A Double Dose of "Different": Disorders and Diaper Loving

Very interesting. Mental illness....ASD, Bi-polar, ADHD and depression run in my family. Except for mild (I think) depression, I am untouched by this. Nonetheless, I struggled with OAB and incontinence as a young child and became a diaper lover very early in life when I saw diapers and plastic pants as security against accidents.
 
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Bi Polar I. I personally believe there is a correlation. It's possible that we are more susceptible to tactile sensations we develop in infancy. These sensations could be stronger than in "normal" individuals. We may possibly become more imprinted to these sensations due to this. As we age and are confronted with the challenges of life, our personalities retreat to those tactile foundations we established early on.

It would be interesting to see a study where the question was asked: "Do you have an attraction to your infancy or childhood years?" when psychological testing is done.
 
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What is mild autism like i think i may have like i mean what are the inside the mind symptoms i know awtism has a lot of complexity two it like hunders of differnt typs like for me i was always quite nice shy polite and all but a couple friends were my age thier mean to others including their friends i was never picked on how ever i would let the persons get bullied un till it was to much. Is this a form of autism? and i have add as well thank you for this report it was veary helpfull as far as my add goes and other things you explaind as well could you please get back in touch with me so i can have an idea.

- - - Updated - - -

Not many friends my age most were older i seen what otyped had to correct it
 
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Nice i have aspergers too and OAB i need to buy more diapers so i dont have to run to the bathroom ever 30 min to 1hr i tend to have occasional accidents if were busy at work i really need to buy more
 
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High functioning autism and aspergers here. Was potty trained rather late as i was forced back into diapers as a punishment for awhile which obviously fueled the desire to acquire and wear them more as i grew
 
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Yep. Asperger's here. Potty trained at 4. Have liked diapers as far back as I can remember.
 
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Being as you asked! Giggles.

D.I.D. over here! We've been going to our same therapist for over 19 years now. This is the therapist that first Dx my issues. Mine is a long, short story. Any of you, who have HAD to experience therapy knows you get one highly paid hour per week! I am allowed as many sessions per week as I feel I need! I haven't had to pay for services in over 12 years because of the rarity of my form of D.I.D.!! I can have as many hours per session as needed and I can also have phone sessions!! I have my therapist's personal phone number and have 24/7 access to my therapist!! There are 42 KNOWN alters and another possible over 20 others not yet confirmed!! Several alters are "little", but our favorite one, and who is most often "brought out" is a 4 year old named Billy. He is a sweet, loving, touchy feely little boy who loves colors, his toys, playing with almost anyone, hugs and snuggles are ALWAYS more than welcome!! And, who woulda thunk it, but he isn't potty trained!! Giggles. So, my wife/mommy loves the many who we are and her favorite alter, as well as many others including my therapist, IS little Billy. He's really no trouble because he is such a little lovey!!

So, that's us over here!! We really like this place and the many brothers, sisters, mommies and daddies, as well as all the caregivers and the many others who come visit this wonderful home that was built with love for us all to feel comfortable in!!

Thank you SO very much to all who keep things going here, making it a happy place to be!!

We (Mommy and me) send our love to all. 🍼👶💕😊🚜🚒🚂🚛😈😇😱
 
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The article concludes that a person with neurological impairments "might be led to the ABDL lifestyle".

I would go further. There is some clinical evidence that tentatively supports the view that there is a neurological basis for being ABDL. This is based on published studies using Magnetic Reasonance Imaging (MRI) brain scans. Let me explain.

Many ABs acknowledge having a ‘Little’ – a baby or child self. I do. At a minimum our Little needs diapers/nappies on a regular basis to feel soothed and settled. Our Little often wants and needs a lot more – stuffed toys, pacifiers, baby clothes, bottles etc. With these accoutrements they inhabit ‘Little-space’ and feel nurtured and safe. We can feel the spontaneous and instinctive delight of our Little when we see favourite AB clothes or pets or whatever has a specific meaning for them. If we ignore our Little and their needs they can make their presence felt whether our adult selves like it or not. Trying to repress them can make us miserable and uptight. It can provoke an involuntary craving for diapers or a binge and purge cycle. Over time many DLs ‘graduate’ to acknowledging some AB aspects – even if it’s only printed disposable diapers. Often it grows to a lot more.

All this represents a form of ‘identity alteration’. That is one of the five components of dissociation, identified by Dr Marlene Steinberg, a leading authority on the diagnosis of dissociative disorders (see her book ‘The Stranger in the Mirror: Dissociation The Hidden Epidemic’ - readily and inexpensively available from Amazon). For many ABs our Little also meets the first 2 of the 4 criteria for diagnosing Dissociative Identity Disorder (DID) (as per the DSM-V, the latest version of the Diagnostic and Statistical Manual of Mental Disorders - the standard diagnostic tool published by the American Psychiatric Association.) A Little can be a subjectively real alternative personality – an ‘alter’. You don’t have to have DID to have alters.

Having a Little places ABs on the dissociation spectrum. Being ABDL is not DID because there is no present day amnesia, one of the other key criteria for DID. It represents a sub-DID position on the spectrum – which is designated in the DSM-V as Other Specified Dissociative Disorder (OSDD). Under the previous version of the DSM, the DSM-IVTR, it was called Dissociative Disorder Not Otherwise Specified (DDNOS).

That brings us to the clinical evidence that tentatively suggests being AB has a neurological basis. These are two articles from 2006 and 2008, the former from the American Journal of Psychiatry. The articles are cited at the end of the post.

The articles indicate when the brains of people with DID were imaged with MRI, they show discernable differences from ‘healthy’ people. The 2008 article found people with DDNOS, those next door to DID on the dissociation spectrum, also had discernable differences when their brains were imaged. As discussed above I believe ABs fall into the DDNOS/OSDD category. On this basis it may be literally true the brains of ABs are hard wired differently.

The articles are concerned with a key part of the limbic (emotional) system in the brain – the hippocampus. The two articles suggest the people with DID had 19 to 25% smaller volumes in the hippocampus. This compares to a study of Vietnam War combat veterans with PTSD which showed a 20% reduction in volume compared with veterans having suffered no such symptoms (cited in Wikipedia). The 2008 article indicated people with DDNOS (ABs?) had 14% less volume in the hippocampus than healthy people. This would put them about mid way between the people with DID, and ‘healthy’ people.

Smaller volumes in the hippocampus have been reported in several stress-related psychiatric disorders, including post-traumatic stress disorder (PTSD), borderline personality disorder with early abuse, and depression with early abuse. The causal relationship between trauma and the size of the hippocampus is unclear. Is the smaller volume caused by trauma, or are people born with a smaller volume more vulnerable to trauma?

We need to be cautious about what we infer from the above. Both articles indicated when they were written in 2006-8, they were amongst the first research into the neurobiology of DID. They are based on small study populations. For ABs I am not inferring any kind of behavioural determinism from those differences, or any diminution of personal responsibility. We need to acknowledge ABs share the vast majority of their psychology with everyone else. What I do take from the articles is a tentative basis for the idea the different wiring in AB’s psyches may be neurological rather than just a matter of psychology.

The two studies cited are -

The two articles are succinct, readily comprehensible to the lay reader and available free on-line

I believe that there is also a link between being ABDL and the depression, anxiety and bulimia that many ABDLs report in on-line forums. I will cover this in a later post on this thread.
 
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In the previous post I suggested that there is a tentative basis for the idea that being ABDL may have a neurological basis.

There may also be a relationship between being ABDL and anxiety, panic attacks, depression and eating disorders like bulimia.

Posts in on-line forums give the impression that a significant proportion of ABDLs have one or other of these conditions. Some of that is probably caused by living with a closeted, stigmatized personality identity. But it may be more than that.

For many ABs, their Littles represent a form of identity alteration – an alternative personality or child alter. You don’t have to have DID to have alters. This places being ABDL on the dissociation spectrum, next door to Dissociative Identity Disorder (DID).

Expert opinion is that the overwhelming cause of alters is trauma in childhood. For people with DID that largely comes from abuse. For ABDLs it is more likely to come from the ‘ordinary catastrophes’ of childhood – temporary separations from mother, accidents, bullying or the like. Such childhood trauma is often repressed in the unconscious, or consciously denied.

Unhealed childhood trauma is also a source of anxiety, panic attacks, compulsive disorders, depression and eating disorders which continue into adulthood. Thus the same trauma which gave rise to a child alter can also produce these other conditions.

To complicate matters further, dissociated based conditions are often misdiagnosed as Borderline Personality Disorder or Bipolar Affective Disorder or treatment resistant depression. This is because of the lack of education about dissociation amongst mental health professionals. If dissociated childhood trauma is not accurately diagnosed, it will continue to drive symptoms such as depression, which are then labelled as treatment resistant.

Dissociated based trauma can be treated by a skilled psychotherapist.

Sources:

Marlene Steinberg. The Stranger in the Mirror: Dissociation The Hidden Epidemic (2010) (hardcopy: Harper Collins. Digital: Amazon)

Colin A. Ross. Be A Teammate With Yourself: Understanding Trauma and Dissociation (2019) (digital and hardcopy: Amazon)
 
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BabyFaceMike said:
Wow how ironic. I have aspergers also which is a form of mild autism and I have had urges to wear diapers my whole life. They make me so happy
Same here.
 
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spddan said:
Each of us, as an individual, has our own unique set of burdens to bear and paths to follow. For many of us, this whole ‘diaper thing’ can seem like quite a burden at times, and it poses a definite roadblock for our social lives, especially if we wish to be accepted in an intimate relationship. For some of us though, we are already experiencing difficulties at fitting in and experiencing challenges that go outside of the norm. We are the disabled, the disorderly, or the neurologically impaired, if you will.

Many ABDL community members have been diagnosed with some sort of a disability, or could be diagnosed if we sought it out. We’ve been told we have Asperger’s Syndrome, ADHD, Dyslexia, Obsessive Compulsive Disorder, or any other of a long list of potential impairments and invisible disorders. We are also infantilists. There seems to be a lot of us who can claim to be both neurologically impaired and involved in this unique lifestyle.


The Big Question: Are They Related?

It has often been pondered whether or not there is a correlation between having a neurological disorder and being a member of the AB/TB/DL community. It has been debated not only throughout our social circle, but has even been brought up in certain places within the neurological disability community, as well.

So what’s the answer? Is there a direct correlation between having a neurological difference and being an infantilist? It is through experience, analysis, and anecdotal evidence that it becomes quite visible that there is a plausible correlation between the two. However, this isn’t exactly an 'X caused Y' or a 'Y caused X' relationship, but rather, a case of an increased likelihood toward infantilism for those of us who qualify as neurologically disabled.


How can being neurologically disabled lead to diaper loving?

There are many ways in which being disabled can lead to a desire and/or need to regress or wear diapers. When determining the likelihood of a disabled individual developing the fetish or becoming a part of the lifestyle, one must look at the type of disorder the individual has, as well as its severity.

In general, neurological impairments such as Autism Spectrum Disorders (including Asperger’s Syndrome), Attention Deficit Disorder, and Sensory Processing Disorder each have a large variety of unique ways in which they can impact a person. No matter what the neurological disorder though, one can expect to find a general difficulty in fitting in with peers, a hard time meeting the day to day requirements the world has placed on people, and an increased likelihood of depression and difficulties coping with stress.

Infantilists are into the lifestyle for a variety of reasons, as well. Many of us are here because we have always liked feeling younger and having less responsibility from time to time, or appreciate or love wearing diapers. For many of us, this is a great way to relieve stress and temporarily remove ourselves from the harsh demands of the adult world. So, what does that mean for the neurologically impaired?


Attachment to babyish coping mechanisms

For those who are neurologically different from their peers, regressive patterns and coping mechanisms can be an attractive option for coping with stress and emotional hardship. Because many had many challenges while attempting to adapt to their social environment throughout the early ages of life, developmental milestones may have been reached late or missed entirely. Essentially, many neurologically disabled individuals have a relatively weak foundation in many of the areas that are required for a happy and well-rounded childhood.

To cope with these difficulties, many develop bonds with habits and items that can be found in their environment. This could be a plushy (stuffed animal), pacifier, bottle, blanket, or diapers, to name some of the most common babyhood coping mechanisms and comfort tools. Essentially, they develop bonds with these coping mechanisms that greatly exceed the bonds that their peers developed for the same items.

When it came time for most neurologically typical children to give up diapers, pacifiers, or their blankie, it was likely to be a minor challenge, but one that they ultimately took and moved on smoothly from, without needing to look back. For disabled kids, on the other hand, it was much harder. Because they lacked many of the same neurological capabilities of the other children, they didn’t feel as safe in their environment, and did not feel comfortable giving up their calming safety tools. This may be a common period in which such a child may begin to develop into an infantilist, refusing to give up on what they had always had before. Even if they do submit to the demands of society and try to move beyond such things, they will ultimately still have a strong emotional attachment.

Another common issue that is typical for people with neurological impairments is the likelihood of sensory problems. It has been stated before that as many as half of every person diagnosed with ADHD, as well as virtually every person diagnosed on the autism spectrum has some level of sensory difficulties. These difficulties have been discovered in children that have none of the aforementioned disabilities, and it has been given its own diagnostic label, Sensory Processing Disorder.


Ways autism and neurological sensory issues can lead to infantilism

One of the most common problems for people who have Autism Spectrum Disorders and Sensory Processing Disorder (making up approximately five percent of the world) is a difficulty with changes in the environment and transitions from one thing to another. Going from being able to wear diapers to having to use a toilet is a very big transition, and a definite change in a child’s environment.

Many people with these disabilities have a very hard time breaking from what they are doing, even for something as mundane as going to the bathroom, and hence, don’t want to do it. This inability to break away from a task to perform a vital bodily function, coupled with a hard time deciphering and experiencing the urge to use the bathroom (another common problem here), is what keeps many children with these disorders from potty training early.

One look at the websites dedicated to parents in the autism or SPD communities will reveal that potty training is a very difficult issue for a good number of children with these conditions. It is not very uncommon for a lot of these kids to be wearing diapers full time until, or even beyond, the age of 5. Many have issues with bedwetting that go on for years later, as well.

People who are hypersensitive to sensory input often have a hard time with a noisy and uncomfortable bathroom environment, and find the seams on most forms of underwear to be extremely agitating. They may prefer the feeling of a smooth porous diaper instead of underwear. Those who are under-sensitive to sensory input may not even feel the need to go until it is too late, causing chronic bedwetting accidents, and those who are sensory seekers may actually crave the sensory input diapers provide.

That’s right, many kids with Autism Spectrum Disorders, Sensory Processing Disorder, and ADHD may actually find the sensory stimuli that comes from diapers addictive, in a sense, and may fixate on them and need them to help maintain better focus and internal regulation. The scent of the powder, the feeling of the interior of the diaper, especially when wet or perhaps even messy, and the bonding pressure of the snug undergarments are all very attractive sensations to many people who are sensory seekers.


So what can be concluded?

It seems quite possible that a person with neurological impairments may be led to this lifestyle. While it is purely illogical to state that having these disorders causes infantilism, it is not too hard to imagine the appeal diapers, pacifiers, and other regression based tools for those who have an abnormal nervous system. Likewise, it is also completely unfounded to suggest that all infantilists have some form of neurological condition.

As for me, I have had Sensory Processing Disorder my whole life, and I never wanted to be potty trained. I intensely seek out the input that diapers can offer me, and have a difficult time with bathrooms, certain clothing textures, and breaking from my tasks to head to the restroom every hour or two. I feel that it is likely that this played a pivotal role in what has brought me to where I am today, as a discreetly open infantilist and diaper lover.

I have made a lot of friends in the SPD community, and most of them turned out to have some sort of regression-type habit, even if they weren’t involved in the ABDL community. I have also made quite a few friends in the ABDL community, and have never been very surprised to see a lot of them suffer from some sort of sensory processing difficulties or neurological differences.

For those of us who are neurologically impaired members of the ABDL community, we have a couple of definite hurdles to overcome when it comes to personal and social acceptance, as well as intimate relationships. If we are able to accept ourselves for both our challenges and our lifestyle, and find someone who is able to love both our unique quirkiness and our diapering interests, then it is something that is truly special, and a sign of true internal strength.

Between our diapers and our disorders, we are indeed very unique and interesting people.
I have just now read this post and all I can say is this is a very fascinating dissertation.

Also, a lot of of what is said here, even rings true with me.
 
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As a kid before they had ADD ect, I was declared Hyperactive. I dont think ADD or adhd is a disability if one learns to use them its a freakin superpower, I can do 5 things at once and always know where I am in the process. other than that I have Ptsd due to Iraq
 
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I have anxiety problems. Had minor OCD as a child, but that’s supposedly normal. It wasn’t diagnosed but I had to do weird things where if I touched something I had to do it with all 10 fingers. Supposedly OCD is sometimes caused by your brain being slightly too high temperature. Back when I wasn’t wearing every night, I’d noticed that my desire to wear was super strong while taking a medication that has a side effect of slightly elevated body temperature.
 
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DylanLewis said:
In the previous post I suggested that there is a tentative basis for the idea that being ABDL may have a neurological basis.

There may also be a relationship between being ABDL and anxiety, panic attacks, depression and eating disorders like bulimia.

Posts in on-line forums give the impression that a significant proportion of ABDLs have one or other of these conditions. Some of that is probably caused by living with a closeted, stigmatized personality identity. But it may be more than that.

OMG, a brain! In fact, multiple brains in this one thread! I'm impressed! So, to continue the conversation ...

Yes, absolutely, Dylan. I agree completely. You do see this. Of course that doesn't negate potential correlations with neurological issues as well. Yet, I think recognizing the potential correlation to identity alteration is equally important. If one moves generally along the trajectory of Ross' Trauma model, even more is suggested. Namely, in most cases, the dissociation and therefore the specific symptoms are caused by the convergence of a susceptible individual and exposure to sufficient levels of trauma in early developmental stages. Not everyone is that susceptible; not everyone susceptible experiences sufficient trauma early in life. But when all factors converge, dissociative symptoms of some sort will result. Sometimes, the result is a child alter that manifests as littles and/or AB personality features.

DylanLewis said:
... For many ABs, their Littles represent a form of identity alteration – an alternative personality or child alter. You don’t have to have DID to have alters. This places being ABDL on the dissociation spectrum, next door to Dissociative Identity Disorder (DID).

Yes, IF/WHEN the AB feature represents a form of identity alteration--certainly plausible in some cases.

But, wouldn't it be just as likely that AB features are typically like any other paraphilia? That is, an alteration of sexuality, not dissociative in nature? Given the wide range of paraphilias documented, it seems to me that a non-dissociative model has the potential to explain a range of phenomena, rather than just infantilism in isolation. So, at this point, I'm thinking of a dissociative model as more the exception than the rule. Are you thinking that way, or is there another way to look at it?

Can you say more about alters without D.I.D.? I am aware that amnesia of ordinary life experience is an essential part of the DSM-V diagnostic criteria, but I am not familiar with any case history of a person having one or more alters who wasn't also diagnosed with D.I.D. Do you know of any? Maybe have references?

BTW, great thread! Some very interesting ideas.
 
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Brandi said:
OMG, a brain! In fact, multiple brains in this one thread! I'm impressed! So, to continue the conversation ...

Yes, absolutely, Dylan. I agree completely. You do see this. Of course that doesn't negate potential correlations with neurological issues as well. Yet, I think recognizing the potential correlation to identity alteration is equally important. If one moves generally along the trajectory of Ross' Trauma model, even more is suggested. Namely, in most cases, the dissociation and therefore the specific symptoms are caused by the convergence of a susceptible individual and exposure to sufficient levels of trauma in early developmental stages. Not everyone is that susceptible; not everyone susceptible experiences sufficient trauma early in life. But when all factors converge, dissociative symptoms of some sort will result. Sometimes, the result is a child alter that manifests as littles and/or AB personality features.



Yes, IF/WHEN the AB feature represents a form of identity alteration--certainly plausible in some cases.

But, wouldn't it be just as likely that AB features are typically like any other paraphilia? That is, an alteration of sexuality, not dissociative in nature? Given the wide range of paraphilias documented, it seems to me that a non-dissociative model has the potential to explain a range of phenomena, rather than just infantilism in isolation. So, at this point, I'm thinking of a dissociative model as more the exception than the rule. Are you thinking that way, or is there another way to look at it?

Can you say more about alters without D.I.D.? I am aware that amnesia of ordinary life experience is an essential part of the DSM-V diagnostic criteria, but I am not familiar with any case history of a person having one or more alters who wasn't also diagnosed with D.I.D. Do you know of any? Maybe have references?

BTW, great thread! Some very interesting ideas.
Brandi, thanks for your perceptive thoughts and queries. If you have an interest you might see my book 'The Adult Baby: An Identity on the Dissociation Spectrum' which covers these issues in greater depth. It is available from Amazon. I am wary of citing it in case people think I am hawking it for financial benefit. That is not the case. I vest all proceeds to the publisher to support public education about ABs. If you download it & don't like it you can return it to Amazon for a refund.

Re alters without DID. Yes this exists. It is recognized in the sub-DID categories of Other Specified Dissociative Disorder (OSDD) in the DSM-V, or Dissociative Disorder Not Otherwise 'Specified (DDNOS) in the DSM-IVTR. The latter divides DDNOS into 5 types. Type 1 DDNOS exists where there is a significant level of identity alteration OR a significant level of amnesia, but not both (otherwise it would be DID). ABs have a significant level of identity alteration (alters) but not the amnesia.

Re ABDL as a non-dissociative sexual paraphilia? Human experience is diverse & all things are possible. I suspect its a small minority of ABDLs. By definition a paraphilia is an intense sexual interest exclusive of the derivation of emotional comfort from the relevant behaviour. Most derive some level of non-sexual emotional comfort from being ABDL. This means there is something else going on besides the sexual fetish. This is consistent with the fetish being a symptom, not the fundamental or defining feature. Dissociation can explain the fetish as a symptom whereas the concept of a paraphilia cannot explain why most ABDLs derive some level of non-sexual emotional comfort. (If you have an interest see my 3 posts under the Fetishism thread in the Articles tab.)

RE Colin Ross. I think he's one of the most insightful authorities on dissociation. His text 'Dissociative Identity Disorder: Diagnosis, Clinical Features and Treatment of Multiple Personality Disorder' is outstanding. I've got his recent books on the Trauma Model on my list to read next.

Thanks again for your interest.
 
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If your a combat veteran and also deal w issues i have, ptsd, and spinal damage, causing antherilosclerosis, and neuropathy of my left leg in this case, a good way i found to understand my psyc issues were two books that assisted me in how understand my brains new workings. As well as how to deal w my at time sibstantial affinity for violent outbursts. The first is On Killing: The Psychological Cost of Learning to Kill in War and Society Another by the same author is On Combat: The Psychology and Physiology of Deadly Conflict in War and in Peace
 
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DylanLewis said:
Re ABDL as a non-dissociative sexual paraphilia? Human experience is diverse & all things are possible. I suspect its a small minority of ABDLs. By definition a paraphilia is an intense sexual interest exclusive of the derivation of emotional comfort from the relevant behaviour. Most derive some level of non-sexual emotional comfort from being ABDL.

Thank you for the reply DylanLewis. And sorry to leave this hanging so long.

I see how, in your theoretical framework, ABDL-ism(?) wouldn't fit as a paraphilia. I'm curious whether this definition is unique to you or whether it is used by other psychologists? For instance, this article at psychology today doesn't include the notion of comfort: https://www.psychologytoday.com/us/conditions/paraphilias For them, it seems like the necessity or preoccupation with the object of desire is central, together with either a sense of distress or resulting in harm.

DylanLewis said:
This means there is something else going on besides the sexual fetish. This is consistent with the fetish being a symptom, not the fundamental or defining feature. Dissociation can explain the fetish as a symptom whereas the concept of a paraphilia cannot explain why most ABDLs derive some level of non-sexual emotional comfort.

Oh, yes. That clearly makes sense. And I'm sure it is true in many cases. So, I see how your view is coherent and also has explanatory power.

But maybe that isn't the whole picture? Wouldn't it work to take food as a parallel, non-dissociative comfort? Lots of people over-eat because it's comforting. It doesn't make eating a symptom of a deeper underlying condition. There are people who over-eat as a symptom of pathology. But there are others who over-eat for comfort in only isolated cases. There's no real long-term pathology. And of course there are lots of other parallels: occasional alcohol use, nicotine, exercise, etc. Not dissociative, not pathological, but definitely comforting when under stress.

So, well, I guess what I'm saying is that I think sex is pretty comforting. (blush) Whether it's ABDL sex, homo- or hetero-sexual ... it doesn't matter. It's comforting.
 
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Brandi said:
Thank you for the reply DylanLewis. And sorry to leave this hanging so long.

I see how, in your theoretical framework, ABDL-ism(?) wouldn't fit as a paraphilia. I'm curious whether this definition is unique to you or whether it is used by other psychologists? For instance, this article at psychology today doesn't include the notion of comfort: https://www.psychologytoday.com/us/conditions/paraphilias For them, it seems like the necessity or preoccupation with the object of desire is central, together with either a sense of distress or resulting in harm.



Oh, yes. That clearly makes sense. And I'm sure it is true in many cases. So, I see how your view is coherent and also has explanatory power.

But maybe that isn't the whole picture? Wouldn't it work to take food as a parallel, non-dissociative comfort? Lots of people over-eat because it's comforting. It doesn't make eating a symptom of a deeper underlying condition. There are people who over-eat as a symptom of pathology. But there are others who over-eat for comfort in only isolated cases. There's no real long-term pathology. And of course there are lots of other parallels: occasional alcohol use, nicotine, exercise, etc. Not dissociative, not pathological, but definitely comforting when under stress.

So, well, I guess what I'm saying is that I think sex is pretty comforting. (blush) Whether it's ABDL sex, homo- or hetero-sexual ... it doesn't matter. It's comforting.
Brandi. You are right in pointing out the definition of a paraphilia is not benign - after all it includes child molesting, groping, flashing, peeping toms etc. (Although some ABDLs seem to have convinced themselves that paraphilia is nothing more than a benign synonym for 'kink' – the Wikipedia citation of ABDL as ‘paraphilic infantilism’ seems to attract little concern.)

The definition of a paraphilia is "recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons that occur over a period of six months." ABDL can include a paraphilia for diapers – particularly in the initial stages of the identity the savage internal conflict can drive compulsive behaviours which would fit the definition. That still doesn't make it the primary or defining feature of being ABDL.

Re the view of psychologists (I am not a psych, just a layman with an interest in psychology). There seems to be little rigor or clarity in the mental health professions' view of ABDL.

The only explicit categorization of ABDL by mental health professionals is as a paraphilia. Take the recent history of the Diagnostic and Statistical Manual of Mental Disorders (the DSM), published by the American Psychiatric Association. The concept of paraphilias was first introduced in the DSM-III of 1980 (without specific reference to infantilism/ABDL). The DSM-IIIR of 1987 first cited ‘infantilism’ (ABDL) as a form of sexual masochism. Such (brief) citations continued in succeeding editions of the DSM, but were dropped from the DSM-V in 2013. To my knowledge there is no explicit citation of infantilism/ABDL in the current DSM.

Even so the baneful legacy of this is still with us today – a search for ABDL on Wikipedia defaults to the article ‘paraphilic infantilism’. In the popular mind ABDL is primarily viewed as a sexual fetish (or more euphemistically as ‘a kink’). Given this prejudice, and the previous history of the DSM, mental health professionals are still likely to identify ABDL as one of the paraphilias.

The designation of ABDL as a paraphilia was arbitrary, without clinical rigor. It seems likely the first citation of paraphilias in the DSM in 1980, and later ‘infantilism’ as a paraphilia in 1987 was due to the work of the controversial sexologist John Money. In a 1984 article and 1986 book he invented a typology of paraphilias. I understand that this was essentially based on intuition. Money was self consciously trying to create sexology as a new, academically respected and popularly understood discipline, with himself as its leading authority. His work and writing viewed all through this lens. ABDL = infantilism, got roped into his newly created typology. Presumably this was so the typology was comprehensive.

The key problem is that this assumed, without any evidence, that any non-conforming sexual behavior was the primary / defining feature of the personality of the person concerned. Sexologists seem occupationally prone to this reductionism (just as Freud was).

When there is distress and impairment, being ABDL has a range of symptoms of which the paraphilia can be one. There are others including the derivation of emotional comfort from wearing diapers (which is in contradiction to the intense/compulsive character of a paraphilia); changes in affect; intrapsychic conflict; problems with self image and personal identity; impaired social and intimate relationships; childhood attachment issues; and mood disorders such as anxiety or depression.

The valid means of ascertaining the primary clinical explanation for any set of symptoms is via a differential diagnosis. This matches the symptoms with the diagnostic criteria for relevant clinical conditions to ascertain which of the latter best explains most of the symptoms. To my knowledge there has never been a published competent differential diagnosis for ABDL. Money and subsequently, the DSM, defined infantilism as a paraphilia without ever having undertaken a differential diagnosis based on a comprehensive set of the relevant symptoms. This is a significant gap in clinical knowledge which has contributed to the lack of understanding of ABDL by mental health professionals. I am hoping to address this in my next book.

Re the derivation of comfort from diapers. I will respond to this in a subsequent post.
 
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