In Celebration Of Our One Year Birthday

Stepping Further Out of The Box

Stanley Siegel, Founder / Editor-in-Chief

As I enter my fortieth year as a psychotherapist, I am able to take a long view of my practice and the profession in a way that wasn’t possible at an earlier age. With the passing of decades, I am especially conscious of the transience of grand theories and practices that were once charged as “true” that later give way to even newer “truths.”

The most influential and stubborn theory to yet topple, however, is the use of psychiatric diagnoses to explain human behavior. A disease model derived from agreed-upon definitions of “normal,” psychiatric diagnoses have been codified in the Diagnostic and Statistical Manual of Mental Disorders (DSM), with far-reaching consequences. It affects millions of people and billions of health care dollars, because it determines who qualifies for subsidized health care services, treatment programs, and insurance reimbursement.

Worse, dehumanizing, cultural biased and lacking in integrity, the DSM medicalizes all behavior, forcing clinicians to make distinctions that trivialize individuality and creativity, and to recommend unneeded treatments and drug prescriptions — a goldmine for pharmaceutical companies. Its architects invent new disorders based on questionable science. Viewing it from a wider perspective, the mental health profession is growing closer to a free market enterprise and away from its original humanistic concerns.

The articles in this issue of PTM, which celebrates our one year birthday, speak against the categorization and codification of behavior in favor of approaches that honor our extraordinary originality as human beings – the ways in which our behavior as individuals defies and transcends concepts of “normal” or “pathological.”

As a first example, the new DSM-V goes as far to include video gaming as a modern-day psychological disorder based on the lack of impulse control, much the same as “compulsive” gambling. Psychiatrists prescribe medications for “video game addiction,” and as a result, some parents, following suit, vilify their children for gaming when they could be “doing more productive things,” like sports or piano lessons.

PTM contributing writer Ben Peck, in his essay, How Video Games Make You A Better Person, tells us that during thirty years of playing games daily, he managed to get through high school and Columbia University cum laude and law school magna cum laude. In fact, He credits video games for sharpening his mind: Improving his critical thinking, decision making abilities, increasing his imagination and knowledge of the world at every stage of his life. And he feels better adjusted, more adaptable, socially-engaged and has a greater sense of well-being than most.

Similarly, in Against The Use of Psychiatric Diagnosis:What is Normal Sex and Who Determines It? I challenge how mental health professionals use the DSM to pathologize, and religious leaders to demonize sexual behavior outside the norm. Instead, I offer an alternative: to honor and express our deepest sexual truths and accept ourselves in all our human complexity.

Does the mental health profession contribute to the subjugation of women? Are women actually the less monogamous gender? Do women really crave intimacy and emotional connection? Are women more disposed to sex with strangers and multiple pairings than either science or society have ever let on? Katherine Schreiber reviews Want Do Women Want? by Daniel Bergner and challenges conventional views of female desire.

Acting out our sexual desires is essential to our sense of well-being. We always have the choice to limit their expression to the bedroom or design a lifestyle around them depending on the depth of our needs and the authenticity of relationship we create with a partner. In this month’s column, What does a sex therapist do? sex therapist Alyssa Siegel explains some of the reasons why couples reach a sexual impasse and brings us into her consultation room to show us how she works with them to move forward, in her essay, What does a sex therapist do?

Art. Is this a word that should make psychoanalysts anxious, concerned, or nervous? In this second half of his two-part essay investigating the interrelationships between art and psychoanalysis, Robert Frashure asks whether there might be limits to the conventions of talk therapy, with a particular focus on psychoanalysis, and ways in which art might be even more therapeutic and powerful. In Should Psychoanalysts Fear Art?, Frashure considers how artists and their creations might enrich the field of psychoanalysis.

No story more exquisitely captures the moment when love is no longer blind than Shelia Heti’s, What Changed? Excerpted from her book, The Middle Stories, a strikingly original collection of short stories that captures the individuality of each of our hearts and minds and at the same time, our shared humanity.

Two deeply personal essays in this month’s issue describe catalyzing moments that lead to personal transformation and change. In I am Hobart, and I am an Alcoholic, Hobart Folwes tells how a chance encounter with a sex worker led him into the rooms of AA and engage in a struggle to save his life. Anonymous author K.E.S. describes why her current partner was the first man with whom she did not want secrecy and with whom she wanted a relationship unlike her previous ones that included secret liasons with anonymous sexual partners that provided momentary jolts of empowerment or sparks of feeling attractive.

For a half century, Edward Field, now 89, has endured as a treasure of American poetry. He continues to add to his legacy with work about his experience with aging. PTM previews two poems in which Field deploys language that is so powerful and honest that it shatters myths of aging like a stone striking glass.

In Deconstructing the Uniform, Matthew Ortiz asks questions fundamental to our understanding of the mass psychology behind fashion. Among them: What does your uniform say about you and the person who’s not wearing it? Just how far beyond the tangible, sartorial world do we put ourselves into a uniform identity? How does the uniform hinder the individual and also the social experience and expression of dress and expectation?

Swedish choreographer Mats Ek’s vision turned ballet from its fairytale story lines to the realities of everyday life. Ek created a structure that bridged classical and contemporary dance, acknowledging their differences while retaining technique at its core. Psychoanalyst and dancer Velleda Cecelli surveys Ek’s extraordinary body of work which reflects the beauty, strength and intimacy of a truly groundbreaking choreographer in Visionaries, innovators and diviners – Mats Ek: Architect of intimacy.

Our team thanks you for your extraordinary support and encouragement this year. We know from your comments and emails that many of you have been awakened, found solace or inspiration in the art and writing we have curated in our inaugural year. With you as our allies, we increasingly will find artists, psychotherapists and scientists who have the courage to think outside of conventional boxes to present their work at professional risk.

Happy Birthday.