You kinda can't just get over it July 6, 2010 10:11 AM   Subscribe

I've noticed that in posts dealing with OCD, anxiety, depression, or other related mental health issues (most recently this thread, though maybe that's not the best example) there often seems to be a pretty dismissive attitude on the part of a number of commenters. What's up with that?
posted by OverlappingElvis to Etiquette/Policy at 10:11 AM (100 comments total) 3 users marked this as a favorite

What are you talking about? All we ever seem to do here is recommend that people get therapy.
posted by amro at 10:18 AM on July 6, 2010 [2 favorites]


Not everyone is going to agree with you on the internet.
posted by smackfu at 10:20 AM on July 6, 2010 [8 favorites]


Well, some people believe that these kinds of conditions are overdiagnosed, or that self-diagnoses of these kinds of conditions are likely to be overstated or otherwise inaccurate (weaselly 'some people believe' construction because I am not necessarily one of these people).

Other people think that words like 'depressed' and 'anxious' are often used in non-clinical ways, and there's an argument that this reduces understanding and sympathy for people with more serious mental-health issues.

There is a widespread perception that people who have not suffered from clinical depression are unable to distinguish between that and, y'know, feeling down in the dumps or whatever.

The rise of CBT and other behavioral approaches to happiness has probably encouraged the belief in some people that many mental-health issues can be overcome with sheer force of will.

The answers that people offer to AskMe questions don't always directly address the question asked, and are sometimes less than helpful. And sometimes, they reveal more about the answerer than they do about the question.

'What's up with that?' is pretty broad. What exactly are you asking here?
posted by box at 10:20 AM on July 6, 2010 [8 favorites]


All we ever seem to do here is recommend that people get therapy.

That's the stereotype of AskMe. On the front page, the stereotype is that we are dismissive of problems.

Which is probably what's going on here: In AskMe, we are dealing with a particular person while on the front page it is usually a class or group of people. Humans seem to be more sympathetic for/empathetic with individuals than groups.
posted by DU at 10:25 AM on July 6, 2010 [3 favorites]


All we ever seem to do here is recommend that people get therapy.

Sorta. A Brief Field Guide To Mental Health Attitudes on MetaFilter:

The Green: Perhaps you should consider cognitive behavioral therapy. And DTMFA.

The Blue: Grow the fuck up, fucking flakes. And GYOFB.

The Grey: If you read this comment __________ posted back in February and the one they just posted here, it's pretty clear that they need professional help; why else would they have called me a presumptuous asshole?
posted by Alvy Ampersand at 10:26 AM on July 6, 2010 [20 favorites]


Well, the DSM process is pretty fucked up. I have all sorts of derisive-sounding problems with it, and I'm a mental health professional.
posted by OmieWise at 10:33 AM on July 6, 2010 [4 favorites]


See a therapist. See a therapist. See a therapist. Obviously that's the answer to everything. Obviously, nobody here has ever heard of therapists, otherwise why would they be asking us for help? Once we've told them to go see a therapist, our job is done.

Either that, or they should read that "Feeling Good" book that's allegedly about overcoming psychological problems without meds, even though nearly one half of the new edition is ALL ABOUT psychiatric meds.

Or, alternatively, they should Take This Drug, because it really helped me (or this one dude I know).

Don't bother suggesting any actual coping skills. That's what therapists, self help books, and meds are for.
posted by Sloop John B at 10:34 AM on July 6, 2010 [5 favorites]


oh just DMTFA
posted by infini at 10:38 AM on July 6, 2010


It's parody.
posted by proj at 10:41 AM on July 6, 2010


The best mental health advice I ever got was to smoke a few vials of crack and then fight a monkey bare-handed (pawed in his case). I had never before felt so alive!
posted by Mister_A at 10:41 AM on July 6, 2010 [1 favorite]


there often seems to be a pretty dismissive attitude on the part of a number of commenters

They're psychotic. Don't worry about it.
posted by mazola at 10:43 AM on July 6, 2010


This plate of beans has onions in it.
posted by Devils Rancher at 10:43 AM on July 6, 2010 [3 favorites]


And a hint of cilantro.
posted by Mister_A at 10:43 AM on July 6, 2010 [1 favorite]


I hate cilantro
posted by infini at 10:47 AM on July 6, 2010 [2 favorites]


Don't therapists and self-help books . . . help develop coping skills? Can't meds . . . clear one's mind enough to work on them? Or are you just trying to prove the OP's point here?

Sure, those things help some people. But really, you don't need AskMe to tell you to see a shrink or take drugs. People come to AskMe with specific problems, and giving them the super-obvious answers (that they've probably already considered) isn't terribly helpful. What's more helpful is to answer someone's question specifically, and give them specific suggestions for dealing with their problems. In x situation, do y. That kind of thing.

Any old asshole can tell you to take drugs or see a shrink. AskMe is valuable if it can tell you something you haven't already heard in a million places.
posted by Sloop John B at 10:49 AM on July 6, 2010 [2 favorites]


I hate cilantro

If you can taste the cilantro, there's too much in the recipe. As an overall flavor-enhancer, it's a brilliant ingredient. There's just way too many kitchen nimrods out there who buy a clump of the stuff and feel compelled to dump the whole thing into a salad or a salsa.
posted by philip-random at 10:55 AM on July 6, 2010 [3 favorites]


there often seems to be a pretty dismissive attitude on the part of a number of commenters. What's up with that?

There are a number of people in the world who are dismissive of certain mental health issues. Some of those people comment on Metafilter.
posted by ericost at 10:55 AM on July 6, 2010 [1 favorite]


A lot of people have difficulty imagining that seemingly normal people in many aspects can suffer from mental health issues. It's not here; it's everywhere.

How many times in your life have you called a person lazy for having no initiative, when it might be completely biologically explained?

How many times are people considered to be antisocial, or jerks, without actually embracing the fact that many times, those are symptoms caused by some underlying psychology?

How many people have fought with someone who has to have things a certain way, not realizing the effect that little things might have on their lives could be catastrophic?

A lot of us assume that unless there's a particularly terrible burden on you, you should be able to deal with life like normal people do. They don't realize their terrible burden is having something that no one but you can really understand and how devastating it can be to feel that way.

As a result of the former, most people are forced to hide their mental illness for fear of being labelled as crazy, or unstable, or whatever, when in fact it's likely more normal than not to have a mental illness of some kind at this point.

We like to see mental illness as a black and white kind of thing, when in fact the majority of us fall into the grey somewhere. Metafilter is an extension of society's inability to understand the prevalence of mental illness and how life, in and of itself, can be harder for you than it is for me.
posted by Hiker at 10:57 AM on July 6, 2010 [19 favorites]


Sloop John B: "Any old asshole can tell you to take drugs or see a shrink. AskMe is valuable if it can tell you something you haven't already heard in a million places."

Yeah, but sometimes you need to have the thing you've heard a million times directed at you by lots of people first. A recent example that sort of pertains:

A buddy is packing up a trailer to move out to Texas from Ohio to be near his daughter that is in the custody of his ex-wife. He fills the trailer up with all the stuff she left behind first to make it easier to deliver and then discovers that there isn't enough room for lots of his stuff. He begins trying to figure out what and how to leave some of his stuff behind. Obviously, he's never gotten over her.

A friend tells him to just leave her stuff behind and let her worry about it. He dismisses it.
I tell him to just leave her stuff behind and let her worry about it. He dismisses it.
My fiance tells him to just leave her stuff behind and let her worry about it. He dismisses it.
Another friend to just leave her stuff behind and let her worry about it. He dismisses it.
His sister tells him to just leave her stuff behind and let her worry about it. It dawns on him, "hey, maybe I should just leave her stuff behind and let her worry about it."

When dealing with psychological hangups, sometimes you need to be repeatedly shouted at to do the right thing.
posted by charred husk at 10:59 AM on July 6, 2010 [5 favorites]


There's just way too many kitchen nimrods out there who buy a clump of the stuff and feel compelled to dump the whole thing into a salad or a salsa.

That's a bit unfair. Some of us kitchen nimrods grow clumps before the compulsion to dump the whole thing into salsa takes control.
posted by DU at 11:02 AM on July 6, 2010


I suspect some folks simply feel vindicated when they can say dismiss people anonymously over the internet. It's frustrating because on the Blue, no one is asking a specific question there is no mod oversight to make sure that people aren't snarking at people who may in fact be suffering the way they would on the Green.

Whether it's a lack of empathy as kalessin suggests, or perhaps a manifestation of some personal insecurities, it's a pain in the ass. It would be nice to be able to have a normal conversation about a topic without people declaring that this is what happens when parents are too lenient or indulgent with their children. It's unfortunate, too. By dismissing, shunning or mocking those who are dealing with the realities of eating disorders, they're perpetuating a common cultural problem. People with OCD, eating disorders or who self-harm often feel they have to hide their problems out of shame and/or embarrassment. As a result, it can be more difficult for them to find find and reach out for the help they need.

Mocking people for their problems is harmful and wrong. It's a shame that this isn't more widely understood.
posted by zarq at 11:04 AM on July 6, 2010 [9 favorites]


"All we ever seem to do here is recommend that people get therapy."

I blame the Avalanches.
posted by Eideteker at 11:05 AM on July 6, 2010 [14 favorites]


I get that you think therapy and drugs and Feeling Good are overrated. That doesn't mean that they are.

What I'm saying is that whatever value you place in the obvious answers, chances are that the asker has heard them before. So perhaps it is not sufficient to dismissively suggest the most popular and obvious answers and then just call it a day.
posted by Sloop John B at 11:05 AM on July 6, 2010


When dealing with psychological hangups, sometimes you need to be repeatedly shouted at to do the right thing.

Perhaps. I wouldn't discount the value people rightfully place on objective advice from outsiders, though.
posted by zarq at 11:07 AM on July 6, 2010


Because psychology is a complex field but, at it's heart there are fundamental questions of personality, mind and identity that are (thus far) so completely unanswered that laymen can and do have meaningful opinions about them.

One of those opinions, held by many people, is that the circumstances described by some DSM-identified conditions (for example, ADD) are not substantially different than other circumstances (for example, laziness and distractibility) which are rightly defined as personality quirks and personal challenges to be overcome like any other.

It's not a wholly unreasonable opinion. But it's a difficult topic to have a reasoned discussion about not least because some other people have their very sense of identity tied up in an opposing assumption. Also, if there were an easy answer to these sorts of questions than psychology/cognitive-science would be a very different field.

That said, there is a difference between saying "I feel like the line between ADD and simple distractibility is so thin as to be meaningless" and saying "ADD? Sack up and take responsibility for yourself, already."

It would be nice if people with opinions like this could tend more towards the former.
posted by 256 at 11:12 AM on July 6, 2010 [5 favorites]


What I'm saying is that whatever value you place in the obvious answers, chances are that the asker has heard them before.

I think the value is in reinforcing the best answer you can think of, not brainstorming for new ideas for the sake of it.

If you've ever been to an intervention, the most powerful part is how everyone agrees that you need help, not that addiction is a new concept the person hasn't heard before, or that the consequences aren't obvious.
posted by Hiker at 11:18 AM on July 6, 2010


Are we not allowed to be dismissive of a particular mental disorder ("picky eating"), for fear of seeming dismissive of all mental disorders? I'm not sure how that follows.
posted by Jaltcoh at 11:20 AM on July 6, 2010


Okay, then let's just say "fuck it" and add some text to the AskMe post form.

"If you're asking about a psychological problem, please see a therapist, take drugs, and read a book that's supposed to be about not taking drugs but actually devotes half of its volume to the taking of drugs. All problems are the same and have the same answers. Additionally, people are kind of slow, kind of like small children and animals, so you just need to endlessly repeat the same advice they've heard everywhere else."

I see no problem with this.
posted by Sloop John B at 11:26 AM on July 6, 2010


Jaltcoh, the meta reads "I've noticed that in posts dealing with OCD, anxiety, depression, or other related mental health issues (most recently this [picky eating] thread, though maybe that's not the best example)." Are you responding to something else?
posted by fleacircus at 11:27 AM on July 6, 2010


No, I'm not responding to something else, and I am aware of how the MeTa reads.
posted by Jaltcoh at 11:28 AM on July 6, 2010


People come in all sorts of varieties. Some people have OCD, some are depressed, some are picky eaters, and some have dismissive attitudes.
posted by ODiV at 11:29 AM on July 6, 2010


Are we not allowed to be dismissive of a particular mental disorder ("picky eating"), for fear of seeming dismissive of all mental disorders? I'm not sure how that follows.

Perhaps not being dismissive of people who are dealing with something you have no personal experience with would be a good start.

I thought nev's comment in the thread made a decent point:
The line between a disorder and a personality quirk is the point at which the issue negatively affects your quality of life (or that of people who are close to you). If you cope by mostly eating at home that's totally cool. If you're lying to people around you or obsessively fearing for your children's health, that's probably a disorder.

posted by zarq at 11:33 AM on July 6, 2010


Try talking objectively about obesity and the efficacy of dieting and exercise, it really brings out the ugly on the blue. You could try a discussion on the relative merits of Zionism or Mac vs. Windows or the latest Lady Gaga video. There are lots of button pushing issues for Mefites.

For most psychological issues, I think unless people experienced some aspect of it either first hand or with some one close to them, them are very libel to dismiss the problem. With picky eating it's very easy to see the "My Mom made us eat everything on our plate" trope or the "my kids were picky eaters when they were young, but grew out of it" trope being offered as the conventional wisdom, because most kids are, to some degree, picky eaters and they do generally grow out of it. What is not common is an 18 year old who will only eat strawberries, dry toast and boiled hot dogs. That's when it becomes obvious that this is probably a symptom of something larger.
posted by doctor_negative at 11:34 AM on July 6, 2010


Perhaps not being dismissive of people who are dealing with something you have no personal experience with would be a good start.

How do you know when someone has had "no personal experience with" what they're commenting about?
posted by Jaltcoh at 11:35 AM on July 6, 2010 [1 favorite]


This is only a legitimate therapeutic modality if the monkey also gets to smoke some crack.

Well of course! And after the fight, we retire to the salon and eat ass-burgers.
posted by Mister_A at 11:35 AM on July 6, 2010


There's just way too many kitchen nimrods out there who buy a clump of the stuff and feel compelled to dump the whole thing into a salad or a salsa.

*cough*

actually that nimrod tends to be mom who will sprinkle chopped coriander (isn't that cilantro?) over everything. I prefer the seeds, roasted adn ground but that's standard spice rack ingredient. subtle flavour that's normal in indian food. its the green leaves everywhere that I hate. and no, they don't taste of soap either :(
posted by infini at 11:38 AM on July 6, 2010


I see no problem with this.

You came in with sore feet. You knew about podiatry before you got here. Did the reinforcement of podiatry on this website change your mind at all?
posted by Hiker at 11:39 AM on July 6, 2010


How do you know when someone has had "no personal experience with" what they're commenting about?

When they say so in their own words.
posted by zarq at 11:39 AM on July 6, 2010


This comment of Hiker's says a lot to me in terms of what's so frustrating with this issue (whole complex of issues).

Second sentence: How many times in your life have you called a person lazy for having no initiative, when it might be completely biologically explained?

Last sentence: We like to see mental illness as a black and white kind of thing, when in fact the majority of us fall into the grey somewhere.

Hiker, sorry to single you out on this, but is it black and white (completely biologically explained) or is it grey? This reminds me of so many complicated discussions I've had over the years, hence, frustration from me.

Personally, I always vote for grey. Not because that's how I wish things to be, but because I've been that lazy, unmotivated, un-initiating guy on the couch. Was I biologically inflicted? Very possibly. But the biggest part of my getting off of that couch was taking responsibility for getting off it. That is, I could blame my schooling, my parenting, my culturing all I wanted, nobody cared more than me about where I was (and wasn't). So I started initiating stuff. I drank less. Smoked less dope. I changed my diet. I watched less TV. I read more books. I started jogging. I walked and took buses instead of driving everywhere. I moved. I got a job. I went back to school. I sought medical assistance.

And so on.
posted by philip-random at 11:42 AM on July 6, 2010 [2 favorites]


And to be sure, people who have such narrowly restricted diets have some mental health challenges. Put me down for, "this is probably a sub-acute manifestation of a known disorder, not a psychiatric disorder in its own right." I think perhaps this is the source of some of the apparent dismissiveness in the thread in question here—the idea that this is some "new" disease, rather than another manifestation of something we already know how to deal with. The specter of disease-mongering looms large over mental health in the USA; I think there is a legitimate fear that designating picky eating as a psychiatric disorder will lead to new therapies of dubious value being developed specifically to treat this "disease."

That said, I don't think this will make it into the DSM as a distinct disorder.
posted by Mister_A at 11:44 AM on July 6, 2010


I don't mind if people are dismissive of my paranoia as long as they STOP CALLING ME A LIAR.

that means you too George Takei

posted by Potomac Avenue at 11:45 AM on July 6, 2010


O mÿ!
posted by Babblesort at 11:51 AM on July 6, 2010 [1 favorite]


Hiker, sorry to single you out on this, but is it black and white (completely biologically explained) or is it grey? This reminds me of so many complicated discussions I've had over the years, hence, frustration from me.

I gave the second line as a particular answer for a particular incident, not as some kind of overreaching "everything you are is biology!" kind of statement. Sorry for the lack of clarity.
posted by Hiker at 11:52 AM on July 6, 2010


Lack of critical thinking? Lack of empathy? Lack of long view? Lack of ability to imagine oneself in another person's footprints?
posted by kalessin

The common phrase you are looking for is "imagine oneself in another person's footshoes"
posted by nola at 11:55 AM on July 6, 2010 [2 favorites]


Footshoes. Footshoes. Footshoes. Footshoes. Footshoes. Footshoes. Footshoes. Footshoes. Footshoes. Footshoes.

If you say it enough it starts to sound ridiculous.

Footshoes. Footshoes. Footshoes. Footshoes. Footshoes. Footshoes.
posted by Mister_A at 11:57 AM on July 6, 2010


But I don't want to imagine my elf doing that.
posted by fleacircus at 11:58 AM on July 6, 2010 [2 favorites]


ORYL? Is this ridiculous?
posted by nola at 11:59 AM on July 6, 2010




its the green leaves everywhere that I hate. and no, they don't taste of soap either :(

Oh, but they do. Nasty nasty soap. Even reeks of it if I have the misfortune to smell it.

Cilantro is evil.
posted by St. Alia of the Bunnies at 12:05 PM on July 6, 2010


Cilantro is evil.

More for the rest of us dirty, dirty sinners, then.
posted by Cool Papa Bell at 12:17 PM on July 6, 2010 [1 favorite]


I don't understand why people care what others eat or don't eat. Seriously, what possible ramifications could this have for you? The only person it affects is my husband, because I won't let him eat a certain food in the house (but he can go out as much as he likes). He'll eat almost anything, but hates a different food that I like. It just doesn't make any sense at all to judge people on what they will or won't eat.

Other things it makes more sense to judge me on:
1) Sometimes I mix patterns with pinstripes
2) I listen to pop music
3) I own an air conditioner
posted by desjardins at 12:26 PM on July 6, 2010


I did not know that cinnamon is a cinnamon of synonym, but now I know and will use it to maximum annoyance.
posted by dirty lies at 12:28 PM on July 6, 2010 [6 favorites]


1) Sometimes I mix patterns with pinstripes

BLASPHEMER!!!!!!!!!!!!!!!!




Heh. ;)
posted by zarq at 12:30 PM on July 6, 2010


Jesus died for somebody's cilantro, but not mine.
posted by ericost at 12:38 PM on July 6, 2010 [1 favorite]


Burhanistan: "Theodicy has little or no place in herbs"

Oh? I can prove cilantro is of the Devil.
JUST TASTE IT!
If you think you like it then you are WRONG!
Keep tasting it until you agree with me.

I'll wait.
posted by charred husk at 12:39 PM on July 6, 2010 [2 favorites]


People for whom cilantro does NOT smell like soap should not be so dismissive of the evils of cilantro when it, in fact, SMELLS LIKE SOAP! More sensitivity towards cilantro hatred, plz!
posted by grapefruitmoon at 12:50 PM on July 6, 2010 [1 favorite]


grapefruitmoon you are an awful person and an unwavering herbalist and you are WORSE THAN GALLAGHER!
posted by Mister_A at 12:55 PM on July 6, 2010


grapefruitmoon you are an awful person and an unwavering herbalist and you are WORSE THAN GALLAGHER!

I'm so bad, I don't know who Gallagher is or what this is a reference to, despite hearing this ALL THE TIME.
posted by grapefruitmoon at 1:07 PM on July 6, 2010


If you added some cilantro to Gallagher he'd be more palatable.
posted by Babblesort at 1:16 PM on July 6, 2010 [1 favorite]


Oh, you know, Gallagher. He started out as a watermelon-smashing prop comic, but he became most famous as part of the Britrock group Oasis.
posted by box at 1:18 PM on July 6, 2010 [1 favorite]


As the world's foremost Gallagher impersonator (and a noted herbalist and monkey wrestler in my OWN right), i demand that you stop taking Gallagher's name in vain for your simple-minded Internet equivalencies.
posted by OneMonkeysUncle at 1:19 PM on July 6, 2010


I'm with 256.

Foucoult wrote about this. Tl;dr: categorizing something as mental illness has at least as much to do with politics* as it does with anything else. Also, previously. Labeling behavior as meriting medical intervention is enormously philosophically problematic, and the DSM notoriously ignores these problems almost entirely. This alone is reason to be skeptical of the entire enterprise. It's even possible that the human person is not regular enough to be a legitimate subject of scientific inquiry, making the whole discipline of psychology** little more than sophisticated quackery.

So if people are skeptical about the DSM and the "personality disorders" it describes, I think that's all to the good. Despite the psychological priesthood's efforts to the contrary, being "diagnosed" with depression or some other mental/emotional/behavioral issue is not the same thing as being diagnosed with a broken bone or cancer.

*In the larger "ordering of society" sense of the word anyways.

**And possibly even psychiatry, though that discipline actually uses, you know, evidence.
posted by valkyryn at 1:23 PM on July 6, 2010 [1 favorite]


First of all, I view the usage of "see a therapist" in those threads to be the equivalent of IANAL - in other words, "don't use us instead of getting help."

Second of all, going to a therapist is where you GET coping skills when everything else fails. If you've never been at rock effing bottom where nothing makes sense and you walk into that room, that's the first step. So be arrogant about "self reliance" if you want, jackass, but it IS self-reliant to recognize that your problems are larger than you and PROFESSIONAL help might actually be in order.

Going to a therapist is actually more - scary - than many of you might make it seem. If someone is coming to AskMe to ask for help, they probably don't have anyone else they can ask, and people saying "see a therapist" might be the help they need, especially if they have friends who are all about pulling themselves up by their bootstraps! and getting COPING SKILLS!
posted by micawber at 1:25 PM on July 6, 2010 [6 favorites]


I must add that there was a point in my life where I was on a new continent and had no established social network except for my recently made business school friends. I figured I might need help but came from a culture that had no heritage of therapy (Asia doesn't really, to broadly generalize except for serious mental illness etc) It was simply talking to a classmate (ex Annapolis, nuclear submarine engineer type) who said 'no, its not weak to need help for this situation, go' that finally gave me the 'permission' to get help. No regrets. So perhaps that's what the Askme does for the person concerned? who knows... why denigrate him/her or it for it?
posted by infini at 1:31 PM on July 6, 2010 [1 favorite]


there often seems to be a pretty dismissive attitude on the part of a number of commenters.

They are saying what they think. They may be right. Everyone is a little nuts one way or the other, but not everyone needs treatment for it.

But if you're worried that someone won't get the full electroshock they need because some anonymous plumber questions the need for it, don't worry, many, many other people here (probably including several electricians) will always be ready to jump down that plumber's throat and offer to hook up the asker's electrodes personally.
posted by pracowity at 1:43 PM on July 6, 2010


Yeah but this is some top-notch anti-eponystericalism.

Mental health is really, really hard. We as a species are still fumbling in the dark, trying to find the light switch without knowing where the floor is and the porous, ill-fitting generalizations we use to diagnose and treat are indicative of that.

Obviously the truth of any given incidence is going to be somewhere between 'get over it' and 'this pill lets you live your life again'; I don't see that clinicians know how to draw that line without trial and error, how can we expect to do it over the internet?
posted by Skorgu at 1:44 PM on July 6, 2010


Don't blame your defective genes that on evil. Theodicy has little or no place in herbs.

CHING CHING
posted by jquinby at 2:01 PM on July 6, 2010


Furthermore, tbh and honest, often, if one has oneself discovered coping strategies for adverse conditions, perhaps one is more sensitive to the nuance between an asker who may have a real problem vs a whiner?
posted by infini at 2:02 PM on July 6, 2010


valkyryn- I disagree in nearly every respect with your comment.

If you actually read the DSM, you will note that almost every disorder has a particular prerequisite symptom- that of causing distress in the person potentially being diagnosed. You don't get treatment merely for habitually pulling your hair out; if you pull your hair out and it distresses you, then you may qualify for the diagnosis of trichotillomania and get treatment. The only exceptions to this that I am aware of are personality disorders (people that the DSM labels as having personality disorders may be perfectly fine with how they act; perhaps this is what you are talking about?).

When you contrast psychology with psychiatry (in that psychiatry uses evidence), I must assume you are talking about the practice of clinical psychology rather that psychology research, much of which doesn't directly deal with disorders and (being research, what with the experiments and all) is evidence-based. Clinical psychology practice lags behind academia, it is true, but the same is true of any aspect of western medicine, and to say that it doesn't use evidence at all would be unwarranted (e.g. the clinical evidence in favor of the efficacy of CBT).
posted by a snickering nuthatch at 2:35 PM on July 6, 2010


I don't understand why people care what others eat or don't eat. Seriously, what possible ramifications could this have for you?

How can I feel superior if I don't have others to look down on?!
posted by new brand day at 2:42 PM on July 6, 2010


I won't eat maraschino cherries, that fake pistachio flavor, or cilantro. I ate maraschino cherries when I was a kid until I got sick and threw them up...through my nose. To this day even the smell makes me queasy. The fake pistachio flavor? Mad science run amok. But my true hatred is reserved for cilantro. There's a conspiracy if I've ever seen one. Sure, it looks harmless like mint or parsley, and even when you go out of your way to say, "Can I get no cilantro?" some ass in the kitchen still thinks you have no idea what your asking and puts it in anyway. It's like trying to opt out of MSG at a Chinese restaurant. Not that I have anything against yummy MSG, but you just try not getting that flavor enhancer.

The world is an unfair place.

I've got no opinion on OCD, depression, or whatever else this thread may be about.
posted by cjorgensen at 3:11 PM on July 6, 2010 [1 favorite]


If we're ever out to eat somewhere, I will happily eat your maraschino cherry so long as you promise not to vomit it through your nose first.
posted by cortex (staff) at 3:12 PM on July 6, 2010 [3 favorites]


So be arrogant about "self reliance" if you want, jackass

So angry! I think you need to see a therapist.

But seriously...

Some of you are acting like therapists, pharmacies, and "Feeling Good" are the only places one can go for coping skills. And I'm sorry, but that's just crap. People have all kinds of tips and advice to offer. That's the whole point of AskMe. Not every answer needs to come from a paid professional, lab, or book.
posted by Sloop John B at 3:21 PM on July 6, 2010 [1 favorite]


threw them up...through my nose.

it's the multiples that makes this so awesome. Not one cherry, but many? Like, twenty? I'd pay good money to see that.
posted by angrycat at 3:28 PM on July 6, 2010 [1 favorite]


I don't really have a dog in this particular race, Sloop John B, but I think the pushback you're getting is not so much from people who actually do believe that "therapists, pharmacies, and 'Feeling Good' are the only places one can go for coping skills" so much as from people who feel like you came on a little strong with the rejection of answers that reference those things as being a valid part of the mix of responses a question gets.

Clearly not every answer needs to come from a pro or a lab or a book. Lots of folks provide ideas other than that in lots of threads. But those specific things have worked for a lot of people, and as far as that goes they're likely to recommend them if their experiences dealing with situations similar to an asker's seem to recommend it.
posted by cortex (staff) at 3:29 PM on July 6, 2010


Dunno that I've noticed it here, but I have tried to speak up about casual speech - I have OCD, and I cannot STAND IT when people who do not have the condition use it in this context: "I'm so OCD about organizing my business papers." Uh, besides the fact that it's grammatically incorrect (I'm so Obsessive-Compulsive Disorder about blank?"), it's not accurate. Using it in a joking context complete ignores the stress and life-obstacle of dealing with a repetitive compulsion or obsession. I still blame stupid shows like Monk for portraying it like a cute personality quirk (and a goddamn ASSET) instead of a real problem for people who have it.
posted by agregoli at 3:34 PM on July 6, 2010 [3 favorites]


I think the pushback you're getting is not so much from people who actually do believe that "therapists, pharmacies, and 'Feeling Good' are the only places one can go for coping skills" so much as from people who feel like you came on a little strong with the rejection of answers that reference those things as being a valid part of the mix of responses a question gets.

Right. And what I'm trying to say here - and the reason I posted to this thread to begin with - is that, a lot of times, "see a therapist" feels kind of dismissive. Like seeing a therapist is some kind of magical box that makes everything better. Most people know that therapists exist and that they can see them if they want to. I don't think "see a therapist" is terribly useful advice, especially if that advice isn't coupled with some other useful suggestion - as in, "Well, you can do x, y, and z, but I also recommend seeing a therapist."

I kinda wish there was some sort of counter on AskMe posts for "see a professional." It would save everyone some time, and the only responses in the thread would be suggestions that are actually original and specifically tailored to the question.
posted by Sloop John B at 3:38 PM on July 6, 2010 [1 favorite]


Right. And what I'm trying to say here - and the reason I posted to this thread to begin with - is that, a lot of times, "see a therapist" feels kind of dismissive. Like seeing a therapist is some kind of magical box that makes everything better.

It's possible some people are actually being dismissive with their therapy suggestions, but I think the default assumption needs to be that people are suggesting therapy because in their experience that seems like an appropriate approach to what the asker is dealing with. You certainly don't have to agree with those assessments, but it's possible that in your disagreement you're assigning a dismissive reading that isn't there in the answerer's intentions.

And I agree in general that something like "get therapy" without some actual context is not a great answer. But the same goes for pretty much any short directive as an answer; it's basically always, always better to include some context for an answer that involves taking one of several possible courses of action, so the asker (and other readers, and other answerers) can understand where a suggestion is coming from.
posted by cortex (staff) at 4:02 PM on July 6, 2010 [1 favorite]


cortex - okay. I dig what you're saying.

Also, aside from the therapist thing, I specifically have a beef with that "Feeling Good" book. Mostly because it's been touted all over AskMe as a way to get over depression without using drugs. In fact, the subheading on the first edition was, "The clinically-proven drug-free treatment for depression."

And then I ordered the book, and like half of it was all about meds. In the first chapter, the guy says something ultra cheesy like, "Although I usually try to start out my patients without drugs, if they don't show any improvement after a few months, I start them out on an antidepressant to put some 'high octane' in their therapy."

And I'm like, Fuck You Mister High Octane. I felt so totally fucking ripped off. I would have sent the book back for a refund, but it was only like $10 and not worth it. But man was I pissed.

I mean, yeah, I know, meds have helped a lot of people, and blah blah blah blah blah, and that's fine for people who want to take meds. But that's not why I bought the book.
posted by Sloop John B at 4:16 PM on July 6, 2010


Not one cherry, but many? Like, twenty?

Oh no, if was a jarful. My mother had them in the basement with the other canned foods. I'd hit the jackpot! I was maybe three. I only stopped when I'd eaten them all. Then, like that scene in "The Witches of Eastwick" (which wouldn't happen for another 14 years) I projected a good two or three jars. Never touched one again.
posted by cjorgensen at 4:27 PM on July 6, 2010


I mean, yeah, I know, meds have helped a lot of people, and blah blah blah blah blah, and that's fine for people who want to take meds. But that's not why I bought the book.

Beyond looking at what percentage that covered meds, did you read the book? Because it seriously has nothing to do with meds. Far as I can tell, they're just listed as a reference because they're so confusing.

Also, yes, ultra cheesy. The dialogues were hilarious.
posted by zennie at 4:47 PM on July 6, 2010


I bought cilantro plants once, about a decade ago. Then I smelled them.

I'll never forget it. It was HORRIBLE. I almost gag just thinking about it.
posted by St. Alia of the Bunnies at 5:22 PM on July 6, 2010


You cilantro people and your cilantro love/hate, I swear..

It's eggs that I have a problem with. I cannot believe people eat these horrifying things. It's a giant single cell. It smells like sulfur, one of the objectively nastier smells right below decomposition. What the hell. Down with eggs!
posted by cj_ at 5:41 PM on July 6, 2010 [2 favorites]


We/re all crazy.
posted by The Whelk at 6:29 PM on July 6, 2010


Well, some people believe that these kinds of conditions are overdiagnosed, or that self-diagnoses of these kinds of conditions are likely to be overstated or otherwise inaccurate

Ironic that they are apparently making these "diagnoses" without medical degrees or meeting the people involved, isn't it?
posted by Ironmouth at 6:32 PM on July 6, 2010


The idea that we are too unique to be adequately measured or studied would hold that neurology is "quackery" as well.

I've got no beef with neurology, the science of nerves and the nervous system. Not much of a beef with psychiatry, the medical discipline dedicated to disorders of brain function. My beef is with psychology, the attempt to scientifically study the human person.

My objection is both scientific and philosophical. It isn't that we're unique. It's that we're 1) unstable, and, if you believe in such things, 2) moral agents.

Any serious statistician will tell you that where n equals one, you've got no validity. Psychology, in its most rigorous form, attempts to use statistics to model individual behavior. You can know general things about human behavior by looking at the way large numbers of people behave in certain circumstances, but you can't know how any single one of them will react with anything like scientific rigor. You can, at best, make vague, general predictions.

Yet instead, we categorize with incredibly narrow definitions, draw fine distinctions between seemingly similar behavior, and, most importantly, leave little room for agency.

And there's my philosophical beef. Psychology leaves no room for human agency. Rather than a flaw in one's character, the DSM diagnoses medical conditions which are treatable, sometimes by talking, sometimes by drugs, sometimes by role-playing, etc. etc. etc. The application of will is explicitly de-emphasized a lot of the time, as the idea is to make deviant behavior amoral. "It's not my fault I can't hold down a job, I've got clinical whosiwhatsit. My doctor said so!"

Now that's a straw man, and I know it. And let me clarify: just because I don't think psychology is science doesn't mean that I think it's useless. We've learned many, many useful things about the human person through the discipline. Just because knowledge isn't scientific doesn't mean it isn't knowledge. But it does mean that we shouldn't treat it in the same way we do harder sciences.

Similarly, I know full well that some personal/personality problems have a medical component. I've met schizophrenics. They're no-shit for-serious screwed up, lithium really does work a lot of the time, and danged if I don't want them to have it.

But all of these things--the malleability of individual personalities, the intricacies of moral agency, and the reality of physical brokenness--blend together in ways which, as I suggested above, the DSM utterly fails to capture. It's too ambitious and too simple a model. It takes what should have been a general rule of thumb--most people act like this when they see that--and turns it into law--if you display four of these six "symptoms", you get that pill. Or maybe that one.

We should be able to say that psychological problems have a moral component without "blaming the victim," and we should be skeptical of any project to mathematicize something as ephemeral and complex as the human person. Again, not because we're unique, but because we aren't the sorts of things you can do math about.

There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.
posted by valkyryn at 6:51 PM on July 6, 2010 [2 favorites]


Lithium is for bipolar, not schizopherenia. Unless you mean type one schizoactive bipolars.
posted by St. Alia of the Bunnies at 7:07 PM on July 6, 2010


I just went out into a crowded street and started telling everyone my personal issues, some people were frankly dismissive - whats up with that ?
posted by sgt.serenity at 7:11 PM on July 6, 2010


Poached Eggs with Tomato Cilantro Sauce
Gourmet | August 2005 (by way of epicurious)

yield: Makes 4 servings
active time: 30 min
total time: 35 min
In Mexico, this breakfast dish is called huevos ahogados, meaning "drowned eggs," since the eggs are served in soup bowls with a lot of sauce.


Ingredients
• 1 teaspoon distilled white vinegar
• 2 lb tomatoes, coarsely chopped
• 2 large garlic cloves, coarsely chopped
• 1 small fresh green serrano chile, coarsely chopped
• 1 teaspoon salt, or to taste
• 1/2 teaspoon sugar, or to taste
• 1 cup water
• 1/4 cup plus 1 tablespoon olive oil
• 1/4 cup chopped fresh cilantro plus additional for sprinkling
• 8 (1/2-inch-thick) slices of baguette
• 8 large eggs

Preparation
Put oven rack in middle position and preheat oven to 350°F.
Fill a deep 12-inch skillet with 1 1/2 inches cold water. Add vinegar and bring to a simmer. Meanwhile, purée tomatoes, garlic, chile, 1 teaspoon salt, 1/2 teaspoon sugar, and 1 cup water in a blender until smooth, then pour through a medium-mesh sieve into a bowl, pressing hard on and then discarding solids.
Heat 1/4 cup oil in a 12-inch heavy skillet over moderately high heat until hot but not smoking, then carefully pour in tomato sauce (it will splatter). Stir in cilantro and briskly simmer, uncovered, stirring occasionally, until sauce is slightly thickened, about 10 minutes. Stir in salt and sugar to taste, then reduce heat to low.
While sauce simmers, put baguette slices in a shallow baking pan and brush with remaining tablespoon oil and season lightly with salt and pepper. Bake until just crisp on top, about 10 minutes. Keep toasts warm in turned-off oven.
Meanwhile, break eggs, 2 at a time, into a cup, then slide eggs into simmering water, spacing them in skillet, and poach at a bare simmer until whites are firm but yolks are still runny, 4 to 5 minutes.
Gently transfer eggs with a slotted spoon to soup bowls and season with salt. Spoon sauce generously over eggs and sprinkle with cilantro. Serve with toasts.
posted by toodleydoodley at 7:27 PM on July 6, 2010 [3 favorites]


I like the smell of sulfur.
posted by that girl at 8:03 PM on July 6, 2010


I don't like the smell of sulfur, but I do like eggs and cilantro. Yep, you guessed it: Pisces.
posted by rhizome at 8:09 PM on July 6, 2010


BRUCE. Robert is schizophrenic. Did you hear me?
ROBERT. No, he's BPD.
BRUCE. He's a Type 1 Schizophrenic with Positive Symptoms including Paranoid Tendencies. Probably Thought Disorder as well.
ROBERT. Is he delusional?
BRUCE. Sometimes.
ROBERT. How delusional?
BRUCE. Give me time and I'll show you.
ROBERT. You haven't got time. He's been here a month. He's been steadily improving - it's therefore a brief Psychotic Episode associated with BPD. Nothing more insidious.
BRUCE. He's paranoid. You heard him.
ROBERT. How does BPD with Paranoia sound? Stick to the ICD 10 Classification.
BRUCE. You love the ICD 10, don't you? All the different euphemisms for "He's Nuts" without actually having to admit he's nuts. It's like your Linus blanket.
ROBERT. OK. BPD and A Bit Nuts.

[via]
posted by mykescipark at 8:20 PM on July 6, 2010


I just went out into a crowded street and started telling everyone my personal issues, some people were frankly dismissive - whats up with that?

Actually, this raises an interesting point - to what degree should mental health issues remain "personal issues," not to be spoken of in polite company? I mean, as someone with OCD who thinks that visibility is super important, I'd personally say "fuck that," but hey, it raises an interesting point.
posted by OverlappingElvis at 8:37 PM on July 6, 2010


Poached Eggs with Tomato Cilantro Sauce

Well played. Any way you can work seafood in there somehow, so as to aliente every picky eater in one shot?
posted by cj_ at 1:23 AM on July 7, 2010 [1 favorite]


Not much of a beef with psychiatry, the medical discipline dedicated to disorders of brain function.

I don't think you know much about psychiatry.
posted by OmieWise at 4:43 AM on July 7, 2010


I tend to think it's too touchy feely, and there's too much of an emphasis on medication and therapy. I guess this probably goes to show that there's some confirmation bias going on either for me, for you, or for both of us.

To the matter in hand.

I'm wary of going along with people who tell me that they've got a specific problem. This is because they're likely the least able to diagnose what's wrong with them.

I'm also wary of people who'll randomly pick up on symptoms, and tell everyone that the symptoms are exactly the same as ones they've got, so this must mean the person has exactly the same mental issue, and needs the exact same fix.

I'm also wary of people who'll take the "medication will sort you out" route. Firstly, because I have some issues with brain drugs, but more importantly because the people who insist you need brain drugs tend to be more emotionally manipulative when putting forward their argument.

Now - I've got my view, and I tend to error on the side of "pull yourself together."

Without going into the whole "She was disturbed but functional, and they turned her into a fricking zombie, and we all lost her." story, I'll just say that the reason I hold the beliefs I hold are deeply personal.

So when I see that my position is described as unempathic and dismissive (this has happened before; not just here), it really upsets me. And when my non-professional viewpoint is blasted by other non-professionals as being dangerous and simply wrong, that upsets me too.

It's only a matter of time before one side or the other gives some dangerous advice. I hope these sort of questions are banned, or we develop a way of dealing properly with them before that happens.
posted by seanyboy at 9:30 AM on July 7, 2010 [3 favorites]


What really intrigued me about that thread is the sheer number of picky eaters that outed themselves. When it comes to selection bias, there was something really amazing going on. I don't know that many really picky eaters-- one friend of mine hates onions, and is therefore the canonical example of pickiness in my circle of friends-- but I suspect that the number of people with Weird Eating Preferences* has to be 20% or less of the general population. Yet over and over and over again strange people were talking about how they don't staple foods.

*If you don't like one or more of the following, you are a weirdo: eggs, peppers, onions, tomatoes. I will give you a pass on cilantro, even though it is awesome, because I hear there is some genetic thing going on there. I will give you a pass on seafood, because it is getting rare and you need to save some for me.
posted by norm at 3:22 PM on July 7, 2010


Sloop John B: Most people know that therapists exist and that they can see them if they want to.

No. People know therapists exist but that does not mean they know they are accessible, or that they themselves should access them.

I come from NYC and a reasonably well-off family. I had a shrink by the time I was 12, and so did everyone else I knew. Therapy was very much a routine thing, like you had a doctor, a dentist and a therapist. Therapists are very much within the toolset I feel comfortable reaching for.

My husband is from a much more working class background. Therapy is like an exotic island to his family - it's somewhere they understand other people go but it simply isn't part of their real world. Plenty of people know therapists exist but it simply would never occur to them to apply that concept to themselves until someone says "You should see a therapist."

I don't think "see a therapist" is terribly useful advice, especially if that advice isn't coupled with some other useful suggestion - as in, "Well, you can do x, y, and z, but I also recommend seeing a therapist."

For the above reason, I think it is often useful. I think some people need that lightbulb moment, or need validation that yes, they really do need help that significantly. it's pretty common for me to read threads here along the lines of:

How can I be less tired? My life is the following array of complete misery . Do you think I should eat more vegetables?

And I think NO DUDE YOU'RE DEPRESSED. PLEASE SEE A DOCTOR. YOU FIX THIS WITH PROZAC, NOT BROCCOLI.

But it really never occurs to people that they're depressed, or that this feeling is so far outside normal that it actually warrants serious attention. They need to be told to see a fucking a doctor, and while they're at it, call a therapist.

So genuinely, I think "see a therapist" is often not only a legitimate and useful answer, but the best answer.
posted by DarlingBri at 4:47 PM on July 7, 2010 [2 favorites]


The reason why I'll post "get therapy" in an AskMe thread is pretty simple:

Depression lies.

Depression lies like a MOTHERFUCKER. Depression tells you that your misery, your apathy, your inability to get even the most basic of your shit together, is ALL YOUR FAULT. Maybe other people have a legitimate mental illness, but not you: you have a character flaw. You would know if you were really depressed, right? I mean, it's your brain! You don't need therapy; therapy is for people who are really sick. You're just lazy and stupid and if you went to therapy you'd be paying some guy to pretend to be your friend while people who were really sick starved in China, or something.

So when someone posts to AskMe "Why am I so lazy and worthless and unmotivated and utterly unable to get my shit together and miserable?" I will often say "My friend, the experience you are describing is very similar to my experience of Clinical Fucking Depression, and I tell you true, therapy is something to try even if just to rule out its effectiveness." And I will say this even if others in the thread have said the same thing, because sometimes you need an entire chorus of helpful strangers to drown out the liar in your head that is Depression.
posted by KathrynT at 10:47 AM on July 8, 2010 [9 favorites]


Poached Eggs with Tomato Cilantro Sauce

Well played. Any way you can work seafood in there somehow, so as to aliente every picky eater in one shot?
posted by cj_ at 4:23 AM on July 7 [1 favorite -] Favorite added! [!]


I obviously lack commitment to the googles. Come to my house and I'll whip you something up ;-)
posted by toodleydoodley at 7:30 PM on July 8, 2010


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