BEYOND Two Hosts: DSM & Beyond - Part 2 (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 second of two parts.

Featuring: The last couple minutes of Part 1; Therapy is a vulnerable setting; Our perfect world of taxonomy; Here's an idea: better research; Recognizing symptom changes over time? Now there's a good plan; Mental health is a spectrum and people are complex; Treat people like people

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Transcript

Demetrea: 0:12

And I also have to think, is some of the things intentional? Because that's - when you think about the 1950s and that timeframe, the mistrust for doctors, and 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.

Pen: 1:02

Oh, extremely.

Demetrea: 1:02

So, yeah, so it's scary for people to - you kno

Pen: 1:03

Yeah., it's so easy to say, like, go o therapy, go to therapy, b t let's hope that the therapis that's sitting in front of yo is competent enough, and, yo know, respects human righ

Demetrea: 1:13

And I think about that all the time as a therapist, s enough to not misuse t e information that they ha e against you. like, wow, we hold so much power over people that it can be used for evil.

Pen: 1:30

It's an inherently vulnerable setting.

Harvey: 1:33

And particularly - and this is something we've talked about on the podcast before - particularly when you're marginalized, and you are disproportionately mistreated by the medical community, that makes it even harder to trust. If you're Black, if you're Latino, if you're Asian, if you're queer, if you're trans, like, I could keep going, if you're disabled...

Demetrea: 1:51

Yes.

Harvey: 1:51

Ironically, if you're disabled.

Pen: 1:53

Yeah, then the medical system treats you worse. It's like, oh, cool, thanks.

Harvey: 1:58

I thought y'all were supposed to help me? Okay. All right.

Pen: 2:00

It is - it's one of those things where, like, you know, I recommend therapy, just generally to basically everyone. And I genuinely do believe in it, like 100%. I also, when I know I've needed to get a new therapist, or when I'm just starting with a new therapist, I'm so nervous. I'm like, I'm hesitant, I'm holding out, because I don't know if I can trust them. I - I've been very lucky with my current psychiatrist - well she's a physician's assistant, technically - and that's great, and she's actually moving practices, but I'm going to be able to follow her, which is excellent, because my first psychiatrist didn't explain my medication to me, and I was at risk of developing a muscle disorder, and he never told me. And this is like, at the time, I- the only thing necessarily working against me was that I was, you know, then I was a - a cis girl teenager. And I was still getting this. Like I was in a fairly, you know, privileged and, like, less likely to be mistreated position, and there was still this. So like, yeah, I believe so much in, you know, doing these things for yourself, for your mental health, for your physical health, whenever you can. And also, ooh, see if you can find someone that someone you know has gone to. The risk that you are taking is exhausting.

Demetrea: 3:22

Mm-hmm. Yeah, absolutely. I always encourage people, like, by that first or second session, and you're just like, "I'm not feeling it," you know, change therapists. Like, you don't need - you don't need too many reasons to change therapists, honestly. Like, if it's not working out for you, you know, move on, find somebody else. And it's not easy to find another therapist. You know, the process of starting therapy itself is long, and hard, and stressful. But I would rather you go through that again, through - than to go through trauma.

Pen: 4:00

Yeah. For your own benefit,

Demetrea: 4:03

Yeah. 'Cause, like, that can cause more harm and distress on you, and you know, it - if you know, in the moment, that your therapist is just, you know, it's just not a good fit, then it's time to change.

Harvey: 4:17

And even if it's not something that they're doing wrong. Like, even if it's just a difference in approach.

Demetrea: 4:21

Yeah, absolutely.

Harvey: 4:23

Like, you - this is where I'm gonna get on my soapbox - interpersonally speaking, you owe your therapist literally nothing. Like...

Demetrea: 4:31

Nothing at all.

Harvey: 4:32

If it's not working, you are not being a bad person or being a bad client by just leaving. You know, therapy is there to help you, and if it's not helping you, you know, you shouldn't feel obligated to stay.

Pen: 4:47

Exactly. This is for your benefit, which means, like, not only do you get to prioritize you, that's literally the point. Right.

Harvey: 4:56

You know, there's a - since we are already coming up on about the 40 minute mark, I, uh, since this question might take a little bit of time to answer, I did want to pose a

question just to everybody here: 5:07

If we were to - sort of in a perfect world, how might y'all want to approach diagnosis, or taxonomies, anything - or how we treat people accordingly, you know, how might - in a perfect world, how might we want that to be different, you think?

Demetrea: 5:31

Ooh, that's - yeah. That's a hard question.

Harvey: 5:37

Because it's something I think about just on my free time, because I - psychology is always a little bit on my brain, so...

Pen: 5:43

Yeah, no, you do a podcast about mental health.

Demetrea: 5:46

Right, yeah.

Harvey: 5:47

I'm also autistic, and one of my special interests is psychology, so there's that.

Demetrea: 5:53

Yeah. It's a little harder for me to answer that, because, um, I haven't really, like, thought that far ahead yet. But I'm more of a, um, people person. Like, you know, like, there's the research part of psychology, and there's the therapy part, um, you know, it's just so many - it's the teaching part, it's the supervision part. So many elements of it.

Harvey: 6:19

Oh, yeah.

Demetrea: 6:21

And I'm more of, like, the therapy, like, in there with the people type of person. So I think that for, you know - and research is developing, there are more, like, marginalized identities out there conducting research to kind of, like, change on some theories that we use currently in therapy, which I don't know why we still learning some of them. Um...

Harvey: 6:43

Yikes.

Demetrea: 6:44

Like, creating new ones - you know, creating new ones, more accurate ones, more - ones that are more, you know, inclusive. And I really commend them, because it takes a lot of hard work to create that level of change. And, um, I had to realize that, like, my level of change was enough from - yo know, for me, like, if I ca touch one person, and change o e person's life, like, I'm happ, you know? But like, that l vel of research that it takes, a d effort, and time. And, ou know... and I hope they're b ing fully compensated for thei- their work as well. But um, I think that ever-changing, like, research - and I think that's why it's also important as a therapist to, like, always, always learn. Always learn the things. Go to trainings. You know, like, learn about new theories. You know, it's important to always stay up to date, because information is changing. As information changed, like, we - we grow. But for those therapists who are, you know, still using the same information that they had when they graduated with their masters 10 years ago, their...

Pen: 7:48

Yeah, that's just not gonna be right.

Demetrea: 7:50

Yeah, it's just not as, you know, effective. So for me, um, I don't know how I would want that to look, but I know, for me, personally, I feel the responsibility to always learn something new, whether I'm in school and not. And I mean, it's a part of our licensure as well. You know, we have to, like, go to trainings and, you know - which I think is amazing, because we kind of need that requirement behind us. If we didn't, therapists probably wouldn't do it. But for me, personally, I love to always learn new stuff. So making sure that, you know, I'm learning new information that can be used, and present it to clients as well, and allowing clients to teach me things about- not teach me things about, like, therapies, specifically - but, things about their lives and their experiences and how they process information to come and, like, help, you know, guide me, and therapy, but I don't know what that would look like, necessarily, like, you know, like, on like, a more like, macro level.

Harvey: 8:52

No, for sure.

Demetrea: 8:53

If that makes sense. Yeah.

Pen: 8:55

If I'm - if I'm understanding you, it's like the treating it as a necessity that this is an ever-changing thing.

Demetrea: 9:02

Right.

Pen: 9:02

There's no one, like... like, if it doesn't look different in five years, then we're doing it wrong.

Demetrea: 9:09

Exactly.

Harvey: 9:10

Sort of like, and some of what I understood from that is, like, recognizing diagnosis and to - to another extent, the DSM, as a tool, but something that you necessarily have to take with a grain of salt because of how quickly things are changing.

Demetrea: 9:27

Yeah, yeah. And people's personal experiences, and how they handle, you know, certain things. You know, like I said, I've had clients with the same diagnosis who experienced different symptoms or just handled their diagnosis differently, so the therapy was different for them. You know, if I went - you know, just based off of, you know, by the DSM, I would look at that and be like,"Oh, well, you're not showing these symptoms, so I don't believe you," and it's like, what's the point of that, you know? Like, and there are cases, like I said, I've seen client's case files, and I'm like, "Um, why are there, like, four diagnose

Harvey: 10:01

For sure. here? Like, what's - can - ca you give me background and hi

Demetrea: 10:04

All of that. tory of how you got these diagn ses?" And that gives me bette information about, you know, ho they got some of these diagnose in. You know, then my work wit them, like, which one is m re accurate? And then we just w rk together to, like, focus on what the client wants to focu on. So...

Harvey: 10:25

Yeah, no, thank - thank you. That's really valuable perspective.

Pen: 10:28

Oh, yeah. I think that that's sort of funny, like, what keep coming back to is, like, value - how valuable perspective is when we talk about these kinds of things.

Demetrea: 10:39

Yeah.

Pen: 10:40

I - I've spent a fair bit of time thinking about diagnoses because, as is very common for people with ADHD, I went through several different misdiagnosis. Briefly, borderline personality disorder, that was one that I brought to the table myself, and that, at the time, I technically qualified for, and that's - that's one of those things, you know? Where like, there's a lot of overlap in disorders. A very good psychiatrist, who I didn't end up sticking with, mostly because I moved, suggested bipolar, specifically type two. And as it turns out, bipolar disorder and ADHD have, actually, more in common than one might think, again, trouble-sitting-still-disorder is such a bad name for it. And misdiagnosis is very common on both sides of that. So I went through several diagnoses, and now it turns out that, like, my depression, my generalized anxiety, even my social anxiety, could all still be tied to my ADHD. Which is not to say that any therapy or, like, treatment that I did for any of those disorders was not helpful in its own way. But there was also an inherent limitation to it, because it was with a limited understanding of what the problem actually was, what any of the underlying issues were. I can't imagine if I had started taking medicine for ADHD back when I was in high school. Like, I literally have no idea what my life would have been like. And that's one of those, like - I feel like treating the DSM - treating diagnosis and - and criteria as something that, like, the process for making something like that, and getting it all put together is incredibly long and requires so much. Like, I don't know the specifics of the DSM. Getting everyone to agree on stuff to put in it? Oh, wow. To the point where it's like, this is something that is inherently ever-changing just in our understanding of it. And as we do, that - Demetrea, as you said- like, more and better theorizing, trying to make it into something solid and unchanging just doesn't seem functional. Like, that doesn't seem like the thing to put time and energy into, when, instead, we could..

Here's - here's an example: 13:01

One of the few things that I have seen of the DSM-5 that I've actually, genuinely, really liked, is the new criteria for ADHD. And this is something that I talked about in a previous episode. One, instead of having separate diagnoses for ADHD and ADD, they just put all of it under ADHD, and then split it into subcategories - primarily inattentive and primarily hyperactive. And then, there's also, like, mixed. And so they have symptoms, common symptoms under each of those, under the inattentive and under the hyperactive. And then, you know, if you have a mix between them, like, a certain number of both of them, then they just have it as mixed. And they also specify in the DSM, that it is expected, you will switch between these throughout your life, because what is true for you as a child is not going to be true for you as an adult. The changing factors in your life are going to mean that, like, if you're primarily hyperactive as a kid, that means nothing about 10 years from now. That is - when I found that out, I was like, that is a shocking amount of, like, self-awareness and actual consideration of the complexity of being neurodivergent. That expectation of, like, so, these are some of the basics. It's gonna change. And not only is that fine, that's expected. That seems so - that is so important to me as someone who is not neurodivergent, to be able to expect clinicians who I work with to not think I'm just going to be one way, and that everyone who is under the same, like, category as me is going to look just the one way. To have it be anticipated. that, like, no, there's no - this isn't a cookie cutter thing.

Harvey: 15:04

Right.

Pen: 15:04

Like, people are going to shift and change, and that's - that's what it is. I think treating it that way is so much more functional than, like, "And if you have six of these, you're depressed." Like, okay, thanks, that's not - that didn't help. Symptoms that they have for ADHD could do some updating. But it's still like, oh, thank God. Thank God I'm not - you're not saying,"Okay, so you have ADD, and if you change, we're going to need to come back to that." Yeah, you should expect that. This is what you should be doing. You should be anticipating that you can't just put people in boxes and label it all nicely. You can't, okay? These are brains. You ever look at brain? It's complicated. Looking all those wrinkles. So many things in 'em.

Demetrea: 15:55

Right.

Harvey: 15:56

More surface area. That's why the brain is wrinkled.

Pen: 15:58

Thank you so much, Harvey.

Harvey: 16:00

You're so welcome. I'll take - I'll take a brief moment to - because I don't want to run too long, but...

Pen: 16:07

We can always split it.

Harvey: 16:09

I'll take a brief moment to talk about sort of how I might like to see things change. And Demetrea, I'm with you on the fact that I am - I'm much more interested in people, I'm much more interested in working with people. That said, the way that my brain works, I am sort of excessively academic. So, I've definitely done a lot of thinking on how we might empirically change the system of taxonomies, just because that's apparently what I do in my free time. But some of what I've landed on, I - when I think - when I think about it, I do think that diagnostic criteria and taxonomies are useful to a point. I think you do have to prioritize the person, and I think you do have to prioritize the context, which is something that we've all been echoing. But, I think it would honestly be good if we switched to a more-or if we push toward a more dimensional or spectrum-based approach to diagnosis and mental health criteria, just because - and this was something that I was going to touch on, but I think it got lost - I just kind of got lost in the shuffle of my brain - that we also have the issue of people who are subthreshold, who still continue to struggle, but aren't recognized as you know, having a disorder. And so, due to insurance in the United States, don't necessarily have the ability to receive the same kind of care that they need.[Groaning] Yeah, that's fair. Um, but yeah, I mean, I think that would be something really valuable. One, to recognize that there is not just - like, we don't need to create this - this just kind of incessant binary between typical functioning and disordered functioning. It changes over time, it isn't always that clear cut. You know, I just - I - I think that those criteria are helpful in some cases, and I think there is such a thing as disordered functioning. Hello, hi, I'm disabled.

Pen: 18:24

Hi.

Harvey: 18:25

Hi! Um, but, you know, I- I don't think that it is just that clear-cut. So, I don't know. It's - it's, again, my queer theory brain being like,"Hey, what if we didn't make this so rigid, though?" So those are just my thoughts, but...

Pen: 18:43

No, I agree entirely. I think it is so important to consider it as a bigger, broader thing. Yeah, that's what that's what I... getting at with the expectations that an ADHD diagnosis changes over time, but it's still an ADHD diagnosis.

Harvey: 19:01

Yeah.

Pen: 19:02

Like, hey, y'all, what if we just did that? What if you - what if we had a general idea of what certain labels, which can be useful to have overall, just so we can have a sense of, like, this is something that tends to help with depression. These are- these are some - some practices that we have, and here are a lot of different ways that depression can look. And if your client, or if you just, like, fall under this broad kind of spectrum, this might be a useful label for you, these methods of treatment might be useful for you.

Demetrea: 19:40

Right, yeah.

Pen: 19:42

Instead of trying to - stop trying to make it about boxes. Stop trying to make it rigid. It will never, ever, ever work.

Demetrea: 19:49

Right. Yeah, that's true. And - and that's similar to, like, how we're kind of being taught to use it now.

Pen: 19:57

Good.

Harvey: 19:58

Yeah.

Demetrea: 19:59

Yeah, which is super helpful, because it's like, you know, having professors who, like, you know, it's not, like, literally by the book. Like, this is just here for, like, a tool, you know, a guide, help... And, um, you know, then there's assessments that you can give clients that, you know, have been proven to be valid and reliable that, you know, assess for these things to help with diagnosis now. Um...

Pen: 20:25

Yeah, I like those. Well, I have mixed feelings on those.

Demetrea: 20:28

Right, right, yeah!

Harvey: 20:28

The amount of times I've taken the SCAARED assessment. Anyway...

Pen: 20:32

I find those useful, broad strokes, because they can help in understanding yourself. And also, because it's, like, self-assessing symptoms. We briefly talked about this before. If it's in an individual's mind, you can't objectively assess those symptoms like you can with, like, a broken bone.

Demetrea: 20:51

Mm-hmm.

Pen: 20:52

Can't do blood tests with it. Well, I mean, you can sometimes, for, like, you know, neurotransmitters that may or may not be, like, more prevalent in the brain. But like, it's got to be what the individual understands.

Demetrea: 21:05

Right.

Harvey: 21:06

Well, with neurotransmitters - I'll briefly go off about psych - um, really more of a - more of a chemical thing. It doesn't - it's - hormones are what goes in the blood?

Pen: 21:15

Yeah, no, I knew that it wasn't, like - your neurotransmitters aren't gonna be in your blood. But you know, you can test for certain things.

Harvey: 21:21

For sure, for sure. You can do brain scans, but like we've mentioned on previous episodes, those are expensive, and also not foolproof.

Demetrea: 21:27

Yes. Mm-hmm.

Pen: 21:29

Like, yeah, you should be asking questions, and letting people self-report.

Demetrea: 21:35

Exactly.

Pen: 21:36

It's their brain.

Demetrea: 21:38

Yeah, and when clients do assessments, it's so important to, like - because, you know, you score it, and, you know, you get the results, and, you know, it tells you like, oh, this, and, you know, whether it's, um, you know, mild or severe, you know, it gives you like all this data that, you know, I think it's so important to go over that with a client, instead of saying, "Well, that's what it is!" And like, shake the paper on your desk, and like, walk away? It's so important to say, "How do you feel about this diagnosis? Do you feel like it's accurate? What - what - what did you think about the questions?" You know, it's so important to get that that information from the client themselves, because there might be certain things that they answered a certain way, because of the way the question was worded, or their thought process, or, you know, just personal experience. You know, when I think of someone asked me this, this is what I think of, which, you know, got me to the conclusion of that. So, it's not just, once again, the assessment should not be just used as an end-all-be-all, you know?

Pen: 22:36

This is - you know, this could be a useful starting point.

Demetrea: 22:40

Exactly. A very useful starting point.

Pen: 22:45

See, it's - and I have thought this many, many, many, many times when we have talked before about mental health things, Demetrea, but it is a comforting thing to know, one, that there will be people who get to be your clients, and will be treated well, and like, cared about as people first and, like, spoken to with this level of genuineness that is very, very real. Like, you can - you can definitely tell, as a client, when your therapist is sort of taking a more detached tone with you, rather than telling you things in a more genuine way. But also, that there are people, more generally, just outside of you specifically, that are coming to this field with, with these intentions of caring about people, and caring about - about being flexible in these ways. Because that's so important. And it's what we need. And so it's, like - it's genuinely uplifting, and like, oh, thank God.

Demetrea: 23:49

Aw, thank you. Sometimes I need to hear that, you know? Sometimes you just don't feel enough. I just want to, like, save the world and fix everything and do everything. But like, that's not my job. My job isn't to fix anybody. No one is broken. So it's having that - that constant reminder that, you know, clients aren't broken, and they were living their life just fine without me. And, you know, when they leave my office, they're gonna live their life once again, you know? It's that comforting feeling of just knowing that, you know, it's good people in the world who come to you and they need support, you know? Nut they don't expect for you to, like - you know, like, they're not broken, they don't need to be fixed. So, you know, having that- that reminder, because, you know, before I entered my master's program, that's what I thought we did. I thought we gave advice, we fixed people problems, like, nobody told me that we didn't do that until I entered my master's program. They was like, "Oh, no, no, no, we don't do that here." Like, that's - that's not what we do. And I was like, this is refreshing.

Harvey: 25:00

I know - you know, when I go into therapy, it's - it's less that I want someone to tell me what the problem is and how to fix it and more to suggest things that I could try to fix it on my own. I'm sort of that kind of person.

Pen: 25:16

So yeah, just assistance in, like processing something.

Harvey: 25:20

Oh, yeah.

Pen: 25:20

I just want to talk to someone objective and be like,"So these are all my feelings," and they can be like, "Yeah, that kind of sounds like to this other thing you told me last week," and I'm like, "Oh, dang." Oh, yeah, you're right. Well, would you look at that? Okay.

Demetrea: 25:32

Yeah. They are able to, you know, connect those - those dots. And, uou know, I've been in and out of therapy for many different reasons, and had many different therapists, some great some not. You know, me and Pen have had this conversation. Um, and I've ghosted a therapist, and you know...

Pen: 25:50

Honestly, good for you.

Harvey: 25:51

Like, me, too. I've done that, too.

Demetrea: 25:54

Yes, yeah, and it happens. And, um, I would say most recently, I had my first ever - because I've been, you know, a student all of this time- so, free services and things like that, but I have my first ever experience with complication with insurance and paying for therapy. That was just annoying and frustrating. And to know what that is like as a client now, it's like, wow, I can't imagine, like, you know, clients having to deal with the, you know, financial barrier of therapy alone, and the struggle of, like, getting your insurance to pay for things. And what if your insurance stop paying, but they don't let you know, and then you get a bill all of the sudden, and it's like, what do I do now? And now I can't see my therapist until I pay this bill. Like that type of struggle.

Pen: 26:43

Yeah. The fundamental ableism of society and how doesn't, uh... and how our healthcare system is not one.

Harvey: 26:51

Ha, ha, uh-oh!

Pen: 26:52

Yeah.

Demetrea: 26:53

Right.

Pen: 26:54

Yep, yep, yep, yep, yep, yep.

Demetrea: 26:55

Very true.

Harvey: 26:57

Oh...

Pen: 26:59

Yep.

Harvey: 27:00

You know... oh, go ahead.

Demetrea: 27:03

Oh, well, I was just gonna bring up something else with the DSM now, that is super helpful is the Z-codes. So, the things that provides, like, definitions and include, like, you can add it to a diagnosis. Um, so, like, homelessness, low income, poverty. Um, I think, um, having parents that were divorced is one of them.

Harvey: 27:29

Uh-oh! Whoops!

Demetrea: 27:30

Yeah! Like, all of this, like, complicated, you know, like, grief, and, you know, like, things like that.

Pen: 27:36

Yeah.

Demetrea: 27:37

Problems related to, like - I just pulled that my PDF DSM now so I can see some more of them. Um...

Harvey: 27:45

Love that.

Demetrea: 27:46

Disruption of family, by separation, divorce, things like that, to add to those, you know, that could help me be like, okay, this is another factor. A victim of crime is on there. Like, there's so many factors on there now that can be added as, like, oh, okay, so it's not just, you know, we're not looking at this, like, one-dimensional. We're looking at, like, the whole system of things.

Pen: 28:09

Good. That's - that seems really - that seems like a very, very good thing to include with it. Like, not everything that I deal with is about the fact that I have three dads, but also, I do have three dads. And that certainly impacts how I grew up and such. And so, having that noted... like, every time I go to therapy, I have to make a whole new family tree to show to people because the circumstances of our lives significantly impact our existence.

Harvey: 28:43

Who'd've thunk it?

Pen: 28:43

And our brains.

Demetrea: 28:45

Yes, absolutely.

Harvey: 28:48

We should probably start wrapping up. So, I do just want to ask, you know, at the end of our episodes, we always ask if anybody has any closing thoughts. So Demetrea, I want to I want to turn to you first, do you have any closing thoughts about anything we've talked about today?

Demetrea: 29:04

Um, yeah. So, I just want to put out that I'm not saying that, you know, the DSM is completely bad and should not be used and that, you know, diagnoses aren't real, because they are. And, you know - you know, we need to, you know, focus more on properly diagnosing people before we give them, you know, that diagnosis that's going to follow them and carry them for the rest of their lives. I'm just saying that, you know, in combination of using the DSM as a tool, they're human beings in front of us that is literally giving their life story, which I really like Narrative Therapy as well because I felt you learned so much about an individual do just them telling their story. And that that is also a very important, key part of - of therapy. I firmly believe in including your client in assessment, and just everything. Like, I just love to get, like, my clients' opinions about things, and kind of see where they're at. Um, I find that to be, like, very helpful as far as, like, creating the treatment plan together. So, not saying that the DSM is bad. It has had some bad diagnoses in there, for sure. It has been used for harm. There - there might still be some questionable things in there that, hopefully, we can change within the next couple of years as research continues. And hopefully we can include, you know, more inclusive research in our teachings as well. So, there are a combination of things that make therapy good and make therapy work. And not one way of doing things is you know, always right.

Harvey: 30:45

Yeah. Pen, do you have any closing thoughts?

Pen: 30:50

I - I really want to echo Demetrea's bit there, on, like... the DSM, and diagnoses in general, all of that, things that I - I tell people about, I give links to assessments that I have used in the past, and that kind of thing. They can be extremely useful as tools, and especially as starting points. And also, we are people we cannot be objectively observed when it comes to mental health and neuro divergence. All of the different parts of our lives, impact us and are impacted by our neurodivergence. And that kind of flexibility, that kind of keeping in mind that this is not something that you can just know about a person, or that can only look one way, I think, is incredibly important. Both like, I always want my - the people that I'm working with, my therapist, my psychiatrist, to understand that I'm a complex being, and please don't expect me to just look one way, because you're used to that being how a disorder looks. And also for people who have diagnoses to know, like, if you feel like you look atypical, that might not be true, or it might be true, and that's all fine. These are terms that can be useful in some ways, but they don't define you. This is - this is not about making a human being... or it shouldn't be about making a human being into a bunch of useful little categories. This should be, like: here is one way to help and to figure things out. Which is a much - kindness, and respect, and flexibility, I think, are - are things that should be key tools along with one with a nice book.

Harvey: 32:49

Absolutely.

Pen: 32:50

What about you, Harvey? You got some thoughts in there?

Harvey: 32:53

Uh, yeah, just definitely echoing like, yeah, useful tool. Put the person first. It's complicated. I think the other thought I have is, like, the DSM has been flawed, it is flawed, there will never be a time where it isn't flawed. That doesn't make that doesn't mean that it's not useful. Just important to take it with a grain of salt, and understand-

Pen: 33:18

A salt shaker.

Harvey: 33:19

Yes, yes. And understand that it is not, you know, the end-all-be-all. So yeah, pretty much just... I think if I were to say much more, I would just be repeating you all, and I'm not going to do that, so...

Pen: 33:33

It's because we all have such good thoughts.

Harvey: 33:36

Right. Well, Demetrea, thank you - thank you very much for joining us today. Your insight was - was just wonderful to have today.

Pen: 33:43

This was awesome.

Demetrea: 33:44

Thank you. Thank y'all for inviting me. I really, really appreciate being on your show and, like, hearing y'all thoughts about everything. So insightful, so thank you for inviting me.

Pen: 33:56

Yeah, yeah, definitely. We were very excited to be able to do this.

Harvey: 33:59

So, stick around for just a few more moments, we'll tell you a little bit more about how this podcast is run and our Patreon. 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: 34:33

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.

Harvey: 35:49

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.