#dsm

[luckysheepharmony]

Why didn't Lennon/McCartney get therapy for their issues?

As a family/couple therapist in my day job and mclennon obsessive at night, I want to correct some overly positive views I feel people on this site often have about therapy and its potential.

Therapy, like anything else, is the product of its environment and the social attitudes of its time. While I'd love to imagine 1969 John and Paul getting couples therapy and living happily ever after, sadly, I have a more jaded view of my profession. Homosexuality was identified as a mental disorder in the DSM 2 (published 1968). Although the wording of this was softened in 1974 to reflect social pressures put on the psychiatric profession by gay liberation groups (suddenly we queers became officially less mad than before!) the DSM 3 (published 1980) still classified "ego-dystonic homosexuality" as a mental illness. (The difference, practically speaking, is that people were no longer deemed as being mad for being gay on its own; they were only mad if living in a homophobic society made them feel sad about being gay. That was, according to the dsm, a problem of the individual, not society. If we take DSM-II (1974 revision) to its natural conclusion, a mentally normal homo in 1974 would simply have skipped along the street, delighting in receiving the punches of strangers and rejection of their close friends and families for their perverted ways; but anyone feeling sadness about how they were treated and maybe feeling bad about being gay as a result should have got therapy to make that problematic sadness go away.) Any therapist, individual or couple, valuing their licence in the late 60s/early 70s would be working within this framework within their profession, as well as the wider social and their own personal attitudes towards homosexuality and bisexuality.

There is also the constraint of the particular therapeutic training. Psychodynamic/psychoanalytic therapy, for example, wouldn't allow LGBTQ people to train as therapists even as late as 2000. I had my own therapy back then (from a nationally known, respectable institution) as a troubled bisexual adolescent, and my therapist kept trying to perform conversion therapy on me, which was technically unethical back in 2000 but many therapists at that time still persisted in these attitudes, feeling it was most ethical to try and cure their patients' mental illness by changing their homo ways (rather than wondering if it was, in fact, society that was sick rather than the individual queer). Luckily I had sufficient self belief, undiagnosed autism and general stroppiness (together with being backed up with the more positive social attitudes towards queers in 2000 when compared to 1970) to tell them to fuck off, but I doubt I would have been able to do that in 1970, even if I had happened to be a Beatle suffering from extreme internalised homophobia and self loathing, desperately wanting to be straight.

If I was a celebrity, I would also not want to chat my business with some random stranger for fear the therapist may try to sell my story. John, I think, might have been OK taking the risk, being the outspoken edgelord he was, but we could certainly rule out the more cautious Paul for this reason alone.

Under all these conditions, even if Lennon wasn't seeing quacks, I can't see how even my favourite 1970 therapist, Salvador Minuchin, could have helped Lennon or Lennon/McCartney with their issues at this time.

A therapist from today, with our revisionist eyes, would of course do things differently than those back then. But unfortunately, as far as I know, even the Beatles didn't have access to a time machine. Therefore, in my professional opinion, mclennon would not have been helped by 1970s therapy. Please understand that doesn't mean I think today's therapists are better than those practicing 60 years ago; I just think today's social attitudes towards LGBTQ people are better than they were 60 years ago. Currently. Let's see how Trump gets on with making America great again.

I think what it comes down to is that it just wasn't soon enough for John and Paul to stand on top of a mountain with their flag unfurled. So just standard mclennon tragedy things then.

[prokopetz]

Today's aesthetic: cosmic horror tabletop RPGs from the 1980s whose creators wrote the "madness rules" by simply plagiarising a list of disorders and their descriptions from the DSM-II and turning it into a d100 lookup table, except the DSM-II still listed "homosexuality" as a mental disorder (it wasn't removed until the DSM-III), with the result that there are several published tabletop RPGs where there's a small but non-zero chance that seeing Cthulhu will make you gay.

[sysmedsaresexist]

Since my reply is hidden, I've decided to just make my own post about this and put some accurate info out there.

Covert DID vs Overt DID & Possession vs Non-possession: They don't mean what you think they mean!

Here's a bunch of facts and info in no particular order!

I saw a post about how masking isn't a type of covert DID, and I'm here to tell you that

Masking was the original covert!

Dissociation and the Dissociative Disorders (by Dorahy, Gold & O'Neil, 2nd edition, 2023)

You know the statistic in the DSM about covert/overt systems? It's taken from Kluft, above. And it includes masking.

Covert and overt aren't actually used all that often clinically, but it actually has several meanings, INCLUDING MASKING. Neither has to do with possession or non-possession, but they're unfortunately often incorrectly equated as "possession form = overt" and "non-possession = covert". They can overlap, but this is incorrect!

Possession's biggest use is for a disorder that no longer exists as a separate entry in the DSM 5.

Possession-Trance disorder still exists in the ICD, though, and we'll start there.

Trance disorder

"The trance state is not characterised by the experience of being replaced by an alternate identity."

"Trance Disorder is characterized by recurrent or single and prolonged involuntary marked alteration in an individual’s state of consciousness involving a trance state (without possession)."

"The trance state is not characterized by the experience of being replaced by an alternate identity."

"The identities of the possessing agents typically correspond to figures from the religious traditions in the society."

"In Possession Trance Disorder, the individual’s normal sense of personal identity is experienced as being replaced by an external ‘possessing’ spirit, power, deity or other spiritual entity, which is not the case in Trance Disorder. Possession trance states often include more complex activities (e.g., coherent conversations, characteristic gestures, facial expressions, specific verbalizations) than are typical of trance states, which tend to involve less complex activities (e.g., staring, falling)."

We can already see how this is starting to play out with overt/covert and non-possession/possession form.

Possession trance disorder

"Possession trance disorder is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness and the individual’s customary sense of personal identity is replaced by an external ‘possessing’ identity and in which the individual’s behaviours or movements are experienced as being controlled by the possessing agent."

"Trance episodes are attributed to the influence of an external ‘possessing’ spirit, power, deity or other spiritual entity."

"During possession trance states, the activities performed are often relatively complex (e.g., coherent conversations, characteristic gestures, facial expressions, specific verbalizations that are frequently culturally accepted as belonging to a particular possessing agent)."

"Presumed possessing agents in Possession Trance Disorder are usually spiritual in nature (e.g., spirits of the dead, gods, demons, or other spiritual entities) and are often experienced as making demands or expressing animosity."

"The identities of the possessing agents typically correspond to figures from the religious traditions in the society."

"This is distinguished from Dissociative Identity Disorder and Partial Dissociative Identity Disorder, which are characterized by the experience of two or more distinct, alternate personality states that are not attributed to an external possessing agent. Individuals describing both internally and externally attributed alternate identities should receive a diagnosis of Dissociative Identity Disorder or Partial Dissociative Identity Disorder. In this situation, an additional diagnosis of Possession Trance Disorder should not be assigned."

From Dissociative Identity Disorder, I only want to note one thing:

"Individuals who describe both internal distinct personality states that assume executive control as well as episodes of being controlled by an external possessing identity should receive a diagnosis of Dissociative Identity Disorder rather than Possession Trance Disorder."

So, already, we've learned that possession and non-possession have to do with whether the entities are experienced as internal or external agents.

You'll note that the ICD doesn't mention covert or overt at all.

So back to the DSM-- “possession” was diagnosed as Atypical Dissociative Disorder in the DSM-III or DDNOS in DSM-III-R. In DSM-IV, possession and trance were diagnosed as sub-categories of the Dissociative Trance Disorder (DTD), and in DSM-IV-TR they were merged into one, and recognized as a cultural variant of the Dissociative Disorder Not Otherwise Specified [DDNOS]. In DSM-5, possession-form presentations are linked with criterion A of DID: “Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession” (p. 292).

Another common myth has to do with amnesia and covert/overt. The facts are:

Covert DID is associated with the highest levels of blackout amnesia. That's how it stays covert. People have amnesia for their own amnesia. It's an incredible phenomenon that's highly documented.

Overt DID typically has the same or less amnesia. It's much harder to explain away noticeable behaviour so people are much more aware of their own gaps in memory and can begin treatment sooner. They're much more easily diagnosed. As internal dialogue and intrusion are far more different in these entities, people become aware sooner and experience more grey out amnesia thanks to this basic awareness.

Covert DID is no longer diagnosed as OSDD 1a. The DSM 5 introduced new reporting criteria that allow the patient and their family to self report switches. OSDD and DDNOS 1a were primarily used for situations where the clinician didn't witness a switch during interviewing. As such, OSDD these days mainly covers P-DID presentations where switching is genuinely rare, if it happens at all. While P-DID is less associated with amnesia, OSDD 1a will require it. P-DID without amnesia will fall into 1b or DID itself, thanks to the DSM's updated amnesia wording.

For this next bit, I'll be using the DSM 5, as that's what I have in front of me, for the purposes of this conversation, this version will do fine.

"Dissociative identity disorder is characterized by a) the presence of two or more distinct personality states or an experience of possession."

"The fragmentation of identity may vary with culture (e.g., possession-form presentations) and circumstance. Thus, individuals may experience discontinuities in identity and memory that may not be immediately evident to others or are obscured by attempts to hide dysfunction."

You know, overt/covert, and wow, it doesn't just have to do with the entities, BUT HOW YOU DESCRIBE YOUR DISORDER?!

You mean... like masking?

Holy shit, yeah, the DSM just said that.

These terms are not as interchangeable as some people think they are. They have very unique meanings and are very different concepts, not only from each other, but from how they're often used within the community.

To reiterate:

Possession form = external entities

Non-possession = internal entities

Overt = noticeable behaviour and mannerisms

Covert = hidden or sneaky behaviour or mannerisms

These can and do overlap, but exist as separate concepts.

More from the DSM:

"The defining feature of dissociative identity disorder is the presence of two or more distinct personality states or an experience of possession (Criterion A). The overtness or covertness of these personality states, however, varies as a function of psychological motivation, current level of stress, culture, internal conflicts and dynamics, and emotional resilience."

Oh, wow, it changes over time and can vary between alters themselves?! Wow.

"Sustained periods of identity disruption may occur when psychosocial pressures are severe and/or prolonged. In many possession-form cases of dissociative identity disorder, and in a small proportion of non-possession-form cases, manifestations of alternate identities are highly overt. Most individuals with non-possession-form dissociative identity disorder do not overtly display their discontinuity of identity for long periods of time; only a small minority present to clinical attention with observable alternation of identities."

"Possession-form identities in dissociative identity disorder typically manifest as behaviors that appear as if a “spirit,” supernatural being, or outside person has taken control, such that the individual begins speaking or acting in a distinctly different manner. For example, an individual’s behavior may give the appearance that her identity has been replaced by the “ghost” of a girl who committed suicide in the same community years before, speaking and acting as though she were still alive. Or an individual may be “taken over” by a demon or deity, resulting in profound impairment, and demanding that the individual or a relative be punished for a past act, followed by more subtle periods of identity alteration."

So, yes, according to the DSM, purposefully masking is a covert presentation, and it has nothing to do with possession or non-possession form. The way a system "naturally" presents will change many times over the course of their disorder.

IN FACT, if we want to get technical, covert actually refers specifically to heavy fragmentation in most clinical texts. Fragments are typically experienced internally and as intrusion, rather than switches. Here's a source.

Covert DID is a less dramatic and more subtle form of the disorder. In this variant, individuals with DID do not display overt switches or distinct personalities. Instead, they experience a fragmentation of their identity, leading to a lack of continuity in their sense of self and memory. These individuals may not even be aware of their condition and might attribute their memory lapses and identity shifts to stress, forgetfulness, or other factors.

Covert DID can be challenging to diagnose because the symptoms are less obvious. It often goes unrecognized for years, and individuals may suffer in silence without understanding the source of their difficulties. Therapy and expert evaluation are essential for identifying and addressing covert DID.

And another.

In addition, diagnostic challenges can result from identity alteration or personality switching not as obvious as expected. In fact, many patients have “covert DID” or “OSDD,” which is characterized by partial dissociation (e.g., dissociative intrusions) rather than full dissociation (i.e., switching plus amnesia).

In the end, though, these terms aren't used all that often, and various uses will still be understood in a clinical setting. Doctors can't even agree on definitions, so use them however you want.

It's not that big of a deal.

I hope this post was useful, even if it was a bit disjointed.

[i-am-aprl]

The short answer is no, not based on what he did.

Pathologizing resistance and protesting in all its forms, including the selfless act of self-immolation in order to communicate an urgent message to save countless innocent lives is a colonial imperialist tool.

Fight any attempt to pathologize Aaron or any activist. They delegitimize Palestinian liberation when they paint us as “mentally ill” as if freedom and liberation are mental diseases!

Rest in peace Aaron.

*Please seek help if you have thoughts of self-harm.

[autism-affirmations]

ICD version comes tomorrow

[grrl-operator]

Stüssy x Cactus Plant Flea Market

[untouchvbles]

Mitsubishi Lancer Evolution IX at Hot Rods On Hampton (2024) in Butler, WI.

[andybug1]

crystal, talking to edwin: oh that’s so funny. anyway have you ever heard of the DSM??

[radracer]

Mitsubishi Eclipse GS-T 2G

@okuyama0522 @yuta_fl5emon.99 @dk_blacksti

[lord-of-the-margins]

Recent thoughts on Transgenderism

Tumblr, I think it’s time we approach the gender talk.

I’ve been very angry at liberals since about 2022. Before that (2019-2021) I was terrified of them. I grew up as a liberal in a very liberal area. I knew one moderate conservative. All I’ve known is liberal perspectives and ideologies for most of my life. I went to Evergreen State college for years (super senior). I lived in the epicenter of woke.

I’m not going to be a liberal ever again. Being around a lot of liberals, like in a city, makes me nervous. That’s how bad things have been in my little world. All the bridges have been burnt and every knife has somehow found its way into my back. I’ve since taken them out and re-calibrated my expectations.

Still, I have gender issues. They’ve gotten a lot better. And gender shit is still consuming society for no real reason other than to spread misery it seems.

Because of how horrifically poorly liberal society handles the issue of transsexualism and transgenderism, I’m scared to share the new insights I’ve made regarding gender dysphoria. The way the left fetishizes and commodifies mental illness is truly disturbing. The teenage impulse to commandeer and mimic mental illness for attention is never discouraged at any point. Not even in fully grown adults.

If I tell you what I’ve discovered, I’m afraid you will destroy yet another portion of the DSM in a misguided attempt to validate me. It is not validating. You are harming people. I needed the DSM to figure out what was happening. I needed psychologists to push back on my impulses. I’m glad they did. They can no longer do so without fear of being slandered as transphobic.

I look at the work you’ve done on behalf of the trans community and it reads as a collection of demons trying their best to fix society.

So yeah.

I like Tumblr for reasons other than politics. I don’t really want to talk about politics on here all that much. But this national gender dysphoria the younger generations all seem to have is hard to ignore. It can also be offensive. I’ve felt as offended by Zoomers and Alphas trying to be inclusive as I did from Gen X trying to hurt my feelings. So that’s been a fun little discovery I’ve made about myself and the world. Maybe you just can’t escape it. It’s part of life either way. And if you’re fucking around with gender, it’s inevitable. Maybe constant offense needs to happen just to make this demented form of self-expression that less attractive. Because a trans identity is not an attractive endeavor. It doesn’t make for attractive men and women. If you must do it, you need a thick skin just to look at yourself in the mirror let alone to hear what anyone else has to say about it. It’s signing up for a lifetime of disappointment and can only be explained through mental illness.

To conclude, what I found behind the mental illness was even more mental illness. Given liberals’ inclination to celebrate, imitate, and capitalize on mental illness, I don’t think it would be wise for me to tell you about what I did to make the pain of gender dysphoria go away.

What I will tell you is that I had to recognize that I suffered incredible abuse growing up. Truly exceptional abuse. I’ve been studying books on the matter on and off for about four years now. I had to learn a lot of new things and it was very overwhelming at first. It changed how I saw myself and even how I view reality. It’s been quite a journey.

None of the resources I used were made by anyone in the trans community. None whatsoever. All the people who helped me wrote their books in saner times. Your big gay trans social justice movement didn’t help me one bit. Just like feminism has never really helped me personally. Because exceptional people don’t need a parade to get their foot in the door.

Whenever I get close to woke people, I get nervous. I’ve gotten better at sensing that malevolent energy. Since I grew up with it, it took some time to suss it out. It took a massive fuck up, followed up with sticking to my convictions, to feel about fifty knives in my back before it finally sank in.

A lot of damage has been done and yet there are people under the left’s banner I could still care for. People who make uplifting art that has truly helped me. If I hadn’t found them, I wouldn’t have bothered writing this. So I guess this is for the innocent, the clueless, the kind.

I would only consider seriously talking about gender dysphoria with the public if and only if the DSM once again recognizes transsexualism and transgenderism as mental illnesses and the American Psychological Association allows its practitioners to discourage transitioning.

[valexombie123]

YANDERETOBER- 2# BITE

"I wonder what I taste like?"

"I can help you."

[prokopetz]

All I'm saying is if you can take a DSM label and replace a random word in that label with "haunted" and the provided diagnostic criteria still sound reasonable, there was probably not a great deal of rigour involved to begin with.

[sysmedsaresexist]

A frustrated reminder

That this entry from the differentials section of PTSD isn't saying that DID is not a trauma disorder or that trauma isn't required for DID.

What this is saying is that DID, and other dissociative disorders, can manifest at any age and without a preceeding trigger, whereas PTSD requires a triggering traumatic event. It's also acknowledging that DID doesn't require PTSD for diagnosis, but that's because the DSM doesn't have complex PTSD in it.

If someone is experiencing PTSD symptoms without a preceding traumatic event, you can then look to dissociative disorders, some of which don't require trauma, and some of which can manifest years after the fact (DID, as explained in the DSM).

If we look to DID for those differentials, we can get a better idea.

Oh, look, wow, it's what I just said. PTSD symptoms without a known cause.

The ICD says something very similar.

In the differentials of PTSD, the ICD says:

If the dissociative symptoms are confined to episodes of re-experiencing in an individual with Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, an additional diagnosis of a Dissociative Disorder should not be assigned. If significant dissociative symptoms are present outside of episodes of re-experiencing and the full diagnostic requirements are met, an additional Dissociative Disorder diagnosis may be assigned.

If symptoms exist outside of a preceding PTSD event, a dissociative disorder can be considered.

And I mean, if we're allowed to look to other sections of the DSM to make points about DID, let's look at DPDR.

Please stop arguing this point, you HURT CDD systems when you do.

[sophieinwonderland]

i have a weapon of massive destruction

How can one person hold so much power!!! 😲

[moonshine-nightlight]

Pre-order: Don't Shoot the Messenger

My novella, Don't Shoot the Messenger, is now available for eBook pre-order on Amazon!

Print to come!

Despite how it might seem, being a messenger for the feared sea-demon pirate, Admiral Satrasi, infamous far and wide for having an entire fleet of raiding vessels who answer to him alone, is a relatively safe job. After all, no one knowingly crosses the Admiral. Right? The most recent captain looking to join his fleet hasn’t gotten that bulletin yet. He's going to find exactly what happens when someone interferes with the Admiral's favorite messenger.

UPDATE! It's officially out now!

Amazon: eBook and Paperback. It's also available through kindleunlimited!

[rootbeercarguy]

Mitsubishi GTO Twin Turbo at High Octane Car Party in penticton bc canada