One morning, my colleague sent me an email and I could tell her blood was boiling. She was angry and hurt when she searched for her news article by using the word “therapy” in the Walton County Tribune and the first article below is what came up. Collectively, we took action and devised a response. This piece goes out to every person who has felt they could not speak or feel heard when their invisible wounds were bullied. My response will appear in the Sunday, September 29th Paper of the Walton County Tribune.
Michael Lynch Editorial From Walton County Tribune:
Disorders for Everyone, printed on July 20, 2013
My head hurts. Let me be clear, I mean this figuratively. I have to use this disclaimer in order to ensure that some new and exotic condition is not randomly assigned to me by an over-educated behavioral health specialist with little common sense.
Why do I say this?
Because of the following headline published this week: “Able-Bodied Woman Wants Surgery to Make Her Paraplegic.” That’s right — no typo here. A 58-year-old Colorado woman wants to have surgery so her legs will stop working. Why, you may ask? Because she has Body Integrity Identity Disorder.
I do not intend to demean mental illness, but it seems we have gotten to a point where any behavior or desire can be explained away by a new-found disorder. I wonder if this has anything to do with the fact that each new disorder justifies an expensive new drug to treat it?
Two of my favorites are Seasonal Affective Disorder and Attention Deficit Disorder. With SAD it seems that some people are prone to experience less than optimal feelings during winter. Wait a minute — I think I may have SAD! Every winter I find myself wishing I were somewhere in the Caribbean and I thought those feelings were normal. Apparently I simply needed medication! Walgreen’s here I come.
The opinion on ADD or ADHD is a bit more contentious. I know parents who swear their child would be incapable of functioning without their ADHD medication. I remember a day not too long ago — let’s call it the 1970s — when the only medication needed was a healthy dose of the back of a parent’s hand. Amazing how little Johnny may be spastic one minute and a model child the next after a dose of “parental medication.”
As a secondary treatment for this disorder, my parents also engaged in a radical therapy known as “play.” During this therapy, they would send us outside to run around, get dirty, explore and expend energy. I don’t know if the World Health Organization has conducted any studies aimed at exploring why “play therapy” seems so effective in bringing down a child’s energy level. Perhaps they can obtain a grant to do so under the Affordable Health Care Act.
As previously stated, there should be no doubt that certain conditions exist. The problem arises when the conditions are applied haphazardly due to parents’ and clinicians’ ineptitude in diagnosing root causes for behavior. Does Sally have a pituitary problem? No, she has been consuming 42 Oreos each day for breakfast over the last two years!
Much like in other areas of our society, we are too eager to make excuses. We seem relieved when a fancy term can be applied to explain away what was normal behavior 30 years ago. Your homework for this week is to go to your parents or an older friend and ask them to smack you in the back of the head. Hard. Lord knows it can’t hurt.
A Response to Michael Lynch: Leave the Snarky Behavior to the REAL Professionals
My head hurts and I do not mean figuratively. I have to recognize that every time another person chooses to demean an educated behavioral health specialist, every human who has ever suffered from a real diagnosable mental health issue gets a smack to the head, causing me a mental headache. So here, a disclaimer should be noted that if you suffer from headaches and no other relatable symptoms, a neurologist and not myself, a mental health professional, would be the best fit.
Why Do I Say this?
Because headaches are only one accompanying symptom in a small number of major mental health disorders and a headache sufferer may have a neurological disorder disabling the brain from thinking clearly. A headache alone is not in the Diagnostic and Statistic Manual of Mental Health Disorders (DSM). I currently have clarity as to why my headache exists, but for many, professional advice from the correct medical provider may be warranted.
Sometimes our neurology can lead to unexplainable circumstances. A headline published in the Huffington Post on July 20, 2013, “Able-Bodied Woman Wants Surgery to Make Her Paraplegic.”
That’s right-no typo here. 58 year old Chloe Jennings, a chemist with a Ph.D, wants to have surgery so her legs will stop working. Why, you may ask? Because she has Body Integrity Identity Disorder. Oh But Wait, this is such a rare and unstudied condition, that it is ALSO not in the DSM. A mental health professional cannot diagnose this condition either. Okay, so another disclaimer: a mental health professional must practice including diagnoses within their area of competency. This diagnosis does not exist in the DSM. One reason may be that research that has been or currently are being conducted on this particular disorder has as few as 50 people, in comparison to thousands who have participated in studies about depression or anxiety disorders.
Anytime a person says that there is not intention to demean- the intention is out rightly demeaning. “I don’t mean to hurt your feelings…..but” (I am going to anyway). It seems we have allowed ourselves to continue to perpetuate verbal violence against what we cannot physically see, like depression and anxiety, and feel justified in emotionally preying upon people who may not have the ability or the motivation to let their voice be louder than compassion and understanding.
Body Integrity Identity Disorder has been studied since at least the 1980’s so there is no “new-found disorder.” So despite just learning about it while internet surfing, I doubt that any drug company will bother marketing new drugs that affect such a small population that has been studied long before the internet could sensationalize anything.
Two favorite mental health diagnoses that people like to demean are people who suffer from Seasonal Affective Disorder (SAD) and Attention Deficit Disorder (ADD). These are mental health disorders that people actually suffer from that can be found in the DSM. With SAD, people are prone to experience: a general malaise or lack of motivation, hopelessness, anxiety, socially withdraw from friends and family, oversleep regularly (also called hyper-somnia), loss of interest in activities, appetite changes with weight gain and difficulty concentrating. But wait, to have this diagnosis these symptoms (and I quote): have to significantly affect the persons ability to function on a daily basis.
Every fall and winter a person with SAD wishes they were no where but in their bed hiding out from the world. They wish the thoughts of just wanting to disappear would go away so they could have normal feelings again. For some, medication to help augment their disappearing happy neurotransmitters are necessary. A behavioral health professional would always say medication is never enough and therapy to create lasting healing and change are necessary. If a therapist believes medication is warranted a referral out to a psychiatrist would be appropriate here as only a physician can prescribe medications.
The opinion on ADD or Attention Deficit Hyper Activity Disorder (ADHD) is a bit more complicated. First, each is a different disorder with different types of symptoms. A child or adult with ADD struggles with attention, focus and a level of distraction that affects their ability to cope and function on a daily basis. ADHD has these symptoms as well as the added component of hyperactivity. Children with this diagnosis cannot focus and lack impulse control beyond what a typical child (dependent upon age) may do. A child with these diagnoses have difficulty learning, they are labeled as the class clown and a trouble maker in school. They often are inappropriate, will hit, bite, scream and when the executive functioning of their brain feels overwhelmed can even self harm in an attempt to quell the excruciating pain they experience desperate to not act out in anger. There is no doubt this diagnosis and medication is over used, however, the over use of the “parental medication” of hitting a child’s head, as far back as the 70’s possibly, has what led us today to an entire government run department of family and children services. Children can now be removed from their parents care when the ongoing and inappropriate use of physical force leads to concussions and trauma as a result of a loved one mistreating their child. I know parents, teachers, physicians and extended family who know their child would be incapable of functioning without medication. If parents of unmedicated ADD or ADHD children were completely honest, they would have to admit they may unintentionally physically harm their child in an attempt to stop their children from participating in ongoing egregious behaviors.
A primary, not secondary treatment for ADD and ADHD is play therapy. Medication prescribed by a psychiatrist should again, augment the process, not be the cure. The main organization that studies this type of therapy is the Association of Play Therapy (APT). This world wide organization has been studying play therapy for the treatment of many types of disorders since its founding in the 1920’s. The primary goal of the affordable health care act is to provide health care, including mental health care to more people in the United States. Grant money is likely not available to the APT. As well, the primary goal of the World Health Organization is to examine how unhealthy diet and lack of physical activity increases chronic diseases. ADD or ADHD is not a disease and this organization does not recognize ADD or ADHD as a disease so would not be suitable in studying play therapy.
It is clearly being stated here, there are no doubts that real mental health disorders exist. The problem arises when the conditions are applied haphazardly by people who are not educated on the real facts of mental health. Let’s leave these diagnoses that are intended to communicate useful information to real experts. A parent knows when their child is suffering beyond the “normal” and clinicians can be present to guide parents, families and individuals towards genuine emotional health and stability.
If Sally does have a pituitary problem she should seek medical support from an endocrinologist, not a behavioral health specialist. If she has been consuming 42 Oreos every breakfast for the past two years and came for counseling, most therapists would want Sally to have a consult with a specialist like an endocrinologist before pursuing possible major mental health issues. Final disclaimer: in order to receive a mental health disorder, not only does a person have to meet a specified amount of criteria, but they must also safely rule out many other possibilities.
The use of mental health terminology in our daily life has led people to believe that they too can look up information on the internet and appropriately diagnose with fancy terms to make us all “crazy” or worse, that everyone else in society is the problem and we are the only people that behave normally.
Your homework this week….hell, your homework in this life: Choose to Learn Instead of Fear. I have the privilege in this moment to share the knowledge I have gained over the last 13 years as a therapist. No smack to the head is going to jar knowledge into it. Take the time to understand how we can use our gifts to encourage growth and change. I feel certain that Chloe Jennings and every human who has ever suffered would appreciate our understanding rather than our judgment.