A Behavioral Approach to Mental Disorders

In 1973 the APA removed homosexuality from its list of “diagnoses,” and in its place they created a new “diagnosis” – gender identity disorder. The essential feature of this so-called illness is a marked and persistent rejection of one’s biological gender and a repeated desire to be of the opposite gender. I’ve touched on these issues in the posts on homosexuality. So I won’t repeat that material here. There is a recently reported development, however, that warrants some attention. A recent Associated Press article out of Chicago reports that sex-changing treatment for children is “on the rise.” This report was picked up by media outlets all over the country, and probably overseas. ...

A few weeks ago I recommended Taking America Off Drugs by Stephen Ray Flora. Well, he has also written The Power of Reinforcement (State University of New York Press, 2004), and this also is well worth reading. Reinforcement is a crucial concept in psychology, and in this book Dr. Flora clarifies the matter and dispels the misinformation. Buy it; read it; keep it close.

Daniel Carlat’s blog carries an interesting item. It seems that a lady named Suzy Chapman started a site called dsm5watch, in which she expressed criticism of the DSM. Well, the APA didn’t like this and sent her a cease and desist letter, claiming that the string “DSM-5” is trademarked, and that she was infringing their rights. She complied, changing the name of her site to dxrevisionwatch. What I find interesting here is that the APA claim to be interested in public comment. I guess as long as it doesn’t get too critical. ...

Taking America Off Drugs by Stephen Ray Flora A few weeks ago, in a comment, A Behaviorist Fan recommended the above book to me. It came out in 2007, and I don’t know how I missed it at the time. But I’ve read it now and it’s a superb piece of work. Definitely a must buy and must keep close at hand. Stephen analyses the various “diagnoses” listed in DSM. He points out their behavioral nature, and describes how they can be ameliorated with relatively simple behavioral techniques. ...

A couple of weeks ago I heard a piece on NPR: “What Vietnam Taught Us About Breaking Bad Habits.” It’s an interesting story. It tells how in 1971, researchers found that about 20% of the American soldiers in Vietnam were addicted to heroin. This was shocking news to the Pentagon and to President Nixon, who promptly created a new government department – the Special Action Office of Drug Abuse Prevention. This was the beginning of the so-called War on Drugs. ...

Last week Reuters ran an article by Toni Clarke: “Insight: Shortage of ADHD Drug Adderall seen persisting.” Here are the first five paragraphs: “A shortage of Adderall, which is used to treat attention deficit hyperactivity disorder, shows little sign of easing as manufacturers struggle to get enough active ingredient to make the drug and demand climbs. Adderall, a stimulant, is a controlled substance, meaning it is addictive and has the potential to be abused. The Drug Enforcement Administration tightly regulates how much of the drug's active pharmaceutical ingredient (API) can be distributed to manufacturers each year. ...

Recently National Public Radio ran a program on California’s state psychiatric hospitals. There has reportedly been an enormous increase in patient violence in recent years, including the murder of a female employee in October 2010. Staff are demanding that some remedial measures be undertaken. Committees are meeting; politicians are giving speeches. But the violence continues. Reportedly the state is spending more than $500 per day per patient – that’s more than $180,000 per year! But the violence continues. ...

The concept of personality is very firmly established in mental health circles and in academic psychology. It is also widely used in common speech, and is frequently offered as having explanatory value, when in fact it has none. Consider the following conversation: “Why is Mary so quiet and reserved?” “Oh, that’s just her personality.” Or “Why is Michael so aggressive and argumentative?” “That’s his personality.” In statements like this the term “personality” is presented as if it explained the behavior in question, when in fact it is merely descriptive. The responder to the question, “Why is Mary so quiet and reserved?” might just as well have said: “Because she is so quiet and reserved.” The so-called explanation adds nothing in terms of understanding how Mary got to be quiet and reserved. As I have discussed elsewhere – the acid test for an explanation is to ask: ...

I’m now in retirement, but during my professional career I usually (almost always) wore a suit and tie when I went to work. I enjoyed my work, and I was very comfortable in that role. But I’m also a committed remodeler. Apart from the time when I was acutely ill, I’ve always had at least one remodeling project on the go – literally all my adult life. So when I got home from work, I changed “uniforms.” Off with the suit and tie, on with the paint-splattered jeans, plaid shirt, scruffy sweater, and tool belt. And here again, I was very comfortable. ...

MPD became an official APA “diagnosis” with the publication of DSM-III in 1980. It has since been renamed as dissociative identity disorder. The criteria are: A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self). B. At least two of these identities or personality states recurrently take control of the person's behavior. ...