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The Battle to Define Mental Illness (2010)

wired.com

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Re: The Battle to Define Mental Illness (2010)

#4

Post by Myrmornis »

rtb wrote: post #2

EDIT: this was an attempt to get past the paywall, but looks like it's javascript driven, so this archived version breaks after a moment, unless you disable js https://web.archive.org/web/20240324050221/https://www.wired...

Thanks. Text is at https://pastebin.com/LTbtPCsV.

Re: The Battle to Define Mental Illness (2010)

#5

Post by neonate »

rtb wrote: post #2

EDIT: this was an attempt to get past the paywall, but looks like it's javascript driven, so this archived version breaks after a moment, unless you disable js https://web.archive.org/web/20240324050221/https://www.wired...

https://archive.ph/XQzIG works, for those who can access it

Re: The Battle to Define Mental Illness (2010)

#6

Post by deanresin »

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm" offer the species a safety net should conditions change rapidly. Should we really be trying to herd everyone back to a norm?

Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete.

Re: The Battle to Define Mental Illness (2010)

#7

Post by triumphblr »

deanresin wrote: post #6

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

> Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete.

That's a fundamentally reductionist perspective and assumes everything is biological in its etiology? For example, you could say we don't need a justice system once we have the biology worked out, or arts, or sports. At some level it's a fundamentally authoritarian argument as well: if you have the biology worked out, what's to keep the holders of power from altering people to whatever norm they want? Having the biology completely worked out won't magically reveal natural disorder states.

The biological explication of a behavior doesn't obviate the need to have some norm for intervention decisions. Biology doesn't have norms, psychosocial systems have norms. Non-behavioral medicine is still full of ethics. And that doesn't even get into issues about whether you could ever identify any biological substrate as synonymous with a human experiential state or history.

Re: The Battle to Define Mental Illness (2010)

#9

Post by 0xcde4c3db »

Frances's concerns definitely aren't wrong on the whole, but I feel like he's not seeing the forest for the trees. This ultimately isn't just a question of whether this or that DSM revision is helpful. The patterns of the mental health establishment of the 21st century are oddly reminiscent of where physics and chemistry stood ca. the mid-19th century. Legitimate advances are being made, but most of the tools are still unreliable and many of the theories still fairly reek of superstition and magical thinking. Practitioners are frequently defined more by which tradition or thought leader they adhere to than by their specialization in established subfields.

It's not a great situation, and I don't see many signs that it's improving. A great deal is said about "awareness" and "stigma". Phrases like "get help" have been around long enough to turn from hero to villain (i.e. from an earnest plea to close friends or loved ones to a passive-aggressive dismissal of strangers). Who's seriously talking about materially improving the situation instead of promoting an allegedly more "correct" theory? Hell if I know. Please tell me if you do.

I guess I broadly agree with the article author that the DSM process is "caught between paradigms" and has "no obvious way forward", but that's a profoundly unsatisfying place to find common ground.

Re: The Battle to Define Mental Illness (2010)

#10

Post by 0xcde4c3db »

triumphblr wrote: post #7
deanresin wrote: post #6

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm"…

> Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete. That's a fundamentally reductionist perspective and assumes everything is biological in its etiology? For example, you could say we don't need a justice system once we have the biology worked out, or ar…

The shape of that argument works equally well for unduly centering psychosocial mechanisms, though. That's how we got pseudoscientific garbage like the "refrigerator mother" theory of autism, the "anal retentive" theory of OCD, "tabula rasa" theories of social behavior, and so on.

Maybe what I'm getting at is that double standards abound when it comes to mental illness, and it's fucking exhausting work to even attempt to avoid them. I'm not blaming anybody (least of all you). I suppose it's just one of those Lovecraftian/Cronenbergesque sorts of things where once you see it, the world never quite makes sense again.

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