The Shadow DSM:

Psychology Suffers from Professional Analogue of Own Disorder

In a Nutshell

A reader wrote me with the following comment: "Encountering these psychologists and psyd's trolling usenet incited me to suspect those who become psychoT's and psyd's might have even bigger psych problems then the majority of their clients have."

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It is my opinion that professionals need to be better persons. At its most surface level (the level of raw observation), their faults consist largely of their expectations of their peers, their students, and human beings in general. What makes my job as a muckraker so difficult is that it is not easy to hang a single-word label on the pathology of academics. With Psychology lacking in rich constructs, I have had to come up with my own classification scheme, one which encompasses the polymorphously perverse effects of their expectations, their prejudices, their paradigms, and their management of an inhospitable training culture and dysfunctional professional community. They are simply counterproductive to TRUE science and TRUE mental health.

In culling my observations, I realized that what also makes my job as a muckraker difficult is the fact that the disorder presented by psychology professors contains many features emblematic of Borderline Personality Disorder. The decision to invoke this term was not an easy one, as BPD is itself a flawed construct. I believe that BPD represents the canonization of a classic or prototypical manifestation of what is in actuality a large family of related but distinguishable disorders, and this canonization short-circuits an adequate exploration of the broader pattern as well as the fabric that is personality and normal psychopathology.

Before I address the DSM criteria in making my case, I would like to address the spirit of this construct. Kernberg claimed borderlines can be distinguished from neurotics on the basis of primitive defenses. I all too frequently observed splitting in psychology professors, who treated me as all good on one day and as all bad on the next in accordance with the implications of my actions or inferred attitudes for their self-esteem. Like borderlines, they react intensely to minimal stress and they seem to enjoy indulging all their imagined sleights. Walking the halls of the psychology departments conjures images of foraging through a post-war nation littered by land mines and trip wire. Just how might you trigger their sensitivities? Let me count the ways.

While you are expected to follow the white line in the middle of the road, your interests, personality, or propensity to think for yourself may cause your vehicle, so to speak, to pull to the right. By expressing an interest in a theorist or phenomenon, role playing a fictitious client with normal psychopathology not scripted in the DSM, leaving textbooks or multiple choice tests off your syllabus, or simply by thinking up some original research design, you may be making yourself vulnerable to critics who wish to paint you as having an alignment problem. Your unconventional choices will be re-framed as unprofessional, ill-fitting the field's epistemology or the department's philosophy. Your colleagues are counting on your slavish compliance with the massive framework of expectations to help them beat down their own repressed self-doubts. They have created all these conventions that masquerade as standards and all these external agencies, which like oases in the desert of uncertainty, offer guidance and validation in exchange for conformity and obedience.

One of the hallmarks of BPD is splitting, in which a person or thing is seen as all good or all bad. Exacerbating the splitting is another hallmark of BPD in which psychology professors seem incapable of perceiving others with any context or consistency. If you want to enjoy their political protection or keep yourself in their good graces, you have to please or re-assure them on an almost daily basis. With psychology professors, it is not the first impression that endures, but the last one, and unfortunately, all it takes is one audible cough or hiccup before you find yourself running from an avalanche of suspicion and remediation. Some have advised those who know themselves to be rugged individualists or independent thinkers that trouble can be avoided by simply keeping quiet or remaining out of sight, but this is not the case. Like borderlines, psychology professors find it difficult to experience an absent loved one as a loving presence. You are expected to be proactive, profuse, and prominent in your endorsement and enforcement of their customs. In a token economy in which self-esteem is the unit of currency, supplication becomes a 9 to 5 job. See Section titled "Profile of Common Storms" in my report titledAPA Click Away from Capitol Hill for a four-fold taxonomy of the way students can trip their professor's wires). And what a psychology professor thinks of me is too heavily skewed by, if not synonymous with, our most recent encounter and, in the event that encounter is not recent enough, it is likely that the professor will behave like a snubbed date. The silver lining in the cloud is that you need not work too hard at appearing genuine. Psychology professors do not seem interested in scanning flattery for traces of insincerity. As long as you pony it up, they are more than happy to receive it and to reward you for it, that is, for as long as it is front and center in short-term memory. Rather than view my actions over any extended period as part of an integrated whole, the psychology professor subjects this or that (single) act to aggressive evaluation, seeking to draw inferences about its meaning or divine soemthing definitive (i.e., global and stable) about my level of fit or professionalism. Many clinical psychology professors like to pathologize clients or reprimand students for having a 'lack of boundaries,' but in almost everything they do I see them taking something beyond its warranted limits, as when they

• borrow an identity from the profession in which they seek membership
  

• look to external agencies for validation and guidance
  

• draw from single or isolated instances global inferences about the validity of a phenomenon under study or about the worth of a student under evaluation (without sufficient facts and without a care for context)
  

• when their own ego defenses depend on reprimanding colleagues/students for failing to conform completely and conspicuously with conventions with which they need to identify to preserve their fragile self-esteem
  

Borderlines set all context aside when interpreting an action from persons in their lives and, consequently, lack a sense of continuity about them. I have read about this symptom about a dozen times in a dozen places and each time I read it, it strikes me as remarkably descriptive of psychology professors, not only in regard to the way they treat their students and colleagues but also to the way they design and deploy their research. Their research is disinterested in the whole of any research participant or phenomenon, and they have this way of gathering data that seems to circumvent an adequate collection of facts surrounding the phenomenon under study or the human vessels that volunteered to model this phenomenon for science. (See ADHD Science for a comprehensive review of the bad habits of psychological researchers).

Speaking of primitive ego defenses, psychology professors engage in a form of magical thinking similar to that exhibited by borderlines. Some borderlines believe that thoughts can cause events, and psychology professors like to use single-word arguments to slander students they do not like in faculty meetings. See Surviving Graduate School in Psychology for a more indepth discussion of this practice). Oh, how I wish I had a nickel for every time I heard one of the following unsupported single-word or single-phrase accusations off the lips of psychology professors: inappropriate, unprofessional, unwilling to adjust, not a good fit, and not psychometrically sound. These words or phrases are incantations, ritualistically invoked and then chanted to ward off anything or anyone that does not perfectly fit their mold. Most victims never question the characterization, either withdrawing from the program or seeking to make amends, but if you ever have an opportunity to observe a victim's request for elaboration or evidence, pull up a seat and watch the carnival freak show unfold. Not even a wine-tasting savant can tease out all the personality disorders in this cocktail. The display is sponsored in part by yet other borderline symptoms, including a sense of omnipotence and efforts to elicit in others the feelings they themselves are experiencing.

Are psychology professors, like borderlines in Linehan's model, born with an innate biological tendency to react intensely to low levels of stress? Linehan's conceptualization of pathology bares a striking resemblance to Jung's dialectical conceptualization of the compensatory relationship between conscious and unconscious attitudes. It was Jung who helped me to see in psychology professors this oscillation between vanity and vulnerability. It is as if each conceals, and compensates for, the other, and this ambivalence allows psychology professors to elude unflattering labels by confusing their victims and critics, who know there is something pathological but have difficulty describing it. It's like trying to hit a moving target. One day, psychology professors cause harm out of insecurity, the next out of arrogance.

Psychology professors tighten up in the face of insecurities most mature people should be able to handle. I once heard it remarked (by a psychology professor) that psychology folk do not have the defense mechanisms available to them because they are too familiar with them. On the contrary, I have come to the conclusion that they are the biggest practitioner of these defenses. I believe they are less equipped than the man-in-the-street to manage their anxieties. I see an intolerance for uncertainty and (cognitive) dissonance that makes them prone to a host of conditions they have named (e.g., groupthink, obsessive-compulsiveness, misattribution, and hysteria).

I promised myself my understanding of their pathology (and the sociological woes of their professional culture) would be conceptually more organized, intellectually deeper, intuitively more appealing, and aesthetically more pretty than the DSM and its number 2 pencil-sketch of what it calls BPD. I haven't yet named my new disorder (for now let's call it "Sun" Exposure consistent with the metaphor packed in the title, Fireflies in the Shadow of the Sun). I list the criteria for "Sun Exposure" below that for BPD:

• BPD-1. Frantic efforts to avoid real or imagined abandonment.
  

  NOTE: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
  

• Sun-1. Inability to tolerate (or modulate affect associated with) the deviation of peers or colleagues from the professional norms.
  

  NOTE: Do not include intolerance for theoretical differences or general unconventionality covered in other criteria.
  

• BPD-2. Pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  

• Sun-2. Pattern of interpersonal relationships characterized by periodic and unpredictable outbursts of irritability and by fragile or fluctuating opinions of others based on the ability of others to meet their dependency needs (i.e., self-esteem; love; legitimacy).
  

  NOTE: Do not include apparent oscillation between insecurity and arrogance covered in other criteria.
  

• BPD-3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  

• Sun-3. Identity disturbance: markedly and persistently unstable self-image or self of self. (3a) Self-doubt arising from the low threshold of uncertainty and the need to believe what they are doing is at every moment entirely right. (3b) Exhibit resentment toward the messiness of their field and toward the notion that not everything can be measured, ranked, or evaluated in precise quantitative terms subject to analysis. (3c) May resort to standard procedures (or the drafting of standards) for the assessment of academic performance, professional progress, mental hygiene, and the attitudes and behaviors of graduate students. (3d) Prone to neglect all phenomena (or theories) that do not lend themselves to rigorous methodologies suggestive of formal end-stage science. (3e) Unable to distinguish between self-identity and identity of department and/or profession. Identification with reference groups that confer prestige or belongingness inhibits personal growth and development. Becomes a creature of imprimatur, a servant of the persona of the profession, which they embrace, enforce, and proliferate both within the university and within the public.
  
  Understanding this aspect of their pathology does not require a college education. Most people who've seen the film Eyes Wide Shut can comprehend this manner and method of deindividuation. We're dealing here with professionals for whom 'identity' is a four-letter word. It's not far afield of the required head-shaving by the U.S. Military of all new recruits. The professionals demand from the neophyte some grand but routine gesture of affirmation for the community in which he or she is seeking membership. Also, just as the U.S. military would not want its soldiers worrying about their hair on the battlefield, personal identities are counterproductive to professional development and mobility. (And, while we're being honest, self-development takes a lot of work). Not long after checking their personal effects at the door, cognitive dissonance kicks in and psychology trainees learn to bask in the mass anonymity and interchangeability. They are taught that a 'professional,' by definition, is an instantiation of the community's norms. The human condition of the budding professional suffers the same fate as a neglected infant or an unused muscle, simplified to a handful of quantitative dimensions that ultimately become the "measure of the man" (or woman), most notably "professionalism." All other personality traits and ideas are regarded as vexing and superfluous. Any student avoiding this institutional marasmus (this "Deindividuation Disorder") by expressing some manner of identity more complex than the one-size-fits-all mask for which they were fitted will be labeled 'arrogant.'
  

• BPD-4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
  

• Sun-4. Impulsivity in at least two areas that are potentially counterproductive to personal and professional self-development, development of students, and aims of the field (e.g., methodology, instruction, tenure abuse, reckless diagnosis, binge evaluation, need to feel loved).
  

• BPD-5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  

• Sun-5. Abhorrence of personal self and disregard for personal development. Willing to proliferate, celebrate, and enforce institutional norms with no real grounding in science or nature but which spell career death to the vocation of my students as well as to the adequate study of the human condition. Willing to pressure students to terminate their own standing in graduate programs in which they are characterologically less than perfect fits. Stamps out individual identities where perceived in students or research subjects. (Nomothetic research and null hypothesis testing system converge to misrepresent or neglect individuality of research participants [AKA "subjects"] and richness of phenomena.
  

• BPD-6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  

• Sun-6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety).
  

• BPD-7. Chronic feelings of emptiness.
  

• Sun-7. Emptiness. Chronic tendency to fill the void in self-development by turning to external sources of validation and guidance, sources they will subsequently defend as if they were personally attacked.
  

• BPD-8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
  

• Sun-8. Reckless endangerment of graduate student careers with malicious hyper-monitoring and documentation of student behaviors and decisions, frequently drawing vague or unsubstantiated inferences about mental health, ideology, or professionalism. Clinical faculty may even attempt to diagnose a student, recommending therapy to address gross patterns of misjudgement. The criticism may become grossly characterological and develop into obdurate expectations disseminated among faculty in post-semester faculty meetings.
  

• BPD-9. Transient, stress-related paranoid ideation or severe dissociative symptoms
  

• Sun-9. Aforementioned symptoms conducive to condition in which faculty dissociate personally from collegues and subject matter. Exhibit reluctance to discuss human nature around water cooler in fear of becoming aware of dissension or diversity of opinions. (Business rules dubbed the "glue that holds the field together" [nomothetic null hypothesis testing and DSM] designed to compensate for over 400 known types of psychotherapy and to conceal and constrain theory. For example, granting agencies outside field typically fund only that clinical research that uses DSM diagnostic categories as independent variables and faculty, in turn, use funding as a supreme criteria for faculty appointment and tenure review). Dissociation occurs when the business rules homogenize and restrict the field, biasing it against (9a) phenomena closest to the heart of the human conditions [e.g., dreaming] that does not lend itself to most rigorous rules and (9b) students and applicants driven by an intellectual curiosity about the raw nature of the psyche [or its theoretical structure and dynamics], favoring applicants with a record of rapid-fire mini-studies in topical, technical, or utilitarian issues. (9c) General dissocation. Student evaluation meetings are one vehicle (or venue) through which the norms can be strengthened (and group harmony promoted), but unfortunately these come at the expense of accuracy of information (e.g., about the student under review). Similarly, they have many other business rules governing research that promote the norms, but at the expense of truth (i.e., accurate AND ADEQUATE information about our subject matter).
  

This is my basic treatise in a nutshell. Most criticisms address the business rules. There are rules for everything (e.g., research methodology, presentation, & publication, career timetables, ethics, student training & evaluation, diagnosis & treatment, classroom instruction). It has gotten to the point where some faculty are required to use the same textbook and allocate a proportion of their class time to various multimedia props and devices. The policies I criticize most on my web site and in my groups include the null hypothesis testing system; the DSM and the requirement of many funding agencies that DSM diagnostic categories be used as independent variables in clinical research; publication & tenure requirements; the reliance on quantitative, confirmatory, inferential, and nomothetic methods to the near-exclusion of qualitative, exploratory, descriptive, and idiographic approaches respectively; the APA writing manual; and the use of textbooks, supplemental guides that teach the instructors how to use them, and banks of multiple choice test items created by publishers.

I refer to the sum of these rules as the "professional culture of Psychology" and I claim modern Psychology is concerned less with the pursuit of truth about the nature of the psyche than about the pursuit of excellence in the culture of professional Psychology.