Time for a New Tale: Diagnosis: 411.07, Privileged Dystopian Syndrome

It is time for a new tale.

I'm proposing a novel diagnosis for the DSM-6. Yes, 411.07, Privileged Dystopian Syndrome. I hope the APA will move swiftly and assemble a committee to review this new proposal. In fact, throughout recent history, there are vast examples of how this sociomedical disease has wreaked havoc on individuals and families.  More on this soon... bear with me.

I lectured in class yesterday about how far removed Western culture has gravitated from the center of our hearts.  What prompted this was an email I received from a client of the MISS Foundation.

I met with her for a few hours, provided some psychological first aid, perhaps, and bore witness to the immense pain she was experiencing over the tragic death of her beautiful 19-year-old son to cancer.  After our meeting, and not uncharacteristically, her story - her beloved child, resonated in my heart for days.

So, I sent her a card telling her how deeply I care, and I sent her a book I thought would be meaningful for her. A few days later, I sent her an email to check on her.

She responded with deep expressions of gratitude and an emphatic "You are AMAZING!" intended for me.

While I do so appreciate her sentiment, this is woefully overstated. Since when, in our history, does basic human compassion and kindness qualify as "AMAZING"?

I wrote back, thanking her; but indeed, it is I who feels tragically-privileged to have been invited into her sacred space where memories and pain and love for her son exist.

Really. How did it come to this?

How did it come to the place where loving another through their time of suffering is some sort of heroic or extraordinary performance of the human being? Is this not our natural state? Or, should it not be?

Back to my proposal for the DSM-6.

411.07, Privileged Dystopian Syndrome

Etiology:
A woefully self-absorbed sociomedical elitist system which is disconnected from the suffering in the world, causing it to keep others who are hurting at a safe emotional distance by pathologizing them, making them the "other", so as not to disrupt its own delusion of security. Often seems to be hubris-based disorder but is, in fact, rooted in deep-seated fear of vulnerability, extinction, annihilation, and death anxiety (Becker, 1970). This system often hides behind numbers, codes, and superfluous vernacular as a means through which it can mesmerize and enchant itself. In particular, normal, authentic human emotions are often medicalized in this syndrome as it helps the system feel more in control and powerful. It derives most of its gratification, valuation, and self-fulfillment, though transitory, from these pathological states, and takes pleasure when other, less powerful systems bow at its throne.

Symptoms:
Intolerance for deep emotional expression; a persistent sense of entitlement for happiness at all costs yet with a nagging inability to actually ever experience such joy; persistent disillusionment of impermeability not to be interrupted by the psychological, social, economic, spiritual, and physical distress of others; forced detachment and disconnection often co-morbid with over-intellectualization; inability to experience compassion (from com- meaning to be with the other and pati- suffering); reactivity to high cultural variability resulting in the system's self-soothing (note that the primary resolution of such conflict is forced nosological labeling of said "other", hasty utilization of less sophisticated, laconic interventions, and the personification of a prescription pad as "best friend"); a tendency to prioritize economics over humanity; failure to recognize the collusion between its own existence and exogenously powerful stakeholders; a morbid preoccupation with monoculturalism combined with an unrelenting and maniacal desire toward social and emotional conformation of the masses; incapacity of the system to accept responsibility for the immense harm it has foisted on powerless others, from immigrants and minorities to women, children, and elderly to war veterans and the homeless. Oh, and let's not forget the grievers.

Treatment:
To date, the only known treatment for such a system is a well-informed, courageous, and educated countermovement. Oh, and human connection, compassion, and love.

Unfortunately, my profession, puts all the emphasis on genetics rather than the environment which of course is a simple explanation but it really takes society off the hook... if behaviors and dysfunctions are controlled by genes, we don't have to look at child welfare policies, we don't have to look at the kind of support we give to pregnant women, we don't have to look at the non-support we give to families...  and society becomes innocent, 

and we don't have to take a hard look at it and its role... 

-Gabor Mate, MD

Our ongoing reductionist view of physical and mental illness is killing us in more ways than we know.   And, the system is a danger to self and others. People are buying into PDS-induced disillusionment that normal behavior is somehow abnormal: For example, "bipolar disorder" in two-year olds (really parents? Aren't two year olds, by definition, "bipolar"?), schizophrenia as a life-long disease from which there is no recovery, and grief as precursor to serious mental illness.

Our sociomedical system is stagnate, it is sick, it is mentally ill, it is wounded, broken, diseased (dis-eased), and it costs us all in many ways. The system doesn't know it yet. But, often such serious illness isn't easily recognizable from the inside.

PDS'ers promulgate dangerous ideology, the slippery slope toward the automotonizing of our race: No touch. No tears. No apologizing. The pathology interferes with their ability to to be, uh, well, human. Doubt it?

Many years ago, we had to euthanize a much-loved family pet, Bandit. One week later, we received this from our veterinarian and his staff:

So, after the death of our pet, we received this beautiful expression of sympathy from our animal doctor. How grateful, how wonderful, how human.

Yet, after the death of my precious baby daughter in 1994, the hospital sent nothing. The psychologists and psychiatrists sent nothing (except a message which was clearly inappropriate and misguided: You are "depressed" and need medication). In other words, your grief has incited a mental illness). What is wrong with us? Is it that we cannot profit from caring? There are no lobby and special interests group, no cuts of legislative porks as perks for caring?

Whatever problem we are hoping to resolve or prevent- 

be it war, terrorism, economic inequality, marital disharmony, 

climate change, or addiction- the way we see its origins 

will largely determine our course of action.  

-Gabor Mate, M.D.

So, when the psychologist says to me: "You are mentally ill. You need medication. Maybe you should consider an inpatient program?" I can offer a dose of anti-PSD reality contained right on the pages of the DSM-6. No, no, no, you, Dr., are sick. You have a mental illness that came from the system within which you work. Here, let me show you (points with an authoritative finger):

You have 411.07, Privileged Dystopian Syndrome or PDS. It's not your fault. It's the system. It renders your psyche helpless in my presence, paralyzed by your own dis-ability. I'm so sorry that you are uncomfortable seeing me break down and cry in your office and that it disrupts your plans of a nice day.  I am so sorry that I'm using your entire box of Kleenex, the one that matches your pretty plaid drapes. I'm so sorry if my nasal and lacrimal discharge makes you nervous and your OCD compels you to walk out until I get my hysteria under control. I'm so sorry if I stain your shirt with my mascara and bad lip gloss. I am so sorry it makes you think about your own baby at home, sleeping in her crib, and the possibility that she, too, might die. Terrible, I know, especially for someone with PDS. My existence utterly undermines that self-created delusion of security and protection, doesn't it? Well, mea culpa.

A culture which does not tolerate grief is diseased. Yep, the system, itself, epitomizes mental illness. Sorta ironic, isn't it? And therein, lies the problem.  We are dealing with a system here, not a human being. I know, human beings make up the system. However, a system cannot be good or kind or compassionate. It's a system. It requires humans, who make up the system, to care. And if one person can foist responsibility for caring onto another in the system, then how is that healing connection made? A system is limited by its own homogeneity and homeostasis and boundaries and stagnation. This sociomedical system cannot feel. It cannot connect. It cannot care and thus it perpetuates its own dysfunction.

Bereaved people need, and deserve, our pause. They deserve heroic love and compassion. This should be the norm not the extraordinary. And let us not forget that, one day, we will all be bereaved. The healing cannot come from within the PDS-ridden system. The healing happens in the space between words, between people.

And so here is our alternate story, with a nod to the one and only Ivan Illich:

One day, if we continue to work toward curing the system, ridding it of its mental illness, then caring for another and deep connection with one another and loving each other through moments of tremendous suffering will no longer be the heroic.

It will be commonplace, it will be normal.

And we will all be healers, and we will all be healed.

_________________________

This blog is dedicated to Blake and his mother. I hold you both in my heart. Thank you for inspiring me with your fearlessness and your courage and mostly your grief and love.

And to a spirited, spicy little monkey-teacher, Ronan and his fearless mom, Maya. Thank you Ro for  helping me speak my truth.