26 de fevereiro de 2018

Enlightment through the DSM-I?

Filed under: Livros, Saúde e bem-estar — Tags:, , — Yurinho @ 21:15

So, these days I have read the Diagnostic and Statistical Manual, first edition, also known as DSM-I. It’s a manual that contains names and symptoms of several mental disorders. We know, everyone knows, that the human behavior can not be pigeon-holed in ingenuously closed diagnostic, but that was the way the writers found of producing statistics concerning different people who exhibit similar behavior. So, the DSM was never absolute; it’s a convention to make the production of quantifiable data easier. We can not assume that different people will act the same way because they received the same diagnosis.

Unfortunately, while reading the DSM-I, I also noticed a tendency for the pathologization of the strange. For example, there’s a diagnosis called “dysocial reacion”, according to which a person who grew up in a morally “abnormal” environment has a mental disorder for rejecting the “normal” moral code. Problem is that the DSM was written in the United States. Let’s suppose, for example, that I grew up in a place where homosexuality is tolerated. If I go to a place where homosexuality is taboo, I would be considered mentally ill for questioning the moral code in that place. And, back when the DSM-I was written (the fifties), homosexuality was considered a mental disorder and is listed as such in that very manual, right beside fetishes and pedophilia. So, with that diagnosis, the DSM-I seemed immune to change: if you challenge the dominant moral discourse, you are ill, so no one could challenge things like heteronormativity or age of consent laws and still be considered “healthy”. Not to mention the pathologization of behaviors that are now seen as not fundamentally wrong, such as antisocial or asocial tendency.

The DSM has changed a lot since then and is currently in it’s fifth revision. Paraphilias, for example, are now only considered a problem if you do something illegal to satisfy them or if they are cause of negative feelings. In practice, that means that, in the DSM-V, no sexuality is inherently sick, but you are disordered depending on how you manage them. You should seek legal means to achieve satisfaction, rather than seeing your sexuality as something to worry about.

I believe that every text teaches you something, even if it just teaches you how to not write a good text. The DSM-I allowed me to revisit an old problem that I have: emetophobia. According to the DSM-I, a phobia is characterized by the transference of anxiety from a general situation or feeling to a specific trigger, thus being an unconscious way to make a person avoid the anxiety that would, in a normal person, be caused by something else as long as they avoid that specific trigger, which is then avoided at all costs.

Since childhood, I’m obsessed with order, method and patterns. There’s not a single thing that I do without planning a pattern first. I have a method for studies, a method to do chores, formularies for creation of tabletop RPG adventures, sleep routines, song composition routines, drawing routines, writing routines, and so on. My desire for control is, sometimes, sexualized too. But vomiting follows no patterns. You never know when it will happen, it’s not something easily ignored and, generally, it can not be supressed. That made me greatly limit my food intake in adolescence. That also made me develop an obsessive worry with expiration dates and food conservation. So, a fear that made me develop more routines.

But I also notice that my fear is smaller, despite still present, if there’s no one looking and, sometimes, I wonder if it would be a more tolerable experience if was warned that I would be nauseous before actually feeling it, so that I would have time to organize myself and become psychologically prepared (I was not scared at all in that single time when I managed to actually achieve that preparation). I sometimes feel like that when thinking about death: maybe it would be a tolerable experience if I was warned beforehand, like, a week before dying. So, I wonder if my fear of throwing up is actually a transference of anxiety from loss of control into vomit. That’s kind of like how I started to feel scared of lightning after I moved to a taller house: I can’t say for sure that the lightning will strike this house, but I know that the chance has grown, even if less than 1%.

Upon reading that description in the DSM-I, I wondered if my fear of vomiting would go away if I managed to accept that some things are beyond my control. That would explain why my father also is emetophobic, as desire for control can be an inherited personality trait. He fears vomiting for similar reasons. If I could control the conditions surrounding the nausea in order to reduce embarrassment, maximize benefit and minimize discomfort, like I do with everything else, I wouldn’t be as scared. But the best thing I can do is to accept that I’m not in full control. The problem is how to do it. No matter how I look at it, I can’t find a “positive side” in not having full control over embarrassing bodily functions.

7 Comentários »

  1. Hi Yure, it seems like you have a mind that is deeply analytical. As far as I know, if you know inside your mind, the more you find problems within.. if you go analyzing it deeply, you will surely find many things to fix somehow.. everyone will come up with labels.. the fear of unknown will make everyone create labels… but it takes courage to look deep within…

    Curtido por 1 pessoa

    Comentário por kalaniyb — 18 de abril de 2018 @ 02:48

    • Indeed. I don’t think I would ever find a cause of some of my feelings in my life time, so I mostly quit looking into it. I only revisit my problems when I’m offered new insights. Plus, they don’t really pose a problem in my daily life, at least for now. It’s used to be a real problem when I was an adolescent. It got to a point where I needed to earn 14kg to have normal weight for my height. I was really underweight, because I was scared of eating and vomiting it afterwards. Was scared of accidentally eating something expired.


      Comentário por Yure — 18 de abril de 2018 @ 15:28

  2. […] touching wood, kissing a cross several times a day, washing hands, doing things in a certain order (my case, I […]


    Pingback por Notes on “Diagnostic and Statistical Manual”. | Analecto — 1 de março de 2018 @ 22:57

  3. Hi Yuri.
    It sounds like you might have what is termed “Obsessive Compulsive Disorder (O.C.D.)”. The solution is simple… stop worrying about things and trying to control everything. I remember having to deal with some clients who had this disorder. Their desire for minor things to be always in a certain way cause them to suspect that somehow something “bad” would happen. It is like the old rhyme, “Step on a crack & break your mothers back.” If you seriously believe this and begin to avoid ever stepping on any crack, this is an example of extreme O.C.D. You can get over it easily by stepping on cracks and regaining control over your own mind and emotions.
    As far as Human Sexuality and expression is concerned… who cares? Only those who themselves must be considered “Mad” because they want to exercise power over others so utterly. They are the ones like O.C.D. who have the problem.
    It always falls back to, “Humans do that they do based upon individual desire, ability and consent. As long as they do no harm to others, and in private, who cares?” Only these sick ones who suffer from an inability to permit people to just be themselves. They want all the World to obey them.

    Curtido por 1 pessoa

    Comentário por octaevius — 27 de fevereiro de 2018 @ 15:13

    • I haven’t sought professional help for this, because I don’t feel like it’s serious enough. I managed to tone it down as I grew older, but it still harms my spontaneity a little. As for the sexual expression point, I agree. If there’s no harm, there’s no victim, why there should be a crime? Only if state is a moral ditactor.


      Comentário por Yure — 27 de fevereiro de 2018 @ 15:27

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