The field of psychiatry has a very complex and often dark history. While they have led the way in identifying life saving treatments for a variety of symptoms and syndromes, they have often made egregious errors by pathologizing natural and healthy human experiences. It must be noted that there have always been stabilizing voices in the field, and it often seems that their own literature and guidance contradicts itself. They may argue that they include statements in their diagnostic criteria to limit the negative effects of this. Those statements include “must be a change from baseline”, “cannot be better explained by another condition”, or “must cause significant clinical distress”, but these tag-on criteria are often ignored by those making the diagnoses. The diagnostic manual (DSM) also waxes eloquently about any symptom or syndrome needing to be different from a “culturally appropriate” experience such as certain cultures seeing the spirits of their dead loved ones, or other phenomena that occur normally in religious contexts. 

All that to say, these cultural adjustments and the concept of distress are too nebulous to be useful. In the past, this led to a destructive and racist overmedicating of minorities and pathologizing of people whose sexual and gender identities diverge from the norm. I’ve seen people who were given antipsychotics for culturally and religiously appropriate visions, sedatives given to people experiencing relatively normal grief after the loss of a loved one, and people being sedated into a stupor simply for having a different opinion of the nature of their experiences. 

Schizophrenia and psychosis are very real conditions that often need to be treated with antipsychotics to keep people safe. However, simply believing something different from your physician doesn’t make you delusional. Bipolar disorder is a terrible disease and treatment with psychotherapy and medications can also be life saving, but it is often diagnosed in otherwise healthy people who would thrive if they were in a more supportive environment. At times, the problem isn’t the patient, but the society in which they live. Unfortunately, this over-pathologizing of normal human experience is so common that a huge number of people avoid psychiatrists, therapists, and even general medical doctors out of fear that their beliefs will be judged and medicated. 

“Personality disorders” are a good example of this problem. The person with a schizotypal personality is experienced as weird by others. They often keep to themselves, have beliefs that others don’t understand, and can seem quite bizarre to others. However, they can often be very beautiful and artistic people with an enormous amount of creativity. They do suffer, but it is because the world is inherently dangerous to them. It is also true that most of them have been severely traumatized early in life, and the magical world they create for themselves is the only safe place they know. With enough stress, they can become overtly psychotic, but medications don’t seem to work because retreating into themselves is the only way for them to feel safe. 

In America, we have even pathologized being an introvert. They even include “extraversion” on lists of the most important components of a psychologically healthy person. I have met many people with severe anxiety, but they didn’t have a true anxiety disorder. They were just an introvert that felt the only way for them to have any success in life was to be a Type A, extroverted person. They can often keep it up for years, but then the stress of fighting their natural personality overwhelms their system and they begin to fall apart. 

Religious experiences are very similar. While modern society seems to have split into an atheist/secular/scientific culture and a religious/dogmatic/fascistic culture, neither of these is the natural state of things. Both of those ingrained cultural groups are two sides of the same organized religious coin. Both have such strong beliefs that they cannot understand the other, and both shrink into little worlds where their television shows, their friends, and their facebook algorithms support their own biases. Both of these are seen as normal, but the natural human experience is seen as illness. 

The natural human has spiritual experiences and cravings. They organically develop beliefs through these experiences rather than by surrounding themselves with a particular dogma. They are rarely obsessed with judgment or punishment, and they usually keep their beliefs to themselves and their loved ones. However, if they talk too much about this normal human experience, then they are often ridiculed or diagnosed by the benevolent paternalism found in medicine and psychology. 

Why is this being talked about in a Neuropsychiatric article? Because many people censor themselves when talking to physicians because of fear of this ridicule. They are also often afraid to be inappropriately diagnosed, or even institutionalized. They are left on their own to navigate these experiences without the help of doctors or guides. They may fear that an experience is a consequence of a medical problem leading to anxiety and distress. Often the experience is very normal or common, or a benign symptom of a condition like migraine. It is their fear that something is wrong with them or possible mistreatment by providers that causes the distress rather than the symptom itself. 

In these articles, I will discuss many different types of human experience that have been well documented as natural, some that we know are common but don’t fully understand, and some that can be part of a medical problem if unaddressed. If you’d like to talk to an expert in the brain from the perspectives of both psychiatry and neurology regarding a particular symptom or belief in a judgment free way, with the safety of knowing that only a risk of imminent self harm or homicidality will break the oath of confidentiality, please request a consult today!