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December 10, 2005

Comments

Volfy

I can agree with what you're saying Robbie, but I had a friend in high school who had a true *phobia* of homosexuals.

It wasn't "homophobia" where he hated gay people, or disapproved of anything really. He jokingly called people "fag" and whatnot like the vast majority of 16 year olds, but you could rationally talk to him and he could calmly talk about it and he wasn't hateful.

However, I have this memory of him, me, and our friends staying over at his house. He was shaking and freaking out because one of us said that we'd rubbed our balls on his pillow while he was out of the room.

It really was an irrational phobia, like people have of spiders or whatnot. I think psychiatric intervention would have been overkill for this guy, but I also think the world is complicated enough that there are at least some people who have psychiatric problems will regards to just about anything.

Aatom

this strikes me as an attempt to elevate symptoms into root causes. but then, the mental health community already tends to do that with addiction issues. like much of psychiatry, this seems like a big load of politicized horsecrap to me.

Jack Malebranche

"I don't consider psychology a science. And neither did Dr. Lecter." (Barney, paraphrased from "Hannibal")

This is the way I feel about psychology, psychiatry and sociology. They're highly subjective. Anything that relies on people interpreting each others (or their own) 'feelings' is a little sketchy in my book. I think it's a racket, and while a mental health professional probably has a lot of insight into the human mind...he also has to filter that information through his own personal prejudices. No one is 100% objective.

I honestly don't think you can call homophobia a real condition any more than you can call religion a mental health problem. I mean, that would be kind of easy to do, wouldn't it? And yet, politically difficult. Personal ideology is not insanity. This is where understanding the mind blurs into thought-policing.

This is an exceptionally well-written post, by the way.

Assistant Village Idiot

Any dislike can reach pathological proportions. Holocaust denial would certainly fit that description, but there is no move to include Judephobia as a diagnostic category. It is the irrational paranoia itself, not which target is chosen, that should be addressed. Differentiating in diagnosis between people who have a pathological hatred for gays and those who have one for Freemasons misses the point.

It dangerously misses the point. When the target of the paranoia becomes the focus for the clinician as well as the patient, then we shade immediately into pathologizing lesser versions of that dislike, culminating perhaps in diagnosing people who just don't feel like having Mormons over for dinner.

When I started in mental health in the 70's, paranoid schizophrenics were likely to single out the CIA as their persecutor. After the Godfather movies came out, the Mafia had a strong run as the focus of the newly paranoid. These days it tends to be computers or satellites beaming thoughts at them. Schizophrenics, at least, gravitate to what is currently in the air at the time they have their first break. It is possible that phobias and anxieties work the same way. A person anxious to the point of emotional paralysis might well light on whatever is in the news, or his neighborhood, as the purported cause.

The societal attitudes which cause something to be "in the air" strike me as something other than a psychiatric problem.

Jack, there is considerable variety in how hard-scientific people are in the social sciences. While I have general agreement with your overall assessment, you can find practitioners, particularly in psychiatry, who are as rigorous as you could wish. In my field, social work, you won't find many though.

I'm not usually a troll, so I'll try and make it back here just for honor's sake, even though gay issues don't often intersect with my current favorites.

T. Harris

I agree with almost everything you have to say on this subject. While I think some individuals who who extreme prejudices against other groups may suffer from some form of mental illness, it is unwise to classify all bigoted people as being mentally ill. Remember, though, that many of the extremist groups on the far right are probably cults--and people who are suffering from some form of mental illness are often attracted to these kinds of groups. I think the whole issue needs intensive research before before it would be appropriate to designate a separate disorder for individuals who hold extreme prejudices. There is no easy explanation, or solution to, the bigotry, hatred, and intolerance in the world.

Essem

Psychotherapy is indeed a very subjective field, although parts of it are supportable by scientific research and thinking. It is more of an art. Well-trained therapists include some degree of self-awareness about their own complexes and biases (countertransference) in relation to patients. Yet it is, in the final analysis, an interpersonal process (excluding the role of pharmacology).

It is also a heavily politicized field (what field, I wonder, isn't?), dominated by the liberal cultural consensus. (Except for mirror-image wackos like the NARTH crowd).

I have no sympathy whatever for expanding the discourse of pathology into wider areas of life. Do people not remember the Soviet Union's use of psychiatry? Not everything which is either imbalanced, unpleasant or wrong (even, evil) can be dealt with by therapy. Therapy can certainly be open to the religious voices in the soul --and as a Jungian, mine is-- but the way in which a toxic combo of liberal politics and psychotherapy join together and then slip into the vacuum created by retreating religion, well, as the boyz in the hood say, that's just nasty. We will always have Inquisitors. Nowadays they are not likely to be priests, more likely to be journalists or therapists.

The DSM, by the way, which is like the Book of Mormon for therapists, includes the following criteria for a good number of its disorders: must a. cause personal distress or b. significantly affect normal functioning. So if a homophobe has no problem being a homophobe and still holds down a job, etc. it's not the business of therapists or cryptotherapists to start diagnosing him. He's not your patient, he's just your enemy.

North Dallas Thirty

I definitely like the way Assistant Village Idiot put it; instead of trying to diagnose via what the individual fixates upon, we should be looking at why they fixate.

EssEm brings up a marvelous point as well; slowly, it seems, psychology is to replace religion as the main source of "right" and "wrong", and the DSM is starting to become the new "holy book".

Dan

Some of the posts here, while eloquent and well-thought, give me the impression that nobody really made it past the headline. If you read the Post article closely, you'll see that nobody's trying to put garden-variety homophobia into the DSM. But there is a subset of the homophobic population that is so wracked with anti-gay fear/hatred that it renders them incapable of living a normal life. Read the article before running off on a rant, people...

North Dallas Thirty

Actually, Dan, if you look at the update, leftists such as John Aravosis ARE trying to encourage people to put "garden-variety homophobia" into the DSM.

Dan

Oh please... debating against Avrosis is sandblasting a soup cracker. He's well on his way to becoming the Ann Coulter of the left.

Read the original Post article, people. You'll see this is a whole lotta hoopla over nothing.

Robbie

Dan, the most striking thing about the article is that the man is obviously suffering from any number of disorders. It seems almost superfluous to focus on homophobia and racism when it seems obvious they are merely symptoms of a more deeply imbedded disorder.

It's the emphasis of the psychiatrists in these cases that is so troubling. As someone else noted, they shouldn't be sympathizing with the political or social manifestation of his pathologies, but diagnosing the base pathologies directly.

They're crossing a boundary that really oughtn't be crossed in this field. I find it troublesome so-called professionals are doing it so willingly.

There are a lot of great comments in this thread though.

Dan

When I read the Post article, I didn't get the impression that the psychiatrists were giving any undue weight to the social stigma associated with xenophobia (whether it be racism/sexism/whatever). All the examples cited in the article showed people with serious social impairments. Let me give you two examples of racism: 1) A woman goes to brunch with her Jewish friend. When the Jewish friend shortchanges on the tip, the woman thinks "cheapass Jew". 2) A woman is so pathologically fearful of Jewish people that she habitually cleans herself on the off chance she touched something a Jew touched. She even refuses to go to a psychiatrist on the off chance the practicioner is Jewish. Which of these two examples was cited by the people supporting an addition to the DSM manual? I don't think the APA is trying to create 'Archie Bunker's Disease' here. I think they're merely investigating another form of delusional paranoia. By insisting that they stay away from anything that has social or political ramifications, I think you're impeding free scientific research... and being every bit as 'politically correct' as those who would seek to institutionalize people just for being racist.

Right on with the comments... interesting subject.

dakrat

What Dan just described in his 12/12/05 post in his second example of "racism" would probably not be considered racism at all. The example given by Volfy in his 12/10/05 post would probably not be considered an irrational fear, as he said it was, either.

Dan said:

"2) A woman is so pathologically fearful of Jewish people that she habitually cleans herself on the off chance she touched something a Jew touched. She even refuses to go to a psychiatrist on the off chance the practicioner is Jewish."

This is not properly a pathological fear or racism. What he has described here is obsessive compulsive disorder. No, not just because she cleans herself. The defining things of OCD is the Obsession; Jews in this case, and the Compulsion; to cleanse herself of all things Jew.

The example cited by Volfy:

"I have this memory of him, me, and our friends staying over at his house. He was shaking and freaking out because one of us said that we'd rubbed our balls on his pillow while he was out of the room."

This brings to light the even more telling signs of a much more severe OCD. OCD is characterized by irrational fears (often mistaken for phobias) which lead to an obsession. In this case it could be contact with other's male genetalia, becoming gay from passive contact with other's male genetalia, going to hell from touching something that someone else's genitals touched, or any completely irrational scenario that the mind can imagine. This irrational idea (fear) is always tied to an irrational consequence in the person's mind. Such as, "if I sleep on this pillow that another man's balls have touched I will become gay." Which leads to the compulsion. "I can't come into contact with anything that has been touched by another man's genitals." Someone with OCD can hide it very well from other people. However, when that world is broken, such as, "we rubbed our balls on your pillow." All hell can break loose. It can cause violent behavior in the individual or extreme fear and panic.

One of the most common examples, is the new mother who becomes obsessed with knives. She becomes obsessed with the irrational idea that she will carelessly leave knives on counters or in drawers where they will either come within reach of the child or fall on the child. This leads to the irrational fear that her child will get hold of a knife and stab himself/herself, or that a knife will fall on the child from a countertop. This causes the irrational compulsion to keep all knives in the highest cupboard and go back again and again and again to count the knives and keep looking at the counters to make sure all are in their place. It will keep her up at night doing this over and over, even though she knows in her mind that this is stupid and she knows where all the knives are she can't get rid of the compulsion to make sure just one more time because the consequence is so dire. And this creates the last symptom of the OCD. The ritual. She will eventually become so comfortable with her obsession and compulsion that it will develop into a safe number or system. She will start to begin to believe that if she counts the knives 7 times (or any other number) that this is the amount of times that makes exactly sure her baby is safe.

I wonder how many times that Volfy's friend had to wash his pillow case before it "came clean."

That example wouldn't be considered a mild case of OCD, but it certainly wouldn't even come close to being considered an extreme case. There are people whose entire lives are consumed by the rituals

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