Cool Thesis of the Week: Rowan Hildebrand-Chupp
“Mental disorder” is a tricky diagnosis to give to any psychological difference, as it immediately implies a judgement that someone has something “wrong” with them. Until recently, for example, homosexuality was officially classified as a disorder, and once, escaped slaves were considered to be disordered. But despite its tricky implications, the diagnosis of “disorder” is a necessary one—many psychological conditions do in fact make living extremely difficult for patients, and require treatment.
This is the central conflict when discussing mental disorders, says Rowan Hildebrand-Chupp ’13. Rowan, who calls Portland his hometown, is writing his Psychology thesis with professor Kathy Oleson on this issue. He will also look at how clinicians apply it to asexuality, the sexual orientation (or lack thereof) wherein people feel no sexual desire or attraction for people of any gender.
“There’s actually a lot of diversity in the asexual community,” says Rowan. Some asexuals feel romantic attraction, which is sometimes directed towards a particular gender; some do not. Some feel sexual attraction, but have no desire to act on it; some don’t even think about sex at all. Rowan recalls becoming interested in it when a friend came out to him as asexual. “My first impulse was like, ‘what is wrong with you?’” he says.
“Is sexuality a basic, fundamental part of being human?”
But he soon reconsidered, questioning why asexuality should be considered a disorder. “When you’re coming from the perspective of something being a disorder, it’s so hard to see how that is not an objective judgement,” he says. A disorder, Rowan explains, is currently defined as a “harmful dysfunction” in the Diagnostic and Statistical Manual of Mental Disorders, or the DSM, the authority for many American psychiatric professionals on mental disorders. “Dysfunction” refers to a “breakdown of evolutionary mechanisms.” If this breakdown is deemed harmful to the patient’s life, it meets the definition of a “disorder.”
But to decide whether something is “harmful,” says Rowan, requires a culturally influenced value judgement. It is “stigmatizing on a basic level,” he says, to claim that someone has something wrong with their mind that is making them worse off in an objective sense. However, this is not a reason for avoiding diagnosing disorders. It is necessary, Rowan says, to identify and treat disorders that do cause genuine distress for those afflicted, even if this means making a potentially alienating value judgement. If a genuine disorder is untreated, it can have profound negative impacts on a patient, but so can stigmatizing an essentially harmless condition. “Diagnosis has power,” says Rowan.
Instead of avoiding this issue, as many psychiatric professionals currently want to do, he says, clinicians should acknowledge it. “At the end of the day, every mental disorder should be subject to cost-benefit analysis,” he says. In the case of asexuality, this means asking “what’s the benefit of treating people vs. what’s the benefit of avoiding treating people and supporting those identities instead?” The DSM currently does not address “asexuality,” but classifies people with low sexual desire, and who are distressed about this fact, as “disordered.” This might be problematic, Rowan says, because some of these people may only be distressed because of social pressures, not because of their asexuality itself.
“Whether or not that’s a disorder,” he says, comes down to a question: “Is sexuality a basic, fundamental part of being human?”
Rowan says he can’t hope to answer this question in any verifiable sense. What he does hope to achieve is to characterize how mental-health professionals answer it. He will be conducting a survey of mental-health treatment providers that provides hypothetical situations with patients who report feeling no sexual desire or attraction. Some are distressed about it, and some are not; the distressed ones attribute their distress to varying causes. Rowan hopes to gain a picture of how asexuality is treated in general by those who have power over its conceptualization as a mental disorder or not.
As for Rowan, he thinks clinicians should at least be required to make it known to patients that it is possible, and that many people do it, to live without sexuality. This could still leave room for patients whose genuine best flourishing would lie in finding a way to express some sexuality.
However, he says, “my position might change in 20 years.”
Each week, The Quest profiles the thesis of one senior whose work is worth sharing with the Reed community. The purpose of this column is to increase awareness among Reedies of the work being done in various academic fields and to make disparate forms of scholarship accessible and understandable to all. Do you have or know of a thesis that compels attention? Just want to see your face in the Quest? Email firstname.lastname@example.org with “Cool Thesis” in the subject line.