Candid questions

My head’s been spinning ever since my latest post, so I guess it’s time to delve deeply into the mysteries of my mind.

First off, gender dysphoria sucks big time and makes a person much more vulnerable to developing mental health problems compared to the general population. Don’t take my word for it, though.

untreated gender dysphoria
source: WebMD

So there we have it. And my gender therapist is a fool not to recognise that simple fact – and act accordingly. His training ought to have provided him with this knowledge. His obvious bias in how he’s been treating me so far is unacceptable and renders him incapable for his job as far as I’m concerned.

But enough of that. I wanted to examine the many different labels I got stuck on me over the course of my life a little closer. Because surely not all 574 of them could be accurate, right? What better point to start that investigation than my diagnosis of schizoaffective disorder? It’s not a pretty diagnosis to be stuck with, but it’s the only one I know with a 99.99% certainty to be correct.

The other day, while I was purging the contents of a cupboard that was filled to overflowing with stuff we never used anyway, I found a letter detailing my mental history. It wasn’t very recent, but not too much has changed since the time it was written. Looking through the rather impressive list of diagnoses I received up till that moment, I can’t help but noticing the pattern: Several mentions of major depression and dysthymia. Several mentions of psychotic disorders. Several mentions of suicidal thoughts and ideations.

Looks to me like all these together fit quite neatly into the schizoaffective disorder. So that cleans the list up quite a bit. Which only leaves the personality disorders and a solitary mention of problems with social relationships.

As for the personality disorders we have been given a choice between: borderline personality disorder (a diagnosis wich was really made by a nurse when it was quite a fashionable one), and a mixed personality disorder with borderline and schizoid elements.

Even though it was decades ago, I still remember exactly what made this particular nurse think I had BPD. I self harmed. That, and I went through some transient psychotic episodes. Her diagnosis was confirmed by a psychiatrist who saw me only once, and very briefly at that.

I had no history of unstable and intense personal relationships. I was never very impulsive and my interest in sex has always been negligible. I did not have frequent mood swings. I certainly had no chronic feelings of emptiness. And the anger problems so commonly seen in borderliners were alien to me. I had no fears of being abandoned and, apart from the gender issues, my self image was pretty stable. So yes, there was the self injurous behaviour and suicidal ideations. There were the transient psychotic episodes, but that was all. Definitely not enough to justify a BPD diagnosis.

As for the mixed personality disorder with borderline and schizoid elements, well, that one makes a lot more sense. We’ve already seen the borderline elements.

Schizoid elements. Let’s see. Remember there was a solitary mention of problems with social relationships? I never had many friends. Not even as a child. For as long as I can remember, I’ve felt uncomfortable around people. I’m not shy, it’s just that people get on my nerves with their constant need to talk, touch and be close to others. I hate it when people touch me. Always have. The friends I had, I lost. I liked them well enough, I guess, but I just couldn’t be bothered to stay in touch and in the end I guess they got sick of always having to be the one to take the first step.

I like to be alone and that reflects in my lifestyle. I read, write and play computer games. I play with  my power tools. But I won’t attend social activities if I can avoid it. And if a stranger has the nerve to say hi to me in the street, I’ll either ignore him or (when I’m in a bad mood) scowl at him. Now, if I meet a cat in the street, that’s a whole different story.

As for sex, I already mentioned that I’m not interested. As far as I’m concerned it’s just a necessary means to an end: procreation.

Though I may not be exactly indifferent to praise or criticism, I definitely have trouble handling both and therefore try to ingore them. Praise is probably hardest to deal with properly. I know the social conventions. You have to say thank you when someone praises you, but when you get right down to it, that’s just silly. You have to thank someone for noticing you did something well? And don’t you dare say, “yes, I know,” because people will think you’re being rude, when in reality you’re just being honest. That simply doesn’t make any sense to me.

Criticism, on the other hand, often annoys me because it’s all too often dumb and irrational. It’s almost like a lot of people just criticise certain things (actions, behaviours) for no other reason than the sheer delight they get from hearing themselves roar. Why can’t they just shut up and learn a thing or two instead?

I do not, however, care very much what people think of me – unless they get in my way, that is. What do I care if they think I’m the best thing since sliced bread? Or why should I get excited about people thinking I’m stuck up and probably more than a little weird? They can think all they want. As long as they don’t try to stop me from reaching my personal goals in life, I don’t give a goat’s fig.

No pleasure. I don’t think that one applies to me at all. I do derive pleasure from certain activities. My books are my best friends. My power tools make me feel strong and capable. My writing helps me make sense of my thoughts and emotions. Music soothes my mind and takes me away to the realms of fantasy. These are all activities that make me feel good. Isn’t that what pleasure is?

When I asked my husband the other day if he thought I was aloof, he not only smiled but actually chuckled. Yes, he said, I definitely was. I was surprised, seeing that most people perceive me as warm and outgoing, but he’s been with me for over 25 years. He knows me well. He’s seen me drop the warm and outgoing mask a few times too many, I’d wager.

So here’s the question. Do I qualify for a diagnosis of SPD? I’d say yes, but obviously I can’t go around diagnosing myself. And there certainly is room for doubt.

I do have a full range of emotions. Or at least I think I do, but I’m not convinced that my emotions run as deep as those of most other people. I definitely have trouble showing my emotions, and will only let them out to play as far as I can control them. Laughing and smiling are easy and help you get along with people. Although I may show annoyance quite easily, I will usually keep anger and sadness to myself.

Unlike most schizoids, I am married and have my own family. And my daughters really mean the world to me.

So, is it really SPD, or is the mixed personality disorder with borderline and schizoid elements more applicable here? I’m not sure.

Also, I take issue with the disorder part. I’d much rather call it schizoid personality organisation. Why medicalise what probably is just a different way of being?

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12 Responses to Candid questions

  1. Jamie Ray says:

    Substance abuse✔️
    Eating disorder✔️


  2. Labels are not often helpful when it comes to the DSM. Sometimes they are helpful. Don’t get me wrong. But I always wonder what came first? In your case gender dysphoria or schizoaffective disorder, SPD or BPD. I’d be curious to see what remains when you are in full alignment with yourself. We all have some characteristics of personality disorders. It’s all about context.

    Liked by 1 person

    • Liam says:

      Oh, gender dysphoria definitely came first. That’s a no-brainer to me. Though if I do happen to have a schizoid personality organisation, that might well have come at just about the same time, if my hypothesis that this is innate rather than environmentally caused, is correct.


  3. Some of what you describe sounds more like high functioning autism than a personality disorder? I am not trying to make an armchair diagnosis, but maybe read a little of anything by Temple Grandin and see if it sounds more like your experience?

    Liked by 2 people

    • No it’s definitely not autism. I don’t mind at all if my routines get disturbed and I have to improvise, e.g. People suffering from ASD invariably lack the flexibility of mind to deal with those situations effectively.


  4. Josh Moll says:

    Is it all a combination of you being you, gender dysphoria and being gifted. Have you ever read about overexitabilities combined with giftedness, ever heard about Dabrowski?

    Liked by 1 person

  5. Kris says:

    Liam, my opinion is that the 575th label is the one that fits you best: “LIAM”. Bedamn the 574 that came before. By the time DSM-6 is published, trans will probably have been eliminated as having been ‘normal’! (Let’s vote Sky onto their panel!) By society’s norm, I will always be ‘borderline’ everything somehow. And I take pride in it. Pity ‘the people’ feel a need to label everything and everybody, but I guess it is useful sometimes. The term ‘asshat’ comes to mind… 😉

    Liked by 3 people

    • Too right Kris! Trans needs to be eliminated from the DSM, as well as many other so-called mental conditions. But you know, labels really are useful. I’ve been thinking of getting myself a label maker, just to help me keep my stuff organised. (I’m a terrible housekeeper but hate clutter and disorganisation – being overexcitable and all that.) And like you said, the label asshat is a very useful one.
      Just looked him up on LinkedIn once more, because I wanted to check up on something, and indeed it was true: he isn’t even a psychiatrist yet. He’s still in training…


    • Thanks for the chuckle – you never know, odder things have happened.

      Liked by 2 people

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