Category Archives: Psychotherapy

Is Psychiatry a Pseudoscience?

Vancouver! Vancouver! This is it!: I think Mr Lindsay would do well to read Crazy Like Us if he hasn’t already.

Is psychiatry a pseudoscience?

Yes and no. That is, the phenomena of mental illness are genuine, but their investigation is sorely lacking in rigor. This added to the fact that psychiatry is a business in the US and the Anglosphere more generally results in huge over-diagnosis, pathologizing difference, etc., and children are the easiest marks for this con.

As someone who works with people who have actual diagnosed DSM disorders on a regular basis, I definitely think that a lot of these things are real, and they are indeed disorders. We actually try very hard not to pathologize anything that could remotely be seen as normal conduct, and we cast a wide net for that phrase.

The people I deal with have Axis 1 disorders, and they are suffering from the most incredible pain and misery. Many of them are almost literally living in Hell. I lost one client to suicide. Further, the disorder often makes it very hard for them to function well in society. It’s not uncommon that I have clients who have been hospitalized, sometimes on multiple occasions.

Axis 2 is real too. Those are real disorders. I have known some people on Axis 2 (personality disorders), and trust me, they are not normal in any way, shape or form. Mostly they are making other people miserable, but the disorder is usually screwing up their own life in a big way too.

As far as psychiatry being a pseudoscience, well, I get people who are misdiagnosed all the time. I’m not allowed to give legal DSM diagnoses, but I tell them my opinion on what they have and how they are misdiagnosed. Often I get people diagnosed psychotic who are not psychotic at all.

Some of them are pretty crazy, but just because you feel really nuts does not mean you are psychotic. Psychosis is a loss of touch with reality. If you are not out of touch with reality, you are not psychotic. Psychosis is grossly misdiagnosed in the US. If you feel really crazy, you get diagnosed “psychotic.” It is just the field’s way of saying “this person is seriously crazy.” But seriously crazy is not the same thing as psychotic. You would not believe how nuts people can feel without being psychotic. Your world can get seriously weirded out when you are not even psychotic at all.

I also get people who are mis-prescribed all the time. Psychiatrists hand this stuff out like candy and they severely play down the side effects.

In short, yes it’s a real science, but we don’t have formal tests like lab tests or X-rays to actually make a perfect diagnosis. So we have to go on symptoms, and it can be quite hard to diagnose a mentally ill person correctly. I have dealt with people who had been diagnosed with 10-15 different disorders. There was no way that they currently had all of those conditions when I spoke to them. This person was extremely ill though, I would agree with that. Unbelievably ill.

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Filed under Health, Medicine, Mental Illness, Personality Disorders, Psychology, Psychopathology, Psychotherapy, Psychotic Disorders, Science

No, Pathological Narcissism Is Not OK

Even water can kill you if you drink too much of it, and at some point, the normal narcissism continuum that most of if not all humans are on gets to be too much of a good thing, and you are going into pathological narcissism. Usually this is heading towards Narcissistic Personality Disorder or something close to that.

Pathological narcissists are not acceptable. They are not ok. They are not all right. They don’t live longer than others. They’re not happier or healthier than others.

Instead of being ok, the truth is that they are simply ill. It’s not normal for a human being to be that way, as it clashes badly with smooth social and occupational functions. It’s a maladaptive disorder because it turns you into the biggest asshole on the planet, and understandably causes a lot of people to dislike you just about everywhere you go.

People with NPD are generally quite damaging. They tend to damage or harm most of the people they are in relationships with. Why? Because that’s just what they do. They can’t really do anything else. Of course they have no insight, and most are utterly incurable. The longer it goes on, the worse they get, and by the time they are in their 40’s or 50’s, almost all of them are completely hopeless and often profoundly ill cases.

As you might expect, therapy with NPD’s is typically a monumental waste of time and often quite unpleasant for the therapist to boot.

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Filed under Mental Illness, Narcissism, Narcissistic, Personality, Personality Disorders, Psychology, Psychopathology, Psychotherapy

Narcissistic Personality Disorder In Therapy: A Pointless and Unpleasant Endeavor

Like everyone on Axis 2, the person with Narcissistic Personality Disorder thinks they are fine. Obviously the problem is everybody else. They will just go through their whole life blaming other people. That’s how they ride.

They rarely if ever show up for therapy, and when they do, it is often at the behest of others who are forcing them into therapy because the narcissists is driving these people insane and ruining their lives. Once in therapy, the narcissist plays games, engages in a boatload of manipulation, does no work on themselves because after all there is nothing to be done, and often engages in a lot of ego and narcissistic games with the therapist, including insulting the therapist, thinking he is better than the therapist and telling him so, deciding that the therapist is a lousy therapist, etc.

If you tell them they are narcissists, will generally either reject the diagnosis, ignore it, blow it off with some humorous blustery remark, decide that psychiatry is a pseudoscience, or say, “So what? I like being this way.”

They might take it as an insult, but they usually will not react aggressively. Instead you will see a spark of recognition and alarm in their eyes. The narcissist is not an idiot. Many are highly intelligent and in fact, sadly it goes with the territory. At some level, most if not all narcissists now what is going on. The problems is they don’t care, or they like to be this way.

If you keep reminding the narcissist of what he is, he will stop being flippant about it and start getting aggressive. Expect dirty fighting, devious and crafty manipulation, nasty insults, or walking out of the room. Keep it up, and the narcissist will just end the relationship. The narcissist is not going to sit there and let you call him a narcissist all day. He’s too good for such degrading treatment. If he cannot do that, at some point, he will probably create a nuclear explosion of a fight and try to terrorize you into not bringing up the subject again.

Generally speaking, they are a complete waste of time in the office, therapy with them is often quite unpleasant, and nothing gets done anyway. It’s not uncommon for the therapist to simply fire the narcissist as client, informing him that nothing is getting done. This a relief to the narcissist, as now he has an excuse to quit the degrading therapy. Technically this is client abandonment and an ethics violation, but the decision is always mutual, and nothing was getting done anyway, so why prolong the pointless endeavor?

Theoretically, the narcissist can be cured. Since lions cannot change into tigers, all we can do with personality disorders is turn the bad side of a basic personality type into the good side of that type. The good side of Narcissistic Personality is Confident Personality. These people can be a bit much too, but they are healthy enough that they can function quite well especially in a hyper-competitive capitalist society like ours. The goal of therapy with an NPD is to turn them into a Confident Personality. But good luck with that.

There is so much more to talk about with narcissism and NPD, but let’s leave that for another day.

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Filed under Ethics, Mental Illness, Narcissistic, Personality, Personality Disorders, Psychology, Psychopathology, Psychotherapy

Can Gay Men Still Be Attracted to Women in Some Sort of Way?

I smash one more insane Cultural Left lie below.

The Cultural Left regularly states as one of its theorems that most if not all gay men get turned on by females on a regular basis. Why the Cultural Left wants to insist on this nonsense, I have no idea.

In general, the Cultural Left hates “generalizations.” They don’t want any laws or rules about anything. Or corollaries or theorems. Or well-supported conclusions. It’s scientific nihilism all the way.

We cannot “generalize” (which means form a conclusion by testing a hypothesis against the collected data) about anything on Earth. Nothing means anything. Or everything means nothing. Or nothing means everything. Or everything means everything. Or everything means anything. Or something. Or something. Or whatever. Or mumbo jumbo. Or bullshit.

Oh, and no labels! The Cultural Left hates labels because labels imply definitions and in the wild and woolly bonkers world of the insipid Cultural Left, definitions are generalizations, and generalized conclusions are bigotry. All generalizations are racist, sexist, homophobic, transphobic, ableist, looksist, speciesist or just some generalized form of oppression by the dominant paradigm of whatever the beaten down subaltern of the day is.

If you notice, the asinine scientific nihilism of the Cultural Left is straight out of the social sciences, where notoriously nothing can ever be proven except whatever silly PC theory the social scientist wants to prove, typically with no evidence, while the obvious common sense wisdom of ages is all “scientifically disproven” by a bunch of fake social science studies and is at any rate waved away as racism, sexism, fat-shaming, slut-shaming, homophobia, transphobia or whatever whatever bla bla. Oppression Olympics.

My answer to this question on Quora:

Newsflash: Gay men don’t get turned on by women! Isn’t that shocking?
Most of the gay men posting below are simply lying. Endless studies in the lab have shown that the typical gay men reacts in the following way:

maximal attraction to males

minimal attraction to females

In fact, this is one of the most robust findings in social science! They’ve tested it so many times that no one wants to test it anymore because everyone knows how it comes out.

To put it another way, how many straight men are turned on by men? Most of them are not, and even those that are have quite low levels of attraction to men.
Hard bisexual men are not common. Most men lean hard one way or the other. Most bisexual men lean straight and usually hard straight. A much smaller percentage of bisexual men lean gay ,and many of those lean hard gay. Fully 87% of men with a bisexual orientation in the lab lean straight. The other 13% lean gay and those vary 2/3 leaning hard gay and 1/3 being significantly bisexual.

I have not the faintest idea why all these gay men below are falling all over themselves to lie that they get hard for women on any regular basis.

Is there some sort of shame in not being turned on by women? So you’re not turned on by women? So what? Or as I would say, lucky you, now you don’t have to be driven insane by them like we are!

If you asked a group of straight men on here if we ever get turned on by men, would they be falling all over each other to deliriously confess how they regularly get hard for Brad Pitt? These gay men trying to desperately to prove that they get hard for women strike me as self-haters. The implication being that a man who cannot get turned on by women is defective somehow. Sad.

I work as a psychological counselor. In the course of my counseling, I have many people who come in with problems that involve sexuality in some way. In these cases, I do a sexual orientation assessment of my male clients. Contrary to the nonsense you are reading below about “don’t believe in labels,” the truth is that labels are completely appropriate for men when it comes to sexual orientation.

That is because by no later than age 15, it has been proven in the lab that male sexual orientation is completely fixed. Not only can gay men not be turned straight (as proven endlessly in the lab), but, even more pessimistically than that, gay men cannot even be moved anywhere towards straight on the orientation scale. A 0-100 gay man cannot even become 10-90. A 20-80 gay man cannot become even a 30-70.

There is no data on whether straight men can turn gay, but if it works one way, it must work the other. In fact, there is one intriguing case in the literature of a miserable and hopelessly heterosexual male college student who hated women and desperately wanted to be gay. He spent most of his time hanging around gay men trying to turn gay. He told the clinician that he had tried everything he could think of to turn gay, and nothing had worked.

We men are simply up the creek as far as our orientation goes. We are whatever we got wired up to be, and that’s that.

The sexual orientation assessment simply assesses what the man was turned on by as a child and then up until age 15, as I don’t care what happened after that, as nothing could have happened anyway. All gay men told me that they were strongly attracted to males from puberty on, and some told me that they were into males even as early as childhood. Most of them reported no attraction to females during childhood, puberty and adolescence.

So far, all of my gay male clients have told me that in general:

  • They rarely look at women and check them out sexually, in most cases never do so. They’re checking out the guys, all guys, all the time.
  • Even more importantly, they never fantasize about sex with women. Like never, ever. All men, all the time.
  • Perhaps most importantly of all, they never think about women when they masturbate. Not even once, ever. It’s all men, all the time.

I have not yet had one gay man in my practice who had any significant attraction to women. Now that’s anecdotal, not scientific, but it ought to tell you something.

Some of the men above who showed no significant reaction to women had identified as 25-75 bisexuals to me on my scale, which is reasonably bisexual. A 25-75 man is maximally attracted to males and attracted to females at only half that rate. However, my 25-75’s practically speaking had no real attraction to women at all. So you see gay men often identify themselves as much more bisexual than they are.

Furthermore, in interviews with women married to closeted gay men, the wives say that their husbands displayed no interest at all in their bodies, even when they were naked. The husbands were often fascinated with male bodies, some claiming to be sports fans and collecting bodybuilder or other magazines that showcase jacked handsome men. They report that their husbands showed a particular aversion to cunnilingus.

The husbands often preferred sex from the rear position, and some liked anal sex a bit too much, if you catch my drift. Others reported that the husband showed little or no interest in sex. Reports of longterm impotence among closeted gay husbands are common. Girlfriends have told me that they have disrobed partially or fully in front of gay or suspected gay men, and the gay men did not look at them for one second and even acted like nothing in the room had changed!

This has actually been born out in the lab, as until recently all studies of so called “bisexual” men found that they tested in the lab exactly the same way as gay men:

  • maximally to men
  • minimally to women

The researchers concluded that “bisexual” men were simply gay men who cannot accept being gay due to stigma or prejudice, so they identify as bisexual because that is more acceptable to society.

This scenario continues to this day, as males in their late teens on through their 20’s identify at fairly high rates as “bisexual.” A common scenario is young men in their 20’s identifying as “bisexual” while they have wives or girlfriends. Yet these men spend most of their free time in gay bars and clubs. If you follow these men to age 30, you will find out that nearly of them have come fully out as gay by then. It simply took them all through their 20’s to accept that they were gay. Sad.

However a study was recently reported where researchers found a group of “bisexual” men who were actually bisexual in that they reacted significantly to both men and women in the lab. So it appears that they do exist. However, pure bisexual men or 50-50’s seem to be quite rare. Surveys show that only 1% of men can be classified this way.

Men are leaners. We either lean straight or we lean gay, often pretty hard one way or the other. This is even true of bisexual men. I do not know why this is, but that is what the research shows us.

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Filed under Cultural Marxists, Gender Studies, Heterosexuality, Homosexuality, Left, Man World, Psychology, Psychotherapy, Science, Scum, Sex

Repost: How Common Is Sex among Siblings among Teenagers and Young Adults?

One of the more shocking posts to have appeared on this site is this post about incest among siblings. It is getting reposted around a lot these days, so I thought I would repost it for those of you who might have missed it the first time. I honestly think this behavior is much more common than realized. I also think that in most cases is not pathological, as it is quite consensual, and even where it is abusive, I would recommend therapy instead of incarceration for the abuser, typically a teenage boy molesting his sister or female cousins. 

Sammy writes:

“Brothers and sisters fuck quite a bit, as teenagers…”

Really? Brothers and sisters who grew up together from day one in the same household? How do you know of this? I’ve heard of it happening between step brothers and sisters, but never heard of it happening between actual “blood” brothers and sisters who both share the same parents and grew up in the same household. Percentage-wise, how often would you say the latter happens (and what are you basing this on)?

Unfortunately a lot of this falls under the category of “child molestation,” but it usually isn’t. A lot of teenage boys have sex with their vulnerable younger sisters. With the sisters, it is often more or less consensual. Childhood sex play often involves brothers, sisters, cousins, and their friends. The age ranges of childhood sex play can range from six all the way up to 15 for both sexes, and it is possible that all ages can be involved at the same time. For instance, scenes, often with brothers, sisters and cousins, can occur with groups where the age ranges from 8 all the way up to 15 and can include both homosexual (often lesbian) and heterosexual conduct.

Not only do brothers and sisters have sexual experiences particularly in adolescence, but sisters have a lot more sex with each other than you could possibly imagine. Young teenage sisters around the ages of 13-15 who are just discovering the joys of masturbation (as almost all teenage girls are nowadays at a very early age, typically 13) have lesbian sex with each other, mutually masturbate each other, etc. I would say that maybe 5-10% of sisters in this age group engage in this activity. All of the cases I saw involved girls with a predominantly heterosexual orientation. So most sisters who are doing this are not lesbians. Instead they are straight or possibly bisexual.

I discovered a lot of this activity when looking through forums where younger teenage girls were discussing sexual issues such as onset of first pubic hair and sexarche, onset and frequency of masturbation, and some other sexual things. It is from these forums that I derive my 5-10% figure because ~5-10% of the girls on the forums admitted to having sex with their sisters. The age range for this sister-sister sex was 13-15.

Sources: I work as a counselor, and I hear stories of childhood sex play from clients constantly.

Teenage boys having sex with their younger sisters is extremely common as we can see from recent famous cases. It is typically brushed under the carpet, as it possibly ought to be.

Arrest in these circumstances is just wrong, and in California, other than rape, all sex between juveniles of all ages is legal. You simply cannot arrest two kids for doing consensual sexual things with each other. If there is a serious age discrepancy with a teenager (usually a boy and typically a brother) doing sexual things with a young child (usually a girl and typically a sister), the teenager must be told that this is unacceptable and must stop, and they should have to undergo counseling.

Generally this sort of thing is handled by Social Services, social workers and therapists in California and not law enforcement, which is how it ought to be. In extreme cases of teenage boys serially molesting young girls, they may be remanded to the juvenile justice system, but they may not be tried in the adult system. At any rate, clinically this behavior means little as according to the DSM, pedophilia cannot be diagnosed in people age 16 or younger.

There are videos on the Internet of brothers having sex with their sisters or at least of people claiming to be brothers having sex with sisters. I have no idea how old they were, but they appeared to be older teenagers. I felt that they were genuine.

To give you an example of how common this activity can be at least in certain circumstances, in Egypt, due to a housing crisis, young people are not able to move out of the parental home, so young adults of the same family are often living under the same roof. Not only that, but living conditions are so overcrowded that these late teens and  young adults are often sleeping in close quarters in living rooms, etc.

A recent article in the US press noted that there is an extremely high level of sexual activity among brothers and sisters occurring in urban Egypt in these circumstances. The brothers and sisters engaging in this activity were ~16-23. Egyptian society didn’t seem to be interested in doing anything about it. I assume that this behavior was either denied, brushed under the carpet or dealt with in the family, probably by silence and willful ignorance. Law enforcement was not getting involved.

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Filed under Africa, Crime, Egypt, Heterosexuality, Incest, Law, Law enforcement, North Africa, Pedophilia, Psychology, Psychotherapy, Regional, Sex, Social Problems, Sociology

Can Gay Men Still Be Attracted to Women in Some Sort of Way?

I smash one more insane Cultural Left lie below.

The Cultural Left regularly states as one of its theorems that most if not all gay men get turned on by females on a regular basis. Why the Cultural Left wants to insist on this nonsense, I have no idea.

In general, the Cultural Left hates “generalizations.” They don’t want any laws or rules about anything. Or corollaries or theorems. Or well-supported conclusions. It’s scientific nihilism all the way.

We cannot “generalize” (which means form a conclusion by testing a hypothesis against the collected data) about anything on Earth. Nothing means anything. Or everything means nothing. Or nothing means everything. Or everything means everything. Or everything means anything. Or something. Or something. Or whatever. Or mumbo jumbo. Or bullshit.

Oh, and no labels! The Cultural Left hates labels because labels imply definitions and in the wild and woolly bonkers world of the insipid Cultural Left, definitions are generalizations, and generalized conclusions are bigotry. All generalizations are racist, sexist, homophobic, transphobic, ableist, looksist, speciesist or just some generalized form of oppression by the dominant paradigm of whatever the beaten down subaltern of the day is.

If you notice, the asinine scientific nihilism of the Cultural Left is straight out of the social sciences, where notoriously nothing can ever be proven except whatever silly PC theory the social scientist wants to prove, typically with no evidence, while the obvious common sense wisdom of ages is all “scientifically disproven” by a bunch of fake social science studies and is at any rate waved away as racism, sexism, fat-shaming, slut-shaming, homophobia, transphobia or whatever whatever bla bla. Oppression Olympics.

My answer to this question on Quora:

Newsflash: Gay men don’t get turned on by women! Isn’t that shocking?
Most of the gay men posting below are simply lying. Endless studies in the lab have shown that the typical gay men reacts in the following way:

maximal attraction to males

minimal attraction to females

In fact, this is one of the most robust findings in social science! They’ve tested it so many times that no one wants to test it anymore because everyone knows how it comes out.

To put it another way, how many straight men are turned on by men? Most of them are not, and even those that are have quite low levels of attraction to men.
Hard bisexual men are not common. Most men lean hard one way or the other. Most bisexual men lean straight and usually hard straight. A much smaller percentage of bisexual men lean gay ,and many of those lean hard gay. Fully 87% of men with a bisexual orientation in the lab lean straight. The other 13% lean gay and those vary 2/3 leaning hard gay and 1/3 being significantly bisexual.

I have not the faintest idea why all these gay men below are falling all over themselves to lie that they get hard for women on any regular basis.

Is there some sort of shame in not being turned on by women? So you’re not turned on by women? So what? Or as I would say, lucky you, now you don’t have to be driven insane by them like we are!

If you asked a group of straight men on here if we ever get turned on by men, would they be falling all over each other to deliriously confess how they regularly get hard for Brad Pitt? These gay men trying to desperately to prove that they get hard for women strike me as self-haters. The implication being that a man who cannot get turned on by women is defective somehow. Sad.

I work as a psychological counselor. In the course of my counseling, I have many people who come in with problems that involve sexuality in some way. In these cases, I do a sexual orientation assessment of my male clients. Contrary to the nonsense you are reading below about “don’t believe in labels,” the truth is that labels are completely appropriate for men when it comes to sexual orientation.

That is because by no later than age 15, it has been proven in the lab that male sexual orientation is completely fixed. Not only can gay men not be turned straight (as proven endlessly in the lab), but, even more pessimistically than that, gay men cannot even be moved anywhere towards straight on the orientation scale. A 0-100 gay man cannot even become 10-90. A 20-80 gay man cannot become even a 30-70.

There is no data on whether straight men can turn gay, but if it works one way, it must work the other. In fact, there is one intriguing case in the literature of a miserable and hopelessly heterosexual male college student who hated women and desperately wanted to be gay. He spent most of his time hanging around gay men trying to turn gay. He told the clinician that he had tried everything he could think of to turn gay, and nothing had worked.

We men are simply up the creek as far as our orientation goes. We are whatever we got wired up to be, and that’s that.

The sexual orientation assessment simply assesses what the man was turned on by as a child and then up until age 15, as I don’t care what happened after that, as nothing could have happened anyway. All gay men told me that they were strongly attracted to males from puberty on, and some told me that they were into males even as early as childhood. Most of them reported no attraction to females during childhood, puberty and adolescence.

So far, all of my gay male clients have told me that in general:

  • They rarely look at women and check them out sexually, in most cases never do so. They’re checking out the guys, all guys, all the time.
  • Even more importantly, they never fantasize about sex with women. Like never, ever. All men, all the time.
  • Perhaps most importantly of all, they never think about women when they masturbate. Not even once, ever. It’s all men, all the time.

I have not yet had one gay man in my practice who had any significant attraction to women. Now that’s anecdotal, not scientific, but it ought to tell you something.

Some of the men above who showed no significant reaction to women had identified as 25-75 bisexuals to me on my scale, which is reasonably bisexual. A 25-75 man is maximally attracted to males and attracted to females at only half that rate. However, my 25-75’s practically speaking had no real attraction to women at all. So you see gay men often identify themselves as much more bisexual than they are.

Furthermore, in interviews with women married to closeted gay men, the wives say that their husbands displayed no interest at all in their bodies, even when they were naked. The husbands were often fascinated with male bodies, some claiming to be sports fans and collecting bodybuilder or other magazines that showcase jacked handsome men. They report that their husbands showed a particular aversion to cunnilingus.

The husbands often preferred sex from the rear position, and some liked anal sex a bit too much, if you catch my drift. Others reported that the husband showed little or no interest in sex. Reports of longterm impotence among closeted gay husbands are common. Girlfriends have told me that they have disrobed partially or fully in front of gay or suspected gay men, and the gay men did not look at them for one second and even acted like nothing in the room had changed!

This has actually been born out in the lab, as until recently all studies of so called “bisexual” men found that they tested in the lab exactly the same way as gay men:

  • maximally to men
  • minimally to women

The researchers concluded that “bisexual” men were simply gay men who cannot accept being gay due to stigma or prejudice, so they identify as bisexual because that is more acceptable to society.

This scenario continues to this day, as males in their late teens on through their 20’s identify at fairly high rates as “bisexual.” A common scenario is young men in their 20’s identifying as “bisexual” while they have wives or girlfriends. Yet these men spend most of their free time in gay bars and clubs. If you follow these men to age 30, you will find out that nearly of them have come fully out as gay by then. It simply took them all through their 20’s to accept that they were gay. Sad.

However a study was recently reported where researchers found a group of “bisexual” men who were actually bisexual in that they reacted significantly to both men and women in the lab. So it appears that they do exist. However, pure bisexual men or 50-50’s seem to be quite rare. Surveys show that only 1% of men can be classified this way.

Men are leaners. We either lean straight or we lean gay, often pretty hard one way or the other. This is even true of bisexual men. I do not know why this is, but that is what the research shows us.

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Filed under Cultural Marxists, Gender Studies, Heterosexuality, Homosexuality, Left, Man World, Psychology, Psychotherapy, Ridiculousness, Science, Scum, Sex

Narcissistic Personality Disorder, Malignant Narcissism, and Sociopathy/Psychopathy

Whitedawg: I was kind of wondering, commenting about the personality traits/qualities of regular everyday people or elected officials, more so than Teddy. There is little doubt Ted crossed a lot of lines.

But it’s not so evident to most that President-elect Trump may have some serious problems that can influence his decision making and tweeting. Many people know non-serial killing psychopaths, sociopaths, and malignant narcissists. And some of those traits are looked at as positive.

I am not sure how many non-pathological Malignant Narcissists there are out there.

George W. Bush was said to be sociopathic and the same was said about LBJ. Hitler was clearly a psychopath, and he also had Paranoid Personality Disorder.

I have known a number of people who had what I would diagnose as Narcissistic Personality Disorder. At first they may seem likable, but there is something pretty awful about them somehow even when they are being good. The one I knew best caused massive damage to me in my life until I severely restricted contact with them. Another person close to me got to know two NPD’s very well and has recently fallen out with one of them.

NPD’s are harmful! If you get involved with an NPD, you are probably going to get harmed or damaged. It’s just what they do. They harm people. That’s their nature. I would advise any of you if you have any NPD’s in your life to think seriously about whether you want this person in your life or not. It’s possible to have them in your life while causing little or no damage, but more often than that, there’s something toxic about them. If they haven’t hurt you yet, they probably will at some point in the future. I don’t cotton to assholes much, and I’ve suffered far too many of them for one lifetime. I don’t have any NPD’s in my life, and that’s the way I like it.

It’s generally a good idea to get all of the Cluster B Personality Disorder types out of your life. Cluster B is Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder and Narcissistic Personality Disorder.

I have dealt with a few people who seemed pretty sociopathic in my life. They all harmed from me. Some of them stole from me. There is one I know to this day, and he is one of the most frightening people I know. The worst is you think he is nice because he has this sort of awful charm about him, so you go make friends with him again, and that’s always a big mistake. He came into my house, stole a $275 Guatemalan knife hanging on my wall when he had my back turned to him and was out the door. I was told he sold it for $10 to buy weed. He is a Bulldogs gang member, has scars from bullet wounds, and I believe he has a criminal record.

I knew his brother, and he came to my house one day carrying a small gun under his jacket. It was larger than a pistol but smaller than a rifle. I guess it was a semiautomatic. Not knowing guns, to me, it looked like a sawed off shotgun. He was bringing it to the local school where he attended in case he might have to fight his gang enemies. He told me he didn’t care if he lived or died anymore. He was only 19 years old when he told me that, a mere boy.

Last time he came over, I let him in and we sat down and watched some videos. He took out a very large knife and put it on the table. He said he did it to put me at ease. I actually did not mind that he did that. I prefer that if people are armed when they see me that they remove their weapons and place them on some furniture near us. That sort of evens the score a bit and shows a lot of trust. I suppose either of us could grab the weapon and murder the other person but it never happens. Plus I sort of like to live dangerously like an outlaw, and this is in line with that image.

A destructive sociopath comes into your life like a whirlwind. All sorts of wild and crazy things happen to you for a while, and it is like you are caught up in an exciting tornado thunderstorm. It’s all pretty wild and crazy, and nothing makes much sense, but you just go along because they seem so fun and charming, and these folks have a sort of a “pull” or attraction to them. I know of no other way to describe it but you might call it a forcefield. There is something about them, possibly in the very look in their eyes, that sort of hypnotizes you and sucks you into them and their world.

At some point, the sociopath vanishes from your life, whirling away in the distance like a funnel cloud. You look around at your life, and everything seems to be in ruins. It’s like someone came into your house and turned everything upside down, threw a lot of stuff on the floor, and now everything is a mixed up mess. You and your life have been seriously damaged by some unknown entity. You don’t even know what hit you. You look around at the human wreckage and think of the times when the sociopath was whirling around in your life and you think, “What in the Hell was that, anyway?”

These people don’t make sense. I have been studying sociopaths forever, and I have even done some psychological counseling with sociopaths. If they are young enough, you can still work with them to some extent and maybe prevent serious damage in the future. After decades of studying sociopaths, they still don’t make sense to me. I think the only way to understand sociopaths is to be one.

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Filed under Antisocial, Borderline, Crime, Democrats, Mental Illness, Narcissistic, Personality Disorders, Politics, Psychology, Psychopathology, Psychotherapy, Republicans, Serial Killers, US Politics

Lexapro Withdrawals

I usually take:

Wellbutrin 300 mg

Lexapro (SSRI) 30 mg. or even up to 40 mg. as needed

I’ve been on this regimen for a long time now and it works great. As needed is usually pretty frequently. Thing is I went off Lexapro on November 24. So I have been off of it for almost three weeks. 19 days to be exact. I didn’t feel much of anything for a while, but after 2 1/2  weeks, I got hit with a heavy dose of anxiety. I don’t usually experience this sort of thing, but of course I have in the past. The drugs work so well that it seems like do not have much anxiety going on, though others may differ on that. I dated a woman a while ago and she ended it pretty quickly. She said I was really nervous and I was making her nervous. I do some weird movement with my shoulders and I talk in these short, rapid, pressured bursts like I’m on cocaine. Thing was, the whole night of that date, I thought I was calm as an ocean and that is pretty much how I felt. I suppose like most things in life, anxiety is a relative thing. What might be a nervous wreck to one person can be complete calm to another because each  person is comparing the person’s state to a different thing.

Anyway, I think those might have been withdrawals I was experiencing. Here are some frequent withdrawals that people commonly report for Lexapro:

  • “Brain zaps”
  • Tinnitus
  • Nausea/gastrointestinal problems
  • Insomnia
  • Tingling feeling over the whole body
  • Itching all over the body, mostly in the face, arms, chest and stomach
  • Burning/dry skin on hands and forearms
  • Dry tingling mouth
  • Headache, sometimes in the upper neck/spine/migraine
  • Sinus pressure
  • Dilated pupils/blurred vision
  • Joint pains/Severe aches and pain all over the body
  • Pain in back and hips
  • Numbness/Pain in the fingertips
  • Parasthesia
  • No appetite
  • Weight loss
  • Fatigue
  • Mind feeling blank, spaced out, foggy
  • Feeling groggy/Hungover
  • Memory loss
  • Inability to concentrate
  • Disassociation
  • Dizziness
  • Anxiety/Agitation/Panic attacks
  • Out of breath
  • Anger, sometimes in explosive outbursts
  • Mood swings
  • Paranoia/Fear
  • Irritability
  • Eyes distracted by everything
  • Strong urge to cry/Crying jags
  • Sadness

Out of all of this stuff, I am only getting the anxiety/agitation. The rest of those symptoms mostly look pretty horrible, and I am glad I am not getting any of that stuff. But I often do not get a lot of the drug or drug withdrawal side effects that are listed. I don’t know, but I often avoid a lot of them. I am not sure what the mechanism is for why some people get this stuff and others don’t.

Most of this stuff applies to any other SSRI’s too, so if you any of you have taken or are taking these things and wish to discuss side effects/withdrawals, go right ahead and be my guest if you are not shy about revealing personal stuff.

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Filed under Health, Mental Illness, Psychology, Psychopathology, Psychotherapy

Case Study: Mr. X

This was recently posted in the comments, and I am going to approve the comment now. Since this person posted to public Internet comments, I assume they would not have much problem with my posting the comments up as a post. I mean what’s the difference, right?

The individual asked for a differential diagnosis of Schizotypal Personality Disorder and Avoidant Personality Disorder. However, he posted to a post called Differential Diagnosis of Avoidant PD Versus Schizoid PD, so he may want to throw Schizoid PD into the mix also.

I have so many comments to make on this post.

First of all, this individual, who we shall call Mr. X, is not all that unhealthy. I deal with people all the time who are far more unhealthy than this, and sad to say, I myself have even been much worse than this man is for way too long. How long you don’t need to know. Suffice to say, I looked at his comments and wished I had functioned that well when I was in bad shape.

He is able to perform the basic functions of life pretty well. He seems to be able to pack up and move to a new town, which believe it or not, is hard for a lot of adults to do.

He is able to live, survive and function well living alone for a long time now. His place is probably well managed, he probably eats well, etc.  I mean what is  going on inside his front door is pretty healthy.

As far as work goes, I think he is pretty healthy. He ran his own tree-trimming business for years and saved up a lot of money from that. He worked for his father at a drilling business for  several years and functioned well there. He managed to accumulate $500K worth of drilling equipment which he sold, so he is able to make a lot of money in our society. Most people do not have $500K net worth in their 30’s. It’s not that easy to do. He seems to be able to hold jobs, maintain them and function well enough at work to keep at jobs for several years at a time.

Believe it or not, a lot of folks can’t even do that! I’m not even very good at it. I tend to get fired wherever I am because somehow they simply come to dislike me. I’m rarely fired for a good reason because I am a good worker. A few times, I was fired for errors, but they were the sort of jobs where you could make errors even if you were a highly diligent worker. I’ve gotten to the point now where I can survive for up to 1 1/2 years without getting canned,  and that is amazing. I don’t think I am really meant to work with other humans. I probably have to work on my own or resign myself to floating from job to job.

He actually functions a lot better socially than he thinks he does. He is able to make and keep friends. He is able to befriend total strangers. He seems to be a good and loyal friend. In his youth, he was sort of a party animal who hung out all the time and had all sorts of friends. That seems to rule out Avoidant PD right there because no Avoidant PD would have a youth that looked like that and then turn Avoidant in adulthood. With all of the PD’s, we see strong signs of the PD even in  childhood and adolescence.

After all, Axis 2 or PD is meant to describe lifelong patterns. Dramatic behavioral change between adolescence and adulthood would seem to rule out a PD right there because PD’s just don’t look like that. However, he did have some Avoidant traits even back then, and it is perfectly reasonable in this case to diagnose PD traits because I believe that they are there.

He is able to date women, though he does not do so much. He was able to have a four-month relationship which was felt to be “too much,” once again suggesting Avoidant traits. However, a four-month intense relationship is not bad.  Further, he functioned so well in the relationship that the woman fell in love with him, wanted to marry him and even to have his kid. This to me implies that he functions fairly enough well in relationships because if you are a complete relationship retard, the scenario with the woman above really never happens to you.

He wears overalls six days a week, but that’s not pathological. On the other hand, you’re not trying to be the most charismatic man out there when you dress like that. Who are you trying to get? Lady truck drivers?

There is so much more I could say about this case, but for now.

Axis 1: Deferred.

I am going to defer on this for now because to me the main problem is an Axis 2 issue (personality disorder) as opposed to an Axis 1 problem (anxiety, mood or psychotic disorder). Sure, there is some mood and anxiety going on, but it seems to be driven more by the Axis 2 stuff as opposed to being generated on its own, which of course is typical with Axis 2.

Axis 2: Present.

There is definitely an Axis 2 problem here. The person has a longstanding  pattern of behavior that causes him major problems in life that is not related to anything on Axis 1. Instead most if not all of the person’s problems stem from the personality that they have generated for themselves starting in childhood.

There are a lot of problems with other people, and the individual himself seems rather dissatisfied with life. This is because the Axis 2 problem is causing conflicts and difficulties with others and because the Axis 2 problem is getting in the way of him living a happy, fulfilled and self-actualized life. Instead, the Axis 2 problem is causing a life that is lived below the individual’s potential, causing frustration even with the individual himself.

Further and most important of all, the man defends his unhealthy behavior, often fiercely. Obviously this is a core Axis 2 issue. At the end of the statement, he says he may not react well if someone tells him he is doing something wrong. Once again, we see Axis 2.

He person angrily reacts against anyone telling there is anything wrong with him psychologically, that he has an actual DSM disorder, that he needs to see a therapist, and in particular, that he needs medication. Axis 2 again, but he is sort of onto something because he is correct in his belief that he isn’t crazy (Axis 1). Instead, he is Axis 2, and Axis 2 people are not really crazy. Axis 2 people are sick, and the distinction is important. Instead of being crazy, there is something wrong with their souls. They are in a sense sick in their souls, what I call soul-sick. And of course that’s why Axis 2 is so hard to fix. It’s hard to cure a sick soul. How do you fix a problem that involves the individual at their basic core essence?

He refuses to take medication, but once again he is onto something because he’s not crazy in the sense that needs medication (Axis 1). He says he doesn’t need pills and in a way he is correct. Pills often do not work well for Axis 2 anyway.

He spent much of the last year in therapy but did not appear to get a lot done. Once again typical Axis 2. However, he is aware enough to go to therapy apparently on his own, which is excellent for an Axis 2 person. Perhaps because the person has only traits and not a full Axis 2 disorder is what drives him into therapy or even makes him think there is anything wrong with him in the first place. Both are quite uncommon in  Axis 2 people, and the presence of these good signs is an excellent sign that this person can actually make  progress with his Axis 2 stuff.

On the other hand, the last sentence that says he will not take it well if you imply that he is doing anything wrong does not bode well for therapy. Guess what is going to happen to him in therapy? The therapist is going to tell him he is doing things wrong. He will be told this over and over, and oftentimes the therapist will not be very nice about it. If you can’t handle criticism, therapy is a waste of time. However, he did spend most of last year in therapy, so it seems that he sticks out therapy even though he does not like being criticized.

Schizoid PD: Absolutely not.

Schizotypal PD: I have a hard time seeing any symptoms of this. I do not why people think this is the problem.

Avoidant  PD: This is where the problem lies. See detailed explanation below.

There is avoidant behavior littered all through this history starting all the way back in childhood. He gets insulted once, and he won’t talk to the person for a year. Someone criticizes him, and he walks out of the room and out of the person’s life. He doesn’t care about losing a lot of friends, possibly because he would rather push them away anyway. He engages in abrasive and hostile behavior towards friends in order to deliberately drive them away, possibly because he thinks they are getting too close to him. This is a clear case of pushing people away, and pushing people away is classic avoidant behavior.

As noted above, the last sentence here does not bode well and is a classic sign of avoidant behavior. Of course Avoidants don’t take criticism well. That is the core of the whole issue with them.

On the other hand, a true Avoidant PD would probably just get up and walk out of the office as soon as he gets criticized. I had a therapist once (yep I have been on both sides of the fence here) told me that he had had ~7 Avoidants in his time as a therapist.  With every single one of them with not a single exception, as soon as the he criticized the person, the person got a very hurt expression on their face, gathered up their stuff, and walked right out of the office never to return. It’s interesting that he saw the exact same thing in 7 different cases over years, but believe or not, a lot of DSM conditions act like this. It’s almost as if the people with the condition were all reading off the same script, as I call it.

There are also classic signs of low self esteem going all the way back to youth. The symptoms of low self-esteem occur over and over again in this history. Of course, low self-esteem in not in the DSM yet, though I they are probably working on it. Not all psychological problems get a DSM diagnosis. That’s the thing. It is possible to have all sorts of  psychological issues without having a single diagnosable DSM condition. Which of course makes sense as almost all of us are at least a bit unhealthy, are personality disordered in at least a slight way, and are at least a little bit weird and crazy if not perverted on top of that. In other words, humans are very fallible creatures, we are not perfect, and life is full of all sorts of  problems even for the healthiest people.

Low self-esteem might go away with pills, but he is a bit too old for that. Much better reactions are seen with adolescents because the low self-esteem has not cemented itself in yet.

Of all of the issues I have worked with in counseling, the two hardest were Major Depression and low self-esteem. I have tried everything and I cannot seem to get low self esteem to budge. I have seen some folks improve in the issue, but they tend to still have the problem to a lesser extent. For some reason low self esteem seems to get cemented in very hard in the brain such that it is quite difficult to turn around. The best results are seen in childhood and especially adolescence before the personality is fully formed.

Therefore, the diagnosis is:

Axis 1: Deferred, a secondary problem to the Axis 2 problem if it is there at all.

Axis 2: Avoidant PD: Avoidant traits, but does not meet criteria for the full disorder.

Other issues: Chronic low self-esteem dating back decades.

Note: The two problems are feeding into each other in an endless feedback loop, as you  might notice if you read the history carefully. You cannot really defeat one of the two conditions above. The stool is being held up with four legs of the chair. You cannot just take out one leg – you will have to take out two legs to make the chair crash down.

 

Hi there,

My mother and I have been arguing about this for 15 years or more. I’m 37 and have been sober with the help of AA – off of marijuana daily, hard alcohol weekly, and LSD monthly – sober for more than 11 years now.

I had a girlfriend in high school for 2 or 3 years. I had many friends through early grade school or partying, and we had much fun while also sharing time and feelings…and sometimes we hurt each other. My mother was also very supportive then (and still is, but can also be hurtful on purpose). Pretty normal stuff, but I can remember being avoidant. If someone did one certain thing to piss me off, I might’ve not spoken to them for half a year.

Eventually, at the end if my drug and alcohol abuse, I had managed to alienate or avoid all but one or two drug-using buddies that needed as much of a an illegal head change as me. I was verbally abused as a kid; they had gotten worse.

In sobriety, I’ve had a couple sexual encounters but only one girlfriend, and we lasted maybe 4 months. She was beautiful and looked 30, my age, but she was 42, wanted me to impregnate her, and started suggesting we go to therapy. 4 months was both too little and too much for me.

I also can make friends but I don’t always keep them. I’ve helped people in AA and they’ve helped me, but after all this time, I get pissed if they start to even think about providing help without my asking. Sometimes they think there are things wrong with me, and that’s fine, but if they start basing their decisions on their hack “diagnoses” of me, I might never call them or go to the same meeting as them.

I basically want people to be my friend, and thats it; I’ve been known to want to make people laugh for an hour or more, and this makes me very happy inside. It’s something I was able to do for people when I was young and in high school. If someone gives me a compliment or tells me I’ve accomplished certain things in my life, I shrug it off. It means not much to me; I don’t feel that’s what’s important in life, your accomplishments.

I’ve recently found peace in Zen writing with some practice, studying the writing of Shinryu Sazuki. I don’t talk bad about other people’s beliefs but really find other religions to be silly in practice, and have never believed in a higher power, instead simply practicing that I don’t have the power, any power, not much power – changing the things I can.

I think part of my problem is my mother. If I had a bad week – maybe any week during the past 15 years – she often thought and sometimes said I needed to be diagnosed with a problem, leading to many arguments, some with me even admitting that I had a clinical problem. She keeps pushing the psychiatric drugs, which ill never take (Never; please hear that if you want to reply and actually help).

What’s most hurtful is I create a boundary, yet even when I have a good day (exercise, meditation, doing good things for myself), I can’t trust her to actively cross that boundary and talk about me in a manner, suggesting I can’t cope, that I make mistakes that exhibit avoidant or schizotypal behavior, and generally, her not letting me live my own life…crazy and fucked up or not…

I care that she is more healthy and lives longer and stops having medical issues, but she has been 300 lbs or more – obese – for 20 years or more. I never diagnose her or tell her she is making bad decisions. I don’t give her advice unless she specifically asks. It’s simply a boundary I respect. It’s common decency. I don’t talk about her problems because I learned early on that it was rude and disrespectful.

I could change my perception of her, but its awfully hard when she does this. What worked is I hardly talked with her for a couple years until she did Alanon work of her own avail and started being enjoyable.

Most recently, we’ve gone back to Square One. For 5 years I trimmed trees, netting thousands before 2008. Then I worked as a office person/driller for my father the next 5 years. We’ve gone out of business, so I’m putting a sleeper on my truck while hauling a motorcycle. Me and the two dogs are gonna hoof it. I have some starter money from selling a house back to my parents, so it’s not the craziest.

At the same time, my parents and some other people have decided to reassert the opinion that I have a “condition” and that my decision- making is screwy. I care about their happiness, but they thinking I can’t have a happy life unless I am actively coping with some mental condition and that it deserves pills, it’s crazy to me when they want to relate the opinion on any given day we spend time with each other.

I also recently dropped a class (not a great sign of progress). While moving out of my house and getting rid of nearly every possession I’d collected the past three decades, selling off $500K worth of drilling equipment to pay off a bank and getting over my workaholic father (a perfect example…which is bad… which is another story) and I not succeeding together professionally – I decided to take two journalism classes at the college. I had to drop both.

There I made one friend, quirky, with whom I spent many hours with at the lab portion talking, bullshitting, and working together. I also made a fool of myself with a couple other people. I got in trouble (embarrassing when you’re 30 something) for writing joke, fake stories on the board. Yelled at another student to make people laugh. Was nervous and self-conscious.

I was scared half the time I had done something wrong to somebody, and the dean was gonna come in and kick me off campus or something. I also managed to meet deadlines and publish two stories. It really was too much for me at the time, so I had to drop what I could, school being something that will always be there.

My father was mad when I enrolled that I didn’t advance my AA in BA and chose to go back to the community college, but I just laughed at him and his preferences for me. Journalism has always been a dream of mine and I plan to take more courses. I got a taste for interviewing people and investigating facts and opinions; it looks like another trade for me.

When I’m at my worst, I don’t do anything. I hole up inside of my home and fail to even start my day. I understand this writing here has been about much else, but my problems can be serious. Oftentimes I’m worried about my appearance or cleanliness. Do they know I masturbate too much? are they gonna notice my fingernails are dirty? Worse off, if they knew I was thinking these things, it’d be worse. This thinking leads me to not going out into the world or hard to be around – to where I make no friends, no connections.

Oftentimes a girl working at a store or somewhere will be nice to me. I’m actually kinda good looking…although I wear overalls 6 days a week for the past 5 or 10 years.) I go home and obsess about her, dream about her. Until either way, I cant go back to that store.

I feel disgusting and have bad thoughts. Is she the right one? Am I disgusting? Do they just want my money anyhow? I’m a shitty person? If I just want to get into bed with them, they’ll know, and that’s hurtful. But if I really think she’s smart and we could get married, there’s something wrong with her. She smokes. Something. I’ll find some reason to not go to that store for a year, maybe more.

Am I just an asshole. If I can’t be in a simple moment with people…I am some sort of asshole.

I usually make friends or closer acquaintance with thinkers or people who are quirky. Most often they are 20 years older than me – teachers at my college or mentors in and out of AA but often out. As I start this new adventure, my experience with relationships is two sided; I’ve kept in touch with none of these older or quirky persons, and I’m sick of being around my parents and them taking care of me. I’m leaving town, and I want to get better at leaving town.

One big deal that happened recently is I saved up a bunch of angst about my neighbor (and other things in my life) and yelled at him for 5 minutes so the whole neighborhood could hear me. He was gone, and I was still in my garage scream epithets. We were surprised he didn’t press some kind of charges. But I didn’t directly threaten him so…

Another thing…my mother can do and say things while just sitting in a room that can make me want to strangle myself. I think its part of my condition or general person, and sometimes the way people breathe or move just irks me. I have to leave the room.

Some people bother me, while others don’t. So my solution is simply to only go places and be around people I like. Sometimes this isn’t enough for me – I cant find anywhere or anyone. And this worries my parents. A bad day of mine is reason for me to have medication for them.

When I started going back to meetings 6 months ago, it helped. I find some peace there. Most recently I made a friend then lost him because he wouldn’t call or text me back. I said I forgave him but didn’t really want to try again. I was also worried about what he thought of me, and I hated him for it. Sometimes I think this is normal but it’s also a little obsessive.

When I go to meetings, I feel better. Things that were a big deal become small deals. The problem is the getting there. Its like working out for most; they just need to go, then they feel great. But getting off the couch and to the gym isn’t exactly as important as being able to get along in public situations or meetings, which I definitely have trouble with.

I guess my dilemma is the same as it was 5 years ago. I exhibit a good deal of avoidant or schizotypal behavior but refuse medication. I talked with a therapist for many of the weeks of last year, and he gave me some tools I didn’t have. Mainly they want me to care more about other people or to develop, maintain or exhibit lasting connections with other people.

It takes much exercise and a routine including morning reading to get me to where I can relax and be happy around people besides myself, to where I can appreciate other people or not be scared of what they are thinking of me.

They also say I’m excellent at guitar. Because it’s not a possession but something I can share for free with others. I like playing for them but don’t really care if they like me as a person, and I sometimes put my foot in my mouth, saying or doing things that will drive them away…It’s not always, but I sometimes have no control…And then I just don’t give a shit, it’s freeing that they’ve left me to me. This is the other part of my behavior that’s acceptable to me but not very many others.

Ive tried herbal supplements…and they actually intensify feelings of doom, embarrassment, depression… leading to further or deeper anxiety. Strange, ain’t it?

Sorry for any length above. I value your thoughts, suggestions, experience, and advice outside of medication.

If you want to tell me I’m wrong in any way, I may react very poorly.

🙂

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Filed under Mental Illness, Personality Disorders, Psychology, Psychopathology, Psychotherapy

Sexual Orientation in Males: Theories and Therapies

From Quora.

How can you know if you’re gay?

Currently I’m 15. I felt like I liked both genders from twelve to 14, now I feel I’m gay. I don’t know if it’s just because I like to admire how guys look and wish I looked like them, or if I actually find them attractive. Have many heterosexuals gone through this in puberty as well?

My response: Few if any heterosexual men go through an early phase in puberty or before of being sexually attracted to males in any significant form.

How do I know? Personal experience and conversations with many men about this. I also work as psychological counselor and in the course of my work, I often have to a sexual orientation assessment for one reason or another as part of the therapy. Most everyone simply cooperates just fine. The average heterosexual male simply tells me that he has been attracted to females since puberty or even before, it’s been that way ever since, there’s nothing confusing about it, and that’s all there is to it.

The only men who were confused about their sexual orientation were mentally ill. The therapy in this case is to try to figure out the man’s true sexual orientation, which to me is always quite clear on detailed questioning. These are usually cases of straight men who are worrying that they are gay for no good reason. The therapy is to pound into their head that they are straight and that the gay stuff is nonsensical and idiotic. They usually get over it after a while. Going round and round with these men about their sexual orientation or worse implying that they are gay is very bad therapy and is likely to make them worse, but this is often what clinicians do nowadays.

I doubt if mentally healthy gay or straight men are much confused about this. I do not know how bisexual men feel. I have had a number of men identify as bisexual to me on interview. In general, they were quite ok about it, gave me a good figure percentage-wise (75-25 or mostly straight or 20-80 or mostly gay, for instance) and were not going round and round at all. What’s there to go round and round about? Most males are pretty clear about what turns them on and what doesn’t. If you aren’t, you’re either still young or there’s something wrong with you.

In my experience, most males who are supposed “confused” or “questioning” their sexual orientation are not actually confused about or questioning anything. Instead these are simply gay males who are having some serious problems accepting the fact that they are gay. The therapy of such a person is to first determine that they are definitely gay by questioning and then to hammer home the idea that they are gay, that their sexual orientation cannot and will not change ever for any reason, and if they hope to have a happy life, they have to accept that they are gay. I often tell them that is great that they are gay, that I can relate to them as a sort of mirror image of myself (they are the other side of my sexual mirror), and emphasize our commonality as males who share a certain male worldview.

Sexual orientation in males is surely fixed at age 15 at the latest. We do not know if or when it is fixed earlier than that, and there is no good evidence that sexual orientation is fixed at birth, though that is possible. It is possible for sexual orientation in men to change before or around puberty. There are some case reports that indicate that this is possible. Some changes have been reported in boys age 10-14, but most reports of strong changes even at that age show that actually nothing changed at all and that this person’s sexual orientation was obvious even at a much younger age. Instead of actual changes, these are more “clearing the air” experiences where the person starts to full recognize just who they are and who they have always been sexually. This is true even in females, though they can move around more than men.

In your case, it appears quite clear to me that you are gay. Not bisexual, not heterosexual, but gay. I suppose you can continue to go round and round about this in future years, but I doubt if your orientation is going to change much after today.

What’s wrong with being gay anyway? Maybe God made you this way.

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