pain associated with traumatic memories. The drug did not induce amnesia that begins at a specific point in time, but it did make the pain more manageable—and in just three days, the study claimed. The discovery caused a flurry of headlines, in light of the thousands of victims who suffer from PTSD (post-traumatic stress disorder). Everyone from war veterans to victims of sexual abuse and horrific accidents could apparently find relief from their symptoms. But it also seemed to fly in the face of brain research, which shows that long-term memories are encoded not electrically, but at the level of protein molecules. Recent experiments, however, suggest that recalling memories requires both the retrieval and then the reassembly of the memory, so that the protein structure might actually be rearranged in the process. In other words, recalling a memory actually changes it. This may be the reason why the drug works: propranolol is known to interfere with adrenaline absorption, a key in creating the long-lasting, vivid memories that often result from traumatic events. “Propranolol sits on that nerve cell and blocks it. So adrenaline can be present, but it can’t do its job,” says Dr. James McGaugh of the University of California at Irvine. In other words, without adrenaline, the memory fades. Controlled tests done on individuals with traumatic memories showed very promising results. But the drug hit a brick wall when it came to the ethics of erasing memory. Some ethicists did not dispute its effectiveness, but they frowned on the very idea of a forgetfulness drug, since memories are there for a purpose: to teach us the lessons of life. Even unpleasant memories, they said, serve some larger purpose. The drug got a thumbs-down from the President’s Council on Bioethics. Its report concluded that “dulling our memory of terrible things [would] make us too comfortable with the world, unmoved by suffering, wrongdoing, or cruelty.… Can we become numb to life’s sharpest sorrows without also becoming numb to its greatest joys?” Dr. David Magus of Stanford University’s Center for Biomedical Ethics says, “Our breakups, our relationships, as painful as they are, we learn from some of those painful experiences. They make us better people.” Others disagree. Dr. Roger Pitman of Harvard University says that if a doctor encounters an accident victim who is in intense pain, “should we deprive them of morphine because we might be taking away the full emotional experience? Who would ever argue with that? Why should psychiatry be different? I think that somehow behind this argument lurks the notion that mental disorders are not the same as physical disorders.

Recently, brain scans of schizophrenics taken while they were having auditory hallucinations have helped explain this ancient disorder. For example, when we silently talk to ourselves, certain parts of the brain light up on an MRI scan, especially in the temporal lobe (such as in Wernicke’s area). When a schizophrenic hears voices, the very same areas of the brain light up. The brain works hard to construct a consistent narrative, so schizophrenics try to make sense of these unauthorized voices, believing they originate from strange sources, such as Martians secretly beaming thoughts into their brains. Dr. Michael Sweeney of Ohio State writes, “Neurons wired for the sensation of sound fire on their own, like gas-soaked rags igniting spontaneously in a hot, dark garage. In the absence of sights and sounds in the surrounding environment, the schizophrenic’s brain creates a powerful illusion of reality.” Notably, these voices seem to be coming from a third party, who often gives the subject commands, which are mostly mundane but sometimes violent. Meanwhile, the simulation centers in the prefrontal cortex seem to be on automatic pilot, so in a way it’s as though the consciousness of a schizophrenic is running the same sort of simulations we all do, except they’re done without his permission. The person is literally talking to himself without his knowledge. HALLUCINATIONS The mind constantly generates hallucinations of its own, but for the most part they are easily controlled. We see images that don’t exist or hear spurious sounds, for example, so the anterior cingulate cortex is vital to distinguish the real from the manufactured. This part of the brain helps us distinguish between stimuli that are external and those that are internally generated by the mind itself. However, in schizophrenics, it is believed that this system is damaged, so that the person cannot distinguish real from imaginary voices. (The anterior cingulate cortex is vital because it lies in a strategic place, between the prefrontal cortex and the limbic system. The link between these two areas is one of the most important in the brain, since one area governs rational thinking, and the other emotions.) Hallucinations, to some extent, can be created on demand. Hallucinations occur naturally if you place someone in a pitch-black room, an isolation chamber, or a creepy environment with strange noises. These are examples of “our eyes playing tricks on us.” Actually, the brain is tricking itself, internally creating false images, trying to make sense of the world and identify threats. This effect is called “pareidolia.” Every time we look at clouds in the sky, we see images of animals, people, or our favorite cartoon characters. We have no choice. It is hardwired into our brains. In a sense, all images we see, both real and virtual, are hallucinations, because the brain is constantly creating false images to “fill in the gaps.” As we’ve seen, even real images are partly manufactured. But in the mentally ill, regions of the brain such as the anterior cingulate cortex are perhaps damaged, so the brain confuses reality and fantasy.

It's unfortunate and worth noting that the same word we use to describe [pathological anxiety], we also use to describe our feelings about a high-pressure day at the office. The word 'anxiety', in all of its derivations, is among the most overused in the English language.

So you really have the same conversations with two or or three people who look exactly like me?' She nodded. 'Don't you feel embarrassed repeating yourself like that?' 'Not at all,' Dr Laine said. 'Remember, I'm not saying the same thing three times to you. I'm saying it once to three different people.' That would take a while to sink in. At least it explained my history of people looking exasperated at work or school or even in shops when I sometimes asked questions. They'd obviously just gone through it with someone else who looked exactly like me!

Even if there can be the first cause of the Universe -- God, it wouldn’t necessarily support any evidence that God can convey some information about his will to some chosen persons, that there is some holy scriptures, containing just God’s message to humanity sent in that way. Any information, which you can get from the alleged ‘holy scripture’, is a product of the human mind, written by humans and changed by humans in various periods.There is no invariant version of any ‘holy scripture’, even if the concepts and propositions of it formally remain the same, their meaning is changing constantly, as a result of different interpretations, from one civilization to another, from one period to another. That interpretation is more essential and decisive than what is formally written there. Not ‘holy scripture’ itself, but its interpretation manipulates brains in such a way that a person builds his religious vision on the basis of the interpretation of ‘holy scripture’ made by somebody else. Without that interpretation, a person can hardly perceive anything in ‘holy scripture’ in terms of religion. But the main problem is that there cannot be only one interpretation of ‘holy scripture’, and there cannot be harmony among various religious visions, even within one religion. One interpretation can make you be humanist, while another -- aggressive, depending on who and how interpreted what is written there. The naked truth is that when someone interprets something, he does it according to his mental apparatus, that is why any ‘holy scripture’ can only express the state of this mental apparatus with its cognitive and emotional bias, in some cases even its serious defect and disorder, and not the will of God itself.

In his TED Talk, entitled The Decline of Play and the Rise of Mental Disorders, he will open your eyes in several ways. In addition to describing play as a critical learning experience, he also compellingly cites the “reality that over the past 60 years in the United States there has been a gradual but, overall dramatic decline in children’s freedom to play with other children, without adult direction. Over this same period, there has been a gradual but overall dramatic increase in anxiety, depression, feelings of helplessness, suicide, and narcissism in children and adolescents.

What has typically happened over the past two hundred years is the slow emergence of a concept as a gradual, evolutionary exercise in collective wisdom: People see something in their patients that hadn’t occurred to them before; they write about it; others start seeing the same thing – for example, that some patients seem to be driven by a kind of furious rage – and slowly the concept emerges. But what comes out of this collective filtering is often a powerful notion, because lots of thoughtful people have endorsed it. (..) in the absence of actual science, the disease designers of the 1970s who produced DSM- 3 in 1980 settled for “consensus”: If a group of influential persons sitting about a table could agree that a disease existed, then it existed.

For several months, about all I did was talk to addicts, counselors, and cops around the country—over the phone because the pandemic restricted travel. Meth was overshadowed by the opioid epidemic. But the people I spoke to told me stories nearly identical to Eric’s. This new meth itself was quickly, intensely damaging people’s brains. The symptoms were always the same—violent paranoia, hallucinations, figures always lurking in the shadows, isolation, rotted and abscessed dental work, uncontrollable limbs, massive memory loss, jumbled speech, and, almost always, homelessness. It was creating a swath of people nationwide who, while on meth and for a good period afterward, were mentally ill and all but untreatable by usual methods of drug rehabilitation. Ephedrine-made meth wasn’t good for the brain, but it was nothing like this. Schizophrenia and bipolar disorder are afflictions that begin in the young. Now people in their thirties and forties were going mad. The new meth was also deadly in a way ephedrine meth was not. It was killing young people with congestive heart failure, a disease common to people over sixty-five.

Unlike joy, anger, and sorrow, which are relatively simple and clear emotions, subtle emotions that cannot be defined. There have been numerous attempts to define love, such as "sad compassion," "sadness," and "something that can give anything," but none of them fit perfectly. Therefore, this emotion has dominated much of human art, and is mainly sublimated into singing. It is the most common but complex of human emotions, and having this feeling for someone itself makes me so happy just to think good about the object, and on the contrary, I feel very sad when the object leaves. If this emotion goes too far and flows in the wrong direction, it can ruin people. As a result, love has a strange power to laugh and make one cry. In addition, people tend to think of themselves as a good person with a lot of love because they are drunk on the feelings they feel toward their favorite object they like. In addition, it is one of the most complex human emotions because it has a singularity that can be fused with joy and sorrow, and because it can be derived from love, and love can be derived from joy and sorrow. In particular, it seems to be the opposite of hate (hate), but it has the same shape as both sides of a coin, so hate is often derived from love and vice versa.[13] In the case of the opposite, it is also called hatefulness, and ironically, there is a theory that it is the longest-lasting affection among the emotions. In Christianity, faith, hope, and love are the best.[14] In the West, it is said that the first letter to the Corinthians of the Bible, Chapter 13:4-7, is often cited as a phrase related to love.[15][16] Also, this is directly related to the problem of salvation, perhaps because it is an attribute of God beyond doctrine/tradition/faith. According to Erich Fromm, love is the same thing as rice, and if it continues to be unsatisfactory, it can lead to deficiency disorders. The more you love your parents, friendship with friends, and love between lovers, the healthier you can be mentally as if you eat a lot of good food. The rationale is that many felons grew up without the love of their parents or neighbors as children. It is often a person who lives alone without meeting a loved one in reality, or if he is a misdeed, he or she often loves something that is not in reality. Along with hatred, it is one of the emotions that greatly affect the human mind. Since the size of the emotion is very, very huge, it is no exaggeration to say that once you fall in love properly, it paralyzes your reason and makes normal judgment impossible. Let's recall that love causes you to hang on while showing all sorts of dirty looks, or even crimes, including stalking and dating violence

Manual of Mental Disorders, 5th Edition (DSM-5)—a person must be distressed by their drug use. In addition, the individual’s drug use must interfere with important life functions, such as parenting, work, and intimate relationships. This use must take up a great deal of time and mental energy and must persist in the face of repeated attempts to stop or cut back. Other symptoms that the person may experience include needing more of the drug to get the same effect (tolerance) and suffering withdrawal symptoms if use suddenly ceases.

Narcissistic Disorder The basic premise of this personality disorder is an inflated sense of self worth. This trait is often emphasized by a need to be appreciated and admired although someone with this disorder usually is unable to have any empathy for others; no matter what their situation. People with this disorder will often be fond of overly grand gestures and will assume they are the most important part of anyone’s life; even if you met them just five minutes ago. There are very few scenarios where this inflated sense of self worth is appropriate in modern society. Surprisingly, under this façade there is usually a very fragile self esteem which needs the consistent bolstering of ego that their behavior attracts. People with this disorder will often appear to be snobbish, disdainful or simply patronizing and condescending. They are likely to give out opinions on the failings of others at the drop of a hat without acknowledging their own shortcomings. The belief that they should be the most important person in any room can lead to issues when dealing with relationships at home or at work; this will be particularly noticeable if someone else is praised and you are not. In situations such as these, it is common for someone with this disorder to react angrily or impatiently; making it very difficult to build a long term relationship. The Symptoms Again, in order for someone to be diagnosed with this condition they will need to display at least five of the following symptoms and to have had these issues for at least one year. •   A sufferer has a hugely inflated opinion of their own self worth. They will usually inflate their achievements and skills to ensure they are the best in the room. They are unlikely to be able to substantiate any of these claims. •   They often indulge in a fantasy world where they have unlimited success, power, money and love. This indulgence can occur at any time. •   They will have a belief that they are very special and that there are only a few other people in the world which are on the same level as them. This belief means they will often try to associate with these people and no one else; as these are the only people who will understand them. •   The belief that they are special necessitates them to expect and demand your praise and adulation at all times of the day. They expect to be admired simply for being who they are. This belief extends to expecting others to provide them with favorable treatment and to know their expectations without being told them. •   This feeling of their own self worth will cause many people with this disorder to take advantage of others in order to achieve their own goal. They are unlikely to see this as exploitation; instead, it is just others doing what they should to satisfy their needs. •   It is usual for someone with this personality disorder to lack empathy towards others, particularly those who they feel are beneath them; which is almost everyone. •   Envy is a common trait in people with this disorder. They are liable to be envious of anyone who has something they do not and they will believe others are envious of them; because of their importance. •   People who suffer from this illness will often come across as arrogant, haughty or even rude. This disorder occurs in more men than women and current estimates suggest that the disorder is present in approximately six percent of the population. Symptoms associated with this disorder will always be present, even when a child; but the constantly evolving personality is likely to mask this and it is not usually possible to diagnose the condition until the late teens or early twenties.

The psychiatrists lobbying for the Durham decision had broadened their own mandate from illness to mental health, and from the individual to society, and were arguing for a system that would treat crime the same way. If crime was a symptom of illness, then perpetrators were also victims, or at least bystanders of their own behavior. Doctors would act like lawyers, offering exonerating explanations of illness, while lawyers would become like doctors, demanding treatment in place of prison for those who could be healed instead of punished. As expert witnesses, psychiatrists would explain to the jury how a particular disorder, in combination with specific environmental factors, had produced behavior for which a defendant could hardly be held responsible. They would also provide the remedy, which would allow the perpetrator turned patient to return quickly to society as a productive member.

I like to say the idea of Phantasma came to me all at once, hitting me like a ton of bricks one cloudy afternoon in November 2021, but truly, my experience with obsessive-compulsive disorder has been building to this story for a very long time. During the process of brainstorming the sort of adult romance I wanted to debut with, I was going through a period where my obsessive-compulsive tendencies were flaring up more than usual and the voices in my head were getting a little too bold. To my friends, these compulsions were alarming little anecdotes over lunch—‘that sounds like a horror movie’ one of them said (affectionately)—which is funny because, to me, someone who has lived with OCD my entire life, it was just another day of being unfazed by the increasingly creative scenarios my mind likes to conjure. OCD has such a wide range of symptoms that it makes every person’s experience with it different. Unfortunately, it has also become a commonly misused term conflated with the idea of being overly neat and clean, when in reality a lot of people with OCD have much darker symptoms. In my experience this has made explaining the real effects of OCD very hard as well as making it more difficult for people to regard the condition seriously. It’s so important to me to convey, with the utmost sincerity, that I know people are not doing this to be malicious! Because of the misuse of the term, however, some of the ways this disorder is shown in this book may come off as exaggerated or dramatic—but the details of Ophelia’s OCD are drawn directly from experiences that I, or someone I know who shares my condition, have had first-hand. And it’s still only a fraction of the symptoms we live with daily. Ophelia’s story is a love letter to my journey of getting comfortable being in my own head (as well as my adoration for Gothic aesthetics and hot ghosts). And while her experience with OCD, my experience with OCD, might look a lot different to someone else’s, I hope that the same message rings clear: struggling with your mental health does not make you unworthy of love. And I hope the people you surround yourself with are the sort of people who know that, too.

ANXIOUS CONTRACTIONS Life is movement. It’s dynamic and pulsating like a swift moving river. To be in a contented and happy state is to be in a state of flow where your thoughts and feelings follow a natural current and there is no inner friction or need to check in on your anxiety every five minutes. When you feel in flow, your body feels light and your mind becomes spontaneous and joyful. Anxiety and fear are the total opposite. They’re the contractions of life. When we get scared, we contract in fear. Our bodies become stiff and our minds become fearful and rigid. If we hold that contracted state, we eventually cut ourselves off from life. We lose flexibility. We lose our flow. We can think of this a bit like pulling a muscle. When a muscle is overused and tired, its cells run out of energy and fluid. This can lead to a sudden and forceful contraction, such as a cramp. This contraction is painful and scary as it comes without warning. In the same way, we can be living our lives with a lot of stress and exhaustion, similar to holding a muscle in an unusual position for too long. If we fail to notice and take care of this situation, we can experience an intense and sudden moment of anxiety or even panic. I call this an “anxious contraction,” and it can feel quite painful. Learning how to respond correctly to this anxious contraction is crucial and determines how quickly we release it. Anxious contractions happen to almost everyone at some point in their lives. We suddenly feel overwhelmed with anxiety as our body experiences all manner of intense sensations, such as a pounding heart or a tight chest or a dizzy sensation. Our anxiety level then is maybe an 8 or 9 out of 10. We recoil in fear and spiral into a downward loop of more fear and anxiety. Some might say they had a spontaneous panic attack while others might describe the feeling as being very “on edge.”   THE ANXIETY LOOP It’s at this point in time where people get split into those that develop an anxiety disorder and those that don’t. The real deciding factor is whether a person gets caught in the “anxiety loop” or not. The anxiety loop is a mental trap, a vicious cycle of fearing fear. Instead of ignoring anxious thoughts or bodily sensations, the person becomes acutely aware and paranoid of them. “What if I lose control and do something crazy?” “What if those sensations come back again while I’m in a meeting?” “What if it’s a sign of a serious health problem?” This trap is akin to quicksand. Our immediate response is to struggle hard to free ourselves, but it’s the wrong response. The more we struggle, the deeper we sink. Anxiety is such a simple but costly trap to fall into. All your additional worry and stress make the problem worse, fueling more anxiety and creating a vicious cycle or loop. It’s like spilling gasoline onto a bonfire: the more you fear the bodily sensations, the more intense they feel. I’ve seen so many carefree people go from feeling fine one day to becoming fearful of everyday situations simply because they had one bad panic attack and then got stuck in this anxious loop of fearing fear. But there is great hope. As strange as it sounds, the greatest obstacle to healing your anxiety is you. You’re the cure. Your body wants to heal your anxiety as much as you do.

In this paper I propose the existence of two distinct presentations of DID, a Stable and an Active one. While people with Stable DID struggle with their traumatic past, with triggers that re-evoke that past and with the problems of daily functioning with severe dissociation, people with Active DID are, in addition, also engaged in a life of current, on-going involvement in abusive relationships, and do not respond to treatment in the same way as other DID patients. The paper observes these two proposed DID presentations in the context of other trauma-based disorders, through the lens of their attachment relationship. It proposes that the type, intensity and frequency of relational trauma shape—and can thus predict—the resulting mental disorder. - Through the lens of attachment relationship: Stable DID, Active DID and other trauma-based mental disorders

Some depression is not long term, some depression is circumstantial, particularly in reference to African Americans. An African American can be diagnosed with depression due to meeting criteria outlined within the Diagnostic and Statistical Manual of Mental Disorders, written by American Psychiatric Association, though that may be a snap shot of a temporary circumstance. The same person a clinician may have diagnosed with depression may have lost a job, house, car or healthcare. The person diagnosed could be homeless, stressed out, crying, unable to sleep or over sleeping, depending on others or having no one to depend on. Yet things could turn around for the person then all of the symptoms that were present may all go away once the person is able to sustain” (McEachern 175).

No life is specially interesting. Almost everybody does the same thing and shares the common career and money-related interests regardless if he is a scientist, an artist or an economist. Almost everybody spends the similar life style — relaxation and satisfaction of the needs of stomach and sex organ. Almost everybody does his best to pass down his genes through originating and nurturing the next generation. Patriotism, intellectuality, religiosity and so on, and so forth are only a pose but not the intrinsic parts of the mental state, of course, if one doesn’t suffer from serious psychological disorder. The commonest thing is delightful if one only hides it. For that reason most men, if not any, tend to wear a mask of patriotism, intellectuality or religiosity in order to give to his ordinary life some “richness of content.

The ingredients of the mélange may include: •  high mental and physical energy (coupled with extreme lassitude at times) •  a fast-moving, easily distracted mind (coupled with an amazingly superfocused mind at times) •  trouble with remembering, planning, and anticipating •  unpredictability and impulsivity •  creativity •  lack of inhibition as compared to others •  disorganization (coupled with remarkable organizational skills in certain domains) •  a tendency toward procrastination (coupled with an I-must-do-it-or-have-it-now attitude at times) •  a high-intensity attitude alternating with a foggy one •  forgetfulness (coupled with an extraordinary recall of certain often irrelevant remote information) •  passionate interests (coupled with an inability to arouse interest at other times) •  an original, often zany way of looking at the world •  irritability (coupled with tenderheartedness) •  a tendency to drink too much alcohol, smoke cigarettes, use other drugs, or get involved with addictive activities such as gambling, shopping, spending, sex, food, and the Internet (coupled with a tendency to abstain altogether at times) •  a tendency to worry unnecessarily (coupled with a tendency not to worry enough when worry is warranted) •  a tendency to be a nonconformist or a maverick •  a tendency to reject help from others (coupled with a tendency to want to give help to others) •  generosity that can go too far •  a tendency to repeat the same mistake many times without learning from it •  a tendency to underestimate the time it takes to complete a task or get to a destination •  various other ingredients, none of which dominates all the time, and any one of which may be absent in a single individual

It is hardly remarkable that we sicken and die; what is truly remarkable is that we don’t usually sicken very often and we don’t die very quickly. We can therefore say the same thing about physical disorders that we said about mental disorders: There is a force, the mechanism of which we do not fully understand, that seems to operate routinely in most people to protect and encourage their physical health even under the most adverse conditions.

I've had the same version from patients in a slightly different take, which is the patient looking at me with fixed eyes saying "I'm not multiple but I think some of the others are", or alternatively, fixedly, "we're not multiple". So whatever it is about multiple realities it affects us all. - 15 years as the director of a trauma and dissociation unit: Perspectives on Trauma-informed Care

What apparently started as a loosening of semantic context, which allowed the patient to make a witty play with words about pyramids and 'extrapyramidal' disorders, completely lost its humorous character when the patient experienced the profound anxieties and cognitive impairments associated with a severe psychotic crisis. Experiencing the lack of precision of higher-order concepts, in this case clear distinction between pyramids in Egypt and pyramids in the brain, can thus be a curse and blessing at the same time: it allows us to detect the fundamental imprecision of language and the shaky metaphorical ground on which common concepts about ourselves and the world are based, and this experience can lead to a state of exhilaration about the fundamental nonsense of the world, the nonexistence of our assumed securities, and the shallowness of cherished beliefs, but it also confronts us with overwhelming complexity and threatening insecurity and throws us in deep anxious turmoil when confronted with the sheer chaos of being.

modern figure most associated with the study of malignant narcissism is my former teacher Otto Kernberg (1970), who defined the syndrome as having four components: (1) narcissistic personality disorder, (2) antisocial behavior, (3) paranoid traits, and (4) sadism. Kernberg told the New York Times that malignantly narcissistic leaders such as Hitler and Stalin are “able to take control because their inordinate narcissism is expressed in grandiosity, a confidence in themselves, and the assurance that they know what the world needs” (Goode 2003). At the same time, “they express their aggression in cruel and sadistic behavior against their enemies: whoever does not submit to them or love them.” As Pollock (1978) wrote, “the malignant narcissist is pathologically grandiose, lacking in conscience and behavioral regulation[,] with characteristic demonstrations of joyful cruelty and sadism.

When it comes to dangerousness, should not the president of a democracy, as First Citizen, be subject to the same standards of practice as the rest of the citizenry? Assessing dangerousness is different from making a diagnosis: it is dependent on the situation, not the person. Signs of likely dangerousness due to mental disorder can become apparent without a full diagnostic interview and can be detected from a distance, and one is expected to err, if at all, on the side of safety when the risk of inaction is too great.

While fear triggers the full response system at the moment of danger, anxiety triggers parts of the same system when a threat is merely perceived as possible. It is healthy to be anxious and on alert when one is in a situation where there really could be dangers lurking. But when our alarm bell is on a hair trigger so that it is frequently activated by ordinary events- including many that pose no real threat-it keeps us in a perpetual state of distress. This is when ordinary, healthy, temporary anxiety turns into an anxiety disorder.

Only then did scientists realize the rather profound conclusions of the experiment: REM sleep is what stands between rationality and insanity. Describe these symptoms to a psychiatrist without informing them of the REM-sleep deprivation context, and the clinician will give clear diagnoses of depression, anxiety disorders, and schizophrenia. But these were all healthy young individuals just days before. They were not depressed, weren’t suffering from anxiety disorders or schizophrenia, nor did they have any history of such conditions, self or familial. Read of any attempts to break sleep-deprivation world records throughout early history, and you will discover this same universal signature of emotional instability and psychosis of one sort or another. It is the lack of REM sleep—that critical stage occurring in the final hours of sleep that we strip from our children and teenagers by way of early school start times—that creates the difference between a stable and unstable mental state.

However, a prevailing view in psychiatry has been that mental disorders cause sleep disruption—a one-way street of influence. Instead, we have demonstrated that otherwise healthy people can experience a neurological pattern of brain activity similar to that observed in many of these psychiatric conditions simply by having their sleep disrupted or blocked. Indeed, many of the brain regions commonly impacted by psychiatric mood disorders are the same regions that are involved in sleep regulation and impacted by sleep loss. Further, many of the genes that show abnormalities in psychiatric illnesses are the same genes that help control sleep and our circadian rhythms.

Another possible explanation for the increase in mental health problems and disorders today is that we’re exposed to the same level of stress—or maybe less stress—than people were previously, but we are reacting to it in a particularly bad way.

looked over at him and said, “Yeah. Sorry, buddy, but that’s not really how anxiety works.” I reminded him of his sister’s ADHD. “Everyone gets distracted sometimes, but for people with ADHD, it’s an all-the-time thing. They are almost always distracted. Being distracted, struggling to focus, it’s the default, and it doesn’t necessarily need a trigger.” He nodded, but continued looking out the window. “So?” he asked in a very typical “What does this have to do with me?” teenager way. “Anxiety is the same way,” I said. “Everyone has anxious moments, but at least for me, and probably you too, the anxiety is kind of always there, even when things are going well. Just last Christmas I had a horrible anxiety attack, so I get it. Most of the time, it just happens without a trigger at all. But the part that sucks the most is how you’ll think to yourself that something must be triggering it, so you start to associate the anxiety with irrational things, like organization, or not getting enough exercise or sleep, or the fear that something bad might happen even though it’s unlikely. For me, that’s when my anxiety turns into obsessive-compulsive disorder. But the anxiety is always there, regardless of good times or bad times.” I went on for a moment more. Eventually, I looked over at Tristan. He was still looking out the window, gripping his stress grip harder than before, and I wondered if I was doing more harm than good, but I also realized how much I wished I’d learned all of this at his age, rather than in my midthirties. It was quiet for a moment, and finally I said, “It’s not hopeless, buddy. I promise. Listen, I still hate it. But I know that it’s part of me, and there are things I have to do to manage it. But as long as I do them, I’m pretty okay. Most days I don’t even notice it.” He thought about what I said.

Studies of the DSM-II found that when two psychiatrists consulted the same patient, they gave the same DSM diagnosis only between 32 and 42 percent of the time. Rates of consistency have improved since then, but the diagnosis of many mental disorders remains, despite pretensions to the contrary, more art than science.b

Every therapy session belongs to both patient and therapist, to the interaction between them. It was the psychoanalyst Harry Stack Sullivan who, in the early twentieth century, developed a theory of psychiatry based on interpersonal relationships. Breaking away from Freud’s position that mental disorders were intrapsychic in origin (meaning “in one’s mind”), Sullivan believed that our struggles were interactional (meaning “relational”). He went so far as to say, “It’s the mark of a senior clinician that he or she is the same person in their living room that they are in their office.” We can’t teach patients to be relational if we aren’t relational with them.

Eating disordered patients often grow up in families that place an inordinate amount of importance upon bodily appearance, including weight, and focus upon particular parts of the body: protruding tummies, thunder thighs, and tree-trunk legs. We see these same pathogenic qualities in much of the advertising that is directed toward women and girls.

Trauma can be defined in terms of the relationship you establish with what happened to you. It involves the way you integrate the experience into your life story, the beliefs you hold about yourself and the world, and the internal dynamics you develop in response to the circumstances. Happiness could be defined exactly the same way!

Each one of us is truly distinct, with unique and subjective experiences. This subjectivity plays a crucial role in traumatization. People can have different reactions to the same occurrence, with one person finding an event devastating while another might consider it uneventful.

The harm done by excluding certain disorders from those based in trauma is particularly evident for categories such as schizophrenia and bipolar disorders. In this, an apparent conceptual separation exists that deems experiences like hearing voices or paranoia as “psychotic-like” in those individuals (usually White women) whose trauma is easily recognized as being associated with such experiences, while others (usually Black men) are designated as having a brain disease (i.e., schizophrenia ) and truly psychotic for expressing these same internal experiences in a more confusing or symbolic manner (Chap. 3). Perhaps more troubling are those individuals whose trauma is recognized but whose responses to this trauma are dismissed as a personality defect, manipulative, fake, and/or representative of a multitude of different diseases (i.e., comorbidity; Chaps. 2 and 4).

The mind and the brain are part of the system that governs our mental health and we are just starting to understand that the mind and brain are not the same.

The Sexual Competition Hypothesis is based on the fact that throughout human evolutionary history the female shape has been a reliable indicator of the female's reproductive history and reproductive potential. The same is not true for men, where physical appearance, while relevant, is much less useful in assessing a man's reproductive potential. The visual signal for a female's peak reproductive potential in ancestral environments was the female's nubile shape, which was generally short-lived and declined with the repeated cycles of gestation and lactation.

Zeus, not before time, decides to step in. To demonstrate the necessity and even favorability of death, Sisyphus is given the task of rolling a boulder from the bottom of a hill to the top; then Zeus, in a trick of his own, which might simply be called “gravity,” returns the boulder to the bottom, where Sisyphus must resume his fruitless and unending labor. Søren Kierkegaard, the Danish brainbox, reckoned it was a good metaphor for addiction to materialism and sex: “It is comic that a mentally disordered man picks up any piece of granite and carries it around because he thinks it is money, and in the same way it is comic that Don Juan has 1,003 mistresses, for the number simply indicates that they have no value. Therefore, one should stay within one’s means in the use of the word ‘love.’ ” This analysis is resonant: this book, to a point, is about my own disillusionment with the material offerings of fame and fortune, which include money and sexual opportunity.

Love weakens rationality and leaves everyone only one step beyond the mental disorder. Love and madness, therefore, are almost the same phenomenon.

A factor that plays an important role in both self-mutilation and eating disorders is a distorted body image. Although many women suffer from poor body image brought about by oppressive public attitudes and media images, societal pressure alone does not cause the kind of deep-seated mental and physiological disturbance that leads to serious and chronic self-mutilation or eating disorders. Cutting and burning, starving and stuffing, bingeing and purging all reflect both an extreme preoccupation with the body and an equally strong sense of alienation from it. The body is viewed as the enemy—an adversary that must be punished and controlled at all costs. At the same time, the body seems dead, unreal, separate from the soul. It's reality must constantly be proven. The root causes of this are much more closer to home. Like the skin ego, body image begins to form with the earliest skin contact between parent and infant. Whether a positive or negative body image ultimately develops as the child grows into adulthood depends on, among other things, the sense of power, control, and autonomy the child feels over her physical self. Inviolate body boundaries are essential to a healthy body image. Intrusive and neglectful caregiving results in poor body image and the compulsive need to artificially create and enforce body boundaries though behaviors like cutting and eating disorders.

These researches renewed his commitment to analysis, which he now conceived more as a means to produce personal growth than as a technique for treating mental disorder, and he increasingly devoted his energy to teaching others, whether as pupils or patients, the same methods he had perfected during his own confrontation with the unconscious and which he had excavated in all their bizarre ambiguity from an occult science of the seventeenth century.

I believe that most, almost all, mental health disorders originates in childhood experience – and it originates as a coping mechanism. If you look at anxiety, if I were to pull a gun on you, you would not be anxious, you’d be afraid, as you should be. When are we afraid? When we’re threatened with something. Either something bad happened to us or something that we need is threatened to be taken away from us. In the young child’s early life, anxiety is an attachment alarm. What is the child’s biggest need? Attachment with the parent, and connection with the parent. When the parent’s not around the child should feel some fear. That serves a positive purpose. When the child feels fear, he cries. And that brings the parent. Look at the mother cat responding to the kittens’ cries – it’s immediate. It’s the same with human beings who are still connected to the parenting instinct – they will respond to the child’s cry for help. That fear is adaptive. It’s a coping mechanism. But what happens to a person whose parents are taught by medical experts not to pick up their kids when they’re crying? Now that natural fear which causes the crying, which brings the parent and ends the anxiety is embedded in the child. So what begins as a coping mechanism, now becomes generalised. Under certain circumstances, there should be fear and anxiety. But when I have this anxiety when there is no immediate threat – what is that about? It’s not a response to anything external, it’s the embedded anxiety that I developed as a child. In a society that makes people more isolated all the time, where human social contact is replaced by the rather cold and impersonal world of the internet. And where young people have less opportunity for meaningful employment and belonging than their parents used to – there is a more general threat. When that general threat hits people who are in childhood over-immersed in anxiety that’s not relieved by the parent coming to help them, now you’ve got an anxiety situation.

Interestingly, the time in history when being multitalented was considered a boon was the very same period when people with eccentricities or even mental health disorders were treated as special.