What is the DSM and Who Cares Anyway?

By Dyanne C. Bresler, RN, LCPC

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA).  It contains descriptions of the diagnoses that may be given for “mental illness”.  The system of insurance reimbursement in our country requires that a diagnosis be submitted in order for payment to be made.  No diagnosis, no payment.

Periodically, committees formed by the APA come up with new diagnoses and they are added to the book in a new edition.  Some diagnoses become unpopular and are removed from later editions.  An example is the removal of a diagnosis for people who are attracted to members of their own sex.  It used to be a disease, and now it isn’t. 

You may have read about the newest edition of the DSM.  There’s been a great hue and cry all over the world about the added diagnoses, most of which now justify the writing of prescriptions for treatment of such things as grief so that patients can be stoned in addition to suffering from the loss of a loved one.

The American Psychiatric Association supports the medical model, which posits that “mental illness” is caused by messed-up neurotransmitters in the brain.  Medical model proponents believe that these messed-up neurotransmitters must be treated with drugs.  This is why one of every four Americans now is diagnosable with a “mental illness”, including over three million children whose exhuberance has  demonstrated to physicians all over the country that they need to sit still and be quiet with the aid of stimulant medication from the same category of drugs as cocaine. 

That no laboratory test, no blood test, no spinal fluid test, no scan of any kind has ever proved a patient has a “mental illness” has not stopped the APA from coming up with lots of new diagnoses.  There has never been any proof of just how many of any neurotransmitters our brain is supposed to have, but still, the APA has insisted that there is a shortage or an overage of them that must be medicated. 

You should consider having some grave concerns about the DSM medicalization of normal problems. The morphing of sadness/anxiety due to death, divorce, job loss, financial ruin, relationship problems or any of the other things that cause misery into a “disease” that requires drug administration is not much more than greed and very effective marketing by pharmaceutical companies.   You will not hear physicians citing the research that proves counseling is more effective than medication for mild to moderate depression.  You will not hear them remind you that exercise, sleep hygiene, good diet and good work have no side effects.

The long-term effects of psychiatric medications are grim, under-reported, cumulative and can be life threatening.  That’s why you should care about the DSM.  

Spanking is the Devil. Or maybe not.

Someone needs to tell the spanking abolitionists to take a course in research design. A new study by one of the chief abolitionists purports to show irrefutable evidence that spanking causes future aggression in children. The study utilized a clever design, which was meant to distinguish those children who were already aggressive and then got spanked from those children who weren't aggressive UNTIL being spanked. It was a nice try...for a high school research project.

But asserting that spanking causes aggression is like saying
that eating causes cancer.

Researchers like this who study spanking continue to make a
fundamental error: neglecting to separate the confounding variables. That is,
the phenomena that go along with spanking are the more likely causes of
aggression that they found. When researchers ignore these variables, it
invalidates their research. They continue to infer a causal relationship
between spanking and aggression, when in fact they have not demonstrated a
causal connection at all.

Some parents who spank do so with rage, in an out of control
manner. They physically dominate the child with a hostility that communicates
loathing, not love. These parents often use no other discipline tool but
spanking. Their model is “spank all the time for anything, anywhere, and to
whatever degree I feel like it.” These parents also tend to exhibit aggression
toward spouses, pets, and other adults. This model of aggression is indeed likely
to teach the child to be aggressive. To the parents in this group, I say: knock
it off. Stop abusing your child and get some help.

On the other hand, plenty of parents spank without any of
the negative side effects. They remain in control, communicate the express
purpose of the punishment, and utilize other means of discipline when
appropriate. They are not indiscriminate and keep the physicality or violence
of spanking to a minimum. It is neither brutal nor injurious. Children spanked
in this manner do not feel abused because they are not being abused. They are
being loved. This kind of parenting and spanking is perfectly appropriate,
healthy, and largely effective. To the parents in this group, I say: keep doing
what you’re doing and ignore the bad science.

Any research that does not distinguish these two
fundamentally different patterns is either willfully deceptive or ignorant;
either way, it should be ignored. Unfortunately, I have not seen any spanking
research that makes the crucial distinction.

Try again, spanking abolitionists. Next time, try good
science, not junk science.

Holidays

GUEST BLOGGER: Dyanne C. Bresler, LCPC, RN

It’s that time of the year.

Starting with Labor Day, holidays tumble round us, closer always than our busy schedules allow us to think they are. We’re all still surprised to see Christmas promoted at the same time that we’re barely thinking of retrieving scarves, gloves, boots and hats from their summertime repository. You know, the closet, way in the back.

Among the moments of joyful anticipation, there may be bittersweet longing. Depression or anxiety may cause you to grit your teeth to face the holidays with little more than grim resolve. Holidays are unlikely to measure up to the media images of friends and family gathered around a Martha Stewart-decorated table.
For many, these are tough times. Our nation is troubled. Many are struggling financially.

Youth may be worried by an uncertain future. Relationships may be disrupted
by illness, death, or financial or emotional insecurity, and it is no
secret that the holidays can serve as a magnifying glass, making
pre-existing problems seem even bigger.

But you are not helpless in the face of the forced gayety in which you find yourself. Here are some tips:

First, take heart. You can safely remind yourself that this, too, will pass. But it isn’t time that is healing; it is what you do with it. So, take charge.

Write down some things that you can do for yourself that feel good, and do some or all of those things.

Get yourself out of your self-imposed exile and go somewhere, visit someone.

Give of yourself. There will be enough left, I promise.

Make a spectacular dinner and invite someone about whom you care. You can let it be tuna casserole. It doesn’t matter.

Make an appointment to grieve mightily if you need to. That’s right, give yourself permission to feel what you feel and do it with all your might. Your ability to feel is one of God’s gifts to us and is, after all, what makes you human. Honor your grief by spending some time with it, privately and for a limited amount of time. Then, leave it. You can return to it another time if you need to.

Make your own golden moments by seeking out connection with those you love.

Share your feelings with someone whom you trust.

Take charge of sifting through long-standing traditions. Keep those that you want to maintain and start a new one. Get creative. Have fun with it.

Go to a place of worship. Allow yourself to feel peace. Peace.

Think about what gifts are supposed to represent. Give one. Give many.

Let your gifts be about something far more meaningful than any money you may spend.

Don’t compare yourself and your own situation with what you perceive others may have. Don’t believe the magazines or the everyone-loves-everyone-all-the-time stories on TV.

Spend some time with children.

Get enough sleep. Eat. Drink plenty of water.

Go for a walk at night when it’s snowing. Bundle up.

Make a short-term goal and a long-term goal. Savor the anticipation of
of attaining them.

Find a way to help someone who needs something you can provide.

Breathe.

Let the message to people you love be that they matter. The message to you from your loving Self is that you matter.

The New Weekly Allowance

By Jessica Fox, LCPC

I love this article Modern Allowance Tribune Story on giving your kids an allowance. One of my clients referenced this article in a session so I decided to check it out, and boy was I glad I did. It’s not a mind-blowing, completely unique concept or anything., but rather, a sort of “duh” moment; why didn’t we think of this before?

I am no economic expert by any means. I am not well versed in the stock market and could probably only last 10 minutes in a conversation about the government’s plan to stimulate the economy. I’m a therapist, I could talk about anxiety and depression for hours…..However, as a therapist that works with parents, I found this article incredibly useful. It connects the concepts of finance with social responsibility. Two ideas that unfortunately have been strangers for some time now.

The article discusses a few different ways to distribute allowance to children. Many families are now adopting a plan that imitates the 401k system where they match what their children save. Other families are trying to teach kids about social responsibility, pushing them to place one third of their allowance into an envelope for charity. It is so important that we model and educate children about being giving. Many researchers have described today’s youth as “entitled.” I hear it all of the time in my practice, parents complaining that their children just seem ungrateful and entitled. It’s not all their faults. We need to do a better job at making charity a part of our lives and sharing this knowledge with our kids. Make it an expectation. You will teach your children two essential lessons about budgeting and valuing every dollar and the responsibility we all have to help those less fortunate.

Post-Traumatic Stress Disorder: Now What? (Guest Blogger Jaclyn Pistorio)

These days it seems most talk about Post-Traumatic Stress Disorder (PTSD) is in regards to men and women in the military. While this diagnosis is quite common in this population, it is also common among the general population. Though not as frequently discussed, men, women, and children without any military experience may also be diagnosed with PTSD. Many have heard of this disorder but, what exactly is it?

Essentially, individuals with this diagnosis have experienced one or several events that they interpreted as traumatic. As a result of this experience(s), these individuals may have trouble sleeping, develop nightmares, experience flashbacks (quick memories, smells, sounds, etc. that remind them of the traumatic event), and have difficulty concentrating. Additionally, these individuals may avoid the place the event occurred at and they also may avoid speaking to others about the traumatic event(s). Of course, there are many more symptoms a person may experience as a result of experiencing a traumatic event but, these are some of the more common symptoms. What is deemed a traumatic event? While natural disasters, witnessing a crime, rape, verbal/physical/sexual abuse, and various accidents are common causes of PTSD, any event(s) that an individual is unable to cope with by himself or herself may be seen as traumatic.

So what do you do with this information? Unfortunately, not many mental health professionals have had sufficient (or any) training in working with individuals who have experienced the above symptoms and may even meet the criteria for PTSD. You may be reading this thinking, “Hey, that sounds like me” or “This sounds like someone I know.” I’m here to give you some helpful suggestions that will help you and your loved ones on the road to recovery and a more fulfilling life!

• Do your research! Believe it or not, but not all therapists are qualified to work with individuals who have experienced trauma. Also, visit the National Center for PTSD’s website: http://www.ptsd.va.gov for more information about PTSD symptoms, up-to-date research, and resources.

• Essential to any individual’s recovery from a debilitating disorder is support. If you feel you may have PTSD, seek out additional support. If you know someone who may have PTSD, show some support! Become involved in their recovery, make yourself available to talk as often as you can, and consider family therapy if it is appropriate.

• Almost all individuals with a diagnosis of PTSD also have co-occurring diagnoses (or eventually develop them). Some common co-occurring problems include: Alcohol Abuse, Depression, Anxiety, Anger, and Substance Abuse to name a few. It is important to seek assistance as soon as possible to minimize the impact of the trauma and begin the healing process.

As a psychotherapist specializing in traumatic stress, I understand that all this information may be overwhelming and you may still be confused if you or a loved one may suffer from PTSD. You may get lost sifting through the millions of publications on PTSD; you are not alone. Contacting a physician or psychotherapist is the first step down the path to recovery and, if necessary, I hope you will take it!

Social Media--Savior or Self-Indulgent? (Guest Blogger Jessica Fox)

Last week's Today Show told a story about a mother who used Facebook to post photos of her son's rash. After going to the doctor and getting a strep test, the rash persisted, leaving her understandably worried. This woman's friends and family instantly posted support and suggestions that she go to the hospital; a few who were doctors even thought it may be a rare disease called Kawasaki's. It turned out they were correct; the search engine that has gotten so much negative coverage helped saved her son's life:

http://today.msnbc.msn.com/id/43757155/ns/health-slate_com/

This story got me thinking about the light and dark sides of Facebook and other social media sites. So often in my private practice, I encounter situations where Facebook has caused tweens and teens to feel isolated, ostracized, and completely stressed out from the pressure to keep up with photos, status updates and friends. I have seen parents ban Facebook altogether, worrying that their child is obsessed! There are also parents who have banned Facebook because their children are using it inappropriately with provocative photos or vulgar messages. So, my overall feeling has been that many adolescents are not truly ready for a responsibility like Facebook.

However, let's be honest: Facebook and other social media sites are here to stay, so when and how do we teach our children to use it wisely? How can they learn if they are banned completely? It will probably only increase the lure of the forbidden fruit. Are we doing them a disservice by robbing them of the opportunity to connect with others? These are difficult questions and ones that most parents in this country should be asking themselves.

As a psychotherapist, I find much of my work--and perhaps my biggest challenge--is being a liaison between parents and teenagers. It is a critical part of my practice because of the huge disconnect that often exists between generations. My advice to parents regarding Facebook is this: allow your child to open a Facebook account as a privilege, not as a human right. I won't suggest an age, because this level of maturity should be determined by you, the parent. Your child should be able to earn this privilege by showing good decision-making skills, a sense of self-worth, responsibility, and the ability to resist peer pressure. When that child of yours does have an account, it is up to you to monitor it and make sure that your child is upholding his or her end of the bargain. No inappropriate photographs or language, no identifiable information, a limited amount of usage on the website, and a healthy usage of it. You should have your child's password and set limits.

If your child misuses Facebook, then of course there should be a consequence; the most natural and logical consequence is a break from Facebook altogether. For how long? Well it is up to you to decide how your child needs to built trust in order to regain the privilege. I encourage you to write out a road map with concrete examples. Sometimes saying "you have to earn back my trust" is too abstract for adolescents. It would be beneficial to give them examples of what "earning my trust back" would look like.

Sometime I get scared when I think about what adolescents will be using for social media in 15 years, and I'm sure I'm not alone. All the more reason to equip our children with the tools necessary to navigate the murky cyberwaters, as a model for navigating all of life's difficult terrain.

Another Study From Captain Obvious: Sexual Abuse Damages the Soul

An interesting new English study of sexual abuse victims has concluded that there is a very strong causal relationship between sexual abuse and future psychotic disorders, such as schizophrenia.

Interestingly, the researchers found that the more profound the abuse suffered, the more profound was the emotional problem and level of psychosis. The researchers also correlated sexual abuse with future struggles with depression and anxiety.

Most people with at least half a brain would say, “Well, duh.”

But wait, didn’t we learn somewhere that psychiatry had determined, definitively, that schizophrenia and other mental disorders were “brain-based” (the term “brain-based” being code for “caused by a genetically inherited birth defect in the brain”). At least this is what the vast majority of psychiatrists preach; this is also what their public advocacy group, the National Alliance for the Mentally Ill, teaches.

The average Joe doesn’t realize that there has been a minority of mental health clinicians who have known for decades that the broken brain theory of mental illness is hogwash. It is heartening to know that at least some professionals are catching on.

It’s about time they caught up. Maybe now they can stop blaming brains and start placing responsibility where it belongs—psychospiritual overwhelm (or emotional trauma). Whatever you want to call it, the vast majority of “mental illness” isn’t really an illness at all; it is a normal, predictable response to an emotional, cognitive, and spiritual trauma that overwhelms a person’s ability to cope. It’s nurture, not nature.

Just wait: psychiatry will “discover” some way to explain away the common sense nurture explanation. With their whacked-out logic, they’ll start telling the public that children born with the predisposition toward schizophrenia somehow invite sexual abuse more often than others. Yeah, that’ll be really helpful. Or psychiatry’s favorite nonsensical refrain, “The abuse uncovered the underlying mental illness.” How these people get advanced degrees is one of the great mysteries of the world…

The truth is that the fountainhead of psychiatry stems from the cockamamie theory that presumes emotional problems are caused by faulty wires or biochemical imbalances. Gratefully, more and more people are turning to common sense, rather than pseudoscience. Hopefully, more scientists will produce science that both reflects and utilizes common sense from this study. Then we can really start helping the hurting.

Until then, they will be drugged into brain-damaged submission, without hope of a cure, wondering how the professionals who were supposed to help them turned out to be almost as cruel as their original abusers.