Look ma! Graduate-level work!

Here is an excerpt from my "DSM Journal" assignment, in which we are asked to critique something in the Big Fat Book from a cultural perspective. This is one of six entries. Some of them are actually thoughtful (and thus have no place in this blog). This just qualifies as smart-ass commentary, posted because I should have *some* evidence of doing homework today. Without further adieu:

On the business of Personality Disorders, I take note of the DSM’s admonition that, “Personality Disorders should not be confused with problems associated with acculturation following immigration or with the expression of habits, customs or religious and political values professed by the individual’s culture of origin.” It also talks about “evaluating someone with a different background.”

To the DSM, I must say, “Pardon me, but a background different from whom? And how, exactly, do you determine a ‘culture of origin’ is justifiably different from whatever is considered the dominant culture?”

I’m thinking, of course, that there are little cultures everywhere. Each family is different; each city is different; each region of the country is different. What’s “normal” in Portland might be considered “outrageous” in Raleigh. When, within the United States alone, you can have so much cultural diversity, why are we giving the benefit of the doubt only to immigrants and religious people?

Here is a little slice of my familial and regional culture: Born in Gainesville, Florida, to the (half non-white) adopted daughter of a wealthy, extremely Catholic, French Canadian lumber baron’s family and to the son of a “Tennessee hillbilly who graduated from the School of Hard Knocks.” Raised in Miami; Greenville, South Carolina; and Houston. Educated by nuns through the sixth grade, then educated in public schools full of stuck-up rich kids. As my parents actively hated each other for 20 years prior to divorcing, no decent role model in the house for love and affection. Taught by my dad to compete in everything. Taught by my mother that competing was unseemly. Learned to smoke pot from my counter-culture uncle and his Honduran wife from New Orleans. Learned to mix a good gin and tonic from my French-speaking grandmother. Taught by my hillbilly grandfather to hate Republicans.

That’s just the smallest view into my culture of origin. Add all the ways in which I diverge from that particular group of influences – such a being a lesbian in the South, then out on the West Coast (two vastly different cultures, I assure you!) – and I have to wonder just where a diagnostician is supposed to draw the line in determining which of my behaviors fit the criteria for a Personality Disorder and which are just quirky detritus generated by my “culture of origin.”

I can easily see why several of the diagnoses are considered disorders in American culture. Antisocial Personality Disorder, for example, is essentially based on the laws of our society and a lack of remorse for breaking them. In Liberia, which has been broiling with cross-dressing, drugged-up militias, this type of behavior may be required for survival. But here, it’s a nuisance at best, and we regard those who don’t behave as a member of our “civilized” society as having a personality disorder.

But Schizotypal Personality Disorder? Just reading the criteria makes me wonder where the DSM gets off, especially with criteria such as “behavior or appearance that is odd, eccentric or peculiar.” By whose definition? Several of the criteria for this disorder seem to defy any cultural considerations, even as they give a nod to things like “subcultural norms.” I wonder how well-versed some therapists are in subcultural norms? How will they – how will I – make that distinction in this multimedia world of endlessly mushrooming subcultures?

And Histrionic Personality Disorder describes just about every actor and drag queen I’ve ever met. What’s up with that?