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Armchair Pathology: The pathologizing (diagnosing, whether by a formal diagnosis or simply a suggestion) of an individual without thorough, knowledge-based, individualized care by a provider or advocate.
In other words, when a provider or advocate labels a victim with certain pathology without spending time actually treating or working with that individual.
Why is “Armchair Pathology” a Dangerous Practice?
The symptoms of trauma often mimic mental illnesses, disorders, and pseudo-psychological conditions (like “codependency”). Meaning that when providers do not factor in trauma and abuse to a client’s profile, any diagnosis or suggestion can be completely inaccurate.
Have YOU Experienced the Dangers of “Armchair Pathology”?
Some victims have experienced the dangers of armchair pathology without even realizing it – because this practice has become so normalized. You can ask yourself these questions:
- Have I been “diagnosed” with a mental illness, disorder, or something else without ever having visited a provider?
- Have I been prescribed medication without having been given a diagnosis?
- Was I given a serious diagnosis after only one visit, or after a telehealth appointment?
- Was I given a serious diagnosis after my husband spoke with the provider?
BTR.ORG Is Here For You
Too many women are subjected to severe abuse by so-called experts who push medication and wrongful diagnoses on them, without factoring in the effects of trauma and abuse. If you worry that you may be experiencing the dangers of armchair pathology, please seek support right away.
Attend a BTR.ORG Group Session today to process your experiences.
Welcome to BTR.ORG. This is Anne. We have a member of our community. We’re going to call her Paige on today’s episode. Welcome, Paige.
Hi, thanks for having me.
What is “Armchair Pathologizing”?
Paige came on today’s episode to address a variety of topics and we’re going to start with armchair pathologizing of victims. So Paige, what is armchair pathologizing?
It is when people are labeled with a disorder or a diagnosis without actually having had interactions or contact with a provider or advocate.
Can you give some examples of that?
Examples of “Armchair Pathology”
One great example is we see it a lot with celebrities where you have experts in psychological fields say, oh, well this person obviously has narcissistic personality disorder, or this person’s presenting with borderline personality disorder when these professionals don’t have a relationship with these individuals, so they’re just observing things from the outside and not actually treating them in any capacity, which makes their statements unethical. We see it a lot in the betrayal trauma community where, oh, well, you’re just not healed enough or You’re just triggered because you’re not healed. Especially when women are countering the narrative that they are codependent or trauma bonded or any of these victim blaming labels and they’re like, no, that’s not the case. I’m actively being abused and this is why what you’re saying is harmful and perpetuating that abuse and that abuse mindset, and then they’re just dismissed as not being healed that they just don’t understand because they’re not healed, they’re triggered.
Does anger = a lack of healing? (Spoiler – no!)
So many people say that if you’re angry, it’s because you’re not healed. It’s not that you’re actively being abused. It’s that the abuse happened long ago and you’re still making a big deal out of it and you shouldn’t be.
Exactly. It’s really amusing to me because a lot of the women that I interact with, the betrayal community that have gotten to that place where they’re like, yeah, this is really harmful language. This is a systemic problem that needs to be addressed. They are some of the most healed individuals I’ve met because they’re really putting in that inner work and they’re not doing a lot of the bypassing that we’re kind of given as therapeutic or healing modules out there.
I think it’s interesting too, if the more healed she gets, the more likely she is to set boundaries, for example, or to know what she wants or to be more confident.
“She’s actually more healed than she was before”
If she’s like, I’m upset about this, this is frustrating and I don’t want to talk to you about it, so will you please leave my presence, people might be like, whoa, what’s wrong with her? She must be really traumatized. She can’t even handle a conversation; instead of realizing, no, she just doesn’t want to deal with this anymore. She’s done and she’s actually more healed than she was before that. She’s able to see what’s going on separate herself from it ore quickly, there’s that form of healing that people might think, oh, she’s not healed when she really is very, very healed. There’s also when she’s being actively abused so she can’t be healed, and they’re saying, you’re not healed enough when that’s probably actually true except for they’re not enabling her to be healed because there’s still ongoing abuse.
When you’re still experiencing that ongoing abuse, you are going to have parts of you that are just being re-traumatized, but that doesn’t necessarily mean that an advocate or provider telling you that you’re not healed isn’t dismissive of reality.
“I can be happy and also acknowledge that there’s harm going on at the same time.”
Totally. Or that it’s useful. If anyone’s going to tell you that you’re not healed, it should be you, right? You should be the one that gets to decide how that goes. I remember someone telling me, I’m sorry you’re not happy. It’s like the classic misogynistic. You need to smile more, and I thought, well, I am happy. That doesn’t have anything to do with this other issue. I can be happy and also be acknowledging that there’s harm going on at the same time,
And that’s why our language is really important and why the pathologizing is so harmful. It’s like when we’re talking about experiencing something, instead of using the word, but use the word end like, I’m happy and I’m still traumatized by this instance that occurred rather than, but a lot of it roots back to our language and how powerful our language is, especially when working with and experiencing this level of trauma and abuse.
“Historically, the models that we have in psychology are steeped in misogyny and the abuse of women.”
With this in mind, how can advocates better help victims of betrayal trauma victims of emotional and psychological abuse?
I mean, I think the biggest part comes with acknowledging that historically, the models that we have in psychology are steeped in misogyny and the abuse of women. So much of psychology is built on a foundation of pathologizing women as being unstable, hysterical, and we need to move away from that, which is why the language that we use is important. Somebody may say, well, I identify with being trauma bonded. That felt empowering to me to realize that I was trauma bonded, where as they move through the process, they find, oh, yeah, that totally is really blaming of victims in its core and essence. It’s like with BTR, naming the abuse for what it is and naming the abuse as a choice is very empowering because we don’t have to revert to pathologizing, which historically for men being pathologized excuses, abusive behavior, and we can just own that this is a choice. I think moving away from those models and unlearning a lot of what is taught, I know with my own provider teaches at the collegiate level and even she was unlearning a lot of harmful and victim blaming models, being teachable and listening to victims and listening to those people who are living these experiences.
Well and just believing them. How hard is that? How hard is it when someone says, actually, I’m doing quite well? Thank you for someone to say, no, you’re not. This is a little a presumptive. I agree that it’s all steeped in misogyny of oppression of women and also that women are property, so they’re like an extension of her husband rather than an individual. I love the book The Woman They Could Not Silence by Kate Moore, and one of the interesting things about that is they put her in an insane asylum because they couldn’t figure out why she didn’t love her husband like you should, and she had so much hatred of him because he was abusing her and because he put her in an insane asylum and they were like, well, she has to stay here because she should love him and be grateful for him. It’s really just a vicious cycle when it comes to armchair pathologizing. If it is so unethical as a whole, why do so many providers and advocates do it without even realizing it?
Why do therapists engage in “Armchair Pathology”?
I think it’s that ego default that I know more than you. I’ve taken more classes, I’ve gotten more certificates. I have more letters after my name. That was a big part of when I went into midwifery that I did the avenue that I did, which is direct entry, the traditional apprenticeship preceptor model because when you add so many letters to the end of your name, you sometimes, I’m not going to say always, I’m going to say sometimes sacrifice pieces of yourself for those letters, and so your ego is sensitive to those challenges. Well, I’ve done all this research and I’ve done all this reading, and you are obviously this unhealed victim, so you don’t know as much as I know, that’s a big part that I’ve witnessed. People have a hard time hearing others’ truths. I can acknowledge that people are going to have different experiences of my spouse, but to minimize the betrayal that I’ve experienced because he’s a nice guy –
As she puts that in quotes, right?
Yes, yes, exactly. Air quotes for that is the ego at play. I don’t want to believe that I’ve been tricked. I don’t want to believe that I’ve been bamboozled and we don’t want to believe that we’ve paid thousands of dollars towards an education system that is flawed, that is inherently based off of the abuse and exploitation of women.
“When professionals have been through it themselves, I think they’re more understanding.”
I’m thinking of one other issue is that if they have not been through it themselves, them thinking, well, this wouldn’t happen to me so I’m somehow smarter, so I have the answers, not realizing that the only reason it did not happen to them was literally a crapshoot luck, Pure luck. It had nothing to do with them. They don’t know that. They don’t know that for the victims. It has nothing to do with the victims either. I do think it’s some sort of self-protection mechanism like, well, I know more and I’m able to see this and I’m able to show her how to get out of it, so that would never happen to me not realizing that no, this very well could happen to you and it actually could be happening to you right now and you don’t even know it. When professionals have been through it themselves, I think they’re more understanding that it can happen to anybody because it happened to them.
Well, and when you put gender into play, there are professionals who may have witnessed abuse and trauma in their own childhoods, but them being male in society has given them a different societal experience of that abuse than what their sister or mother or grandmother or whomever experienced, and their witnessing of it is not the same as somebody actively experiencing it.
How does gender play a role into this dynamic?
Then they might be being abused. By default, all children of women who are being abused are also abused, but the type of abuse they’re experiencing and the way they’re experiencing it is vastly different than what the wife is experiencing.
Well, it’s like when we talk about privilege with male offspring, they are going to experience that abuse. Depending upon how extreme the abuser is, they’re going to experience that vastly different than what a female sibling would.
How are we reacting as we collectively learn more about abuse?
Yeah, it’s hard. It’s hard out there. The more women are becoming aware of this type of abuse and the systemic oppressive nature of the exploitation of women and the oppression of women, the more upset we’re getting about it for good reason, and then the more the abusers think that women are overreacting and thank goodness the healthy men are like, yeah, this makes sense, so even if they can’t really understand it on a visceral level, at least they’re allies in it and that is helpful, but the more women are speaking out about it, the more abusive men are also trying to continue that tradition of oppression of women rather than listening and learning. They’re like, no, no, no. That’s not what’s happening. I’m not abusive. YOu are because you won’t give me sex or you are because you won’t do the dishes or you are because you’re asking me questions.
Well, and then they just want to gaslight the situation by being like, well, now you’re just an angry feminist, or whatever thing that they’ve deemed derogatory or less than, so it can just completely excuse their behavior because you’ve fallen into this less than category to them.
“Of course I’m an angry feminist – all people who realize the systemic oppression of women should be angry and they should be feminists.”
When someone says that to me, I’m like, absolutely I am. Of course I’m an angry feminist. What else would I be? I always agree if anyone accuses accuses me, I’m going to put that in quotes of that. I’m like, yes, absolutely. You’re not. Why would you not be? That’s confusing because of course, I’m an angry feminist. All people who realize the systemic oppression of women should be angry and they should be feminists. To me, it’s not an insult. I’m like, yes, you’ve hit the nail on the head. Thank you. The reason they say that is to manipulate you to act differently. Right. Well, you’re just an angry feminist hoping that you’ll be like, oh, I am. I’m sorry. I won’t be so upset. I’ll do something different. So when we agree and say, oh, yeah, thanks for pointing that out, I’m so proud to be that. Yeah, that’s great. You get this confused on their face like, wait, wait. No, no, no. That was supposed to be an insult. Okay. Did you have anything else you wanted to talk about? When it comes to the armchair pathologizing, maybe not even pathologizing, right? Even in a professional’s actual office where they are your therapist, they might pathologize you.
“I was being emotionally abused – and was misdiagnosed with this pathology”
My personal experience from 20 years ago, not even experiencing the betrayal trauma that I have, I went to see a provider and was diagnosed with bipolar disorder and medicated with multiple medications, was dating somebody that I had been friends with since middle school. We dated after high school, and the reality of it was I was being emotionally abused by this person and was misdiagnosed with this pathology because I checked whatever boxes and we have a mass medicalization of women because we don’t have the proper avenues in place to address trauma and abuse or even name it for what it’s, that’s a big part of it. Now, I definitely experienced a lot of abuse in my home growing up, like my family of origin and even that is medicalized away. I stopped all medication in separating from that my first husband. I have not taken any psychiatric medication since, and any provider that I’ve interacted with since then is that’s a really weird thing to diagnose you with.
“Women’s pathology is used to medicate and further abuse them – men’s pathology is used to enable and excuse abusive behaviors”
You definitely don’t fit the category for bipolar disorder, but the family history of people being diagnosed with that and the lack of naming abuse that’s occurring happens so often to women. You have a woman who is sexually assaulted and then she’s diagnosed with borderline personality disorder. Well, you’ve had this all along. It’s just being highlighted now that you experienced this traumatic instance when really you’re just having an organic response to trauma. Your body is responding organically and physiologically how it’s designed to when it comes to trauma and abuse, and the biggest issue with the pathologizing that we see is that oftentimes women’s pathology is used to medicate and further abuse them, and men’s pathology is used to enable and excuse abusive behaviors, and so we have this societal issue that all goes back to the language that we use where calling your ex a narcissist or a psycho might feel nice, but let’s be mindful of the language that we’re using because we’re excusing harmful behavior and choice.
A psychopathic narcissist or someone with a deeply flawed character?
Yeah, yeah. We’ve all done that for good reason because they are acting like a psycho, but you’re right, it is, especially to other people, it works against you when they don’t understand, so those are types of words that are best used in a safe place where people understand that what you’re describing is what you experienced and that you’re not necessarily diagnosing them as a literal psychopath even though they might be acting like that, you are just expressing how you feel. I do think it’s helpful for victims though to think of them in those terms sometimes, and the reason I say that is because then it does sort of remove the option of thinking that if you just educate them, they’ll be able to make different choices. If you say, Hey, this is a choice that they’re making, which is true, rather than thinking like, oh, their character is deeply flawed and this is not an appropriate person that I should be interacting with, they think, oh, well, if it’s a choice, then I should be able to get my whiteboard out and explain to them why lying is bad and why it’s hurtful, and that gets them caught as well and does not help them get to safety. So I think it’s a little bit of a catch 22.
“In our society it’s more palatable to say ‘My ex is a narcissist’ rather than to say that he’s abusive.”
I think you could have that with either end of the spectrum, so our society is, it’s more palatable to say, my ex is a narcissist, or my ex is a psycho, rather than to say he’s abusive and it’s more palatable, especially when you’re in a relationship with somebody still to say that they have whatever personality disorder rather than say they’re abusive because if you say your partner’s abusive people are like, well, what the heck are you doing? What are you doing? Why are you there? Where if they have a disorder, it’s more societally acceptable than just naming the abuse either end of the spectrum. I think we want to educate, and even with narcissistic personality disorder, there are people out there that are using social media platforms with their diagnosis to try and educate people, and it gives this kind of false sense of hope to be like, see, look, he could move in this direction. He could own this behavior.
“You need to get to safety, whether he can change or not.”
There’s also this misogynistic thing going on that it’s easier for women if they have some kind of black and white situation where he is 100% unable to change, so now I can get to safety or he’s 100% is not willing to change, so now I can get to safety rather than realizing that you need to get to safety, whether he can change or not. If he’s not safe right now, you don’t need to worry about whether or not he can change. You don’t need to worry about if a program can change him. You don’t need to worry about any of that, which is really, really hard. All you need to do is say, is he a healthy, safe person right now today, and then today I need to get to safety. I’ve used this example before and I don’t know if it’s working, so if you hear this podcast and you’ve heard the example before and it was a terrible example, please go to our website and I’d love to hear your comments.
The Ebola Analogy
It’s like saying, this person has Ebola and I know that they can be cured, so I’m going to continue sleeping in the same bed with them. That would be crazy if the person is currently unsafe, your proximity to them is not a good idea. Just like if they had some kind of really dangerous disease, you would not be wanting to be in proximity to them until they were better. Once they’re better, sure, be in proximity to them, but thinking that someone can be cured from Ebola and so you can hang out with them and go to dinner with them and stuff when they’re still actively showing symptoms is just not a very wise thing to do.
I’ve not heard that analogy before, but I can see the application of it regardless of whether they can be cured or not. You’re actively being abused. You’re actively exposed to this virus, so you are still experiencing the negative effects of it.
And you’re in danger really of being harmed.
You’re in danger.
Ask Yourself: are they currently exhibiting unhealthy abusive behaviors?
So I think that’s what people need to really think about is are they currently exhibiting unhealthy abusive behaviors? That’s your indicator, not whether or not they could stop them in the future, and then also being able to recognize the difference between actual real healthy behaviors and grooming, which is also hard.
Oh, yeah, so one of the things on that same subject that is harmful with the armchair or pathologizing is the providers who tell women that they aren’t healed are the same people that are profiting from their desperate desires to be whole. It would go into the unethical side of it is are you consciously telling people that they’re not healed because you have these answers or because you’re profiting from the models that you have in place, and that’s where that discernment in the midst of trauma is kind of hard. We have a lot of women within one of the groups that I help with that are like, Hey, what about this program? Or, Hey, what about that program? And you have hundreds of almost thousands of women with their experiences as to why, okay, well, this is really codependency heavy or this is this, or I found this helpful, but you might want to be aware of these aspects of it, and we just have this primal want to heal and be healed, and when we are reaching out to those people who are saying, here’s how I can help you, and then they’re dismissive or pathologizing you, it makes it really confusing in this process to try and find what’s right for me on this journey,
Does the codependency model “work”?
Especially if it’s another woman who has been through it. For example, there are women out there who have been through it who absolutely feel like the codependency model helped them. Who am I to disagree with their experience? I can only disagree with the model in and of itself.
And the thing is when you disagree with the model itself, that’s where that ego comes into play, where people are like, no, you’re telling me that I didn’t experience what I did, and it’s like I am literally just saying that this model itself is harmful and here are the reasons why it’s harmful and why it continues to blame victims for being active in their own abuse when that’s not the case.
“We’re strong, we’re brave, we can get to safety.”
For me, there were times where I was doing pornography addiction recovery. I was working on my side of the street because I really thought at that time that that was going to work because that’s what people told me and I had faith in that and I practiced the principles that they taught and found myself being abused repeatedly and not really understanding abuse and not getting any abuse education from doing that. Now, looking back, I actually really appreciate the 12 steps for my own growth, but for an abuse victim, I look back and just think I was so much more traumatized than I needed to be at the time. I also was really, really humbled through being traumatized. I learned a lot. I’m not necessarily mad about that experience because there wasn’t anything else at the time that I knew about, so I was doing the best that I could, and I think the people trying to help me in 12 step were doing the best that they could too, so I don’t think they had negative intentions, but now thinking back, I’m like, wow, they really said some things that were super, super harmful, and to have a bunch of victims sitting in a room in a circle not knowing that they’re victims of abuse, trying to look at their own character defects rather than realizing, wait, wait, wait. We’re victims of abuse. We’re strong, we’re brave. We can get to safety. Just thinking back on that is taking my breath away right now.