My Worst DID Awareness Day Post Ever

[lb_lee]

Rogan: Apparently DID Awareness Day was yesterday. I... frankly had more important things to be doing, but okay, let's... let's pull the old shit together and say something.

DID is kinda the crowned king of multi respectability in the circles I run in, which is hilarious since greater singlet society sees us all as rich white teenagers/housewives with nothing better to do than feel sorry for ourselves, but fine. I guess we're supposed to pretend the Memory Wars never happened and that DID is a totally legit, respected mental illness now.

(Wow, I am really failing at my professional persona today. Y'all're just gonna have to forgive me, my friend is dead.)

Now, during the Memory Wars--and I'm talking about the people who actually have a point here, not the abusers who were just mad about getting caught so decided to lobby and lawyer up--some clever boots called MPD/DID a "culture-bound syndrome," meaning an ailment that only happens with a specific society. Do random guys in Papua New Guinea get MPD? No? Then it's a culture-bound syndrome.

And because we are a society utterly obsessed with the idea of fakery, for a lot of folks, "culture-bound syndrome" means illegitimate or not real, so a bunch of the MPD/DID therapist guys got really into digging around and retroactively declaring other people multi who, in their time and place, were considered demon-possessed or something else entirely. (See "Jeanne Fery: A Sixteenth Century Case of Dissociative Identity Disorder" by van der Hart, Lierens, and Goodwin for an example. I've also heard that this is a problem in Suryani and Jensen's Trance and Possession in Bali: A Window on Western Multiple Personality Disorder, Possession Disorder, and Suicide, and one day, I will finally reach a point where I READ my goddamned copy, but that day is not today!)

Now, if you think about this for more than half a second, you can quickly see this going super-racist places, and you are correct. It's the height of arrogance to decide YOUR culture's mental illness is the objective be-all end-all TRUE REALITY, and that therefore all other cultural interpretations are wrong. There can quickly become a sort of evangelist "have you heard the good good news about MPD/DID?" attitude. When all you have is a DID hammer, everyone is an MPD nail.

(And yes, I'm gonna keep using the MPD term, it was still being used outside the USA until the ICD-10 in 2015, I think, and there are still PLENTY of people running around with the old diagnosis. I'm not in the mood to dignify DID as though it's the Single Most Legit, not today. DDNOS and OSDD exist, and come on, how often have you heard the DID guys giving even lip service to Possession Trance Disorder?)

If my tone and utter failure at subtlety hasn't cued you, I am not a big fan of this way of seeing things. I've done enough reading and wandering around the wilderness of my own fucking head to come around to the idea that yes, MPD/DID is probably a culture-bound syndrome... but that doesn't make it fake. It's just the local cultural expression of a far greater tendency towards sharing personhood, many-selvedness, and spirit relationships, all of which manifests in different ways depending on time and place. (I have to use this awkward kludge of terms because there isn't one term for it... and hey, for all I know, my attempt to even create one is equally wrong and a sign of my own narrow thinking! But I DO feel confident that the idea that "singlet = healthful, desirable norm" is NOT culturally universal, NOR is it a scientific idea. I still don't know where it comes from! I desperately want to!)

So yeah, I might be officially disabled with DID. In some people's sad, narrow little minds, that gives me some bullshit cachet of authority, splattered on me like jizz from the noble alabaster pricks of scientific medicine (well, some of them). But I disagree with that bullshit definition. For me, DID is an insurance code, with a long, inglorious history of slapfights and wingnuttery. Yes, MPD/DID resources have helped me out... but so has learning about Korean mansin, Mapuche machi, vodouisants, spirit marriages, soulbonders, and god only knows what other forms that I'm not remembering right at the moment. There is more to fucking life and sharing personhood than fucking DID.

If you too have DID, I cannot urge you strongly enough to learn about other forms of sharing-personhood that AREN'T that. Break out of the cultural conditioning. Go learn about stuff. Don't let some crusty old doctor's idea of "proper multiplicity" (or dissociated singlethood, whatever) be the straitjacket you put on yourselves for the rest of y'all's goddamn life. Even if it turns out to be tailor-made for you all the while, you'll have done nothing but expand your horizons.

Happy DID fuckin' Awareness Day. Belatedly.

Comments

[wolfy_writing]

Yeah, I think a lot of people have very narrow ideas about the role of culture and belief in anything that's categorized as a mental illness. It's like they think the two options are 1) people around the world have always had this specific mental illness as defined by the current DSM diagnostic label and it they were just too tragically ignorant to have our current enlightened understanding, or 2) it's fake. The first one has huge levels of cultural bias and presumption of superiority passed off as Mental Health Awareness, and the second one assumes that if culture influences the manifestation to any degree, then you're pretending and could just snap out of it if you want to.

The reality is messy and complicated. For a lot of what's categorized as a mental illness, there's shared aspects of the human experience and specific cultural aspects, both of which influence how our current diagnostic categories look. Even the line between an illness and an unusual way of experiencing the world can be influenced by culture. (It's only recently that Western psychology began looking at people who, like many members of the Hearing Voices Movement, experience what could be considered hallucinations but don't have significant impairment or distress, because it was assumed that "sees and hears things that aren't part of consensus reality" meant a serious illness.) It would be weird if culture didn't influence DID, and implausible to think that having multiple selves in a single body wouldn't look different and be experienced differently in different cultures.

[lb_lee]

Mori: exactly. I see it as like... relationships. There isn’t some inherent biological scientific reason to buy someone cut roses. That’s a culturally specific way to express romantic affection (usually a man for a woman). In a land without roses, such an idea wouldn’t exist. But that doesn’t mean getting someone flowers isn’t super meaningful or important for some people, or that cultures without roses don’t have romance! The affection is the same, just how that affection is expressed takes culturally considered avenues. (Buying someone a potted cactus carries a different message.) But I don’t think many people would claim only roses are legit love!

[pantha]

Oh, 100%.

There's the whole thing around "mental illness" as a field where it has high rates of diagnostic instability and that's almost certainly underlain by the fact that the diagnostic categories are so poor that multiple transdiagnostic approaches are now being considered (e.g. RDoC, HiTOP). It's hardly surprising considering how psychiatry is entirely built on frankly unverifiable theories by Great Men rather than any biologically measurable differences and that even the effected systems are unknown. Add in that many psychiatric conditions clearly come in primary and secondary forms and that there's a huge amount of cultural influence on expression (if not always to the extent of being an actual culture-bound syndrome) and... yeah. Mess.

I think that point about distress is a really interesting one. That's how Gender, Sexual and Romantic Minorities have moved out of diagnostic criteria - in a step-wise pattern. First, it's all a disorder. Then, it's only a disorder if it's distressing. Finally, it's not a disorder. Transgender identities are still in the "disorder" stage. Asexuality is in the "disorder if its distressing" stage. Homo- and bisexuality are in the "not a disorder" stage.

Also, how in addition to culture broadly the way our culture intersects with our medical and other support systems definitely also impacts on this. E.g. I suspect transgender identities are going to stay classified as "disorder" as that classification is the (highly imperfect, but often only) means of obtaining medical assistance. Likewise, you can look at the USA and the various states' bills to enforce support for autistic folks (particularly those with high support needs) - it's been documented to result in doctors medically classifying patients as autistic when they don't strictly meet the criteria or when they meet the criteria for another disorder, simply to ensure they get help.

...

My personal take is similar to Rogan's (if far, far less eloquently cutting). There's reality, which is many-faceted. And then there is the medical (and other support) criteria of our own geographic and temporal location. We have to play the rules of the latter, but that should not mean believing it to be Truth. We can even choose to categorise ourselves within the systems of the latter, but we must recognise that that's just a short-hand to communicate within our own cultural milieu rather than some objective Truth about ourselves.

[lb_lee]

frankly unverifiable theories by Great Men

Rogan/Mori: be fair, pantha, some of them were like... Okay Men. Acceptable Men. Mediocre But Fine Men.

First, it's all a disorder. Then, it's only a disorder if it's distressing. Finally, it's not a disorder. [...] I suspect transgender identities are going to stay classified as "disorder" as that classification is the (highly imperfect, but often only) means of obtaining medical assistance.

Rogan: Interestingly, I’m reading an academic book from 1988 with the regrettable title of What About Demons? Possession and Exorcism in the Modern World (it’s better than it sounds, I promise) that argues that the difference between benign possession and MPD isn’t trauma or distress, but lack of control over the possession/switching state. I haven’t dug deep enough into that section yet, but it’s a novel argument I haven’t really seen focused on before!

Also, reading 1940s work by gay people about themselves as a mental illness that can be treated (though they argue PROMISCUITY is the problem, not the gayness itself), is a fascinating look at the medicalization of gayness past.

[pantha]

Oh, Great Men was meant with full air-quotes and eye-rolling. Even if they were ok, acceptable or mediocre-but-fine in their words and deeds, their elevation by society to the untouchable status of Great Men is still a problem.

~~~

Ooooooooooooh, those are both really interesting!

I wonder if the Western medical world's focus on "distress" is perhaps (probably unconsciously) on its inheritance. With mental health stuff in general (and including formerly-classified-as-such stuff like homosexuality, kinks, etc.) they have gone through an interesting cycle over a longer period of time, from a protestant religious model (sin) to a medical model (illness) and then, more recently to a diversity model (natural human variation). And, in many ways, that initial conversion was an attempt at empathy, kindness and humane treatment - don't punish the person, they aren't doing this on purpose, they are unwell. However, as we know, that didn't entirely work as a humane solution. Firstly, because there was still extreme stigma. Secondly, illnesses are "supposed" to be treatable so a failure of treatment comes back to being an individual failing.

And somehow in the process of that medical model (sorry, I'm a bit hazy on the details here) we go from things being a medical problem because of how they affect society ("get rid of the dangerous mad people") to a more individualist perspective where medicine is focused on helping the person. However, IMO, I wonder if "distress" as part of this became ... effectively an "objective" and "individual-focused" way of measuring mental illness. But in the complete absence of any wider thought about why that distress is present.

Distress, of course, in many cases is not intrinsic to the condition but caused by society's lack of acceptance (or, indeed, active rejection) of the condition. Or, it's caused by feelings of loss or isolation or other negatives. But, as we've seen with homosexuality, if society changes then the condition can stop being associated with distress. And, equally, we can see historically and geographically that the treatment of "distress" is highly culturally bound. I don't know enough to properly comment, but I wonder about a comparison between the treatment in the early 20th C of a homosexual man's distress at his homosexuality and how it bars him from a socially-accepted life partner versus a woman's distress about how her sex bars her from a career - homosexuality is seen as a medical problem, but womanhood is seen as a state that comes with an increased risk of gender-specific medical problems. There's definitely a difference there, but I haven't thought about it (or read about it) enough to be able to articulate the boundaries properly.

Additionally, the "treatment" for distress is culturally-bound and not always helpful. For example, how in the mid-20th C trans folks could get treatment in the USA but only if they were the most gender norm-aligning trans women (heterosexual, hyper-feminine, etc.). Or how in ... I forget exactly which middle-Eastern country, but homosexuality is considered haram but being a trans woman is seen as a medical problem - so, gay men end up seeking asylum in the West to avoid being forcibly transitioned.

Uff... sorry, much rambling.

[lb_lee]

Rogan: that makes sense to me! And back in the day, women WERE considered intrinsically mentally disabled (as were “inferior races,” etc.) so the American concept of disability is deeply intertwined with other forms of oppression. (Still is, really: a lot of ageism boils down to “you are too young/old to think clearly or make your own decisions.” A baby can’t make decisions, of course, but many older children or old folks can!)

I know at least pre-Civil War fake diagnosis (drapetomania) where the “cure” was to realign the slave with their “proper place,” so it was clearly NOT intended to humanize them. But it was still a “rational” attempt to explain an “irrational” behavior.

[pantha]

(Thinking on the spot here, so apologies for the half-baked ideas.) Ah, maybe that's the distinction. Women (and "inferior races" - and indeed, to a varying extent, the poor) were/are considered mentally disabled - like children. Whereas mental disorder is what happens to upstanding cishet white men. So, one needs to find an explanation for it beyond "well, these people are already inferior, so perhaps a tendency to X is just part of that inherent weakness". And, of course, distress would then be a consistent manifestation across conditions - after all, if you are in that position of social power, anything that threatens to "expose" you as secretly inferior would be deeply, deeply distressing.

Hmmm... more thought required!

-------

Hmm, yes - that's the word I was thinking around but somehow hadn't managed to grasp. Rational.

Medicine is (particularly at first) an attempt to rationalise the world, as part of a wider scientific attempt to classify the world. However, that time and time again (and particularly in psychology) seems to end up as "my world-view is Truth" and then coming up with just-so stories to explain "other people wrong". Drapetomania is, at least to most eyes, now a very obvious example of that. However, few cast that same critical eye over our other diagnostic categories. *siiiiiiiiiiiiiiiiiiiiiigh*

[pilotsofanewsky]

(The ICD-11 changed MPD to DID, and also created the option of cPTSD rather than just PTSD. It is to this day *not being used*, for some reason, despite being created in...2019? 2021? Anyway we managed to get an MPD diagnosis in Europe in the year of our Lorde 2023, so.)

[lb_lee]

Rogan: thank you! I knew it was fucking recent!

[sva_system]

We very much agree with the general point of this, that medical insurance codes are not descriptions of experience etc.

But I DO feel confident that the idea that "singlet = healthful, desirable norm" is NOT culturally universal, NOR is it a scientific idea. I still don't know where it comes from! I desperately want to!

On this, we actually wrote a longer paper in January on this (on the singlet-centricity embedded in the history of western philosophy, under the title "Plural Self-Experience as a challenge to the Heno-
Theo-Logic structure of philosophy since Parmenides"); we couldn't manage to get it published and it's still not out there since we don't know how the status of it would be for republication, but we can def send you a copy of the preprint privately if you let us know how you would like that (if you're okay with us sending a private message on dreamwidth or if you prefer sth else).

- Hypatia of Sva

[lb_lee]

Ooh, yes please, that would be super helpful, we've been banging our head against a wall trying to figure out where this singlet norm CAME from, with very little success! PMing you our email address now.