I would also suggest that if the subjective anxiety were preventing me from accomplishing my wants that it would be at the level of a pathology. For example, I have no desire to go up on scaffolding, but if I were an agoraphobe who was missing my child's wedding because I could not bring myself to go into public, I believe that condition would be interfering with my wants. Clearly, I do believe that there are some conditions where subjective distress is indicative of a disorder. However, I also fervently believe that both psychologists and psychiatrists are likely to over diagnose people, turning normal variation into illness. Normal and average are not the same thing, and they should not be treated as such by mental health professionals. I believe that simple phobias are probably the best candidate for being excluded from the DSM. Specific phobias rarely meaningfully impact quality of life. For example, I have a friend who has a rodent phobia. She does not find rodents simply distasteful; she is irrationally scared of them. If she sees a rodent, she runs and screams, she has been known to lose bladder control when around rodents, and she avoids scenarios where seeing a rodent is likely. For example, she rides horses, and when she saw rodent horses at her stable she purchased traps and rodent-proof feed containers, and avoided the feed room until other people could reassure her that the rodents had been trapped and killed and that no new droppings had appeared for some time. There is no doubt that her fear of rodents impacts her daily activities in some way. However, her fear of rodents does not prevent her from engaging in activities she enjoys. Furthermore, her fear of rodents, like most phobias, is an extreme version of a rational fear; humans naturally fear rodents because they carry disease and are associated with illness. While I do not feel that a single specific phobia should be enough to qualify for a pathology, I do think it is important to note that I would change diagnostic criteria for generalized anxiety to disorder to include...
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