Tag Archives: DSM

Mar 30

Global Mental Health: “Hidden Pictures”

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In the words of Ethan Watters in his book Crazy Like Us: The Globalization of the American Psyche (2010), “We may indeed be far along in homogenizing the way the world goes mad.” And this is not a good thing.

An excerpt from the opening of Crazy Like Us shows some of the significant ways, in addition to the American-bred DSM‘s far-ranging influence, in which the U.S. has been inappropriately viewed or has functioned as “the world’s therapist”:

American researchers and organizations run the premier scholarly journals and host top conferences in the fields of psychology and psychiatry. Western universities train the world’s most influential clinicians and academics. Western drug companies dole out the funds for research and spend billions marketing medications for mental illnesses. Western-trained traumatologists rush in wherever war or natural disasters strike to deliver ‘psychological first aid,’ bringing with them their assumptions about how the mind becomes broken and how it is best healed.

Publishers Weekly notes the author’s argument that Americans’ way of doing psych business often doesn’t translate well to other cultures in various different lands: “…Western treatments, from experimental, unproven drugs to talk therapy, have clashed with local customs, understandings and religions.”

The documentary Hidden Pictures: A Personal Journey Into Global Mental Health, created by physician and mental health advocate Delaney Ruston, apparently was the first of its type to address global mental health.

NAMI (National Alliance on Mental Illness) indicates that Hidden Pictures “looks at individuals and families affected by mental illness in Africa, China, France, India and the United States. Stigma and the need for greater access to treatment and care are major themes, framed against colorful, emotionally powerful backgrounds.”

And NAMI offers some pertinent statistics: “Approximately 450 million people live with mental illness worldwide. About 800,000 die from suicide, mostly in low and middle income countries—where as many as 85 percent of people living with severe mental illness receive no treatment. In high income countries, the figure is as high as 65 percent. Global spending on mental health is less than two dollars per year.”

In an interview with Real Change News, Ruston addresses such global issues as the lack of options for receiving adequate mental health care, the lack of mental health advocacy organizations, the importance of housing availability, and the need for mental health education in schools.

Her closing words: “Indeed, one of my key take-home points from making ‘Hidden Pictures’ is that, unlike the myth that our experiences globally are too diverse to understand and help, in fact, our experiences at the very core are much more similar than different, and global solutions are possible.”

A preview is available below:

Marvin Swartz, Professor of Psychiatry, Duke University School of Medicine: “The written word often fails to convey the particular poignancy of people’s lives. Delaney Ruston’s masterfully told stories of individuals and families struggling with mental illness across the world, conveys a profound and visceral appreciation of the myriad effects of such illnesses. Hidden Pictures makes the story of the global burden of mental illness deeply personal and hauntingly memorable.”

Sep 12

Over-Labeling: David A. Levy Spoof Gives It a Label

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In the spirit of recognizing that things often defy easy categorization, I present an over-labeling (spoof) “diagnosis” proposed years ago by psychologist and professor David A. Levy in an article called “A Proposed Category for the Diagnostic and Statistical Manual of Mental Disorders (DSM): Pervasive Labeling Disorder.”

The main symptoms and features of PLD are as follows: “(1) an uncontrollable impulse, drive, or temptation to invent labels and to apply them to other people, (2) a repetitive pattern of trying to fit people into preconceived categories, (3) an increasing sense of fear or inadequacy before committing the act, (4) an experience of overwhelming triumph or relief at the time of committing the act.”

Furthermore, “Persons with PLD operate under the fallacious belief that, by having named something, they have therefore explained it. Research indicates that many persons with PLD are exceptionally adept at seeing in other people the flaws they cannot see in themselves…”

And here’s the kicker: “…(M)any people have found a means to obtain reinforcement for this disorder in socially acceptable ways by becoming psychiatrists, psychoanalysts, psychologists, astrologists, Scientologists, evangelists, cult leaders, authors of self-help books, politicians, and interview guests on radio and television shows.”

Usually people with PLD remain undiagnosed until they’ve reached “a position of social power.” Furthermore, “(r)ecovery from PLD rarely occurs once the person’s annual income exceeds six figures.”

Other David A. Levy Quotes

On a somewhat related idea to over-labeling, David A. Levy is also known to have said, “There are two types of people in this world — those who think that there are two types of people in this world, and those who don’t.”

And let’s not stop there. Here’s a collection of other quotes from Levy’s lectures on “Humor in Psychotherapy” (2007):

  • There are three things needed to eliminate human misery. Unfortunately, nobody knows what they are.
  • When a psychoanalyst takes on the role of a blank screen, all he really learns is how the patient responds to people who try to act like they’re a blank screen.
  • To the optimist, pessimists are neurotic; to the pessimist, optimists are deluded.
  • I used to fear that taking medication would change my personality; now I fear that it won’t.
  • To be neurotic is to spend one’s life perpetually replacing one worry with the next.
Mar 20

Is Your Boss a Narcissist? (Kinda Like Miranda Priestly?)

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Is your boss a narcissist? Well, does his or her behavior resemble that of fashion magazine editor Miranda Priestly (Meryl Streep), the demonic boss in The Devil Wears Prada (2006)? Because almost everyone seems to believe she’s a really good example of a narcissist.

Marco R. della Cava, USA Today, writes about asking Dr. Paul Babiak, co-author of Snakes in Suits: When Psychopaths Go to Work, about the Priestly character. “As the ability to diagnose psychopathic behavior has improved, we find there are more women who fit this profile,” he states.

Or perhaps she’s a psychopathic narcissist? A narcissistic psychopath? A psychopath who’s also a narcissist? This sort of parsing is precisely what the DSM folks were getting at with their thoughts about eliminating NPD in the next edition—and placing it instead under Antisocial/Psychopathic Personality Disorder. But this has been dismissed for now.

(Charles Zanor reported on this for the New York Times in his aptly titled “A Fate That Narcissists Will Hate: Being Ignored.”)

But, do we really care that much about how to diagnose Miranda Priestly? We’re more concerned with whether your boss is a narcissist.

Andrea, Anne Hathaway‘s character, does, of course, wind up experiencing the misfortune of getting hired after all. And of course is wildly mistreated by boss Priestley.

If you are unlucky enough to have a boss who’s a bully or a manipulator or a puppetmaster, these just happen to be the three types of psychopaths Babiak and Hare, authors of Snakes in Suits, believe exist. Constructive advice is provided in the book about how to deal with them.

Mar 19

“Horrible Bosses”: Is Your Boss a Psychopath Like Dave Harken?

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Listen to me, you stupid little runt. I OWN YOU. You’re my BITCH! So don’t walk around here thinking you have free will because you DON’T. I can break you anytime I want! Dave Harken, boss portrayed by Kevin Spacey in Horrible Bosses

It’s Monday morning. Do you know if your boss is a psychopath?

Well, first, do you even know what a psychopath is? I for one have not always been sure. It’s a term too loosely thrown around.

If you look for it in the DSM, it’s currently hidden within Antisocial Personality Disorder. Wait until 2013, though, and word is that you just might find it as Antisocial/Psychopathic Personality Disorder. Maybe. We don’t know yet for sure.

And now I will proceed to list all the traits that define psychopathic personality disorder…

Not. It’s so much more fun to illustrate with an example.

When the movie Horrible Bosses came out last year, management coach Phil Hayes reportedly stated that “by far the most realistic” portrayal of a bad boss in the film was Kevin Spacey‘s character, Dave Harken. Harken is “a psychopath who likes nothing more than tormenting his employees.” (Source: Laura Barnett, The Guardian.)

Before going any further, let’s meet Harken. View the movie trailer below to catch glimpses of such horrible behavior as Harken tricking an employee (played by Jason Bateman) into working hard for a deserved promotion–and then yanking it out from under him:

So, then, what is a psychopath? Writer Kevin Voigt cites Clive Boddy, author of Corporate Psychopaths: Organizational Destroyers (2011), as stating: “Psychopaths are great bullies. They are cunning and manipulative, and great at engineering situations. Although they don’t have emotions themselves, they can create emotional situations. The rest of us don’t even realize we’re being manipulated until it’s too late.”

Chances are better than you might think that you have a boss who is one. Voigt reports on a 2010 study that “found about 4% of senior managers displayed psychopathic tendencies, up from the 1% that researchers say could normally be found in society.” That’s one in 25, by the way.

Voigt also provides a relevant quiz developed by psychologists Robert Hare and Paul Babiak, authors of Snakes in Suits: When Psychopaths Go to Work (2007). Take the quiz. Read the books. Maybe you’ll figure out if your boss is one of these dreaded types. Or maybe you already know.

Is it any wonder that the black-comedy cinematic solution becomes joining forces with other mistreated employees of “horrible bosses” to do them all in?

Special note: Such behavior is not condoned by this blog.