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A difficult case: Diagnosis made by hallucinatory voices (1997)

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Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#21
Imagine event that could happen once in a million days (once 2700 years) , once in in 10 million days (once in 27,000 years) and so on.

When you have hundreds of millions of people, these events happen several times per day.

The patient had tumor in her head causing voices. The voices made right call. Voices are not random. They come from the same brain that is worried about being crazy or sick.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#22
post #12

This reminds me of a quote from Mark Cuban: “Unless you have a reliable, duplicatable, scalable and consistent way to bring potential customers in, you don’t have a business. You have a hobby!” I think it’s very similar in science. It’s difficult to argue that this is science because it seems impossible to design a repeatable experiment which yields the same outcome every time.

Welcome to psychology.

Turns out, it's unethical to design "repeatable experiments" when it comes to the human existence, which is why we have to make do with less rigorous forms of science. That doesn't mean it isn't science, it just means it's harder to draw solid conclusions than "just run a repeatable experiment".

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#23

Earlier quoted context omitted.

This isn't science. "Multiplicity" isn't real. The Wikipedia article on disassociative identity disorder ("multiple personality disorder") is much more extensive, and while some psychiatrists consider that to be clinically real, the majority don't. There's no evidence of any of it being anything more than an act. It's all crackpot nonsense.

I don't know too much about it. But I knew somebody who said they had it and it turned out to be a more ordinary psychosis that they eventually had treatment for. Seems to me that if you are correct that it doesn't exist, that there can still be people who genuinely believe they have it and may have another illness. Those people deserve better than to be dismissed as crackpots. Like maybe to approach it as one would…

Let me clarify that I wasn't referring to the patient as a crackpot. I fully believe that there are people suffering from mental illnesses with frightening and confusing symptoms, including auditory hallucinations and hearing voices. I do think that the idea of multiple personalities is a "crackpot theory" that some mental health professionals are proponents of. I don't think a plurality of psychiatrists accept the notion of independent personalities. Some of them do, and push the notion, to the detriment of their patients. I'm referring to that when I say "crackpot". Maybe I'm wrong; I'm no professional. But I'm in good company in being critical of the idea. Hyperbolic, to be fair.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#24
post #13

Simplest explanation is usually the correct one(Occam’s razor). In this case i would agree with the second or third explanations. She probably made it up. Similar thing is going on with resignation syndrome in Sweden, where refugee children are pretending to be be in coma/sleeping because this prevents Sweden to send them out of the country. In this case the woman wanted to get free treatment from NHS. Or maybe this…

> She probably made it up. [...] In this case the woman wanted to get free treatment from NHS. Or maybe this whole story is made up.

Per the article, that is a pretty unlikely explanation, given the vacation and her entitlement to free treatment regardless or the psychiatric eval.

The more likely explanations are either that the story is made up by the doctor, in whole or in part; or the 3rd explanation of the article, that prior knowledge for the woman, along with the tumor itself and different kinds of unpleasant sensations, led to the psychiatric symptoms focusing on the idea of a brain tumor.

EDIT:

> Similar thing is going on with resignation syndrome in Sweden, where refugee children are pretending to be be in coma/sleeping because this prevents Sweden to send them out of the country.

Reading a bit about this, it seems that the Swedish health authorities who actually investigated these children believe that this is a real condition (whether a novel condition or some form of psychosis or depression), so I'm not sure why you are so confident in asserting that it is an obvious ploy.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#25

As I was reading this I immediately went for the third explanation given, or a similar variant. One possible take on it is that the tumour made her plural/multiple. Then her new members wondered where they came from and came up with the tumour explanation, researched treatment, and communicated it back to her main self. Read this if you haven't heard about plurality: https://en.m.wikipedia.org/wiki/Multiplicity_(psyc…

This isn't science. "Multiplicity" isn't real. The Wikipedia article on disassociative identity disorder ("multiple personality disorder") is much more extensive, and while some psychiatrists consider that to be clinically real, the majority don't. There's no evidence of any of it being anything more than an act. It's all crackpot nonsense.

> while some psychiatrists consider that to be clinically real, the majority don't

Given its inclusion in the DSM-5, I would venture to say that the opposite is true - that the majority (or at least, the majority of the more prominent psychiatrists) do believe it is a real condition.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#26

Earlier quoted context omitted.

This isn't science. "Multiplicity" isn't real. The Wikipedia article on disassociative identity disorder ("multiple personality disorder") is much more extensive, and while some psychiatrists consider that to be clinically real, the majority don't. There's no evidence of any of it being anything more than an act. It's all crackpot nonsense.

"It's all crackpot nonsense" isn't a very good argument when it comes to the human brain, now is it? That sounds like the same class of garbage argument that transphobes use to claim trans people aren't real. You can call it whatever you want, but DID is indeed recognized in the DSM-5 and fits the OP story, and the disorder vs neurodiversity argument is largely tangential to the question of whether the condition exis…

> DID is indeed recognized in the DSM-5 and fits the OP story

I'm not sure that it fits the OP story, though, at least at is told. As far as I understand, DID would be recognizable to others, it would not be purely perceived as a hallucination by the patient. Even if she were not aware of this, her husband or others around her would have reported behavioral changes, presumably.

Otherwise, I tend to agree with what you are saying.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#27
post #12

This reminds me of a quote from Mark Cuban: “Unless you have a reliable, duplicatable, scalable and consistent way to bring potential customers in, you don’t have a business. You have a hobby!” I think it’s very similar in science. It’s difficult to argue that this is science because it seems impossible to design a repeatable experiment which yields the same outcome every time.

If you were right, science would be limited to designed experiments. The scope of science is broader, and collecting information about rare cases and studying them, even when they can't be predicted ahead of time or artificially induced, is absolutely a part of science.

By the logic you stated, seismology or volcanology would not be real sciences either, as earthquakes and volcanic erruptions can't be repeated with the same outcome each time.

Now, the article does seem to light on clinical details, and has a few personal flourishes that detract a lot from its use as a basis for a future study of similar cases, so I don't disagree that it's not really a scientific article, but the reasons are more nuanced. Well-written case studies are absolutely a valid scientific tool. This one reads more like an anecdote than a case study, though.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#28

Earlier quoted context omitted.

"It's all crackpot nonsense" isn't a very good argument when it comes to the human brain, now is it? That sounds like the same class of garbage argument that transphobes use to claim trans people aren't real. You can call it whatever you want, but DID is indeed recognized in the DSM-5 and fits the OP story, and the disorder vs neurodiversity argument is largely tangential to the question of whether the condition exis…

> DID is indeed recognized in the DSM-5 and fits the OP story I'm not sure that it fits the OP story, though, at least at is told. As far as I understand, DID would be recognizable to others, it would not be purely perceived as a hallucination by the patient. Even if she were not aware of this, her husband or others around her would have reported behavioral changes, presumably. Otherwise, I tend to agree with what yo…

The thing is fitting psychological conditions into neat little boxes is just a convenient diagnosis mechanism; human brains don't have on/off switches for different conditions, and actual presentations vary. So it's entirely reasonable that her behavioral changes (which could be as minor as looking up certain things on the internet) were not noticeable to others.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#29
post #9

I simply don't believe this. The implication is that some external knowledgable entity communicated with the patient. There's no way to prove what really happened, and in the absence of any evidence to the contrary, the easiest explanations are that the entire anecdote is fabricated; that someone was communicating with the patient through normal means and due to illness she interpreted it as a hallucinatory voice; or…

That's not the easiest explanation, it's just more convenient for you. Burde of proof is on the accuser, you can't prove they fabricated or hallucinated and no one can prove their experience to you. If they learned new information with no prior visits to any one capable of diagnosing them then the easiest explanation is their experience was real, especially give that this phenomena has been observed in other historic…

I would be careful of playing hardcore skeptic when it comes to the brain.

You can heal someone by giving them sugar pills, that makes no sense (said a straw-man i just built) - yet placebo effect is a reality. As a matter of fact placebo take place even if you tell patient that they are given a sugar pill that has no effect on them (though effect is lower).

We are not master of our brain.

There are a lot of things happening inside that we are not aware of or only vaguely. Like split brain patients show symptoms of possibly two entities with separate choices on given questions.

Also consider tuplas, which are created entities that are separate from yourself living gin your brain. Those I believe were first described by Buddhist monks.

And the whole multiple personality disorder. I remember reading article about a person that was blind when one personality was in charge. Theirs pupils would not respond to light like a blind persons.

Sure there is no definitive answer here, but saying everything is fake and you need hard evidence is not getting us any closer to the truth.

Re: A difficult case: Diagnosis made by hallucinatory voices (1997)

#30
post #12

This reminds me of a quote from Mark Cuban: “Unless you have a reliable, duplicatable, scalable and consistent way to bring potential customers in, you don’t have a business. You have a hobby!” I think it’s very similar in science. It’s difficult to argue that this is science because it seems impossible to design a repeatable experiment which yields the same outcome every time.

If you were right, science would be limited to designed experiments. The scope of science is broader, and collecting information about rare cases and studying them, even when they can't be predicted ahead of time or artificially induced, is absolutely a part of science. By the logic you stated, seismology or volcanology would not be real sciences either, as earthquakes and volcanic erruptions can't be repeated with t…

Science is the process that makes our cultural representations of the world match the world as it can be observed and measured.

Provided the author is otherwise trusted, even anecdotes add to the scientific corpus. "Hey, I saw this" is IMO valid science, even if a more thorough examination would have been better.

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