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benny  1yr ago (academic.oup.com)   Edited 1yr ago   2898 thread views

Stop that! It’s not Tourette’s but a new type of mass sociogenic illness

academic.oup.com

In Germany, the current outbreak of mass social media-induced illness is initiated by a ‘virtual’ index case, who is the second most successful YouTube creator in Germany and enjoys enormous popularity among young people. Affected teenagers present with similar or identical functional ‘Tourette-like’ behaviours, which can be clearly differentiated from tics in Tourette syndrome.

Another choice quote

patients often reported to be unable to perform unpleasant tasks because of their symptoms resulting in release from obligations at school and home, while symptoms temporarily completely disappear while conducting favourite activities.

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Rather than these teens being denied a Tourette's diagnosis, it seems more likely to me that the practical definition of Tourette's (or "Tourette's like [blah blah blah]", whatever makes them feel satisfied that they've been "heard" and can brag to their online friends about an official diagnosis) will just expand to include people like them. Anything else would run the severe risk of being attacked by a mob of the usual advocates of "disability rights", "social justice", etc.

Conversely, with the general understanding evolving to be that most tics are semi-conscious/chosen, we can expect those with genuinely involuntarily but controversial tics such as those involving repeating racial slurs, etc. to become more stigmatized (in the name of rights for the "disabled", that is other people half-pantomiming their actual illness), similarly to how the "Mental illness isn't an excuse for racism!" canard evolved (after you had thousands of people (primarily self-diagnosed) allegedly possessing X mental illness around to say "Well I also have [X] and it's never caused me to say [non-PC thing]!").

On the other hand, I think the line between performance and authenticity has always been a lot blurrier than many would like to believe. Perhaps the pseudonymous and polyonymous nature of the Internet has just made this a more practically implementable tendency, increasing its behavioral potency. As with most fads, this particular manifestation of it will probably wax and wane though, same as all fashion (and isn't all fashion inherently performance desperately grasping for authenticity?). (I for one am waiting for wheelchairs, colostomy bags, etc. to become in many cases voluntary fashion accessories.)

risk of being attacked by a mob of the usual advocates of "disability rights", "social justice", etc.

Getting an effective mob going doesn't seem easy, though. There are far more fat people than transgender people, but "fat acceptance" hasn't made many inroads while "trans rights" have expanded at a dizzying pace. A major reason for that seems to be aggressive lobbying by experienced, well-funded LGBT groups. It seems unlikely that similarly effective groups will emerge to support annoying teenagers with fake tics, DID larpers, etc.

There are far more fat people than transgender people, but "fat acceptance" hasn't made many inroads

I think this is because there are so many fat people that their acceptance (in the sense of acceptance of the fact of their existence, basic tolerance in the classical sense, not raucous approval) is essentially automatic nowadays. You don't need advocacy groups when you're 60%+ of the population. If you refuse to accommodate fat people, you simply lose access to huge portions of the population. Discrimination against them is untenable.

You also can't have much of an advocacy group when even most people that are a part of the group admit that they're inferior. So I think it's more that fat people don't want to be an advocacy mob on their own behalf because they hate themselves and that they don't really need to be since they get enough basic allowance for their existence anyway more than that they couldn't if they tried. Conversely, genuine minorities have much more of an incentive to push in these areas because they don't necessarily have safety in numbers (quantity or size).

fake tics, DID larpers

I forgot about the DID larpers. Can't wait until these kids figure out the idea of claiming that only some of their "alters" have Tourette's. That way they can stop the tics whenever they want.

So I think it's more that fat people don't want to be an advocacy mob on their own behalf because they hate themselves

I wonder what it is that gives fat people self-loathing but not trans people.

It's certainly easier to stop being trans than stop being fat ("just don't put on the skirt" Vs "run 20km a day every day for the rest of your life"), so fat people have a much higher "exit barrier", and from that angle I would think the fat people would have more to gain from advocacy.

Being an aspiring transsexual is both much more of a choice (for the most part you can't become more transsexualized than you'd like just by engaging in the wrong personal habits) and far more celebrated than being fat (though even they do get some play with the whole "love your body" stuff, promoting Lizzo, etc.). It's also probably still healthier other than in the realm of suicide risk.

Ultimately I don't think most advocacy solely comes from pragmatism. I think you really do have to believe that your identity is valid and worth advocating on behalf of to some degree. Most aspiring transsexuals are waiting for technology to potentially actually let them change their sex to a large degree. They want to become more transsexual in the future. Most fat people conversely are waiting for technology to make them skinny. (If the perfect diet pill came along tomorrow, I have no doubt that most of the members of the fat activism movement would magically slim down rather quickly.)

I for one am waiting for wheelchairs, colostomy bags, etc. to become in many cases voluntary fashion accessories

The munchies are way ahead of you, though their preferred accessories are nasogastric tubes, hickman lines and IVs (and wheelchairs).

Are you willing to make a concrete testable prediction of this, like say putting a probability on a particular modification to the definition in a given future DSM revision?

Okay, I'll try:

90% certainty: For as long as this trend continues, the number of official diagnoses of anything Tourette's-related that officially deem the involved symptoms to be caused by a sociogenic component, social contagion, social media etc. will not rise above 50% even solely amongst cases that don't fit traditional diagnostic criteria. They may get a diagnosis of "Tourette's-like functional movement disorder" or whatever instead of the real deal from more cautious docs but they won't get "You're larping this because of social media." The vast majority of providers won't touch that because why give your customer what they explicitly don't want?

To be clear I think it's likely that the actual hard definition of Tourette's will remain mostly unchanged (and articles like the OP's will continue to bemoan the conflation of fully involuntary tics with their more voluntary counterparts), but the actual practical definition in the field will become much more porous based on consumer demand. Diagnostic criteria, like all words on paper, only matter if they're followed. So I wouldn't expect to see the words on the paper describing Tourette's change necessarily, but I would expect to see it become more and more normalized for people who don't exactly fit those words to nevertheless be deemed as defined by them regardless (maybe that's not changing the definition per se, depends on your point of view about ontology).

Do doctors in Germany have "customers"?

I'm assuming they're subjected to patient evaluation to some degree. Surely people in Germany can at least indicate their wish to no longer see a particular doctor, public healthcare or not.

What part of his comment implies there will be some sort of DSM revision? What are you even disagreeing with?

Perhaps the pseudonymous and polyonymous nature of the Internet has just made this a more practically implementable tendency, increasing its behavioral potency.

I think this is key. Absent any physical reality, the need for others to validate one’s identity/perceived reality online is significantly heightened, and makes social contagion more prevalent.

That's a terrifying thought, and explains so much of what happened to the brains of people I used to know a few years ago.

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