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A psychiatrist who didn’t believe in mental illness (2013)

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21–30 of 74 posts

Re: A psychiatrist who didn’t believe in mental illness (2013)

#21
post #11

Earlier quoted context omitted.

There's one critical nuance here on the physiological issue. Physiological differences imply that an issue is a product of biological, physical, or other sources outside of individual choice or mental mechanisms, but this is not necessarily so. A great example of this is the difference between amateur and master chess players. An entirely different area of the brain is used when masters analyze a position than when a…

Got a link (or name) for that chess brain mapping study? Sounds interesting? (sorry, tangent)

There are an immense amount. The chess player's brain is apparently a popular topic of study! Here's a Google Scholar link for 'chess brain' which turns up lots of relevant studies: https://scholar.google.com/scholar?q=chess+brain

Re: A psychiatrist who didn’t believe in mental illness (2013)

#22
post #21

Earlier quoted context omitted.

Got a link (or name) for that chess brain mapping study? Sounds interesting? (sorry, tangent)

There are an immense amount. The chess player's brain is apparently a popular topic of study! Here's a Google Scholar link for 'chess brain' which turns up lots of relevant studies: https://scholar.google.com/scholar?q=chess+brain

Know which of these deals specifically with the differences between amateur and titled players?

Re: A psychiatrist who didn’t believe in mental illness (2013)

#23
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

> The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying."

Even at the more generous level of “mental illness is different from physical illness” it is wrong, and dangerously so.

> The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness.

This has never been what “illness” means; illness (both in general and in specific named instances) is often recognized and identified long before causes.

> The conditions which we call mental illness don't have a knowable cause.

They don't usually have a known cause. That they don't have knowable cause is an unwarranted conclusion. Plenty of physical illness don't have known mechanisms, and most of those that do were noticed and given names as illnesses before (sometimes centuries before) the mechanism was identified. This doesn't mean they don't generally have knowable causes, as is evident from the ones whose causes were later learned.

> Illnesses should be hypothetically curable.

That doesn't even remotely follow. Having a know cause doesn't imply curability because causes are not necessarily reversible.

> I think often the hacker news crowd forgets how ill-informed most of the world is

True. It's easy to forget that many people do not even realize that pattern matching on symptoms is how much diagnosis of physical illness is done, and that even where causes are known it's often not worthwhile (and sometimes not practical) to actually test for them directly.

Re: A psychiatrist who didn’t believe in mental illness (2013)

#24
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

I haven't read the book, but from your summary it sounds like the argument is that for illnesses that we don't yet understand well enough to cure or even have a potential cure, we should use a different word. That sounds pedantic.

There's many non-mental diseases that we don't yet understand fully enough to know how to cure completely. There are many diseases where there are varied causes of the disease, where we are still learning these causes, and still learning what could be a cure. Should all these not be called an illness too?

The disease like this that I'm most familiar with is Cystic Fibrosis. 35 years ago, doctors had no idea what caused it. Now we know it is genetic. However, the disease is caused by many different possible combinations of gene mutations and we're still discovering more that can cause it. There's currently over a thousand gene mutations that cause Cystic Fibrosis. While a lot of progress in slowing disease progression has been made, there is no cure. We're not even certain about what would be needed for a full cure as science is still learning about the full extent of the disease. Cystic Fibrosis does not meet your criteria for an illness either. Should we not call it as such? I think that would be absurd. It is clearly an illness.

Just because we don't fully understand a disease yet doesn't mean it can't be called an illness. If you want to come up with a new word that can clarify the fact that we don't fully understand it yet, I guess that's fine, but I don't like confusing people by trying to deny the common understanding of a word.

Re: A psychiatrist who didn’t believe in mental illness (2013)

#25
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

> The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying." Even at the more generous level of “mental illness is different from physical illness” it is wrong, and dangerously so. > The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. This has never been what “illn…

But mental illness _is_ different from physical illness. That's the whole point.

The dangerous thing is to presume that's not true. Or even worse: to lie about it. The phrase "chemical imbalance" comes to mind. Complete and utter fabrication of a physical cause.

It may be that a physical cause is discovered for some conditions which today are considered "mental illnesses"... say, schizophrenia. Well, when that happens it will stop being known as a mental illness and just a physical illness.

Re: A psychiatrist who didn’t believe in mental illness (2013)

#26
post #24
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

I haven't read the book, but from your summary it sounds like the argument is that for illnesses that we don't yet understand well enough to cure or even have a potential cure, we should use a different word. That sounds pedantic. There's many non-mental diseases that we don't yet understand fully enough to know how to cure completely. There are many diseases where there are varied causes of the disease, where we are…

> but I don't like confusing people by trying to deny the common understanding of a word.

I think that's actually the crux of the argument. The phrase "mental illness" IS the perversion of a common understanding of a word. When people hear "illness" they think "thing that is broken". Is a runny nose an illness? No, the flu is an illness.

I don't think it's about whether we fully understand the cause or not; I think it's about whether or not we think there probably is a single, physical cause.

So we absolutely should call Cystic Fibrosis an illness even if we don't know the cause, because we think there probably IS one. And heck, there may be two causes! And then... well, then it would be TWO illnesses with similar symptoms, not one.

At this point I'm straying from the book because I don't remember it too well, so this is editorializing: I don't think that holds for many mental illnesses.

"Depression"--do we think there's one, or few, underlying physical causes of it? Highly doubtful. And we know it's highly doubtful because the treatments that make the symptoms go away are so varied in their mechanisms of action and effectiveness. Exercise. Sunlight. Changing jobs. Medication. Time. Talk therapy. All these things "work", to some degree or another, but the odds that they are targeting the same underlying, malfunctioning, physical mechanism are very slim. So one would say "depression is not an illness, the same way a runny nose is not an illness. It's a pattern."

Re: A psychiatrist who didn’t believe in mental illness (2013)

#27
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

In The Manufacture of Madness: A Comparative Study and of the Inquisition and the Mental Health Movement, Szasz goes into the history of Psychiatry and how it evolved out of and is the modern day equivalent of the Inquisition.

After the Enlightenment, Church was separated from State, but the need for the subjugation of thought criminals remained. In fact, the first psychiatrists asserted that the witches of the Inquisition were in fact just insane people.

The Soul was rebranded as the Mind, and heretics were rebranded as insane while the truth about the mind remained a mystery.

Re: A psychiatrist who didn’t believe in mental illness (2013)

#28
post #25

Earlier quoted context omitted.

> The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying." Even at the more generous level of “mental illness is different from physical illness” it is wrong, and dangerously so. > The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. This has never been what “illn…

But mental illness _is_ different from physical illness. That's the whole point. The dangerous thing is to presume that's not true. Or even worse: to lie about it. The phrase "chemical imbalance" comes to mind. Complete and utter fabrication of a physical cause. It may be that a physical cause is discovered for some conditions which today are considered "mental illnesses"... say, schizophrenia. Well, when that happen…

> But mental illness _is_ different from physical illness.

No, it's not, it's a subset of physical illness. It's not even possible for it to be otherwise without magic.

Re: A psychiatrist who didn’t believe in mental illness (2013)

#29
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

As someone who has depression and anxiety, I can definitely testify that there's a certain fatalism that one experiences once they've been "diagnosed" with mental illness.

However. There's a dangerous perspective held by a conservatively-minded minority of more people who say mental illness "isn't real" and you just need to "suck it up" and "have stronger character", and it amounts to victim-blaming. Arguing to eliminate the insanity plea sounds very much along those lines, regardless of what the book said. Whether the doctor in question falls into that camp or not, it's a dangerous line to walk.

Personally I think of mental illness as analogous to obesity: it is simply a current state of being, and a spectrum at that. But it's important not to let it slide outside the realm of medicine and of having factors outside of the victim's control. People have fought long and hard for that ground and it's understandable they would feel threatened when someone (even just seemingly) tries to undercut it.

Re: A psychiatrist who didn’t believe in mental illness (2013)

#30
post #19

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is sayi…

Sometimes there is a specific physical cause:

https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2...

The situations with those two patients is revealing - the same genetic condition underlying two different diagnoses. The same treatment. The fact that not everyone with those conditions has the same defect or can benefit from that treatment. The field really is in its infancy. But sometimes there really is a physical cause and treatment.

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