The Epistemology of Mental Illness Diagnosis
It seems to be that the way psychologists and psychiatrists diagnose mental illness is through conversation with the patient. The patient tells them what bothers them, what they feel, their thoughts, etc. So, if you have lost enjoyment in life, and experience constant sadness, you are diagnosed with depression (based on the things that you said to the mental health professional.) The way in which we diagnose depression seems to be way less reliable than the way that for example you would find a tumor on someones body, or a life weakening viral infection. The latter seems to have more epistemological validity than the former. What are your thoughts on this? And given this problem, can psychology really be called a science?
Comments (116)
Actually, mental health diagnoses are based on an interview (objective symptoms are observed) and the result of a checklist survey completed by the patient (subjective symptoms are reported). Symptoms are then mapped to a corresponding category in ICD-10, Chapter V: Mental and behavioural disorders.
Also, Psychology (a science by virtue of the method it employs to acquire knowledge that can be rationally explained and reliably applied) is very broad (i.e., not limited to a clinical application).
That said, there are certainly a fair number of charlatans peddling pseudo-psychology on public forums.
It's not a very successful science. The scientific basis of medicine in other departments seems to result in cures, ameliorations, a reduction in suffering. In mental health, the exact opposite seems to happen.
There is a very simple reason for this. In every other field, the object of study is unaffected by the theory applied to it; what the scientist thinks about electrons or fossils does not affect them at all. This cannot be said of humans. One sees the beginnings of this in physical medicine, where one must take great pains to eliminate the placebo effect in order to escape the psychological effects. But one cannot even in principle do this in psychology.
Thus it turns out that the scientific mindset not only does not work psychologically, but is in fact a mental illness in its own right.
I think unenlightened has the right approach here. I believe the "scientific" status of psychology is highly suspect. The scientific method verifies theories through experimentation and empirical observations of the activities in the physical world. How is it possible to account for, within the theories of psychology, the fact that the thing being observed is a free willing human being? Since free will is at the root, the foundation, of all human actions, the psychologist has no hope of any scientific understanding without a firm understanding of the nature of free will. And this we simply do not have.
So it is a mental illness to make observations and then categorize those observations? If that is the case, then every human being is mentally ill.
It would seem to me that several philosophical stances are equivalent to a mental illness - like believing that no one but yourself exists, believing that some unseen entity loves you and that makes you important, believing that you will live forever, a gross misuse of the English language, etc.
Quoting rickyk95
Of course it can. It is based on observations, categorizing those observations, and sharing those observations with other psychologists in order to apply them to the masses. Psychology has been around for about 150 years and since then it has several other fields branching out from, or overlapping psychology and neuroscience - like cognitive neuroscience and physiological psychology.
Observing your own mental states and categorizing those mental states, and then sharing those observations with others is a scientific act.
Science is very successful when directed outwards to the world of objects. But directed inwards at the subject that is (or isn't) scientific, it fails utterly, precisely because it must methodologically eliminate subjectivity in trying to be objective. Thus science applied to the psyche is a madness of the form of going to sea in a sieve. Sieves are great for getting the lumps out of stuff, but useless for keeping one's feet dry.
Far and few are the lands where the Jumblies live, because they went to sea in a sieve. Not all users of sieves are mad, only those that set sail in them.
Self-categorizing one's mental state doesn't sound part of a scientific act.
"Imagine someone saying: "But I know how tall I am!" and laying his hand on top of his head to prove it."
The shortcomings of Clinical Psychology are acknowledged by its own practitioners. Do the so-called "hard" sciences have any shortcomings? If not, please explain mental phenomena in terms of Biology, Chemistry, or Physics.
I would suggest the use of Physiological terms, since it is thought (by some) that Psychology can be reduced to Biology.
I could be in favour of maintaining higher (less abstract) levels of explanation, only because it would be cumbersome to explain foreign language acquisition or culture shock in terms of quantum-mechanical interactions between elementary particles.
However, the higher level explanations provided by Psychology are required for an exhaustive explanation of reality. These contribute new qualities (emergent properties) to mental phenomena, and are undetermined by, hence; independent of, the lower levels.
The fact that experiences are ontologically subjective does not make them epistemically inaccessible. It is possible to talk meaningfully about experiences, recall, and some of that talk can be epistemically objective, supported by knowledge of physiology, chemistry and so on.
On the main question, we rely on conversations with others for all the measurements we make, not just assessing how we and others are feeling. Without being able to compare experiences with other people I would not know how to read a thermometer or what a thermometer is or whether the reading that I take is the same as or different from another person's reading or what kind of thing thermometers are presumed to measure. If we can reliably compare experiences of that sort and for that purpose, then I would not assume that we cannot compare experiences of mood, emotion, thought etc equally reliably and equally fallibly.
They have limits. The whole notion of 'mental phenomena' is rather confused; are your posts physical phenomena or mental phenomena? I'm not sure what you are referring to.
Quoting Galuchat
But they are sadly misunderstood, the way a hole in the ground might be misunderstood to be a building with shortcomings. The whole project of scientific psychology is to objectify, and thus dehumanise the person. It is thus not only impossible, but also counterproductive. It fosters a deep misunderstanding of the person, and a dehumanising and therefore maddening treatment. To try and understand others and oneself in a way that dehumanises them also dehumanises oneself, and is itself insane.
This is not to say that psychology cannot be studied, or that people cannot be treated. It is simply to say that it must be done differently, and practitioners who are worth anything already do so.
By focusing on Clinical Psychology, 97% of Psychology is ignored.
By focusing on a term that you yourself introduced, you avoid any serious response. By focusing on clinical psychology, everything else is being ignored for the moment - so the fuck what? It's the topic of the thread. But how's about addressing the argument I made which is equally applicable to any area of scientific psychology? I'll spell it out in different words for you:
Any psychological theory, scientific or not, is an integral part of a psyche; that is it shapes the psyche. Humans are actually changed psychologically by the ways in which they regard and treat each other, and this is in turn changed by the psychological theory that they hold. Therefore, any theory that is accumulative of knowledge is an attempt to fix a nature that is radically fluid and will be as useful as nailing a river to its bed.
It's actually pretty easy to diagnose whether someone has depression or not. The difficulty, though, is figuring out what sort of depression someone has, why they have it, and how treatment can be applied so as to move the patient forward into a healthier future. It doesn't take a psychiatrist or a rocket scientist to tell me or anyone else that a lot of people out there are seriously mentally screwed up, and just because diagnosis and treatment doesn't always work doesn't mean we should throw everything out.
Quoting unenlightened
Uh, no it's not. Your refusal to acknowledge the practical differences between academic psychology and clinical psychology is entirely against the premise of the thread. University professors testing lab rats are not diagnosing and treating people, clinical psychologists, counselors, and therapists are, in conjunction with medical doctors.
If you know nothing about the subject, keep your fingers still, eh?
Where? Are we confused when we speak about our experiences in a public language? All talk is public, one does not assume a private language by talking about one's private experiences.
Experiences are ontologically subjective, but talk about them ontologically objective and possibly epistemically objective.
Confusion arises from talk of the subjective and the objective which does not clearly distinguish the ontological from the epistemological (hence the many "philosophical" metaphors in this thread instead of arguments).
The topic is mental illness diagnosis, if you care to look, and I am fairly confident that that is part of clinical psychology. So kindly do not berate me for talking mainly about clinical psychology. I am well aware that there are practical differences, just as there are between medicine and medical research, but again, so the fuck what?
Quoting Heister EggcartI studied psychology for four years at one o them academic universities, where they play with rats, and also monkeys in the good old days. What is your qualification for wagging your fingers so strenuously?
Depression does have a specific definition (it's a collection of moods and behavior changes), but the term is also used very generally. There is a difference between "major depression" and "my life is a pile of shit and I am very unhappy about it".
"Depression or unhappiness" generates a lot of traffic in doctor's offices, but some of the patients that report depression really do have a mood disorder called "depression".
Consider something more specific: bi-polar or manic-depressive disorder. The visible signs of mania or severe depression do not require a patients report. Sleeplessness, severe agitation, screaming incoherently, extreme anxiety, and response to hallucinations for mania; for depression one sees flat affect, retarded movement, very slow response in speech, lack of physical care, excessive periods of sleeping, very poor task performance, and so on.
Major and severe psychiatric conditions like paranoid schizophrenia, anxiety disorder, obsessive compulsive disorder, etc. all have obvious behavioral components.
The diagnosis of physical maladies often begins with self-reports. If patients don't report double vision and headaches, a doctor will not order MRI or CAT scans for brain tumors. Severe headaches are invisible to MRIs or CAT scans, so a diagnosis of Migraine pretty much has to depend on patient reports. Blood tests can reveal some disorders, but not all of them, and even tumors can be mistaken for something else.
Are you really this dumb? >:O
Quoting unenlightened
You studied psychology for four years, yet you still can't figure out why it's important to distinguish between different forms of psychology. Wow. *grabs rope*
Ah, none at all I see. Keep holding the rope.
(Y)
Quoting Bitter Crank
This is a bit too cynical I think. Number pushing can be attributed to practically any field. To be honest, you're getting more at the fact that medical practitioners aren't themselves without problems (even though modern society holds them up now as gods.)
Only if you keep living up to your name, ;)
Quoting Bitter Crank
This is a rather important difference. In the case of physical maladies, the self report and other behaviour is explained in terms of bugs, wounds, inflammation, genes, or whatever. Absent such identifiable physical causal factors, there is a strong tendency to reach - as a last resort, for the 'psychosomatic' diagnosis.
This good science, to look for causes of symptoms and treat them rather than the symptoms. When the causes are known, we no longer tend to call the symptoms 'mental illness'; Parkinson's, epilepsy, CJD, for examples.
It would be nice if we could locate the causes of depression; gene therapy, or some such might become a possibility, but everything we know suggests that while there are genetic predisposing factors, and some potential environmental triggers, there is no unique physical causal agent.
So the good scientist turns to neuroscience. And there is talk of dopamine levels and the like. But here is where the waters start to muddy. Are the chemical imbalances the cause of the depression, or the effect of the depression? Are they different things at all, or the same thing seen in different ways?
We have a behavioural definition, and we have an associated brain state, unsurprisingly, but we still don't have a cause, and it is the lack of physical cause that makes it a classical mental illness. Exit science, muttering 'give me more research grants'.
So we resort to psychobabble; talking therapies. There is (because it is the only possibility left) a way of looking at the world and oneself, that leads to depression - a meme. And another name for 'a way of looking at the world and oneself' is 'a psychological theory'.
I wasn't trying to be cynical, nor was I trying (here) to suggest that medical practitioners are either gods or unusually screwed up.
If you go back a ways, say 1817, the definition of mental illness was (I am guessing here -- don't have a source) relatively simple. Over time, mental illness was differentiated into more specific diagnoses. This is useful. At some point, it started going overboard, and finding 'new' and 'different' disorders that were already listed under a different name. However, I'm not an expert on this.
While there are few physical markers that exist for schizophrenia, bi-polar, psychosis, or catatonic depression--the several types of mental illness where patients need hospitalization for weeks at a time and are clearly "out of their minds" (hearing voices, having visual hallucinations, are afflicted with severe anxiety, agitation, etc.) it is the case that we are not talking psychobabble. When even high doses of major tranquilizers can't settle people down, one can conclude that one is dealing with a real problem.
There are the major mental illnesses that afflict 1% to 2% of the population, and then there are the vague unhappinesses that afflict between 10% and 20% (at least) of the population. The major mental illnesses must have some kind of biological origin, and the many not-major mental illnesses (or not mental illnesses at all) are the result of the condition that Freud (and many others) have identified: "Happiness just isn't in the cards a good share of the time".
Where talk therapy is helpful to people with these major mental illnesses is assisting them to cope with their serious problem that isn't going to go away, and to provide them with the comfort of an attentive listener. (And lots of ordinary people are perfectly capable of providing this kind of help.)
For the 10% to 20%--or more--psychobabble is usually the proffered cure, along with some sort of medication.
I am pretty sure that at least 20% of the population are quite unhappy; some of the population are profoundly unhappy. In most cases, there is nothing wrong with their "psychology". Their brains are in working order. They can concentrate, learn, remember, cope, produce, get up every day and go to work, get their laundry washed, and so on. If they are unhappy, they need to change -- their job, their family, their society, themselves, or all of the above. If they can't change, then they are going to stay unhappy, or they'll make some kind of accommodation. They don't need therapy--they need courage.
I think the talk of a "brain state" is somewhat misleading. "State" implies static, but the brain is continuously active. Ideas, beliefs, and concepts can be understood as static things, but I think it is a mistake to try to understand the brain in terms of states. Physicists have encountered the very same problem. They talk about quantum states, but what is being referred to is a bunch of activity, and not a state at all. So it is impossible for them to understand what they are talking about.
I once spent six weeks with a schizophrenic in the full flowering of a manic episode, and without drugs. It is a distressing, baffling, frightening condition for all parties. In no sense am I a mental illness denier. However, to say that it must have a biological origin is to deny strong evidence that there is a significant social environment factor. It is well established, for example, that the the status of immigrant is a significant risk; there are also known genetic risk factors, but there is no identifiable biological cause. The situation is similar to cancers, except there is zero understanding of the (possibly) random factors that decide whether the risk will be realised or not. Not for the want of looking.
And as you indicate, there are similar but milder versions, hearing voices or seeing hallucinations, for examples, that some people manage to live with and still function in society, with or without medication. The spectrum nature of these things make your distinctions and percentages somewhat arbitrary.
Quoting Bitter Crank
But lack of courage is a failing of the psyche. What the above illustrates is that the only measure we have of mental health is a social functional one. A few million men go off to shoot each other in trenches, and we think them sane, but if one runs down the street wielding an axe, we think him mad.
Quoting Metaphysician Undercover
I agree. It is just a shorthand for talking about the kind of global factors of neurotransmitter levels and such, that seem to be the rough physical analogues of 'moods'. I don't think brain talk in general is very illuminating, but one has to engage with it when conversing with physicalists.
lol. So in other words, if 'perfectly healthy' miserable people continue to kill themselves and others because their psychological needs are ignored by psychiatry who should only concentrate on a minority of major depression disorder cases, then society's response should be a post-hoc sermon of "oughts".
Fanelli D (2010). ""Positive" results increase down the Hierarchy of the Sciences.": "...these results support the scientific status of the social sciences against claims that they are completely subjective, by showing that, when they adopt a scientific approach to discovery, they differ from the natural sciences only by a matter of degree."
https://doi.org/10.1371%2Fjournal.pone.0010068
The hard science - soft science debate is useful to an agenda which attempts to discredit Psychology by means of disinformation (itself a psychological tool based on the premise: information control is mind control). What would be the purpose of such an agenda? The findings of Scientific Psychology can have disturbing implications regarding human behaviour. Would it cause distress among the populace to know how easily their thoughts, attitudes, and behaviour can be (and are) manipulated?
The more pertinent question is: to what extent has the reliable application of Psychology affected people over the past 120 years?
It is the nature of human beings to be genetically predisposed to certain cognitive and intuitive misinterpretations (i.e., errors, biases, and illusions), and to predictable behaviour in group dynamics, etc. If the facts of extensive psychological research were known and understood, many cherished models of "free will" (among other things) would be considered absurd, and simply collapse.
Structural models of the human mind based on memory, knowledge, and processing capacity, dynamic models which simulate cognitive and intuitive processing (e.g., interpretation and mental modelling), and formal domain ontologies containing knowledge, are all being constructed and contribute to the field of artificial intelligence.
Time doesn't permit a sufficient summary of the many other applications, but the Wikipedia article on Psychology would be a good place to start.
Of course the inverse of this is true as well. If the nature of free will was known, and understood, many cherished psychological models would simply collapse.
Quoting Galuchat
The concept of free will, as developed by St. Augustine is based on a tripartite model of the human mind consisting of memory, understanding, and will. If you remove will, such that you produce a model based on memory and processing (understanding), you have an incomplete model, ignoring a crucial aspect of the mind. You cannot even bring "knowledge" into this model because knowledge is based in belief which requires a choice, i.e. an act of will, conviction. So you necessarily have a gap of inconsistency between your model with its memory and processing, and the content which exists within the memory, and is being processed. Where does that content (knowledge) come from? I know, your model takes it for granted. That's how those models work, they take some fundamental principles as granted, and build upon that. But the production of such principles is critical to a real understanding of the mind. How valid is any claim to have modeled the mind, when you simply leave out, as granted, a very important aspect?
It seems to me that all diagnosis is based on dialogue. The concept of 'diagnosis' is dialogue-based: it assumes that a medical professional can eventually write something down, generally with the patient's agreement, which they both believe is a satisfactory explanation of why the person called 'the patient' came along in the first place. It's just a ritual we like.
A substantial minority of doctor-patient encounters end without diagnosis, or with a labelling that lacks significant content.
I don't see that there's something separate about mental distress from physical distress. One issue is, how far do we spread the causal web. Many people in the polluted valley where I live have difficulties called respiratory problems, but they aren't diagnosed as having pollution problems. The poor visit the doctor disproportionately for 'mental' problems: they are not diagnosed as having inadequate incomes. It requires coroners with an active view of public health to make sure that individual diagnoses of all sorts of industrially- or behaviourally-caused problems are recognised as not simply the problems of indivduals.
The conversation depends on the type of therapy.
Cognitive Control Therapy begins at media res and proceeds to establish goals which the patient sets with the assistance of the therapist. This method removes symptoms, which may be sufficient for normal functioning in society. I think it tries to transfer (the unconscious redirection of feelings) these symptoms into the goals the patient has established. The US Military use Cognitive Control Therapy to treat cases of PTSD. This is the quickest treatment method, 3 to 6 months avg and it can be combined with online sessions.
Many believe that all mental issues are chemical related. Imbalances in the brain. This is the case for schizophrenics and others with severe forms of psychosis. Structural issues need to be addressed with such treatments, talk has limited utility in these cases.
Neurotics make up the majority of those with mental issues and in order to get at the causes of these issues long term psychiatric sessions are necessary. The psychiatrist does not effect the relief, the patient does, and over time with the careful guidance of a skilled psychiatrist good results are possible. It is not so much finding causes but leading the patient to make his own realizations.
Is is a science? Perhaps at the structural level but...I get the impression that finding the right fit between patient and therapist is critical to the success of the treatment.
Isnt that why you go to the psychologists - to ask the person in which many others go to and shares their internal states with in order to compare them and apply similar solutions to similar problems?
And just like there are objective elements in other fields, so too psychology. That you feel sad is subjective, but that you sleep 20 hours a day, you drink a pint of gin a day, that you can't hold a job, and that you commit crimes is not. The reduction in measurable criteria is evidence of resolution.
And no, I don't accept the conclusion that psychology has no therapeutic value. It can work.
I don't think anyone was offering it.
But you said "Science is very successful when directed outwards to the world of objects. But directed inwards at the subject that is (or isn't) scientific, it fails utterly, precisely because it must methodologically eliminate subjectivity in trying to be objective. Thus science applied to the psyche is a madness of the form of going to sea in a sieve."
I took "fails utterly" to mean it's useless.
How dare you.
No, no. It is neither possible nor appropriate for 'psychiatry' to deal with the unhappiness of 20% of the population -- that's 60 million people in the US alone. The unhappiness of 60 million people is something that society as a whole can, should, and must deal with. We have arranged society to function in some unhealthy ways, and this can be changed. Not easy, certainly, but there is no other entity other than "society" capable of doing it.
Check out "The Sane Society" by Erich Fromm.
I once spent 30 years with a mate who was afflicted with a severe bi-polar disorder.
I'll readily grant that there are several factors in play: social factors, personal factors (lifestyle, good or bad life-choices, etc.), and biological factors. I'll readily grant that most people with major mental illness diagnoses are capable of functioning productively, most of the time, at least.
But what convinces me that the major mental illnesses (which, after all, do not afflict most people -- 97% of the population) have a significant causative biological component is that otherwise bright, happy, productive people who are doing well in society can quickly unravel into disabling psychotic or depressive conditions.
For most of us who have or will display garden variety mental dysfunction, it's almost all socially related, or related to bad decisions (like getting into and staying in a bad job, a bad marriage, a bad relationship, bad habits, etc).
Why do you think it is, that people of various age groups, who are apparently completely mentally stable, not diagnosable of having major mental illness, will decide to commit suicide? Doesn't the act of suicide imply "major mental illness"?
It could mean major mental illness or it could mean excessive other-directedness which has suddenly let them down.
However, when we see high rates of suicide among a particular demographic, like middle aged, white, unemployed, working class men, then it points towards social dysfunction -- on the part of society and maybe on the part of some of the men. The number of working class men that have been shuffled out of the economy is quite high, and not very much has been done on their behalf. That's a social dysfunction. Some working class men simply can't find an identity outside of work, and that's a social dysfunction on the part of the men.
I'm not blaming them for despair, please understand.
What is "other-directedness"?
Quoting Bitter Crank
I think you are adding too many qualifying terms to your demographic here. Doing this just directs your conclusion. So for instance, many middle aged men commit suicide, regardless of whether they are white or unemployed. You might conclude that this is the result of a dysfunctional society, casting the blame of causation onto some phantom existent called "society". But why not look at the reality of this, that these are individuals who cannot cope with their environment. Who knows, perhaps if the conditions were right, you or I could join that group, but wouldn't this classify us as mentally ill? Mental illness doesn't have to be something you are born with.
"other directed" people rely heavily on other people for cues about their own worth, their proper role, what's important, what's not. Nobody is entirely other-directed of course. The opposite is inner directed people who rely more on the own judgements about their self worth, their proper role, what's important, what's not. Inner-directed people are usually somewhat less gregarious. It isn't that they are at all unsocial, they just don't require as much social interaction with and validation from others as other directed people do.
There is nothing inherently wrong with being either inner or other directed. Different traits are better in different circumstances.
In the suicide context, an other-directed young person who relies on the group's approval for self-esteem may lose that approval--for some odd reason. This would be more devastating for an other directed person than an inner directed one. Being inner directed is no protection against suicide.
I didn't make up the group, "middle aged, white, unemployed, working class men". They figure large in the declining economies of rust-belt areas in the midwest (Wisconsin, Illinois, Indiana, Ohio, Pennsylvania, Appalachia). It is among this group that the highest rates of unemployment for the longest periods have recently occurred; this is the group figuring largely into the opiate drug epidemic, and has a significantly higher rate of suicide than they did 25 years ago, and a significantly higher rate of suicide than among their employees peers.
Long-term unemployment with little likelihood of re-employment is a relatively new experience for these people. This group self-identified very strongly as "the American work force", and now that has come unraveled for millions of this demographic.
Some members of this group are resilient, resourceful, flexible, and take the initiative in finding some other type of work. If they are not resilient, resourceful, flexible, and take a passive approach, then things can not get better for them (they might not get better even for the agile, nimble, flexible worker either).
When entire industries vacate a region, the consequences are often so devastating that individuals just get chewed up and spat out. This happened in Flint, MI (GM); Gary, Indiana (steel); Akron, OH (rubber); Janesville, WI (GM); and many other places where once mainstay industries either went bankrupt or the industry decamped to Asia.
Quoting Metaphysician Undercover
You and I could certainly end up in this group, and I didn't suggest that merely being in this group made one mentally ill. I've had bad episodes of work and unemployment and it did not make me feel at all suicidal. One doesn't need to be mentally ill to commit suicide. But being depressed and feeling hopeless and abandoned makes it a bit more likely that somebody that has a gun handy will load it, point it at their head, and pull the trigger.
Quoting Metaphysician Undercover
You aren't going to quote me Margaret Thatcher, "there's no such thing as society" are you?
Society exists, and it exists in various functions, forms, and demographics. It's not a phantom. It is also a useful "placeholder" for several subsystems of society: the economy, foreign trade, the education system, the mental health system, the welfare system, religious organizations, labor, corporations, the government--all sorts of things.
What I conclude is that the whole notion of mental illness is flawed. As you say, anyone can find themselves in an environment they cannot cope with, and the details of what they cannot cope with will vary with the individual. But one becomes dysfunctional in relation to a social environment, and that is what we call 'mental illness'. The same mentality that functions stably in one environment breaks down in another. Whereas another mentality might respond in the opposite way.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3230535/ (to placate the science addicts)
The fact that these epigenetic changes are reversible seems to suggest that they are more like immunological responses to a toxic environment than illnesses (to stick as close as possible to the medical model). Thus I appear idiotic, self-contradictory and frankly insane, because I am writing in a science and medicine addicted community, where my challenges to the socially established mode of thought are 'unthinkable'.
Calling it 'mental illness' directs one to look only at one side of the relation. But perhaps sometimes the suicide is simply conforming, manifesting the fact that his environment, that is the community he finds himself in, wishes him dead. Which happens to marginalised folks everywhere. But in wishing himself dead, his mentality is exactly the same as the rest of the community that we call, by definition, sane.
But this is exactly the proposition I am question, and merely stating it doesn't prove it. It appears to me like the will to commit suicide would be a defining element of mental illness. Doesn't the mind serve to support ad protect oneself? To will an end to oneself is of course contrary to this, so why wouldn't this be called metal illness? Do you believe that the mind serves a purpose other than to support and protect oneself?
Quoting Bitter Crank
"Society" is a phantom notion because it's a manmade object which is immaterial. It has many material manifestations, such as school houses, courts, town halls, etc., but to assign to "society" some kind of causal power, requires that one adopts a metaphysics whereby immaterial things such as ideas have causal power. The only way I see that it is possible for ideas to have causal power, is through the willful actions of individual human beings. Ideas do not have causal power the willful actions of individual human beings do. This forces a reduction of "society" to the actions of individual human beings. So in the context of "society is a cause of mental illness", what is really being said here is that an individual's interactions with other individuals is a cause of mental illness.
More specifically though, since "society" refers to this immaterial aspect, which is best described as concepts and ideas, laws, or perhaps ideology in this case, then to blame society for mental illness is to blame this interaction of ideas and ideologies between individuals. But this opens a whole can of worms, because we cannot say that an individual who has unstable ideas is mentally ill, as this is how we develop and grow our knowledge, by allowing our ideas to evolve. Furthermore, we cannot say that a person who has stable ideas which are inconsistent with others (bad or incorrect), is mentally ill, because this person must be held morally or legally responsible.
Quoting unenlightened
If I understand you correctly then, what we call "mental illness" is an inability to adapt to one's changing social environment. Depending on the individual, a different sort of social environment might trigger the mental illness. Would you say that if given the necessary social environment, every one of us would suffer mental illness? There is no one who can adapt to every possible social environment?
According to the quoted passage, it is quite likely that the adaptation you refer to requires methylation and demethylation of DNA. I had to research this methylation, because it's new to me. It appears like H3C binds itself to the DNA molecule, so the DNA may or may not have H3C. And this affects the activities of the DNA. If I understand correctly, H3C cannot exist freely, it is too unstable and must be bound to oxygen or something. Do you have any opinion as to how it is possible that H3C can move around freely within the living organism, what moves it to and from the DNA?
Quoting Mongrel
It's not difficult at all to overcome the resistance to consciously inflict pain. We quite often do this with our dealings with animals, in training and husbandry. It is a simple part of the occupation. There are two aspects to overcome, one is the noise, or actions, which the animal makes indicting it is in pain, and the other is the moral feeling of guilt, this is wrong to inflict pain on this animal. The former, the noise and behaviour enhances, or even brings about the latter, the guilt. So the desired procedure is to inflict just enough pain to induce the desired behaviour, without the animal displaying its pain, then the animal behaves with no evidence of pain, and no feeling of guilt for the trainer. The well trained animal then doesn't even require pain, just a signal, a reminder, an indication that pain could be coming if it doesn't behave. We take this to the extreme with slaughter. Quick and easy is no display of pain, and no feeling of guilt.
Of course there may be some human beings who go the opposite way, and start to enjoy those noises and actions which indicate pain. Then we have to judge those individuals are they suppressing their guilt, or are they mentally ill?
Yeah, well this just reinforces unenlightened's point "the whole notion of mental illness is flawed".
It doesn't have to do with the society itself defining what is sane vs. insane behavior. It has to do with the common features we all share vs. rare features that occur within our population.
One of the defining properties of a human being is that they are highly social. If a person is anti-social, in any social environment, that person is defined as mentally unstable in every social environment, even in the social environment of ISIS.
What kind of social environment produces denial (i.e., an unconscious defense mechanism used to reduce anxiety by denying thoughts, feelings, or facts that are consciously intolerable)?
Typically, childhood abuse, physical, sexual, or psychological. More generally, a dependent relationship that is simultaneously intolerable and inescapable. Such is my best current understanding, anyway.
Not at all. An anti-social person is ideally suited to being a night-watchman or a lighthouse keeper, or a mountain shepherd. No reason at all to call such people ill.
Or do you mean by 'antisocial' one who opposes the society they are in, in some way? Such people are agents of change and progress.
Thanks for that.
Actually, what we call mental disorders are listed in diagnostic manuals (e.g., ICD-10, Chapter V). What kind of social environments produce autism and catatonia?
I'm not sure. Some people are more adaptable than others. Even concentration camps can be sanely survived by a few, perhaps. On the other hand, no one survives the end of the world. What I am really saying is that the 'illness' is not confined to the person, but is in the relationship, and very often is more to do with the society than the individual.
Thomas Moore said "cure" and "care" are etymologically related. Bla blah blah.
Says the psychiatrist to the psychologist and vice versa.
One always has to address the placebo effect in this context.
Quoting unenlightened
What I mean is the definition of antisocial. Here, let me help you:
Definition of antisocial
1
: averse to the society of others : unsociable
2
: hostile or harmful to organized society;
In other words, being asocial just means that you avoid social interaction. Antisocial means that you are antagonistic towards other people - regardless of the culture you find yourself in.
How does an agent of change and progress get others to agree with them and follow them if they are hostile to everyone they interact with?
Quoting Harry Hindu
Smack them briskly about the head until they comply. Or possibly crucify a few of them to encourage the others. Are these mental illnesses?
A-sociality and anti-sociality by themselves aren't mental illnesses at least in my book. They may be perceived by the subject as afflictions, in which case the person may need some assistance, and it need not be from somebody in the mental health field. People have many problems which are not mental health problems. Like they may have abysmal social skills -- a potentially significant problem and not necessarily having anything to do with mental health. Lots of people (most people? Is it a feature of humanness?) manage to be pains in the ass without having anything wrong with their mental health.
If you read the research papers, there's plenty of evidence that the placebo effect has quite a significant impact on general wellbeing scores (PANSS, MADRS, etc.)
That would be their purpose, to treat those conditions*.
*I purposely refuse to use the term disorder.
Can you clarify what you mean, here?
Tell me about it. Medication helps though!
So, what I mean to say is that the epistemological quantifier of mental illnesses is derived from the results one obtains from the drug treatment for the condition. It's not an exact science; but, if someone complains about being sad all the time, then putting them on SSRI's or other drugs that treat depression is what one has to do to become less depressed. If the drug works, then we have knowledge that either the drug was effective for the condition described or the placebo effect had an equal but not greater effect.
Other than that it's a condition one has to accept and live with or in the worst case scenario never come to terms with it and... well I think you get the idea. Unmedicated schizophrenics are pretty bad cases and non-compliant schizophrenics are worse...
There's a great movie that gives you a direct experience about how the condition can become manifest. 'God knows where I am' is the movie.
Thanks for the movie recommendation...Ill keep my eye out for it. I have roku so I can search for it.
My symptoms aren't hallucinations of any sort (thank God), rather excessive paranoia about my surroundings. I tend to think I'm hyper-vigilant, but that's not the same as paranoia which I experience daily.
Well, it's not always that simple. For some a drug to rebalance the brain is all one needs. For others, like me, it's just one factor that goes into keeping me upright. I don't think the ones prescribing drugs think that if the drugs don't "work" that its entirely the drug's fault.
That's just how psychiatry works. You keep on trying different drugs due to the incredibly complex nature of how the etymology of depression works. Today, we tend to have established antidepressants that have been proven ad hoc by time since their approval.
There are a couple of ways one can go about finding out which neurons to target, hormones to monitor, BDNF levels to raise, NMDA receptor antagonists to treat major cases, etc.
All of the above few known methods for treating depression resulted from trial and error, along with examining the brains of post-mortem victims of major depression (typically suicide victims). Otherwise, most progress is from the doctor-patient relationship and clinical trials conducted by pharmaceutical companies.
If one is 2., hostile to society, and would then be a revolutionary, then they would only be a revolutionary against any social order. This all goes back to my first post about how the majority of humans behave, and that being the norm for humans - being social, just as we define the normal behavior of all living things based on the commonality of the behavior among the species. Being antisocial is simply abnormal and we usually define abnormalities as an illness or something to fix in someone.
If someone possesses a trait that, if all members of the species possessed would mean the demise of the species - like being hostile to other members, then that would be sufficient to call that trait an illness.
That is completely ridiculous. If everyone was a full time writer, or a woman, or for that matter, a metal worker, the species would die out. But these are not illnesses.
If all the bees were queens, the species would die out, and if all the bees were workers, the species would die out, and if all the bees were drones, the species would die out. Therefore all bees are ill.
You seem to just like to be contrarian for the sake of it. :(
Just point to the way people use the words and drop the mike.
True it now becomes impossible to have an intelligent discussion about the concepts on the table... but look at your interlocutor objectively. Was there ever any chance of an intelligent discussion? If not then you have lost nothing.
http://www.npr.org/2013/05/31/187534467/bad-diagnosis-for-new-psychiatry-bible
If everyone was suddenly being born a female and there were no males being born, yes the species would die out and would probably be the result of some disease, or damage to our DNA.
The same goes for all bees being drones, or queens, etc. Something would be wrong and Natural selection would filter out the problem. It is a fundamental feature of life to procreate and if that doesn't happen, then one would argue that life isn't happening.
Quoting unenlightenedYou seem to just like to be obtuse for the sake of it.
Shouldn't the way people use words be logical? Aren't I pointing to the illogical ways people are using words? From my perspective, it is those people that are using words improperly, or conflating words like "asocial" and "antisocial", that aren't participating intelligently in this discussion.
I wish the history of the mental health (MH) profession was such that MH professionals came forward and said something like, "after objectively looking at homosexuality (using circumstances, experience, facts, etc) from a mental health perspective we can confidently assure humankind that homosexuality is within the realm of normal human behavior."
Again... not saying we need to get rid of the field of study. It just doesn't appear that the field of study is capable of much objectivity. I suppose we could just assume it's a relatively new field of study, and/or that it's more difficult than other fields of study, and cut them some slack.
I think psychology and psychiatry are both very much sciences, although I agree that they are less reliable than, say, physics and chemistry.
I think, though, that we are at a very early stage of our conceptual understanding of what mental illness is.
Just as there are particular traits involved in a disease like cancer, there are particular traits involved in a disease like depression. In cancer, the main trait involved is the uncontrolled and harmful division of cells or something like that (I'm the worst scientist or doctor).
In major depressive disorder, say, the dominant traits are something like low mood / sad affect and pervasive negative thinking. There are ancillary symptoms too, but that seems to be to be the essence of depression based on my own readings and my own direct experience of the illness.
As time goes by,I think the science will become much more reliable.
Every individual "out there" has, at all times, some condition/state that is not considered normal. But if we see a person walking with a limp, struggling to hear a sound, violently coughing, etc. we don't say that he/she is in any way "screwed up". We have compassion for him/her.
We recognize that some part of him/her is not functioning normally and we show compassion.
We must not really believe that mental illnesses are abnormalities, because a lot of people refer to them with words like "screwed up". Those words imply that, rather than suffering from symptoms of something that has gone wrong, a person is inherently defective, flawed, etc.
And "screwed up" is not a fact that can be confirmed by science. It is an attitude--an uncharitable attitude that sees people as less than human rather than as humans experiencing a variation of what all humans experience: suffering. If psychology is science, "screwed up" has no place in a discussion of psychology.
Read the work of David Smail. See his arguments about how psychological distress is the result of one's position in society, not something that originates internally. See his arguments about how clinical psychologists fail to help clients see the real source of their distress.
His internet publication Power, Responsibility and Freedom is a great place to start.
Psychiatrists prescribe medications. Non-psychiatrists don't.
I'm sure by "full time" he meant something along the lines of the standard 8 hours a day, 5 days a week.
Quoting unenlightened Most people are already full time workers in that sense and still have time to have sex and raise a family, so no, that isn't what he meant.
I'll have my own go at addressing this. What about being male and being female? If all members of the species were male, or if all members of the species were female, then that would mean the demise of the species. Therefore being male and being female are illnesses?
Good for you, un. I heartily agree that Smail was a fine man, and his website is still alive and kicking, but alas he isn't.
You read my post that you quoted about as wrongly and uncharitably as possible. None of what you say here goes against my position.
This seems like a bizarre thing to say. Plenty of patients are either cured or have their mental illnesses ameliorated via psychological and psychiatric treatment.
This seems like an impossible situation. How would a species even survive to make it to be an all male or all female species? There are species that are neither and can procreate just fine. Let's just say that if you are born different than the species you are part of and what makes you different would be a detriment to the species you are part of if they all had it (meaning that they wouldn't even be considered the same species), then it would be an illness to the survival of THAT species.
It is isn't it.
https://www.psychologytoday.com/blog/our-changing-culture/201510/are-mental-health-issues-the-rise
So, if psychology appears to fail as a science it's only because it's in the process of collecting data that'll vindicate/void their theories. The problem is made more difficult by the complexity of the subject; the prime difficulty being emotions and thoughts can't be quantified and thus the exactitude of mathematics can't be applied. Therefore, it's not surprising psychology lacks the rigor that is claimed by its cousin, biology.
It's easy to overlook important details when you're in the thick of something and hindsight is always 20/20. So, pay attention to the timeline - the beginnings, the progress, the successes and failures of psychology as a discipline. Even if it's not a science now, in the next few decades it may achieve that status.
The data has been around for a long time - as long as we've been around to collect it. The prime difficulty is that our psychology is radically altered by our psychological theories. If this happened in biology, it would be as though as soon as we discover that rabbits breed like rabbits, the all turn celibate.
So above, for example linked to some evidence that suggests to me the hypothesis that the scientific study of the psyche changes the psyche in particular ways; that it leads to objectification of the self and of others, and this tends to produce isolation, dissociation, anxiety, and depression.
What's your views on things like personality disorders and how they might affect social interactions in particular? Personality disorders, more so than anxiety disorders or depression, are manifested in the poor social interactions that manifest from those who may have these disorders. Thus, what looks like just someone who has abysmal social skills might have an underlying personality disorder. Of course, it may be that someone just has abysmal social skills. I guess when does one look deeper and when does one say that it is just a feature of this person but no underlying issue?
I see, the problem is a fundamental one - like trying to observe animal behavior crudely, unaware that the observer alters the behavior of the animals e.g. they may be taken as prey or predator. I wonder how animal researchers solve this issue? Can't we apply that to humans? Perhaps not, given our intelligence and impressionable nature, this problem multiplies manifold.
I'm sure this issue is a known problem to psychologists. Don't they have a solution? I'm asking because it invalidates all their work.
From another angle, psychology reveals harmful behavior e.g. biases, prejudices, fallacious thinking, etc. Knowledge of such aspects of the psyche and behavior modifications arising therefrom, seem to me, a positive thing. The study itself may become outmoded the moment it becomes public knowledge BUT its effects have been therapeutic. Don't we owe it to the diligent psychologist for continuing to work despite the flaw you mentioned?
From such a perspective, psychology is a highly dynamic field, requiring constant research and data collection because its data has such a short shelf-life. So, in my humble opinion, we can solve this problem in psychology by keeping pace with the data as it changes.
I'm not sure it's known at all. I fear it may be a bee confined entirely to my own bonnet.
Quoting TheMadFool
I don't think it is a positive thing at all. If you treat people as complex objects - objectively - then you learn how to manipulate them. So marketing and personnel management are where psychologists find a use.
But the real question is what such treatment teaches people, not just the subjects/objects of experiments, but the victims of the everyday work of psychologists in marketing etc - that they are malfunctioning computers. It's not just that the theory becomes outmoded, but that it negatively impacts the way people relate to each other, and the way they see themselves.
Clearly, a personality disorder can affect social interactions. This is always true because personality (good bad or indifferent) is that with which we interact in the world.
Quoting schopenhauer1
Oh, I don't know. It depends. I knew a guy, Eric, who was a paranoid schizophrenic. When he was feeling well, he was smart, charming, perceptive, and a pleasure to be with. BUT, when he was not feeling well (when he experienced intense fear and delusions) it was instantly obvious--even to a casual observer--that this fellow was not doing well on any level.
I don't have as much knowledge about personality disorder as I would like, and I don't have well developed theories about it.
We develop our personalities over time, along with all our other personal resources. Some disorders seem to be built in -- like schizophrenia -- while others -- like PTSD -- are a response to experience. Eric had developed a very pleasant personality and a brilliant mind as a young man. He was well educated and well read. I don't know when his symptoms of paranoid schizophrenia emerged -- I didn't know him as a young man.
Some people develop odd, eccentric, weird behaviors and affects from childhood on up. "Why?" is hard to say. I don't know. Determining when "oddness" or "weirdness" is diagnostically significant requires more knowledge than I have.
Quoting unenlightened
Does anybody get depressed or anxious about believing that" their mind is a computer", in some sense? It is a slightly "odd" feeling, I will admit. But so does the existential question "why is there something?" generate an odd feeling in me. I think the two feelings are similar existential ones. Is there a history of certain existential discourse ,per se, actually causing "isolation, dissociation, anxiety and depression"? (and not it just reflecting an already established mood or pathology). I say probably not.
There might be triggers as follows - somewhat arbitrary ones, epistemologically speaking, but perhaps sensible.
1) Constant unhappiness
2) Threatening others
It's a shorthand, don't take it literally. But what I am saying is that the methodological turn of scientific psychology is a turn to treat humans as objects rather than as persons. Thus it tends to dehumanise, and that leads to increasing mental illness. Nobody gets depressed by one sentence, but the dominant psychological theory at any period is a powerful cultural influence on individuals. The advertising industry is a powerful and inescapable influence designed by psychologists to manipulate through raising anxiety.
And you seem to be saying, (I think) that any theory, in principle is not worth having. Because I can't see how any theory does not tend to objectify.
I believe it is a science, with the caveat that it is a very young an underdeveloped science. Psychiatric science has a long way to go, although I believe it's made incredible progress since the time of say Freud.
"A disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury."
So, in essence, an illness or disease is a disorder that affects the functioning of a human being (or etc) that produces specific symptoms.
So psychiatry would be the science that studies diseases that affect the functioning of a human being's mentality.
Health and illness are normative concepts, right? Health essentially states that a well-functioning body ought to behave in certain ways, and a well-functioning mind ought to behave in certain ways.
In the case of the mind, the mental should generally produce states of relative (though not constant) happiness, enthusiasm for life, positive thinking, and the like.
When the mind spirals down into the opposite states for a pro-longed period of time, I believe an illness is present. Psychiatry is the science that sets about to restore mental unhealth to health.
I believe there are tried-and-true methodologies and treatments that have scienced-back efficacy. The research supports the notion that treatments like Cognitive Behavioral Therapy (CBT), certain medications like Paxil or Prozac, as well as alternative treatments such as mindfulness and self-compassion, can go a long way in restoring mental health.
I know this from personal experience, as I have recovered from a long bout of major depressive disorder and anxiety disorder using a combination of such treatments.
Psychiatry is far from an exact science, but I do believe it is a proto-science in its earliest stages, and one that can be quite helpful in finding solutions to mental un-wellness.