Archive for July 2010
What? Another letter for which there is no diagnosis in the DSM-IV-TR?
You’d think we could come up with something. Good heavens – what about these:
Umbrella Abuse (the compulsive opening of an umbrella inside; when I was a kid, if they told me not to do it, I had to do it, right? Come on, how many of you have done it…?)
Unglued Disorder (actually, this one probably goes under another name, like “psychotic disorder NOS,” etc.)
UFO Phobia (aka “alienaphobia”; speaks for itself)
Unemployed syndrome (aka, “recession syndrome”)
Unibrow Disorder (again, speaks for itself)
Unique Personality Disorder (aka “Special and Different Personality”)
UPC Disorder (compulsive need to decipher the UPC barcodes on packages of Oreos, cell phones, pretty much anything…)
Utopic Personality Disorder (aka Pollyana Syndrome)
Ullagone Syndrome (compulsive funeral lamentation)
Ultion Disorder (obsession with revenge or vengeance)
Ultraism Syndrome (aka, stubborn holding of extreme opinions on a subject)
Umbilical Disorder (inability to separate from mother)
Unbosoming Abuse (to abuse those around by pouring out or freely telling anyone available each and every detail of one’s life, regardless of interest on the part of the listener; therapists are automatically exempt from this diagnosis)
Undecennial Depressive Disorder (depression that happens only every eleven years)
Undinism (psychological obsession with urine and urination; this is real; I did not make this up)
Uranomania (obsession with the idea of divinity, and yes, it’s real; I did not make this up)
So there you go.
P.S. Most of these are fictitious; do not ask your psychiatrist if you should be diagnosed with these disorders. Then you would be diagnosed with “Diagnostic Disorder NOS.”
“Trichotilomania” is recurrent pulling out of one’s own hair that results in noticeable hair loss.
Trich (for short) is classified under “Impulse Control Disorders,” which I translate as a process addiction. Pathological gambling is classified in the same way, as is pyromania, kleptomania, and intermittent explosive disorder (failure to resist aggressive impulses).
Many of us play with or twist our hair (if it’s long enough!) out of anxiety, a behavior that can restore regulation to the central nervous system if agitated. The hair damage from this “habit” is minimal, if any. It probably also does not cause significant distress to the individual.
Distress is significant for an individual with trich. Damage from trich includes patches of baldness and damaged hair.
Imagine being a girl with trich which began in about 4th grade. The girl may have significant patches of baldness in her hair, and so wears a wig (yes, this does happen in youngsters). In junior high, for the first time, she must take off all her clothes in front of her peers, get in a bathing suit, swim, and shower in the same room as her classmates.
How will she navigate that without the class and teacher finding out that she wears a wig? How will she explain the hair loss? Teasing and stigma are sure to follow.
How will she keep her wig in place on a windy day? How will she handle slumber parties? Will she wake up in a room full of girls with her wig twisted to the side, or laying on the floor next to her pillow?
If she chooses to go without the wig, will she shave her hair close to her head so she is not tempted to pull (can’t pull the hair if it’s only 1/4″ long)?
If she goes without a wig and leaves her hair long, will she increase the size of the bald spot with continued pulling? Long hair is a powerful trigger for trich. The shame and hiding that comes with trich in our society is enormous.
Triching (the act of pulling) is a CNS regulating behavior. It is especially notable in individuals with anxiety, and acts to soothe the individual. The individual may also be dissociated while triching. Like any other negative regulating behavior, it can become deeply ingrained in an individual’s regulation repertoire.
Treatment may include such things as medication (SSRIs, etc.), cognitive behavioral therapy, motivational interviewing, 12-step, DBT.
The individual you see in front of you at the supermarket with bald patches on their head may well suffer from this illness. Your compassion, kindness, and a warm smile, not staring, may be the best gift you can give them.
So it’s late, and I’m tired. Is this a good time to bring up a touchy subject with my spouse? Good guess – no.
I used to think I ought to be able to handle anything emotionally in my relationship. I’m a therapist right? I’ve had tons of therapy right? Yes, and yes. BUT (and as you can see this is a big BUT) I’m also human.
The less I accept my humanity, and all the foibles that go with it, the more likely I am to step in it (“it” of course being doo doo) in my relationship.
Everyone has limitations. It doesn’t make me weak. It means I’m human. Being human is much more acceptable to me than it used to be. It’s okay to say, “you know, I just can’t be there for you now,” or “I know you want me to do you a favor, but I’m wiped out, so… sorry.”
I accept my limitations and my humanity more and more. I accept others’ limitations and humanity more and more. That makes for a lot more peace in relationship with others.