EEOC Guidance on Psychiatric Disabilities

The Equal Employment Opportunity Commission ("EEOC" or "Commission") receives a large number of charges under the ADA alleging employment discrimination based on psychiatric disability.3 These charges raise a wide array of legal issues including, for example, whether an individual has a psychiatric disability as defined by the ADA and whether an employer may ask about an individual's psychiatric disability. People with psychiatric disabilities and employers also have posed numerous questions to the EEOC about this topic.

WHAT IS A PSYCHIATRIC DISABILITY UNDER THE ADA?

Under the ADA, the term "disability" means: "(a) A physical or mental impairment that substantially limits one or more of the major life activities of [an] individual; (b) a record of such an impairment; or (c) being regarded as having such an impairment." This guidance focuses on the first prong of the ADA's definition of "disability" because of the great number of questions about how it is applied in the context of psychiatric conditions.

Enjoying ill Health: The Seduction of Secondary Gains

The Seduction of Secondary Gains

You probably don't think about the seductive benefits that come from being sick, since the prevailing cultural belief is that the sick are innocent sufferers, incapable of the kind of manipulation that would make their unpleasant situation advantageous. In fact, this belief may be the central benefit of illness: you’re assumed to be innocent because illness is something that "just happens," which means you can’t help being the way you are. Helpless and suffering because of an act of fate, you must be catered to and accommodated, no matter how much trouble it makes for everyone around you.

But we all use illness for secondary gains—consciously and unconsciously. When you call in sick to work and escape the whole onerous day without being accused of deliberately shirking your duties, you are enjoying a secondary gain of illness. When you cut short or avoid unwanted social engagements because you’re sick, you are enjoying a benefit of illness. When someone waits on you tenderly and takes care of all the chores as you languish in bed, you are enjoying a secondary gain. When a child escapes a day at school by claiming a stomachache or sore throat, this is a secondary gain—and often escalates to blatant manipulation when paired with an overly protective parent.

Subjectivity and Ambiguity of Mental Disability Evaluation

Mental Impairments

Decisionmaking problems which are troubling and unavoidable in the adjudication of physical disability claims are of even greater consequence in the evaluation of mental disability. Early recognition of the differences between the two was reflected in the 1938 Social Security Board's conclusion that mental disability "should be excluded" from any SSA program "because it would be too hard to determine" (Stone, 1984, p. 72). The very existence of mental "illness," of course, has been questioned on theoretical grounds (Szasz, 1974). Less theoretically, DDS psychiatrists, clinical psychologists, and examiners who see themselves as responsible for dispensing tax dollars more often expect the mentally disabled to "try" to work. This especially seems to be the case when the disability includes alcoholism or drug addiction, which many doctors and examiners simply do not think should be a consideration despite guidelines to the contrary. The fact that people are stigmatized more by mental impairments than by physical ones (Tringo, 1970) may reduce the sympathy that often makes the adjudicatory difference in close cases. In general, "habits of thought and policies derived from medical care often have different results when applied to mental health services" (Buck, 1982, p. 219.

Sex Reassignment Therapy

Click Here to Download Transgender Need Assessment Survey

Sex reassignment therapy (SRT) is an umbrella term for all medical procedures regarding sex reassignment of both transgender and intersexual people. Sometimes SRT is also called gender reassignment, even though many people[who?] consider this term inaccurate as SRT alters physical sexual characteristics to more accurately reflect the individual's psychological/social gender identity, rather than vice versa as is implied by the term "gender reassignment." Most trans people simply call this process transition.

The Real Revolution (by Krishnamurti)

Meditation is to find out whether the brain, with all its activities, all its experiences, can be absolutely quiet. Not forced, because the moment you force, there is duality. The entity that says, “I would like to have marvellous experiences, therefore I must force my brain to be quiet” will never do it. But if you begin to inquire, observe, listen to all movements of thought, its conditioning, its pursuits, its fears, its pleasures, watch how the brain operates, then you will see that the brain becomes extraordinarily quiet; that quietness is not sleep but it is tremendously active and therefore quiet. A big dynamo that is working perfectly hardly makes a sound; it is only when there is friction that there is noise.

Meditation is to find out whether the brain, with all its activities, all its experiences, can be absolutely quiet. Not forced, because the moment you force, there is duality. The entity that says, “I would like to have marvellous experiences, therefore I must force my brain to be quiet” will never do it. But if you begin to inquire, observe, listen to all movements of thought, its conditioning, its pursuits, its fears, its pleasures, watch how the brain operates, then you will see that the brain becomes extraordinarily quiet; that quietness is not sleep but it is tremendously active and therefore quiet. A big dynamo that is working perfectly hardly makes a sound; it is only when there is friction that there is noise..

We hardly ever listen to the sound of a dog’s bark, or to the cry of a child or the laughter of a man as he passes by. We separate ourselves from everything, and then from this isolation look and listen to all things. It is this separation that is so destructive, for in that lies all conflict and confusion. If you listened to the sound of those bells with complete silence, you would be riding on it-or, rather, the sound would carry you across the valley and over the hill. The beauty of it is felt only when you and the sound are not separate, when you are part of it. Meditation is the ending of the separation not by any action of will or desire. Meditation is not a separate thing from life; it is the very essence of life, the very essence of daily living. To listen to those bells, to hear the laughter of that peasant as he walks by with his wife, to listen to the sound of the bell on the bicycle of the little girl as she passes by: it is the whole of life, and not just a fragment of it, that meditation opens.

More about  Krishnamurti = >> http://www.jkrishnamurti.org

The power of negative thinking

Feeling grumpy 'is good for you'

“IF you can’t say something good about someone,” a wise woman once said, “sit right here by me.” Alice Roosevelt Longworth, daughter of Teddy and notorious curmudgeon, would have been awfully lonely if she’d come up with that personal motto during the past decade. America’s mania for “The Secret,” team-building exercises, Oprah, vision boards, life coaches, antidepressants and inspirational terminal-illness ribbons has all but outlawed any manner of negative thought.

According to this philosophy, if you’re not constantly generating positive brain waves, you’re dooming yourself to a life half-lived, and you deserve whatever hardships may come your way (obviously, as you’re the one who psychically invited them in). But recently, there’s been an undercurrent of doubt. It seems a perkiness backlash may be brewing, fueled not by hopeful thoughts but by actual scientific research. In his study “Think Negative!,” published this month in Australian Science, psychology professor Joseph Forgas says bad moods are actually useful for us.

Misdiagnosing Personality Disorders as Bipolar

The Bipolar Disorder got its name because the mania is followed by - usually protracted - depressive attacks. The manic phase of the Bipolar I Disorder is often misdiagnosed as a Personality Disorder.

In the manic phase of Bipolar Disorder, patients exhibit many of the signs and symptoms of certain personality disorders, such as the Narcissistic, Borderline, Histrionic, or even Schizotypal Personality Disorders: they are hyperactive, self-centered, lack empathy, and are control freaks. The manic patient is euphoric, delusional, has grandiose fantasies, spins unrealistic schemes, and has frequent rage attacks (is irritable) if her or his wishes and plans are (inevitably) frustrated.

The Bipolar Disorder got its name because the mania is followed by - usually protracted - depressive attacks. A similar pattern of mood shifts and dysphorias occurs in many personality disorders such as the Borderline, Narcissistic, Paranoid, and Masochistic. But whereas the bipolar patient sinks into deep self-deprecation, self-devaluation, unbounded pessimism, all-pervasive guilt and anhedonia - patients with personality disorders, even when depressed, never lose the underlying and overarching structure of their primary mental health problem. The narcissist, for instance, never foregoes his narcissism, even when down and blue: his grandiosity, sense of entitlement, haughtiness, and lack of empathy remain intact.

"Narcissistic dysphorias are much shorter and reactive - they constitute a response to the Grandiosity Gap. In plain words, the narcissist is dejected when confronted with the abyss between his inflated self-image and grandiose fantasies - and the drab reality of his life: his failures, lack of accomplishments, disintegrating interpersonal relationships, and low status. Yet, one dose of Narcissistic Supply is enough to elevate the narcissists from the depth of misery to the heights of manic euphoria."