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	<title>Behaviorism and Mental Health</title>
	
	<link>http://behaviorismandmentalhealth.com</link>
	<description>An alternative perspective on mental disorders | PHILIP HICKEY, PH.D.</description>
	<lastBuildDate>Mon, 14 May 2012 20:41:53 +0000</lastBuildDate>
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		<title>More Cracks in the Sandcastle</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/K2h8NHDtBbY/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/05/14/more-cracks-in-the-sandcastle/#comments</comments>
		<pubDate>Mon, 14 May 2012 20:36:29 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[DSM-5]]></category>

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		<description><![CDATA[Christopher Lane has a post up on Psychology Today (May 14 2012) called:  DSM-5 Is Diagnosed, With a Stinging Rebuke to the APA. About a year ago, the APA announced the new “diagnoses” that they proposed to include in the upcoming DSM-5.  This kind of expansion is nothing new.  The APA has been engaged in [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Christopher Lane has a post up on Psychology Today (May 14 2012) called:  <a href="http://www.psychologytoday.com/blog/side-effects/201205/dsm-5-is-diagnosed-stinging-rebuke-the-apa">DSM-5 Is Diagnosed, With a Stinging Rebuke to the APA.</a></p>
<p>About a year ago, the APA announced the new “diagnoses” that they proposed to include in the upcoming DSM-5.  This kind of expansion is nothing new.  The APA has been engaged in the medicalization of every conceivable human problem for the past 50 or 60 years.</p>
<p>But on this occasion, some of their more creative and potentially damaging creations generated a good deal of fairly vocal opposition.  The upshot of this is a decision by the APA to drop two of the more contentious “diagnoses:”  - “attenuated psychosis syndrome” and “mixed anxiety and depression.”</p>
<p>Clearly they thought that these concessions would allay criticism and draw away some of the flak.  And to some extent the move was successful.  However, there has been a backlash of sorts.  The APA’s reversal has drawn attention to the fact that the “diagnoses” are simply their own inventions, with no basis in nature.  By eliminating these two “diagnoses” with the stroke of a pen, they have underlined the fact that they <em>make</em> “diagnoses” with the stroke of the same pen.</p>
<p>Here’s a quote from Christopher Lane’s article:</p>
<p style="padding-left: 30px;">Among the fiercest critics quoted is Mark Rapley, a clinical psychologist at the University of East London, who puts it this way: “The APA insists that psychiatry is a science. [But] real sciences do not decide on the existence and nature of the phenomena they are dealing with via a show of hands with a vested interest and pharmaceutical industry sponsorship.”</p>
<p>Let us hope that the controversy continues.  It’s not DSM-5 that’s the problem.  The problem is the APA’s spurious insistence that <em>all</em> human problems are to be considered illnesses and – in most cases – treated with drugs.</p>
<p>By the way, one of the “diagnoses” still slated for appearance in DSM-5 is premenstrual dysphoric disorder (formerly known as PMS).  So this will become a “mental illness” and will be grounds for prescription of drugs – and who knows – perhaps even commitment to a mental hospital.</p>
<p>Please read the complete Christopher Lane article.</p>
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		<item>
		<title>Number of US Newborns with Drug Withdrawal Triples</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/IXmYNYz1ghw/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/05/14/number-of-us-newborns-with-drug-withdrawal-triples/#comments</comments>
		<pubDate>Mon, 14 May 2012 19:49:01 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[abuse]]></category>
		<category><![CDATA[alcohol/drugs]]></category>
		<category><![CDATA[war on drugs]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=689</guid>
		<description><![CDATA[Yahoo News recently ran an Associated Press article with the above heading.  Here are some quotes: Disturbing new research says the number of U.S. babies born with signs of opiate drug withdrawal has tripled in a decade because of a surge in pregnant women&#8217;s use of legal and illegal narcotics, including Vicodin, OxyContin and heroin, [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Yahoo News recently ran an Associated Press <a href="http://news.yahoo.com/number-us-newborns-drug-withdrawal-triples-201814938.html">article</a> with the above heading.  Here are some quotes:</p>
<p style="padding-left: 30px;">Disturbing new research says the number of U.S. babies born with signs of opiate drug withdrawal has tripled in a decade because of a surge in pregnant women&#8217;s use of legal and illegal narcotics, including Vicodin, OxyContin and heroin, researchers say.</p>
<p style="padding-left: 30px;">The number of newborns with withdrawal symptoms increased from a little more than 1 per 1,000 babies sent home from the hospital in 2000 to more than 3 per 1,000 in 2009, the study found. More than 13,000 U.S. infants were affected in 2009, the researchers estimated.</p>
<p style="padding-left: 30px;">Weaning infants from these drugs can take weeks or months and often requires a lengthy stay in intensive care units. Hospital charges for treating these newborns soared from $190 million to $720 million between 2000 and 2009, the study found.</p>
<p>What we are seeing here is one more example of the failure of the War on Drugs.</p>
<p>In the early 1900’s there was a popular movement in the US against alcohol, resulting in Prohibition, which became law in 1920.  However, it soon became clear that the evils of prohibition greatly outweighed the evils of alcohol.  This realization developed into a popular groundswell for repeal, which was successful in 1933.</p>
<p>The US government first started restricting use of certain drugs in 1914.  But the term War on Drugs was used by President Nixon, and the present War on Drugs started about 1970.  Within ten years it was clear that it was unsuccessful, and that it was spawning crime at an unprecedented rate.</p>
<p>The fact is that people like alcohol and other drugs, and will pursue these products even in the face of the most draconian restrictions.  It has been estimated that half of the individuals in American prisons are in for drug-related offences.  And yet the demand continues, even among pregnant women!</p>
<p>To date the War on Drugs has cost America <a href="http://www.foxnews.com/world/2010/05/13/ap-impact-years-trillion-war-drugs-failed-meet-goals/">over a trillion dollars</a> in taxpayer money.  What a waste!  Elsewhere on the blog I have proposed a <a href="http://behaviorismandmentalhealth.com/2010/10/16/drugs-and-alcohol-part-3/#.T7Fgd-sV3T8">legalization of all drugs with certain basic safeguards</a>.</p>
<p>The APA includes alcohol and drug abuse as diagnosable “mental illnesses.”  This decision lends passive support to the futile and destructive War on Drugs.  It ludicrously puts the War on Drugs on a par with disease eradication programs like the successful smallpox eradication program of the 1970’s and the present day malaria eradication drive.</p>
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		<item>
		<title>Too Much Sex?</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/0z1LjWdZ-Ko/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/05/14/too-much-sex/#comments</comments>
		<pubDate>Mon, 14 May 2012 17:38:14 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[DSM-5]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=684</guid>
		<description><![CDATA[Christopher Lane recently published an interesting article on Psychology Today. The article covers a number of topics, including the APA’s proposal to include “hypersexual disorder” in the upcoming DSM-5.  The implications of this proposed “diagnosis” are that if you think about sex too much or engage in sexual activity too much, then you have a [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Christopher Lane recently published an interesting<a href="http://www.psychologytoday.com/blog/side-effects/201204/american-sex-and-american-psychiatry"> article </a>on Psychology Today.</p>
<p>The article covers a number of topics, including the APA’s proposal to include “hypersexual disorder” in the upcoming DSM-5.  The implications of this proposed “diagnosis” are that if you think about sex too much or engage in sexual activity too much, then you have a mental illness.</p>
<p>Back in the 60’s, when I was at college, I would frequently find myself chatting with a group of fellow students on a wide range of topics, including sex.  Often someone would cite the old statistic that the average young adult male thinks about sex 171 times a day (or whatever), to which the chorus of replies was always – “no way; it’s much more often than that.”</p>
<p>The point being – who’s to say that a person is engaging in too much sexual activity?  Only the APA, with its self-serving agenda of medicalizing more and more aspects of normal human existence coupled with its monumental arrogance, would take such a step.</p>
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		<item>
		<title>Parenting and Psychiatry</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/RaT15cEsZwA/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/04/24/parenting-and-psychiatry/#comments</comments>
		<pubDate>Tue, 24 Apr 2012 20:12:56 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[ADHD]]></category>
		<category><![CDATA[parenting]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=678</guid>
		<description><![CDATA[About a week ago an article appeared on the ‘net concerning an attempt by parents to ban ice cream vendors from a playground in Brooklyn, New York.  The piece was reprinted in the New York Post.  Apparently some of the parents are upset because the arrival of the vendors stimulates requests for ice cream from [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>About a week ago an article appeared on the ‘net concerning an attempt by parents to ban ice cream vendors from a playground in Brooklyn, New York.  The piece was reprinted in the <a href="http://www.nypost.com/p/news/local/slopers_creamy_river_lcaxb1lj4D0SHqo4f2K3GO">New York Post</a>.  Apparently some of the parents are upset because the arrival of the vendors stimulates requests for ice cream from the children, which results in confrontation and bitterness.</p>
<p>Responsible parents everywhere will recognize the dilemma.  Ice cream has little or no nutritional value, but children like it.  So do we stand our ground or do we give in?</p>
<p>When I was young an ice cream van (Mr. Whippy) would come round our street every afternoon.  We would run in and ask our mother if we could have money for ice cream.  She would say no. (“I’ll give you ice cream!&#8221;) And we would go back to playing tag or handball, or whatever we were doing.</p>
<p>Back then (the old days) it was generally understood that small children are, by nature, willful, self-centered, and bad-tempered, and that eradicating these traits and instilling something more sociable was an intrinsic part of parenting.  It was also understood that this socializing process required the routine delivery of unpleasant consequences when children misbehaved.  Now in the old days, this usually meant beating the tar out of them, and I’m not advocating a return to that sort of thing.  But you can’t raise children properly without confrontation and negative consequences.</p>
<p>So how did we get to this stage, where parents are trying to ban ice cream vendors rather than take charge of their children?  And what has this got to do with psychiatry?</p>
<p>For the past fifty or sixty years, the APA has been engaged in turf expansion.  Their position is that <em>every</em> human problem is a mental illness, and they have been remarkably successful in promoting this notion to other medical practitioners and to the general public.</p>
<p>According to the APA, there is no such thing as a misbehaved child.  If a child is defiant, he has oppositional defiance disorder; if he’s an out and out delinquent, he has conduct disorder; if he won’t pay attention to the teacher, and runs around the classroom, he has attention deficit hyperactivity disorder; and so on.  These are all mental illnesses.  So according to the APA, these children don’t need discipline and correction, they need “treatment” – which invariably means pharmaceutical products.  Parents can’t take care of these problems – they need to take these children to experts.</p>
<p>The result of all this is that children are consuming more pills each year, and parents are being disempowered.  They can’t even say no to their children’s requests for ice cream!  And, of course, we’re building more and more prisons.</p>
<p>And all for the sake of psychiatric turf and pharmaceutical dollars!</p>
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		<item>
		<title>Cracks in the Sandcastle</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/a1USYxfI53M/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/04/03/cracks-in-the-sandcastle/#comments</comments>
		<pubDate>Tue, 03 Apr 2012 19:46:54 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=672</guid>
		<description><![CDATA[The central theme of this blog is that the APA’s so-called diagnostic system is spurious and destructive.  It is destructive of the individuals that get caught in its net and destructive socially in that it undermines those values of resourcefulness and efficacy which are essential ingredients of a successful society. Psychiatrists have become tawdry drug [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>The central theme of this blog is that the APA’s so-called diagnostic system is spurious and destructive.  It is destructive of the individuals that get caught in its net and destructive socially in that it undermines those values of resourcefulness and efficacy which are essential ingredients of a successful society.</p>
<p>Psychiatrists have become tawdry drug pushers.  To this end they have prostituted their medical affiliations and have avidly promoted the big lie:  that ordinary human problems are in fact illnesses best “treated” by drugs.</p>
<p>Now as everyone knows, you can’t fool all the people all the time.  And it is my prediction that eventually this pernicious system will fall.  It is like a sandcastle.  It can’t last.</p>
<p>And cracks are starting to appear in the sandcastle.  I recently came across two articles which I’d like to share with my readers.</p>
<p>The first is <a href="http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html?_r=1&amp;pagewanted=all">“Ritalin Gone Wrong”</a> by Alan Sroufe, PhD, in the New York Times, January 28, 2012.  Here are some quotes:</p>
<p style="padding-left: 30px;"> Attention-deficit drugs increase concentration in the short term, which is why they work so well for college students cramming for exams. But when given to children over long periods of time, they neither improve school achievement nor reduce behavior problems. The drugs can also have serious side effects, including stunting growth.</p>
<p style="padding-left: 30px;"> To date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems, the very things we would most want to improve. Until recently, most studies of these drugs had not been properly randomized, and some of them had other methodological flaws.</p>
<p style="padding-left: 30px;"> What we found was that the environment of the child predicted development of A.D.D. problems. In stark contrast, measures of neurological anomalies at birth, I.Q. and infant temperament — including infant activity level — did not predict A.D.D.</p>
<p style="padding-left: 30px;"> Finally, the illusion that children’s behavior problems can be cured with drugs prevents us as a society from seeking the more complex solutions that will be necessary. Drugs get everyone — politicians, scientists, teachers and parents — off the hook. Everyone except the children, that is.</p>
<p> The second article is <a href="http://www.psychologytoday.com/blog/self-promotion-introverts/201008/giant-step-backward-introverts">“A Giant Step Backwards for Introverts”</a> by Nancy Ancowitz and Laurie Helgoe, PhD.  (I am grateful to reader Francisco for referring me to this piece.)  Here are some quotes:</p>
<p style="padding-left: 30px;">Is there really something wrong with you if you’re an introvert—or among that 50 percent of Americans who are more energized by their quiet time than their social time?</p>
<p style="padding-left: 30px;">We know what happens when a naturally occurring orientation is determined to be unhealthy while another is upheld as the standard of health. As recently as the 1970′s, the WHO and the APA considered homosexuality a psychiatric diagnosis. Inclusion in the ICD and DSM justifies existing stigmas—whether targeting homosexuality or introversion. Such diagnoses mistake difference for illness.</p>
<p style="padding-left: 30px;">In the United States giddy and garrulous are good, and quiet and contemplative are suspect. The WHO’s definition and APA’s proposed definition of introversion align with that rigid Western bias. Martin Kommor, Ph.D., chair of the Department of Behavioral Medicine and Psychiatry at the West Virginia University School of Medicine, Charleston, says, “We psychiatrists know too well that many of our diagnostic labels have been more a reflection of the political/moral climate than any real disease.”</p>
<p>It was this last statement by Martin Kommor that truly jumped off the page.  Although the article shows Dr. Kommor’s credentials as a PhD, he is in fact an MD and a psychiatrist.  “We psychiatrists know too well that many of our diagnostic labels have been more a reflection of the political/moral climate than any real disease.”</p>
<p>No matter how you read this, he is saying that psychiatrists have been blatantly <em>lying</em> about this matter for the past several decades.  Not mistaken.  Not overly zealous – but simple straightforward deception!  And this is from the chairman of a prestigious university psychiatry department!</p>
<p>Cracks in the sandcastle!  Please check out these articles.  Write to the authors expressing support and send the link to a friend.  It has been suggested that the psychiatric Juggernaut is unstoppable.  We’ll see.</p>
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		<title>Obsessive Compulsive Disorder Is Not An Illness</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/gRvbVdCO6wE/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/04/02/obsessive-compulsive-disorder-is-not-an-illness/#comments</comments>
		<pubDate>Mon, 02 Apr 2012 19:36:25 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[anxiety]]></category>
		<category><![CDATA[compulsions]]></category>
		<category><![CDATA[obsessions]]></category>

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		<description><![CDATA[Recently I was listening to NPR on the car radio.  The program was about so-called obsessive compulsive disorder, and a woman was describing her difficulty in this area.  I didn’t record her actual words, but it went something like this: I have all these checks and rituals that I have to do each day.  And [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Recently I was listening to NPR on the car radio.  The program was about so-called obsessive compulsive disorder, and a woman was describing her difficulty in this area.  I didn’t record her actual words, but it went something like this:</p>
<p style="padding-left: 30px;">I have all these checks and rituals that I have to do each day.  And it’s beginning to put a strain on my marriage.  Sometimes my husband wants to go somewhere but I can’t go until I finish my checks.</p>
<p>I was immediately struck by the possibility that either this woman doesn’t want to go out, or doesn’t want to go out with her husband.  These avenues certainly warrant exploration, but within the present mental health system, all she is likely to get is a “diagnosis” and a prescription.  (“You have an illness, takes these pills.”)  It would be very rare nowadays for anybody to take the time to explore what payoffs might be involved in the pursuit of the rituals.</p>
<p>The psychodynamics of rituals are self-evident.  Most rituals are simply repetitive actions that we can do without effort, and in which we can almost always be completely successful.  And we all have them.  We get out of bed in the morning; comb our hair (those of us who have any left); shave (those who care to); wash; brush teeth, etc..  And so on at various points of the day.</p>
<p>In my experience, the people who get into rituals to a disturbing degree fall into two groups.</p>
<p>Firstly, people who are very anxious/fearful.  The rituals have a calming effect.  They’re not the best way to deal with anxieties, but they work after a fashion.  I have dealt with more effective ways to cope with anxieties elsewhere in this blog.</p>
<p>Secondly, people who are not feeling generally successful in their everyday lives.  This is truly the modern malaise.  So many people are stuck in jobs from which they derive no feelings of accomplishment.  In my view we all need daily doses of feelings of success.  The subject area doesn’t matter.  Raking the lawn; building a fence; writing a letter; cooking a meal; teaching a child to ride a bike; painting a door; fixing the car; etc., etc..  Many people manage to get feelings of success through their jobs – this is great.  But those who don’t need to organize their leisure time in such a way as to ensure a steady flow of these kinds of feelings. There just isn’t time for rituals when you’re teaching your daughter how to change the oil in the car or helping a neighbor fix his porch or whatever.  And everyone can find something that they can do and do well.</p>
<p>Obsessions and compulsions do not constitute an illness.  Rather they are ways in which people deal with sub-optimal circumstances.  They can be replaced by more effective activities through the normal methods of behavioral change.</p>
<p>There are no mental illnesses.</p>
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		<item>
		<title>Eccentricity</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/4po4smJCGZ0/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/03/21/eccentricity/#comments</comments>
		<pubDate>Thu, 22 Mar 2012 03:15:01 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[DSM-5]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=644</guid>
		<description><![CDATA[Yesterday I received the following email from a reader. “What’s your stance on eccentricity? How do you relate to the general view in the APA that deviation from cultural norms is pathological? And, have you ever read about David Weeks? I consider myself an eccentric person with many quirks and some fetishes. While I have [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>Yesterday I received the following email from a reader.</p>
<p style="padding-left: 30px;">“What’s your stance on eccentricity? How do you relate to the general view in the APA that deviation from cultural norms is pathological? And, have you ever read about David Weeks?</p>
<p style="padding-left: 30px;">I consider myself an eccentric person with many quirks and some fetishes. While I have many friends who share the same interests or many of them, I still feel a little bad about psychiatrists labeling eccentricity with SPD or Schizoid personality disorder. I am 19, and my friends are from the 18-25 years of age, and we share a common love for anime and cartoons. Maybe not always the same but sometimes we share two or more common cartoons. Some of them also are collectors of stuffed animals and figurines like me, and some of them engage in masturbation with those objects as me.</p>
<p style="padding-left: 30px;">I came across your blog when I was reading about some proposals for the DSM-5 to remove all paraphilias. That was proposed by some psychiatrist who I forgot the name of, and he said that labeling paraphilias as illnesses just reflects social prejudice and a lack of tolerance for difference. Then I started wondering whether removing them would help at all, because we still have the schizotypal disorder floating there like a remaining Cheshire cat smile after it disappeared. The prejudice against difference would still be there, even with the paraphilias removed. Why? because many of us who engage in paraphilic acts such as plushophilia or other fetishes sometimes PREFER introversion, which seems to be a symptom of schizotypal. I can deal with all this by ignoring the DSM bullshit entirely, and even though I am going to be a psychologist, I can pretend I believe its bullshit. What do you think about eccentricity in general, and not just the quirkiness me and my friends engage in? Thanks for reading the email and I&#8217;ll await while I read more of your posts.”</p>
<p>I did a post on the so-called <a href="http://behaviorismandmentalhealth.com/2010/05/05/personality-disorders-are-not-illnesses/#.T2qBTBGPXT8">personality disorders</a> earlier, and gave some thoughts on what DSM calls schizoid personality disorder.  Essentially this consists of being a loner with little emotional attachment to other people.  “Schizotypal personality disorder” is the name the APA gives to eccentricity.</p>
<p>In my view eccentricity and/or social isolativeness are simply variations of normality, and are certainly not illnesses and do not of themselves need treatment.</p>
<p>If a socially isolative person is unhappy and longs to be more gregarious, then of course it is a problem. It is not a disease or illness, but he might need help.  The kind of help I envisage would be from a friend/family member who would help him get out and about, meet people, etc..</p>
<p>However, in my experience most “loners” simply prefer to be by themselves, and we should respect their wishes.</p>
<p>Similar considerations apply to eccentricity.  I think that in former times people were more tolerant of eccentricity.  Western society, however, has become very standardized, and I notice in the school systems that children tend to be ostracized fairly severely if they deviate from the norm in dress, manners, etc..</p>
<p>In DSM, eccentricity is included as schizotypal personality disorder.  The APA’s criteria are listed below:</p>
<p style="padding-left: 30px;">A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:</p>
<p style="padding-left: 60px;">(1) ideas of reference (excluding delusions of reference)<br />
(2) odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or &#8220;sixth sense&#8221;; in children and adolescents, bizarre fantasies or preoccupations)<br />
(3) unusual perceptual experiences, including bodily illusions<br />
(4) odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)<br />
(5) suspiciousness or paranoid ideation<br />
(6) inappropriate or constricted affect<br />
(7) behavior or appearance that is odd, eccentric, or peculiar<br />
(8) lack of close friends or confidants other than first-degree relatives<br />
(9) excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self</p>
<p style="padding-left: 30px;">B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder.</p>
<p>During my career I have worked with a number of individuals who met these criteria more or less.  Almost all came to me under some form of pressure – usually from family/friends, etc..  I seldom sensed any interest in major life change.  Like the loners mentioned earlier, they seemed fairly content with themselves as they were.</p>
<p>I remember one young lady who came across as quite different in a variety of ways.  She claimed that she was clairvoyant, and in particular she always knew when the phone was about to ring before it actually rang.  Now I don’t believe she did know this – but what difference does it make?  We all entertain erroneous ideas in some area or other.  If a person is content with him/herself and is not harming other people, then my position is that they should be left alone.</p>
<p>I would apply these considerations to the so-called paraphilias also.  In the old days (bad old days?) one sexual activity was condoned – heterosexual vaginal intercourse (preferably missionary position and with as little enjoyment as possible).  Now, as any 12 year old schoolboy can tell you, there’s a lot more to it than that.  For a great many generations feelings of guilt were used extensively by society to encourage sexual conformity.  This changed considerably during the 60’s, and people today are less guilt-ridden.</p>
<p>The central theme of this blog is that there are no mental illnesses – that people behave and operate in a wide range of ways, and if they are finding contentment with their lifestyles and are not harming others, then what’s the problem?</p>
<p>People who – for whatever reason – are NOT content with themselves and can’t seem to effect appropriate changes should consider asking for help.  Because the mental health system is so immersed in the medicalization process, it is unlikely that real help can be found in that area.  But there are other places people can turn to:  friends, neighbors, family, co-workers, etc..  My general advice here is to try to identify the specific problem that troubles one.  Then identify someone in one’s circle of acquaintances who seems particularly skilled in that area – and ask that person for help.</p>
<p>Something truly magical happens when  a person asks another person for help in learning something new.  Doors get opened, clouds dissipate, etc..  In my view this is a big part of what life is all about.</p>
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		<title>Intrusive Thoughts</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/UEiWd4QBmW8/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/03/13/intrusive-thoughts/#comments</comments>
		<pubDate>Wed, 14 Mar 2012 05:06:10 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=634</guid>
		<description><![CDATA[I recently received the following email from a reader: “I was wondering what your thoughts were on intrusive thoughts and anxiety problems or what some people call pure ocd. I have had problems for as long as I can remember.  There is so much information out there it gets confusing. I don&#8217;t believe these are [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>I recently received the following email from a reader:</p>
<p style="padding-left: 30px;">“I was wondering what your thoughts were on intrusive thoughts and anxiety problems or what some people call pure ocd. I have had problems for as long as I can remember.  There is so much information out there it gets confusing. I don&#8217;t believe these are illnesses I believe alot is learned or habitual.  I am alot better thanks to my own hard work, but intrusive thoughts are one of the harder things to shake. Thank you.”</p>
<p>Within the APA’s diagnostic and statistical manual intrusive thoughts are incorporated in the category obsessive-compulsive disorder.  In other words, according to the APA, if you’re experiencing intrusive (or obsessive) thoughts, it is because you have a mental illness called OCD.  This putative illness is routinely attributed to a neurological aberration and is “treated” with drugs.  I have critiqued this standard psychiatric approach to behavioral problems elsewhere, and need not repeat it here.  The current question is:  how can one better conceptualize these matters?</p>
<p>For the behaviorist, thoughts are best conceptualized as behaviors.  They are largely internal, but behaviors nonetheless.  Thoughts are not something that happen to us, rather they are things that we <em>do</em>.</p>
<p>Once we start considering thoughts in this light, it becomes clearer why we think as we do and why a certain kind of thought might come to dominate our cognitive content.</p>
<p>Just as our overt habits are formed essentially by reinforcement, so it is for our “inner” habits.   Many people, for instance, are habitual counters.  They count almost everything they come across.  If they are performing a chore, they count the number of items involved even though there is no need or purpose for this.  The likely reason for this is that within our culture, young children receive a great deal of reinforcement for counting.  The small child who successfully counts to five on the fingers of his hand is rewarded with smiles, hugs, etc.. Later, in school, a high premium is attached to the ability to count, and punishment and ridicule are meted out to those who fail in this area.  In addition, counting is one of those activities that can be done successfully without any great effort or inconvenience.  There is a sense of success and accomplishment in counting that isn’t as readily available in other areas.  A great many people on seeing a small group of cows in a field will count them almost without being aware of having done so.  Similar considerations apply to other intrusive/obsessive thoughts.</p>
<p>One must also distinguish between obsessive-compulsive behaviors that are a problem and those that are not.  Most men, for instance, in professional/managerial positions wear neckties every day when they go to work.  By any standard this is compulsive behavior, but for most people it’s not a problem, and many of these individuals would feel very uncomfortable without this item of apparel.</p>
<p>A common obsessive thought is the notion that dangerous germs are everywhere and that contact with other humans has to be particularly avoided.  The problem here, of course, is that there is a grain of truth underlying this obsession, and most parents encourage their children to exercise an appropriate measure of caution in this regard.  A small number of children take the measure to extremes, however, probably because for some random reason this kind of concern was particularly reinforced at a critical juncture.  Some people with these kinds of obsessions have poor social skills, and it is easy to see how the obsessive thought serves as an effective rationalization for avoiding people.  The solution here, of course, is to improve the social skills.</p>
<p>So what can you do?  There are a number of approaches.  Firstly, trying not to think about the particular obsession tends to be counter-productive.  Distraction is a more successful tactic.  Let’s say, for instance, that the intrusive thoughts usually occur at your desk and distract you from your work.  Identify your least favorite task – say filing or preparing financial reports or whatever.  As soon as you realize that the intrusive thoughts are present, get up from your desk and tackle the unpleasant job.  What you’re doing essentially is punishing yourself mildly for having the intrusive thought.</p>
<p>If you ever go to a psychologists’ conference/meeting, you will probably notice a number of individuals wearing thick rubber bands around one of their wrists.  At odd moments during the lectures they snap these bands painfully against their skin.  Again, it’s a way of delivering a punishment for an intrusive thought.  I’ve never used this technique, largely because on the few occasions I’ve gone to conferences I have usually found my own daydreams more interesting than the lectures.</p>
<p>I’ve always been a big believer in friends helping friends.  Consider discussing the problem with a trusted friend.  A problem shared really is a problem halved.</p>
<p>At the risk of stating the obvious, ask yourself whether the intrusive thoughts are really a problem.  If they are not terribly distressing, perhaps it’s better to just live with them – even indulge them?</p>
<p>Few details were provided in the email, so I’ve had to confine myself largely to generalities.  But I hope that you may be able to develop these thoughts and apply them to your own circumstances.</p>
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		<title>“Normal” Bereavement</title>
		<link>http://feedproxy.google.com/~r/BehaviorismAndMentalHealth/~3/8_cuLbCyj38/</link>
		<comments>http://behaviorismandmentalhealth.com/2012/03/13/normal-bereavement/#comments</comments>
		<pubDate>Wed, 14 Mar 2012 04:50:20 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>
		<category><![CDATA[DSM-5]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=629</guid>
		<description><![CDATA[There was a nice article in the Lancet last month.  The article posed the question: “When should grief be classified as a mental illness?” The author criticized the APA’s draft version of DSM-5 for blurring the distinction and for making it more likely that people in bereavement will be “diagnosed” as depressed and, of course, [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>There was a nice article in the <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960248-7/fulltext">Lancet</a> last month.  The article posed the question: “When should grief be classified as a mental illness?”</p>
<p>The author criticized the APA’s draft version of DSM-5 for blurring the distinction and for making it more likely that people in bereavement will be “diagnosed” as depressed and, of course, “treated” with prescription drugs.</p>
<p>There has been a good deal of criticism against the APA on this issue, and it is likely that the final version of DSM-5 will reflect some retreat in this matter.</p>
<p>The problem is not new, however.  DSM-III included “uncomplicated bereavement” (V62-82) as a V code (i.e. “conditions not attributable to a mental disorder.”)  V62-82 occurs also in DSM-IV, but without the word “uncomplicated.”  What is noteworthy, however, is that in DSM-IV, a list is provided of “symptoms” that can be used to distinguish a normal bereavement from major depression.  The APA’s agenda is clear and has always been clear:  to pathologize for their own profit, and for the profit of pharmaceutical companies, as much of human existence as possible.  There is clear and steady progression in this regard from DSM-III to DSM-IV and now to the draft DSM-5.</p>
<p>There are no mental disorders.  There are people with problems, one of which is the loss of loved ones.  These human problems are not helped by drug-taking.  Bereavement in particular should not be addressed in this way.  Attempts to smother the feelings of loss and despondency with chemicals are always counter-productive.</p>
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		<title>Major Tranquilizers and Seniors</title>
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		<comments>http://behaviorismandmentalhealth.com/2012/03/05/major-tranquilizers-and-seniors/#comments</comments>
		<pubDate>Mon, 05 Mar 2012 20:16:16 +0000</pubDate>
		<dc:creator>Phil</dc:creator>
				<category><![CDATA[A Behavioral Approach to Mental Disorders]]></category>

		<guid isPermaLink="false">http://behaviorismandmentalhealth.com/?p=625</guid>
		<description><![CDATA[In 1997 I worked part-time for a nursing home.  This facility had an open-door policy and had a reputation in the state for being able to accommodate even the most difficult and unmanageable clients. Some of this reputation was attributable to their generous administration of major tranquilizers, but in addition there was a high level [...]]]></description>
			<content:encoded><![CDATA[<p></p><p>In 1997 I worked part-time for a nursing home.  This facility had an open-door policy and had a reputation in the state for being able to accommodate even the most difficult and unmanageable clients.</p>
<p>Some of this reputation was attributable to their generous administration of major tranquilizers, but in addition there was a high level of acceptance and compassion among the staff, and there is no doubt in my mind that this was a major factor in their success.</p>
<p>On one of my visits there I was asked to see a new admission, whom I shall call Brian.  The reason for the referral was that the staff were having difficulty getting him to eat, and he was losing weight.  I visited Brian for the next few weeks, but he was largely unresponsive to my approaches.  His speech was minimal, and when he did say anything, it was: &#8220;leave me alone;” “get out of my room;” “I don’t care,” etc..</p>
<p>I noticed from the record that he was receiving a major tranquilizer, and I asked the nurse manager why.  He replied that he didn’t know, but that Brian had been taking this when he had been transferred in from another facility, and that the admitting physician had just continued at the same dosage.  Attempts to learn the reason from the earlier facility were unsuccessful.</p>
<p>I suggested to the treatment team that the major tranquilizer be discontinued, and that Brian be closely monitored for signs of aggression or unmanageability.  The next week I returned and found to my surprise that there had been no problems and that Brian was going to the dining room every meal time and was eating well.</p>
<p>I visited him in his room, and he seemed pleased at the opportunity to talk.  He had been a ham radio operator in the 30&#8242;s, and he was able to talk about these matters.  He had also worked small cargo vessels along the Maine coast and could recount features of the harbors, coastline, etc.. He talked fluently and knowledgeably on a wide range of subjects.  He began interacting with other residents and in general was doing very well.</p>
<p>I left this job about a year later, but a year after that I was in the area and stopped in to say hello to my former clients.  Brian recognized me immediately and addressed me by my name!</p>
<p>The point of the story is that major tranquilizers are a kind of chemical straightjacket, and there are far too many people in nursing homes who are being restrained in this manner.</p>
<p>The pharma-psychiatric faction like to call these drugs anti-psychotics, implying that they somehow target psychotic behavior and make crazy people sane.  In fact, the earlier name – major tranquilizers – is more accurate.  They suppress crazy behavior for the simple reason that they suppress <em>all</em> behavior.</p>
<p>What brought this to mind is a recent blog post by Christopher Lane: <a href="http://www.psychologytoday.com/blog/side-effects/201202/antipsychotic-medication-seniors-and-children"> Antipsychotic Medication, Seniors and Children.  </a>Christopher laments the widespread use of these dangerous products.  Three quotes:</p>
<p style="padding-left: 30px;">“Only 5 one-year-olds were prescribed the drugs the following year, the paper reports. Similarly, &#8220;only&#8221; 107 three-year-olds, 268 four-year-olds, and 437 five-year-olds on Medicaid in Florida were given the powerful antipsychotics in 2008.”</p>
<p style="padding-left: 30px;">“… in 2009, <em>BBC News</em> reports, a study commissioned by the UK Department of Health found that &#8220;<a href="http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_108302.pdf" target="_blank">180,000 people with dementia</a>&#8221; had been prescribed antipsychotic medication in the UK and that &#8220;the drugs [had] resulted in 1,800 additional deaths.&#8221;</p>
<p style="padding-left: 30px;">“… atypical antipsychotics were associated with a 60-70% increased risk of death compared with placebo in randomized controlled trials among older patients with dementia…”</p>
<p>Psychiatry is drug-pushing, and it is expanding its reach to the younger and older extremes of the population.</p>
<p>&nbsp;</p>
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