My Love-Shyness
& Asperger's BLOG
Love-Shy Related Diagnostic and Statistical Manual Revisions
The American Psychiatric Association is updating its main book
of psychological related conditions, formally known as the Diagnostic and Statistical
Manual of Mental Disorders. The APA updates this book,
considered the “bible” among psychological professionals, about every
dozen years. This new fifth major revision is commonly called DSM-5 and set for
release in 2013. While love-shyness and incel are not included in the
draft version recently posted for public review at www.dsm5.org, a few
interesting key revisions relate to love-shyness.
Primarily, the condition of Sexual Aversion Disorder will be dropped as discussed on this
DSM revision page:
302.79
Sexual Aversion Disorder
Proposed Revision
The work group is recommending that this disorder not be included in
DSM-5
A possible option is to classify sexual aversion under Specific Phobia.
Rationale
Despite the large number of recent population-based epidemiological
studies on sexual symptoms and distress, none have asked about the
prevalence and associated features of sexual aversion. Although SAD is
listed as one of the two Sexual Desire Disorders, there appear to be
few similarities between HSDD and SAD--the former being characterized
by the absence of desire and the latter the presence of fear and
avoidance (Kaplan, 1987). Instead, Sexual Aversion Disorder seems to
bear similarities to Specific Phobias. If one considers the Specific
Phobia criteria in the context of the feared sexual stimulus, it is
readily apparent that the individual with sexual aversion could meet
criteria for a Specific Phobia. Although the text on SAD indicates that
“…sexual aversion may technically meet the criteria for Specific
Phobia, this additional diagnosis is not given” (American Psychiatric
Association, 1994, p. 499), paradoxically the text on Specific Phobia
makes no mention of sexual aversion disorder. The limited empirical
data available suggest that SAD is similar to Specific Phobias in that
(1) it likely follows Mowrer’s (1947) two-factor theory of pathogenesis
and (2) it responds optimally to behavior therapy in the form of
systematic desensitization. Whether this option is adopted or not will
depend on the discussions held by the Anxiety, Obsessive-Compulsive
Spectrum, Posttraumatic, and Dissociative Disorders Workgroup.
References
Kaplan, H. S. (1987). Sexual aversion, sexual phobias, and panic
disorder. New York: Brunner-Mazel.
Mowrer, O. H. (1947). On the dual nature of learning: A
reinterpretation of "conditioning" and "problem-solving". Harvard
Educational Review, 17, 102-148.
Since I classify love-shyness as a phobia, I believe this is an excellent change. Unfortunately, I don't see sex on this page of the proposed revision of Specific Phobia:
Specific Phobia
A. Marked fear or anxiety about a specific object or situation (e.g.,
flying, heights, animals, receiving an injection, seeing blood).
B. The phobic object or situation almost invariably provokes immediate
fear or anxiety. Note: In children, the fear or anxiety may be
expressed by crying, tantrums, freezing, or clinging.
C. The phobic object or situation is actively avoided or endured with
intense fear.
D. The fear or anxiety is out of proportion to the actual
danger posed by the specific object or situation. NOTE: Out of
proportion refers to the sociocultural context; see text.
E. The duration is at least xxx months *
F. The fear, anxiety or avoidance cause clinically significant distress
or impairment in social, occupational, or other important areas of
functioning
G: The fear, anxiety and avoidance associated with the
specific object or situation are not restricted to the symptoms of
another mental disorder, such as Obsessive-Compulsive Disorder (e.g.,
fear of dirt in someone with an obsession about contamination),
Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated
with a traumatic event), Separation Anxiety Disorder (e.g., avoidance
of school), Social Phobia (e.g., avoidance of social situations because
of fear of embarrassment), Panic Disorder, or Agoraphobia.
Specify Type:
Animal type (e.g., spiders, insects, dogs)
Natural environment type (e.g., heights, storms, water)
Blood-injection-injury type (e.g. needles, invasive
medical procedures)
Situational type (e.g., flying, driving, bridges, tunnels,
enclosed places)
Other type (e.g., situations that may lead to choking or
vomiting; in children, loud sounds or costumed characters).
It would be nice if sexual phobias were mentioned as a Specify Type
or even in Other Type. However, the above are just examples, and I
understand this section to not limit what one can develop a phobia of.
One may consider love-shyness at least partially a Situational Type
since phobic symptoms present during romantic situations. A love-shy
man may interact unproblematically with a woman he perceives as married
or unavailable. But, if he were attracted to this same woman and
thought she were available to date, his love-shy symptoms would flare
up.
Consider the latter interaction as an example of a phobia of
romance rather than a phobia of sex. I still estimate that at least
half of love-shys have a significant enough phobia of sex to prevent
them from performing adequately sexually and would benefit from
utilizing sex surrogate therapy. Likewise, the romantic and
non-explicitly sexual part of the love-shy phobia must still be
overcome by Exposure Therapy employing an attractive member of the
opposite sex, either before sex surrogate therapy or in place of it.
Specifically mentioning sexual phobias in the DSM-5
would help love-shys seeking treatment as therapists do not generally
believe in these sexual and romantic phobias. Virtually no therapist
seems able to deal with the problem of chronically single men and women
suffering from these phobias. Even sex therapists almost exclusively
deal with couples, leaving the single involuntary celibate sufferer
with no formal treatment options, forcing him to rely on prostitutes,
strippers and so-called experts known as Pick Up Artists. Obviously,
such options are fraught with dangers and provided limited
treatment.
Since Dr. Gilmartin estimates 40 percent of love-shy men also have Asperger's Syndrome (in his letter allowing his Shyness & Love book (1987) for free download), the DSM-5 changes to Aspergers are also noteworthy. The draft calls for Asperger's, first introduced in DSM-4
in 1994, to be subsumed into Autistic Disorder (Autism Spectrum
Disorder). As someone diagnosed with Asperger's, I am a bit conflicted
but welcome the change.
On one hand the Asperger's diagnosis is
good for separating those with severe autism from those with very mild
autism. For example, as an adult before my Asperger's diagnosis, I
never made the connection between myself and the institutionalized
autistic character in the movie Rain Man. Also my parents have a hard time accepting my diagnosis as they can't see me as autistic since I am generally able to function acceptably.
On the other hand, Asperger's is
an Autism Spectrum Disorder. I see Asperger's as just part of the
autism spectrum. Now that I am well versed in the autism spectrum and
have met many people with varying degrees of autism and Asperger's, I
see the only real difference between my relatively mild Asperger's and
a case of autism where the person is unable to talk as merely a matter
of severity. Thus, I applaud the APA for its proposed elimination of
the formal Asperger's diagnosis as good science and good for the rights
of those with Asperger's. Hopefully, it can be the best of both worlds
with the Asperger's term still used informally. I suggest that with too
much of the population still doubting the existence of Asperger's, both
in general and in specific cases, that merging the diagnoses will help
disarm the unbelieving skeptics.
Although love-shyness mainly
affects heterosexual males, there is no reason why homosexuals, and
females, cannot develop love-shyness. Just as the DSM-3 in the 1970s finally stopped considering homosexuality a disorder (due to much protesting by gay rights activists), the DSM-5 plans to rename Gender Identity Disorder as Gender Incongruence.
This is a good sign of accepting atypical sexualities as inborn rather
than a choice. Of course, Gender Incongruence is slightly different
than homosexuality in that a sex change operation can “cure” the
problem, whereas no cure for homosexuality exists.
While
love-shyness and incel are psychological conditions open to treatment,
Male Lesbianism as basically described by Gilmartin (1987) I consider
an inborn trait. Despite various layperson usages of the term, Male
Lesbianism is when a male has certain female inclinations, notably
passivity during courtship. How much Male Lesbians are able to overcome
their condition to act romantically assertive remains to be proven, but
I am optimistic since I notice many younger women acting more
romantically assertive than historically typical for their gender.
In conclusion the APA seems to be making wise improvements in the DSM-5,
even if some people see them as baby steps regarding conditions related
to love-shyness. Love-shyness may never be explicitly mentioned in the DSM,
but perhaps as long as it shows therapists that phobias of sex and
romance exist in a sizable portion of the population, that may be good
enough for commonly available love-shy treatments to develop.
