2 Big Changes to the DSM in the 1980's

 In the 1980s, the American Psychiatric Association added PTSD into the DSM and phased out homosexuality as a diagnosis. Today the DSM does not even list homosexuality as a disease, and the DSM has revised the criteria for PTSD and reclassified it. And while the LGBTQ community and PTSD victims benefit from these changes, they did not occur overnight. 


  This change in the DSM regarding homosexuality occurred from conflicting theories about homosexuality throughout history. Pathology, Immaturity, and normal variation were the main categories of theories about homosexuality (Drescher, 2015a). Pathology saw homosexuality as a disease. Richard von Krafft-Ebbing was a German psychiatrist who stated that homosexuality was the result of a disorder. His theory stated that people could have a predisposition to being gay, but the tendencies of homosexuality constituted a disease. He wrote Psychopathia Sexualis in 1886, and this defined the framework for deviant human sexual behavior diagnostic manuals of the mid-twentieth century.  


Sigmund Freud believed in the immaturity theory which stated that homosexual feelings at an early age were a normal step toward adult development of sexuality (Drescher,2015). With this theory, homosexuality resulted from stunted growth and the development of adult heterosexuality. Mid-nineteenth century Karl Heinrich Ulrichs, Magnus Hirschfeld, and Hungarian journalist Karl Maria Kertbeny all believed there was some normal variation in nature. Kertbeny coined the phrase homosexual and homosexuality (Drescher, 2015a). After Freud died in 1939, Sandor Rado impacted the mid-twentieth century with his theory that homosexuality was a phobia of heterosexuality and pathological. Rado stated that this was caused by inadequate parenting. In 1952 homosexuality was classified as a “sociopathic personality disturbance” (Drescher, 2015a). Psychiatrists reclassified homosexuality as a sexual deviation in 1968. The pendulum swung back and forth on the topic until finally in 1973 gay activists disrupted the 1970 and 1971 APA meetings. This led to the APA removing homosexuality from the DSM in 1973; however, they only changed the name to sexual orientation disturbance diagnosis. This allowed for insurance-endorsed sexual conversion therapies if the individual’s same-sex attractions caused self-distress. In 1973 the DSM-III replaced it with Ego-dystonic homosexuality disorder and in 1987 the DSM-III-R finally removed this diagnosis. 



When the APA added PTSD to the DSM-III, it only applied to victims of such events such as war, torture, the Nazi holocaust, major war bombings, natural disasters, and human-caused disasters such as mass shootings, crashes, and bombings (PTSD History and Overview - PTSD: National Center for PTSD, n.d.). Since the APA separated traumatic events from life stressors such as divorce, rejection, failure, etc..., they categorized these life stressors as adjustment disorders instead of PTSD. In 1987 and 1994 the DSM-IIIR and the DSM-IV revised PTSD diagnostic criteria. The 1994 DSM-IV stated that the patient had exhibited a history of traumatic event exposure and symptoms from the following three clusters: intrusive recollections, avoidant/numbing symptoms, and hyperarousal symptoms (PTSD History and Overview - PTSD: National Center for PTSD, n.d.). The fifth criterion defined the duration of symptoms and the sixth criterion stated that the severity of the symptoms must cause a lot of distress and/ or impairment of necessary functions. The DSM-IV-TR also revised PTSD diagnosis. In 1980 no one knew the actual prevalence of PTSD, so the DSM-5 made evidence-based revisions to PTSD (PTSD History and Overview - PTSD: National Center for PTSD, n.d.). The American Psychiatric Association categorized PTSD as a Trauma-stressor-related disorder with the DSM-5 in 2013. The DSM expanded diagnostic criteria to include disruptive behaviors such as anger, impulsiveness, recklessness, and self-destruction. Also, the patient can experience trauma directly or indirectly. A dissociative subtype was added to the DSM-5, along with a preschool subtype for children up to six. Due to these changes in the DSM, there are more effective treatments including the FDA-approved use of SSRIs. There is also a psychological first aid kit online (Psychological First Aid: Field Operations Guide - PTSD: National Center for PTSD, 2014). 


Research trends in the DSM include changes to the DSM on homosexuality and the addition and revision of PTSD. Due to these research trends, public emotional intelligence regarding these topics increased and public stigmas surrounding them decreased. Social justice is also achieved when public stigma and discrimination are reduced. 


References 


Drescher, J. (2015a). Out of DSM: Depathologizing Homosexuality. Behavioral Sciences, 5(4), 565–575. https://doi-org.ezproxy.snhu.edu/10.3390/bs5040565 


Psychological First Aid: Field Operations Guide - PTSD: National Center for PTSD. (2014). Va.gov. https://www.ptsd.va.gov/professional/treat/type/psych_firstaid_manual.asp 


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PTSD History and Overview - PTSD: National Center for PTSD. (n.d.). Www.ptsd.va.gov. https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp#:~:text=In%201980%2 

The Evolution of Abnormal Behavior

         

Humans have been documenting abnormal behavior for thousands of years. The Egyptians recorded treatments and diseases of humans back in the sixteenth century. The Egyptians were the first to connect the brain with mental functions. The Egyptians also relied on magic to treat these unfamiliar conditions. The Chinese, Egyptians, Hebrews, and Greeks blamed abnormal behavior on demonic possession and the wrath of God. One extreme treatment used in the beginning was drilling holes in the afflicted person's head to
release evil spirits from their head. China was one of the earliest civilizations to relate mental disorders and medicine. The Chinese introduced the concept of the yin and yang, which was about the balance of positive and negative forces in the human body. Balancing these forces in the human body led to physical and mental health. 

During the Middle Ages, the scientific approach of the Greeks carried over into the Islamic countries, and the first mental hospital was set up in Baghdad in A.D 792 (Hooley et al., 2019). In these hospitals, patients suffering from mental illness received more humane and ethical treatment. Avicenna from Persia wrote The Canon of Medicine, which referred to the following conditions: hysteria, epilepsy, manic reactions, and melancholia. 


Finally, around 400 B.C.E., the Greeks realized that abnormal behavior was pathological and not the result of supernatural forces. Hippocrates emphasized” the importance of heredity and predisposition and pointed out that injuries to the head could cause sensory and motor disorders” (Hooley et al., 2019). Hippocrates “was a harbinger of a basic concept of modern psychodynamic psychotherapy” (Hooley et al., 2019). Plato, Aristotle, and Galen’s teachings looked at these abnormal behaviors with a scientific approach. Plato even suggested that people suffering from mental health disorders were not accountable for their actions like ordinary people. Aristotle and Galen also first started investigating depression in the Greek and Roman era. In the Middle Ages, religious persecution hindered the scientific approach to studying mental disorders; however, Hildegard, a nun who was noted as the first female of medicine to publish studies, still believed in the pre-modern view of depression.  Philippe Pinel was a French physician who believed in the more humane treatment of mental health patients during the humanitarian reform. William Tuke, an English Quaker, introduced theories of treatment that involved treating mental illness patients with kindness and acceptance.  During the humanitarian reform because of Pine and Tuke, asylums ended inhumane practices such as chaining mental health patients and therapies such as near drowning mental illness patients.” The success of Pinel’s and Tuke’s humanitarian experiments revolutionized the treatment of patients with mental illness throughout the Western world” (Hooley et al., 2019). 


    Back in America, Benjamin Rush, the founder of American Psychiatry, carried on the humanitarian reform. He also wrote the” first systematic treatise on psychiatry in America, Medical Inquiries, and Observations upon Diseases of the Mind in 1812 (Hooley et al., 2019). Rush was also the first to introduce a course in psychology. Dorothea Dix encouraged legislatures and people to raise standards in mental hospitals in the U.S. between 1841 and 1881. The humanitarian movement continued to positively influence the treatment of people with mental illness into the 1800s and 1900s. Psychiatrists and physicians started running mental health facilities and raising the standards of caring for mentally ill patients, as well as incorporating a more scientific approach. During this time and into the twentieth- century, the stigma of mental illness changed for the better. Clifford Beers published A Mind That Found Itself in 1908 and led a campaign that shifted peoples’ views away from inhumane therapies used to treat mental illness. Mental facilities grew for the first part of the twentieth century, as did the length of their hospitalization. In 1946, Mary Jane Ward’s The Snake Pit inspired increased humane treatments for mental health patients. That same year, the National Institutes of Mental Health was born, which eventually affected research and training in mental health.  The Hill-Burton and Community Mental Health Act of 1963 helped develop outpatient treatment centers. Finally, during the later part of the twentieth century, most of these mental institutions closed, and most of these patients returned to society because of better therapies and outpatient centers. 

While there is no universal indicator for diagnosing abnormal behavior, three main areas can indicate an abnormality. The first area is subjective distress, such as anxiety and depression, or some people may describe psychological pain. Another area is maladaptiveness, which is behavior that inhibits our well-being and relationships. Another area is” Statistical deviancy “(Hooley et al., 2019). In other words, the behavior is rare and not seen in everyday situations. And while these indicators provide the first piece of the puzzle, contributing factors to abnormal behavior give another piece. 

Biological, psychological, social, and cultural perspectives contribute to abnormal behavior.” In examining biologically based vulnerabilities, we must consider genetic abnormalities, brain dysfunction and neural plasticity, neurotransmitter and hormonal abnormalities in the brain or other parts of the central nervous system, and temperament” (Hooley et al., 2019). A vulnerability in someone’s genetics can affect the development of mental illness as well as the outcome of their exposure to external stimuli. Psychodynamic, behavioral, and cognitive-behavioral factors contribute to abnormal behavior. Early life trauma, parenting problems, divorce, unemployment, discrimination, and dysfunctional relationships are contributing social factors that also contribute to abnormal behavior. The norms of a culture can also define abnormal behavior. Cultural perspectives can also contribute to abnormal behavior. Typical behavior in one culture may be offensive or not accepted in another culture. 

Social factors contributing to abnormal behavior are also related to the programmatic theme of social justice. People of low socio-economic classes have often experienced issues such as unemployment and discrimination. These events can lead to abnormal behavior. But is this abnormal behavior or an adaptive behavior necessary for their survival? So, diagnosing abnormal behavior and providing treatment is a puzzle. One cannot draw conclusions or diagnose one puzzle piece because all the puzzle pieces not only form the complete picture but also give each other contextual meaning. 


References 


Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education     (US). https://bookshelf.vitalsource.com/books/9780135191033   




What not to do for a loved one who is a victim of domestic violence.




  Domestic violence is a serious and complex issue that affects millions of people around the world. It can take many forms, such as physical, emotional, sexual, financial, or psychological abuse. It can happen to anyone, regardless of age, gender, race, religion, or socioeconomic status. If you suspect that someone you care about is a victim of domestic violence, you may feel helpless, angry, scared, or confused. You may want to help them, but you may not know how. You may also worry about making things worse or putting yourself in danger. While there is no one right way to support a loved one who is experiencing domestic violence, there are some things that you should avoid doing. Here are some common mistakes that well-meaning people make when trying to help a victim of domestic violence, and why they can be harmful. 


- Don't blame them for the abuse. It is never the victim's fault that they are being abused. They are not responsible for the abuser's actions or choices. Blaming them can make them feel guilty, ashamed, or hopeless. It can also make them less likely to trust you or seek help. 


- Don't pressure them to leave. Leaving an abusive relationship is not easy or simple. It can be very dangerous, as the risk of violence can increase when the victim tries to end the relationship. It can also be emotionally and financially challenging, as the victim may have strong feelings for the abuser or depend on them for survival. Pressuring them to leave can make them feel judged, isolated, or overwhelmed. It can also make them more resistant to change or more loyal to the abuser. 


- Don't give ultimatums or threats. You may think that by threatening to cut off contact, report the abuse, or intervene in some way, you are motivating the victim to take action. However, this can backfire and have the opposite effect. Ultimatums and threats can make the victim feel trapped, manipulated, or betrayed. They can also increase their fear of losing you or facing negative consequences. Instead of helping them, you may be pushing them away or endangering them. 


- Don't ignore or minimize the abuse. You may find it hard to believe or accept that someone you love is being abused by someone else you love. You may hope that it is a one-time incident or that it will get better over time. You may also think that it is not your place to interfere or that it is a private matter. However, ignoring or minimizing the abuse can make it worse and more dangerous. It can also send the message that you don't care about the victim or that you condone the abuse. 


- Don't confront the abuser. You may feel angry or frustrated with the abuser and want to confront them or make them stop. You may think that by talking to them, reasoning with them, or challenging them, you can change their behavior or protect the victim. However, this can be very risky and ineffective. Confronting the abuser can provoke them to lash out at you or the victim. It can also undermine the victim's autonomy and agency and make them feel disempowered or betrayed. 


So what can you do instead? Here are some positive ways to support a loved one who is a victim ๐Ÿ’“of domestic violence. 


- Listen to them without judgment. Let them know that you are there for them and that you believe them. Validate their feelings and experiences and acknowledge their strengths and resilience. 


- Respect their decisions and choices. Understand that they are the experts on their own situation and that they know what is best for them. Support their goals and needs and help them explore their options and resources. 


- Empower them to take action. Encourage them to seek help from professionals who specialize in domestic violence, such as counselors, advocates, lawyers, or police officers. Help them create a safety plan and access emergency services if needed. 


 


- Educate yourself about domestic violence. Learn about the dynamics of abuse, the barriers to leaving, the signs of danger, and the available resources in your community. Avoid myths and stereotypes about domestic violence and challenge any victim-blaming attitudes. 


- Take care of yourself. Supporting a loved one who is a victim of domestic violence can be stressful and exhausting. Make sure that you have your own support system and coping strategies. Seek help from others if you feel overwhelmed or unsafe. 


 

Remember that domestic violence is not a problem that you can solve by yourself. It is a social issue that requires collective action and systemic change. By supporting your loved one in a compassionate and respectful way, you are making a difference in their life and in the world 


 

How to Love Someone with PTSD

 How to love someone with PTSD


Post-traumatic stress disorder (PTSD) is a mental health condition that affects people who have experienced or witnessed a traumatic event, such as war, violence, abuse, or natural disasters. People with PTSD may have flashbacks, nightmares, anxiety, depression, anger, guilt, or other emotional and behavioral difficulties. They may also have trouble sleeping, concentrating, or relating to others.

Loving someone with PTSD can be challenging, but not impossible. If you care about someone who has PTSD, you may wonder how you can support them and help them heal. Here are some tips on how to love someone with PTSD with compassion.

- Educate yourself about PTSD. Learn about the causes, symptoms, and treatments of PTSD. This will help you understand what your loved one is going through and how you can help them cope. You can find reliable information online, in books, or from mental health professionals.

- Listen without judgment. Sometimes, the best thing you can do for someone with PTSD is to listen to them and let them express their feelings and thoughts. Don't interrupt, criticize, or offer advice unless they ask for it. Just be present and attentive, and show them that you care and respect them.

- Validate their feelings. People with PTSD may feel ashamed, guilty, or angry about their trauma and how it affects them. They may also feel isolated or misunderstood by others. Don't dismiss or minimize their feelings or experiences. Instead, acknowledge and validate them. Say things like "I'm sorry that happened to you", "That must have been very hard", or "I can see why you feel that way".

- Encourage them to seek professional help. PTSD is a serious condition that requires professional treatment. You can't fix your loved one's PTSD by yourself, nor should you try to. Encourage them to seek therapy, medication, or other forms of help that suit their needs and preferences. You can offer to help them find a therapist, make an appointment, or accompany them to their sessions if they want.

- Respect their boundaries. People with PTSD may have triggers that remind them of their trauma and cause them to relive it. They may also have difficulty trusting others or feeling safe. Respect their boundaries and don't push them to do things they are not comfortable with. Ask for their consent before touching them, hugging them, or initiating intimacy. Give them space and time when they need it.

- Take care of yourself. Loving someone with PTSD can be stressful and exhausting. You may feel overwhelmed, frustrated, or helpless at times. You may also neglect your own needs and well-being in the process of caring for your loved one. Remember that you can't help anyone if you are not well yourself. Take care of your physical and mental health by eating well, sleeping enough, exercising regularly, and doing things that make you happy. Seek support from friends, family, or professionals if you need it.

Decreasing Public Stigma

 Mental health disorders are often misunderstood and stigmatized by society. People who suffer from them may face discrimination, isolation, and shame. They may also avoid seeking help or treatment due to fear of being judged or labeled. This can have serious consequences for their well-being and quality of life. 

In this blog post, I want to share some facts and tips on how to destigmatize mental health disorders and support those who are affected by them. Here are some things you can do: 


  • - Educate yourself and others about mental health disorders. Learn about the causes, symptoms, and treatments of different conditions. Challenge the myths and stereotypes that surround them. Share accurate and reliable information with your friends, family, and community. 
  • - Be respectful and compassionate towards people with mental health disorders. Don't use derogatory or insensitive language to describe them or their experiences. Don't make jokes or assumptions about their abilities or character. Treat them with dignity and kindness, just like you would anyone else. 
  • - Listen and empathize with people who open up about their mental health struggles. Don't dismiss, minimize, or invalidate their feelings or experiences. Don't offer unsolicited advice or solutions. Just be there for them and show that you care and understand. 
  • - Encourage and support people who seek help or treatment for their mental health disorders. Don't judge, blame, or discourage them from getting the help they need. Recognize that seeking help is a sign of strength and courage, not weakness or failure. Celebrate their progress and achievements, no matter how big or small. 
  • - Advocate for mental health awareness and inclusion in your community. Speak up against stigma and discrimination when you see or hear it. Join or support organizations that promote mental health education and services. Volunteer or donate to causes that help people with mental health disorders. Use your voice and platform to spread positive messages and stories about mental health. 
  • By doing these things, you can help destigmatize mental health disorders and create a more supportive and inclusive environment for everyone. Remember that mental health is just as important as physical health, and that no one should suffer in silence or alone. 

10 MOST POPULAR TOPICS FOR PEOPLE WHO TALK TO THEMSELVES

 The top 10 topics for people who talk to themselves


Talking to yourself is not a sign of madness, but a way of expressing your thoughts and feelings out loud. Some people find it helpful, especially when they are alone or need to focus on something. But what do people who talk to themselves usually talk about? Here are the top 10 topics that you might hear them say:


1. Motivational pep talks. Sometimes, you need a boost of confidence or encouragement to face a challenge or achieve a goal. Talking to yourself can help you remind yourself of your strengths, abilities and potential. You can say things like "You can do this", "You are awesome" or "You got this".

2. Self-reflection. Talking to yourself can also help you gain insight into your own thoughts, feelings and actions. You can ask yourself questions like "Why did I do that?", "How do I feel about this?" or "What do I want to do next?". You can also express your gratitude, regrets or hopes for the future.

3. Planning and organizing. Talking to yourself can help you sort out your tasks and priorities, especially if you have a lot on your plate. You can make lists, schedules or reminders for yourself, such as "I need to finish this report by tomorrow", "I have to call my mom later" or "I should go grocery shopping on the way home".

4. Problem-solving. Talking to yourself can help you brainstorm ideas, analyze situations and find solutions. You can use logic, creativity or intuition to tackle any problem that comes your way. You can say things like "What if I try this?", "What are the pros and cons of this option?" or "What is the best way to approach this?".

5. Learning and memorizing. Talking to yourself can help you improve your memory and retention of information, especially if you are studying or learning something new. You can repeat, explain or summarize what you have learned, such as "The capital of France is Paris", "The formula for the area of a circle is pi times radius squared" or "The main characters of this story are...".

6. Imagining and fantasizing. Talking to yourself can help you unleash your imagination and creativity, especially if you are bored or need some inspiration. You can create stories, scenarios or characters in your mind, such as "What if I won the lottery?", "How would I survive a zombie apocalypse?" or "Who would I be if I lived in another time period?".

7. Humor and entertainment. Talking to yourself can help you have some fun and laughter, especially if you are feeling stressed or sad. You can make jokes, puns or funny observations about yourself or the world around you, such as "Why did the chicken cross the road?", "I'm so hungry I could eat a horse" or "That's what she said".

8. Venting and ranting. Talking to yourself can help you release your emotions and frustrations, especially if you are angry or annoyed. You can complain, criticize or curse about anything that bothers you, such as "This traffic is driving me crazy", "I hate my boss" or "This is bullshit".

9. Complimenting and praising. Talking to yourself can help you boost your self-esteem and happiness, especially if you are feeling insecure or depressed. You can compliment, praise or celebrate yourself for anything that you are proud of, such as "You look great today", "You did a good job" or "You deserve a treat".

10. Conversing and socializing. Talking to yourself can help you practice your communication and social skills, especially if you are shy or lonely. You can pretend that you are talking to someone else, such as a friend, a family member or a celebrity. You can ask them questions, share stories or opinions, or just chat about anything.

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