April 4, 2013 by MARCO TORRES
Enjoy a little spanking during foreplay? What about being tied to the
bed posts, role playing or admiring a pair of stilettos to help turn on
that sexual engine? Such sexual fixations may soon land you in the
psychiatrist's bible of diagnoses. All the kinksters are saying it can't
be, but psychiatrists are now stating that such behavior should be
diagnosed as mental illness deserving of pharmaceutical drug treatment.
“Understanding peoples’ attitudes about whether states of
being should be considered diseases can inform social discourse
regarding a number of contentious social and health public policy
issues,” says Kari Tikkinen, MD, PhD.
“The word disease seems to be as difficult to define as
beauty, truth or love, although the concept of disease lies at the
heart of medicine,” Tikkinen says. But why is it that the medical
community has no hesitation in defining dozens of new diseases every
year, most of which have no scientific justification?
Most of these nonsensical medical terminologies and
inventions seem to be centered around children being children and a
society determined to turn our youngest generations into robots.
Intermittent Explosive Disorder,
Oppositional Defiant Disorder or what about Mathematics Disorder? Yes,
these are all real and officially recognized diagnoses by doctors.
Proposed Changes
The newest Diagnostic and Statistical Manual of Mental Disorders,
known as the DSM-5, is due out in May. The book sets the standard
criteria for psychiatric diagnoses (not to mention health insurance
reimbursement), making its pronouncements crucial to mental health
treatment.
Proposed changes discussed online by the American Psychiatric
Association researchers who worked on the new edition suggest that foot
fetishists and bondage aficionados who hoped to get out of the book
altogether won't see that wish come true.
Instead, unusual sexual fixations, or "paraphilias," will likely get their own category as odd.
Psychiatrists argue that leaving benign paraphilias in the DSM goes
too far. Sexual fixations that cause harm and distress can be dealt
with under other diagnoses, they say, ones that don't stigmatize people
who enjoy non-mainstream but harmless sexual activities.
"I've heard people at meetings talk about 'those paraphiliacs,' 'those
people,'" said Alan Shindel, an urologist and specialist in sexual
problems at the University of California, Davis Health System. "I think
that's always a dangerous road to go down when you're talking about
othering people in that way."
Some psychiatrists and paraphilics even draw parallels
between their position and that of gays and lesbians, who were
considered mentally ill until homosexuality was removed from the DSM in
1974. [The History of Sex in the DSM]
The proposals and discussions posted online by the American Psychiatric
Association suggest the new DSM will take that DSM-IV-TR qualification
further. Turned on by obscene phone calls or spanking? You've got a
paraphilia.
The DSM-5 may also, for the first time, clearly define "paraphilia"
(previous incarnations have simply listed odd sexual targets). They
proposed a definition describing paraphilia as "any intense and
persistent sexual interest other than sexual interest in genital
stimulation or preparatory fondling with phenotypically normal,
consenting human partners between the ages of physical maturity and
physical decline."
In that study, researchers found the most common paraphilia was
voyeurism (spying on an unknowing person), followed by fetishism (sexual
fixation on a nonliving object).
Who is Really Crazy?
Sex has a controversial history in the DSM. Up until 1986 (12 years
after homosexuality was removed from the DSM), psychiatrists still had
the option of declaring gay people mentally ill if their sexuality
caused them distress. Now, people who get aroused by bondage or unusual
objects say they're in the same position as gay individuals in the
1980s: stigmatized, with any problems they do have unfairly blamed on
their sexuality. The real problem behind the woes of the shoe fetishist
or BDSM practitioner is that society judges them harshly, not that
their sexual desires are somehow wrong, these advocates say.
A similar argument helped to oust homosexuality from the
DSM. And many psychiatrists agree that the evidence for consensual
paraphilias causing harm is lacking
Part of the challenge of classifying the paraphilias
is that they range from undoubtedly harmful to benign. Sexual
excitement over urine (urophilia) may seem icky to most people, but
it's unlikely to hurt anyone. Similarly, many individuals consensually
engage in sexual activities meant to inflict pain, such as spanking.
"The act of specifying particular, sexual behaviors as
pathological leads to discrimination against all practitioners of
those behaviors, even when their behavioral expressions are
appropriate and benign," wrote psychiatrists Charles Moser and Peggy
Kleinplatz in 2005 in the Journal of Psychology and Human Sexuality.
It's hard to separate value judgments from what's
considered "sick." This also applies to paraphilias that typically
don't harm others: As long as mental illness remains tangled in
cultural ideas about morality and right and wrong, handling sensitive
subjects such as sexual desire will remain complicated.
Health conscious communities have recently bonded together
to prevent fictitious medical advances and
the accompanying flood of new drugs for a
range of ills that threaten to
"medicalize" every human condition and
behavior, according to some experts.
In addition, they say the advent of genetic screening
could eventually mean that apparently healthy
people will be labeled "sick" decades
before an actual diagnosis.
"Illness is always a social construct," notes
Dr. Nortin Hadler, professor of medicine and microbiology/immunology
at the University of North Carolina at Chapel
Hill, and author of the book "Worried Sick:
A Prescription for Health in an Overtreated
America."
"People have to agree -- both people, in general,
and those in the medical community -- that a life
experience shouldn't be labeled an illness,"
Hadler says. "For example, the Victorians
medicalized orgasm, and we medicalize the
lack of it."
So who is really crazy? Those who they attempt to diagnose or the psychiatrists themselves?
Marco Torres
is a research specialist, writer and consumer advocate
for healthy lifestyles. He holds degrees in Public Health
and Environmental Science and is a professional
speaker on topics such as disease prevention,
environmental toxins and health policy.
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