Tag Archives: polarization

Reflections from the Protest at the American Psychiatric Association Convention: Existential Psychology in Action

This blog was originally posted on June 7, 2013 on the New Existentialist Blog. It was reposted here after the New Existentialist Blog was discontinued.

A few Sundays ago, I attended a protest at the American Psychiatric Association Convention in San Francisco with my Saybrook colleagues, Kirk Schneider, Kristopher Lichtanski, and Shawn Rubin. We attended because of our concerns about Diagnostic and Statistical Manual of Mental
Disorders (DSM5) due to be published next month. Despite numerous strong critiques of this new manual that have been coming from mental health professionals, this book has already been on bestseller lists based on preorders. Saybrook University and the Society for Humanistic Psychology have been among the leaders in voicing critiques of this manual. However, the critiques are quite widespread.

An Honorable Process

I have been proud of humanistic and existential psychology’s leadership in responding to the DSM5. Often, humanistic and existential psychology are seen as a movement of rebels, and occasionally, we get portrayed as radicals. While there is some truth to this (I think it is more accurate to say we tend to be a passionate group as opposed to extremist), it is hardly an accurate portrayal of the broader fields of humanistic and existential psychology. In regard to the DSM5, humanistic psychology has brought forth a balanced critique rooted in scholarship, philosophy, research, and ethical sensitivity. In the initial thrust of voicing our concern, we focused on developing strong critiques while asking for dialogue and an external review.

It would have been easy to take a more radical approach, and other groups have done this. However, our willingness to take a balanced approach has brought about credibility. Recently, I had two interviews about the DSM5 and the concerns about this manual. In one, it seemed evident that the reporter was frustrated that I would not provide anything “juicier.” While sensationalism may draw more attention, it does not bring with it credibility.

Personally, I am glad that other groups are also drawing attention to the DSM5, and I hope that this leads to a much larger conversation about these concerns. As this occurs, I hope humanistic and existential psychology can remain a balanced, credible voice rooted in good scholarship and clinical wisdom.

The Heart of the Concern

There are many places where readers can find a more in depth discussion of the concerns about
the DSM5, so I will not review all of them in this article. Instead, I would direct readers to the
following resources:

  • The Global Summit on Diagnostic Alternatives: An Online Platform for Rethinking Mental Health (http://dxsummit.org)
  • The Coalition for DSM5 Reform (http://dsm5reform.com)

However, let me briefly highlight some major concerns:

Science: Many of the new diagnostic categories have been criticized for being based upon questionable reliability by the DSM’s own standards. Thus, even from within its own epistemological framework, the DSM5 has significant weaknesses.

Peer Review: While the DSM5, during in its development, proposed that it was an open process and receptive to feedback, the evidence does not support this. The Society for Humanistic Psychology’s open letterturnedpetition gained nearly 15,000 signatures and was endorsed by many major mental health organizations around the world. In this letter, there was a call for dialogue and an external review. This was denied. The American Psychiatric Association demonstrated that it was not open to conversation or alternative perspectives even when there was a strong voice of concerns by many mental health colleagues and leaders in the field. The DSM5’s alleged attempts to be open failed as they went around a more thorough and objective peer review process.

Ethical: The DSM5 is lowering many diagnostic thresholds, which will drastically increase the number of people with a diagnosis. As medication continues to be advertised and purported as the first line of treatment, this means many more people will be stigmatized and then placed on medications that have sometimes serious and unknown long-term side effects (they are not old enough to really know the long-term effects) despite safer alternatives.

Economic: There are at least two serious economic concerns with strong implications. First, there exists a serious conflict of interest in that well over half of individuals serving on the DSM committees were also on the payrolls of pharmaceutical companies. Second, while it is touted that the lowered diagnostic thresholds will help with access to mental health, I am not convinced. The insurance companies are well aware that the APA is, in essence, changing what is considered a mental illness to get more money out of them. It is likely that the insurance companies will respond in a way to protect themselves and, in ways, they need to. This may dramatically increase the costs of health care, particularly if it contributes to placing a large number of individuals experiencing temporary life distress onto medications for a long-term period. This impacts everyone. Additionally, it is likely that insurance companies may respond by demanding more evidence to justify treatment, which could mean that many people who really do need treatment will be put through greater scrutiny and possibly have difficulty getting access to treatment. Therapists may see an increase in documentation required to support the need for treatment, particularly when longer-term treatment of more serious issues is warranted. There are better ways to work to assure that people who need treatment have access to it.

Sociopolitical: Already, individuals representing various forms of diversity, including cultural diversity, are more likely to be diagnosed at higher rates than the dominant culture. This labeling can be used in ways to exert power over these groups through stigmatization and furthering group stereotypes. It is likely that the lower thresholds will disproportionately stigmatize these individuals. Additionally, vulnerable populations, including the elderly and children, are already seeing the largest increases in prescriptions of medications. This will likely get worse.

Conclusion

As we stood on the sidewalks outside the Moscone Center in San Francisco, we knew many people who walked by would discard us as extremists. However, if one were to step back to take a more objective look, it quickly becomes evident that the extremists in this case is the perspective of the American Psychiatric Association as evidenced in the new DSM5 manual. It is clear that this manual in many ways meets the criteria of a polarized position, as it represents a “fixation on one point of view to the utter exclusion of competing points of view” (Schneider, 2013, p. v). The American Psychiatric Association demonstrated polarization in rejecting the widespread call for an external review by qualified experts.

Yet, even if we are considered the extremists, rebels, or radicals, there is often a place for this. As Rollo May (1975) stated, “Recall how often in human history the saint and the rebel have been the same person” (p. 35). While none of us protesting the DSM5 would claim to be saints, I am confident that in this situation we are on the same side as the saints.

References

May, R. (1975). The courage to create. New York, NY: Norton & Company.

Schneider, K. J. (2013). The polarized mind: Why it’s killing us and what we can do about it. Colorado Springs, CO: University Professors Press.

~ Louis Hoffman

Note: Although this site is owned by Louis Hoffman, it supports the Rocky Mountain Humanistic Counseling and Psychological Association (RMHCPA), which is a 501(c)3 nonprofit organization. As an Amazon Associate, RMHCPA earns from qualifying purchases made through the links on this page.

Marriage Equality, Religion, and Polarization

This blog was originally posted on May 14, 2013 on the New Existentialist Blog. It was reposted here after the New Existentialist Blog was discontinued.

One of the most divisive and polarizing issues in contemporary United States society is marriage equality. Kirk Schneider’s new book, The Polarized Mind, aptly demonstrates why we should be very concerned about this not only because of the importance of the issue, but also because of the dangers inherent in polarization. Schneider (2013) describes polarization as “the elevation of one point of view to the utter exclusion of competing points of view” (p. 1).

According to Schneider (2013), polarization often has some type of fear or anxiety at its root, such as the fear of one’s own insignificance. However, many fears and anxieties can be at the root of polarization. Often, polarization emerges from our inability to tolerate the unknown. Similarly, Terror Management Theory suggests that in times of fear and insecurity we often cling to one’s own identified “in group,” while strongly directing anger or aggression toward an out group, especially if that out group is identifiably different in important ways (Pyszczynski, Solomon, & Greenberg, 2003). It should not be a surprise that both Schneider and Terror Management Theory draw heavily upon the work of Ernest Becker, and in particular, his important existential treatise, The Denial of Death (1973).

Photo by Louis Hoffman, PhD

Polarization in the Gay Marriage Debate

Too often, the debate over marriage equality is ugly. This easily qualifies as a polarized issue. Frequently, individuals involved in the debate talk past each other, not able to recognize the arguments, or even the humanity, of the other person. This is quite evident when Pat Robertson, a popular Christian television evangelist, says that “a murder can change, a rapist can change, a thief can change” as a direct comparison in his argument that God can change a person’s sexual orientation. To make such an audacious and offensive claim seems to require “the utter exclusion of competing points of view,” as Schneider has stated.

Yet, despite being an ardent activist for marriage equality, I do not believe that all individuals arguing against gay marriage are polarized, nor are they “bad people.” Furthermore, there are individuals who are for marriage equality in such a way that it does not respect the humanity of those who are genuinely struggling with the issues of gay marriage because of their religious convictions. This is not helpful in the fight for marriage equality.

The place where transformation occurs is a space where we can move beyond our polarizations —a place where we can meet and listen to each other humanely, despite our differences. I am confident that if we can meet in this space, more people will be converted to supporting marriage equality than if we remain in our polarized camps villainizing each other.

Power and Victimization

It has become popular for Christians opposing gay marriage to claim victimization in the debates over marriage equality. Following Jason Collins coming out as a gay pro basketball player, there were many articles and captioned pictures saying that Collins was being portrayed as a hero, while Tim Tebow, the pro football quarterback who was very forthright in his Christian beliefs, was being told to “shut up” and portrayed negatively for being a Christian. This, too, reflects polarization, as it utterly disregards significant evidence that contradicts this portrait. First, and most obviously, there are many, many professional athletes who are open about their Christian faith who are never criticized for this and often praised. Tebow was criticized and made fun of for many reasons, with his approach to talking about his faith just being one of them. While this treatment of Tebow was often cruel and frequently crossed the line, it was not his faith, per se, that drew the criticism and mocking.

However, there is also a disregard for the issue of power when maintaining that Christianity is being victimized and discriminated against. Much of the first half of Schneider’s (2013) book, The Polarized Mind, presents case studies on what happens when polarization is combined with power. This is a dangerous combination. Generally, the more extreme the polarization and power, the more extreme the consequence will be.

Recently, many in the Christian community have started to point out that Christians are becoming the target of oppression, discrimination, and derogatory acts. There is some truth in this claim and to a degree I am sympathetic. At the same time, it is important to keep in mind that Christianity has long been the most privileged religion in the world. This may be beginning to change; however, it is evident that it is still the most privileged religion in the world at this time and, in particular, in the United States. It may be that the marriage equality issue is the one that signifies the loss of this privileged position. Yet, if Christianity wants to advocate for sympathy, it ought to concurrently speak out against those who, in the name of Christianity, say harmful, extremist, derogatory statements. It ought be Christians, even those who are in agreement in opposition to marriage equality, who are the first to tell Pat Robertson that he crossed the line. Until this occurs on a broad level, I do not anticipate Christianity will receive
much sympathy except from within Christianity.

I want to clarify that I am not advocating for a statement against Christianity. I come from a background of Christianity, even earned degrees in Christian theology and studied at two Christian seminaries. I am also quite aware that many Christians are strong advocates of marriage equality. Rather, this statement is a human statement, and I believe that marriage equality is a human issue. Thus, I see marriage equality highly consistent with an existential worldview.

We ought to strive for all people to rise above their polarizations and for all people to rise above harmful prejudices. Yet, we are human and these will continue. If we are to become a more civil and less violent world, we must first hold our self and the groups with whom we identify accountable. We must also be honest about the role of power in all discourse.

Conclusion

Marriage equality is arguably the civil rights issue of the current era. As a strong advocate for marriage equality, I have advocated that 1) there is an existential foundation for marriage equality, and 2) that the polarization of this issue is problematic and dangerous. Polarized advocates for marriage equality are less likely to be effective in garnering support for marriage equality. Additionally, many of the polarized statements of the opponents of gay marriage make statements that are discriminatory and hurtful. Our goal in this debate ought be to move beyond polarization into honest dialogue.

References

Becker, E. (1973). The denial of death. New York, NY: Free Press.

Pyszczynski, T., Solomon, S., & Greenberg, J. (2003). In the wake of 9/11: The psychology of terror. Washington, DC: American Psychological Association.

Schneider, K. J. (2013). The polarized mind: Why it’s killing us and what we can do about it. Colorado Springs, CO: University Professors Press.

~ Louis Hoffman

Note: Although this site is owned by Louis Hoffman, it supports the Rocky Mountain Humanistic Counseling and Psychological Association (RMHCPA), which is a 501(c)3 nonprofit organization. As an Amazon Associate, RMHCPA earns from qualifying purchases made through the links on this page.