The MD and the Imaginary Eating Disorder


For almost 8 years I struggled with cyclical depression associated with a hormonally-induced mental illness known as premenstrual dysphoric disorder or PMDD. I also lived for 40 years with undiagnosed auditory processing disorder (APD).

APD is understood by audiologists to have severe social consequences. It is very difficult to have normal social interactions when your brain experiences difficulty getting meaning from speech. Some of my APD symptoms, such as the anxiety I experience due to my inability to focus in noisy environments, my difficulty speaking in groups, and my inability to understand and remember verbal directions, were mistaken for psychiatric disorders throughout my life as well.

I am currently working with an audiologist to address the auditory processing disorder. I was cured of the PMDD by a hysterectomy in 2014 and have not experienced depression since. In the years leading up to the diagnosis and treatment of the PMDD by a physician trained in reproductive endocrinology, I had multitudes of unfortunate interactions with psychiatrists who mischaracterized my APD and PMDD in some of the most ludicrous ways. This is a story of one of those interactions following a PMDD-induced suicide attempt.

After waiting in the emergency room lobby, I was taken to a small room and interviewed by a mental health intake nurse.

“What medications are you taking?” she asked.

“Phentermine,” I replied.

“What else?” she asked.

“That’s all.”

“Why are you taking the phentermine?” she continued.

“I’m overweight,” I said. My body was covered by a blanket. “I wasn’t able to lose weight with diet and exercise so my doctor prescribed phentermine.”

I had gained a little weight after my husband and I had started dating. My lifestyle transition from a single athlete cooking for one to a part of a family cooking for three (my husband had a daughter from a previous marriage), coupled with a few glasses of wine here and there, had caused a little weight gain. This small weight gain grew larger when I found out my then-fiancé had cancer. I had little time to exercise while I was his caregiver as he recovered from the thoracotomy he had undergone to remove a carcinoid tumor from his left lung. And then there was the Paxil, prescribed after my last PMDD-induced depressive episode. I gained 25 pounds in the first month of taking that drug, and I kept growing from there.

The intake tech told me I should be checked into the inpatient psychiatric ward immediately. I didn’t want to die, so I offered no resistance.

Upstairs on the ward, I was made to undress so that a ‘body check’ could be performed. Two young female staff members checked my skin for evidence of cuts or injuries. There were none.

Next, another young woman began to interview me.

“How long have you been depressed?”

“Off and on since around 2006.”

“And how long have you been anxious?”

“I don’t know, for maybe a couple of years?”

“How long have you had an eating disorder?”

“Huh? I don’t have an eating disorder.”

The two young women exchanged glances.

“It says here you are taking phentermine.”

“Yes, I am.”

“Why are you taking it?”

“Because I weigh about 155 pounds and a healthy weight for my height would be between 98 and 130.”

More glances.

“Well, you don’t look overweight.”

“Well, thank you, but I would like to be a healthier size. When I was in better shape, I was also happier.”


“Okay, well we’ll take you to your room now and you’ll see a doctor tonight or tomorrow afternoon.”

“Okay, thank you,” I replied.

I found a lounge area with a phone and called my husband. Struggling to ignore the blaring television in the background, I tearfully explained where I was and why I was there. He was upset but supportive. I had been successfully hiding my cyclical depression from him so he was also very surprised. I told him how I was confused about being asked about an eating disorder.

He became angry when he heard this. “Idiots,” he declared. “I’ll have Dr. Good send them a fax tomorrow explaining your prescription.”

Dr. Good was the primary care provider for both my husband and I. He is a very competent physician and a very compassionate human being. My husband is a clinical laboratory scientist and he ran the lab in the same practice where Dr. Good worked, so Dr. Good knew us very well.

He knew about my husband Alec’s cancer and how it had disrupted our lives. As Alec’s doctor and co-worker he saw firsthand how painful my husband’s surgery had been, and how long his recovery had taken. He knew how much time Alec had to take off of work for his recovery, and how that had impacted our finances. He knew we were adapting to life as newlyweds and that I was adapting to life as a step parent. He knew how I had gone from running 10k races to being overweight due to stress eating, lack of time to exercise, and Paxil. The letter was faxed from Dr. Good to the hospital psychiatrist right away.

The next afternoon I met for the first time with my psychiatrist, Dr. Gaandu. He asked me about my mood, and I explained my recent depression through more tears and choking. He then abruptly said, “I got this fax from your primary care doctor this morning. It says he prescribed you phentermine for weight loss. I think it is very interesting that you went to such lengths to hide your eating disorder. I don’t know what you’re so worried about, we don’t even treat eating disorders here.”

It took me a moment to absorb what he had said. “What? I don’t have an eating disorder, that’s why I had Dr. Good fax the letter, to clear that up.”

“Don’t you think someone with an eating disorder would go to exactly that length to hide it?” Dr. Gaandu asked smugly.

I lapsed into the choking tears again. Was this really happening? How was I supposed to know what someone with an eating disorder would do? How would I know and why would I care if eating disorders were treated at this facility? I didn’t know anyone with an eating disorder and I had taken precisely one psychology course at a community college and none at the university from which I had graduated. How would I know what behavior would typify someone struggling with that? I was so bewildered and perplexed that I could no longer speak. After about five minutes of me sobbing in the chair, Dr. Gaandu released me to go back to my room.

Over the course of the next few days I was given more drugs that made me feel even worse. But I lied and told the staff I was feeling more stable, because I wanted to go home where I could kill myself in peace.

Thankfully I survived to tell this story.

The most important question about what happened is:

Why did Dr. Gaandu choose to confront me about an imaginary eating disorder instead of choosing to obtain valid information from me that could have aided in my treatment?

When we met, he had at minimum the following information about me available to him:

• General demographics such as gender and age,

• Diagnosis of major depressive disorder based on previous treatment records by other physicians at the same facility,

• Intake information describing my current state as suicidal,

• Speculation about an eating disorder based on a hasty conclusion made by a mental health intake tech in a 15 minute interview,

• A fax from my primary care physician explaining the legitimate use of my phentermine prescription with background context of my weight gain and failed weight loss attempts.

When he stepped into the room armed with the information listed above, he visually observed a slightly plump and tearful woman.

With all of the information and his visual observation, he made a choice to open our meeting by calling me a liar and implicitly weighing in his approval of an irrelevant diagnosis made by an intake tech, for which there was no real evidence.

He thought that confrontation was the best course of action that he, as my treating psychiatrist, could take. He had an enormous range of options available to him regarding our initial interaction. And he, as a board certified medical doctor specializing in psychiatry, chose to accost me over a fictitious diagnosis rendered by a non-physician (the intake tech).

He could have asked me if there was a specific event that had precipitated my suicide attempt.


He could have asked if I had a history of trauma.


He could have simply asked, “What happened?” “What are you feeling?” or “So what’s going on?”


He chose to open our meeting with an accusatory remark about a make-believe eating disorder.

He determined that was the best course of action when meeting this particular suicidal patient.

He chose to believe that his behavior was clinically appropriate and moral.

It was neither.

Of all the available choices, he chose to rely on an unsupported conclusion based on circumstantial evidence. And then he took it a step further and chose to pathologize my behavior even more because I had enlisted my primary care doctor’s aid to eliminate a mistaken diagnosis. The fact that I had believed that he would consider the professional opinion of another physician who knew me well was clearly a sign of serious mental illness!


How could such a confrontation have been beneficial for a suicidal psychiatric patient? Even one who may have legitimately been experiencing an eating disorder?

It could not have been.

Therefore, I can only conclude that his agenda consisted of something other than offering professional medical services to the patient with the patient’s best interests in mind.

I was further harmed and not at all helped. He knew this. Then I was billed for almost $7000.00.

He, on the other hand, collected his paycheck and moved on to the next patient.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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Twilah Hiari
Twilah Hiari is a recovering patient with a B.A. in Philosophy. She's the author of Regression, a memoir that chronicles her medically induced descent from undiagnosed Asperger's to lower-functioning autism. She's an impassioned medical freedom advocate who supports holistic, non-coercive recovery methods for neuroimmunological conditions such as autism, PANS/PANDAS, and autoimmune encephalitis.


  1. In American medical schools, the worst students in classes are the ones who opt for psychiatry because it gives them MD status without them being able to actually practice medicine. This is also why our big-time shrinks are all so defensive about protecting the pseudo-medical model they follow that they hope gives them legitimacy as doctors. Had they been real doctors, they’d have likely found out about the physical problems that caused the writer’s depressive episodes.

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  2. I’m sorry you had to go through this. It sounds like you were smart enough to realize what the cons were up to.

    As most people here know, going to a mental hospital and addressing the real causes of one’s problems have very little to do with one another…

    The very notion that someone has or does not have an eating disorder is also somewhat ridiculous; it is too binary. People have different degrees of problematic eating patterns/behaviors at different times in response to different internal and external stresses. There’s no magic point at which one can say “Ah, she has this particular eating disorder” or “No, she doesn’t have it.” Psychiatrists continue to exist within their colorless, simplistic, delusional, materialistic, reductionist world where they think “mental illnesses” either exist or do not exist within the “patient.”

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    • She was smart enough, but the shrinks weren’t. Unlike the shrinks, I realize there are different classes of eating disorders, from anorexia to addictive allergies (where suspect foods get you buzzed, tempting you to eat them to get and stay high).The attitude “one treatment fits all” works no better here than it does for the other “psychiatric” syndromes.

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  3. It took me a moment to absorb what he had said. “What? I don’t have an eating disorder, that’s why I had Dr. Good fax the letter, to clear that up.”

    “Don’t you think someone with an eating disorder would go to exactly that length to hide it?” Dr. Gaandu asked smugly.

    Classic psychiatry. It’s crap like this that actually makes people crazy, and the kicker is that so often these shrinks obviously think of themselves as being unusually insightful and observant. I’m so glad you got away. Thank you so much for sharing this.

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  4. I ran into an issue recently which also resulted in a doctor thinking my daughter had an “eating disorder.” Thankfully, the outcome went better than yours, and I’m sorry you had to deal with such an idiot psychiatrist.

    My daughter had been having trouble digesting all meats, since the end of last summer, eating meat was giving her terrible stomach aches. So we tried free range meats, thinking it might be the drugs they give most animals these days, but that didn’t work. My daughter did a little research online, and came up with some online diagnosis theories. She shared these with me, so I did some more research, and ended up suggesting she try taking probiotics. Wa-la! After doing this, she was able to at least start digesting white meats without getting stomach cramps, which was fine with her.

    But we had the doctor’s appointment already set up, with our new family physician, since our last PCP moved out of state. And we wanted to know what the doctor might recommend. My daughter explained the situation to the intake nurse, who wrote down “eating disorder.”

    The doctor walks in, we explained the situation. She said the internet has lots of diagnoses that she wasn’t taught in medical school, and the diagnosis my daughter found on the internet was not a valid diagnosis, according to mainstream medicine. But she was glad we found a solution that worked to my daughter’s satisfaction. Then she said, “Whew, I was trying to figure out which psychiatrist I was going to send her to, since the nurse said she had an eating disorder.” I said, “Oh, talk about scientifically invalid and unreliable diagnoses, the DSM diagnoses are not ones we believe in. No, we would never be going that route.”

    It strikes me that the mere acceptance of the made up DSM diagnoses, as “real” diseases by today’s mainstream medical industry, is a real problem within mainstream medicine. If my daughter and I had not happened upon a solution to my daughter’s issue prior to us going to the doctor, as medical researchers. Rather than actually doing tests or trying to actually help my daughter, the doctor’s first course of action would have been to try to ship her off to be defamed, tortured, and murdered by the psychiatrists. And we did go in there already equipped with the knowledge of what tests my mother’s doctor, a bank president’s wife, recommended be given. And this is at a hospital considered one of the top five in the nation.

    There is absolutely a problem within this country with the doctors providing good care for the wealthy, and poor care = psychiatry, for the poor starving artist’s families, and all others who do not worship an unjust, fraudulent, morally and now actually fiscally bankrupt Federal Reserve monetary system.

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  5. He could have simply asked, “What happened?” “What are you feeling?” or “So what’s going on?”

    Not sure the exact number of times I did the ER to psych thing but I was so messed up before my recovery from psychiatry I would have these hellish anxiety attacks and goto the ER as much as that was the last place I wanted to go.

    I always waited and expected those questions “What happened?” “What are you feeling?” or “So what’s going on?”

    I would sit and think the best I could in that state how to explain it in chronological order without skipping from the beginning of the story to the end and to the middle and not get it out right so they know. No one really asks nut each time I would get it ready.

    A few times I was lucky got Ativan and went home other times the kidnapping , I mean admission to psych and coerced drugs , it was hit or miss.

    What happened? So what’s going on? … Thats not really part of the process but it should be.

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    • I forgot to add the time I was in for the Zyprexa withdrawal , really sick and they were accusing me of “schizoaffective disorder” and trying to get me to take effing Geodon and screw me up on that I wrote down what was going on. Not what was going on with my life but how I was given that wicked Zyprexa for anxiety and insomnia and it robbed my ability to feel and now I am in this hospital cause the withdrawal is causing nausea vomiting insomnia from hell anxiety attacks and I have no appetite at all and can’t eat

      I wrote it all down cause I knew I was only getting that 2 minutes with the doctor so I just handed what I wrote to him and said to put it in my chart.

      I didn’t know then what I know about psychiatry but I knew enough to do that.

      I never got to see a gastroenterologist or get any medical explanation for the vomiting and nausea or what damage that drug did to my body but I got what I had to say in the chart.

      But for anyone reading this that’s how you get what you want to say in the chart “here I wrote it down to save time”

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  6. I got accused of having one too! By the psychiatrist that caused my weight loss and the therapist in her office! They told my dad that they thought I’d had an eating disorder as well.

    I had seen, a multitude of times, my PCP complaining of “inability to eat” and “weight loss”. They’d run basic labs, and always just refer me to the psychiatrist when they found nothing. What person with an “eating disorder” goes to the doctor repeatedly asking for help b/c they can’t eat and are losing weight??

    The problem was polydrug neurotoxicity and tolerance withdrawal to the three benzodiazepine drugs they had me on simultaneously.

    When the benzos caused depression (they’re CNS depressants and I was on the equivalent of about 105mg of Valium), the psych added Adderall for “depression” (the SSRIs caused severe reactions w each one she tried). The Adderall killed my appetite and caused weight loss. I was down under 90 lbs. I was also so depressed and in tolerance from the benzos, I couldn’t function to feed myself or complete ADLs. Then when I was losing more weight and accused of the so-called “eating disorder,” I was prescribed 45mg of Remeron which caused me to plop a chair in front of the fridge in the middle of the night when it kicked in after taking it before bed. I still never gained any weight though b/c that’s the only time I’d eat – the lack of appetite kicked back in as soon as the morning came and I took my first dose of Adderall and I woke up to my benzo interdose morning hell.

    A drug for the adverse effects of the first drug and then more for the adverse effects of the second one…and so on and so forth. And then blame and label the patient for the symptoms and effects of polypharmacy. That was my living hell for half a decade. Sigh.

    Now my living hell is the withdrawal from them. But I’m off all six of them – and I’m a normal weight. Don’t have – and never did – and eating disorder.

    I’m so glad to be free from that fraud that is psychiatry. Now if my nervous system will just heal from the toxic insult.

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  7. I can relate; I was diagnosed with Dependent Personality Disorder during one visit with a new psychiatrist I was seeing for med management for bipolar disorder. Why? Because my husband had control and anger issues, but I wouldn’t leave him because my religious beliefs prohibit divorce. Somehow, that gave me a personality disorder. Incidentally, my husband got help and faith too and is now an incredibly kind and gentle man. I wonder if that means I’m cured of DPD? lol Utterly ludicrous.

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  8. I wonder if they will diagnose half of the country who are overweight or obese as having eating disorders, and what medications they will make money prescribing for these people. Just another example of a system looking to treat illness to profit, rather than treat illness for fair and ethical compensation.

    Though there is an obesity epidemic that is causing rising health care costs, they need to find more humane ways of treating it like more investments in therapists who can help people find out why they eat too much or too little, and work to resolve the problems or sadness associated with it.

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    • Well, now they have invented “Binge Eating Disorder” to flesh out (ha, ha) their range of potential victi- oops, I mean CLIENTS to include the overweight as well as the underweight. Fascinatingly and frighteningly, the “treatment” is taking stimulants. We’re right back to the 1960s and Benzedrine!

      And “obesity” has been classified as a medical disease. Soon to be “treated” with new drugs, probably more stimulants re-branded as “anti-0besity” drugs.

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      • Yes, but addressing obesity and “eating disorders” while handing out prescriptions for “medications” that are becoming well known for causing metabolic disorders that are ignored.

        I got the Paxil and then Vyvanse when I couldn’t shed the weight I had gained. I am now off the anti-depressants and the pills to manage the symptoms they cause. Healthy weight and healthy activity level. Correlation? I think so.

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  9. A most interesting article.

    Of course everyone is unique, especially in how they think and how they process information. Massive amounts of untold harm is done when we refuse to accept this.

    As far as why people are different, nature or nurture, hard to say.

    But my own view is that things are made into problems when we have those with power who make them into problems. So there are abusive parents, schools, work places, and peer groups, and more.

    So I am slow to go along with the idea that anyone has any kind of a disorder.

    And if disability money and benefits are the issue, I’m for Citizenship Pay, give everyone whatever they need. Don’t worry about labels or making people prove neediness. Everyone wants to do well, and so this is where we should focus our attention.

    One of the most common abusive labelings being used right now seems to be Autism Spectrum Disorder. But again, I am convinced that all such things amount to Munchausen’s By Proxy, or Medical Abuse. If we just remember that everyone is unique, and that people do better in supportive and accepting environments, then there is no problem. People only get rigid when the circumstances require it. So much of it just amounts to convincing the patient that they have a problem, and that they alone are responsible for this. I do not go along with it at all.

    Thanks for the article and I am glad to hear that you are studying Philosophy. I am convinced that there are deep philosophical problems which underlie all of this labeling, as well as psychiatry and psychotherapy.


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    • Nomadic – I appreciate your thoughtful comment but I want to clear up a potential misunderstanding. While I think it is accurate and healthy to understand that we all exist on a spectrum of neurological and audiological diversity, it is very ignorant to use that diversity as a basis for dismissing the legitimacy of audiological processing disorder and disorders that may appear similar to you. That would be like saying we all exist with varying ranges of mobility (indisputably true), from yoga master to quadriplegic, but to erroneously conclude that quadriplegia has no significant impact on a person’s potential for achievement in a society built for the able bodied. My APD is the result of multiple pneumonias and otitis media as an infant. It is a processing problem with genesis in infection. When ears are filled with fluid when children are first learning language, sounds are learned in a distorted fashion. I coped for 40 years with a persistent inability to understand speech in multiple environments, especially environments with background noise. I accurately hear very few words spoken to me. I have to use context clues and visual skills to figure out meaning beyond the 30-50% of words that my brain processes clearly in a quiet environment. This has had real life ramifications. I have never been able to fully understand lectures in an academic environment, so I only did well in classes where I could avoid lectures and obtain information from texts instead. I have never been able to get meaning from media such as movies, television, or radio as some of my coping mechanisms, such as lip reading, do not help in those contexts. An iatrogenic brain injury exacerbated my APD and reduced my coping mechanisms and now my brain can no longer tolerate or interpret most sounds at all. It’s not a matter of a processing nuance, it is a matter of my ears being able to hear but my brain being quite deaf when there are competing sounds. My APD was a bigger problem for me before it was diagnosed than after. I hope my description here helps you understand that. Now that I have a diagnosis or label I can get treatment and ask for accommodations so that I can integrate more fully back into professional life. I completed my Philosophy degree 16 years ago, but I was unable to attend the law schools to which I had been accepted afterward because I couldn’t hear in the mandatory lecture formats that exist in law school. But I had no idea why I couldn’t hear or what to do about it before my diagnosis/label. Now that I have an understanding of my auditory disorder, I can pursue the education that I had to previously postpone. And no, benefits are not a core issue for me, I am fortunate to have a financially supportive spouse.

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      • Again I still see that the remedy is just in learning that everyone is different, and then doing what works. I won’t even call it making allowances, as we don’t have any right to impose rigid standards in the first place.

        Autism advocate John Elder Robinson says that they don’t owe you any allowances. He is wrong here, as he is about absolutely everything else.

        That you Twilah have some sort of condition which seems clear cut and physical, is interesting. But I’m still not one to want to engage in labeling. I still say, everyone is unique and we need to accept this and do what it takes to help each person thrive.

        I accept that you might see this differently.

        And I support Citizenship Pay as the alternative to the label based Welfare and Disability Money.

        I say that you don’t respond to one doctor with another doctor. You respond to all doctors with an attorney.


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        • I’m still not sure you’re understanding what I’m saying. I didn’t say allowance, I said accommodation, such is provided by the Americans with Disabilities Act. Like people who use wheelchairs use ramps, and people who are blind use braille, I deserve an education I am academically and intellectually qualified to obtain. I can’t hear in certain environments, it is that simple. I am learning American Sign Language because my condition is not guaranteed to improve. I am also learning ASL because Deaf culture is amazing and hearing people can learn a lot from people who live full lives without spoken language. Like a Deaf person, I am entitled to accommodations like an ASL interpreter or to have information presented via writing/text instead of spoken language. If a room has good acoustics, the only accommodation I might need is to sit in front so I can see a lecturer’s face. I get that you don’t like labels. But labels are words and meanings of words change with time. You make valid points about labels but your point is irrelevant in my case. My concern is about changing a medical model that can ignore a physical disability but punish a person for having a normal psychological reaction to an disability that medicine failed to diagnose.

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          • Twilah – I thought your article was excellent. I really really did – and you’re a great writer, on top of a great thinker. But – I just want to make sure of one thing – I hope you’re not saying you don’t think I – a person who has been diagnosed with an eating disorder, as well as obsessive compulsive disorder – who struggles with aspects of both but who is firmly anti-psychiatry, anti-labeling etc. – am not just as deserving of ADA accommodations? Are only people with true PHYSICAL limitations deserving of it? I’m hoping you do know the ADA covers mental disorders as well? Now, I actually detest the term “mental disorder” – nonetheless, I don’t have a mind that fits in well with standard work weeks and standard work environments, so if “mental disorder” diagnosis is what I need in this stupid world to get certain benefits and accommodations (even though employers are rarely held accountable to upholding accommodations for mental disorders, and I know the literal federal court appellate numbers, because I’m contributing a chapter to a university textbook about issues related to this) – then I believe I am just as entitled to help – I sincerely hope you think so too. Because otherwise I wouldn’t have the money to buy the food I can even get myself to eat.

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          • I think what “Nomadic” is saying is he doesn’t like using the word “disorder” in any context; he recognizes the legitimacy of any personal struggle, even if he chooses not to name things a certain way. I feel as though you are diminishing people who struggle with purely things of the mind, as I do. My struggle is anything but “clear cut” and not remotely physical. Some would dispute it. And I don’t agree with the labels which are used to classify me. But nonetheless my struggle is severe and I can’t survive in this world without help – and when it comes to the ADA, I don’t get the kind of help you do precisely because of the stigma surrounding “mental disorders.” My struggle is just as real as yours. But you seem to only view clear cut, physical limitations as worthy of ADA help. That’s what bothered me about your comment, even though I agreed with almost everything else you said. I hope you understand what I’m trying to say – because I understand what you’re critiquing and agree with you. I’m not trying to attack you, I’m just trying to make a point about the ADA, and point out that perhaps you have a bias yourself in regards to who is entitled to accommodations, however unintentional….

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          • Jeanene, Thanks for taking time to respond and ask for clarification on what I meant. I am very sorry to have given the impression that I thought only people with physical differences should receive accommodations. I was just using physical comparisons because they are more easily understood.
            I think everyone should have access to whatever accommodations can be made to allow them to make the contributions that they choose to make or simply live the life they find must fulfilling. I believe wholeheartedly that people who are challenged by things that are not evidently physically based, whether the challenges is be mental or really of any variety, deserve the same accommodations as anyone. You are right, all of our struggles are equally challenging and our needs are equally valid. We are all worthy of having our needs met in order to live our lives most fully. I was just explaining the specifics of my situation to Nomadic as Nomadic’s perspective seemed to be I was simply over labeled and not in need of anything different or specific to succeed.

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          • Jeanene- And thank you too for your remark as it helps me become a better commenter. I definitely didn’t mean to make anyone feel invalidated or less worthy of accommodations. Your constructive criticism will help me avoid that impression in the future I hope!

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          • Hi again Twilah 🙂 — Thank you for your gracious clarification. I had a feeling it was just a matter of semantics… I think you, me and Nomadic are pretty much all of the same mind, but that perhaps we just express things differently. I do think it’s particularly valuable to prove points by showing the disparate ways mental versus physical disorders are treated and named. I guess language in general just causes problems! (For a good novel on the subject, read “A New York Trilogy” by P. Auster. That’s the former lit major in me speaking, I apologize…!). I have a feeling if you and I met in person we’d be kindred spirits. Your writing style speaks to me and you’re clearly a formidable philosopher. I tried to visit your blog but the URL appears to not be working. I literally just got out of the hospital today following the last round of surgery from my own suicide attempt in the fall; which is the only reason I allowed myself the “luxury” of reading and responding to MIA today. I’m really grateful to have read your work and hope I can find time to read more soon. Thanks again.

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          • I don’t have a mind that fits in well with standard work weeks and standard work environments, so if “mental disorder” diagnosis is what I need in this stupid world to get certain benefits and accommodations …

            One, no one should try to guilt-trip you for that very logical decision about what you need to do in order to survive in this fucked up system. And if they do you should ignore them, unless you’d rather confront them about it.

            I’m also not clear why people would challenge the idea that people with physical disablilties (which almost always have an emotional component) are entitled to state assistance in regard to this, whatever it may entail. It seems that Ms. Hiari understands the absurdity of her situation and understands that when she agrees, “yeah, I have a mental disorder” it’s because she knows that’s what she has to do to survive. So is there an issue here?

            Were the U.S. to adopt a guaranteed annual income (as I believe Canada has just done) people wouldn’t be expected to accept such “disabllity/disorder” labels just to put food on the table.

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    • I think its a necessary evil to have diagnostic labels for severe emotional troubles, as many people reject compassion for their own severe problems much less handing out compassion to others with their tax dollars.

      Half of the country doesn’t want anyone to have any income or welfare when they are too sad or troubled psychologically to work, much less ‘citizenship pay’.

      I do see a compromise that can be made where medicine isn’t incentivized to force treatment, but rather encourage it so at least the ones who have done their research can be spared.

      The author being coerced to admit she overeats and needs to be medicated because she appears overweight is insulting and poor bedside manner.

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  10. Don’t pay the $7,000.
    Most counties pay out on “bad holds” every month–one night detention from a bad hold is about $10,000 in “hush money” from the county–I’m sure they want a non-disclosure agreement. They pay out $30,000 on 72 hour holds with the regularity of a casino slot machine. That in itself should be publicized to the taxpayer.
    Get an attorney. You don’t mind going public, so go to the local newspapers and pressure the hospital to justify its conduct. Good luck.

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  11. “he recognizes the legitimacy of any personal struggle, even if he chooses not to name things a certain way.”

    Yes, Jeanene has got it right. I don’t go along with any sort of disorder label.

    Twilah, you and everybody should be given what they need to function and succeed. None of us really know what that might entail. Everyone is unique and so we just have to recognize this. People learn in different ways and have different strengths and weaknesses. We don’t need to label them and we never will completely understand them.

    Anyway, I like your article. Most of all, you are studying Philosophy and so you will come to sort such issues out for yourself. I feel that the current Mental Health and Disorders fields are based on complete fallacies. So you will soon be able to help in sorting this out.


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    • That’s all fine and well. You can reject labels to your heart’s content. That is your right as an autonomous human being and as such I will support it. I will accept description/labels that accurately explain the etiology of my experience and the effect of my experience on my life. Such descriptions/labels have a net result of improving my quality of life through effective treatment protocol and recommendations for modifying my environment so that I can do the things I want to do and be the person I want to be. I’ll take a label/description any day of the week if it helps me live the life I want to live. Do you have a problem with descriptions/labels like “blind” or “paralyzed”? If so at least you are consistent. If not I would ask you to examine why not. Because of an invisible disability bias? Because of a conflation of description with oppression? I don’t know, these are just questions to consider. You trash your labels, I’ll embrace mine.

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    • Nomadic, your concern here is somewhat misplaced. Abstract discussions about labeling have their place but here 1) we are dealing with physical issues and 2) there is a practical “how do I eat TODAY?” consideration which makes all such abstractions academic until your stomach’s full.

      Plus when we talk about labeling we are generally discussing inappropriate labeling, not the general fact that many things have names.

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      • oldhead, I don’t think we can distinguish what is and what is not physical. That is one of the fallacies of everything involving psychotherapy, psychoanalysis, psychiatry, and developmental disabilities treatment. And likewise I don’t think we can distinguish appropriate and inappropriate labeling.

        I do respect the OP in her quest to define herself as seems correct to her. And on this I am not even going to comment. But I still hold to my own position against all labeling. I still see it as simply the legitimation of the abuse children and adults, and generally falling into the Muchausen’s By Proxy / Medical Abuse category.

        Sami Timimi. No More Psychiatric Labels: Working Beyond Diagnosis

        I do support Citizenship Pay to replace Welfare and Disability Payments. And I want everyone to get what they need to do well in school.

        This issue vanishes once we stop expecting people to fit into slots or to prove their worth. There is not a need for special allowances, as we should not be subjecting anyone to narrowly defined standards in the first place.

        It is a minority of people who do well in school social environments, classrooms, or with book learning. So there should not be a need to justify this by accepting any kind of disability label.

        And I am most pleased to know that the OP is studying Philosophy, because I believe that therein the solutions to our current insanity will be found.


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        • Okay, I’m making this my last comment on this issue. As we speak, I am typing with a broken left wrist, I can show radiology reports if necessary. I would be foolish to refuse to have my wrist labeled as “broken” and insist it just be acknowledged that my wrist is on a spectrum where my distal radius is less fused than the distal radius bones of other people. I needed a cast when I broke my wrist last month and I need a splint now. You have crossed a line from promoting liberation from labels to denying the validity of invisible disabilities that you don’t understand. My auditory issues are just as real as my broken wrist, and I need to DO things differently to function with them, just as I cannot lift heavy objects with my left hand right now. I am not the audiologist who decided to call this a “disorder” any more than I am the person who decided to call the process of a bone fracturing a “break”. This conversation has turned from liberating to invalidating.

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          • And so we’re clear. APD is not a psychiatric label or disorder. Psychiatrists, psychologists, social workers etc cannot and do not diagnosis it. It is not in the DSM. It can only be diagnosed by a specific battery of HEARING tests administered by an audiologist.

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        • I don’t think we can distinguish what is and what is not physical

          Nor should that be our goal. I think you’re beating a dead horse here, as much as I hate that analogy, as the only thing at issue seems to be tangential semantics about which no one’s in serious disagreement, plus this isn’t primarily an article about psychiatry per se, more the medical industry in general. I can see why Twilah would be getting somewhat exasperated by now.

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          • Twilah Hiari, If where you are at, handling things as you have, works for you, great. I’m glad you are thriving. And I hope that you continue to study philosophy.

            I just say that human sensory experience is so complex, that it is very hard to define what is purely physical and what is the result of more plastic neuro programming.

            But in the end it does not matter, as everyone is unique anyway.

            Some people do reject labels like blind or paralyzed.

            I think when you’ve got a child, already being exploited by the middle-class family, and then further by the school system, that is a toxic, dangerous, and even fatal combination.

            Now I know you have grown beyond that age. But I still say that the concept of learning disabilities is extremely dangerous. It can be, and often is, just family blacksheeping. So for this reason I am reluctant to sign on to any of them, even ones which might seem so cut and dry.


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          • Nomadic-I didn’t have the luxury of being “blacksheeped” by a “learning disability” [your term] growing up. I was literally black and I was “educated” in a substandard inner city school district in the 1980s. The only kids who got learning disability labels were badly behaved boys. Everyone else got crammed into an overcrowded classroom and treated interchangeably. There were no IEPs. There was no hand holding. This was a different generation and a different socioeconomic scenario. So my inability to understand lectures was overlooked for my entire school career. Not much is expected of poor minority children you see. It was overlooked right until I dropped out after never passing a grade beyond 8th. Yes, I continued to get promoted through 11th grade, but it was not because I had achieved promotion, it was because that’s the way school in the hood works. I then fought my way through college, skipping lectures I couldn’t understand but doing fine because I read the books. Losing participation credits for never speaking in class because I couldn’t figure out how – but not knowing why. I then had to give up my dream of law school because I simply couldn’t follow the law school lecture and debate format. So I don’t deserve “allowances” because I’m just a little different? I have a legal right to an education that takes into consideration my APD. What other civil rights would you have taken from me? Please understand the whole story before dismiss the pain of my experience because you have a problem with my language. I heard you and respect your opinion, now please respect my experience.

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  12. Twilah, I’m not going to challenge any aspect of your self identification. And if it works for you, as I said before, GREAT!

    I do know that the specific issues of blacksheeping ( better called scapegoating ) and Munchausen’s By Proxy do seem to be much more prevalent in the White middle-class, because we are the hegemonic and privileged majority. It comes down to Capitalism and representations it generates. And I have long observed that members of minority racial groups will often see these sorts of issues differently. And as such I am always interested in dialog as that might increase the degree of mutual understanding.

    To shed more light here, I have known women who work in the sex industry, where there is a huge amount of alcohol and drug use. I’ve commented that those of color work there, because they want to earn a living. Whereas the whites work in that realm because they are the family blacksheep, but lack political consciousness. So the rate of drug use and just general destructiveness and screwy thinking is much higher among the whites.

    And I am involved in community groups who deal with those always in and out of jail, and often living on the street. Immigrants and ethnic minorities almost always conduct themselves more responsibly and less destructively than the scapegoats of the white middle-class American family.

    And what you have described of the school you went to is horrible and I am sorry that you experienced that. But it was not just horrible because not much was expected of the students, it was horrible because they were expecting everyone to compete with each other to fit into a standardized mold. That accomplishes nothing, and everybody is different and they learn in different ways.

    So while I am not going to sign on to endorse any more disability labels, I’m also not going to comment at all on whatever you might do.

    What I would like to see are schools that are more open and accepting and which promote independent study and learning in whatever ways work for a particular person. And I know that even if someone seems to have some sort of a disability, the effects of this will tend to lessen if they are in more flexible and positive environments.

    Good Luck!


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    • I too am interested in dialogue that increases mutual understanding. That is why I write and will keep writing. It is also why I choose to engage in conversation with people who hold different positions and have different life experiences.

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  13. That’s good that you write and engage in conversations with people who hold different life experiences. I do the same.

    I also have a fledgling forum of my own:

    This forum is about the Mental Health System, which I am strongly opposed to. But I am also opposed to psychotherapy and the labeling of children with developmental disabilities.

    I see all of this as coming from Capitalism and the Middle-Class Family, and so I say we need to fight back. Lots of people are effected, but most are slow to organize and fight back.

    But here are some articles and threads I feel could be important:


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  14. re: education – Having your “hand held” isn’t a benefit. For me it meant being bullied out of regular classes and teachers picking me as the designated problem child, and nothing I did counted, because the school didn’t want me on the college-bound track despite qualifying. Now, being 15 years removed from that, I have nothing left and nothing to show for it, and I can barely hold a normal conversation. Doctors don’t even want to hear about brain damage or auditory processing issues that could be helped, and to this day I am and always will be nothing but Retarded in the eyes of the law, with no escape possible except suicide, which I have been pressured to accept as my fate more than once. They won, I lost.

    I wish every day that I was merely overlooked and left to languish in normal classes, rather than live through their hostile interventions. Ultimately though, the system did what it was supposed to do – put me in my place and made sure I never forget that others have the god-given right to spit on me. There is no reform.

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    • I didn’t state or imply that hand holding was a benefit. I made that statement because the previous commenter seemed to think there is one single middle class educational experience that we all have. I was seeking to correct that assumption. I am sorry that your educational experience failed you as well. Many people are failed by education for many different reasons.

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  15. Wow, Twilah, your experience is so typical. In those places they so often fail to listen and fail to hear what is really the matter. I had to fight and fight to get them to hear me. I went to them and plainly stated I had an eating disorder (“eating problems,” since I didn’t even know the words for it) and I wasn’t believed nor taken seriously. I was even told I had a “Jewish problem.” Oh, and a “bad mother.” My poor mom got blamed and blamed, as does every Jewish mother, simply for being a Jewish mother. For every one of us, they overlook what the problem is, often because they do not ask, nor do they want to know what the problem is, or they cannot solve it, so they invent other ones. Often times they want to contradict whatever the patient says just for the sake of saying “The patient is wrong and the doctor is always right.” The last thing they dare admit is that we happen to know ourselves very well. That is why I ditched mental health care entirely, because I found it was totally off base. That’s awful what happened to you and I hope it NEVER happens again.

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    • Julia, I’m so sorry you had such a terrible experience as well, but I’m very happy to hear that you have moved beyond it. I’m saddened but not surprised that you were told you had a cultural/ethnic/religion based problem when the actual problem is with health care culture. These biases are killing us, but if people like you and I keep speaking up, I hope we can promote change. I wish you the best!

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