The Politics of Normal

February 26, 2010

In a recent NY Times article, “Revising the Book on Disorders of the Mind”, the fact that so-called mental disorders are decided by people, rather than being self-evident “facts,” is readily apparent.

As a psychologist, this is old news, but for many parents who may come into contact with “experts” who have been using jargon for so long that they mistake it for some inexorable and inevitable truth, it is good to have a wider perspective on things.

Children who do not behave annoy parents and teachers, but how much is childhood angst a product of adult angst, particularly societal angst?  How much does denial, emptiness and anxiety filter down to children where it gets projected by parents who would rather treat their kids than look at their own issues?

The DSM (soon to be edition V), is generally considered to be the psychiatric text that sets forth criteria for diagnosis on everything from anxiety to schizophrenia; it is a book that tells other doctors, and in turn the rest of the world that relies on those doctors, what is “normal” and what is “pathology.”

It is highly worth keeping in mind, however, that over the years this book has changed significantly.  For example, it wasn’t that long ago when being gay was a clinical diagnosis—an illness in the view of psychiatry.  Besides being unenlightened, it makes me think about how homophobic, and/or angrily repressed psychiatrists might have unconsciously projected onto, and pathologized, others what they could not resolve in themselves.

In this spirit of unconscious bumbling, I wonder about the increase in kids who have been getting diagnosed with bi-polar disorder as young as two years old.  Sure, the big change afoot (in the mouth) of the DSM may be to call it “temper dysregulation disorder with dysphoria” (wow, now that feels like children getting better already).

The name change is “a recommendation that grew out of recent findings that many wildly aggressive, irritable children who have been given a diagnosis of bipolar disorder do not have it.

The misdiagnosis led many children to be given powerful antipsychotic drugs, which have serious side effects, including metabolic changes.

Some diagnoses of bipolar disorder have been in children as young as 2, and there have been widespread reports that doctors promoting the diagnosis received consulting and speaking fees from the makers of the drugs.”

Cynicism aside, “Dysregulation” is likely to become a widely used buzzword in the near future, but in simple words, it just means imbalance—fluctuations in moods, energies, feeling states.  While more and more kids may be found to have issues with regulating their feelings (and, in turn, “acting” them “out” with disruption, aggression, etc.), it serves us parents to give some serious thought to our own ability to regulate affect (i.e. hold our shit together).

Do we “lose it” in traffic?  Do we blow up and holler?  Do we smoke, drink, eat or spend to try and numb or feed our hungers?  Do we trust that everything is okay right now, and is going to continue to be okay?  And if not, are we nevertheless able to truly calm and comfort our children?  Or does our angst leak into our kids’ unconscious and come roaring back at us as we feign ignorance of where it could possibly be coming from?

We live in a very jumpy, hungry and fear-stricken culture.  We could consider the true pathology to be dysregulation at the societal level—evidenced by market volatility, unemployment, pending inflation, and a policy of running around the world trying to stop terrorists from terrorizing us, spiraling into debt while printing money that has no really understandable anchor other than that Uncle Sam gives his word that he’s good for it…

Since the drugs we’ve been given for our adult depression and anxiety are starting to reach their plateau of effectiveness (and may turn out to have been no better than placebos… billions of dollars after big pharma realized it, oops), but since there is still no money to be made in wellness, we are changing the names around of our illnesses.

But what if “normal” children want to run around and play and don’t really need to be sitting still and paying attention in preschool?  What if it’s the way we treat them that makes them angry and anxious; and what if it’s the way we treat each other that makes us angry and anxious… and what if that’s what keeps trickling down onto our children?

So, let’s dedicate today to eyes-open thinking for ourselves, compassionately seeing all the dysregulation in which we swim—often unaware, but in the hopes that we might surface and start to breathe—breathing in love and breathing out fear and desire—self-regulating (at no economic expense) in the service of all our collective children.

Namaste, Bruce

{ 2 comments… read them below or add one }

Jen February 28, 2010 at 1:16 pm

As usual, Bruce, your perspective on the DSM sheds light and promotes rational thought and discourse about a tool used by experts, and far too many not-so-experts, to define normal, crazy and everything in between.

Having been raised by parents who had 3 out of 3 offspring develop emotional disorders and have only 2 of 3 offspring survive to middle age, the DSM, starting with v. III, has been a familiar tome in my life. I truly enjoy seeing how it changes (almost as much as I enjoy observing the positive changes in myself and my surviving family members) as we all continue to grow, love and learn to know/accept one another. Breathing in love, forgiveness, acceptance, compassion and breathing out anxiety, anger, sadness, blame…namaste.

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privilegeofparenting February 28, 2010 at 11:22 pm

Namaste

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