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Cake day: August 2nd, 2023

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  • I’ll add a few.

    American Movie (1999) - An amateur filmmaker has spent years trying to finish his magnum opus. It’s a hilarious and endearing portrait of a distracted visionary. The most Milwaukee movie you’ll ever see.

    Gates of Heaven (1978) - Errol Morris’s first feature about a small town’s relationship with a pet cemetery. It’s under 90 minutes and full of characters.

    Into the Abyss (2011) - Werner Herzog explores a triple homicide in Texas and its two perpetrators - one sentenced to life, the other sentenced to death. Conversations with everyone involved in the execution process - the killers, the victim’s families, investigators, the chaplain, and the executioner.

    The Inventor: Out For Blood in Silicon Valley (2019) - Alex Gibney’s story about Theranos, who scammed investors out of billions of dollars for a medical device that didn’t exist.

    Roxy: The Movie (2015) - A 1973 concert by Frank Zappa and the Mothers of Invention. I know almost nothing about Zappa and his music, but it’s a marvel to watch everyone’s musicianship.

    The Summit (2012) - 11 climbers on K2 die within about 24 hours. A mix of interviews with survivors and very well-produced dramatizations.

    Tim’s Vermeer (2013) - A software engineer tries to recreate the famously mysterious painting techniques of Johannes Vermeer. A movie about technology, tinkering, and obsession.














  • Sorry, you said insurance and I missed it somehow. I agree that laymen and insurance companies treat it as a bible, but I also think that’s how the APA presents it. If the goal is to compile “symptoms that tend to present together” the DSM does a poor job of making that clear.

    I have several problems with the DSM. This isn’t an exhaustive list but off the top of my head:

    -It’s based on the idea that there’s a clear line between “normal” and “disordered” mental functioning, and that we can quantify all of a person’s experiences to land on either side of that line. There are a handful of diagnoses that are discrete enough for me to say “you either have it or you don’t” but the majority of them are so arbitrary that they’re not useful. Mood disorders are especially vague.

    -Inter-rater reliability is notoriously poor. I can diagnose anyone with a disorder to argue medical necessity for therapy.

    -It includes conditions that cannot and should not be diagnosed by mental health professionals, like narcolepsy. It’s good for providers to know what narcolepsy is, but unless they’re going to include every other medical condition, I don’t know why they include the ones they do.

    -DSM-5 broadened the criteria for several disorders, possibly to increase access to insurance coverage, but it’s edging ever closer to categorizing every human experience as a disorder. According to DSM-5, if you’re having depressive symptoms for more than 2 weeks after a loved one dies, it’s no longer grief and it’s considered a major depressive episode. When people criticized that bereavement clause, DSM-5-TR included “prolonged grief disorder” which extends the time you can grieve the loss without a MDD diagnosis. But grief is absolutely a normal response to loss, and sometimes it can be really disruptive and long-lasting. Why are we pretending that’s disordered?

    -The majority of every DSM task force has been older white men, and we should be very skeptical of what they consider normal or not.