Thursday, April 1, 2010

Rerun: Breaking News: Psychiatry Comes Up With New Diagnosis of Asshole

A Knowledge is Necessity exclusive.

In a surprise move expected to be announced shortly, the American Psychiatric Association's Task Force responsible for overseeing the revision of the DSM - psychiatry's diagnostic bible - has come up with the new diagnosis of "Asshole."

Unlike other disorders, episodes, types, and specifiers listed in the DSM, the diagnosis of Asshole fails to mention any symptoms. Nor does it offer a description of the illness.

"Let's put it this way," said E Pontius Paella MD, director of the Darwin Awards Treatment Center at Johns Hopkins and member of the working group that came up with the new diagnosis, "you know one when you see one."

The new diagnosis is the result of heated discussion throughout the Task Force's many working groups, in particular the one responsible for updating the bipolar diagnosis. According to bipolar group member S Belinda Humphries MD of the University of Northern South Dakota, speaking strictly off the record: "We were sick of hearing from our bipolar patients about the bad rap they were getting as a result of Assholes who had mistakenly been diagnosed as bipolar."

Leading bipolar patient advocate Phil Toogood was ecstatic over the news. "It's about time," he commented. "Since the dawn of history we've been putting up with their shit. Every time someone does some asshole thing, people automatically assume the jerk must be bipolar. Maybe now the public won't confuse us."

It isn't just bipolars. Reports Charles Manson from his prison cell: "For years, assholes have been giving us sociopaths a bad name."

The illness is considered chronic and untreatable. When asked to give an example, Dr Paella commented, "That's easy. Rush Limbaugh. Say no more." Dr Paella did add that Assholes can go on to lead productive lives. "Look at all those idiot commentators on Fox News," he observed. "See, there is hope."

When advised that not every Asshole can aspire to a position on Fox News, Dr Paella replied: "No problem. They can always become antipsychiatry bloggers."

The new diagnosis of Asshole is expected to become official in 2013, when the American Psychiatric Association is scheduled to publish the fifth edition of the DSM.


Anonymous said...

Yeah but with an affliction rate of like 1 in 3 you get asshole doctors too, afraid of admitting to their affliction, and projecting onto their patients their sense of denial. Thus enabling a reason for anti-psychiatry.

Just ask Dr. Quack....

Willa Goodfellow said...

The pension fund of the Episcopal Church specifically excludes disability coverage for assholes. Assholes have to stay on the job until their parish or diocese is willing to buy them off. (This happens with depressing regularity.)

John McManamy said...

Hey, Anonymous. Our infamous "Dr Drake" is in a dead heat with Glenn Beck for Asshole of the Year. :)

John McManamy said...

Hey, Willa. I've run across way too many assholes masquerading as Christians, so I can identify. Jesus hated them. Remove the terms Pharisees, scribes, doctors of the law, and priests from the Gospels and put in assholes and you'll see what I mean. I suspect the Gospel writers may have cleaned up Jesus' language by doing the reverse.

John McManamy said...

Hey, Anonymous. Forgot to reply to your antipsychiatry "enabling" comment. Yes! Asshole doctors are antipsychiatry's best friend. One asshole doctor gives the antipsychiatry movement instant credibility.

Anonymous said...

half human monster reveals itself like the car
of your dreams becomes the crash of your
life in the hills of shame dealers play the
blame game the winner is a chronic assoholic
do i know you? who's deciding now
or never the animals'
agenda sonic defender
three blue suits argue
the button to push you
the best laid plans distorted
by the deaf-like
assoholic do i know you?
you wanna play me
backwards a bad idea whose time is now

guess the lyrics/artist?

battleatbipolarhill ;-)

Tony said...

One key symptom of assholes is a good dose of anosognosia. They have no insight how much of an asshole they are.

John McManamy said...

Hey, Tony. I think anosognosia spelled backward is asshole. :)

Anonymous said...

You do know that this unofficial diagnosis has been used by staff in cutting edge mental health units for decades already. It is an optional term for antisocial or borderline personality disordered individuals, as part of staff dark humour, and calling spades spades really. Not all a-holes have aspd or borderline PD it is true, but the vast majority with these disorders do qualify as a-holes. Certainly there is an issue with bordeline PDs being misdiagnosed as bipolar disorder - hence the borderline a-holes are bringing an undeserved bad name on real bipolars. Blame the pharmacuetical companies, they encourage Drs to shunt the borderlines under the bipolar classification because this way it's allowable to prescribe more drugs to them. Not ones that they need but oh well... I guess the pharmaceutical pushers may be a-holes too. Signed registered psych nurse.

John McManamy said...

Hey, Registered Psych Nurse. Thanks for bringing this out into the open. I definitely encountered this working with DBSA. People who were given a drive-by diagnosis of bipolar, but whose asshole behavior could not be accounted for by bipolar.

So here are these people acting like assholes trying to get a free pass for their behavior by playing the bipolar card. Yes, bipolars can act outrageously, too, but hang us for the right crime, please.

No doubt about it, bipolars get a bad rap on account of assholes mistakenly identified as bipolars.

I was on the board of a state DBSA group and I had to resign - the board was dominated by certifiable assholes. Suffice to say, organizing at the state level proved impossible. I strongly suspect this occurs at other DBSAs, as well.

Making the borderline call is not rocket science. But a routine psych evaluation won't pick it up. You have to be around them - experience their unpredictable behavior, their meltdowns, etc.

The tragedy is they're sent out the door with a bipolar diagnosis and thus continue to lead miserable lonely lives. The right diagnostic call with the right therapy can turn their lives around.

So yes, if you see asshole behavior, if you can't link it to a mood episode, then borderline is your prime suspect.

As for antisocial. The DSM differentiates this from borderline, but I suspect in the real world this translates to the male version of borderline.

Again, it is a tragedy. Those with borderline and antisocial wind up alone and ostracized, at odds with the world and themselves. Psychiatry needs to do a much better job identifying and treating these individuals.

But, yes, let's call a spade a spade. This is clearly asshole behavior.

There. We've stirred up the pot. Let the conversation begin.