How the cult of trauma took over mental health

[Sanman]

And conflation of every negative experience with trauma. If everything is trauma and trauma always causes PTSD, then everyone has PTSD.

How do we get the insurance companies to accept this logic? Maybe just those that can afford $200/hr cash have PTSD?

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[SomeGreatNotion]

People act like trauma is some mystical thing and PTSD is inevitable rather than an (actually uncommon) failure in the body's natural process to recover. That's IMO the biggest part of the problem.

While I agree with you, the difficulty with this is that you are essentially asking people with PTSD to accept the idea that they are flawed due to their body's "failure" to recover.

 

[WisNeuro]

While I agree with you, the difficulty with this is that you are essentially asking people with PTSD to accept the idea that they are flawed due to their body's "failure" to recover.

Healthcare and medicine is full of instances in which our bodies/minds do not bounce back like they are supposed to. I find that notion much more palatable and less harmful than the current trend that there is something wrong with them when they do recover from a stressful or traumatic experience.

 

[cara susanna]

While I agree with you, the difficulty with this is that you are essentially asking people with PTSD to accept the idea that they are flawed due to their body's "failure" to recover.

But it's due to factors that are generally controllable and reversible. That's the idea: it makes sense that you avoid, AND it's what's prevented you from recovering from this.

 

[AcronymAllergy]

While I agree with you, the difficulty with this is that you are essentially asking people with PTSD to accept the idea that they are flawed due to their body's "failure" to recover.

I think the important part here is us trying to prevent the patient from jumping to the broader conclusion that they're "flawed." Rather, they're experiencing a problem getting through the natural recovery process involving this specific incident/aspect of their life, so it's our job to help them proceed along with their recovery.

 

[Sanman]

While I agree with you, the difficulty with this is that you are essentially asking people with PTSD to accept the idea that they are flawed due to their body's "failure" to recover.

I once broke a finger. I didn't go to a doctor to have it set properly because I was a tough guy and I could handle the pain. It is a little crooked because it was not set properly and occasionally causes a bit of arthritic pain . I am slightly flawed because I have a crooked finger. We all do the best we can until someone shows us there is a better way. Just a part of life.

 

[PsychSupreme]

Off topic a bit, but since we’re discussing pseudoscience in trauma, let’s pivot to other pseudoscience—how many of you have the absolutely nonsense floating around the Redditsphere regarding dopamine and “addiction?” According to these folk neuroscience bros on Reddit threads, every single (mostly male) individual is at imminent risk of developing severe and crippling porn addiction and hijacking their reward systems with instant gratification (because somehow the nervous system can tell the difference between “normal” sex and, well, self-stimming 😑). But not just that! Screen “addiction,” internet “addiction…” everything even slightly habitual or compulsive is being rebranded as an addiction.

(And slightly more on topic, we can all thank Gabor Maté for spreading the notion of ADHD and substance abuse disorders being traumatogenic, instead of the former being neurodevelopmental and the latter being multifactoral with a heavy dose of genetic diathesis involved in addiction responses).

 

[WisNeuro]

Off topic a bit, but since we’re discussing pseudoscience in trauma, let’s pivot to other pseudoscience—how many of you have the absolutely nonsense floating around the Redditsphere regarding dopamine and “addiction?” According to these folk neuroscience bros on Reddit threads, every single (mostly male) individual is at imminent risk of developing severe and crippling porn addiction and hijacking their reward systems with instant gratification (because somehow the nervous system can tell the difference between “normal” sex and, well, self-stimming 😑). But not just that! Screen “addiction,” internet “addiction…” everything even slightly habitual or compulsive is being rebranded as an addiction.

(And slightly more on topic, we can all thank Gabor Maté for spreading the notion of ADHD and substance abuse disorders being traumatogenic, instead of the former being neurodevelopmental and the latter being multifactoral with a heavy dose of genetic diathesis involved in addiction responses).

Pssh, typical neurotypical response /s

 

[cara susanna]

Off topic a bit, but since we’re discussing pseudoscience in trauma, let’s pivot to other pseudoscience—how many of you have the absolutely nonsense floating around the Redditsphere regarding dopamine and “addiction?” According to these folk neuroscience bros on Reddit threads, every single (mostly male) individual is at imminent risk of developing severe and crippling porn addiction and hijacking their reward systems with instant gratification (because somehow the nervous system can tell the difference between “normal” sex and, well, self-stimming 😑). But not just that! Screen “addiction,” internet “addiction…” everything even slightly habitual or compulsive is being rebranded as an addiction.

(And slightly more on topic, we can all thank Gabor Maté for spreading the notion of ADHD and substance abuse disorders being traumatogenic, instead of the former being neurodevelopmental and the latter being multifactoral with a heavy dose of genetic diathesis involved in addiction responses).

I literally once saw someone diagnosed with "adult onset" ADHD secondary to trauma. A literal psychologist wrote that.

Jesus wept.

 

[WisNeuro]

I literally once saw someone diagnosed with "adult onset" ADHD secondary to trauma. A literal psychologist wrote that.

Jesus wept.

Did a psychologist write that, or did someone who somehow managed to get licensed as one write that? Personally, I don't consider people with limited or no meaningful research training as psychologists. They're just midlevels who bought a piece of paper.

 

[PsychSupreme]

I literally once saw someone diagnosed with "adult onset" ADHD secondary to trauma. A literal psychologist wrote that.

Jesus wept.

I was just scrolling through a creative writing subReddit with a post to the effect of: "Which types of trauma are most poorly portrayed in literature?" The comments were shockingly bad. One of them was about "the trauma of caring for someone with dementia" and another was "the trauma attached to having ADHD," after which one of the replies was something along the lines of "Yeah, the whole 'is your problem ADHD or CPTSD' was a fun conversation to have had with my therapist."

Side note: when did diagnosing or opining about ADHD become part of the midlevel scope? Is it still technically not?

 

[smalltownpsych]

Off topic a bit, but since we’re discussing pseudoscience in trauma, let’s pivot to other pseudoscience—how many of you have the absolutely nonsense floating around the Redditsphere regarding dopamine and “addiction?” According to these folk neuroscience bros on Reddit threads, every single (mostly male) individual is at imminent risk of developing severe and crippling porn addiction and hijacking their reward systems with instant gratification (because somehow the nervous system can tell the difference between “normal” sex and, well, self-stimming 😑). But not just that! Screen “addiction,” internet “addiction…” everything even slightly habitual or compulsive is being rebranded as an addiction.

(And slightly more on topic, we can all thank Gabor Maté for spreading the notion of ADHD and substance abuse disorders being traumatogenic, instead of the former being neurodevelopmental and the latter being multifactoral with a heavy dose of genetic diathesis involved in addiction responses).

I just explain to people that there is a significant difference between behavioral addictions and chemical addictions because the chemicals directly release dopamine. Treatment is kind of the same for either, a lot of it boils down to stop doing the behavior and replace with other rewarding activities that stimulate dopamine release. Eating is a little trickier because you can’t stop the behavior, but you can still add in other behaviors including expressing emotions in a healthy way to people who can respond appropriately and help you feel better aka dopamine release aka basic psychotherapy.

 

[PsychSupreme]

I just explain to people that there is a significant difference between behavioral addictions and chemical addictions because the chemicals directly release dopamine. Treatment is kind of the same for either, a lot of it boils down to stop doing the behavior and replace with other rewarding activities that stimulate dopamine release. Eating is a little trickier because you can’t stop the behavior, but you can still add in other behaviors including expressing emotions in a healthy way to people who can respond appropriately and help you feel better aka dopamine release aka basic psychotherapy.

Are we, as a field, comfortable using "addiction" as a term to describe purely behavioral/non-chemical patterns? Admittedly this is not my area, but I was under the impression that we have yet to really codify any official diagnosis for a "behavioral addiction." I know we have some compulsive/impulsive disorders (e.g., gambling disorder, etc.), but I thought that referring to them as addictions was a subject of intense controversy. Could be wrong--like I said, not my area. Even so, I still think much of the current discourse around supposed "addictions" like "internet/social media addiction" and "porn addiction" are mostly attributable to moral/public health panics than to actual behaviors that warrant those labels. It's easy to point to social media as a scapegoat for more fundamental problems. Clearly there are some people who lie further down the "problematic usage" spectrum than others, but I think it's hyperbolic to go into epidemic mode. And don't even get me started on the manosphere/toxic masculinity spheres perpetuating stigma and shame driving the current online discourse on "porn addiction" and the need to go "nofap" to dopamine detox and improve your sex life/be more manly/preserve testosterone. Pretty sure the literature is strongly in favor of self-reported porn addiction being almost entirely explained by subjective guilt and shame tied to moral objections to porn rather than measurably problematic behaviors. I have no horse in the race either way--I do not care what people do or do not consume in their private lives, as long as it is consensual--I just don't like pseudoscience haha.

 

[PsychSupreme]

Side note again--how sad is it that, aside from a small handful of dedicated psychologists like Lilienfeld, Lynn, Hupp, and some others, the more prolific psychology/mental health debunkers I can find on YouTube are journalists? Anyway, great talk below--she really highlights the issues well and has solid points. @cara susanna, you in particular may enjoy this.

 

[smalltownpsych]

Are we, as a field, comfortable using "addiction" as a term to describe purely behavioral/non-chemical patterns? Admittedly this is not my area, but I was under the impression that we have yet to really codify any official diagnosis for a "behavioral addiction." I know we have some compulsive/impulsive disorders (e.g., gambling disorder, etc.), but I thought that referring to them as addictions was a subject of intense controversy. Could be wrong--like I said, not my area. Even so, I still think much of the current discourse around supposed "addictions" like "internet/social media addiction" and "porn addiction" are mostly attributable to moral/public health panics than to actual behaviors that warrant those labels. It's easy to point to social media as a scapegoat for more fundamental problems. Clearly there are some people who lie further down the "problematic usage" spectrum than others, but I think it's hyperbolic to go into epidemic mode. And don't even get me started on the manosphere/toxic masculinity spheres perpetuating stigma and shame driving the current online discourse on "porn addiction" and the need to go "nofap" to dopamine detox and improve your sex life/be more manly/preserve testosterone. Pretty sure the literature is strongly in favor of self-reported porn addiction being almost entirely explained by subjective guilt and shame tied to moral objections to porn rather than measurably problematic behaviors. I have no horse in the race either way--I do not care what people do or do not consume in their private lives, as long as it is consensual--I just don't like pseudoscience haha.

My understanding is that addiction is a non-specific term that patients use. I also say that to patients. We just call it Substance Use Disorder. a little different from trauma where we have it operationally defined in the DSM

 

[smalltownpsych]

Also, since I am mainly interested in treatment, I just use the semantics discussion to access how they view their “problem” as part of the implementation of solid MI techniques.

 

[PsychSupreme]

Also, since I am mainly interested in treatment, I just use the semantics discussion to access how they view their “problem” as part of the implementation of solid MI techniques.

Yeah, this is fair.