Posted by alexandra_k on January 16, 2006, at 14:54:15
In reply to Re: The social construction of (some) mental illne » alexandra_k, posted by Dinah on January 6, 2006, at 23:43:03
> Well, there's an easy way to tell. MPD today is more likely to get you scorn than help from the majority of clinicians.
So will BPD. So will psychosomatic symptoms. The majority of clinician's don't want to know, that is true. But I think it is fair to say that people do get more attention from the DID label than the BPD label. And there are less judgements (from those who will treat). And there are some clinicians... Who specialise in the field and don't see clients with any other dx. Where you have to contest with the 'lying and manipulative and attention seeking' judgements prevalent in the BPD literature in the DID literature you have about how 'wonderfully special and sensitive and smart such people are to come up with such an ingenious coping strategy'.
Which would you rather have?
Which is most reinforcing (based on reading the literature?)
> Will the presentation go away?
I imagine it will evolve in time...
If theory drives the manifestation then it would follow that there should be an increase in amnesiatic symptoms with the reintroduction of the amnesia requirement in the current version of the DSM...
If rft from clinician's drives the manifestation then it would follow that if they stopped reinforcing then...
Alternative manifestations would evolve.
My guess would be... Something that is reinforced the way hysteria was and DID seems to be...> The theory seems to assume that the presentation of symptoms has a goal in mind.
No.
The symptoms aren't goal *directed*
But the symptoms are under the control of the rft contingencies.
The difference is that the first implies that people manifest their symptoms with the intention of deceiving in order to meet their needs.
The second implies that people manifest their symptoms because it leads to them getting more of their needs met (but that they do not need to be and mostly are not consciously aware of this).> But in the people who really are having problems in an emotional sense, that isn't necessarily the primary purpose.
To get a little help? I think that is fairly important. Sometimes thats what people need. I don't think there should be any judgement or shame associated with that. But... Seems that in todays society there is :-(
Unless...
> I'm guessing the primary purpose behind organizing one's experience into a certain mold (a mold that one learns from one's culture to a large degree) is to make sense of one's experience. It's unsettling in a very large degree to have experiences one doesn't understand. Or to have experiences that one can't organize into a concept that one can grasp. So if an explanation comes up that organizes those experiences a person having genuine problems might grab onto that explanation.
Yes. And when the organising scheme / concept glamorises the disorder (and / or people who manifest those symptoms)... Then it is a goodie :-) Spanos (the socio-cognitive guy) said fairly much that... That the DID dx gives people a 'glamorous and interesting (or similar) explanation for their difficulties). That can be latched onto by therapist and client both. But that can lead to... The rft of the manifestations (symptoms)... And the manifestations (symptoms) aren't the problem (because they vary depending on the rft contingencies)... And the manifestations (symptoms) become a way of defending against... The underlying problem. And working on the underlying problem.
> Like someone who hears voices in their head. Well naturally it makes sense that those voices come from somewhere. And it occurs to them that those voices are being beamed into their head from alien spacecraft because the culture is full of science fiction references. While someone from 1750 would come up with a different "explanation" for what they're experiencing.
Yep. 'Whatever existent technology might suggest'. People may be replaced by aliens... robots (in this day and age)... and even clones :-)
> But in any case, I think the way a person organizes their experience says a lot about their experience.
But there is a reciprocal relationship between theory and data. Theory doesn't just organise data... If you accept a certain theory of the data... Then that predicts certain things about what data will be observed. And then (suprise suprise) people act in ways that are consistent with the theory (so they manifest (more) symptoms that are consistent with the theory).
And so some theories...
The acceptance of the theory... Can lead to the existence of the phenomena. Not to say that some people didn't present with those symptoms some of the time initially. But they come to exhibit them more often. And more people come to exhibit them.
> Besides, hasn't MPS been identified throughout the ages in a small percentage of people?
Yes. Though its manifestation was a bit different. In particular... Switching used to take longer and be more gradual. Now switching tends to me more like... TV funnily enough. A sudden change like a change between scenes. The number of alters has also been on the rise (quite significantly) - which means people are presenting with WORSE symptoms. The situation has escalated quite significantly (severity of symptoms within the average sufferer, also number of people meeting dx criteria for the disorder).
Also worth bearing in mind that the current increase in the number of cases... Is largely limited to the US (or to areas of the world where a major DID clinician has gone to 'set up shop'). In particular... Bible belt areas where clinicians think there is something interesting about these cases (usually to do with demonic possession, satanic ritual abuse, and the notion of multiple souls).
> While isn't it just as likely that many people who organize their experiences along the lines of MPD have completely different reasons for choosing that way of organizing their experiences?
Maybe...
If so then the people who currently present with DID symptoms do not form a natural kind (or category) of people.
What I'm interested in is the thought that they DO have something underlying in common...
Possibly something they share with people with BPD...
Possibly something they share with people with PTSD...
Possibly something they share with people with hysteria etc...
Perhaps.> And so are those who are just trying to express general distress. And so are those who are trying to absolve themselves of responsibility. And so are those who are trying to get themselves help or attention.
Maybe the third is part of the first? Regarding the second... If people do this consciously (especially in a criminal context) then they tend to be written off as malingering or feigning.
:-)
poster:alexandra_k
thread:595576
URL: http://www.dr-bob.org/babble/psycho/20060110/msgs/599681.html