BEYOND Two Hosts: DSM & Beyond - Part 1 (Feat. Demetrea Edwards)

Harvey and Pen are joined by Demetrea Edwards to talk about the DSM, including its uses, shortcomings, and how therapy and treatment look outside of it. The first of two parts.

Featuring: Welcome back Demetrea!; Thanks Wikipedia for the useful definitions; Diagnoses: They Aren't Always Right; Please don't take this book's word over real people's experiences; Wow, this sure was written by neurotypical cis white men; We need better studies, y'all; Masochistic Personality Disorder, aka Men Hating Their Wives

Referenced Wikipedia pages:

• https://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders
• https://en.wikipedia.org/wiki/Self-defeating_personality_disorder

Suicide Hotline & Resources for Trans People: 

https://translifeline.org/

USA Suicide Prevention: 

https://suicidepreventionlifeline.org/

International Suicide Hotlines: 

https://www.opencounseling.com/suicide-hotlines

Suicide Hotline & Resources for LGBTQ+ Young People: 

https://www.thetrevorproject.org/


Ways to support Black Lives Matter and find anti-racism resources:

https://linktr.ee/blacklivesmatte

Resources to support AAPI (Asian-American & Pacific Islander) communities:

https://www.advancingjustice-aajc.org/

https://stopaapihate.org/

Resources for US Immigrants:

https://www.informedimmigrant.com/

Resources to Support Undocumented Immigrants in the US:

https://immigrationjustice.us/

Transcript

Pen: 0:00

Hi, everybody, this is Pen. I just wanted to come in at the top here and let you know that we are going to be doing another two-part episode. We were lucky enough to be able to record with Demetrea Edwards. If you listened to our two-part episode on Blackness and Mental Health, you might remember her. This episode is on the DSM. I think, as is pretty typical for when we're going to be talking with another person or other people, we went a bit longer with recording than we usually do. So, this is going to be split into two about 30-minute sections. So when it fades off, and doesn't have, you know, the usual ending bits of Harvey sort of talking us out, that is why and then, in the next episode, just like I did with the Blackness and Mental Health one, I will lead in with about 30 seconds-ish of the ending audio, previous episode, so that it will make sense and work if you are listening to it in real-time or relistening. So yeah, go ahead, and I hope you enjoy. Hello, and welcome to Beyond Introspection, a podcast about mental health, neurodivergence and how it impacts literally every aspect of our lives.

Harvey: 1:22

All of them.

Pen: 1:23

Every one. On this episode, we are going to be talking about the DSM, that's the Diagnostic and Statistical Manual. Yeah, we're - okay, we're gonna definition in a minute here, because--what?

Harvey: 1:35

No, no, no, no, no. We didn't introduce ourselves.

Pen: 1:37

We didn't? Oh. I'm Pen.

Harvey: 1:39

And I'm Harvey.

Pen: 1:40

And we're gonna talk about the DSM. And we also have a guest! Demetrea, who was on our two-part episode on Blackness and mental health.

Harvey: 1:51

Way back, almost a year ago now.

Pen: 1:53

No, don't do that.

Demetrea: 1:56

I was like, wait, really? It's been a year?

Harvey: 1:59

It's been a bit.

Pen: 1:59

No! God, no! You can't - Harvey, you can't just say things!

Harvey: 2:03

I'm sorry. It is my duty as the co-host without ADHD.

Pen: 2:09

Yeah, yeah. Demetrea, would you like to introduce yourself at all?

Demetrea: 2:12

Yeah, sure. I'm Demetrea, she/her/hers pronouns. Um, I'm currently a national certified counselor, which is new for me. I'm excited about that.

Harvey: 2:23

Whoa, congratulations!

Demetrea: 2:25

Thank you. Thank you. I'm in the very lengthy and expensive process of applying for my license, so that has been fun and interesting, so... but I'm excited.

Pen: 2:38

Good luck! Thank you. I need it. Oh, wow. I know nothing about the process of becoming a counselor.

Demetrea: 2:48

You know, I didn't either, until I started it, which is so fun.

Pen: 2:52

That sounds like something they should have told you about during your...

Demetrea: 2:58

We could have a whole'nother conversation.

Harvey: 3:03

Oh, man.

Pen: 3:04

Yeah, yeah. We were originally going to record an episode on the DSM with Demetrea back in January, I think. And then life-

Harvey: 3:14

Life happened.

Pen: 3:14

It really just did keep happening.

Harvey: 3:16

Yeah.

Pen: 3:17

Because, you know, 2021 might not be 2020, but like, that's such a low bar.

Harvey: 3:23

I told you about the stairs, bro.

Pen: 3:24

Oh, my... hey!

Harvey: 3:27

I can say whatever I want on the podcast.

Pen: 3:29

Yeah, you can, and I can also edit it.

Harvey: 3:32

Ah, that's true.

Pen: 3:32

I wouldn't do that. But yeah, we're gonna talk about the DSM. Um, I know a little bit about what it is, but there are two people here who have actually had to, like, study it, I bet.

Harvey: 3:47

Honestly, me, not much. Um, the extent to my knowledge of the DSM is that I know what it is, and I know generally the taxonomies. And then I also - like, I'm aware of some of the diagnostic criteria, particularly as it relates to adult psychopathology, which is just how mental illness presents in adults. So I wouldn't say I'm an expert on it, but I know enough to have opinions on it and be mad about it, I would say.

Demetrea: 4:21

Yeah, I agree with you, Harvey. I'm pretty much in the same boat. You know, studies- especially pertaining to adults because that's kind of, like, my clientele. But um, yeah, very interesting book.

Harvey: 4:37

It's... yeah. So I know we were gonna touch on... you said a definition, Pen.

Pen: 4:43

Yes, yeah.

Harvey: 4:44

I mean, the DSM is something that is tricky to define. But as you were saying, we are on... okay, of the DSM stands for the Diagnostic and Statistical Manual, I believe, and we are on the fifth edition. We've had several. I believe the DSM has been around since the mid 20th century.

Pen: 5:01

I can look it up.

Harvey: 5:02

Early to mid, I believe, was when the first edition came out. You know, we've gone through a variety of editions. We've had a variety of different things listed as disorders, including being gay. It's - it's a - it's a document that is constantly in development, but I guess the.... kind of the big thing to know about the DSM is that it is... basically a list of all - mm, maybe not all - but, of some of the... trying to think of how to word this. It's a...

Pen: 5:41

Wikipedia has a wording.

Harvey: 5:43

Yeah, you know what? Let's - let's hear it from Wikipedia.

Pen: 5:47

"Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association for the classification of mental disorders using a common language and standard criteria."

Harvey: 5:59

Ah.

Pen: 6:00

The first one, DSM-1, was 1952.

Harvey: 6:02

Okay, yeah.

Pen: 6:03

Second, 1968. Third, 1980. Third-R, 1987. The fourth was'94. The fourth-TR, I'm guessing that's not like Pokemon technical record, 2000 - someone's gonna laugh at that joke. And then the DSM-5 was 2013.

Harvey: 6:24

Yes. And, you know, all those Rs, the TRs, those are revisions of the DSM.

Demetrea: 6:29

Yeah, yeah. Yes.

Harvey: 6:29

I know - I know, the third was revised, I think, partially to remove homosexuality as a - as a disorder.

Pen: 6:35

Wow, would you look at that!

Harvey: 6:37

But there's - I think there were other things. But, you know, Demetrea, I guess I did want to - I did want to pull you into the conversation and ask: you know, with you, I know, you are still working on your licensure and you like, you know, just, you know, just kind of started kind of the professional side of things, as opposed to just being in school. But I guess I'd be curious, so far, in the experience that you've had, like, how relevant has the DSM actually been for you?

Demetrea: 7:07

So, mm, I would say that, it gets complicated because... so, for my internship, I worked with Community Mental Health, which a lot of clients, you know - we don't diagnose. You know, they already have their diagnosis, um, and some of them have several, which I find very interesting, but also very realistic to what - what happens when you, you know, misdiagnose people, then they end up having, like, three or four different diagnoses on there.

Pen: 7:37

Hi!

Demetrea: 7:39

That they don't necessarily need, that is incorrect. And, you know, it gets, you know, confusing for, like, you know, clinicians who are coming in, they're like, you know, why do you have... you know - and it's not their fault, it's not their fault. So, um, I- I've had, you know, clients that - that are living with Borderline Personality Disorder, who was, very much so, by the book definition Borderline Personality Disorder, and then I've had clients who were not by the book, you know? So it - I think it depends, and I think that the book can be useful for very, like, basic, general knowledge. As long as you're not sitting in front of a human being and saying, "Well, this book says that you should be x, y, and z," you know, then I... you know what I mean? Like, it's very, like, good for. like, basic, General, like, standard knowledge, But once a client is in front of you and say, "Hey, this is what I'm experiencing," And, you know, "this is how my life has been, and this is what I need," then that's the information that I like to go based off of.

Pen: 8:47

Like, a person-centered approach... Yeah....rather than - yeah, that seems, mm, better.

Harvey: 8:56

And frankly, I would argue vital, but go on.

Pen: 8:57

Yeah, here's my, um - I have never had the DSM be relevant in any of my[unintelligible] comms major. But, here's the thing I would legitimately do back in - think it was when I was in community college.

Harvey: 9:14

Oh, I remember you saying this.

Pen: 9:15

Because I worked at the college library, and we had a copy of the DSM. And it was on, like, the hold shelf for classes. So psych class must have had it or whatever. And I would take it off - off the shelf, and like, look at some diagnoses that I was kind of, like, suspicious that I might have to just compare, like, my symptoms to that, and, like, what technically counted as a diagnosis. And in some ways, that was genuinely helpful, because I would go to my therapist and be like, "Hey, do you think I might have this?" And in other ways, like, could sometimes hinder it, because I was focused so much on, like, specific symptoms, and whether that, like, counted, or whether it was technically that diagnosis and trying to - it is useful to have, you know, labels, for what you're experiencing. But also, like, focusing so much on symptomology and - and objective definitions can be a complicated kind of thing, I say as a complete layperson.

Harvey: 10:15

But no, I mean, I would- I would fully agree with you, so much so that in the psychological community, there are two, I would say, predominant ways of looking at diagnosis, mental health, neurodivergence. And this is what I vaguely remember for one of my undergraduate courses. I'm- I'm blanking a little bit on the terminology, but there is... I believe it's categorical and dimensional, where the cat- the categorical model is - is what the DSM, uses where there is a certain - there are certain criteria involved in a disorder or a neurodivergence, and an individual must meet a certain number of those to be considered disordered. Whereas - there is a dim- there is the dimensional

Demetrea: 11:02

Yes, mm-hm. model, which is more used in certain circumstances, but generally is less widely used, that posits pretty much everything related to mental health is on an axis and that everyone sort of exists at some point. So I think, yeah, if you want an example of how that is complicated, I mean, psychology can't agree on anything. We can agree on very little, except that neurotransmitters are important and - and conditioning seems to work, but...

Pen: 11:41

Yeah, neurotransmitters are so important. Every time I find out that I, like, fundamentally, physiologically, lack them, I'm like, God, again?! Really?!

Harvey: 11:51

Feel that. But yeah, I mean, the thing is, I think it gets - I think diagnosis in particular, gets tricky, especially when, you know, like, there isn't even necessarily an agreement on how we ought to be evaluating it. And whether or not it's useful to have agreement, I'm not really sure. But I think that's - I think that's definitely part of it, that, you know, are we too rigid? And then-

Demetrea: 12:17

Yes.

Harvey: 12:17

On the other - and I would agree with you - and then on the other side of it, is there - is there such a thing as being too loose in one of those situations? And I think - I think that's where - I think that's one of the main places where diagnosis gets really dicey.

Demetrea: 12:34

Yeah. Yeah, that's the complicated part. And, and with that, too, there are, like, um, time frames of things. Like, if these symptoms last more than, you know, six months. I think, at some point or another, we've all especially experienced symptoms related to anxiety and depression, but may not, you know, be diagnosed with depression, or have depression, but you know, experienced some symptoms related to that. And, you know, during that period of time, people can look, you know, Google it, and look it up and research it, and be like, like, oh, my gosh, I have this diagnosis, when it's not necessarily true, it's just that you're experiencing, you know, symptoms related to, you know, those things. So, kind of that psychoeducation behind it kind of helps people understand it a little better, you know, kind of having - and I don't - you know, I don't exactly know how they come up with these time frames of, like, oh, if you have these symptoms, you know, like, three or more of these symptoms more than six months, I don't know, how, you know, that - the six month period determined it. But I know that a lot, you know, diagnoses have that time frame behind it.

Harvey: 13:45

Yeah, that is a curious thing about it, that I have a - okay, so I have a diagnosis of persistent depressive disorder, you know, and then I wonder, why is the threshold two years? Why is it not one? Why is it - why is it not another random interval of months? Like...

Pen: 13:59

So many of them are six months that it makes me think they were, like, "Six months is long enough, right? Like, that's a pattern."

Demetrea: 14:04

Right!

Pen: 14:06

There's - there are things that um, and then there are some, like, ADHD, like, some of these symptoms need to have been present since childhood?

Demetrea: 14:14

Yeah, mm-hm.

Pen: 14:15

And what gets sort of... that's an interesting one, because the symptoms for ADHD genuinely vary a lot if you're diagnosing as a child, versus as an adult.

Harvey: 14:28

And that's true of a lot of things.

Pen: 14:31

Because, you know, like, kids and adults act differently and are in different circumstances.

Harvey: 14:35

Their brains are different.

Pen: 14:36

A lot of symptoms of ADHD are kind of, intentionally or not, geared towards results in a classroom setting. Like, kids who are - who it's picked up that they have ADHD, I mean, it's because they're presenting in one very stereotypical way in the classroom, but, so they look for that, and it's like, "Okay, so you have to have had these symptoms since you were a kid," and it's like... like, which ones, though? Like... because it's genuinely different as an adult versus as a child, and so you have to recontextualize your experiences as a kid in order to count. And that's not even getting into the fact that the people who - can I just say, sometimes it's so obvious that the people who come up with these diagnostic criteria are neurotypical. That they've not actually experienced things. They're just going off of their own observations. Sometimes it's like, really? This is the best y'all go, huh? Did you, like, talk to somebody?

Harvey: 15:39

Did you, like, get an individual perspective? Like...

Pen: 15:42

Did you - have you thought, like - one of the, not exactly controversies, but conversations in the ADHD community is, did we really need to name it that? Really? Attention deficit disorder? Um, that's definitely not the biggest part of it. How about emotional dysregulation? And also, my attention is not deficit inherently. I have issues with focus, but sometimes it's focusing too much on something.

Demetrea: 16:07

Yeah, yeah.

Pen: 16:08

Y'all call the trouble sitting still disorder? I can't eat sometimes. What? Which is like, boy, the people who made this really... they really didn't, hm, know as much as they did. As much as I thought they did.

Demetrea: 16:26

Yeah. And that's why it's been, you know, revised so many times, and changed, and language have changed in there as well, I mean... Harvey, I think what you were saying was correct, like, by the third one, when they took homosexuality out of the DSM as a - as a diagnosis. And it wasn't until, I think, 2017, that they removed gender identity disorder out of there and changed the name to, like, gender dysphoria. And then they changed, like, um, the - the symptoms and things behind it, as well. And that was just 2017 when they, you know, kind of did, like, a revamp on some of the language in the DSM-5. So, here we are still, you know, revamping things.

Pen: 17:13

Let's - yeah, in 1987, the DSM 3-R - I'm still on the Wikipedia page, so to cite that, it's literally just the Wikipedia page for Diagnostic and Statistical Manual of Mental Disorders-

Harvey: 17:25

Which probably has, like, a - like a sub citation if you want to, like, go to directly to the source.

Pen: 17:30

I can link it in the episode description and whatnot.

Harvey: 17:33

For sure, for sure.

Pen: 17:33

Categories were renamed and reorganized, significant changes in criteria. Controversial diagnoses such as Premenstrual Dysphoric Disorder, Masochistic Personality Disorder, were considered in discarded. Egodystonic homosexuality was also removed, and largely subsumed under Sexual Disorder Not Otherwise Specified, which could include persistent and marked distress about one's sexual orientation. So, if you were sad about being gay, you could still be mentally ill.

Harvey: 18:08

And it's like, okay, so are we not just considering - you know, I know I've mentioned this in a previous episode, that one of the things involved in determining what even is disordered or what is considered a mental illness is heavily dependent on culture. Because it- one of the criteria is, like, how deviant is it from what is expected in society? And, you know, I think there are ways in which that that definition can be useful. I think more often than not, it isn't. And, you know, we run into issues like that, where it's like, okay, if you did critical thinking for, like, two minutes, you could figure out why people might be sad about being gay.

Demetrea: 18:51

Right.

Pen: 18:54

Maybe it's not actually about their brains, but in fact about homophobia, question mark?

Demetrea: 18:58

Exactly, exactly. And that goes back to what you were saying, Pen, like, the lack of actually talking to people and finding out the deeper, underlying issues there. Like, maybe I'm sad about being gay because my grandfather's the pastor of my church, and is telling me I'm gonna go to hell. Like, maybe that's where the sadness is coming from, you know? So it's like, that deeper rooted stuff that society is putting out there that could be causing that sadness. It's not exactly like, you know, "I'm sad that I'm gay." Like, "I'm sad that I'm gay, and I'm receiving all this negative, you know, imagery and language around my identity."

Pen: 19:39

Like, I'm sad that my grandpa hates gay people and I think he might hate me.

Demetrea: 19:42

Exactly.

Pen: 19:43

It ain't neurotransmitters, babe. Like, this is - it's society.

Harvey: 19:48

Yeah. And I - ugh, man, there was a point I was gonna make, I think, but it escaped me. So if it comes to me, I will- I'll definitely mention it but it was... It was something about- oh! I recall. So, you know, just definitionally, psychology cannot be an exact science. We are working with things like the mind, which in itself is, like, nearly impossible to define, because the mind, not the brain, but the mind is such an abstract concept. But then, we also get into the fact that the majority of psychological research that we have done is primarily Western, primarily - not even just Western - primarily American, primarily white, primarily middle class, primarily college age. So, that which we consider typical functioning is already really quite skewed and quite limited.

Pen: 20:46

Yeah, read the studies sometimes just in, like, the, uh... their - what's it called? Participants and whatnot?

Harvey: 20:54

Yeah, they're...

Pen: 20:55

They'll have, like, the - the data on...

Harvey: 20:58

Demographics.

Pen: 20:59

Demographic data. And I remember reading a few comms articles during one of my courses, and it was like, so you're telling me that 90% of your participants were white? 87% of them were male? And all of them were within like, 21 to 25? Cool study! Very cool study. This does not say as much as you think it says.

Demetrea: 21:25

Right. Yeah, and they base that - that - that information and present it as general knowledge for, like, everyone, it's like...

Pen: 21:34

This is how the brain works.

Demetrea: 21:37

No, I'm nowhere represented in any of these studies as a Black woman. Like, where's the information about culture and things? And it's like, also, the outside elements and factors. You know, I think now we're including environment more - environmental factors more, but it took a long time for us to even get here to, you know, and I get this all the time, like, especially, like, in my classes and stuff and, like, have a question about something and they're like, "It depends." And it's true! It's actually really, really true. It used to frustrate me as a student, because I'm like, how am I supposed to learn? Like, you're not giving me an answer here. But actually, working with clients, I'm like, it really does depend. It depends on, you know, how they grew up, it depends on the environment, it - it's more than just, you have this diagnosis, so this is, you know, the only information that I'm basing treatment off of,

Pen: 22:32

Yeah, it - it's, uh, objectivity when it comes to the brain is..

Harvey: 22:40

It just doesn't work.

Pen: 22:41

No, 'cause, I mean, we're shaped by our experiences, fundamentally.

Harvey: 22:46

And just beyond experiences, we're also shaped by the way that our language is structured, and - and culture, and so on and so forth. There are about a million things that will fundamentally change the way that the brain is wired and thusly, the way that it'll work.

Pen: 23:02

Yeah, it's-

Demetrea: 23:03

Yeah.

Pen: 23:04

And there's, like, um, sort of touching on several different points of this, there's a phenomena, for sure, of - I think I know... I know, one queer person who definitely doesn't have generalized anxiety. I'm pretty sure there's like something there, vis-a-vis neurodivergence, but like, everyone who I have met, and, like, worked with in terms of, you know, activism and such for marginalized rights in, like, whether that be focused on queer identity, racial identity, just, like, more general stuff, we're all neurodivergent or mentally ill. It's not because we're marginalized and marginalized people's brains are kind of just wrong. It's because of society.

Harvey: 24:03

Yeah.

Pen: 24:04

It's - it's something, you know, like, there is that - that, uh, phenomenon of, like, wow, we really are - are all neurodivergent, hm? Hm?

Harvey: 24:13

Hm? And, you know, I actually think in psychology, there is a term for - what is this, minority stress model or something like that? Honestly, Demetrea, you might know more about that. But there's, like, a psychological principle that states that, generally, marginalized people experience, you know, just more mental health problems on average, which, like, we knew. We know.

Pen: 24:39

When kind of stuff comes out as, like, a study or whatever it's like, yeah.

Harvey: 24:43

Correct.

Pen: 24:43

Yeah, you're right.

Demetrea: 24:45

We already know that. We lived it. We know. Been trying to tell y'all.

Pen: 24:50

Like, literally, just talk to someone. I'm begging you.

Demetrea: 24:52

Right! Just ask me. I'll tell you everything you need to know.

Harvey: 24:56

I'll tell you everything about why my upbringing was inherent more traumatic. Not to make it the trauma Olympics, but, you know, I can tell you exactly why I struggle with my mental health more than the average person. It's because society hates gay and trans people. and I just happen to be a gay and trans people. So...

Pen: 25:14

Uh-huh. That's.... ugh. Hey, speaking of that, kind of, I got curious about one of the diagnoses that was taken out of- or like, considered but not put in - in the DSM-3, when they did that adjustment. Like, premenstrual dysphoric disorder, that was like, yeah, no, I get it. No, I get it. You hate women. I mean, AFAB people generally, but they intended to hate women.

Harvey: 25:38

Right.

Pen: 25:39

And then homosexuality. And there was masochistic personality disorder, and I was like, "I don't know what that is, and it has a link, so I will click it." Have either kf you heard of, uh... it's also called self-defeating personality disorder?

Harvey: 25:55

Huh.

Pen: 25:55

Have either of you heard of this before?

Demetrea: 25:57

No.

Harvey: 25:58

No, never heard of it.

Pen: 25:59

Uh, so it wasn't... it was... let's see, it's not... as an alternative, the diagnosis personality disorder not otherwise specified remains in use and such, but like, it was never officially put in. Okay, so self-defeating personality disorder is a pervasive pattern of self-defeating behavior, beginning in early adulthood and present in a variety of contexts. May avoid or undermine pleasurable experiences, be drawn to situations or relationships in which they will sufferlmand prevent others from helping them, as indicated by different things. So it's basically being traumatized.

Harvey: 26:39

Yeah, I was gonna say, that sounds like a combination of, like, low self esteem, depression, and maybe a hint of trauma, which all just will coincide. That's the other thing about the DSM. You know, I don't want to sound like one of those people, like, "Oh, they're making up disorders, and we're over diagnosing our kids." But what is true is that I think there is an - there is a pattern of over-pathologizing certain things, like whatever that just was.

Pen: 27:05

Like, yeah, that's not a personality disorder. Like, yeah, I relate to that. I - like, I have childhood trauma.

And, oh! Exclusion from DSM-IV: 27:14

historically, masochism has been associated with feminine submissiveness. This sort of became politically controversial when associated with domestic violence.

Harvey: 27:27

Oh, you don't say!

Demetrea: 27:28

Yeah! Right?

Pen: 27:29

In spite of its exclusion from the DSM-IV in 1994, it continues to enjoy - enjoy, God- widespread currency among clinicians as a construct that explains a great many facets of human behavior, which is such a weird way to phrase that, but like, yeah, it's not a personality disorder. It's the consequences of being mistreated and learning that you're supposed to be submissive in order to be safe, or because that's all you ever learned. This is not a personality disorder, you fools. You absolute fools. God, this was written by cis men.

Demetrea: 28:03

Clearly. Clearly.

Pen: 28:06

Oh, my God, one of the criteria for the disorder, this

is number one: 28:10

chooses people and situations that lead to disappointment, failure, or mistreatment, even when better options are clearly available.

Demetrea: 28:19

Oh, no.

Harvey: 28:20

According to whom? Like, ugh.

Pen: 28:23

Oh, my God.

Demetrea: 28:23

Oh, my goodness.

Harvey: 28:24

And I think, here's the thing, we can say that this is a thing of the past. Given, I haven't spend - I haven't spent extensive time with the DSM-5, I think we would probably still find terminology like this, wher we can read it and we'd just be like, "Oh, come on." And t

Demetrea: 28:38

Right, yeah.

Harvey: 28:41

I think that's the issue with excluding the experiencial part of diagnosis, especially in the DSM.

Pen: 28:51

Engages in excessive self - self-sacrifice that is unsolicited by the intended recipients of the sacrifice. This was just a group of cis men who got together and felt, like, petty and mad.

Demetrea: 29:02

That's ridiculous.

Pen: 29:04

Oh. The behaviors in A do not occur exclusively in response to, or in anticipation of, being physically sexually or psychologically abused. I'm gonna be real, y'all, I don't trust you guys to actually quantify what counts as abuse.

Demetrea: 29:17

Right.

Pen: 29:17

It's like the - like, it's- it's so bizarre. Hearing this, it genuinely sounds like - like an alien came to Earth, had no idea what trauma was, and then made up a disorder. Like, this is - this is just absurd. Oh, my God.

Harvey: 29:36

Now what?

Pen: 29:37

Incites angry and or rejecting responses from others, and then feels hurt, defeated, or humiliated. Humiliated is - has a hyperlink to it. I have no idea why.

Harvey: 29:47

Uhh.

Pen: 29:47

Um, for example, the example that it gives: makes fun of spouse in public, provoking an angry retort, then feels devastated. Sorry, that's a symptom of a mental illness, now. That's a personality disorder, is, uh, teasing your husband. and he snaps at you, and you don't like that he snapped. Really?

Harvey: 30:12

My brain is just kind of stopping right now.

Pen: 30:15

Yeah, it sucks.

Demetrea: 30:17

I just can't believe that this was even being considered to be put in - into the DSM. Like, that's... oh, wow.

Pen: 30:25

God. There are so many of these. And it's like, it's - I'm- the way it's all phrased, too is so clearly, like, concerning for the - it - it is phrased exactly like cis men who were annoyed with their wives, and we're trying to explain why their wives were doing these things that just didn't make sense to them. Instead of thinking, one, let me talk to my wife or think about her, and, like, her experiences and such. I'm glad I didn't make it in, but honestly, like... doesn't say anything good about the things that did make it in.

Harvey: 31:04

I don't even know if I have a follow up to that.

Demetrea: 31:07

Right? I really don't, either.

Pen: 31:10

And that's the DSM, folks. Do you want a history lesson on, like, how it's always been kind of, ugh, not sure about that? There we go.

Demetrea: 31:20

Right?

Pen: 31:20

That was very, very sincerely considered, and almost made it in. Twice.

Demetrea: 31:24

I mean, just the fact that -- and I'm not sure which version of the DSM it was, and I think the language is still kind of tricky when it comes to, like, sexual disorders and things like that. Because the sexual diagnosis, you know - you know, when they were thinking, like, just on the binary of like, women and men, it was like women only experienced, like, mental, you know, concerns when it came to, like, you know, sexual diagnosis. And then for men, it was always physical. And it's like, you do realize that, like, there are physical aspe - like, it can go either way. Like everyone can experience physical or mental, um, you know, things that can contribute to, you know, sexual diagnosis and disorders. Like, it's not.

Pen: 32:13

This is not separate. You can't actually separate those.

Harvey: 32:16

[Crosstalk] Oh, go ahead.

Demetrea: 32:18

Oh, no, go ahead, Harvey.

Harvey: 32:20

I was gonna say, um, let's also keep in mind, the first version of the DSM, which had some of these diagnoses, came out in the 1950s. That wasn't that long ago.

Pen: 32:33

Oh, sorry, no, I just thought about the 1950s. People trying to put, like, psychological stuff together, and I was like, oh, my God, that would have been so sexist, and racist, and, like, that's just touching at the beginning of it. Oh, my God, oh, my God, oh, my God.

Harvey: 32:48

And you know, then, I think with that point being raised, that oh, God, that's so racist, that's so sexist, if it was made in the '50s. I think we're still having those issues today.

Pen: 32:56

Yeah.

Demetrea: 32:57

Yeah.

Pen: 32:59

Oh, God. You know, sometime I - I don't really want to, but I'm almost curious about, like, picking up a copy of the original DSM and flipping through, except that I don't need to do that to myself.

Harvey: 33:10

No.

Demetrea: 33:11

Yeah, please don't.

Pen: 33:11

You know, I try to practice self-love, and I can only guess at how horrific it would be. Because, like, even when it made good points, and I'm sure that it made something to build off of, whatever. It was fundamentally wrong. The people who were making it in the way that they were making it was just... there was no way for it to be accurate, because they weren't considering these things that are just basic for everyone who isn't specifically a white cis man.

Demetrea: 33:42

Yeah. And also have to think, is some of the things intentional? Because this - when you think about the 1950s and that time frame, the mistrust for doctors and psychologists - psychiatrists and psychologists then was very real, which is why people don't trust them now, because you put things like this in the DSM to control people, to manipulate people, and to cause harm. On purpose? Possibly. I'm- I'm certain that some of this was, like, on purpose. You know, and - and this is why people are, like, "I don't feel comfortable going to a therapist. I don't feel comfortable seeking a psychiatrist." I don't feel comfortable, you know, doing these things, because it's still- it can still be used in a very inappropriate way today, these diagnoses. So, yeah, so it's scary for people to - you know, it's so easy to say, like, go to therapy, go to therapy, but let's hope that the therapist that sitting in front of you is competent enough, and, you know, respects human rights enough to not misuse the information that they have against you.

Pen: 34:50

Yeah.

Demetrea: 34:51

And I think about that all the time as a therapist, like, wow we hold so much power over people that it can be used for evil.

Harvey: 35:02

Beyond Introspection is an independently-run podcast by Pen Novus and Harvey LaFord. Music by Girl Lloyd. You can find us on Twitter and Instagram at ByndPodcast or you can email us at beyonddotpodcast@gmail.com. That's beyond d-o-t podcast, no spaces. We publish on Buzzsprout, iTunes, Spotify or wherever you get your podcasts. You can find the links to our social media and email in the podcast description.

Pen: 35:27

We also have a Patreon. You can find us at patreon.com/beyondintrospection. That's all one word. We also have links to it on our site and on our social media. Our podcast is entirely independent, so we pay for hosting fees and transcript service subscriptions out of pocket. This is a passion project that we're really happy to do, and any support you're able to give us would really make a difference. On our Patreon, there are four tiers: $2, which gives you access to test audio and other bloopers; $5 which will give you access to bonus episodes that will make in the future, on topics like how angry we are at Freud, our frustrations with our respective fields of studies and even guest episodes; $10 will get you a direct line and priority access to request episode topics and new bonus content; and $15, which will give you access to monthly AMAs--that's ask me anything for those who don't know--where we can answer questions ranging from the podcast process and we figure out what to record, more in depth questions about our neurodivergences, and more. All of those tiers will include benefits from lower tiers of course. Got feedback for us? Want to request an episode topic? Just feel like saying hello? Feel free to reach out on social media, or via email. We'd love to hear from everyone. Take care of yourselves.