A sociological theory of mental illness
Today we live in a world of representations. Just take a look at any modern, developed city: big images, vivid and oversaturated colors, lots of advertising, instant gratification. A world of images mediated by people. It has reached such an apex that this has affected the real of the individual in such a way that he also becomes a representation for himself, an image, an abstract, and this is the fundamental basis of all psychoanalysis.
In psychoanalysis the person in the present, in the session, is an abstraction of the person in the past, all his feelings, thoughts and emotions are inductive, and so existence itself carries this thick layer of abstraction by which nothing is really felt or understood except as a relation of the notion he, the person, has of himself and the discrepancy between that and what he thinks he ought to realize.
In a sense, he is reduced to an abstraction that destroys at the root his sense of intuition and self-confidence and reduces him to the mere level of affects and deterministic behavior.
Thus, in a world mediated by images, he is reduced to the lowest level: an affect.
Most people are quite sane and therefore very capable and totally self-sufficient. But by increasing the distance between your intuition and your experience of the world, we destroy the tools you need to be self-sufficient.
Most people are healthy and therefore are not, as is commonly thought, a product of their past or of a mental condition that inhibits them from self-realization. The very idea of assuming oneself to be something that needs to be "fixed" or "corrected" is the disease of the modern world of abstractions.
What I find particularly interesting is the choice of language; words [...] have reached such a pernicious level of influence that they have no real or useful clinical meaning. We are all a bit narcissistic and lonely but not by virtue of our past, but by virtue of the collective. What does the invention of the automobile do for a society? It creates roads, highways, interstate travel, connects, yes, but also distance.
And it is precisely this distance (sociological and moral) that cuts people off at the knees. The addict is a victim of his addiction, but he is also fully responsible and knows it. Otherwise, he could have taken his own life, condemned to vice and mediocrity. But he does not do so, precisely because above the fear [of death] he still carries the core of hope, indispensable for every change and every nature of self-sufficiency. He is not a victim of vice, but of his own responsibility.
And it is precisely this weight that drags him to his pacifying behaviors, which we, for lack of empathy simply label as pathological. It is this vice that I detest so much that turns people into a means of psychological self-satisfaction and mental masturbation.
But this is a symptom of a much bigger problem; just as it is for the addict, so it is for society. The lack of religion has turned scientific progress into a cult, based not on empiricism, but on skepticism. That is to say: distrust. That is why it is indispensable for members of Alcoholics Anonymous to adopt the step of faith in a higher power. Most people are born into a lack of resilience, so this faith centers their spiritual energy outside themselves, that is, it is transcendental and frees them from the yoke of their immanence.
Precisely this very faith they place in Christ is an abstraction of the willpower they initially placed in themselves at the moment they came to their first encounter.
Their self-confidence has escaped the pressures of the will and has taken on a more sublimated form, free from necessity and precisely free from the world of images and abstractions to which their very human essence had been subjected.
What most people need, therefore, is not to be fixed, but to be understood. And it starts by attacking the very institutions of Freudianism and the very arrogance and vileness that stinks so much even in their own physiognomy. His attitude is a cancer to that people who struggle with real and palpable problems in the present and not in some distant fixed trauma of the past that if people knew about, would only be as strong as any other memory.
In psychoanalysis the person in the present, in the session, is an abstraction of the person in the past, all his feelings, thoughts and emotions are inductive, and so existence itself carries this thick layer of abstraction by which nothing is really felt or understood except as a relation of the notion he, the person, has of himself and the discrepancy between that and what he thinks he ought to realize.
In a sense, he is reduced to an abstraction that destroys at the root his sense of intuition and self-confidence and reduces him to the mere level of affects and deterministic behavior.
Thus, in a world mediated by images, he is reduced to the lowest level: an affect.
Most people are quite sane and therefore very capable and totally self-sufficient. But by increasing the distance between your intuition and your experience of the world, we destroy the tools you need to be self-sufficient.
Most people are healthy and therefore are not, as is commonly thought, a product of their past or of a mental condition that inhibits them from self-realization. The very idea of assuming oneself to be something that needs to be "fixed" or "corrected" is the disease of the modern world of abstractions.
What I find particularly interesting is the choice of language; words [...] have reached such a pernicious level of influence that they have no real or useful clinical meaning. We are all a bit narcissistic and lonely but not by virtue of our past, but by virtue of the collective. What does the invention of the automobile do for a society? It creates roads, highways, interstate travel, connects, yes, but also distance.
And it is precisely this distance (sociological and moral) that cuts people off at the knees. The addict is a victim of his addiction, but he is also fully responsible and knows it. Otherwise, he could have taken his own life, condemned to vice and mediocrity. But he does not do so, precisely because above the fear [of death] he still carries the core of hope, indispensable for every change and every nature of self-sufficiency. He is not a victim of vice, but of his own responsibility.
And it is precisely this weight that drags him to his pacifying behaviors, which we, for lack of empathy simply label as pathological. It is this vice that I detest so much that turns people into a means of psychological self-satisfaction and mental masturbation.
But this is a symptom of a much bigger problem; just as it is for the addict, so it is for society. The lack of religion has turned scientific progress into a cult, based not on empiricism, but on skepticism. That is to say: distrust. That is why it is indispensable for members of Alcoholics Anonymous to adopt the step of faith in a higher power. Most people are born into a lack of resilience, so this faith centers their spiritual energy outside themselves, that is, it is transcendental and frees them from the yoke of their immanence.
Precisely this very faith they place in Christ is an abstraction of the willpower they initially placed in themselves at the moment they came to their first encounter.
Their self-confidence has escaped the pressures of the will and has taken on a more sublimated form, free from necessity and precisely free from the world of images and abstractions to which their very human essence had been subjected.
What most people need, therefore, is not to be fixed, but to be understood. And it starts by attacking the very institutions of Freudianism and the very arrogance and vileness that stinks so much even in their own physiognomy. His attitude is a cancer to that people who struggle with real and palpable problems in the present and not in some distant fixed trauma of the past that if people knew about, would only be as strong as any other memory.
Comments (55)
Meanwhile, I will take issue with this.
Quoting Abdul
Most people are pretty fucked up and miserable, and no one at all is self sufficient. Just in order to communicate this message to you, for example, I require a whole army of assistants to nurse my infant self, teach me to read and write, put food on the table and a roof over my head and construct a communications network and this electronic device on which I am typing. None of this would I be remotely capable of doing on my own. Not to mention your own self that has been the provocation of my current thoughts.
Self-sufficiency is a dangerous fantasy, that is widely promoted, with false corollary that to fail to be (in the imagination) self sufficient is an illness and a loss of contact with reality.
:100:
Agreed. But surely people exist on a spectrum of self-sufficiency, especially once they reach adulthood? I mean we could give "self-sufficiency" a stipulative definition of, say, "the degree to which one can currently maintain oneself absent outside aid", as opposed to the commonly held definition of total self-sufficiency? You would agree that the less aid you receive and the more you manage to sustain yourself independently, the more self-sufficient you are, right? Even if you are not totally self-sufficient?
I have no theory, I only propose that psychoanalysis has done more wrong for the average person and it shouldn't be a first place resource except for those who need it. People can overcome more things than they believe they can, but our market economy makes them a product or a means and not a participant of their own well-being.
I do think religion can be very helpful to people, but not for this particular solution. As you noted, Quoting Abdul
Exactly. I see it on social media and culture. "I have OCD". No you don't. OCD is a crippling compulsion that is in no way reasonable. Do you wash your hands 10 minutes every day on the dot to the point your hands are bleeding and raw? Then you don't have OCD. You have an attention to detail, order, and habit, which is part of the human spectrum.
The problem is medicalized terms that represent crippling deficiencies, have been relegated to personality differences that people are uncomfortable with. The psychology industry makes bank off of it, and well meaning psychologists are trying to make people's lives better. Being sad is not depression. Not moving from your bed for hours after you wake up is. Popular culture looks for what is wrong with us, when it should be celebrating our differences.
Compound this with a for-profit medicalized industry, and we're marketing pills to people who are quite healthy, have no problems working and taking care of themselves, but are sold a magic pill to "make life better". This especially hits the youth hard. You have teenagers dealing with normal stresses and fears and thinking its "anxiety". A diagnosis becomes an excuse for poor behavior that you could easily overcome. Its definitely a problem.
The psychology industry has people who understand this as well. They want psychology to emphasize less what is wrong with people, and more what is right. As long as there is money to be made however, and people are more willing to look for an excuse for what's wrong with them instead of accepting that life is going to have struggles you have to overcome yourself, I don't see it changing anytime soon.
Sure. If you don't use the roads, or the shops, or the internet, or oil products, or imports, etc, you can come close to self-sufficiency (neglecting your total dependence on the environment).
[quote=Karl Sagan] If you wish to make an apple pie from scratch, you must first invent the universe.[/quote]
Psychiatry isn't psychoanalysis. Psychoanalysis is a very old fashioned approach, practiced by a handful of boutique, middle-class therapists.
For the most part psychiatry is built around the client's needs, around robust diagnostic criteria.
Your concern is perhaps more about the wellness and psychology industries that are not generally connected to psychiatry and are closer to Oprah Winfrey than Freud.
Like religion, which says we are all sinners who need god to be saved, psychology can sometimes fall into the trap of saying we are all bungled and need insight through treatment.
This is a very complex field, full of great and some terrible work. The psychiatrists I have worked with over the past 30 years (in public mental health) generally dislike psychology and are not especially tolerant of the self-help industry. They would rather people develop their own skills and resilience than make them dependent upon theories or ongoing counselling.
Psychiatry is of course poorly understood and one of the great bogeymen of popular culture and many people are incapable of considering the subject rationally ( also like religion) There have been some spectacular examples of poor practice and oppression from some sections of the mental health community, as there have been in many professions.
Quoting Abdul
Most psychiatrists I have worked with would agree with you that most people do not require their help or any treatment.
:up: It seems to me, (Abrahamic / Dharmic) religions are just Bronze Age variations on psychoanalysis memorialized in Iron Age manuals and rituals.
There are physiological differences between different brains and how theyre wired but at the same time all human beings deserve to be treated with dignity and respect and as such the choice of treatment whether it be therapy or medication should remain with the individual rather than the state unless of course such an individual has committed a crime in which case its up to the justice system to deal with.
Life is hard, no doubt and we all face different problems and challenges in our day to day lives and individuals have different capacities for handling the problems that life can present depending on the level of resilience each person posses they may sometimes need help from others.
I think disorders of the mind are purely cognitive rather than physiological because thought is intangible which means that modern medicine when it comes to treating such disorders largely fails as they mostly have a sedative effect and turn individuals into docile zombies rather than cure anything.
Quoting Tom Storm
I think this is the main issue, diagnosis, which presents a problem because we cannot access the patients brain to see how they think but we infer from dialogue and observation which brings in an element of subjectivity and possibly bias.
Quoting Philosophim
The real issue with psychology is that it tries to treat non-organic problems organically that is through medication rather than other more reliable methods such as CBT for example. It makes too many assumptions about the workings of the brain by trying to simplify it. Mental health problems are not located in the brain but in how we think which is purely cognitive. In doing so psychiatry/psychology does more harm then good, neuroscience is in its infancy barely able to understand what gives rise to consciousness let alone provide any practical solutions to mental illnesses.
Im not sure whether having faith in God helps this matter but I dont think human beings have the right to meddle with another human beings brain through well meaning medication because the way such medicines work is not by altering thought procceses at all but mostly alter brain chemistry via sedation.
On the issue of religion if it provides comfort and relief and strength to individuals experiencing mental unhealth then Im all for it but on the flip side it can also cause damage if they dont take responsibility for their actions.
Quoting Tom Storm
Are you trying to make my point for me? :wink:
Quoting tim wood
Not the most useful question - rhetorical and disingenuous I assume, given the kool-aid smear? Wouldn't it depend upon your reason and the context for engaging a psychiatrist? If you are experiencing psychosis or delusions or bulimia, or suicidal ideation or acute paranoia or chronic addiction, or if you're trying to cope with a physical decline alongside a terminal illness, you might need one to help diagnose, treat and support the management of your issue.
Maybe you're more curious about psychiatrists in private practice who provide counselling or psychotherapy (analytic or otherwise) to wealthy neurotics? There's plenty of shit on the internet about that, good and bad.
You get, in most circumstances, "the medical model". This consists of a history, interpreted by the expert to form a diagnosis, followed by a recommendation of treatment.
The medical model is what this thread is questioning, and suggesting be replaced with a sociological model, such that mental distress arises from a person's relationships, to the environment and particularly to significant others and various 'authorities'. One of those relationships is that between the person and the psychiatrist. One can look at the power relations involved and consider what about the relationship might tend to confirm or disconfirm the person's feelings of distress - of, for random example, persecution.
There is definitely something wrong, that's not in dispute. The medical model is that there is something wrong with the patient; the social model is that there is something wrong between the person and their environment.
An example, Mr X goes to the doctor suffering from depression. says he hasn't been depressed before but the last year he's feeling down unmotivated. He used to be a skilled steel worker but he got laid off two years ago and hasn't been able to find a job. He feels useless, the house is about to be repossessed, his wife has left him. The social diagnosis is that he is suffering from a worldwide recession engineered by financial interests he has zero knowledge of, and what he needs is a new government. The doctor gives him sympathy and some happy pills.
Founders of that tradition such as Alfred Adler would have a more nuanced take.
I think many people recognize that mental health cannot merely be reduced to a medical issue or a social issue or a psychological issue, etc. Nevertheless, paradigms for treatment remain necessary.
I'm willing to consider, but where do you want me to consider redirecting?
Quoting Leontiskos
It's a hypothetical example - nuance is to be avoided in making the distinction between the personal psychological analysis and the social relations analysis. One can of course make use of both in the real world.
I suppose my point is that social approaches to mental health need not be conspiracy theories. Describing social theories with the example of, "worldwide recession engineered by financial interests he has zero knowledge of," and the need of "a new government," makes it sound a lot like a conspiracy theory.
There is a lot going on in the OP. Probably too much. The social aspect is part of it, but not an especially large part.
So you left out that part of the answer in your summary -
Quoting Tom Storm
Your question probably should have been, 'what does treatment and support the management, look like?'
Quoting tim wood
Seems a bit limited to say a diagnosis is reducing people's illness to just a label. Medicine works by identifying the correct diagnosis. Doing this saves lives. There's a big difference between bi-polar disorder and depression, or between schizophrenia and autism. Having expertise in mental illness and providing the right response, saves lives. Getting medication (the type as well as the dosage) right is critical. Linking people into psychosocial support is also critical. And when all this is done appropriately, it can lead to people's recovery and full participation in community. This is no small thing.
Quoting tim wood
And what does it tell you?
Quoting tim wood
I think you are getting closer with this answer. One of the psychiatrists I work with is 'doing psychiatry' to use your term and is overseeing the treatment of around 150 people who have psychotic illnesses. This involves the ongoing support of their patient - regular medication reviews, listening to feedback, tweaking and reducing mediation dosage, accepting people's decisions if they no longer want to take medication, supporting them with ongoing psychoeducation. Through this, most of the 150 have an enhanced quality of life.
But you'd be right if you said psychiatry isn't all they need. Psychiatry is always understood as being just a part of a person's recovery. They also need supportive friends, engagement with community, employment, meaning. And I would agree with those who say that community, connection with others and meaning often play a bigger role in people becoming well than just psychiatry.
No doubt there are shonky shrinks, just as there are dubious lawyers, doctors and plumbers. Are there some who abuse power? You bet. Are there some who are complacent and lazy? Yep. I am currently involved in lobbying to get some accountability from one local area mental health service, where the local psychiatrist and his team do too little too late.
Quoting unenlightened
Mental illness is surely a problem, no? And how do we approach it? Psychologically, sociologically, medicinally...? You may not like the psychiatric approach to mental illness, but what alternative would you propose? Do you at least admit that mental illness represents a societal problem?
Partly right. But also has the appropriate qualifications and capacity to undertake diagnosis (which is far from straight forward) and the expertise to determine the best treatment plan and medication, which includes ongoing case reviews. They may also supervise and take clinical responsibility for the ongoing treatment provided by an entire department and review all cases. These are things that a nurse or a GP can do to some extent, but they lack expertise and will make more errors or hold erroneous assumptions. They are generalists and have gaps. I've seen that plenty of times. How do we determine, say, Korsakoff syndrome as opposed to Alzheimer's, or determine whether the person has drug induced psychoses or has schizoaffective disorder, etc. It's nuanced work. How do we treat the woman who is trying to cut the baby out of her stomach because she believes her fetus is the anti-Christ? (I've had variations of this twice) I'd rather a psychiatrist lead the treatment provision than a nurse. But a nurse will no doubt be required too. And probably police.
Quoting tim wood
I have not heard anyone with unquestioning beliefs in any presuppositions. I am critical of psychiatry and have been viewed as denunciatory pain in the arse many times in my community. I'm not here to suggest psychiatry is a panacea. Not everyone needs it. And there are multiple types of psychiatry (modalities) some useful, some not. And I am no expert on the subject, except for what I have seen work at first hand over many years. Essentially I made the point that psychiatry is poorly understood and demonized. No doubt there are self-styled countercultural hippy types, prancing around in the ruins of the 1960s "all-you-need-is-love" culture, who view psychiatry as a tool used by "the man" and Big Pharma to suppress dissent. We all know why that is and to some extent this has been a fair criticism in instances, but shouldn't be the only frame.
But just thinking on this now - even if there were other occupations who can sometimes do a similar job to a psychiatrist (whatever that might look like) so what? There are people, other than philosophers who can do philosophy. This doesn't mean that philosophy as an academic profession is worthless, or does nothing. There are people other than mechanics who can service my car and maintain it. Does that make mechanics superfluous? I think expertise and credentialing remain important, and we generally opt for expertise where the stakes are higher, but this is the era of denigrating expertise, so there is that. I think it's fine to be skeptical of expertise, but I know where I draw the line. Others may draw the line differently.
That's for sure.
Quoting Leontiskos
Yes, I think this summaries the matter appropriately.
In some instances there may well be alternatives for the psychiatric approach. Many psychiatrists would be the first to say this. And this can mislead people, if they focus just on some alternatives and overlook the thorny end of metal ill health, which does appear to require medical and psychiatric intervention, not just an accepting buddy or a generic counsellor.
Sure, but this is throwing out the baby with the bathwater. Psychiatry could be the Devil himself, but even so the whole system would collapse without it. So we'll need to keep the devil around until we can figure out how to do without him. Cutting off his head will only make things worse.
Quoting Leontiskos
Quoting tim wood
Okay, so you think psychiatry is too narrow of an intervention. I don't find that controversial, but I'm not sure we want the thread to devolve into an argument over psychiatry. The larger picture must be kept in mind, which is abductive. Churchill's saying about democracy could be adapted for psychiatry. If one wants to oppose psychiatry then the true task is to offer a better alternative, not to just bash psychiatry.
A psychiatric intervention is where a mental illness is suspected and then assessed and diagnosed and provided with treatment options under the clinal care and recommendations of a psychiatrist.
But I'm happy to move on. We obviously hold differing frames.
Quoting tim wood
Yes, most psychiatrists would completely agree with this.
You don't seem willing to entertain a social analysis, and at the same time seem reluctant to actually say what you mean. *shrug*
Quoting Leontiskos
It's an example. What it illustrates is that one's social condition and thereby one's psychological condition can be - as David Smail puts it - strongly affected by events beyond the individual's event horizon. One tends to take things like job loss to be personal failings rather than socio-economic adjustments or as you choose to call them 'conspiracy theories.'
One might ask the medical modellers, for example, why there seems at the moment to be something of a plague of paranoia and conspiracy theories. It's hard to see how 'chemicals in the brain' can be infectious (apart from prions of course).
They are the priestly caste, and the priestly caste is always taken seriously both by others and by themselves, in part because their function within society is seen to be so important. And of course it cannot be denied that it is important.
This is a pretty conventional view these days and was a thesis articulated rather well by a famous psychiatrist called E Fuller Tory in his 1980's best seller Witchdoctors and Psychiatrists: The Common Roots of Psycotherapy and it's Future. Like most good psychiatrists, Fuller Tory was critical of many aspects of psychiatry, just as many good philosophers are critical of aspects of philosophy.
We agree thus far at least, so I might be able to convince you to consider that the medical model may be somewhat at fault. Witch doctors have a rather similar model, in which 'evil spirits' play the role of 'chemicals in the brain'. One of the difficulties of the medical model is the way pathologies change over time. Anorexia and self-harm, for instance are modern epidemics, and in the complete absence of any physical explanation for such novelties, social change should surely be considered as a possible explanation? At which point one can ask "how does your society fuck you up, and what are your coping strategies/self-medication?" to psychiatrists and their clients even handedly,
In my experience that is actually the starting point for most assessments. The conventional wisdom is that self harm and substance misuse are adaptive behaviours and the best resolutions are not found in medication, but in meaning. Hence the emphasis on the psychosocial.
Yes, but always psychological reform, never social reform, because ... actually, the medical model still informs the social structure that is psychiatry - one goes to the doctor, not the politician/lawyer.
Quoting tim wood
Then you seem to be arguing that psychiatry is not knowledge. I guess there's not much to discuss then.
Quoting unenlightened
We weren't talking about reform but as you raised it I don't think this is right either. It doesn't describe what happens here. Reform to mental health system is generally led by people outside of medical services, by those with lived experience, by relatives, by lawyers, by community workers and by politicians. And when mental health unit workers meets a potential patient for the first time, the overarching view is ususally how can they keep people out of the system and away from the need for medication. Your question - Quoting unenlightened is to some extent the one which informs them.
I think I have mostly answered this already, but essentially a psychiatrist is a medical doctor with further specialist knowledge - so has all the knowledge of a GP and additionally has expert knowledge of mental illness and can conduct a differential diagnosis (what may be organic and what may be psychological in origin) and can conduct assessments, provide diagnosis, develop treatment plans, provide pharmacotherapy, and counselling. All of these are extremely specialized and intricate matters.
Quoting tim wood
I would say that is a limited lens - bi-polar disorder, schizoaffective disorder, schizophrenia, depression, etc, are fairly clear situations that can be described clearly and do respond to treatment, almost as well as diabetes can be managed by insulin.
I would agree that psychiatry is still in its infancy and that mental health treatment still has a long way to go in its development.
Personally I have provided testimony to several tribunals arguing that particular psychiatrists and hospitals have made mistakes and that the mental health system is deeply flawed and requires reform.
Quoting tim wood
A few observations - in 1970 many psychiatrists were also reformers and challenged all kinds of notions of what qualified as 'sickness'. Psychiatry, like most disciplines, has had many reformers from within, contributing to many changes. In fact, the anti-psychiatry movement of the 1960's was led by psychiatrists. In 1970 there were psychiatrists who did not think homosexuality was an illness. Many psychiatrists I've known think that the DSM manual is inflexible and flawed.
To argue that because positions change and therefore psychiatry does not hold knowledge seems to be like the religious fundamentalists who say that science is bunk because science changes its paradigms over time.
Anyway, I'm going to leave this one here since there is no end to a debate like this and it's not really my role to defend psychiatry, which is an imperfect and evolving profession - and I am no expert. I simply know from decades of personal experince that psychiatrists can work scrupulously to provide extremely helpful life saving interventions for people. The profession is generally demonized and poorly understood. Which was my original observation.
In today's world many people do not have the social outlets they need to confront personal issues. Forms of basic therapy are more or less a means of mental maintenance than treatments of disorders.
All that said simply not using social media so much would help SO many people out - especially teenagers!
:up:
Quoting tim wood
The same observations youre making concerning psychiatry could be made with respect to philosophy. The only difference is that most philosophers dont claim to be doing science. Underlying your analysis is what I detect to be an assumption concerning the nature of scientific objectivity and the difference between empirical
objectivity and the aims and methods of philosophical discourse. I reject this dichotomy. Science is just a conventionalized form of philosophy, and the reason that psychiatry seems inadequate in comparison with the harder sciences isnt that it fails to solidly ground itself in objective facts like a domain like physics does, but that it has one foot in philosophy and one in science. This gives it a vantage on its subject matter that is more nuanced and richer than the abstractive generalizations that define the hard sciences. It is what the hard sciences ignore (namely, the interpenetration between subjectivity and objectivity) that makes them seem more successful and certain in their descriptions than psychiatry. But their grasp of the world is no truer in an ultimate sense than psychiatrys.
Quoting tim wood
Oooh, false claims. That sounds like a terrible thing. Imagine not accepting true claims like the idea that mental illness is the result of a chemical imbalance in the brain. Anyone trying to peddle true claims with respect to psychological issues is someone I would run away from as fast as possible. I dont want the claims of my therapist to be true, I want them to be useful, and that is as much a function of the mesh between client and therapist as it is the theoretical orientation of the therapist. Also , the true claims of one era of psychiatry will inevitably be seen as false, or more likely simply forgotten by a succeeding era. Does any one remember when what we now call depression was understood very differently as melancholy? How long before the rage of bipolar and Adhd diagnosis gives way to something else? Is this the result of runaway pseudoscience , or does all science operate on the basis of historically changing social constructions?
The stretch from psychology to all science misses a rather important difference that is peculiar to the 'human' sciences. When one studies electrons, or planets, or plate tectonics, one can reasonably assume that right or wrong, one's hypothesis about phenomena will not materially affect the behaviour one is studying. But human behaviour is radically transformed by human understanding, so that as soon as a psychological theory has some measure of success, it alters human nature and the phenomena one is studying change. This explains why psychology appears more like the fashion industry than a science.
Quoting Joshs
Quoting unenlightened
I like what Rorty has to say about this:
[quote=Rorty?]But we dont need the notion of experience as a mediating tribunal. We can be content with an account of the world as exerting control on our inquiries in a merely causal way, rather than as exerting what McDowell calls rational control.[/quote]
I'm not sure if I understand this, but if I do, then it goes something like this: the cliff doesn't mind if you have a theory of gravity or a theory of under-cliff trolls that will suck you down and eat your soul, as long as the effect is that you don't fall off the cliff. But when it comes to Psyche, and more so when it comes to Sophia, then either rational, or irrational control is what it is all about and the causal effect cannot be predicted at all either way, other than by a rational or irrational calculation that is itself in the purview of those same goddesses.
Psychiatry has little to offer people who are merely very unhappy, other than tranquilizers and antidepressants.
The people who really need psychiatry are those with major mental illnesses -- bi-polar; schizophrenics; psychotic disorders, OCD, CD / MI, and the like. Changing one's life circumstances might improve life for someone experiencing episodes of psychosis. Or not. It won't cure them.
My own experience with psychiatry -- antidepressant and sedative therapy on the one hand, and extended talk therapy on the other -- is that they help one cope with the life one is living but not liking. In the end what helped me was major change, not adjustment. I can't claim that I engineered the kinds of change that helped. Life changed and I started feeling much better.
I've seen major mental illness up close--in partners and relatives. It can be pretty ugly. They needed all the psychiatric help they could get. And it helped. Bi-polar, MI/CD, and the like are not really 'curable' but they benefit from the benefit which the medical model of psychiatry can give.
There certainly are abuses by the pharmo-medical industry. I suspect that far too many children are being 'identified' with Attention Deficit Disorder (ADD) and being prescribed stimulants (which in children have a 'paradoxical' effect). This idea was being studied in the late 1960s, early 1970s in Boston in largely black elementary schools. (I was working at a hospital at the time where the research was being done, though I wasn't involved in it.) Drugging overly active black boys seemed like a good idea to both the schools and the doctors.
For these disruptive boys what was needed was change -- better homes, better communities, better schools, better opportunities, better environments -- not therapy.
There are people without MDs, MAs, or PhDs--even without BAs, who--because they are healthy, intelligent, reasonably insightful, good listeners, and kind can help people they know through rough patches of life. For a lot of people that kind of "helping volunteer" is all they will need.
This is a very old study -- it's maybe 60 years old now, and I can't vouch for its quality. When I was in graduate school in 1970 we discussed a study in Wisconsin where psychiatrists, counselors, and laymen (people without any training in therapy) were each assigned several patients with fairly serious mental health problems. Each "therapist" provided the kind of therapy they thought would be beneficial. What was remarkable in the finding was that patients who were treated by laymen did as well as patients assigned a trained therapist.
What this shows is that either a) one kind of therapy is as likely or unlikely to work as a different therapy, OR that some kinds of mental illness (like schizophrenia) are resistant to psychotherapy. This strikes me as consistent with reality. A kind, insightful, skilled psychiatrist can use medication to suppress outbreaks of psychosis. All the kind insightful talk in the world probably won't help. On the other hand, a schizophrenic or bi-polar person is likely to enjoy the social contact of talking with a kind, friendly, thoughtful person, whether that cures them or not.
The real issue with psychology is that it tries to treat non-organic problems organically that is through medication which can be inhumane rather than other more humane methods such as CBT for example. It makes too many assumptions about the workings of the brain by trying to simplify it. Mental health problems are not located in the brain but in the patients perception/cognition of the world. In this regard the field of psychiatry remains in the dark ages.