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Help me identify this condition?
April 18, 2010 3:23 PM   Subscribe

Dissociation? Borderline? Detachment? Sociopathy? Anhedonia? Depersonalization Disorder? What would you call this? Also, related therapy question.

L, for all appearances from the outside looks and acts normally. L laughs delightfully at a witty comment, seems worried about his parents getting older, goes on dates with girls, things like that.

However, L has a very peculiar lack of awareness of his emotional state. He hears the witty comment and laughs at it, but never at any point registers a sensation of delight, concluding by his reaction that he enjoyed it. He feels his stomach upset and his face turn at thoughts of his parents' mortality, and thus knows he's sad. He meets with said date and feels a bodily tingle and has sexual thoughts, but never feels anything like connection.

To put it another way, it's not that L doesn't have emotions or an emotional process, quite the contrary, he seems fairly normal to an outside observer. The issue is that he has virtually no experience of his emotional process. This lack of being able to experience his feelings aside from the physical sensations and thoughts they cause makes it very difficult to plan for the future or maintain relationships.

L had always assumed this was a symptom of depression because both began concurrently about three years ago (L's in his mid-20's). I think it might be the other way around, the lack of awareness might be causing the depression; It interferes greatly with his motivation, which then leads to him not doing anything or looking forward to anything, which then leads to depression (And he's only aware of it when he feels it bodily and mentally as fatigue, a lack of talkativeness, darker than usual thoughts, etc.).

What would you call this? We're trying to find a therapist and it would help if we had some shorthand way of describing this. Also, if you could help us narrow the field as to what kind of therapist to look for (social worker/psychologist/counselor/psychiatrist, there are so many!) that would be great.
posted by Ndwright to Human Relations (7 answers total) 4 users marked this as a favorite
 
I hate offering this answer, but...: what we, the unwashed and unstudied masses of AskMefi, would call it would not help you a wit. Why? Because we're not trained to call*'em*like*we*see*'em. And those of us who are know better than to try to clinically diagnose "L" by way of a couple of paragraphs. You're trying to do the equivalent of showing a photo of some skin with a lump on it and asking "Bug bite? Tumor? Alien seed pod?"

Does L have a physician? The physician would be a better person to ask what sort of therapy L should seek out.
posted by griphus at 3:42 PM on April 18, 2010 [4 favorites]


A therapist will want to know about L's relationships - family, friends, romantic partners, co-workers, so you could start by organizing that information. For example, you mentioned a date and that L experiences arousal. Ok, what else? How did L meet that particular date? Was there a second date? Did L meet the friends of the date? How did that go? et cetera.

I would concentrate on organizing and describing the symptoms for reporting to the Psychiatrist rather than seeking a diagnosis via your own research. And I say Psychiatrist because from what you described it sounds like there is enough there that L should see one.
posted by mlis at 4:05 PM on April 18, 2010


Find L any therapist of any kind. Start w/ a doctor to refer you if you wish. Get L to tell their experiences above to the therapist. Let the therapist diagnose L. Move on from there.

Don't look for a label, apply it to L and then seek therapy according to this lay diagnosis you have laid upon them. Speaking from personal experience getting a mislabel can do real harm and set back to any benefits therapy can bring.

Sorry if that comes across strong but getting a mislabel from a lay person did much harm to me mentally and caused me to enter therapy w/ mistrust when I would've been fine w/ it if I had left it to professionals.
posted by kanata at 4:09 PM on April 18, 2010 [2 favorites]


Okay, I am not a therapist, but when I have experienced something similar it was more on the depersonalization spectrum.

But, since I am NOT a therapist, my opinion means squat. As to type, licenced clinical social worker or psychologist would be where I would start. If an actual psychiatrist is needed (and this would only be if meds were in order) the starting therapist could refer you to a good one.

You don't need a shorthand way to describe this-that would get in the way of true help, btw.
posted by St. Alia of the Bunnies at 4:21 PM on April 18, 2010


Alexithymia a the word used to describe difficulty identifying and describing emotions. Not a DSM diagnosis, and can be present as a result of many specific disorders. but that's a word that can be a starting point for some google searches and perhaps conversations with L

It has been my experience that people who prefer to avoid discussing and identifying their emotions can get better at it if they wish to work at it. (and of course, IANYD.)
posted by gilsonal at 4:46 PM on April 18, 2010 [1 favorite]


Don't look for a label, apply it to L and then seek therapy according to this lay diagnosis you have laid upon them. Speaking from personal experience getting a mislabel can do real harm and set back to any benefits therapy can bring.

Oof, didn't even think of that. The road to hell. . . I guess "forget about the shorthand" is the way to go.

Thanks for the feedback, guys!
posted by Ndwright at 5:44 PM on April 18, 2010


The description of alexithymia might interest you. Mind you, not as a lable to get hung up on - I agree that diagnoses are best left for professionals. But it might still help you prepare to describe the issue to one, though.
posted by sively at 4:49 AM on April 19, 2010


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