Psychopathology Ate Personality: The Thickening DSM and Erosion of Normality [video]
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> Once upon a time there was a field called Personality Psychology, which concerned itself with normal-range individual differences between people, as distinct from dysfunction-inducing extremes classified as psychopathologies. Over the last 40 years, however, mental health diagnostic categories have broadened markedly, making the range of what we used to think of as "normal" much narrower. Diversity has become disorder. Although intended to broaden the availability of mental health services to more people, there is no evidence that this trend has contributed to improvements in population mental health - indeed, the opposite seems to be true.
Edit: clarified that this quotes the video description.
Greater awareness with more accessible treatment means the reported number of cases of X go up.
Autism wasn't invented in the '90s.
Widening the disorder criteria seems to cause more harm than good. We could already improve ourselves without identifying as disordered. And we usually do better when we identify as normal, healthy humans.
Fortunately, we can recognize the absurdity of the widening criteria and opt-in to identifying as normal, like most people are.
The purpose of the "disorder" is to group common pathologies and their respective treatments (methods to improve).
Let's take high functioning autism as an example of a "expanding disorder". The "treatment" for high functioning autism is largely behavioural. Preparing for known stressful events, methods to stay focused on a task you don't like, practicing identifying and displaying emotions appropriately, etc.
> We could already improve ourselves without identifying as disordered.
Many people with high functioning autism don't see it as a disorder and view it as a "different thinking style".
We can (and I think should) "embrace" that, but that does nothing to improve difficulties such as dealing with a new situation, making friends, communicating with their boss, etc.
Similarly I've heard "everyone says that have trouble focusing, you don't have adhd".
Whether you have adhd or not, the ways to improve your behaviour are the same. Methods to stay organized, prepare your environment to focus, prioritizing, etc. apply regardless of whether "you really have adhd or not"
> The purpose of the "disorder" is to group common pathologies and their respective treatments (methods to improve).
So nice to see this expressed. Classification helps when it lets us find effective treatment approaches. We do want to give people effective tools to face life difficulties.
That said, a problem happens when a classification has many different presentations. Person A with high functioning autism might need help staying focused on disliked tasks. Person B with high functioning autism might have trouble expressing emotions (but do fine with disliked tasks). As the classification widens, so does the range of presentations, and that increases the risk of treating people like B for difficulties that they don't have.
We can remove that risk if we treat the difficulty directly. Instead of `person -> classification -> difficulties -> treatments` we go `person -> difficulty -> treatment`. Simply match difficulties to treatments directly.
"Lots of people have difficulty staying focused on tasks they don't like. These things tend to help... "
> Many people with high functioning autism don't see it as a disorder and view it as a "different thinking style".
It's just so nice to see that. Happily, the DSM may remove high functioning autism, at least in part. Good! We did the same with homosexuality in 1973. The classification was the stigma.
It looks like we agree that classifications can help, if it points to effective treatment. I like to point out that wide categories obscure effective treatments and also introduce stigma. By dropping the classification, we can focus on the person, their real difficulties, and to normalizing their human experience.