Posted in science, Uncategorized, writing

Why I’m Leaving Behind Psychology as a Major (but still read and talk about research).

It’s not challenging enough, simple as that.

It’s also one of those majors where 80-90% of the students pass because it’s not challenging enough. And what I mean by that is it’s easy to get through a class without doing the supplemental reading or textbook work. You can even write papers without reading all the research necessary for your paper–and still pass.

The problem with textbooks and laxadasical studying is that these students grow into clinical professionals who believe their intuition knows better than science. Now, in some cases, intuition is important. Maybe your client has a tendency toward injuring themselves, and you notice this is increased when they lack eye contact in a session, talk softly, and rub their hands. You ask if they’ve had thoughts of hurting themselves, and maybe that client is comfortable with you, so they admit it. That’s using your intuition correctly.

When you believe that you know how to treat someone’s Panic Disorder or PTSD over the ONLY emprically proven method of CBT, you’re being clinically arrogant.

You can sit here and tell me “well this treatment worked better for me than CBT.” Great. The problem is that’s anecdotal. If we studied your treatment specifically, maybe we’d find your psychologist hyped up the treatment so much, your effects were placebo. Granted, once you knew that, your symptoms could come back full force, but at least you’re know the truth.

If you’re a psychology major and don’t know what “anecdotal” means, you’re only proving my point.

I know many people whose mindset is “C’s get degrees” and that’s true. For some classes like physics where the required GPA at my university is 2.7, that’s true. Those classes are HARD.

If your mindset in psychology is “Cs get degrees” and you become a clinician with the “C’s get degrees” mindset, I wouldn’t want you on my professional team. It’s nothing against you personally, it’s about the drive, the motivation, and the curiosity. I want all three of those things in someone who is digging into my brain.

You can also say there are a lot of different career options under psychology, and that’s true, but none of them interest me. It’s all a bunch of reading and that’s just not challenging enough.

Research psychology tickles my fancy, but what’s the point when the people who are supposed to be reading the papers (clinicians and professionals) DON’T READ THEM.

I. . .

It’s BAFFLING.

Almost sickening.

The general public still believes chemical imbalance is a proven theory, when it’s nothing more than a poorly supported hypothesis (that’s been debunked by researchers many times) that got headway in the media and is easier to accept than “we don’t know what’s going on, maybe people are just a variety of human” or “maybe people are more traumatized than we realize.”

In fact, a lot of research gets headway in the media. Often if you hear a researcher in the news, their article isn’t peer reviewed nor do they have multiple replications of their data under their belt. They just want the recognition. The writers who write about science don’t always have a background in it, mostly a background in journalism or English, and purport things that aren’t discussed in the research or that they are misconstruing; they don’t understand methods and procedures, and therefore misrepresent the findings.

That’s what propels me toward science writing. If I can impact the public, if I can help researchers get valid experiments out to the general public, that would be grand. I’ll have a background in lab science as well as psychology research and I’ll understand when a researcher puts out an article talking about the black hole in the center of our universe, I’ll know it to mean we’re not getting sucked in right away.

I’m not saying don’t pursue psychology. I think they are many great students as well, who are going into it with the mindset of “I want to make a difference.” And that’s beautiful. Just make sure you understand the facts and the research and you and I will be fine.

I’m writing this for others but also for myself. It’s been hard deciding to drop a major I once fell in love with. It’s a break up. I’m processing emotions and feelings of betrayal.

It’s hard, guys.

Until next time.

You’re not following The Philosophical Psychotic? Don’t forget! Just hit that little button and we’ll be all squared away. Join me on instagram @alilivesagain and twitter @thephilopsychotic.

Posted in Late Night Thoughts, Questions for you, science, Uncategorized, writing

Death in the Anthropocene

I fell asleep at 8pm last night and woke up at 5 this morning and so let’s talk about death.

I read this essay called Learning How to Die in the Anthropocene by Roy Scranton in the book Modern Ethics in 77 Arguments. If you’re a philosophy buff like me, if you took a lot of classes in undergraduate college on the subject and found that you talked often about the older guys and not so much about the people today, then this is the book for you. I will say some of the people today are lacking in their creative abilities and misunderstanding a lot of basic philosophical concepts, but I guess that’s just how we move with the time.

How to Die in the Anthropocene (our new era today), though, is well above some of the other essays I’ve read so far in this book. It talks about facing one’s death in light of climate change, in light of war, in light of being human and succumbing to our ultimate end. Scranton challenges that a bunch of philosophers sitting around and talking about life doesn’t make changes, BUT that the Anthropocene may indeed be the most philosophical of ages in that it’s requiring we question what it means to live, what does being human mean, and, most importantly, what do our lives mean in the face of death? He says, “What does one life mean in the face of species death or the collapse of global civilization? How do we make meaningful choices in the shadow of our inevitable end? . . . we have entered humanity’s most philosophical age–for this is precisely the problem of the Anthropocene. The rub is that now we have to learn how to die not as individuals, but as civilization.”

He describes his time in Iraq and how he faced death everyday. Yamamoto Tsunetomo’s Hagakure, a samurai manual, provided some solace. It said we should “meditate on inevitable death” daily. And so Scranton did so, imaging each day that he’d be blown up or shot or killed in some other war-torn, horrific sense, and he’d tell himself he didn’t need to worry because he was already dead. What mattered, then, was helping others come back alive. Tsunetomo says, “If by setting one’s heart right every morning and evening, one is able to live as though his body were already dead. . . He gains freedom in the Way.”

In the end, we realize that we are already dead. Each day is a new death for us in that every moment is something new, the next moment new still. We are indeed living death. Scranton doesn’t focus on what we need to do to save ourselves or our planet, he focuses on the fact that we’re already dead and that instead we should focus on adapting to this new way of life; “we can continue acting as if tomorrow will be just like yesterday, growing less and less prepared for each new disaster . . . or we can learn to see each day as the death of what came before, freeing ourselves to deal with whatever problems the present offers without attachment or fear.”

That is learning how to die.

We can apply this to physical life just the same as Scranton did. When someone passes, they leave behind what has come before (life) and if they move on to something, each moment will start anew again, as there is nothing that doesn’t come with something; if something came alone, there would be no such thing as nothing, and visa-versa. If we didn’t have death, there would be no life, quite literally, and so to those wondering whether living infinitely is possible, it’s not. You wouldn’t be alive if you can’t die. You couldn’t even “be” because there is no chance for you to “not be.” Sorry to burst your bubble.

I would argue that in the face of death our life means exactly what it’s meant to mean: we are here, shortly, and then we are not, and that goes the same for the bee that stung my foot, for the plants I sniffed as a child, for my first cat who died peacefully on the kitchen floor. We aren’t here to make a purpose on earth, we’re here to die. And the sooner you’re okay with that, the sooner life will be enjoyable.

Death hurts. I would go so far as to say it’s the most hollow, defeating, crushing feeling I’ve ever felt, to have someone pass on without either of you ready for that. But it doesn’t have to be. They have not only graduated from life, they’ve completed their purpose.

We can’t know if anything is next, we’re almost purposefully physically limited from ever knowing something like that. All we can know is that we will all complete the same end-goal and we should find celebration and happiness in what people do here and in their graduation.

This isn’t a somber topic. Rejoice.

Until next time.

Don’t forget to hit that follow button and join me over on Instagram @alilivesagain or on Twitter @Thephilopsychotic.

Posted in advocacy, Community, Emotions, Peer Support, psychology, science, Uncategorized, Voices, writing

Why I left Social Media Mental Health Advocacy

I got tired of living for my unwellness. It’s as simple as that.

One of the most rampant messages in mental health advocacy among peers is “I am not my illness,” which also requires you to view yourself as ill, which I never have, even with such “damning” diagnoses like Schizoaffective and PTSD. The thing is, if you are not your illness, why is it the focus of your day 24/7? Why are you constantly evaluating your symptoms to the point where simple, normal, everyday reactions are suddenly a product of your “illness” and you post each bad moment (with a sprinkle of good)? Don’t get me wrong, I get that the whole point is to erase stigma, especially when a diagnosis is on the schizophrenia spectrum. We’re seen as dangerous or unpredictable or unfit for society, and to come out and share your story theoretically shows people that we do not fit those labels. You know what else shows that?

Literally living your life.

Literally.

I hate that word literally, but this time I actually mean LITERALLY.

I’ve held a job for the last five years, I go to college, I love reading, art, writing, making music, writing songs, shopping, traveling, driving, going out for a drink once in a while. I enjoy people for the most part, until I’ve had enough of them. Best Buy and other tech stores are my safe haven. I would like to work in a lab one day or maybe as an editor or maybe both. The last thing on my mind is schizoaffective, and not because I don’t deal with bizarre thoughts or anxieties or delusions or voices or voice-thoughts or visual interruptions, but because the more I focus on it, the worse it gets.

If some people want to focus their life around their symptoms, that’s great. For me, I’d rather show neurotypical people that I can live just as normal and full of a life as they can. That discounts the myths of dangerousness and unpredictability more than me selling my face on instagram or Facebook with a caption of “we are not ‘this, this, this or this’.”

Don’t mistake this for hate. I know many people who do just that on Instagram. And you know what? We NEED some of that. We need some people constantly talking about it to keep it in people’s faces. The thing is, I’m just not fit for it. I want to live happily and healthily and focusing on psychosis doesn’t help me do that.

What I will never give up is sharing pertinent information on mental health and discussing the ramifications of the unending fraud of psychological and pharmaceutical research. For example, a ramification of that is everyone actually believing in the poorly supported hypothesis of chemical imbalance. It’s why I’m going to school.

I will also always counter people’s stigma where I find it. I will always promote peer services and maybe one day design research around them. So I’m not giving up being apart of the mental health community. I’m giving up what I thought I was supposed to do: share my story constantly, talk about my symptoms constantly, wrap my whole entire life around my experiences, constantly.

That shit is boring, I’ve realized, and stressful.

I feel this is the last time I will mention my diagnoses on this blog for the sake of my own health. I appreciate people who do share their story and who find solace in it. I, too, found solace in sharing my story when the psychosis hit heavy and I was still in denial and confused and suddenly my entire life was a lie. I needed people to relate to and I had so much to figure out about myself. I’ve gone past that point now. Now it’s time to actually live.

Thanks for reading, guys. I was absent to go to my second viewing/funeral in the last five months, and just needed a few days to let the existentialism quiet down.

Don’t forget to hit that follow button and join me over on instagram @alilivesagain or on twitter @thephilopsychotic.

Posted in Community, science

Changes, Changes, Changes

I’ve been absent from this blog, which was at one point my baby after I monstrously left MentalTruths.com to biodegrade in the internet ether. It seems I have a problem with deciding what I would like to write about. Anyone else?

I have taken hiatus from the mental health world. I’ve learned that constantly talking about my experiences has kept me unwell. I worked for almost five years as a peer counselor for at an adult residential discussing other people’s problems, and relating mine to theirs, and being a support, and it’s just been a really great way to distract myself from myself. It’s also been the most enlightening experience of my life. I’ve learned compassion and patience and work ethic and I am eternally grateful.

But it’s time to move on.

I will continue, on this site, to talk about psychological research and how it relates to what we see advertised to the general public (hint, it’s warped and embellished A LOT). What I WON’T be talking about as often, unless relevant somehow, is my personal experiences with voices, visions, depression, PTSD, or anxiety. If you are curious, you can reference other such great writings on this site such as : My Experience With Schizoaffective or February’s Scheduled Mental Breakdown.

I’d also like to focus on other topics of interests that I have, like fiction writing and photography and graphic art. There will be some structural site changes coming up that include new tabs for easy access to Psychological Research articles, writing articles, photography, and any other categories I’ll write about. I would like to create a community of many interests and hopefully full of some writers willing to share work with each other!

If all of this sounds interesting to you, please consider following ThePhilosophicalPsychotic, and also join me on Instagram @alilivesagain.

Any feedback or ideas are also greatly appreciated! What would YOU like to know about psychology research? (Disclaimer: I am not yet a researcher, but my bachelor’s is toward the field, and I’m considering my master’s in science communication. All information I provide on this site WILL be from primary, peer-reviewed sources, however).

What would you like to see a story about? Want to write one together? I’ve never done that before, but I’m open to it.

What kind of photos are your favorite? Do you do photography?

I welcome all and any comments, even if it’s just a heart emoji. People seem to like those.

Until next time.

Posted in psychology, science, Therapy

The Two Branches of Psychology

If you have been or are a psychology major, or you’re thinking about becoming one, you’re probably familiar with (or will become familiar with very quickly) people riding your major off as humanities, soft-science, and asking you “bro, you gunna be my counselor now?” There’s a reason psychology isn’t taken seriously, and part of it is the narrative psychology professionals have created and perpetrated. Let me explain.

Having been this major for a while now, I see two very distinct branches of psychology: the humanities side that dominates the media and is what everyone thinks of when you say you’re majoring in psychology, and the science side, which rarely ever makes the media unless the research hasn’t been peer reviewed and the researcher is money hungry.

Earlier in the year, I wrote a series called “Is Psychology a Science?” which you can read the first of at this link. We concluded there is a lot of science and that the problem is it isn’t being taken seriously, or it’s purposefully being subverted.

The Perfect Example: Gabapentin

At work, I’ve spoken with plenty of people who have been prescribed Gabapentin for anxiety or depression or as a PRN (as needed) medication. After a panic attack which I mistook for an allergic reaction to a medication, I ended up in Urgent Care and was prescribed Gabapentin “to make it through the weekend” because it’s “really great for anxiety.” I picked up the prescription (with insurance, it only cost eighty one cents, kind of how Percocet only cost me one dollar, and no, I don’t have high tier insurance) and got straight to work.

Gabapentin is FDA approved for treating Seizures and Postherapetic neuralgia (nerve pain, particularly after Shingles). It is often prescribed off-label for anxiety (usually social phobia, GAD, panic attacks, and generally worry), depression, insomnia, neuropathic pain related to fibromyalgia, regular pain, just pain, migraines, any headaches that could probably go away with aspirin or time, as a replacement for benzodiazepines (Ativan, e.t.c), as a replacement for opioids (oxycodone, e.t.c), alcohol withdrawal, benzodiazepine withdrawal, alcohol treatment (reduce drinking or sustain abstinence), bipolar disorder, any mood disorder, any perported mood dysfunction, restless leg syndrome. It can be taken as needed or daily. It belongs to its own class of drugs: the gapapentinoids. Another drug you may recognize from commercials that belongs to the gabapentoid class is Pregabalin, a.k.a Lyrica.

Anyone remember Lyrica commercials? God. Disturbing shit. I don’t watch television anymore, only streaming services, so I haven’t seen a pharmaceutical ad in a while. I don’t miss it.

What Does Research Say?

I didn’t take the Gabapentin because research told me what the doctor didn’t, or couldn’t: there is no robust evidence supporting Gabapentin for any of the off-label prescriptions above. My first indication of this came from a Vice article, which I was hesitant to read because, well, it’s Vice. So I took their investigative journalism with a grain of salt and used it to guide my database research. Here’s what I learned:

  • Parke-Davis, the company that funded research and research articles for Gabapentin purposefully avoided publishing the disappointing effects of Gabapentin. They tweaked the research to appear positive. This was found out in 2009, when researchers looked more carefully at the articles more carefully.
  • David Franklin, biologist, started working for Parke-Davis in 1996. He quit three months later, just after an executive “allegedly” told him: “I want you out there every day selling Neurontin. We all know Neurontin’s not growing for adjunctive therapy, besides that’s not where the money is. Pain management, now that’s money.” You can read more here.
  • This was all in the past, and Parke-Davis paid 420 million in restitution for violating, in the most disgusting way, psychological and biological research. The problem is, the rhetoric that Gabapentin is a “great drug” and “works well for anxiety, depression, and your momma’s broken hip” still permeates the medical world. Particularly the psychological one. This was done purposefully.
  • There is no substantial evidence for any off-label use. I searched the databases all this morning. I found one measly Meta-Analysis (review of multiple studies studying the same thing, analyzed statistically) that showed 7 studies using Gabapentin for alcohol use reduction or abstinence. It was better than placebo slightly, but “the only measure on which the analysis clearly favors the active medication is percentage of heavy drinking.” So, it didn’t stop drinking or help withdrawal, it just kind of made people drink less. Or mix the two. Which is even more dangerous.
  • The only research with Gabapentin and anxiety says it’s not substantial enough to help panic attacks and that many people are most likely experiencing a placebo effect when they take it. Given that I learned that, I saw no point in trying Gabapentin: the chances it wouldn’t work for me because I don’t believe it will was too great. When I checked my college’s database, I went through over ten pages of articles and didn’t see one study geared toward Gabapentin and anxiety.

What Does This Have to do With Psychologists?

Well, the same rhetoric permeates the clinical psychology department of the world as well. That is, psychologists are more likely to trust the word of their colleague than to go read a primary research source themselves, scrutinize the methods, results, and read the confounding variables. Human beings are naturally trusting, and that is a beautiful thing. It gets us into a lot of trouble though–most likely a colleague hasn’t read the primary research either, and is simply going off what their colleague told them.

Believe it or not, this is a research topic in psychology.

I came across this analysis in my searches this morning. In summary, the researchers did a qualitative analysis of different psychologists in private practice, and their attitudes toward things like empirically supported treatments. What did they find?

  • Psychologists are “interested in what works.”
  • They were skeptical about using protocols described by the treatments proved to work.
  • They were worried non-psychologists would use those treatments to dictate practice (which I’m having trouble seeing as bad).
  • Clinicians mostly used an “eclectic framework”, meaning they drew from many sources (most of which were probably not supported by any empirical data, I’m guessing.)
  • They valued: experience, peer networks, practitioner-orientated books, and continuing education that wasn’t “basic”. So, nothing that involves a Starbucks drink I guess.
  • If resources for learning empirically supported treatments became easier to access, they would be interested in implementing them into their practice.
  • Money, time, and training are all aspects which have been preventing psychologists from actually implementing researched practices into their treatment. 68% cited this as a major issue preventing them from adhering their practice to researched methods. 14% said it was because they just didn’t believe in the efficacy of the treatment and 5% said it was because that treatment wouldn’t fit a cliental population. Again, that is a belief, not a fact.
  • Only 19% of psychologists surveyed around the nation (United States) used psychological research papers as their primary source of research information. What the fuck are they reading? The Key To Beating Anxiety by some random self-published author on Amazon?

The analysis is much longer than what I’ve listed here, and gets deep into some real topics anyone considering going into clinical or counseling psychology should pay attention to. The message to take away here is that attitudes and beliefs are driving how we are being treated both in the psychological world and the medical field. Physicians fall prey to the “word-of-mouth” about drugs in the same way psychologists fall prey to the “word-of-mouth” about treatments. This is why I write these articles: it’s up to the consumers to play an active role in what they are putting into their body, how, and why. It’s also up to the consumers to be informed in treatments, ideas, and beliefs.

Otherwise, you’re giving your life up to someone who may not know what they’re talking about any better than you do.

Lastly, let’s get something straight: I’m thankful for every medical professional I’ve ever come in contact with, because they’ve all taught me something for better or for worse. I’m thankful for the front-line workers who have spent the last 8 or 9 months using insanely inventive strategies to try and keep their worse Covid patients alive. Doctors are reading researched evidence because the links to research are suddenly in the media, and researchers are putting out what works and what doesn’t, as they should always be. This scramble to beat Covid has stirred probably the most ethical (and probably also the most unethical) research that’s been done in a while.

It suddenly makes sense to do things right when your life is at stake.

The point is, stay informed, stay healthy, and read.

Agree or disagree? Leave it in the comments below, or find me here:

Instagram: @written_in_the_photo

Twitter: @philopsychotic

If you liked this post, please share and follow The Philosophical Psychotic. I appreciate every reader and commentator. You give me more reason to encourage critical thinking about mental health.

Posted in Peer Support, Questions for you, science, Voices

What’s Your Ideal Treatment?

I think one thing that frustrates me the most about mental health treatment services today is that the services available are shoddy, expensive, and instead of being tailored toward the individual they’re tailored to the diagnosis.

For example, if you walk in to your average psychiatrist and say: “I have a diagnosis of Schizophrenia. My mom just passed and I’ve been struggling a lot at work. I haven’t had to be on meds for a while (or, I’m on a low dose of meds, or my medication usually works), and really I’ve just been struggling with anxiety. I’m shaking a lot and I think I need some help. What do you suggest?” Chances are all your psychiatrist heard was “schizophrenia”.

It’s better to leave the diagnosis out of it.

I use this example because I can empathize with it. My most recent psychiatrist, for example, couldn’t get it out of her head that I hear voices sometimes, even though I said my voices and I are on pretty decent terms compared to what others struggle through. For me, they aren’t 24/7, they are a mix of inside my head and outside of my head, aren’t very commanding, and I gather comfort from their perspective sometimes. I am not overly attached to them. What I went to her for was anxiety and mood issues, as my official diagnosis is schizoAFFECTIVE. She seemed to remove the affective part, completely ignored the fact that a death close to me unhinged me (she said “Oh, that’s tough”, and moved on), and continuously tried to medicate my voices instead of focusing on ways I could help my anxiety–the reason I came to her.

Mind you, through all of our appointments, she never once asked me what my voices are like, what I think about them, how they respond to me. The reception staff messed up on my insurance and suddenly I owe them money I don’t have. Every time I email her for a simple question, which could be answered in an email, she wants to set up an appointment so I have to pay for it. This is why I stayed away from mainstream mental health.

But it’s not just that.

Studies show residential, communal, and peer support services are, dare I say, essential for growth and recovery, and yet you’ll be hard pressed to find any of those services affordable, available, or promoted in your area. I work in peer support, and I didn’t learn about any programs until I got a job there. Doctors didn’t know, therapists didn’t know, and of course it would be much too hard for them to do their job and help me find something.

Maybe this is just a California complaint.

There are wonderful communal options and residential facilities, places where true growth and opportunity are available . . .to those who can afford 35,000 dollars a month.

My point here is not a rant. My point is that mental health treatment has gone from ice baths in asylums backed by half-assed scientists to money traps and one-size-fits-all cardboard boxes backed by people with degrees who haven’t read a psychological research paper since their undergraduate research methods class.

We’ve dropped the ice baths, the asylums, AND the scientists.

Don’t you think this needs to change? What would you change? What is your version of ideal treatment? Leave your comments below or come to my instagram and join the discussion!

Instagram: @written_in_the_photo

Twitter: @philopsychotic

If you liked this post, please share and follow The Philosophical Psychotic. I appreciate every reader and commentator. You give me more reason to encourage critical thinking about mental health.

Posted in advocacy, Community, psychology, science

Black Mental Health in America

ATTENTION:

If you are black in America right now, you’re probably feeling pretty unsafe, especially if you’re in the south. If you are black in America right now with Schizophrenia, you’re probably feeling pretty unsafe, especially if you don’t have a lot of support. Chances are you don’t have a lot of support.

We know racism has been around. This ain’t nothing new to us. Some places you see it more than others. For example, the South tends to be a prime example of blatant, flamboyant displays of hatred. Here in California, in Santa Cruz, things are more subtle. You’ll have the skinhead clerk ring up your groceries, toss them aside, not ask you if you want a bag, never look you in the eyes, whereas he’ll greet the white woman in front of you and the white man behind you with a pearly smile.

(He works at The Dollar Store on Portola, if you’re reading this and from Santa Cruz. At least, he was. I haven’t seen him in a while.)

If you are biracial or light skinned, you might experience a lesser racism here in Santa Cruz if you keep quiet. If they assume you’re hispanic, you won’t be treated as equal but you’ll be offered more opportunities than your black friends, especially in school. If they are confused of who you are, if they see your brown skin, your curly hair, but don’t hear a thick accent industries have coined as “black”, they will treat you as an unknown. An unknown is just as dangerous. I’ve had four cop cars (a total of eight cops) called on me for a license plate light that wasn’t out. They kept my boyfriend and I sitting in the car for a total of thirty minutes while they ran my license, my insurance, huddled in a group behind my car, flooded us with white light from two SUVs. Had I let my anger or fear show, the night may have ended very differently.

Feeling hunted is a prime experience of paranoia. I think the reason this has not exacerbated my paranoia is because there is valid reason to fear existence right now.

It’s different now. The racists are coming out to play.

A local black woman (catch her page: @bellagmo on IG), someone who has been integral in bringing the community together during this time, was chased down the street on Fourth of July by a white person screaming “I”ll be racist if I want, black bitch!”. She continued her rant, saying she was downtown every day, hunting her–people like her. Black women, men, people. She made active, verbal threats caught on camera, things like, “I will fuck you up!” The police gave her a stern finger wag. A rope tied as a noose was seen hanging on a sign up by our University campus: UCSC.

There is so much hate against us in this county, in the world. And where do we get to go to express this pain?

Our white therapist?

Our white psychiatrist?

Our white Primary Care?

The nearest black therapist accepting patients is over 4 hours away.

There is an inherent feeling of being bonded with people of the same ethnicity. This does not mean other ethnicities can’t be helpful, supporting, or amazingly kind. It just means it’s not the same. My white therapist isn’t going to understand when I say watching people with my skin color and darker, people with my culture, people who talk the same as me, eat the same foods as me, like the same music, the same stories, have the same BLOODLINE as me, getting slaughtered on film makes me feel hunted. They won’t understand when I say it brings up a sadness generations deep. They won’t understand when I say I just want to stay inside, and not just because of COVID. They won’t understand when I say I feel like I’m doing all I can to be involved with my community but that I still don’t feel like it’s enough. They won’t understand when I talk about how invisible I felt growing up in a school system that labeled me hispanic and refused to acknowledge my own culture, who refused to teach the reality of my ancestors. They won’t understand the damage done by people who told me I wasn’t black, that I was Oreo, without even knowing my history.

You know what they’ll tell me?

Maybe it’s time to stay away from the news.

Because they don’t understand that when one of us gets shot, hanged, threatened, I will still know. The news doesn’t need to tell me. I feel it in my heart.

If you think this is just another person whining about inequality, you damn right.

I’m not whining, I’m putting the truth in your face.

I grew up unable to talk, terrified to do so, Selectively Mute. My voice was never encouraged and so I never developed one. And that, my friends, is the definition of genocide: to silence a people until their screams are just as invisible as their being. They’ve done it to Native Americans and indigenous people across the globe. They’ve taken their names, their language, tried to warp their culture, shame them as alcoholics, drug addicts, shove them in the corner of the classroom and forget about them after the bell rings.

I’m tired of walking around with this fucking weight on my chest. It feels like I can’t breathe, and it’s not because of COVID. It’s anxiety. It’s all this anger and confusion and sadness that I’m carrying with my ancestors who marched from their native area of what is now called Tennessee down to the western part of what is now called Mississippi. It’s all this anger and confusion and sadness that I’m carrying with my ancestors who were tossed, chained, onto a boat by pale men who didn’t speak their language, who didn’t respect our pleads for our children, for our lives, for our existence as a culture.

And now you expect me to respect yours?

My mother’s family is Polish. They fled Poland to escape World War 2.

No matter what ancestral part of me you rip into, I’ve been running, fighting, fearful, crying. My first instinct, whenever confronted with a problem, even the smallest thing, is to escape, hide, retreat, survive. A white therapist interprets this as chemical imbalance. Do you see the problem here?

I have been carrying this anger and fear since I can remember forming memories. It’s not just coming out because the racists are. It’s always been here and I’ve never talked about it because I’m supposed to keep my composure. I’m supposed to “let the past be the past.” I’m suppose to “just live in the now.” It’s not something therapists bring up because they have no idea it exists. Now I have voices in my head telling me to kill myself, and I attempted it in 2018. I also have voices that protect me, that feel with me, that make me laugh. I have voices I consider my ancestors and that, to me, isn’t a disorder.

I have anxiety that alerts me when I need to run, which is all the time. I’m constantly running. I’m constantly breathing hard. Just as all my brothers and sisters today, I’m having to carry 400 years of agony.

I remember growing up learning how we are apart of the animals, the Earth, the plants, the air, the sun, way before I learned the physics and math that say the same. I remember learning about both The Christian God and The Creator. I grew up with the last name Dauterive, the name of a man I am not biologically related to; my father’s biological father’s last name is Ware. My family is scattered. My grandmother grew up in Jackson, Mississippi. My father grew up in Sacramento. He moved to Santa Cruz, and we didn’t stay in contact with his family very much. I don’t know much about them other than bits of native history, food recipes, and cultural things my dad passed down. His dad grew up in Louisiana. I will never know what boat his ancestors came off of. I will never know what my name really is.

Dauterive is the last name of four different slave owners in Louisiana.

Who knows what Ware is attached to.

If you are black and have struggled with psychosis, anxiety, depression, bipolar, or any other label, understand that the medications you take (I have taken them in the past as well) are tested on white people for less than four months. If you’ve struggled finding one that works well with your body, or one that has strange side effects no one else seems to get, this may be a reason why. Understand that if you are a black woman, most of the med trials are done with white, middle-aged men. The trainings therapists receive are not culturally aware, they are based on white culture. Understand that it is up to you and I to break down the stigma in our own family and help our older parents understand that our mental health is not just some “defect” or “disorder” or “chemical imbalance”, it’s also the result of our genes being bombarded with environmental, traumatic triggers for 400 years.

This trauma is in our nervous system. We aren’t getting anxious for no reason. There is a reason: never having been safe. Never having been free. Being labeled dangerous, disgusting, dirty, less than human.

To my black, native, and biracial brothers and sisters: we no longer need to keep it in. We no longer need to keep our composure. We have a right to be angry. We have a right to demand change. We have a right to rest when we need to. We have a right to make racists uncomfortable.

We have a right to use our voice.

It’s taken me 25 years to learn this, and I’m not ashamed. I’m angry.

I don’t know if you’ve ever seen the kind of passion that can come from an angry person. But let me tell you. It’s somethin.

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Posted in Peer Support, science, Voices

Self-Compassion and Hearing Voices

Let’s talk about this concept of self-love, self-compassion and why it’s so pivotal when hearing voices.

My experience with the diagnosis Schizoaffective (Bipolar Type) may be different than yours, vastly, and much more so if you have been diagnosed with the blanket term Schizophrenia. I read a post the other day on an alternative treatment center dedicated solely to Schizoaffective, discussing their push to separate the label from the umbrella term schizophrenia, citing a need to treat it in its own category. I don’t think it’s so much the category that needs individualization, but the treatment itself. That’s a story for another day.

My point of bringing that into the story is that not everyone hears voices constantly and not everyone hears them the same way. Researchers are starting to catch up with this fact. There have been just a *few* studies into the differences between thought-like voices and external (hearing outside of the ear) voices, and some of the studies are fascinating. One, which I will link later when I find it again, cited 17% as the amount of time people say they heard exclusively external voices. For your personal interest, here is a survey and a study highlighting the differences between external and internal experiences.

Some of the marked differences included the types of responses. The researchers hypothesized that internal voices may have a more distressing quality to them–and this does not mean that external sounds and voices aren’t distressing, it just means they have a particular scale they were using to rate this. They obviously have no idea what it’s like in either experience. Let’s not make this into a petty competition about “who has it worse”. I hate that. It happens a lot in the mental health community, I’ve noticed.

The last table of the study showed some interesting percentages:

Hallucination Type:

Non-Verbal Auditory

Voices Commenting.

Voices Conversing

Voices commanding.

Commands to harm/kill oneself.

Commands to harm/kill others.

Positive/helpful voices

Persecutory Voices

Internal (or both)

63%

85%

55%

83%

30%

33%

32%

73%

External only

59%

68%

26%

66%

37%

13%

46%

53%

If you look at the study, they also listed their Chi-squared test results (statistical measurement) and their P values, bolding the significant differences. I’ve bolded the ones which were significantly different.

What Does This Mean?

They use this as evidence to confirm their hypothesis, I use it as evidence to show that variability in our experiences of the world. I also use it as evidence to show kindness and compassion is a necessity to yourself. If you are constantly being attacked by Persecutory Voices telling you the police believe you’re a murderer or a pedophile or a liar who has put their entire family in danger of the C.I.A, it takes a lot of strength to tell them “I’m better than you’re saying” or “I’m not any of what you’re telling me I am.” It takes double the strength to do so in a composed, neutral manner. It also takes a lot of practice. I still yell sometimes. I try not to do it in public.

It also takes a level of confidence in yourself, and comfortability with yourself, acceptance that what other people say about you isn’t necessarily true, and all of that can be easily stripped away from years of hospitalizations and being told you’re sick, ill, and broken. It rarely gets built back up because people with schizophrenia and psychosis alike are not encouraged into therapy much of the time. They aren’t encouraged to explore themselves. They aren’t encouraged to melt into the darkness because, well, it’s too dark. This prevents the growth necessary to heal.

Therapists and professionals are scared to talk when someone is, to them, incomprehensible, and for some reason they’re also scared to listen, as if they might hear something that makes sense in a bout of babbling that shouldn’t make any sense. And so a lot of the work is left up to us. After all, we are the ones with the voices, the thoughts, and the thought-like voices.

What Does Compassion Mean?

I had an experience a few months ago that was another cog in the machine of changing the way I see my voices. Although they’ve been telling me to kill a lot lately, mostly myself, sometimes other people if I’m around them, they’re not usually as aggressive, not since I’ve accepted them as beings tied down by the law of opposites: good must exist in the bad for the bad to exist, and bad must exist in the good for good to exist. When I realized they can’t possibly exist outside of that truth, I stopped labeling them as demons. For the past two years they’ve shaped into your regular, uncertain, lost souls, just like the rest of us.

But one night I felt particularly scattered, my thoughts weren’t making sense, and one of my voices told me to go for a drive. They urged and urged until I got off my ass and did so. We drove out to the cliffs, and I worried if I stopped the car I’d have a heart attack. So I kept driving and cry-singing because that’s always the best medicine, and at some point I think I asked them “why are you doing this to me?” And the response I got was something along the lines of “pain is necessary”. And I stopped crying not because the answer was profound, it’s certainly not, but because it reminded me of everything I’ve ever read, everything I’ve ever calculated, everything I’ve ever understood. There was a beauty in the pain I’d forgotten about, there had to be because pain cannot exist without the concept of pleasure and visa versa. He reminded me of my own duality and that this too shall pass; it must, for something that comes must also go.

And so part of the compassion involved with dealing with voices is submitting yourself, not in a passive way, but in an understanding way. If you don’t listen to them, they will never listen to you. To talk back is to not be “more crazy”, it’s to learn about yourself. That’s all you’re doing. You’re not “feeding into the sickness”. You’re not “making yourself worse”. You’re learning more than your therapist will ever know.

Another part of compassion is building your self-esteem. This can’t come from repeated mirror mantra’s of “you can do this”. Studies show it can make you feel worse; when you don’t live up to your expectations, you take a harder hit than someone who didn’t look at themselves in the mirror and convince themselves of a lie.

I say it’s a lie because if you don’t actually believe it while you’re saying it, it’s pointless. And telling yourself you believe it is not the same as believing it.

I’ve built my self-esteem along the years through support of others encouragement. Most of believing in myself came from other people believing in me, believing I could do something when I didn’t believe I could. Now, you see the opposite effect a lot of the time: in hospitals, for example, you may encounter a professional who has no confidence in your healing path (although they may consistently say “you can do this) and the less they believe in you, the more you’re convinced you’re sick for life, doomed to a plethora of medication and condescending doctors. Imagine the opposite. Imagine surrounding yourself with supportive people who understanding that falling down, that relapse, is apart of the process. Remember the law of opposites: one thing cannot exist without the other. You will have days of confidence, days of no confidence, and it’s how to grow from each happy and not-so-happy experience that will dictate your future path.

I think there are a bunch of cliche things you can list for self-compassion and care: eat healthy, exercise, reach out for help when you need it. Those are blanket examples, things that promote over-all wellness, but I think when dealing with voices, your self-compassion must be very individualized. What you and your voices need may be different from what me and my voices need, and this is why modern-day psychiatry has failed in so many aspects.

Showing yourself compassion also means avoiding judgement. Be careful labeling a feeling, voice, thought, as good or bad. Be careful labeling yourself as good or bad. What I’ve found more helpful is asking myself how the moment (if I hear something negative or positive, if I think of something strange, bizarre, or scary) can help me grow. If a voice tells me to pick up a rock and kill my partner with it, I ask myself if killing my partner will help me grow. The obvious answer is no. And therefore I respect the request, acknowledge the voice (laugh about it kind of) and continue on with my day, judgement-free.

Is Being Alone Okay?

Yes. This is part of the individualistic plan. For me, I haven’t yet gotten comfortable talking about my voices to anyone other than my significant other, and at times (if I’m feeling spunky) my therapist. Most of you know I work in peer services, and have the opportunity to talk about my voices everyday with others who experience similar things, and I find it very difficult to do so. I was raised to stay quiet and it’s been a long journey realizing that I don’t need to force myself to speak, even if others say that’s what I need to do to heal. I also don’t need to force myself to stay quiet. There’s a delicate balance here.

If keeping to yourself, exploring your feelings and voices with yourself, is what has helped enlighten you, what has helped you process your emotions, then that is okay. Remember how we mentioned it doesn’t matter what other people say? About how accepting that mind-state may help also with voices, particularly ones that accuse you of things? Well, shocker: it also supports you in dealing with pushy people who think they know how you should live.

We get told a lot of things. We get told we have to do this, eat this, act this way, fit this mold, fit this criteria, apply for this, stop doing this, take this, etc. We are rarely given the chance to truly decide for ourselves, and taking away that level of independence doesn’t built self-esteem. You are capable of making decisions for yourself.

I find that processing things in my head is quicker, more efficient, and when I come to a realization I get a warm feeling from the top of my head to the soles of my feet. Those are moments that change my perspective. I rarely have those moments when discussing feelings with people. That being said, there are moments I can’t keep things in my head, when I need to vent to someone, or ask for an outside perspective, and those times are okay too.

Overall . . .

. . . I think it’s important to recognize that no one is one-size-fits-all and that every way of living is an acceptable way of living, as it is life doing what life does. We may not see one person’s life as the way we think it should go. We may see more potential in them than they do in themselves, and that makes us want to help, make us want to push them into being “better” and that’s a judgement. It is. It is inevitable in life that some people will never heal. You may judge or perceive this as sad, but if everyone always healed then there would be no such thing as being stuck. If there was no such things as being stuck, well, there would be no such thing (or need for) healing. We wouldn’t exist as complex beings, only cookie-cutter versions of each other.

Each way to wellness (or not wellness), whether that be medication, no medication, therapy, no therapy, family, or no family, is an acceptable path. Once you are able to avoid judgement of where you are, once you are able to avoid the trap of “I should be here, but instead I’m here“, you will see life get much simpler.

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Posted in psychology, science

Mental Health Month: Substance Use

I’m going to try and write this as coherently as possible. We still have one more week left of Mental Health Month, and this Thursday, Friday, and Saturday (given my brain doesn’t melt from out of my ears) we will be covering the last stretch of diagnoses we could fit in this month: Somatic disorders, eating disorders, and depressive disorders. If you have a story you’d like to share about any of the labels we’ve covered this month, contact me here or on my social media handles (below).

This evening we’ll be covering Substance-related and addictive disorders, with “substance related” excluding any of the typically prescribed psychotropic medications. That seems like a given, but it shouldn’t be; a lot of psychotropic meds can induce mania, depression, panic, and psychosis. This often gets labeled as proof of a disorder, but in the future when we dive more deeply into what kind of industry this is (and how helpful it can be in many circumstances), we’ll talk about how that’s bullshit.

To be frank.

But for now, we’ll talk about what they want to talk about, and that is the illegal substances no agency can make money from.

What we’re talking about here is the big ten: Alcohol, Caffeine, Cannabis, Hallucinogens, Inhalants, Opioids, Sedatives, Stimulants, Tobacco, and unknown.

What Is a Substance Use Disorder?

In order to be classified under this section, an individual has to continue using their choice substance even while recognizing (or not) significant substance-related problems. This is like the alcoholic whose doctor says their liver is fatty and swollen (a sign of cirrhosis) and despite the eventual fatal outcome, the alcoholic continues to drink. This could be because of many reasons. It could be the person is psychologically dependent on the mood alteration provided by the alcohol. Drinking may be the only way to feel “normal” by then. Physically, the person may be dependent on the resulting biochemical reactions of heavy drinking; stopping alcohol suddenly is the same death sentence as cirrhosis of the liver, but quicker. The body becomes so dependent on the substance that the removal of the substance puts the body (the brain mostly) in shock. This is called withdrawal.

It’s the same thing you experience if you stop your medication suddenly: your brain, having gotten used to whatever receptors that medication was binding to, suddenly has a stark depletion in that neurotransmitter and this can cause irregular electrical activity, mood changes, physical changes like heat flashes, cold sweats, muscle aches, etc. Your brain is constantly seeking homeostasis and there are two ways this gets disrupted: ingesting a substance and stopping a substances after long-term use. For those of us who stop, say, antipsychotics, the psychosis that presents itself is not necessarily what would happen if you were substance free. It’s not your “illness coming back”, its the disruption in homeostasis exacerbating your experiences.

Alcohol withdrawal is one of the most dangerous withdrawals and, if I’m still up to date on all my medical understanding of this, the only one in which you have a high chance of dying. I believe it surpasses benzo withdrawal risk. Those in severe Alcohol withdrawal will typically experience Grand Mal Seizures alongside all of the other mental and physical experiences.

How Do These Substances Interact With Our Body?

Benzodiazepines are some of the quickest addictive substances prescribed. Even if you don’t feel psychological dependent on them, you may realize quite suddenly that your body has become very accustomed to them. Some people have stated that even when taking two of their PRN Benzo medication per week for four weeks, their body went through physical withdrawal. The problem with that is benzos also work on GABA receptors, like alcohol. This is why Benzos are often a first choice in easing alcohol withdrawal.

It’s kind of like when they learned Morphine was addictive and synthesized heroin to use as a replacement. That backfired. We just don’t learn.

You can read about that in short-form here. There’s a much more in-depth, dependable review on the history of this on PubMed, I’ve just yet to find it again.

Stimulants, like cocaine, are not addictive as quickly but people still lose their lives to them. They target chemicals like dopamine, serotonin, and norepinephrine, all that handle feelings of pleasure, confidence, and energy.

Opiates target Endorphins, which inhibit both GABA and Dopamine. This stimulates the receptors to increase the amount of dopamine that’s released because there’s not enough in the synapses. This is the same chemical that releases when you exercise.

I’m not up to date on Inhalants, but I’m going to go ahead and say breathing in condensed chemicals probably tears a few cells up in the process.

Hallucinogens, including Acid, are some of the safest drugs, if you want to think of them like that. They still affect the body; some raise blood pressure or cause a racing heart, but their addictive properties are non-existent. These are being studied currently to treat depression, PTSD, and anxiety which means at some point they’ll be monetized, synthesized and eventually ruined. Many have had profound experiences though, and worked through trauma while micro-dosing LSD or being a risktaker and experimenting with one of the most powerful hallucinogens, Ayahuasca. These substances have a rich history in religious ceremony.

Tobacco and Caffeine are very much legal. Tobacco, once used in abundance as a smoking agent, is now full of carcinogens and heavy nicotine doses which trap the user in one of the hardest addiction cycles to break. Caffeine perpetuates anxiety, raises blood pressure, and is also great on cold mornings with a cigarette. So, pick your poison.

Aren’t These All Plants?

The majority of them, yes.

No, that does not make them safe.

Yes, many are not safe in part due to what people put in them.

No, I don’t suggest traveling to South America just to chew on a coca leaf.

Yes, if I didn’t have such bad anxiety, I’d probably be one of those people to travel to South American just to chew on a coca leaf.

Why Can’t People Just Stop?

Some people can, and do.

This is not a problem of disease. It is, however, a problem of weakened and exhausted self-control. This sounds as if it is blaming the user, but it is not.

There was a study I just learned about in a previous course where they tested individuals self-control and whether it could be exhausted. They set a task in front of a set group of people, one by one, and told them one specific instruction: do not eat the cookies, but feel free to have some of the radishes. They set the same task in front of another set group of people, one by one, and told them one specific instruction: have anything you want on the plate.

Those who had to exercise their self-control (by not eating the cookies) had less patience when it came to do the second task, which were some puzzles on paper. Those who did not have to exercise any self-control maintained their base awareness.

This is one of many tasks that shows it may not be indulgence that starts or continues an addiction, but rather a consistent breakdown of self-control; once someone uses a substance, they have went against the cultural norm to NOT use that substance. The physicality of the drug doesn’t make the second time easier, the reduction in self-control does.

There are many ways to continue to test this and could revolutionize how addiction is treated and looked at. It’s not the fault of the person. It’s not a defect in will-power or a weakness. It’s simply exhausting your bandwidth of self-control, which we could all easily do. That’s why addiction has no preference for creed or color.

Some may be genetically predisposed to a shorter self-control bandwidth, not addiction. This is my hypothesis. It’s not disproven, and it probably won’t be any time soon, not by me at least. But having grown up with generations of severe alcoholics behind me, one of which died at 56 because of it, I know what it’s like to feel like your genes might be defective. The truth is, at least between fathers and sons, sons of alcoholics are no more likely to become alcoholics than the average man.

I’m a woman, so I’m not sure of our statistics.

When I was prescribed Percocet for my back injury, the first pill did nothing. So I took two. And had no idea how hard it would hit me. I remember sitting in my research course and the room feeling light as air. My body felt warm and nice and I felt kind, friendly, approachable. I felt social, something I never feel. Then I spent forty minutes trying to keep my eyes awake and my notes were just scribbles. By the end of the class, I’d written nothing worthwhile, and my back still hurt.

But coming out of that I realized how people could get so attached to the feeling. It’s a level of happiness one couldn’t attain naturally, and evolution probably derived that limit for a reason. We’d have no sense, no awareness, no anxiety, no fear. We wouldn’t survive as a species.

I also noticed my need to take more. I told myself no.

I told myself no for two months.

And then I rewarded my self-control with a lack of self-control and two months later my stomach was tore up, I felt I couldn’t make it through the day without at least a half of pill, and I was becoming increasingly dissatisfied with my own natural state of being–the state without the high.

I went into this experimenting; if I focused on my self-control, designated days to take one pill, two pills, a half a pill, one and a half pills, could I sustain myself without becoming attached? And I did for one month until I exhausted that bandwidth; the more times I told myself “no” and then “okay, just take half”, the more likely I was to say “well, half isn’t going to do it, take one and a half.”

So, another way to evaluate this hypothesis would be to ask: is someone more likely to become addicted if they exercise self-control or no self-control? We couldn’t run those trials ethically, but there may be a way to design an experiment without ruining people’s bodies.

I was not addicted. But I felt the pull.

This can happen to anyone, for any reason, at any time, and it’s not a sign of internal weakness or brokenness or some other negative connotation that gets thrown alongside these experiences. We are creatures who often want to alter our moods. We want our anxiety to stop, our depression to ease up, our happiness to never end. We’re a culture ripe for the course of addiction. Think twice before your blame someone for their experiences.

Do Rehabs Really Do Anything?

I’ve never been. They didn’t work for my dad. But they work for many. Some people embrace the programs, like 12 Steps, and swear by it. Others find a different path. Some find no path and succumb to the substance. I’ve only been to an Alanon meeting for myself with a previous therapist and it felt too programed. I’ve went to AA and NA meetings and the cult aspect of it gave me panic attacks. But for those who felt truly touched by the program, there were many success stories and as long as people are living the life of health that they want to be living, I’m not going to knock that.

What About Relapse?

What about it? I hear many people learn new things from their relapses. Don’t get me wrong, these slips can and do kill people. But to regress and then progress and regress again only provides a new insight to the self and a different perspective on life. Relapse is slowly being seen as a natural progression of addiction rather than an added failure of the person.

If we take away the aspect of death (not to minimize it, but for the purpose of this thought experiment) we can think of it as experiencing another depression episode or psychotic episode. We learn more about how we need to care for ourselves. We may have a new respect for friends and family who come through for us. We can look back and see where we slipped up in self-care or evaluate an incident that lead to our regression.

We all fall back into things we don’t mean to. And when we learn to stop attacking ourselves for mistakes we make, we may just give ourselves a chance to heal.

I will be back with Somatic disorders on Thursday. Although, keep your eye out for a post on something a little more personal. I feel the need to express feelings through words. Thank you for reading.

If you want to connect or inquire about sharing your story, catch me here:

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Posted in psychology, science

Mental Health Month: Personality Disorders

Hey everyone. Welcome to this hour of Mental Health Month. Upon checking my notes, I realized I’ve completely skipped the week of the 18th, where we cover Somatic disorders, eating disorders, and depressive disorders, and went straight into the last week which covers Gender Dysphoria, Neurodevelopmental disorders, and personality disorders. So, I’m switching things around a little.

Yesterday we talked about Gender Dysphoria, the meaning of tolerance, and the realities of biological humans–that is, a brain can indeed develop specifically toward a different sex than the sex of the body. Today, we’re going to talk about Personality Disorders. Tomorrow we will cover Substance-Related and addictive Disorders. The following week will be Somatic disorders, eating disorders, and depressive disorders. We will include Neurodevelopmental disorders on the last day of the month so no one feels left out.

If you want to share an experience you’ve had with any of the above conditions, or even ones we’ve already talked about, feel free to contact me here or on my social media (profiles below).

Now, we come to my favorite section of the DSM-5, with one of the only disorders that has been characteristically diagnosed unreliably–that is, psychologists often come to same conclusions on other disorders but can never quite agree who has this one– and with little to no genetic influence detected. I’m, of course, talking about Borderline Personality Disorder. We’ll get to that shortly. 761

Because personality disorders widely controversial, the DSM constructs this section completely differently. First they describe personality disorders, clinically, as a discrepancy between a persons inner experience/behavior and the expectations of their culture. This is stable over time and generates impairment.

Then, they mention because of the “complexity” of the review process (this is a fancy way of saying because research that correlates these labels with “disordered brains” are inconclusive and scarce), they have split the personality disorder section into two. The second section updates what was in the DSM-4-TR, and the third section has a “proposed research model” for diagnosis and conceptualization.

Personality disorders are separated into clusters still. Cluster “A” disorders are:

Paranoid Personality Disorder: this includes someone with a “pervasive distrust” of others. People’s motives are perceived as malevolent and the individual has a preoccupation with doubts about people’s loyalty, and trustworthiness. There is a constant level of perceiving personal attacks where attacks are not intended and believe that others are exploiting them. This cannot occur during schizophrenia or any other psychotic disorder, including Bipolar mania. They may, however, experience brief psychotic episodes that last minutes or hours. I’ve always thought of this disorder as a miniature schizophrenia.

Schizoid Personality Disorder: This one is actually less harmful in terms of relationships because the person does not form close relationships and has no desire to do so. Not quite sure why that’s a problem. But, they have restricted range of expressed emotions and chooses solitary activities. They may be indifferent to praise or criticism and has a flattened affect. I’ve always thought of this disorder as the negative symptoms of schizophrenia, plus one.

Schizotypal Personality Disorder: This includes issues with close relationships as well but includes cognitive distortions, ideas of references but NOT delusions of reference, odd beliefs, bodily illusions and odd thinking. Paranoid ideation and constricted affect are also included. This cannot occur during the course of other psychotic disorders either, and is probably more of a mini schizophrenia than Paranoid Personality. People often seek treatment for the anxiety and depression rather than their thoughts or behaviors and they may experience psychotic episodes that last minutes to hours.

Cluster “B” Personality Disorders are the ones everyone wants to get their hands on.

And by hands on I mean “grasp an understanding of.”

And when I say Cluster B personality disorders, I really mean just the first two. The others no one seems to mention very often.

Antisocial Personality Disorder: This is not sociopathy. Sociopath isn’t even the correct word. Psychopath is. But that’s not who these people really are. We’ll talk about The Dark Triad next month. It’ll be great fun.

Those diagnosed with Antisocial PD do share some things with clinical psychopaths though, and that is their unyielding disregard for other’s natural rights. This includes breaking the law remorselessly, lying, conning, and being otherwise deceitful for fun or personal gain. It also includes impulsivity, aggressiveness, disregard for other’s safety, and irresponsibility. People must be 18 years old before this diagnosis is concluded and must have evidence of a conduct disorder before 15 years of age. None of these criteria can occur during schizophrenia episodes or bipolar episodes.

Borderline Personality DIsorder: This is the controversial one. It’s described as instability of relationships, self-image, and affects, with a sprinkle of impulsivity and efforts to avoid real/imagined abandonment. Individuals may also be impulsive with self-damaging activities, like reckless driving or spending, binge eating, substance abuse. There may be reoccurring self-mutilation and emotional instability around irritability and anxiety that lists a few hours and rarely more than a few days. Feels of emptiness, intense anger, and severe dissociative symptoms may also occur.

The dissociative symptoms should give a clue to what is one of the number one correlations with this disorder.

75% of diagnoses are female. And with every clinician learning that statistic, more females are likely to be diagnosed with it than actually have it. Across cultures as well, according to the DSM, it is often misdiagnosed.

Histrionic Personality Disorder: Not a commonly heard one, but in reading the description you might think you know someone with this personality type.

These individuals are attention seeking excessively, and very emotional. They need to be the center of attention and are often seductive. They have rapidly shifting expressions of emotions and their speech lacks detail. Everything is a theatrical display.

Narcissistic Personality Disorder: The second of the Dark Triad, which we will talk about next month. This is a pattern of serious grandiosity, fantastical or in behavior, and a need for admiration. There is a severe lack of empathy and these individuals generally want to be recognized as superior without reason. They are obsessed with fantasies of unlimited power, love, beauty, and success. An individual may believe they are inherently “special” and are insanely entitled. They are arrogant and envious.

50-75% are male. Again, these numbers also make it more likely they will be diagnosed with this.

Cluster C Personality Disorders are on the softer end of the spectrum. Softer not in intensity, but in personality. These are the people certain Cluster B types would take advantage of easily.

Avoidant Personality Disorder: This is someone who feels inadequate and hypersensitive to criticism, so much so that they avoid anything that may make them feel inadequate. This includes social gatherings, work, and any other interpersonal situations.

Dependent Personality Disorder: These individuals have a pervasive need to be taken care of. This may lead to serious submissiveness and clinging behavior. They fear making others feel bad, and so they will not disagree with people. Initiating projects on their own is hard, and seeks another relationship as comfort when another relationship ends.

Obsessive-Compulsive Personality Disorder: This is kind of like the umbrella diagnosis of OCD, but more inclined toward only orderliness, perfectionism, interpersonal control, and lists. They really like lists, rules, and organization. Money will be hoarded in case of catastrophe and they may be inflexible about morality, ethics, and values.

There are other personality disorders that may be due to medical conditions or are unspecified/otherwise specified.

What’s Up With Borderline Personality Disorder?

Well, what isn’t up with Borderline Personality?

It’s been the hot button in clinical psychology because of the intensity of emotions these individuals feel. It often results in some psychologists refusing to treat people diagnosed with these conditions. Two out of my six therapists have told me some version of a “horror story” of an anonymous someone diagnosed with BPD who stormed out of an appointment or blew up in anger and then stormed out of an appointment.

I feel this attaches a very negative connotation to this set of experiences. Everyone expects the outbursts, the sudden changes, the unruly emotions, and so when they happen it’s just more affirmation that the individual is out of control. Self-expectations and other’s expectations can play a huge role in behavior, even in those with this condition.

The problem is, psychologists actually really struggle in diagnosing this. Back in my research course I learned that studies showed psychologists are quite confident when they make the diagnosis, but when other psychologists evaluate the same patient, they often don’t come to the same conclusion. This is in comparison to someone with narcissistic personality disorder, where most psychologists came to the conclusion that that diagnosis was fit for that person. This could be for many reasons: the background of the psychologist, the presentation of the person, the interpretations of the psychologist. It could also be, though, that this condition presents varying experiences and that makes it harder to recognize patterns.

Borderline Personality usually comes with a decent set of childhood trauma. This article from 2017 talks about how childhood trauma can affect biological systems that are then connected to the development of borderline personality. This article from 2014 talks about Complex PTSD (which is not a DSM diagnosis) and Borderline personality. CPTSD overlaps a lot with Borderline, and so these researchers question the scientific integrity of CPTSD and the role of trauma in BPD.

It could be that we’ve had it wrong this whole time, that BPD is not in fact a personality “disorder”, but instead a trauma response condition. This switch would require absolute links between BPD and trauma, the likes of which would match with PTSD, and right now we have no absolute links for any mental health anything. So let’s not hold our breaths.

The point is, the experience of BPD are very real. The label and possible cause mean nothing when someone’s life is turned upside down, when relationships are constantly crumbling, when someone blames themselves constantly for “not being normal.”

Let me re-frame: the possible cause is important in the sense that it could change how treatment is approached. But it is not more important than affirming people’s experiences. Right now treatment for BPD includes therapies in which the individual learns to recognize, label, and acknowledge when their emotions are exaggerated, and medications normally meant for other conditions. There are no medications registered solely for the treatment of BPD.

People often see this as a hopeless diagnosis. Because of this, I encourage people to read personal stories from people diagnosed with this condition so you can see that many of these individuals are creative, vibrant, determined, beautiful people in many ways. There’s one personal story and one more here to get you started.

What’s the Difference Between Antisocial Personality and Psychopathy?

Well, one’s in the DSM-5 and the other is a checklist, for starters.

Psychopaths often lead pretty normal lives. The likelihood that you will see them in a therapists office or in the cell of a jail getting diagnosed with something is very, very slim. They are charming people, do very well in life, and no, they are NOT only serial killers. That’s romanticized Hollywood bullshit. They will manipulate, remain remorseless, and often create an abundance of wealth for themselves. C.E.O’s can score quite high on the psychopath checklist.

People with Antisocial Personality have trouble leading normal lives and can find themselves in trouble. They may be erratic and rage-prone, which can catch quite a lot of attention.

Criminals, like gang-members, are not necessarily psychopaths or antisocial. The DSM mentions that Antisocial may be misdiagnosed if someone is fighting for what they believe to be is their survival. Often gangs are comprised of people who feel close to the other members and consider them family, people who believe they are fighting for “the principle of the matter”, for honor, for integrity, for power. They know their lifestyle inflicts violence and fear, but believes there is no other way to live. They are willing to die for their street family.

That is the opposite of antisocial. It is criminal, but not abnormal given the circumstance.

Some people with antisocial personality are also psychopaths. Some people who are psychopaths are serial killers. Both overlaps are rare.

You are safe.

If anyone watches SBSK on Youtube with Chris, they did an interesting interview with someone diagnosed as Antisocial. You can watch it here. Again, sociopath is a clinically incorrect term.

Please. Stop using it.

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Twitter: @philopsychotic

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