Fucking Insults, How do they Work?

[RobbyPants]

Your psychiatrist is a hack
Asperberger's is no longer a valid medical diagnosis.

I all fall unders the Autistic Disorder umbrella.

I thought it was valid, but that term is antiquated.

[Chamomile]

Psychiatrists handing out a pet diagnosis like Halloween candy is something that's happened in the past. I'd ignore the diagnosis until it's confirmed by someone without an ulterior motive.

[JigokuBosatsu]

Well, most of the salient points have been made already, but I figured I would comment on the shocking level of Asperger hipsterism on here.

[Ancient History]

I for one am just an asshole.

[Corsair114]

I for one am just an asshole.

Theme song power up, go!

[Shrapnel]

I'm special: I have Aspergers, and I'm an asshole. Although my assholery isn't caused by the Aspergers; it's due more to the fact that I'm a child of the Nineties and only have one kidney.

[tussock]

Asperberger's is no longer a valid medical diagnosis.

The Asperberger's association of people who are unabashedly right when everyone else is wrong have told the medical community that their new book of valid medical diagnoses is full of shit, and they shall be sticking to the references in the DSM IV until further notice.

I mean, it's true, there's no actual line in the sand between Autism and Savants and high-functioning Autism and Asperger's and PDDNOS and just being a bit of a nerd who genuinely can't help that, and as such Asperger's is not a real thing that a person can have in the way that Schizophrenia or Bipolar Disorder is, ....

But having it be a thing where people will tell you that most folk are (ahem, seem) crazy because 99% of the population has learnt a bunch of common stuff without effort and you missed out there in a way that is hard-wired from birth, and that they didn't know they needed to teach you that stuff in the first place, that is a valuable thing and could do with a name, so people can google it, and you can know to ask people to tell you shit like that.


Like, when I was young, people told me I was mean, so I tried associating with people who where also called mean, which was shocking, because those people meant to do that shit, all the time, and folk thought I was like them! And by young, I mean in my 20's. Those people turned out to be criminals. Quelle horreur.

[Username17]

There's pretty major controversy around DSM-V. Which mostly comes down to the fact that the methodology for making the DSM-V was kept secret, and now everyone who disagrees with any part of it has limitless speculatory ammunition against it. The DSM-IV is going to be a fallback that a lot of people continue to use for a long time. Probably until DSM-VI comes out, which would be in like 2025 unless it gets pushed forward by the DSM-V validity slap fight.

I'm personally glad that I'm not a psychiatrist and don't have to take a side. Because a lot of the changes made in DSM-V seem reasonable to me, but the idea of giving non-disclosure agreements to the committee writing the diagnosis guidelines is unscientific and insane.

-Username17

[CatharzGodfoot]

The DSM-V is the D&D 4e of psychiatry.

With any luck, there won't be a DSM-VI, and instead there will be a more researched document put together by a more open and global group to replace it. But I'm not betting on it.

[Parthenon]

Can someone go briefly into the DSM-V and how it's changed? Preferably with a bit of extra information about the DSM in general if needed, because I know just enough to be interested, but not enough to fully understand the changes. And if there is the huge controversy, then it's unlikely that I'll find a reasonable explanation.

[DSMatticus]

The biggest complaint about the DSM-V is less specific changes and more that it is written behind closed doors by lots of people who are a part of the industry. The conflicts of interest are obvious, and instead of opening up the process to a watchful eye and scrutiny to help keep everyone on the straight and narrow, they insisted that they were Divine Beings Who Could Do No Wrong and they would issue their mandates and everyone would damn well like them.

The DSM-V needs to go up in flames in a spectacular display of fiery failure, because the process that created it would allow the industry to unilaterally declare what is and is not a psychiatric illness so long as the DSM is respected.

[Username17]

The DSM approach is based on the fact that mental illness manifests differently in different people. As such it works from clusters of signs, symptoms, and behaviors to diagnosis through what can only be described as "weight of evidence". Each potential diagnosis has core features that it requires a certain number of to be considered, and then there are additional features that make the diagnosis more likely. But basically no one fulfills all the criteria for any diagnosis (indeed, due to compensation effects, some criteria for the same condition can be incompatible).

And of course, treatment options are the same way. People don't respond the same way to the same interventions. So the manual is supposed to run down different treatment options and give statistical analysis on how those work on people with the condition being discussed.

OK, now we get to the part where people are mad at revision five. Because the process of formulating the book was secret, people can't trust that the statistical information is accurate. A lot of people suspect that pharmaceutical options are being portrayed in an overly rosy light, and the conspiracy theorists there have some pretty good meat to chew on. A number of people on the DSM-V committee have financial ties to pharmaceutical companies, and the secrecy in the process means that you basically can't know if any of those people stuck their dick in.

Also, there's the usual bullshit about how every revision various diagnosis categories get created or destroyed, and there are good arguments either way on most of them. Some people don't like new directions or don't agree with new decisions, and without a transparent process it's basically impossible to get those people to fall in line. In general, these changes are based on good scientific evidence - for example when they took homosexuality off the list of mental disorders in 1973. But if they won't show you the discussion and tell you what that evidence actually is? Well, you can't really know if any particular change is based on a mountain of scientific evidence or just the pet prejudices of someone on the writing committee.

Big changes include: Schizophrenia is no longer divided into subtypes; Depression is no longer discounted if someone has an extremely valid reason to feel and act depressed (such as the death of a loved one); and PTSD has had its definition expanded to better cover combat veterans and emergency personnel. These all seem very reasonable to me. Paralogic in schizophrenia can sort of be classified into Paranoid, Catatonic, Disorganized, Residual, and Undifferentiated, but it also sort of can't. In that actual schizophrenic thought is often so out-there that they'll switch from one "category" to the next even in the middle of a conversation.

But there are also lots of changes in treatment protocols and shit, and accusations fly left and right that these have been unduly influenced by pharmaceutical companies, and you actually can't trust the fine print anywhere in the book. And that is not something that I am competent enough to even judge.

Internet toughguys are most upset about how Asperger's Syndrome got subsumed into Autism Spectrum Disorder (being simply part of the severity scale at the low end). As you're aware, a really large number of internet geeks self-diagnose as Asperger's in order to justify being obsessive jerkwads. So that particular choice set off all kinds of forum warriors into a tizzy. I... don't think it actually matters whether we say "Autism Spectrum" or "Asperger's". Like, literally the two seem exactly the same. The real slap fight that psychiatrists are in is the new diagnosis and treatment protocols, which have been revised in various minor seeming ways that various specialists in the field are pissed off about.

-Username17

[Parthenon]

Okay, thanks. So some improvements amidst a sea of shitty product endorsements written in secret.

[Orion]

There was also a lot of back-and-forth on this in the Kink community. Basically, they added new disorders named after various BDSM things, like "sexual masochism disorder." As a headline, that sounds pretty bad. I mean, kinksters have been trying to prove they're not insane for a while, and having a "masochism disorder" in the book doesn't help. Uninformed people took it mean that masochism itself is now considered a disorder and got mad.

If you actually read the definition of Sexual Masochism Disorder, it specifies that it's a diagnosis for people who are masochistic and deeply unhappy about it. You get the label if you perceive your fantasies to be ruining your life and want help getting rid of them or adapting to them. So the upside is: Kinksters have long complained that mental health professionals don't pay enough attention to our issues. It sounds nice to think that someone with major sexual guilt or anxiety can now get a label that points directly at his problem. On the other hand, the optics are terrible.

[sabs]

My son has high functioning autism and all of the self diagnosing assholes are very frustrating, because they don't really have autism. They're just using it as an excuse to act like assholes, and they make it harder for people who really do have autism, and aren't assholes.

Most of the kids I have run across with autism, aren't actually assholes. And when I see someone post how they don't mean to be an asshole, but they can't help it because they have autism, I just want to slap them upside the head.

[Whipstitch]

I partly blame people's weird hangups about authenticity and the goofy enshrinement of "natural" tendencies. There's a difference between being true to yourself and acting upon every dopey impulse that bubbles into your consciousness, but apparently some people would just rather claim that they couldn't help it or that they were just saying what everyone else was thinking instead of making an attempt to get along.

[tussock]

And when I see someone post how they don't mean to be an asshole, but they can't help it because they have autism, I just want to slap them upside the head.

Sabs, sweetie, fuck off. M'kay. Go read some more about Aspergers, because it manifests differently to high functioning Autism, being further along the spectrum, and you are right there positing that violence is a fair response to one of the key indicators of Aspergers.

Which is that people can get really upset about not being able to keep up with the social conventions that you need to not be labelled an asshole.

Fuck it all, the main fucking diagnostic criteria for Aspergers is (/was, whatever) the ability to sound like you're a normal smart person who should be able to figure that shit out, and you fucking can't because you've fucking well got Aspergers and your personal options do not ever include being casually "nice" with words, because that shit is impossibly complicated and you just aren't wired for it.

Yes, they could forcibly learn to say "I'm sorry" all the fucking time, but as that word describes an emotional state, and what they're actually feeling is a desperate need to explain and clarify and expound on the subject at length, because they have Aspergers, all you're ever going to get is the explanation.

Real assholes, the criminal types I hinted at, they're really good with the fake "sorry". People who constantly explain why you're wrong to be offended actually have a real social disability. A rather easy test being to ask them about Aspergers and sit quietly while they fill in your next four hours with a disconnected stream of facts and weirdly precise anecdotes. Which I may or may not be doing right here. Or something. Damnit.

[PhoneLobster]

While I believe Aspergers could easily be a thing, I don't think I've ever seen a post of a so called Aspergers sufferer on this or any forum that I actually find in anyway a convincing demonstration or argument that they actually genuinely have it.

Yes I put this right after your post Tussock. For someone who claims he can't handle seeming normal you sound very normal while apparently trying to claim not to be.

[Stahlseele]

Because seeming normal on the Den means shit compared to most everywhere else as you should probably be well aware of by now . .

[Whipstitch]

While I believe Aspergers could easily be a thing, I don't think I've ever seen a post of a so called Aspergers sufferer on this or any forum that I actually find in anyway a convincing demonstration or argument that they actually genuinely have it.

Yes I put this right after your post Tussock. For someone who claims he can't handle seeming normal you sound very normal while apparently trying to claim not to be.

In all fairness, trying to tell over the internet is stupid hard, and on forums it's practically impossible. The kind of things Aspies struggle to deal with is shit like mild sarcasm, feigned ignorance, or nuanced attempts to change the subject or end the conversation without being rude about it. Meanwhile the internet is often a subtlety free environment, because without body language or vocal tone to go by you need pretty good writing skills to convey any of the shit normal people are accustomed to dealing with irl and it is often advised not to even try that crap. Combine that with the "This is the topic, love it or leave it" attitude common to forum cultures, and you've got a perfect environment for aspies to do what they do: That is, glom onto their favorite pet topic and never, ever shut up. That makes it super easy to pass on the internet even if you are shit terrible at parties.

Otherwise though, Tussock should probably stow his outrage given that Sabs just expressed some frustration rather than make an actual argument for slapping people with autism. I mean, honestly, the first step to coping with Aspergers in a social situation is accepting that it is totes possible to annoy people by indulging in the behavior that comes to you most naturally, and whether or not you can relate to that annoyance is rather meaningless. Also, bringing up the criminals bit is kind of a low blow towards the norms since it kinda implies that there's some sort of secret virtue to being emotionally transparent all the damn time. And, spoiler alert: there isn't.

[Chamomile]

Combine that with the "This is the topic, love it or leave it" attitude common to forum cultures, and you've got a perfect environment for aspies to do what they do: That is, glom onto their favorite pet topic and never, ever shut up.

It occurs to me that this makes self-diagnosing to excuse terrible behavior on the internet double-pointless. Everyone is aspie on the internet.

[Whipstitch]

Stahl really is right about the Den in particular. As a group we're blunt, pedantic, and routinely double dog dare eachother not to back out of the conversation on pain of being seen as a weenie.

[Whatever]

the Den...we're blunt, pedantic,

You could even call us a bunch of frank trolls, or, troll-men, if you will. Frank Troll-Men.

[Chamomile]

the Den...we're blunt, pedantic,

You could even call us a bunch of frank trolls, or, troll-men, if you will. Frank Troll-Men.

I'm pretty sure every person who meets Frank online thinks his name is a screenname making exactly this pun.

[Stahlseele]

i did.
i still think that's the most awesome name his parents could have given him . .
and now i kinda wonder where his family name stems from O.o