Friday, December 26, 2008

A Bit of Radical-Feminist Analysis, from an Unexpected Source

Here I am, reading Thomas Hardy's Jude the Obscure --- a novel whose entire plot might well constitute an at least somewhat feminist protest against the constraints and entrapments of patriarchal marriage --- when I come across three passages that would not be out of place in a book of radical-feminist theory.

Sue was silent. "Is it wrong, Jude," she said with a tentative tremor, "for a husband or wife to tell a third person that they are unhappy in their marriage? If a marriage ceremony is a religious thing, it is possibly wrong; but if it is only a sordid contract, based on material convenience in householding, rating, and taxing, and the inheritance of land and money by children, making it necessary that the male parent be known --- which it seems to be --- why surely a person may say, even proclaim upon the housetops, that it hurts and grieves him or her?"
In the above passage, Sue (who is apparently a New Woman, that turn-of-the-last-century participant in and beneficiary of first-wave feminism) bemoans the simultaneous crass economic underpinnings and strict rules of etiquette in marriage, which conspire to cut the married person off from frank and emotionally satisfying discourse, and isolate her in her own doubts, discontents and anxieties.

Jude, will you give me away? ... I have been looking at the marriage service in the prayer-book, and it seems to me very humiliating that a giver-away should be required at all. According to the ceremony as there printed, my bridegroom chooses me of his own will and pleasure; but I don't choose him. Somebody gives me to him, like a she-ass or she-goat, or any other domestic animal. Bless your exalted views of woman, O churchman!
This hardly needs explanation; I do like that, though much of Jude is told from a male point of view, and accordingly most of its condemnations of patriarchal marriage issue from male characters' mouths, a female character writes these lines complaining of marriage's role in keeping alive the idea that women are property.

"What --- you'll let her go? And with her lover?"
"Whom with is her matter. I shall let her go; with him certainly, if she wishes. ..."
"But if people did as you want to do, there'd be a general domestic disintegration. The family would no longer be the social unit."
"Yes --- I am all abroad, I suppose!" said Phillotson sadly. "I was never a very bright reasoner, you remember. ... And yet, I don't see why the woman and the children should not be the unit without the man."
"By the Lord Harry! --- Matriarchy! ... Does she say all this too?"
(I love that last line, and the highly entertaining mental picture it leads me to conjure of this "Lord Harry" character. I imagine a pipe, a dressing gown and an expression of refined astonishment).

Finally, Jude himself (whom I have not quoted yet --- the speakers above are Jude's cousin Sue in the first two passages and Sue's husband Mr. Phillotson in the third) has this to say about the nuclear family:
The beggarly question of parentage --- what is it, after all? What does it matter, when you come to think of it, whether a child is yours by blood or not? All the little ones of our time are collectively the children of us adults of the time, and entitled to our general care. That excessive regard of parents for their own children, and their dislike of other people's, is, like class-feeling, patriotism, save-your-own-soul-ism, and other virtues, a mean exclusiveness at bottom.
Let's compare this last passage with some of Shulamith Firestone's thoughts on child-rearing; she, too, thought communal child-rearing* would be a more humane scheme:
But what about children? Doesn't everyone want children sometime in their lives? There is no denying that people now feel a genuine desire to have children. But we don't know how much of this is the product of an authentic liking for children and how much is a displacement of other needs. We have seen that parental satisfaction is obtainable only through crippling the child: The attempted extension of ego through one's children --- in the case of the man, the "immortalizing" of name, property, class, and ethnic identification, and in the case of the woman, motherhood as the justification of her existence, the resulting attempt to live through the child, child-as-project --- in the end damages or destroys either the child or the parent, or both when neither wins, as the case may be.
I shall now outline a system that I believe will satisfy any remaining needs for children after ego concerns are no longer part of our motivations. Suppose a person or a couple at some point in their lives desire to live around children in a family-size unit. While we will no longer have reproduction as the life goal of the normal individual --- we have seen how single and group nonreproductive life styles could be enlarged to become satisfactory to many people for their whole lifetimes and for others, for good portions of their lifetime --- certain people may still prefer community-style group living permanently, and other people may want to experience it at some time in their lives, especially during early childhood.

Thus at any given time a proportion of the population will want to live in reproductive social structures. Correspondingly, the society in general will still need reproduction, though reduced, if only to create a new generation.

The proportion of the population will be automatically a select group with a predictably higher rate of stability, because they will have had a freedom of choice now generally unavailable. Today those who do not marry and have children by a certain age are penalized: they find themselves alone, excluded, and miserable, on the margins of a society in which everyone else is compartmentalized into lifetime generational families, chauvinism and exclusiveness their chief characteristic. (Only in Manhattan is single living even tolerable, and that can be debated). Most people are still forced into marriage by family pressure, the "shotgun," economic considerations, and other reasons that have nothing to do with choice of life style. In our new reproductive unit, with the limited contract (see below), childrearing so diffused as to be practically eliminated, economic considerations nonexistent, and all participating members having entered only on the basis of personal preference, "unstable" reproductive social structures will have disappeared.

This unit I shall call a household rather than an extended family. The distinction is important: the word family implies biological reproduction and some degree of division of labor by sex, and thus the traditional dependencies and resulting power
relations, extended over generations; though the size of the family --- in this case, the larger numbers in the "extended" family --- may affect the strength of the hierarchy, it does not change its structual definition. "Household," however, connotes only a large grouping of people living together for an unspecified time, and with no specified set of interpersonal relations.

Though the two books approach the same problem from opposite angles --- Firestone's is a purely structural and political analysis, while Hardy's characters, lacking political consciousness, have only their own thoughts, feelings and experiences to guide them. They feel trapped by marriage laws and social strictures, and suspect that a freer, humaner way of life might be possible.

*At least, to the limited extent Firestone believed in childhood and the need of children to be reared at all, she felt it would best be handled communally, with the child hirself choosing which adults would feature most prominently in hir life.

Sunday, December 21, 2008

A Bit More on Reproductive Choice

It occurs to me that, in my last post, I neglected to mention what has probably been the single most important reproductive-choice issue for disabled women throughout history: the right to reproduce.

Here is a brief passage from Edwin Black's 2003 history of the American eugenics movement, War Against the Weak, describing the far-reaching campaign to sterilize all people deemed "unfit"*:
In the two decades between Indiana's pioneering eugenical sterilization law and the Carrie Buck decision [link], state and local jurisdictions had steadily retreated from the irreversible path to human sterilization. Of the twenty-three states that had enacted legislation, Maine, Minnesota, Nevada, New Jersey, South Dakota and Utah had recorded no sterilizations at all. Idaho and Washington had performed only one procedure each, and Delaware just five. Even states with strong eugenics movements had only performed a small number: Kansas, for instance, had sterilized or castrated 335 men and women; Nebraska had sterilized 262 men and women; Oregon had sterilized 313; and Wisconsin had sterilized 144.

Although some 6,244 state-sanctioned operations were logged from 1907 to July of 1925, three-fourths of these were in just one state: California [link]. California, which boasted the country's most activist eugenic organizations and theorists, proudly performed 4,636 sterilizations and castrations in less than two decades. Under California's sweeping eugenics law, all feebleminded or other mental patients were sterilized before discharge, and any criminal found guilty of any crime three times could be asexualized upon the discretion of a consulting physician. But even California's record was considered by leading eugenicists to be "very limited when compared to the extent of the problem."

Many state officials were simply waiting for the outcome of the Carrie Buck case. Once [Justice Oliver Wendell] Holmes' ruling was handed down, it was cited everywhere as the law of the land. New laws were enacted, bringing the total number of states sanctioning sterilization to twenty-nine. Old laws were revised and replaced. Maine, which had not performed such operations before, was reponsible for 190 in the next thirteen years. Utah, which had also abstained, performed 252 in the next thirteen years. South Dakota, which had performed none, recorded 577 in the next thirteen years. Minnesota, which had previously declined to act on its legislation, registered 1,880 in the next thirteen years.

The totals from 1907 to 1940 now changed dramatically. North Carolina: 1,017. Michigan: 2,145. Virginia: 3,924. California's numbers soared to 14,568. Even New York State sterilized forty-one men and one woman. The grounds for sterilization fluctuated wildly. Most were adjudged feebleminded, insane or criminal; many were guilty of the crime of being poor. Many were deemed "moral degenerates." Seven hundred were classed as "other." Some were adjudged medically unacceptable. All told, by the end of 1940, no fewer than 35,878 men and women had been sterilized or castrated --- almost 30,000 of them after Buck v. Bell.
Because of differences in available procedures (the first vasectomy was performed in 1897, and they were being used for eugenic purposes by 1899, while tubal ligation did not become widely used until after 1930**), the sex ratio among people sterilized during this period changed with time. In the earlier years, from 1907 until about the mid-1930s, more men than women were sterilized, but in the 1930s and after, the trend reversed, with more women being sterilized even though tubal ligation is a more invasive, riskier procedure than vasectomy***.

In case you're under the impression that coerced sterilization of disabled people (particularly women) has been relegated to the history books, here is a brief, noncomprehensive list of forced-sterilization cases since 2000:

  • Ashley X (2004)
  • Katie Thorpe (2007) - a 15-year-old British girl with cerebral palsy, whose mother has asked that her growth be stunted and her uterus removed.
  • Kristen Johnson (also called KEJ) (2008) - a 29-year-old Chicago woman who has said she wants to have children, but whose aunt filed a request for a tubal ligation, which the Illinois Appellate Court refused.
  • Laura Ferris (2003) - 13-year-old girl from Tasmania with Childhood Disintegrative Disorder whose mother had sought a hysterectomy for her in order to prevent menstruation. The request was denied.
  • "Carla" (2001) - 24-year-old woman with Down syndrome, cared for by her grandfather, who wants her to get a tubal ligation

Why do I bring all this up? I have two reasons, one political and one personal. (Or, since the personal is political, maybe one is just more explicitly political than the other). First, this new rule from the Department of Health and Human Services, which allows health-care workers to refuse any treatment that "violates their personal beliefs", could make it even harder for disabled women who want children to find an OB-GYN willing to help them. In a cultural climate where disabled women (and men) have, until fairly recently, been routinely sterilized for the perceived good of Society, and where, even now, disabled women and girls are sometimes sterilized without their consent because their parents or guardians believe it would be best for them, and disabled people are seen as selfish, irresponsible and reckless for choosing to have children, this rule adds another layer of uncertainty and hazard to the already-fraught process of Procreating While Disabled.

The other, more personal, reason I bring this up is that this is the context in which my own reproductive choices are being shaped, and into which they will reverberate. I do not wish to have children. I'm so confident in the strength and persistence of this wish (and the various reasons that feed into it) that I want, and am seriously considering, surgical sterilization. What I emphatically do *NOT* want, however, is to strengthen anybody's conviction that disabled women should not have children just because I don't want to. I'm choosing sterilization because it's what I want; I'm not being "unselfish" or "mature" or "responsible", except inasmuch as recognizing what one wants and taking steps to achieve it is mature and responsible. Hence, when I do go in, I think I will leave my autism (and depression) out of it entirely, and tell them why I don't want children in generic, personalized terms --- I don't much like other people, I like a lot of time to myself, I don't handle demands well, I like quiet --- or broad, impersonal terms --- I have ethical issues with adding more people to an already-overpopulated world, especially when I'd be adding them to the richest, most energy- and resource-hogging country on the planet, and when so many children who already exist need homes. I will shift the question from "Should I give this autistic woman a tubal?" to "Should I give Lindsay a tubal?"

*This term encompassed many different categories of people: racial and ethnic minorities (blacks, Native Americans, Mexicans, Chinese, and even non-Anglo-Saxon European immigrants), petty criminals, poor people, chronically unemployed people (researchers at the time observed that crime, poverty and unemployment tended to affect whole families, and inferred that therefore those things must be genetically transmissible!), alcoholics, epileptics, blind and deaf people, people with low IQ scores (who were, of course, overwhelmingly poor, nonwhite or immigrants), and people who had been committed to insane asylums. Often, the "unfit" also included blood relatives of any of the above.
**Procedures for female sterilization, like the salpingectomy and primitive, non-laparoscopic versions of the tubal ligation, had existed and been used infrequently since the 1880s.
***One possible reason more women were sterilized once tubal ligation came into common use might be the practice of clandestinely performing tubal ligations on women who had children by C-section.

Monday, December 15, 2008

Disability Rights and Bodily Autonomy

Shiva has an intriguing post up about assisted suicide and "mercy" killing --- as a libertarian, he is obviously in favor of the former and opposed to the latter. While most of his post is about recent assisted-suicide cases in the UK, and specific details thereof, it's the general principles I want to respond to:

The thing I really want to get to here, though, is the concept of "mercy killing". I want to say, as emphatically as possible, that there is no such thing. If Lynn Gilderdale's mother was actively involved in her death [link], then it was either murder or assisted suicide - if Lynn did not ask her mother to help her take the overdose, then it was the former, and if she did it was the latter. As, according to the Mail report [link], she had twice attempted suicide already by the same method (although it does not say why she was not successful), in this particular case assisted suicide looks more likely - but that doesn't equate to "mercy killing", which term suggests a person being killed, not at their own request, but based on the decision of the killer, not the killed, that killing them would be more "merciful" than letting them live.

That is killing someone against their will, and that, emphatically and undeniably, is murder. In fact, as far as I'm concerned, it's a worse kind of murder than one motivated by hate, anger or jealousy. Murder with those motives I can understand, but the monstrous twistedness of the mentality of someone who claims to murder someone else out of love utterly terrifies me, so much that I can hardly write coherently about it. A society in which familial love can be twisted into wishing those you love dead, apparently doing so because you love them, is a society there is something deeply, horrifically wrong with.
It would logically not need to be said, but probably still bears repeating, that in a libertarian worldview this is totally different from assisting with a person's own decision to end their life, even though (as I said in my previous post on the subject) the mainstream media (and seemingly some parts of the disability rights movement) insist on conflating them.
I said in a comment on his post that I could see being against even assisted suicide from a disability-rights perspective: in the ableist, profoundly stratified society we live in, where access to needed supports is often confined to those who can pay for them, more people may choose to end their lives than would in a more accessible, egalitarian society, and many of those people could not be said to have "chosen" their fate so much as to have been pushed into it by myriad external forces. It is not hyperbole to say that this, if it became widely practiced, would constitute genocide.

This conflict between the individual's right to hir own body and the existence of social conditions that make some choices problematic comes up in a few other issues at the intersection of feminism and disability rights: sterilization, genetic testing and selective abortion.

Most feminists believe that women have the right to absolute reproductive freedom --- that they ought to be free to make whatever choice, for whatever reason, irrespective of whether it's a good reason. That includes the freedom to abort a perfectly viable, uncomplicated pregnancy if she discovers the fetus will be born with a disability. Disability-rights activists, even feminist ones, do not much like that possibility. They condemn prenatal testing for such conditions as Down syndrome, autism and whatever else as eugenic, and abortions sought on the basis of positive results to such tests as genocidal.

In the objections to both assisted suicide and selective abortion, in addition to the immediate concern that any individual's rights are being violated, there's an overarching concern about the direction society will take (with respect to disability rights). Since individual solutions to these problems (of severe disability, prolonged illness, or pregnancy with a disabled fetus) cost society nothing, while systemic solutions (greatly improving the quality and availability of healthcare, reworking infrastructures to make them more accessible, changing cultural attitudes toward disability, etc.), though they are often the best solution, and though they solve the problem once and for all rather than one instance at a time, cost a lot in money, time and effort. Especially with selective abortion, there is a fear that people with whatever disability is being talked about (usually Down syndrome) might become such a tiny numerical minority due to selective abortion that social supports for them will atrophy, having become no longer cost-effective. No choice is made in a vacuum, these critics say, and even when they do not wish to bar women from getting selective abortions, they call on women to realize that their choices, in aggregate, will have effects far beyond their own lives, and to factor the likely impact of different courses of action into their choices.

This same question lies at the heart of the endless quarreling within feminism over pornography and prostitution. How can the right of those women who choose to be sex workers to do whatever they want with their own bodies be squared with the rights of other women who were forced into sex work? Furthermore, how can the right to do sex work be reconciled with the endemic cultural stew of woman-hating imagery of which sex work is part and parcel?

In all of these quandaries, I think the right choice lies in preserving the greatest possible level of individual freedom (in other words, yes, you should be free to decide to die, even if you need help performing the life-ending act; yes, you should be free to get an abortion for whatever reason; and yes, you should be free to use your body however you like, and to choose whatever line of work you want, even if most people wouldn't approve of your choices) while simultaneously pursuing a more equal society with the vigor that comes from knowing that, even with the whole panoply of individual solutions open (theoretically) to all, most people will be restricted by economic, personal and social circumstances to a few bad choices.

Systemic solutions don't destroy people's freedom to pursue individual solutions; they just make it less likely that very many, outside the elite, will do so.

Sunday, December 14, 2008

Biology Geeks of the World, Rejoice

There's a protein-folding game you can download!

You can play it by yourself, online or off, or you can choose to compete with other players (online) to see who can find the best configuration for a given protein fastest.

(Because of the time component, I am unlikely ever to try PVP protein-folding. I am very slow at games in general).

But the best part? Just by playing the game, you're helping the researchers who created it determine whether a big group of human players can predict protein structures better than existing computer simulations.

The one gripe I have with it is that it doesn't tell you very much about how to play. I just started by wiggling stuff around more or less randomly, and then going with what seemed to work.

(I think I might solve puzzles exactly like the computers they're hoping to replace. D'oh!)

Tuesday, December 9, 2008

"You Are a Strange Child, Miss Jane"

In the comments to an earlier post, Shiva linked to this article in the online journal Nineteenth-Century Gender Studies, titled "On the Spectrum: Rereading Contact and Affect in Jane Eyre." It looks at Jane's interactions with other characters, and her emotional expressivity. This latter quality, the article's author (Julia Miele Rodas, who is working on a book on disability in Jane Eyre) cautions, appears very different to us, the readers, who see Jane's emotions as she experiences them, than it does to the other characters, who see her characteristic impassive facade. To Rodas, this "flattened affect" she presents to the other characters constitutes Jane's "most obvious autistic characteristic":
It makes sense to explore further the appearance of Jane Eyre's autism by looking more closely at the impression of missed connection that frequently arises between autistic and nonautistic people. Nonautistic people often attribute this sense of disconnect to a mistaken belief that individuals with autism have little or no feeling, but indeed, the contrary is more likely true. Autistic persons typically experience intense sensations and emotions, but may habitually reduce the appearance of feeling or shield the self from a barrage of overwhelming external stimuli (including dialogue and other forms of communication) in order to preserve an integrated sense of identity. For "high functioning" autistic persons, this shielding may take the form of exceedingly effective social performance that can leave both self and other with a sensation of loss or failure. ...
Within Jane Eyre, there is substantial evidence that Jane, too, participates in similar autistically informed social exchanges. In adulthood, as Jane exerts increasing control over her passionate emotional life, reducing her affect and concealing her deeply rooted feelings with ever greater success, experienced readers tend to contextualize this process in terms of cultural history, understanding the narrator's extreme self-control, her apparent poise, as meshing with historically appropriate social conventions. Readers know, as Jane does, that a Victorian gentlewoman must not evidence feelings of passion, must not put herself forward, must not be seen to harbor ideas or opinions that are beyond her limited social scope. Because the reader experiences Jane's self-control from the inside, though, he always sees the roiling passions and rarely notices or questions the narrator's most obvious autistic characteristic, the silence and flattened affect, the autistic remoteness that other characters clearly experience. (emphases added; italics in original)
While I had been perfectly content to ascribe Jane's awkward, bookish remoteness to her childhood (she is, after all, an orphan reared by unloving and resentful relatives) and her station (she is a governess, which makes her at once servant and gentlewoman, and obliges her to display simultaneously the self-effacing deference of the one and the fine manners and haughty reserve of the other), Rodas finds in the character a still-deeper vein of strangeness. She points out other characters' frequent mystification by Jane's utterances and behavior, and musters a slew of other minor details to paint a tantalizingly autistic-like picture:
Having already touched on her experience of exclusion in childhood, an account that dovetails suggestively with narratives offered in modern autism autobiography, it may be helpful to reconsider the character of the adult Jane Eyre with a sense of autism in mind. With an interpretive gesture alert to autistic possibilities, all kinds of minor details and episodes, all manner of quirky characteristics, take on new significance. Jane's "Quakerish" appearance, her sense of aloneness at Lowood, even after many years of residence; the feeling of peace and wholeness she seems to derive from nature, from gardens, from plants instead of people; her silent impatience with a talkative roommate ("a teacher who occupied the same room with me kept me from the subject to which I longed to recur, by a prolonged effusion of small talk. How I wished sleep would silence her" [85; Ch.10]). The episode of homelessness between her residences at Thornfield and Moor House, failing to take valuables with her, forgetting the morsel of luggage she does take along, forgetting her newly discovered connections, are all strongly reminiscent of homeless experiences described by [Dawn] Prince-Hughes and Donna Williams, each of whom describes a sense of panic which induces them to leave places of comparative security. Think of Jane's sincere, but formal affection for Adele, the consideration of the girl's well-being as though from a distance. Jane's early period of engagement with Rochester, she provoking him into sparring with her continually, actively and consciously resistant to tenderer forms of affection, hints at a fear of conventional contact, a reluctance to connect sexually which is also a recurrent theme in autism literature. Even Jane's discreet relationship with Pilot, her acknowledgment of Rochester's dog as a seeming peer, as an individual worthy of respect, demonstrates an autistic sensibility, a connection to animals that echoes that of many other autistic persons.
I'm not convinced by all this that Jane has to be autistic --- there are too many other possible explanations for this constellation of traits --- but it is a lot of fun to play literary Spot-the-Aspie (or Autie). I actually wrote a paper (it was supposed to be a personal essay, not a serious critical work, don't freak out) very like this one about Stephen Dedalus in A Portrait of the Artist as a Young Man. If I can find it (which I doubt I can; I suspect it was on my old computer which now belongs to my grandpa, having been wiped clean), I will post a heavily edited version here. (Heavily edited because the thing was a ten-page monster).

The thing that strikes me about Rodas's list is the extent to which I noticed similar traits in other Brontë characters. Emotional intensity, social roughness bordering on crudity, extreme self-possession and self-sufficiency, a disdain for frivolity and gossip, a love of nature, animals and solitude, bafflement when it comes to other people --- all of these appear in Gilbert Markham, the narrator of Anne Brontë's The Tenant of Wildfell Hall, and all but the last appear in the hero and heroine of Emily Brontë's Wuthering Heights. (Cathy and Heathcliff are not so much baffled by other people as they have determined those others' desires and expectations of them to be irrelevant). All three sisters' works feature heroes (and, in Tenant of Wildfell Hall's case, villains too) who display some or all of these traits, who are wild, intense, elemental loners whose passions are just too strong, too pure, to be squashed into the confines of socially acceptable expression. I suspect this arises more from the Brontës' lingering Romanticism and collective experience of frustrated passions than from a shared knowledge of (and desire to recreate in fiction) the broad autism phenotype.

Illustration taken from this site; artist unknown.

Monday, December 8, 2008

Autism, Suggestibility and Acculturation

Lili Marlene has an interesting post up about cults, wondering if autistics as a group might be less vulnerable to that sort of manipulation:
The thing that I think is interesting about this vile, vile man [Australian cult leader Ken Dyers] is that people described him with terms like "charismatic" etc, and obviously many people must have felt some form of attraction towards this man, who was apparently a paedophile many times over. So why did this guy leave me feeling as cold as a dead fish? Why do I feel that there is no way in the world that I would ever have viewed this man as anything but a self-serving arsehole? According to the results of various tests and questionnaires I have the psychology of a person who has Asperger syndrome. That is supposed to mean that I am socially blind; organically unable to tell a con artiste from a true friend. I'm supposed to have no sense at all when it comes to people. I'm supposed to be unable to understand the good and bad intentions of others. Then why did I find this man, and all of the many people of his type, to be basically yuckity-yuk-yuk? When I meet people like this I just can't get away from them fast enough, because I know, and I'm sure they know just as well, that we are just wasting each other's time, as we can get nothing that we need or desire from each other.
Am I just kidding myself that I'm so smart? Well, I've never been a member of any group that is anything like a cult. I've been an atheist since late in my religious childhood. But according to all the theories about AS and autism I'm supposed to be ripe for exploitation and as naive as a young child. Perhaps that is true of some autistic people, I don't know. According to the "extreme male brain" theory of autism, men are supposed to have less "social skills" than women, with autists possessing even less social sense than "normal" average males. Then I wonder how Professor Simon Baron-Cohen, who is the champion of this theory, would explain why it appeared that females greatly outnumbered males as members of this truly harmful and exploitative Australian cult? Shouldn't these very feminine-looking women with supposedly superior "mind-reading" abilities have had the inborn people-skills to read what was on this dirty old bastard's mind?
Catana pointed out in the comments, and I agree, that cult leaders target potential victims specifically, and "work" particular emotional angles --- we, the outside observers, do not see the same side of those people that their acolytes do. It's therefore misleading to compare our impressions of cult leaders from the glimpses we get on TV with their followers' experiences with them; they're putting on an act for the faithful that they don't bother to put on for the rest of us.

It wasn't cults that Lili's post inspired me to think about, though; it was broader, society-wide patterns of socialization. Social norms, it seems to me, propagate themselves by suggestion: people see other people acting a certain way and learn to act that way themselves, and to think it perfectly natural to act that way, and feel surprised and somewhat repulsed when they see a person doing otherwise. The more insular the group, often, the more outlandish the beliefs and behaviors that emerge (this is where cults and episodes of mass hysteria/mass delusion fit in --- these are not, in my view, exotic psychological phenomena but exaggerated instances of normal acculturation).

Autistic people are well-known for their resistance to socialization: we don't fit in (often, don't even try to fit in) as children; we don't fit gender roles; we don't follow the usual scripts for social encounters. Is this because we're not suggestible? Do ideas coming from other people not penetrate our minds and take hold subconsciously the way they do in most people? Or is it something else, perhaps our failure to imitate others?

Googling "autism and suggestibility" brought me two studies from 2007, both testing the susceptibility of autistic children to suggestion of false memories. The first study had 24 Aspie schoolchildren and 27 age-, sex- and IQ-matched NT children watch a scene involving two actors pretending to be visiting artists coming to photograph the children, then try to remember specific details about what had happened the next day. Their recall was tested several ways: first, by a "free recall," where the interviewer just sat there and let the children tell everything they remembered; next, the interviewer asked questions to jog their memories (both general questions like "What were [the visitors] wearing?" and specific ones like "When the woman had trouble with the [camera] tripod, what did she say?"); and, finally, the interviewers asked leading questions based on false assumptions (like, "What color was the man's scarf?" when he wasn't wearing a scarf) after briefing the children that it was OK to say they didn't know or to correct the interviewer if he or she got something wrong.

Where that study tested suggestibility in eyewitness memory, the second looked at autobiographical memory. This study had 30 children on the autism spectrum and 38 age-matched NT children split into two groups (a younger group with an average age of around 7, and an older group with an average age of 9) answer questions about events they experienced, first about events in their lives prior to participating in the experiment and then about an event (a magic show) put on by the researchers. An interviewer asked them, first, to tell her everything they remembered about the magic show, and then began to ask specific, leading questions, half of which contained false assumptions.

Both studies found that the autistic children were just as suggestible as their NT peers; their memories of events, whether merely witnessed or actually experienced directly, were equally likely to be influenced by leading questions. So it's not suggestibility per se that underlies the obliviousness to social cues that characterizes autism.

Given identical levels of suggestibility in autistics and NTs, I'm going to have to modify my theory a bit: it's not that we're resistant to suggestion in general, it's that we don't perceive as many things as suggestions as NTs do. Both of the above experiments featured very clear-cut scenarios: the interviewers were asking questions about actual events, and the wording of some of the questions introduced misleading details. This is a much more explicit interaction than many of those that constitute the ongoing process of becoming a fully socialized member of one's own culture. In those, the suggestions are often entirely unspoken urges to imitate certain people (and avoid certain others). There was a bit of confirming evidence for this hypothesis in the eyewitness-memory study: one of the elements in the short scene the actors pretending to be photographers performed was something the researchers termed a "socially salient sub-scene": the actors would be trying to use a tape measure, and the man would pretend to hurt his hand and get angry, and the woman would apologize, and ultimately they would abandon their tape-measuring project altogether, such was the anxiety it caused their characters. Now, when the children were asked to describe whatever came into their heads about the scene the next day, the NT children focused more on this sub-scene than on the "neutral" sub-scene, and in this preference they differed markedly from the AS children. The NTs' attention was drawn selectively to the social and emotional content of this scene, while to the AS children it was just another set of events.

I think this lack of selective attention to the social significance of events goes a long way toward explaining our relative resistance to socialization. It is not a complete resistance, as I've argued before with respect to gender, but it's enough to distinguish us.

By way of analogy, it might be interesting to compare how much the average autistic person remembers from school (or from recreational research!) with how much the average NT remembers. I find that I have retained a whole lot of knowledge from high school, while to a lot of people my age it's just a blur. If they remember high school, they're more likely to remember what their lives were like, who their friends and crushes were, and what they did on the weekends than what they learned in class. For me, it tends to be the other way around. I told my mom, when she marveled at how much I could recall, that it was only because I perceived so much less in high school that I remembered so many details: with fewer streams of data going in, you can devote more energy to retaining each one than if you were trying to attend to zillions of different channels at once, as most NTs do.

Thursday, December 4, 2008

Better Late Than Never

I just sent this picture to the Autistic Adults Picture Project:

Actually, I sent several pictures (since Jypsy expressed a preference for a certain size photo; since mine are all digital, I sent her files of varying sizes --- 15 KB to just under 2 MB), though I did specify a preference that this be the one displayed, if it were at all feasible.

This is the best self-portrait I've done so far; I'm still not totally satisfied with it. I added the ink initially just around the eyes, since the eyelashes and eyelid folds got lost under the paint, which is a decision I stand by, though if I were to do it again I would not ink any of the other lines. I also think I got the texture of my hair mostly right on the right side, but on the left side it looks too much like brown spaghetti. The skin tone is pretty much right on, but the hair is too light, and I think the nose might be too long.

Also, in real life I wear glasses --- have done so consistently since age 11 --- but I hate drawing them and think I look prettier without them. So they do not appear in this painting.

Yes, *ALL* Women Have a Right Not to Be Raped

From Joel's blog, I found this horrible story from Korea, about a sixteen-year-old developmentally disabled girl whose grandfather and uncles had repeatedly raped her over a period of seven years. When they were finally arrested and tried, the judge suspended their sentences so that they might go back to being her caregivers.

For me, what sticks out most about this story are two things: first, that most people people in power really don't care about disabled people so much as they want us to go away. As long as someone is taking care of "the problem," --- and, we see from this story and from the periodically recurring horror stories about conditions inside mental institutions and group homes, it hardly matters who is doing it, or how well, so long as it is done at all (and by Somebody Else) --- everything is fine. Second, this underscores to me the importance of autonomy to civil rights in general, and to disabled people's civil rights in particular. Families cannot be counted on to be reliable advocates for people's interests, and often will act in opposition to those interests. The current situation for most disabled people, eerily similar to that of women pre-feminism, is to be completely dependent on one's family for survival.

This needs to change.

Wednesday, December 3, 2008

Book Meme

TheGonzoGirl has set a cunning trap --- whoever reads her most recent entry gets tagged with a meme!

The meme is this --- grab whatever book is closest, open it to page 56, find the fifth sentence and post the next seven sentences (on that page? spilling onto the next page? I don't know) on your blog.

As luck would have it, the book nearest to my computer is a book of Shakespeare's sonnets, which makes the sentence-posting a bit problematic. At most, his sonnets might contain two or three sentences, and many of them are one big, long sentence. There's almost no chance of seven complete sentences all residing on the same page, since this edition puts one sonnet on each page.

So I will just post half (i.e., seven lines) of the sonnet on page 56.
Which though it alter not love's sole effect,
Yet doth it steal sweet hours from love's delight.
I may not evermore acknowledge thee,
Lest my bewailèd guilt should do thee shame;
Nor thou with public kindness honor me
Unless thou take that honor from thy name:

But do not so; I love thee in such sort
As, thou being mine, mine is thy good report.

Now, who among you is Shakespeare buff enough to identify that sonnet?

Monday, December 1, 2008


So, according to some website, I am a woman. I am also an INTP.

These are both true enough; most websites tag me as either male or androgynous, though I wonder if the program might simply assume all feminist bloggers are female. (Or, at least, assume a greater probability that we are female?)

This, if you're wondering, is what the Typealyzer seems to think an INTP looks like. I'm pleased to note all the points in which it does not resemble me.

(One of those points is our differing attitude to the alarming tilt of Cartoon Blogger's desk. Ze appears to be blithely oblivious to it, but it is really bugging me. If motion could exist in hir world, I'm sure that open can of Jolt! cola would be all over hir keyboard).

A Footnote to Feminist History

In an interesting epilogue to the famous Christine Craft saga, three women have sued Kansas City's news channel, KMBC-9, for age and sex discrimination.

About 25 years ago, KMBC-TV anchor Christine Craft filed a pioneering gender discrimination suit against the Kansas City television station — a suit that damaged its reputation for years.

Now three of the most senior female on-air personalities at KMBC (Channel 9) have filed their own gender and age discrimination suit against the station, claiming they were publicly humiliated, degraded and demoted.

Kelly Eckerman, Peggy Breit and Maria Albisu-Twyman, known on air as Maria Antonia, allege a “pattern and practice” of discrimination at Channel 9 and “a hostile environment, permeated with threats, intimidation and disrespect.”

“Even unaffected newsroom employees have commented about the publicly humiliating and degrading treatment of women over 40, including but not limited to these plaintiffs,” the suit states.

Eckerman is 48 and has worked at KMBC for more than 18 years. Breit is 54 and has worked there for 27 years. Antonia is 49 and has been there for 25 years. They continue to work at the station.

Eckerman and Antonia contend they were demoted as anchors even as much older men kept their anchor positions and younger women were promoted.
Eckerman claims she was abruptly demoted in October 2007 as anchor of the 5 p.m. and 6 p.m. news Monday through Friday to a Tuesday through Saturday weekend shift. Eckerman, who had recently gone through “a nasty divorce that had depleted her financially and emotionally,” was allegedly told later by Sherrie Brown, who became KMBC’s news director in December 2007, that Brown wanted to hire someone “who would devote everything to the position and not be distracted by family.”

Breit, a reporter, contends that her schedule was changed from Monday through Friday dayside to Tuesday through Saturday dayside and that a 30-year-old male reporter was promoted around the same time to the coveted Sunday through Thursday prime-time nightside spot.

“Male anchors are treated much differently and advantageously, compared to females at KMBC-Channel 9,” the suit states. “Males are allowed to age, gain weight, turn grey and wear glasses. Female anchors, by contrast, have been told they are ‘no longer part of the future’ and are oppressively criticized, targeted and harassed after they reach their 40s.”

Antonia says she was told “totally out of the blue” in October 2007 that she was being removed from her anchor position to one as a full-time reporter. Station general manager Wayne Godsey allegedly told her, “You will never anchor at Channel 9 again,” although he also told her she might have the opportunity to be an anchor at KMBC’s sister station, KCWE (Channel 29), according to the suit.

Antonia, however, “was not invited to audition for the Channel 29 anchor position. A younger female in her 20s, along with plaintiff’s male co-anchor, were given that opportunity,” the suit alleges.

“Continuously since January 2008 through present, plaintiff Antonia has been subjected to a demeaning, discriminatory and hostile work environment compared to the younger female and male employees,” the suit states. “Antonia is yelled at … while on air. She is yelled at when she asks for the means to get to the scene of a live report.”
According to this article by local columnist Mary Sanchez, if you work in TV journalism, you don't even have to wait until middle age to have the lovely experience of your bosses constantly policing your appearance:
In her early 20s, my mentee was beautiful in ways society usually favors: deep expressive eyes, high cheek bones, a trim figure, long shiny brown hair, the most gleaming white of smiles.

But the attributes weren’t good enough. She worked in broadcast journalism, a far different field from print journalism, where, if anything, reporters who are a bit disheveled are more the norm.

For television, appearance meant everything. At times, it seemed more important than the stories she produced during her first years as a reporter.

I’ll spare her the embarrassment of using her name.

Every time she has changed stations, she has moved up in prestige. But each new boss demanded a new look for her.

One time, she came for a weekend visit sporting a rather a bowl-shaped, lacquered hairdo. It was far shorter and boxier than what she preferred. Her makeup was heavy, the spatula effect. Her skin was breaking out and she knew it was because of the heavy layers of product she applied daily.

“You don’t look like yourself,” I remember remarking.

“I know,” she replied.

But for her, looking a certain way was a job requirement. Like meeting a deadline is for me.Yet I’ve always wondered how much of her spirit was neutralized by the fussing to make her “fit” the profile that different news directors demanded. As a young journalist, she seemed to be expected to shift to every news director’s whim.
I wonder how Breit, Eckerman and Antonia will fare with their lawsuit. The Star article expressed the opinion that they'd have an easier time of it, since they were taking their case to a Jackson County circuit court, and using a statute that had recently been ruled able to be decided by a jury. (Christine Craft always won the juries, but judges kept throwing her case out when KMBC appealed to higher courts). But I see another legal precedent that could give them trouble: Lilly Ledbetter. These women's complaints are mostly recent --- not like Ledbetter's twenty-year history of underpayment --- but some occur outside the 180-day window mentioned in that case. I am not sure that matters for Breit, Eckerman and Antonia, though, since they aren't going through the EEOC.

Say What?!

I spotted this story in today's Kansas City Star* (there's more detail in this Reuters article), describing a very interesting study done at the Children's Hospital of Philadephia and presented yesterday at the (still ongoing) yearly meeting of the Radiological Society of North America.

What the study's authors (Timothy P. L. Roberts, Ph.D., J. Christopher Edgar, Ph.D., Deborah M. Zarnow, M.D., and Susan E. Levy, M.D.) did was to have 30 autistic children ages 6-15, and 34 age-matched NT children, listen to recordings of fairly simple, neutral sounds --- tones of varying frequencies (probably like what you hear when you get your hearing tested) or a voice, either speaking complete sentences or pronouncing random English vowel sounds. The children were not told to do anything, or to listen for anything in particular; just to listen, while sitting under a biomagnetometer***, which measured the magnetic fields generated by their brains as they listened.

While both groups of children appeared to be using their superior temporal gyri to make sense of what they heard, the autistic children distinguished themselves by responding more slowly and to a lesser degree than their nonautistic peers.

In particular, they were looking at the M100 latency, which is the lag between the 100-millisecond mark and the characteristic peak in the wave-form expressing the strength of the magnetic field generated by a particular area of the brain (in this case, a spot on top of the temporal lobe, toward the middle of the brain). The length of time it takes for this peak to form has been shown to vary in relation to certain properties of the sound being heard, as well as between the hemispheres of the brain. In this study, the range of M100 latencies for autistic children was about half that of NT children; the NT children's M100 peaks might occur anywhere within a 40-millisecond window depending on the frequency of the tone they heard, while the autistic children's responses were closer together, staying within a 20-millisecond window. Also, when two or more tones were played in quick succession, the autistic children's response to the second tone would be diminished, and when a long series of similar sounds was interrupted by one sharply contrasting "oddball" sound, the autistic children lagged their NT peers by 50 milliseconds in detecting it. (I am assuming they equate detection of a sound with altering one's brain activity in response to it). The abstract also mentions "abnormal patterns of gamma oscillation" in the superior temporal gyrus of autistic children, but without a full article to refer to, I cannot guess what they might mean by that.

Reuters quotes Dr. Roberts on the potential diagnostic utility of these findings:

Children are usually diagnosed with autism only after they reach age 2 years or older and Roberts said the hope is that MEG could diagnose children as young as 1 year, so therapy could begin earlier and perhaps be monitored to evaluate the results on the brain.

MEG can cost roughly $400 an hour to perform, but it is harmless and could become less expensive if more devices were available. MEG is used currently to help locate brain tumors and to diagnose epilepsy.

Roberts foresees MEG being employed to examine people with attention deficit disorder and other mental problems.

He said it may also provide researchers with more clues to the causes of autism and help solve the dilemma of what is hereditary and what is environmental about the condition.

Obviously, those same patterns would have to be observed reliably in 1- and 2-year-olds before MEG could be used as an early diagnostic instrument; as of now, I think MEG studies have only been done in older children.

Kristina Chew wonders how, if this ever did come to be a widespread diagnostic tool, doctors would tell the difference between autistic toddlers and hearing-impaired ones. While I think deaf children, or children who couldn't hear as wide a range as most people can, could be easily screened out (they'd fail to respond at all to some or all of the tones, as opposed to responding later), children with auditory processing disorders (that make them less able to distinguish between sounds), tone deafness or some other more subtle hearing or cognitive disability might be mistakenly ID'd as autistic by this metric. I think the solution to that problem lies in a very careful reading of the results, in the use of multiple types of imaging, and the reliance on multiple indicators. (Another potential early-identification signal for autism, much ballyhooed a year or two ago, was gaze cuing --- tracking eye movements as the child watched a video of a human face to see if they met the actor's eyes, which NT children apparently learn to do around six months old). Just with regard to hearing, Autism Diva has an impressive roundup of what's been discovered about autistic differences; indeed, one of the things she cites is a huge difference between the left and right hemispheres in M100 latency. Another autistic difference she cites is superior ability at identifying individual notes within a chord; it is highly unlikely that a child who consistently shows both a delay in processing sounds and greater perceptual acuity is hearing impaired.

Further Reading:

Basic information on MEG can be found here and here; a Powerpoint presentation on the finer points of using MEG to measure auditory-cortex activity in response to different types of sounds can be found here; for a paper on how different vowel sounds affect M100 latency, go here.

*The full article didn't make it into the print edition, which is what I actually read every day. No, there was only the tiniest stub of a notice there --- maybe two or three sentences in a box on the far left side of Page Two. The print edition of the Star, like those of many other newspapers, is shrinking rapidly, and opting for a much lower content-to-fluff ratio on the few pages it still prints. This is very annoying if you, like me, prefer to read rather than hear or watch your news** and find staring at screens irritating.

**Ironically, the very research I describe here deals with why I --- and, quite possibly, you too --- might have this preference.

***The biomagnetometer is described in the press release as resembling an "old-fashioned hair dryer".

Saturday, November 29, 2008

In Which Margaret Atwood Speaks For Me

This is a short piece from Margaret Atwood's 2006 collection of essays, short stories and poems called The Tent. It's not a poem, but it's too short to be an essay.

Whatever it is, I'm reproducing it here:


Walking was not fast enough, so we ran. Running was not fast enough, so we galloped. Galloping was not fast enough, so we sailed. Sailing was not fast enough, so we rolled merrily along on long metal tracks. Long metal tracks were not fast enough, so we drove. Driving was not fast enough, so we flew.

Flying isn't fast enough, not fast enough for us. We want to get there faster. Get where? Wherever we are not. But a human soul can only go as fast as a man can walk, they used to say. In that case, where are all the souls? Left behind. They wander here and there, slowly, dim lights flickering in the marshes at night, looking for us. But they're not nearly fast enough, not for us, we're way ahead of them, they'll never catch up. That's why we can go so fast: our souls don't weigh us down.

This speaks to me on multiple levels. On the literal level, it gets at the core of my problems with most modes of transportation --- they really do go too fast. I never learned to drive, in part because of motion sickness but in part because I just could never react fast enough. I'd be sitting at a stop sign for ten or twenty seconds figuring out what to do, while other cars sat wondering WTF I was doing. I can't give directions to someone who is driving me around, because the scenery whizzes by too fast for me to register it, and I end up realizing where we are after the person driving me has already missed the turn. (What I end up having to do is draw out a map ahead of time, and read off from it to direct people). On the slightly less literal level, the same dynamic applies to life in general. I seem to move through time as slowly as I do through space, and with the same level of confusion and inability to plan while moving.

It also seems to work as a parable of industrial civilization: we've become so caught up in going faster --- extracting more and more of the Earth's natural resources to burn for energy, to build more and more gadgets that will use that energy up faster and faster, clearing more and more of the available land to grow food in a supercharged, unsustainable manner to feed more and more people --- that we no longer ask ourselves if we should do whatever it is we're doing at the time. We take the imperatives of our way of life --- to make money, to acquire more and better possessions --- for universal human needs. Most of us, I think, understand perfectly well the destruction our way of life wreaks on the planet, but we can't conceive of the radical changes we'd have to make in order to stop that destruction, so we just accept it.

Our souls don't weigh us down.

Monday, November 24, 2008

Autism in the DSM-V

Yesterday's post on the proposed inclusion of "relational disorders" in the DSM-V got so long, I decided to put the rest of my DSM-V observations in a separate post. Hopefully this one will not reach such an epic length.

First, autism. There are a lot of proposed changes to the diagnostic criteria for all the autism-spectrum labels, which you can read about here at Autism Vox, or here at the American Psychiatric Association's webpage. I don't want to go into all of the proposed changes here, so I recommend clicking the links.

I just want to point out two relatively minor points in the Neurodevelopmental Disorders Work Group's agenda that interest me: first, for the first time they're going to look into how autism might look somewhat different in different groups (they mention females, adults and cultural minorities) and need alternative diagnostic criteria; and second, they're entertaining the notion that autism might not be lifelong.

From the APA's online summary of its Autism and Other Pervasive Developmental Disorders Conference, here's what the panel on International, Cultural and Gender considerations in the diagnosis of Autistic Spectrum Disorders* had to say:

In his introduction, Poul Thorsen, M.D., Ph.D., (Aarhus, Denmark) focused on gender differences, noting that the male-female ratio for a diagnosis of ASD is 5:1 whereas the ratio for childhood autism is 3-4:1. ... Autism sex ratio (male:female) is lower in individuals with ID [Intellectual Disability] than in individuals with normal cognitive functioning and lower in individuals with significant dysmorphology or microcephaly than those without. Data from a Danish psychiatry registry of children born from 1990 to 1999 found that males on average met 0.63 more items than females. ... He concluded that since males consistently met more autism items than females, the current diagnostic criteria may favor the diagnosis of autism in males. (emphasis mine)
Other ideas to come out of that panel were:

  • That studies of autism prevalence are likely to give us a skewed picture of autism itself, since most of the people recruited for those studies are preschool and school-age children signed up for special services
  • That cultural and linguistic factors should be taken into account when diagnosing autism**
  • That sometimes what appears to be autism is actually a response to trauma, and
  • That what constitutes trauma varies among cultures
The panel on whether autism can go into "remission" echoes some of the concerns about diagnostic criteria for autism being too age-specific:
Craig Newschaffer, Ph.D., (Philadelphia, PA), in his presentation, noted that we are still at a point where the connections between [the?] pathology and the phenotype of autism are not understood. How the manifestations of underlying pathology change over time and what, if any correlations exist between pathology and clinical phenotype are still unknown. Regarding the evolution of the behavioral phenotype over the life course, there are very few cross-sectional studies in adolescents and adults, and even fewer longitudinal studies. The lack of availability of age-appropriate measures may contribute to this lack. The few small sample studies that have been published focus on the loss of diagnosis (typically in children) and presentation of previously undiagnosed adults. From the clinical perspective, should the diagnosis of autism be lost when symptom-based criteria are no longer met? This has potential impact on treatment plans and access to services for the child or young adult and their family. The diagnosis of ASD in symptomatic adults is also difficult, due to the lack of tools appropriate for use in adults and the difficulty in obtaining the developmental data required to make a diagnosis of ASD (which must be present before age 3 years). The differential diagnosis is particularly challenging in adults because of the number of other disorders that affect the social domain. These limitations suggest that other features (e.g., nonverbal communication, prosody, subtle use of language, posture, etc.) might prove to be better diagnostic criteria for adults? Without such clarity, it is questionable whether the prevalence of ASD in adult populations can bevalidly and accurately estimated through epidemiological studies.
This has the potential to be a good thing --- in that they're looking to characterize autism across the lifespan, and recognize that adult autistics are more than just autistic children who happen to be grown --- but the question of whether to drop the autism diagnosis from people who no longer meet the "symptom-based criteria" strikes me as leading down a blind alley. It seems to be an attempt to define the problem (of autistics maturing and exceeding doctors' expectations of them) out of existence by declaring those people no longer autistic.

*Of all the panelists quoted/paraphrased above, only one (Poul Thorsen) is on the Neurodevelopmental Disorders Work Group for the DSM-V. So his ideas, at least, are pretty likely actually to make it in there.
**The example given is of adapting the Autism Diagnostic Interview for use in China, where the main language (Mandarin) apparently doesn't really have separate verb tenses for singular and plural, or for past and present, and where "the cultural norm ... is for gestures to be discouraged and for persistence to be highly valued." You can probably imagine how someone used to the way Americans behave around other people might find most Chinese to be "autistic" in their reserve.

Sunday, November 23, 2008

Feminist Issues and the DSM-V

ABFH linked this article from the Los Angeles Times, which calls wider attention to the heated argument in the letters pages of the second July issue of Psychiatric News over the extent to which the process of drafting the DSM-V should be made accessible to the public.

In response to this June 6 editorial, describing the process as "complex but open," Robert Spitzer (the psychiatrist who chaired the DSM-III and DSM-III-R task forces) wrote a letter denouncing DSM-V task force vice-chair Darrel Regier's refusal to give him a copy of the task force's meeting minutes. (That same issue also printed a response, co-written by Regier, DSM-V task force chair David Kupfer, APA President Nada Stotland, and APA Medical Director and CEO James Scully, Jr.).

The LA Times writer, Christopher Lane (who has written a book, Shyness: How Normal Behavior Became a Sickness, which accuses DSM-III-era psychiatry of essentially making up disorders to sell drugs to healthy people), argues that the task force's failure to make the minutes public betrays an insularity and protectiveness that undermine its efforts to improve the DSM's validity:
Spitzer counters that "the real purpose ... is to avoid possible criticism of the ... process." He has called the attempt to revise the DSM in secret "a big mistake" and a likely "public relations disaster."

I fear that I may have unintentionally contributed to Regier's excessively secretive behavior. Back in the 1970s, during the creation of the third edition of the manual, I published much of the correspondence that had circulated between committee members. Some of the exchanges were frankly hair-raising. They included proposals for the approval of such dubious conditions as "Chronic Complaint Disorder" and "Chronic Undifferentiated Unhappiness Disorder." When asked to define how he was using the term "masochism," one leading psychiatrist replied: "Oh, you know what I mean, a whiny individual ... the Jewish-mother type." And so it went for dozens of other terms that later became bona-fide illnesses. (emphasis mine)

Regier obviously wants to prevent any such embarrassment for his task force; he apparently fears the public will not find his committee's work entirely convincing.
The ideas Lane ridicules in this passage (Chronic Complaint Disorder, Chronic Undifferentiated Unhappiness Disorder) were more than just silly attempts to turn everyday grumpiness into a medical problem; they functioned to lend authority to long-standing stereotypes about women, and to deflect attention away from social conditions that might distribute life stresses unequally between the sexes. That's what Carol Tavris argues in The Mismeasure of Woman, in the chapter on women and psychiatry:
Self-defeating Personality Disorder and codependency are the latest incarnations of an old American game that we might call "Name What's Wrong With Women." Every few years a wave of best-selling books sweeps over the land, purporting to explain to women the origins of their unhappiness. In many of the self-help versions of these books, the author begins by describing how she herself suffered from the disorder in question, and, through persistence, effort, or revelation, found the cure.

Thus, in the 1950s, women's problem was said to be their inherent masochism, an idea that derived from Freud's theory that female psychology includes an unconscious need for, and pleasure in, suffering. Wrong, said Martina Horner in the late 1960s. The problem is women's fear of success; the cure is to understand and then overcome their internal barriers to achievement. Wrong, said Marabel Morgan, Phyllis Schlafly, and other religious conservatives in the 1970s. The problem is that women want success, when they should be spending their energies being obedient to God and husband; the cure is to strive to become "The Total Woman," "The Fulfilled Woman," or "The Positive Woman." Wrong, said Colette Dowling in 1981. The problem is that women have a "Cinderella Complex --- a hidden fear of independence"; they must struggle against their desires to be rescued by Prince Charming. Wrong, said a spate of writers in the early 1980s. The problem is that women "say yes when they mean no," and "when they say no, they feel guilty"; the cure is assertiveness training. Wrong, said Robin Norwood in 1985. The problem is that women love too much. Wrong, said a flurry of books in rebuttal. It's not that women love too much but that they love the wrong men --- men who are immature, angry, abusive, chauvinistic, and cold. Wrong, said Melody Beattie in 1987; the poor guys aren't to blame, because they are sick. Women love too much because they are codependent --- addicted to addicts, addicted to bad relationships.

Long ago in The Feminine Mystique, Betty Friedan wrote of "the problem that has no name" --- the vague emptiness and desolation that plagued many women in the postwar era. But in fact the problem has gone by far too many names. The symptoms that all these books attempt to treat are invariably the same: low self-esteem, passivity, depression, dependency on others, an exaggerated sense of responsibility to other people, a belief that it is important to be good and to please others, and an apparent inability to break out of bad relationships. I do not doubt that many women are unhappy, and I do not doubt that these descriptions apply to many women --- and to a goodly number of men. But it is time to ask why these psychological diagnoses of women's alleged inner flaws, which keep returning like swallows to Capistrano, year after year, fail to deliver on their promises. And it is time to ask why the explanations we make of female problems differ in kind and function from those we make of male problems.

Thus, the problems that are more characteristic of men than women --- such as drug abuse, narcissism, rape, and other forms of violence --- are rarely related to an inherent male psychology in the way women's behavior is [related to an inherent female psychology]. When men have problems, it's because of their upbringing, personality, or environment; when women have problems, it's because of something in their very psyche. When men have problems, society tends to look outward for explanations; when women have problems, society looks inward.

For example, psychologist Silvia Canetto has compared attitudes toward people who attempt suicide (typically women) with those toward people who abuse drugs (typically men). Both of these actions, says, Canetto, are "gambles with death"; both actions can be lethal although the individual may not intend them to be. Suicide attempters and drug abusers share feelings of depression and hopelessness. Yet mental-health experts tend to regard suicide attempts as a sign of a woman's psychological inadequacy, reports Canetto, whereas they regard drug abuse as "caused by circumstances beyond the person's control, such as a biological predisposition."

Likewise, people speculate endlessly about the inner motives that keep battered wives from leaving their husbands. Are these women masochistic? Do they believe they deserve abuse? Are they codependent, unwittingly collaborating in the abuse against them? Whatever the answer, the problem is construed as the battered wives, not the battering husbands. But when experts ponder the reasons that some husbands abuse their wives, they rarely ask comparable questions: Are these men sadistic? Do they believe they deserve to abuse others? Rather, their explanations focus on the pressures the men are under, their own abuse as children, or the wife's provocations. Male violence is not considered a problem that is inherent in male psychology; but the female recipients of male violence are responsible because they "provoked" it or "tolerated" it or "enabled" it or are "masochistic" --- problems presumed to be inherent in female psychology. A man who gets into a fight with a stranger and hits him may spur an observer to ask, "Why is this guy so aggressive and hostile?" But if the same man goes home and hits his wife, the same observer is likely to wonder: "Why does she stay with him?"
The DSM-III/DSM-III-R disorders Tavris cites --- Self-defeating Personality Disorder (which appears in an appendix to the DSM-III-R), Dependent Personality Disorder, Histrionic Personality Disorder (which are not included in the passage I quoted, but are discussed in a later section of the same chapter) --- explicitly locate the reasons for women's problems in their own defective personalities. Because the symptoms of these disorders closely match common stereotypes of feminine behavior, and because personality disorders in general are understood to reflect long-standing self-destructive patterns in one's thought and behavior, women with the kind of diffuse, generalized malaise that Friedan's interviewees complained of, and that might in the consciousness-raising groups of the 1970s have prompted an examination of the conflicts between women's desires and society's expectations of them, are now once again directed to blame themselves for their unhappiness. The only difference is that now, instead of merely being labeled sick for failing to be feminine enough, a woman can also be pathologized for being too feminine.

I bring all this up because one of the proposed new categories of mental illness being considered for inclusion in the DSM-V threatens to do a similar thing: to muddy the waters around lingering issues of gender inequality by overpersonalizing those issues.

The diagnostic category in question would encompass the relational disorders --- those "persistent and painful patterns of feelings, behavior and perceptions involving two or more partners in an important personal relationship." No individual would get a diagnosis; whatever pathology exists is understood to be an emergent property of the relationship --- a diseased whole that might be composed of perfectly healthy parts who just interact pathologically. While this is an intriguing idea, and strikes me as potentially very useful in therapy, I worry about its implications for domestic abuse. The Research Agenda for DSM-V mentions domestic violence explicitly, classifying it as Marital Abuse Disorder or, alternatively, Marital Conflict Disorder With Violence. I am extremely uncomfortable with classifying all, or even most, domestic violence as a diseased interaction because that conception of it implies that both partners contribute to the hostility, when the simple truth is that all of the blame lies with the battering partner. An abuser could easily use the pretext of wanting to work through a "relational disorder" to maintain contact with his victim, or guilt her into staying with him. Abuse victims already have a strong tendency to blame themselves for their partners' violence, and a DSM diagnosis that seems to corroborate that belief would be a giant step in exactly the wrong direction.

To get back to the beginning paragraphs, this is exactly the sort of criticism that would be brought to the attention of the DSM-V task force if they made their discussions public. While there are feminist psychologists, they are a small minority within the profession, and I doubt more than one or two (if any at all) are represented on the task force. Without opening the discussion to the public, and inviting the feminist critique that is marginalized within psychiatry, these objections may never be heard, and psychiatry will continue to lend its support to societal misogyny.