![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by alexandra_k on January 5, 2006, at 19:16:04
I was reading this last night and I thought I'd put excerpts up here incase anyone had any thoughts on it...
It is just one persons opinion (well, he is reporting other peoples opinions in the extracts really)...
Please don't shoot the messenger...
Though you are of course free to disagree with the message (though reasons are preferred)Happy reading :-)
The Gururumba people experience the state of “being a wild pig” (Newman 1964). In this state they run wild, looting articles of small value and attacking bystanders. The Gururumba think the wild-pig syndrome is caused by being bitten by the ghost of a recently dead member of the tribe. The antisocial behaviour is tolerated to a quite remarkable extent. The disease either runs its course or is ritually cured. Wild-pig behaviour is largely restricted to males between the ages of twenty-five and thirty-five. At this age men are likely to be under considerable economic pressure following the acquisition of a wife. Wild-pig behaviour seems to occur when a man cannot meet his financial obligations. After a display of wild-pig behaviour the individual receives special consideration with respect to these obligations. Newman convincingly explains wild-pig behaviour as a device by which a man can obtain this consideration without denying the fact that the demands made on him are legitimate. The behaviour is an action, but it is not acknowledged as such by the individual or by society. It is part of the wild-pig role that wild-pig behaviour is involuntary.In a recent book on multiple personality syndrome (MPS) Ian Hacking describes a form of social construction very similar to that seen in the Gururumba (Hacking 1995). According to Hacking the modern symptomology of MPS evolved hand in hand with theories of the disorder. By channelling their distress into forms recognized by current theory, individuals were able to gain social acceptance as “sick” and to receive positive feedback from therapists, support groups, and so forth. In the early days of the modern MPS epidemic individuals rarely presented with the full range of symptoms. Distressed individuals were “trained” in the production of MPS symptoms, first by expert therapists, and later by a voluntary movement of laypersons. Today, with the help of literature and television talk shows, patients are able to produce the symptoms without individual tuition. MPS has become part of the local culture in countries suffering the MPS epidemic.
A similar explanation might be given of the syndrome found in a number of southeast Asian societies and referred to as amok. The syndrome consists of indiscriminate attacks on others and usually culminates in the killing of the person who runs amok. Amok is traditionally triggered by perceived dishonour. Cases are cited of Westerners living in Asia running amok, presumably by example. Once again, this can be interpreted as a disclaimed action. The man running amok is not pretending to be in a frenzy, but he would not be in the frenzy unless he had learned that this is an appropriate response to certain unbearable social pressures. He is acting out a social role, part of which is that he is not in control of his actions. It might be argued that a similar syndrome now exists in Western culture. Men who believe that none of their options allows them self-respect exhibit a rather stereotypical pattern of behaviour, probably derived from contemporary action films. They shoot at a large group of people, not necessarily people associated with their misfortunes, before being shot or shooting themselves. They purport to be “out of control” and are treated as such by society, yet their behaviour is under the fairly precise control of a recently developed model of how one might behave in such a situation. Pg 140-141.
…
…There are at least three important senses in which categories can be socially constructed. First, there is the trivial sense in which all concepts are socially constructed. In this sense, the concepts of electron, magnesium, and clade are social constructions, as well as the concepts of citizen, member of parliament, and licensed dog owner. None of these concepts can exist independently of a community of speakers and thinkers, and each was created by a sociolinguistic process.
In the second, stronger sense, citizens, members of parliament, and licensed dog owners are social constructions while electrons, magnesium, and clades are not. The categories referred to in the first list are social constructions, whereas those referred to by the second list are not. The categories electron, magnesium, and clade would exist (their members would have certain properties in common) whether or not the concepts of those categories had been formulated. The elements described by the periodic table do not need the activities of a community of speakers and thinkers to make them differ in atomic weight and number. Modern systematics was not needed for evolving lineages to speciate. The category of MP’s, however, depends for its existence on the formulation of the concept of a member of parliament. Were it not for the sociolinguistic activities centered on this concept, the members of parliament would have nothing in common to differentiate them from nonmembers. According to Hacking the same is true of multiple personality syndrome The potential to develop MPS could be developed very differently. Another society might make something very different of the individuals who are now made into sufferers of MPS. That society might also make some cases of MPS into one alternative way of being and others into another alternative way of being . This way of grouping would find as much justification in the occurring phenomena as the current groupings. Hacking describes his view as dynamic nominalism. Dynamic nominalism differs from simple nominalism in that the members of the category do share something over and above the fact that they are members of that category. However, the fact that the members have these shared properties reflects the existence of the category and the social practices in which it is embedded (Hacking 1995).
The third sense of socially constructed is the sense expressed when someone remarks that a thing is “just socially constructed” and infers from this that no such thing exists. It would be natural to say this about Newman’s condition of ghost possession. Ghost possession is not a category like electron which exists independently of our social practice, but neither is it like member of parliament or licensed dog owner. Most people would happily admit that the only difference between MP’s and non-MP’s is that we as a community treat these people in a particular way. This realisation has no effect on the social practice in which the concept of MP is embedded. But it would make all the difference in the world to the Gururumba if they believed that the only difference between wild-pig men and other men is the decision of the men to be wild pigs and the decision of the community to treat them as such. The Gururumba practice of ghost possession rests on a collective pretense that this is not the case. Socially constructed categories in this third sense are social pretenses that cannot survive the realisation that they are merely our inventions. The general acceptance of Hacking’s analysis of multiple personality syndrome would have a corrosive effect on the social practices of the modern MPS community. Another Western example of this third sort of social construction may be the social construction of gender. Our social practices have been transformed by the growing acceptance that traditional gender characteristics are not the inevitable effects of biological sex. P 145-146
hmm...
i'm thinking there might be some confusion around whether mps is considered to be a social construction in the second or the third sense...there is more but i thought i'd see if there was a general interest first...
Posted by Damos on January 5, 2006, at 20:16:56
In reply to The social construction of (some) mental illness, posted by alexandra_k on January 5, 2006, at 19:16:04
> hmm...
> i'm thinking there might be some confusion around whether mps is considered to be a social construction in the second or the third sense...I was wondering about that too >:-/
> there is more but i thought i'd see if there was a general interest first...I'm not the sharpest chisel in the toolbox and my knowledge of MPS is considerably limited, but it's definitely interesting. If you don't get much of a response here maybe you could throw some other bit you find interesting over on Write.
Thanks Alex
Posted by James K on January 5, 2006, at 21:44:01
In reply to The social construction of (some) mental illness, posted by alexandra_k on January 5, 2006, at 19:16:04
> I was reading this last night and I thought I'd put excerpts up here incase anyone had any thoughts on it...
---I love having new concepts introduced into my head. New ways of seeing the world.
>
>
> According to Hacking the modern symptomology of MPS evolved hand in hand with theories of the disorder. By channelling their distress into forms recognized by current theory, individuals were able to gain social acceptance as “sick” and to receive positive feedback from therapists, support groups, and so forth. In the early days of the modern MPS epidemic individuals rarely presented with the full range of symptoms. Distressed individuals were “trained” in the production of MPS symptoms, first by expert therapists, and later by a voluntary movement of laypersons. Today, with the help of literature and television talk shows, patients are able to produce the symptoms without individual tuition. MPS has become part of the local culture in countries suffering the MPS epidemic.
>
---I wonder if there is any difference between the early "classic" mps or mpd (is there a difference) where a person had two or more distinct personalities that may or not be aware of each other (a very rare and severe condition), and this more society and therapist induced diagnosis? I am not a student so my knowledge is limited and varied.* The syndrome consists of indiscriminate attacks on others and usually culminates in the killing of the person who runs amok.
---suicide by cop.
* The man running amok is not pretending to be in a frenzy, but he would not be in the frenzy unless he had learned that this is an appropriate response to certain unbearable social pressures. He is acting out a social role, part of which is that he is not in control of his actions.
---The idea of an societal expectation induced psychosis fascinates me.
It might be argued that a similar syndrome now exists in Western culture. Men who believe that none of their options allows them self-respect exhibit a rather stereotypical pattern of behaviour, probably derived from contemporary action films. They shoot at a large group of people, not necessarily people associated with their misfortunes, before being shot or shooting themselves. They purport to be “out of control” and are treated as such by society, yet their behaviour is under the fairly precise control of a recently developed model of how one might behave in such a situation.>
> …
---It seems this first showed up as "going postal", but now mainly seems to be "killing my ex-wife".---I'm going to have to think about how this may relate to another concept that I've bought into involving a kind of death before dishonour attitude that leads to violence or murder over trivial or misunderstood slights.
>
That society might also make some cases of MPS into one alternative way of being and others into another alternative way of being . social practices in which it is embedded (Hacking 1995).
>
The general acceptance of Hacking’s analysis of multiple personality syndrome would have a corrosive effect on the social practices of the modern MPS community.
> hmm...
> i'm thinking there might be some confusion around whether mps is considered to be a social construction in the second or the third sense...---I'm now in way over my head, but mightn't what I might refer to as "classic mps" be of the second, and the common 1990's version be of the third?
> there is more but i thought i'd see if there was a general interest first...
>
---the fascinating part to me has to do with the concept of "reality of behavior including mental illness to the point of psychosis being capable of being produced by society's subconcious belief systems." Or I may be missing some or all of the point - or making up my own point.---It is putting me in a frame of mind of Philip K. Dick's more advanced fiction. The second time I've thought of him this week on this board.
This is too hard for my underexercised brain,
James_k
Posted by muffled on January 5, 2006, at 23:34:23
In reply to The social construction of (some) mental illness, posted by alexandra_k on January 5, 2006, at 19:16:04
Posted by alexandra_k on January 5, 2006, at 23:44:42
In reply to Re: The social construction of (some) mental illness, posted by Damos on January 5, 2006, at 20:16:56
> I'm not the sharpest chisel in the toolbox
i had to read it a number of times and i'm still a little confused... thats where i thought people might want to discuss it a little...
>If you don't get much of a response here maybe you could throw some other bit you find interesting over on Write.
yeah i could...
or...
i could quit spamming the boards
(and quite possibly breeching copyright):-(
;-)
Posted by alexandra_k on January 5, 2006, at 23:56:49
In reply to Re: The social construction of (some) mental illness » alexandra_k, posted by James K on January 5, 2006, at 21:44:01
i haven't encountered 'multiple personality syndrome' (as opposed to 'multiple personality disorder' or 'dissociative identity disorder') before...
i guess... i put that down to him being a biologist (well... philosophy of biology) really...
> ---I wonder if there is any difference between the early "classic" mps or mpd (is there a difference) where a person had two or more distinct personalities that may or not be aware of each other (a very rare and severe condition), and this more society and therapist induced diagnosis? I am not a student so my knowledge is limited and varied.
ah. no... i think they are supposed to be the same thing... though of course you can get the odd case of something... and i suppose you do get the odd case and then the theory is developed in order to explain the case... but then in virtue of the theory (the thought is)... you end up with an epidemic of cases...
> ---The idea of an societal expectation induced psychosis fascinates me.not sure if this is related...
there was something about the content of deluisons having a cultural component too...
so... people who were raised christian are more likely to have delusions with christian religious themes...> ---I'm going to have to think about how this may relate to another concept that I've bought into involving a kind of death before dishonour attitude that leads to violence or murder over trivial or misunderstood slights.
hmm.
> The general acceptance of Hacking’s analysis of multiple personality syndrome would have a corrosive effect on the social practices of the modern MPS community.> ---I'm now in way over my head, but mightn't what I might refer to as "classic mps" be of the second, and the common 1990's version be of the third?
yes... i think i get what you are saying...
i think... they are supposed to be the same thing though...and...
i'm wondering about something he goes on to say a little later...
ideas i have heard before...
where did all the hysterics go????
(people with psychosomatic paralysis)
you don't see many nowdays
(nowdays when it is fairly easy to detect as psychosomatic and patients tend to get a fairly unsympathetic response)
whereas when freud and co were all interested...
lotsa cases...one thought is that...
it evolved into mpd.
interesting...
but what i'm wondering...
is whether there is a bunch of people...
with similar personality (dunno what ya call it, hysterical, borderline, histeroid, dissociative, whatever...) where the SYMPTOMS may manifest differently as a function of culture but where...there is an underlying similarity that does not vary as a function of culture...
dunno.
> ---the fascinating part to me has to do with the concept of "reality of behavior including mental illness to the point of psychosis being capable of being produced by society's subconcious belief systems."hmm. i'm not sure what that is about... i'm not sure what you mean by 'societies subconscious belief systems'.
> ---It is putting me in a frame of mind of Philip K. Dick's more advanced fiction. The second time I've thought of him this week on this board.
i haven't read that...
> This is too hard for my underexercised brain,
its a bit too hard for mine too right now :-(
Posted by alexandra_k on January 5, 2006, at 23:57:35
In reply to Alex you giving me brain pain! :-) (nm) » alexandra_k, posted by muffled on January 5, 2006, at 23:34:23
Posted by muffled on January 6, 2006, at 0:01:13
In reply to sorry muffled... i think i'm giving it to myself. (nm) » muffled, posted by alexandra_k on January 5, 2006, at 23:57:35
Posted by James K on January 6, 2006, at 0:39:51
In reply to Re: The social construction of (some) mental illness » James K, posted by alexandra_k on January 5, 2006, at 23:56:49
>
> ideas i have heard before...
>
> where did all the hysterics go????
> (people with psychosomatic paralysis)
> you don't see many nowdays
> (nowdays when it is fairly easy to detect as psychosomatic and patients tend to get a fairly unsympathetic response)
> whereas when freud and co were all interested...
> lotsa cases...
>
> one thought is that...
>
> it evolved into mpd.
>
> interesting...
>
> but what i'm wondering...
>
> is whether there is a bunch of people...
> with similar personality (dunno what ya call it, hysterical, borderline, histeroid, dissociative, whatever...) where the SYMPTOMS may manifest differently as a function of culture but where...
>
> there is an underlying similarity that does not vary as a function of culture...
>
> dunno.---that is a thought worth pondering.
> > ---the fascinating part to me has to do with the concept of "reality of behavior including mental illness to the point of psychosis being capable of being produced by society's subconcious belief systems."
>
> hmm. i'm not sure what that is about... i'm not sure what you mean by 'societies subconscious belief systems'.
>
>
--- What I'm trying to refer to by stringing big words together. Is like the pig people, their society has this belief (which i guess isn't subconscious on second thought), and the men buy into and are actually mentally ill, and seemingly acting psychotic (not faking psychotic). And this doesn't exist except for their communities belief system. Another man in a different community (society?) would act completely different, but usually not psychotic. And I realize I'm the one who introduced psychosis into the conversation, so maybe this is my theory.---Taking this into modern western society esp. usa, then the beliefs would be subconscious. Folks don't know that young men think their only option is murder/suicide because society has told them that it is, but maybe that is why they think murder/suicide is their only option. (assuming this isn't all bunk), but the message is received anyway and amplified each time it occurs. So the man's real behavior which manifests itself in mentally ill, possibly psychotic mindset, was conceived and encouraged unknowingly by the society it hurts. (I don't want to excuse the crimes here I'm just speculating this theory farther out)
---I'm losing myself in run on sentences and inventing new sidetracks.
Time to go to bed. I enjoyed the idea. I'll read it all tomorrow and see if any of it makes sense. Maybe I'll bring it up in process group. that should get me more days in my program.
good night from
James K
Posted by Dinah on January 6, 2006, at 19:37:12
In reply to The social construction of (some) mental illness, posted by alexandra_k on January 5, 2006, at 19:16:04
Does it have to be all one or all the other?
Can't it be that the underlying "stuff" is the same, but the way it is described and organized is influenced by the information available to the patient's brain as presented by the patient's culture?
For example, perhaps the underlying feelings that were expressed in hysteria last century are expressed in self injury today. But that doesn't mean the entire thing is fake. The inchoate feelings are merely arranged around symptoms that have been already introduced to the patient.
It doesn't mean that the symptoms should be disregarded or the patient considered a perfectly healthy malingerer.
With regard to MPS, the feelings of separateness may be at times over history be presented as demonic possession or multiple personalities, or whatever else is recognized in society. But the experience of being separate is nonetheless real.
Of course in other cases, there may be no experience of separateness at all, but other driving forces that provoke the same symptoms.
By the way, I'm not sure hysteria is dead and gone. I had a nasty rash recently that was apparently caused completely by nervous scratching. It was still awfully itchy.
Posted by alexandra_k on January 6, 2006, at 22:40:05
In reply to Re: The social construction of (some) mental illness » alexandra_k, posted by James K on January 6, 2006, at 0:39:51
> Is like the pig people, their society has this belief... and the men buy into and are actually mentally ill, and seemingly acting psychotic (not faking psychotic). And this doesn't exist except for their communities belief system. Another man in a different community (society?) would act completely different, but usually not psychotic. And I realize I'm the one who introduced psychosis into the conversation, so maybe this is my theory.
ah. in this case... i'm not sure that the people who were considered spirit possessed were considered mentally ill. i'm not sure that... the tribe has the concept 'mental illness'. i think... it was just that they were inclined to be sympathetic regarding assisting them in meeting their financial obligations.
does it constitute a mental illness? i'm not sure... dsm says that mental illness must be abnormal in the persons culture... if every man claimed spirit possession and requested financial assistance i think the practice would die out fairly soon... i guess there are just a few cases... so i guess it is relatively abnormal in that persons culture. what is interesting... is that some people in that culture (not heaps but a few...) claim spirit possession. whereas nobody claims that they are possessed by a spirit which has turned them into a wild pig in western culture. or... there might be the odd case, but there aren't enough cases for dsm to consider it to be a disorder that is prevalent in western society. the disorder seems to be culture bound...
but that means... it isn't really a disorder like cancer or hiv or schizophrenia even (catatonic, for example)...
interesting that that is what they have to do in order to achieve assistance in their culture...
over here... you fill out a form or two for work and income new zealand ;-)maybe the latter cases are the 'non-psychotic' counter-parts? don't know...
> Folks don't know that young men think their only option is murder/suicide because society has told them that it is, but maybe that is why they think murder/suicide is their only option. (assuming this isn't all bunk), but the message is received anyway and amplified each time it occurs. So the man's real behavior which manifests itself in mentally ill, possibly psychotic mindset, was conceived and encouraged unknowingly by the society it hurts. (I don't want to excuse the crimes here I'm just speculating this theory farther out)
yes i hear you.
society has many double standards...
real men are breadwinners
that is fairly prevalent (though maybe not said as explicitly as it used to be)
the other stuff abotu it being okay if you aren't...
well...
politeness?society has a long way to go...
Posted by alexandra_k on January 6, 2006, at 22:57:10
In reply to Re: The social construction of (some) mental illne » alexandra_k, posted by Dinah on January 6, 2006, at 19:37:12
> Does it have to be all one or all the other?
?
do you mean all a social construct or all not a social construct?even if it is all a social construct...
there are three different senses in which it could be a social construct...
i guess the issue i'm considering is whether...
if it was widely accepted that DID was a culture bound syndrome (ie that people only exhibit the symptoms because exhibiting the symptoms is legitimated by our culture...) then... would the people be cured?
or...
would the symptoms just manifest in a new way? in whatever way they need to manifest in order to be legitimated by our culture?
i'm wondering about this...
and i'm also thinking... that even if it is true that the symptoms are as they are because the culture legitimates that... that doesn't mean that awareness of the fact will mean that society has to cease to legitimate that. i mean... i fairly much buy this account... the reason why so many people present with DID symptoms is because they are more likely to be helped than if they do not. also... the reason why so many people present with self injurous behaviour is because they are more likely to be helped than if they do not. same for suicide promices or threats or predictions or whatever...
but even if society recognises this as fact...
then i don't think it follows from that that people will suddenly cease with these things and be cured.
because...
i mean... if clincians decide to punish these behaviours then that would work i reckon. but... it would also increase suffering i think.
and it is playing chicken a little too much.but you can be aware of this... yet it doesn't change one hell of a lot. okay so i have alters because thats the thing of this century. last centuary i might have developed hysterical blindness. oh well. doesn't make them go away. doesn't help the hysteric be able to see.
i don't think...
the symptoms may vary...
but imo the distress is very real
the distress is the problem
while the manifestation may be culture bound
punishing the symptoms
ain't gonna help
the real problem...> For example, perhaps the underlying feelings that were expressed in hysteria last century are expressed in self injury today. But that doesn't mean the entire thing is fake. The inchoate feelings are merely arranged around symptoms that have been already introduced to the patient.
:-)
yeah.> It doesn't mean that the symptoms should be disregarded or the patient considered a perfectly healthy malingerer.
absolutely :-)
> With regard to MPS, the feelings of separateness may be at times over history be presented as demonic possession or multiple personalities, or whatever else is recognized in society. But the experience of being separate is nonetheless real.yes. what was supposed to be in common to the examples in the extract was...
'disclaimed action'
ie - i didn't do that it was the possessing spirit / alter / whatever...
it absolves the person of responsibility for their action...
that was the thought.
but then the action only occurs... in order to achieve the end goal...
if there was a 'non-pathological' option available to the person...
if people didn't have to get worse in order to get what they needed...well gee
that might put an end to culture bound syndromes
perhaps...
> By the way, I'm not sure hysteria is dead and gone. I had a nasty rash recently that was apparently caused completely by nervous scratching. It was still awfully itchy.yeah.
thats a little different to the classic symptoms (fairly extreme)
blindness
limb (leg for example) paralysis
etc.not being able to walk
or to see...will get you into hospital too ;-)
and it is fairly easy to tell these days whether limb paralysis is neurological or psychosomatic...
hence...
you tend not to see that manifestation
(because they don't receive the sympathy they used to)
is it pathological to want a little help?
to be hurting inside?i don't think so...
the trouble is that the mental health system is only supposed to deal with the severe cases...
so...
who is prepared to do what they need to do in order to be considered severe?
and all this operated UNCONSCIOUSLY
(most of the time)
UNCONSCIOUSLY
interesting...
Posted by Dinah on January 6, 2006, at 23:43:03
In reply to Re: The social construction of (some) mental illne » Dinah, posted by alexandra_k on January 6, 2006, at 22:57:10
Well, there's an easy way to tell. MPD today is more likely to get you scorn than help from the majority of clinicians. Will the presentation go away?
The theory seems to assume that the presentation of symptoms has a goal in mind. To absolve one of responsibility. To get help or attention.
And that may be the case in a certain percentage of cases, maybe even a large percentage of cases.
But in the people who really are having problems in an emotional sense, that isn't necessarily the primary purpose. I'm guessing the primary purpose behind organizing one's experience into a certain mold (a mold that one learns from one's culture to a large degree) is to make sense of one's experience. It's unsettling in a very large degree to have experiences one doesn't understand. Or to have experiences that one can't organize into a concept that one can grasp. So if an explanation comes up that organizes those experiences a person having genuine problems might grab onto that explanation.
Like someone who hears voices in their head. Well naturally it makes sense that those voices come from somewhere. And it occurs to them that those voices are being beamed into their head from alien spacecraft because the culture is full of science fiction references. While someone from 1750 would come up with a different "explanation" for what they're experiencing.
Or someone who is experiencing overwhelming overstimulation or anxiety might be convinced that their arm is paralyzed if that is something that is considered not unlikely in their society. Because they know that something is very wrong with them and they feel out of control. While someone in today's society would be somaticizing in a different way that is more in keeping with today's ideas. Like scratching themselves into an rash.
I don't know. Maybe we're saying the same things.
But in any case, I think the way a person organizes their experience says a lot about their experience. But not everyone who organizes their experiences in a given way is saying the *same* thing about themselves.
Besides, hasn't MPS been identified throughout the ages in a small percentage of people? And the only difference is that in recent years the percentage has grown larger and the alters have grown more numerous? Leading some to say that it was underdiagnosed in previous times, and some to say that it is a social construct?
While isn't it just as likely that many people who organize their experiences along the lines of MPD have completely different reasons for choosing that way of organizing their experiences?
Again, maybe we're saying the same things. People trying to grab for an explanation are most likely to choose one that is available to them. And so are those who are just trying to express general distress. And so are those who are trying to absolve themselves of responsibility. And so are those who are trying to get themselves help or attention.
Posted by James K on January 7, 2006, at 1:24:59
In reply to Re: The social construction of (some) mental illne » alexandra_k, posted by Dinah on January 6, 2006, at 23:43:03
Sometimes I'm following this, and sometimes I get lost in the complicated ideas and my own head. So if this isn't really relevant, carry on or feel free to respond to this as well.
This is about the self injury aspect that has come up a couple of times. I first hurt myself as a child and young adolescent. I think the impulse was pure hurt and rage + rebellion, proving my toughness to myself, and exploring pain on my own terms.
At that time I didn't know about self injury as a phenomenoen and the idea of hospitalization or any kind of help was completely foreign to me. We were poor and religious. Also, nobody knew. So I don't think anything about accepted or unaccepted manifestations could have played into my actions.
As I grew into adolescence and young adulthood, my world expanded and knowledge about psychiatry and it's history and personal stories was something I pursued. My first treatment was strictly for substance abuse, and all this other stuff came up in the testing. That's when things like Disasociation, and borderline were introduced to me as concepts.
Again, my knowledge continued to increase and so in my late twenties to mid-thirties. Behavior I think of as rolling the dice showed up. Meaning, If this doesn't kill me (and chances are good it won't) I know I can get help and step off the merry-go-round for a while.
Now I know I can get help just by asking. Because I have a history. And admitting to active alcoholism and suicidal ideation is a guaranteed ticket.
So it seems like there was a progression to conforming to society's definitions or diagnosises as I became more aware of them. But I thought I would die, and I self inflicted pain way before I understood anything?
I've never thought about any of this in this way so I may be off on it. this current attempt at real recovery is forcing me to be more linear in my life story.
Can any of this have any bearing on the really big picture concepts in the original reading or the subsequent comments? Is my story typical or atypical. And does the uncounscious or subconcious aspect of the culture override what I "Knew"?
I don't have to have answers, I'm just working things out in words.
James K.
Posted by Declan on January 11, 2006, at 17:26:58
In reply to Can I take it to the personal for a minute?, posted by James K on January 7, 2006, at 1:24:59
Social consruction had something to do with me. I was born in 1952, 20 in 1972 at university. I'd seen years before some hippies on the TV and incautiously said to my mother 'I want to be a hippy'. So if we say self harm of the Russian roulette sort, what more fun way, culturally out there as well (then), than reckless drug use?
Just recently someone I know was going to use a cricket bat to resolve a dispute with a boyfriend. Straight out of the movies.
It's hard for us in the west to have an understanding of the psychologies of less atomised, more collective and traditional cultures. Mental illness in India is different, so I have heard.
Maybe when this tea kicks in I will be able to read your post, Alex.
Declan
Posted by alexandra_k on January 16, 2006, at 14:28:31
In reply to Can I take it to the personal for a minute?, posted by James K on January 7, 2006, at 1:24:59
Hey. Sorry I have taken so long to get back to you on this.
> So it seems like there was a progression to conforming to society's definitions or diagnosises as I became more aware of them.
Yeah. I can trace my deterioration to my first hospitalisation. Not to say everything was all wonderful before then. But my behavioural symptoms... Escalated. And became a lot more frequent.
I think... There is something about how some people do deteriorate on admission / with contact from the service. Suprise, suprise, that was the verdict with hysteria too.
People started considering... How much it was the presence of psychiatry / psychiatric intervention / therapy that reinforced people exhibiting those symptoms.
Hence... Therapist created disorders.
Though... Maybe it has a lot to do with the concepts and theories too. Especially... In people who like to read (I sometimes wonder if I am my own worst enemy)...
Thanks for sharing.
Posted by James K on January 16, 2006, at 14:37:44
In reply to Re: Can I take it to the personal for a minute? » James K, posted by alexandra_k on January 16, 2006, at 14:28:31
Posted by alexandra_k on January 16, 2006, at 14:54:15
In reply to Re: The social construction of (some) mental illne » alexandra_k, posted by Dinah on January 6, 2006, at 23:43:03
> Well, there's an easy way to tell. MPD today is more likely to get you scorn than help from the majority of clinicians.
So will BPD. So will psychosomatic symptoms. The majority of clinician's don't want to know, that is true. But I think it is fair to say that people do get more attention from the DID label than the BPD label. And there are less judgements (from those who will treat). And there are some clinicians... Who specialise in the field and don't see clients with any other dx. Where you have to contest with the 'lying and manipulative and attention seeking' judgements prevalent in the BPD literature in the DID literature you have about how 'wonderfully special and sensitive and smart such people are to come up with such an ingenious coping strategy'.
Which would you rather have?
Which is most reinforcing (based on reading the literature?)
> Will the presentation go away?
I imagine it will evolve in time...
If theory drives the manifestation then it would follow that there should be an increase in amnesiatic symptoms with the reintroduction of the amnesia requirement in the current version of the DSM...
If rft from clinician's drives the manifestation then it would follow that if they stopped reinforcing then...
Alternative manifestations would evolve.
My guess would be... Something that is reinforced the way hysteria was and DID seems to be...> The theory seems to assume that the presentation of symptoms has a goal in mind.
No.
The symptoms aren't goal *directed*
But the symptoms are under the control of the rft contingencies.
The difference is that the first implies that people manifest their symptoms with the intention of deceiving in order to meet their needs.
The second implies that people manifest their symptoms because it leads to them getting more of their needs met (but that they do not need to be and mostly are not consciously aware of this).> But in the people who really are having problems in an emotional sense, that isn't necessarily the primary purpose.
To get a little help? I think that is fairly important. Sometimes thats what people need. I don't think there should be any judgement or shame associated with that. But... Seems that in todays society there is :-(
Unless...
> I'm guessing the primary purpose behind organizing one's experience into a certain mold (a mold that one learns from one's culture to a large degree) is to make sense of one's experience. It's unsettling in a very large degree to have experiences one doesn't understand. Or to have experiences that one can't organize into a concept that one can grasp. So if an explanation comes up that organizes those experiences a person having genuine problems might grab onto that explanation.
Yes. And when the organising scheme / concept glamorises the disorder (and / or people who manifest those symptoms)... Then it is a goodie :-) Spanos (the socio-cognitive guy) said fairly much that... That the DID dx gives people a 'glamorous and interesting (or similar) explanation for their difficulties). That can be latched onto by therapist and client both. But that can lead to... The rft of the manifestations (symptoms)... And the manifestations (symptoms) aren't the problem (because they vary depending on the rft contingencies)... And the manifestations (symptoms) become a way of defending against... The underlying problem. And working on the underlying problem.
> Like someone who hears voices in their head. Well naturally it makes sense that those voices come from somewhere. And it occurs to them that those voices are being beamed into their head from alien spacecraft because the culture is full of science fiction references. While someone from 1750 would come up with a different "explanation" for what they're experiencing.
Yep. 'Whatever existent technology might suggest'. People may be replaced by aliens... robots (in this day and age)... and even clones :-)
> But in any case, I think the way a person organizes their experience says a lot about their experience.
But there is a reciprocal relationship between theory and data. Theory doesn't just organise data... If you accept a certain theory of the data... Then that predicts certain things about what data will be observed. And then (suprise suprise) people act in ways that are consistent with the theory (so they manifest (more) symptoms that are consistent with the theory).
And so some theories...
The acceptance of the theory... Can lead to the existence of the phenomena. Not to say that some people didn't present with those symptoms some of the time initially. But they come to exhibit them more often. And more people come to exhibit them.
> Besides, hasn't MPS been identified throughout the ages in a small percentage of people?
Yes. Though its manifestation was a bit different. In particular... Switching used to take longer and be more gradual. Now switching tends to me more like... TV funnily enough. A sudden change like a change between scenes. The number of alters has also been on the rise (quite significantly) - which means people are presenting with WORSE symptoms. The situation has escalated quite significantly (severity of symptoms within the average sufferer, also number of people meeting dx criteria for the disorder).
Also worth bearing in mind that the current increase in the number of cases... Is largely limited to the US (or to areas of the world where a major DID clinician has gone to 'set up shop'). In particular... Bible belt areas where clinicians think there is something interesting about these cases (usually to do with demonic possession, satanic ritual abuse, and the notion of multiple souls).
> While isn't it just as likely that many people who organize their experiences along the lines of MPD have completely different reasons for choosing that way of organizing their experiences?
Maybe...
If so then the people who currently present with DID symptoms do not form a natural kind (or category) of people.
What I'm interested in is the thought that they DO have something underlying in common...
Possibly something they share with people with BPD...
Possibly something they share with people with PTSD...
Possibly something they share with people with hysteria etc...
Perhaps.> And so are those who are just trying to express general distress. And so are those who are trying to absolve themselves of responsibility. And so are those who are trying to get themselves help or attention.
Maybe the third is part of the first? Regarding the second... If people do this consciously (especially in a criminal context) then they tend to be written off as malingering or feigning.
:-)
Posted by alexandra_k on January 16, 2006, at 14:54:51
In reply to Glad you're back (nm) » alexandra_k, posted by James K on January 16, 2006, at 14:37:44
Posted by Dinah on January 16, 2006, at 20:17:26
In reply to Re: The social construction of (some) mental illne » Dinah, posted by alexandra_k on January 16, 2006, at 14:54:15
But I have no idea what point I was trying to make. And rereading my post doesn't seem to help any.
Blush.
Posted by alexandra_k on January 16, 2006, at 20:35:21
In reply to I'm dreadfully embarassed to admit this » alexandra_k, posted by Dinah on January 16, 2006, at 20:17:26
oh.
well maybe you weren't trying to make a point so much as kicking ideas around. i don't think i was trying to make a point... well... i started out just wanting to kick ideas around at any rate, but sometimes points emerge and i find i do have an opinion or two along the way ;-)
This is the end of the thread.
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