11 thoughts on “Is Abnormal the New Normal?

  • May 17, 2013 at 8:42 pm

    I still have questions. In what way does NIMH’s push toward geneticizing disorder present a different problem? Are we seeing the beginnings of neo-eugenics raise it’s ugly head? Treatment is one thing, but a healthy respect for biodiversity is another. In what way is not just the DSM V, but the larger cultural shift that’s granted by genetic, and the yet unacheived but possible neuronal therapy define the need for a new ethical dilemma?

    The DSM V, while pathologizing several behaviors that may be considered normal, still offers a palliative model of care, which some, including me, believe is more appropriate in respecting individual client decisions, lifestyle and overall autonomy.

    The curative model, however, is inherently ethically sketchy. Whom do we cure and why? These are the questions that need to be answered with rational discussions that work past our apparent motives. We must remember, now that we have the biotech tools (or are building them), that a motive is not an action, but merely the justification. The action is still performed on a client who, in the end, must live with the consequences of both our actions, and our motives.

  • May 22, 2013 at 10:44 am

    Not only is there a move to over pathologize people, but also over use and inappropriate off label use of psychotropics. And many of these medications are allowed on the market without rigorous independent research, but with just the drug companies own research. I do not trust this. And the Psychitrists who are doing the medicating do not really know their patients enough before they medicate them. And psychotherapy as first line of treatment for a good amount of time instead of or before any medications is not what most psychitrists do, at least in my experience in private practice psychotherapy and working for the VA. From a Buddhist Psychology perspective, most of us have neurotic habitual patterns of perception, thinking, and behavior. To work on this takes alot of work which medications cannot replace and many times get in the way.

  • May 22, 2013 at 11:08 am

    Loved your article Marla. There is a back-and-forth struggle with the validity of the DSM medical model. On one hand it works well for me to get the right diagnosis for insurance…on the other hand one can easily over pathologize people if we don’t take the time to do a thorough assessment.
    I had to laugh out loud at the last line about hovering over the purchase button because I had just done the same thing, only minutes before reading the article, on amazon and decided to put the DSM-V in my cart instead of purchasing it.
    Dr. Ray, PhD in Clinical Psychology

  • May 22, 2013 at 3:31 pm

    Skin picking is absolutely more than just “grooming”; I would say it’s definitely valid to classify it as a disorder.

    I suffer from skin-picking, and I have deep scars all over my chest and arms from it. It’s not something I can just stop (and believe you me, I’ve tried and tried); I feel a need to do it, regardless of the fact that I’m destroying my skin. There’s a lot of emotional stuff involved with skin-picking.

  • May 23, 2013 at 12:32 am

    Very interesting article. Imho it seems that there is a tendency to see almost everyone as ill, or going to be ill,so that a treatment can be used as soon as possible. One can debate if it’s made for people’s health or just for business. If everyone is ill then everyone must or can be cured through treatments and drugs.

    It really seems that today we’re all ill, except medical professionists obviously.

    Unfortunately medicine is not a perfect science especially when dealing with minds. Last century women where treated for Hysteria and in this century there has been the Recovered Memories case.

    Who knows fifty years from now how many errors are being done today?

  • June 17, 2013 at 4:47 am

    My daughter is in a study at the NIH and let me be very clear… Once you have experienced being a parent of DMDD you will no longer question if it is indeed a true disabling condition! Recently my daughter with bare feet kicked our windshield and shattered it in four places and then jumped out of my moving car!! She is 11… This is a little girl that is smart, beautiful compassionate and yet straggles with perfection, sensory sensitivities, and extremely easily frustrated.. All of which will send her to the state of no longer being rationale or able to turn her fixated outburst around until either restrained and can fight until exhaustion or is so destructive that it wears her out.. Its horribly sad to see this and also see her verbally beat herself up for loosing it so bad and wish herself dead!! Let me tell you its very real and very sad…

  • July 5, 2013 at 1:57 am

    The two examples you gave to specify how ‘normal’ behavior is being patholigized is not ‘normal’ behavior. Skin picking that qualifies for enough criteria to be classified as a disorder is a type of OCD behavior much like trichotillomania, It is very disabling. With the two way oversimplified examples you just gave it leads to me believe that you are not informed to even be giving an opinion on this topic. These types of articles only further stigmatize people with mental health issues who face serious challenges, and struggles everyday. I have not read the manual, nor am I familiar with it’s contents fully, but I can assure you that we are finding out more, and more about human behavior everyday. Just because there wasn’t a name for something 20 yrs ago, doesn’t mean it didn’t exist. Most diagnosis’s require the symptoms to be pervasive, and significantly affect all areas of life, or functioning to qualify.

    • July 5, 2013 at 9:17 am

      I think you have misunderstood the point of this post. I am actually a specialist in this area and the point of this post is that these behaviors **are** disordered and that they **do** impair the functioning of these individuals. The point of the article is that normal behavior can extend beyond the normal range, impairing individuals’ lives. These are examples of such behaviors.

  • July 5, 2013 at 10:47 am

    Wow! this article sure did kick up a lot of emotions. I hate to over-simplify psychology because Lord knows that human behavior can range from Mother Theresa, to Adolf Hittler…covering the spectrum from devoted loving to horrific mass murder. Expecting a book to cover all ranges would not be realistic but we do need some guidelines to agree upon. In a perfect world we would take each person as an individual and help them find relief from suffering. Diagnosis is the first step to identifing the problem however, taylored treatment plans to help find relief is the real challenge because each person has a diverse mind-body-spirit experience that affects us differently, so finding a taylored treatment plan, or solution to healing is the real challengs. Basic questions such as where and how do you suffer…and how willing are you to do some work to change? can tell us a lot about what we (patient and therapist) need to do to make a shift reguardless of what catagory one fits into in the DSM.

  • September 24, 2013 at 11:24 am

    “This new disorder’s hallmark criteria are “temper outbursts that are grossly out of proportion in intensity or duration to the situation.” Yes, that’s right. It sounds like temper tantrums.”

    This certainly sounds as if you are mocking DSM-5. My son is 15 and entered his Forth admission yesterday. Reading the diagnostic criteria sounds as though the authors had been stalking my child. He is sad and angry all the time. He overreacts to everything. Last week it took him 45 minutes to take out the trash while he berated and cursed my wife. He has been this way since he was 7 years old! Yesterday, after two weeks of escalating his behaviors, he threatened to kill my wife and daughter. This goes way beyond temper tantrums.

    Although he was diagnosed as Mood Disorder NOS at age 8, he has been treated as though he is bi-polar and ADD. You cannot imagine the pain and regret I feel for having him on medications which possibly increased his symptoms and most likely permanently changed his brain chemistry.

    So if its not bi-polar and it goes far beyond any definition of “normal” tantrums, I don’t care what you call it, I just want to know how you treat it.

    • December 3, 2013 at 1:22 am

      Quite the contrary, this does not mock the DSM-5. These problems are real, but often misunderstood. I do believe it is a step in the direction of acknowledging these problems and improving access to care.


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