Are therapists and psychiatrists the new Saint Augustines? Attempting to convert heretics into pious automatons. Diagnosing is an escape from the freedoms of self-definition and into a disempowered clinical and social identity.
When did mental health become monotheistic? A belief in one “god” and truth of “right”. There are many ways to think, to behave, and to identify.
Diagnosis is the Trojan Horse masquerading as a gift of healing when it’s truly an impending attempt to normalize and whitewash diversity of psychologies. Disruptive children labeled disordered and placed into medicinal straightjackets to aid parents and teachers in controlling them. Sexually confident individuals shamed into labels of addiction. It’s the modern day psychological eugenics. Attempts to weed out and perpetuate a mental survival of the fittest only. This concepts ignores the beauty of variability and liberty, by working to reform the “broken” to ensure a society of “fit”. The world of addiction and trauma therapy already operate from a paternalistic geographic of condescension. The poor elementary client is unable to recognize his own pathos and needs an “expert” to frame a “could be” neutral experience as a trauma, thereby victimizing them. All to what end?
The emergent academic field of “Disability Studies” has much to teach us about our views on mental illness and social pathology. The concepts of “impairment” versus “disability” call into question how an “expert” or institution (medicine/psychology) can so patronizingly turn an impairment, a physical fact, into a social identity and experience of “disability”, a social construct. Lennard J. Davis brilliantly states that Disability Studies demands a shift from the ideology of normalcy…to a vision of the body as changeable, unperfectable, unruly, and untidy. I grew up academically worshipping the deities of brain scans, SPECTS, and psych testing (modern day psychological eugenics) and do believe in the existence of brain functioning and neurology. But there is NOT a one-to-one relationship from brain functioning and localized brain activation to personality characteristics, mental health functioning, or mood (this is called “reverse inference fallacy”, an embarrassing blunder not to be made by a neuro intellectual). I love brain science but it is sloppy and lazy to myopically ignore all the social, relational, cultural, even epigenetic (read up on this fascinating emergent field) implications upon that which occurs between brain functioning and local activation and what one thinks, feels, and does behaviorally. To label ones “impairment” or “sexual interest” as an “illness” is taking the physical and turning it into the psycho-social. The undereducated “experts” with flimsy certifications to legitimize the work of a sex phobes, and psychiatry education which provides little to no psychology or therapy training, both police sexuality like the Nazi’s policed racial identity. Both work towards extermination of diversity.
We get to choose our identities and labels. A body (mind and personality, too) that isn’t functioning up to par with the “ideal” (which is what?), is not “disabled” or “ill” unless one chooses to subscribe to the social construction of non-ideal as “broken” and in need of rehabilitation and fixing. “Disability being in the eye of the observer and not the observed.”
The mental health field has the simple goal of working to improve the lives of those suffering from various mental disorders. They often fail, and this is due to their insistence on maintaining DSM diagnoses, social values, and pop culture disorders. Often “mental disorders” are social creations and attempts at social control to extinguish behaviors that scare, upset, offend, or do not follow “moral” codes. Institutions such as the psychology field, pill pushing psychiatrists, and certified pseudo specialists exacerbate client issues by keeping them bound and held hostage within shaming and pathologizing narratives, identities, and diagnoses.
During my early clinical training with therapists untrained in sex therapy and sexology, I had the oppurtunity to witness firsthand the integrity violations enacted upon naïve clients seeking alleviation of their sexual distress. Clients arrive to therapy anxious and mentally exhausted looking to the “expert” to help them stabilize, explore, and hopefully heal themselves. The specialist’s own sex phobia sadly leaks into the equation from the very first therapeutic meeting with the client. A therapist’s discomforts with non-normative sexual behaviors or their own chaotic history with sex is the lens through which they analyze their client’s sex lives. Shaming assessments, demobilizing labels, and misunderstandings about sexuality abound and add further injury to an already uncomfortable client. The problem is that there is no “healthy” or “right” way to be sexual or to run ones relational life. I don’t patronize my clients by forcing them into a prefixed structure that determines a one-size-fits-all paradigm of health. As adults we are all challenged to decide for ourselves what is ‘right”, “healthy”, and “functional”. If an “expert” claims to know, run! What is “healthy” will change and be different for different people, at different times, within different relationships.
Let me provide a clinical case study to illustrate my point of shaming and misdirection. A female client came in to work with me on what an “expert” diagnosed as a sex addiction and intimacy disorder. This woman had been told that her consistent sexual engagements with men other then her husband was an “addiction” and that her lack of interest in sex with her husband was an “intimacy disorder”. Please note that neither of these “diagnoses” have operational definitions or exist in any diagnostic manual. This does not mean they do not exist, but it does mean that they are wide-open for misunderstanding and misinterpretation and often directed by the clinician’s own anxieties about sex. This woman, due to her diagnosis of “sex addict” and “intimacy disordered,” felt shamed and broken, because even with attendance at 12 step meetings and “therapy” she was still not able to develop desire to have sex with her husband.
The most poignant theme that arose in our work was the acknowledgment of a lack of sexual attraction for her partner that had existed from the beginning of their relationship. The woman’s sexual behavior with other men was her attempt, albeit a poor choice of all the available options, to have a pleasing sex life after having chosen the relational option of monogamy and commitment with a man she wasn’t sexually attracted to. She was not a sex addict and there was absolutely no “intimacy disorder.” She was fully capable of tolerating and being interested in intimacy, on both physical and psychological levels, as evidenced by her behaviors both with her committed partner and outside sexual partners. It is expected for an individual to avoid sexual contact, and possibly affection and physical closeness, from a partner that they are not attracted to, aroused by, or feeling chemistry towards. This woman had followed culturally misguided notions of sex not being as important as psychological or emotional intimacy; sex as a small portion of a relationship. How erroneous this concept is. Sex is as important, and I believe more important, than other levels of intimacy. Sex and our sexuality are ALWAYS with us. Its what we wear, how we walk, eye contact we make, what we say and the way we say it. We are always utilizing our “erotic capital”.
I tell my clients to seek partners that they connect to both sexually and emotionally. We need both, especially during times when one level is lacking. If we are not connecting or feeling close emotionally, it’s the attraction and sexual arousal that hold us close and together. Without it we have nothing to keep us within the relationship. Does sexual interest and arousal slowly drop off as our relationships extend in the future, sure. Is this due to our obsession with monogamy and our attempts to sustain monogamy and commitment for longer periods of time then ever before as we live longer, probably.
All the sensate focus exercises, 12 step sex addiction meetings, and couples therapy will not and cannot create sexual interest, arousal, or chemistry. Thankfully this is beyond conscious control. This is one part of “nature” and “biology” that we have yet been able to vandalize. This case study may serve as warning for many when deciding on making commitments or as a source of freedom for others who thought they were disordered. Let it speak to how the mental health field is often too comfortable utilizing questionable labels and concepts, and how important sexual interest, desire, and chemistry are if one chooses the option of monogamy.