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

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

#51

Post by [deleted] »

umvi wrote: post #46
dragonwriter wrote: post #28

Earlier quoted context omitted.

> 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.

> No, it's not, it's a subset of physical illness. It's not even possible for it to be otherwise without magic. I think GP's point is that you can't determine a mental illness with physical characteristics/measurements. Can you diagnose schizophrenia with a blood test? X-Rays? Nope. Perhaps an MRI? Maybe, though AFAIK this still isn't really possible. With physical illnesses it's easy. Broken bone. Cancer. Viral infe…

[deleted]

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

#52

Post by wiry-bulb »

gmfawcett wrote: post #47

I wish I could remember the title and author, but this reminds me of an (unrelated) book on pain management, where the author's thesis is that most musculoskeletal pain is psychosomatic: you can essentially will yourself out of chronic pain once you accept this statement as fact. Does anyone recall the book I'm talking about?

http://www.neuroplastix.com/styled-4/aboutus.html

Maybe Dr. Moskowtizs. His technique is the subject of chapter 1 in Norman Doidge’s “The Brain’s Way of Healing”

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

#53

Post by eigenstuff »

coldtea wrote: post #16
TheOtherHobbes wrote: post #13

Earlier quoted context omitted.

This is fine as far as it goes, but some psychotic people really are dangerous. A percentage become murderous and violent, and criticising the admittedly poor state of psychiatric understanding doesn't make them less likely to harm themselves or others. Of course the problem is related to wider social issues about permissive violence. If one person murders another because of their delusions, it's a crime and a medica…

> This is fine as far as it goes, but some psychotic people really are dangerous. A percentage become murderous and violent Sure, but then again most non-psychotic people are as well. It's not like the majority of murders is done by psychotic people.

In fact, those with psychotic disorders are far more likely to be VICTIMS of violence than perpetrators. Psychosis comes in a wide variety of flavors. I have a psychotic disorder and have occasional psychotic episodes. It feels like my brain is short circuiting and my thoughts become too rapid fire and disorganized for me to do anything but stare into space and just ride it out and go to bed. Its pretty frightening to feel like you've lost control of your own brain like that if you don't know what's happening. About once a year or so I'll have a paranoid episode, I just get really combative and accusatory and start trying to pick (text, verbal) fights with my friends but fortunately it's so out of character for me that everybody can tell something is wrong. The next morning I'll wake up just fine and dandy like it never happened, minus feeling really embarrassed and apologizing profusely to whoever I was trying to pick fights with.

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

#54

Post by GuB-42 »

yellowstuff wrote: post #37
elbasti wrote: 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 book "The Emperor of all Maladies" doesn't put it in those exact terms, but makes it clear that essentially the same is true of cancer. Cancer is a symptom of many kinds of health problems, not a single disease that responds to a single treatment. If we understood bleeding as poorly as we understood cancer, then everything from R&D for better bandages to public campaigns to reduce gun violence would be lumped tog…

Cancer is a class of well identified diseases. Like a bacterial infection.

There are many types of cancer just like there are many types of bacterial infection. But they are both well identified. We can see the cancer cells and bacteria, and when they are gone, the patient is cured.

Mental illnesses are more like the "flu-like syndrome". The causes can range from leukemia to heroin withdrawal to a wide variety of viral infections like AIDS, the common cold, and of course, the flu. You can treat the symptoms with Tylenol but we can't really call that a disease, more like the symptoms of a yet undiscovered disease.

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

#55

Post by new12345 »

GuB-42 wrote: post #54
yellowstuff wrote: post #37

Earlier quoted context omitted.

The book "The Emperor of all Maladies" doesn't put it in those exact terms, but makes it clear that essentially the same is true of cancer. Cancer is a symptom of many kinds of health problems, not a single disease that responds to a single treatment. If we understood bleeding as poorly as we understood cancer, then everything from R&D for better bandages to public campaigns to reduce gun violence would be lumped tog…

Cancer is a class of well identified diseases. Like a bacterial infection. There are many types of cancer just like there are many types of bacterial infection. But they are both well identified. We can see the cancer cells and bacteria, and when they are gone, the patient is cured. Mental illnesses are more like the "flu-like syndrome". The causes can range from leukemia to heroin withdrawal to a wide variety of vir…

Cancer is no where close to "well identified disease". Bacterial infection is one as we understand what causes it and that's why we have been successfully able to bring down the number of bacterial infection cases by educating folks on how and what to avoid. Its not the case for cancer(or we intentionally ignoring the cause here) whose numbers are rapidly increasing every year.

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

#56

Post by AchieveLife »

elbasti wrote: 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…

> No. The we think "I've been diagnosed with a disease. (Sorry I'm being an a-hole|I won't go to your party|didn't get out of bed, I suffer from bipolar and there's no cure".

Straw man argument and incredibly insensitive. The proposed causation between diagnosis and excuse making behavior is ridiculous. People will make excuses regardless of their knowledge of a diagnosis. It's about what they _want_ to do and their level of comfort with confrontation.

Medicine will continue categorization because it assists with treatment. IMO, it's stigma like your pov that needs to be re-educated.

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

#57

Post by elbasti »

dragonwriter wrote: post #28
elbasti wrote: post #25

Earlier quoted context omitted.

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.

Until 1973, homosexuality was considered "mental illness", with diagnostic criteria in the DSM.

Then it was removed. What happened? Did it stop existing? No. Were homosexual individuals "cured"? No.

Quite simply, the psychiatric community decided that individuals with same-sex desires were not, _and never had been_ mentally ill. The illness was no more.

The same is not true of physical illness.

Different argument:

The diagnostic criteria for "mental illness" overlap. So it's possible to be diagnosed with say, ADD and "Bipolar type 2" and "generalized anxiety disorder".

Which is it? Which illness does the patient have? How does one decide? Which _physical_ mechanism is responsible for one vs the other two?

Physical illness has no such ambiguity.

Nobody knows. Because the map does not map to reality. It's like asking if a hot dog is a kind of sandwich. Maybe. Who cares. It's the wrong question.

Last example:

People suffering from grief/bereavement match many, if not all, the diagnostic criteria for "Depression". Are they depressed? Or are they merely grieving? The answer (if you're a psychiatrist) depends on which volume of the DSM you use (the latest one does not exclude bereavement from the diagnostic criteria).

Is there similar subjectivity with physical illness? No. So they are clearly categorically different kinds of diagnoses, and Thomas Szasz's argument is that for that reason we should not use the word "illness" to talk about these kinds of very real problems.

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

#58

Post by elbasti »

_bxg1 wrote: post #29
elbasti wrote: 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 elimi…

I completely agree and understand the defensive position. I don't think that Szasz (and certainly I'm not) saying that the condition/suffering/symptom's are not real; and I think that's why he regrets calling the book what he did.

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

#59

Post by elbasti »

AchieveLife wrote: post #56
elbasti wrote: 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…

> No. The we think "I've been diagnosed with a disease. (Sorry I'm being an a-hole|I won't go to your party|didn't get out of bed, I suffer from bipolar and there's no cure". Straw man argument and incredibly insensitive. The proposed causation between diagnosis and excuse making behavior is ridiculous. People will make excuses regardless of their knowledge of a diagnosis. It's about what they _want_ to do and their…

Agree it sounded (and probably is) insensitive. I think a different comment expressed this more clearly, by saying

"that there's a certain fatalism that one experiences once they've been "diagnosed" with mental illness."

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

#60

Post by dang »

austinjp wrote: post #12
dang wrote: post #8

Earlier quoted context omitted.

Can you please stop posting rants to HN? They're not what this site is for, and you've done it a lot, unfortunately. Your non-rant comments are fine. HN is for intellectual curiosity—see https://news.ycombinator.com/newsguidelines.html .

Personally I read their comment as impassioned rather than ranting.

What I meant is that it was unsubstantive (i.e. contains little information) and calls names. That's what makes it a bad comment for HN.
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