PSYCHIATRIC VIEWS ON THE NEWS
Do I contradict myself?
Very well, then, I contradict myself:
(I am large—I contain multitudes)
–Walt Whitman, Song of Myself
I am he as you are he as you are me
And we are all together . . .
I am the eggman, they are the eggmen
I am the walrus, goo goo g’ joob
–The Beatles, I Am the Walrus
These lines from both the poet Walt Whitman and the Beatles span about 150 years. Like the best art, they have a depth of meaning that can be predictive and prescient.
In American culture, we are witnessing a rapid evolution of public processing of our personal identities. On a basic level, this includes taking “selfies” and posting Facebook profiles. On another level, socially acceptable aspects of our identities are being expanded.
Gay marriage is rapidly becoming socially acceptable. As gay marriage has become legal in more and more states, it has changed the meaning of the personal identify of each of the spouses. However, the counter reaction to gay marriage is resulting in the anticipated Supreme Court ruling on this development. There is also more public expression of a variety of sexual preferences.
We also are observing and participating in a rapid public processing of gender identity preference. Twenty years ago, when I first began to work with those with gender identity disorders, public disclosure was rare due to prejudice, discrimination, and misunderstanding. Now, Caitlyn Jenner can come out on the cover of the July issue of Vanity Fair, followed by a cover story in the New York Times on The New Girl in School: Transgender Surgery at 18. For the most part, I saw patients who had a firm sense since early childhood of an identity opposite to their physical appearance and gender. Today, a preference to change one’s gender, to some extent, seems that it can be based on a desired social identity, besides—or even instead of—any sense of biological necessity.
From the racial or cultural standpoint, a critical uproar has occurred about a former Spokane NAACP official who posed and presented herself as “black.”Her “white” parents deny this claim. Whether she was being intentionally deceptive or not, little has been said about the positive social aspects of someone from a majority cultural group wanting to be part of a minority group. We also have seen a rising interracial (and interfaith) marriage rate.
Most recently, we have the tragic killing in Charleston, South Carolina, of black Americans while they attended Church, by a young white male—an act of racial hatred. The perpetrator had a history of substance abuse, but nothing is yet clear about possible other mental disorders.
DSM-III classified identity disorder and focused especially on the difficulty adolescents have in forming a comfortable personal identity. This seemed relevant to the cultural psychiatry seminars I had with psychiatric residents, and allowed us to address how difficult it was for people who were culturally discriminated against to form a positive personal identity. In DSM-IV, identity disorder was omitted and replaced by the more innocuous “identity problem” under the additional codes section. In DSM-5, there is no identity classification. However, we have continued to use related and more specific identity terminology, such as dissociative identity disorder or gender identity disorder.