[Paleopsych] Hermanaut: Identiopathy

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Dear Colleagues:

   Enclosed please find a supplemental addition to the Diagnostic and 
Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Section 
301.75: Identiopathic Personality Disorder, should be added to DSM-IV 
between 301.7: Anti-Social Personality Disorder, and 301.83: Borderline 
Personality Disorder.

   As you know, the DSM-IV is a classification of mental disorders
that was developed for use in clinical, educational, and research
settings. The diagnostic categories, criteria, and textual
descriptions are meant to be employed by individuals with appropriate
clinical training and experience in diagnosis. This addition to the
category of Personality Disorders is the product of the extensive
research and clinical experience of the Task Force on DSM-IV and the
Personality Disorder Work Group. We hope the identification of this
new diagnosis will enhance your knowledge and understanding in a
constantly evolving field.


The Association

301.75 Identiopathic Personality Disorder

Diagnostic Features

The essential feature of Identiopathic Personality Disorder is a
pervasive pattern of acute, inflexible mimetic attachment to an
exaggerated and overly demonstrative identification of oneself with
perceived subversive ideology. This pattern typically begins in early
adulthood (though increasing reports of onset as early as age 10 are
becoming significant) and persists well into the 30s and beyond, and
is present in a variety of contexts.

This pattern has also been referred to as Identiopathy, Subsociopathy,
and Inverted Self-Aggrandizing Psychosis.

Individuals with Identiopathic Personality Disorder can only perceive,
relate to, or think about their environment or themselves through the
filter of a perceived collective truth, specifically one which is--or
appears to be--at odds with, or subversive of, received dominant
cultural truths (Criterion 1). In a parody of Paranoid Personality
Disorder, with which it is often mistaken, their attraction to
oversimplified formulations of the world tend to make them wary and
dismissive of ambiguous situations. This tendency resembles Paranoid
Personality Disorder, as these individuals often behave as fanatics
and form tightly knit groups with others who share "their" belief
system. Unlike individuals with Paranoid Personality disorder, their
understanding about the nature of the world is not in the least
abstract or fantastical, but is extremely concrete and literal
(Criterion 2).

Individuals with this disorder experience severe subjective distress
regarding an overly rigid certainty on issues relating to identity,
including long-term goals, lifestyle, friendship patterns, moral
values, and group loyalty. They have a pattern of immediate
demonstrative and intense relationships based predominantly on the
notion of shared vision and struggle (e.g., social, political,
personal). These relationships, though believed to be enduring, tend
to be unstable over time. Beneath the sense of camaraderie lies a
thinly veiled hierarchy based on a competitive mastering of the group
identity (e.g., A exuberantly tells B, "I too once thought that until
C called me on it..."). They demand consistency from themselves,
others, and their environment, and are unable to accept or reconcile
conflicting beliefs and desires. These relationships also tend to have
an undercurrent of distrust which grows out of a fear that the
individuals involved will prove inadequate to the demands of the group
identity. As a result, these individuals often experience low-grade
feelings of trepidation and one-up-myn-ship (Criterion 3).

Individuals with Identiopathic Personality Disorder cling to their
identities in order to authenticate their existence in a manner that
can be readily observed and taken note of by others. In doing so, the
individual solemnifies his sense of self (Criterion 4). Identiopathic
Personality disorder is often initially misdiagnosed as Borderline
Personality Disorder, since in both we see a pervasive pattern of
instability of interpersonal relationships, self-image, and affects,
and a chronic feeling of emptiness. However, whereas individuals with
Borderline Personality Disorder suffer from a markedly and
persistently unstable self-image or sense of self, in the
Identiopathic Personality Disorder the sense of self is, although
deeply flawed, unfortunately quite stable. Individuals with this
disorder may perceive themselves as possessing superior intellectual
powers and a vast capacity for empathy, causing them to have an
unreasonable expectation of deference or automatic compliance with
their values and beliefs (Criterion 5); they often appear haughty and
arrogant, and believe they can only be understood by, or should only
associate with, other "special people" (e.g., individuals believed to
be like-minded, more knowledgeable and unique, or relevant to "the
cause"). These individuals may interpret a lack of deference or
directed difference of opinion to be a personal attack, and may
quickly assume a combative and defensive stance. This is because their
sense of self is inextricable from a rigid belief system. Because this
enduring personality trait, which is exhibited in a wide range of
social and personal contexts, deviates markedly from the expectations
of dominant culture, individuals with this disorder tend to suffer
distress and/or impairment in social and occupational settings.

Individuals with Identiopathic Personality Disorder tend to be more
concerned with expressing impressions rather than ideas because of a
fear that misinterpretation of the information they convey may be used
against them. These individuals may use carefully regulated language
and word choices to ensure consistency and avoid misinterpretation.
Individuals with Identiopathic Personality Disorder are ever alert
for, and intolerant of, views that are perceived to deviate from their
"own" (Criterion 6). Any perceived deviation, whether it be through
simple misunderstanding or difference of opinion, is believed to be
untrustworthy and injurious, and reinforces the belief that the
individual is in possession of the Ultimate Truth. They experience a
compulsion to assert the wrongness of such deviations, often prefacing
their tirades with a huff, hiss, gasp, or tsk, lest their silence be
construed as tacit acquiescence; this compulsion is in no way lessened
in situations where the offending viewpoint is directed at a general
audience, or at someone else entirely: e.g., in classrooms, at the
movies, at nearby restaurant tables (Criterion 7). Although it is most
common for these individuals¹ beliefs to be grounded in an ideology
based on tolerance and inclusiveness, they may in fact be highly
intolerant (e.g., A verbally attacks B in public, on grounds that B¹s
views are insensitive); the irony of this tends to be lost on them due
to their chronic state of humorless literalism (Criterion 8).

Associated Features

A regressive need to belong, which is at odds with their determination
to distinguish themselves from the dominant culture, may incline these
individuals to co-opt the cultural, social, and spiritual practices of
others. These individuals understand their born culture to be bland,
ill-defined, and unexotic. They may adopt the beliefs and ideologies
of other cultures (often more than one, creating a spiritual and
cultural mélange), but most often they will focus on visible
representations such as outward customs, garb, or icons to demonstrate
their affinity and compassion, as well as confirm their allegiance and
loyalty to the targeted identity. The result is often a recognizable
sub-fashion which enables these individuals to identify each other and
distinguish themselves from dominant culture.

Some identiopaths are quite charismatic and find easy converts in
their counterparts with weaker self-constitutions. These converts are
in a sense "brought out" by their own through a system of rewards and
punishments (e.g., special treatment and excessive attention followed
by sudden and severe disinterest) not dissimilar to the recruitment
process of religious cults.

Authoritative pseudo-intellectual ramblings may be used to establish
the authenticity of these individuals' identity and beliefs; these
ramblings may vary in substance, but sometimes suffer from the
absolute poverty of content seen in the condition of alogia.
Interpersonal relations are typically impaired due to problems derived
from arrogance, inflexibility, and a disregard for the sensitivity of
others. Sometimes vocational functioning is limited where individuals
are unable to reconcile the content of their work and workplace with
their life criteria. Having initially adopted and applied theory of
real import in artificial and isolated situations (e.g., graduate
school), individuals with Identiopathic Personality Disorder
experience cognitive impairment and dysfunction when the applicability
of the theory is challenged by the ambiguities posed by the variations
of day-to-day life. These individuals become distressed with any
ambiguity when they are unable to reconcile their belief system with
the external world, causing them to lapse into an echopraxic parroting
of a party line.

Diagnostic Criteria for 301.75 Identiopathic Personality Disorder

A lemming-like pattern of behavior and ideas beginning in early
adulthood (and quickly stagnating thereafter) whose so-called
alternative vision of dominant culture is unoriginal, predictable, and
un-open to discussion on any other terms, and which is present in a
variety of contexts, as indicated by six (or more) of the following:

  1. inability to interpret any information or experience without first
  filtering for deviations from, or inconsistencies with, chosen
  2. extremely concrete and literal understanding of the world that
  disables capacity for thinking critically, or considering
  3. is quick to bond with mirror-image-like peers for a solidarity
  that is ultimately superficial and trepidatious
  4. gnawing desire to be seen and perceived as not-like-everybody-else
  5. perception of being more intelligent, sensitive, and privy to a
  "Truth" which others could see if they would only just listen
  6. infertile imagination and cowardice, manifested as a fanatical
  need for control over speech acts
  7. uses (often inappropriate) repetition to convince self and others
  of ideas; regularly hisses in movie theatres
  8. is so literal as to be humorless, hypocritical, and helpless

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