6 ms·

As I'm sure you realize, what is admitted, what is observed and what truly is are not necessarily the same.

by eivarv 11y ago

wpietri 11y ago
Sure, which is my point. DanBC is claiming that the person with the nominal disease is the source of deciding whether it affects day-to-day life. I'm saying that's not the case. Other people get to decide whether it's a disease based on what's normal to them. An example others brought up was that homosexuality was defined as a mental illness for many years. That's the same dynamic I'm pointing at.
- eivarv 11y ago
  That's not the case, though. Clients are typically asked to assess to what extent the perceived symptoms affects their day-to-day life, any changes, etc., in addition to conferring with friends/family for their point of view on this. These are considered in addition to an absolute deviance from the "average spectrum" and diagnostic criteria. I don't really think the pathologization of homosexuality is comparable to modern issues, as the reasons for this were very much informed by its historical context (its history as an immoral concept in christian/western culture, the state of psychology and psychiatry as fields at the time vs. now, etc.) in a way modern diagnoses aren't. Also, according to Wikipedia [0], APA members were critical to homosexuality as a disorder at least from its inclusion in the first DSM. [0]: https://en.wikipedia.org/wiki/Homosexuality#Psychology https://en.wikipedia.org/wiki/Homosexuality#Psychology
  - wpietri 11y ago
    What's your source for your claims? In the US, a lot of mental illnesses are medicated by general practitioners, and mental health insurance coverage is notoriously poor. That sounds like a great way to work, but it's not how I see the system actually working. That you don't think pathologization of homosexuality is comparable is, I suppose, fine for you. I obviously do or I wouldn't have made the comparison. It's not like we don't have a historical context now as well; it's just a different context. In particular, the US has some very deeply culturally embedded notions about work ethic and willpower that are relevant to ADD and addiction treatment. That we corrected one mistake does not mean we corrected the general pattern of mistake. Regarding the last bit, glad to know Wikipedia is now a reliable source when you're citing it in your favor.
    - eivarv 11y ago
      There are sources abound [0-3]. The four Ds of abnormality [0] might be of particular interest. The point may be better explained (as I'll get back to) by textbooks and lecture notes, also available via Google. That's the case in much of the world, which is indeed considered a problem, and may explain why medication may be overutilized. But the fact that the system's current practice is unfavorable, does not really say anything about the models used to understand mental illness. ADD comes with certain dysfunction [0] (and perhaps distress) that homosexuality just doesn't, which is one of the reasons for my objection. While the field of psychopathology is certainly influenced by culture (as is readily acknowledged) I have yet to see any reasonable argument that addiction and ADD are pathologized on the sole basis of falling outside of "normal" experience. Additionally, the notions of work ethic and willpower that you mention might just as well be used to explain stigma towards the mentally ill – that they should just apply discipline and willpower. Apropos of sources, I should very much like to see some that claim that ADD as diagnosis is inherently problematic, as opposed to it being abused as a consequence of certain cultures. My gripe with your previous use of Wikipedia was not about Wikipedia itself, but the way it was used. By this I mean that while Wikipedia articles might contain misinformation, it is known to be surprisingly good, for the most part (though certainly no credible academic source). The problem, though, is that it will in quite a few cases not provide readers with minute details, standard practice or underlying assumptions – Wikipedia is an encyclopedia, not a practitioner's handbook. [0]: https://en.wikipedia.org/wiki/Psychopathology#The_four_Ds https://en.wikipedia.org/wiki/Psychopathology#The_four_Ds [1]: https://en.wikipedia.org/wiki/Mental_health#Perspectives https://en.wikipedia.org/wiki/Mental_health#Perspectives [2]: https://en.wikipedia.org/wiki/Mental_disorder#Classifications https://en.wikipedia.org/wiki/Mental_disorder#Classification... [3]: https://en.wikipedia.org/wiki/Mental_status_examination https://en.wikipedia.org/wiki/Mental_status_examination
      - wpietri 11y ago
        You seem to be arguing from the theory of mental health; I am talking about what people do in practice, and the cultural norms and views that shape the application of theory. As to, "I have yet to see any reasonable argument" bit, I can certainly believe it. But I think that's mainly because you haven't looked. Plenty of people have talked about rampant overdiagnosis of ADHD in the US because putting everybody on stimulants makes classrooms easier to control. Overdiagnosis here means taking healthy but inconvenient behavior and pathologizing it. If people only have "dysfunction" in particular classroom environments with particular teachers, I think it's reasonable to suggest that what's dysfunctional is the environment and the expectation of universal conformity, not the people who are different. It seems like we are mainly talking in circles here, and given that this is a topic on which I have paid attention to for a couple of decades and also have direct experience, your arguments from Wikipedia theory links aren't going to do much for me. Maybe we should stop now?

As I'm sure you realize, what is admitted, what is observed and what truly is are not necessarily the same.

by eivarv 11y ago

As I'm sure you realize, what is admitted, what is observed and what truly is are not necessarily the same.

Sure, which is my point. DanBC is claiming that the person with the nominal disease is the source of deciding whether it affects day-to-day life. I'm saying that's not the case. Other people get to decide whether it's a disease based on what's normal to them. An example others brought up was that homosexuality was defined as a mental illness for many years. That's the same dynamic I'm pointing at.

eivarv 11y ago
That's not the case, though. Clients are typically asked to assess to what extent the perceived symptoms affects their day-to-day life, any changes, etc., in addition to conferring with friends/family for their point of view on this. These are considered in addition to an absolute deviance from the "average spectrum" and diagnostic criteria. I don't really think the pathologization of homosexuality is comparable to modern issues, as the reasons for this were very much informed by its historical context (its history as an immoral concept in christian/western culture, the state of psychology and psychiatry as fields at the time vs. now, etc.) in a way modern diagnoses aren't. Also, according to Wikipedia [0], APA members were critical to homosexuality as a disorder at least from its inclusion in the first DSM. [0]: https://en.wikipedia.org/wiki/Homosexuality#Psychology https://en.wikipedia.org/wiki/Homosexuality#Psychology
- wpietri 11y ago
  What's your source for your claims? In the US, a lot of mental illnesses are medicated by general practitioners, and mental health insurance coverage is notoriously poor. That sounds like a great way to work, but it's not how I see the system actually working. That you don't think pathologization of homosexuality is comparable is, I suppose, fine for you. I obviously do or I wouldn't have made the comparison. It's not like we don't have a historical context now as well; it's just a different context. In particular, the US has some very deeply culturally embedded notions about work ethic and willpower that are relevant to ADD and addiction treatment. That we corrected one mistake does not mean we corrected the general pattern of mistake. Regarding the last bit, glad to know Wikipedia is now a reliable source when you're citing it in your favor.
  - eivarv 11y ago
    There are sources abound [0-3]. The four Ds of abnormality [0] might be of particular interest. The point may be better explained (as I'll get back to) by textbooks and lecture notes, also available via Google. That's the case in much of the world, which is indeed considered a problem, and may explain why medication may be overutilized. But the fact that the system's current practice is unfavorable, does not really say anything about the models used to understand mental illness. ADD comes with certain dysfunction [0] (and perhaps distress) that homosexuality just doesn't, which is one of the reasons for my objection. While the field of psychopathology is certainly influenced by culture (as is readily acknowledged) I have yet to see any reasonable argument that addiction and ADD are pathologized on the sole basis of falling outside of "normal" experience. Additionally, the notions of work ethic and willpower that you mention might just as well be used to explain stigma towards the mentally ill – that they should just apply discipline and willpower. Apropos of sources, I should very much like to see some that claim that ADD as diagnosis is inherently problematic, as opposed to it being abused as a consequence of certain cultures. My gripe with your previous use of Wikipedia was not about Wikipedia itself, but the way it was used. By this I mean that while Wikipedia articles might contain misinformation, it is known to be surprisingly good, for the most part (though certainly no credible academic source). The problem, though, is that it will in quite a few cases not provide readers with minute details, standard practice or underlying assumptions – Wikipedia is an encyclopedia, not a practitioner's handbook. [0]: https://en.wikipedia.org/wiki/Psychopathology#The_four_Ds https://en.wikipedia.org/wiki/Psychopathology#The_four_Ds [1]: https://en.wikipedia.org/wiki/Mental_health#Perspectives https://en.wikipedia.org/wiki/Mental_health#Perspectives [2]: https://en.wikipedia.org/wiki/Mental_disorder#Classifications https://en.wikipedia.org/wiki/Mental_disorder#Classification... [3]: https://en.wikipedia.org/wiki/Mental_status_examination https://en.wikipedia.org/wiki/Mental_status_examination
    - wpietri 11y ago
      You seem to be arguing from the theory of mental health; I am talking about what people do in practice, and the cultural norms and views that shape the application of theory. As to, "I have yet to see any reasonable argument" bit, I can certainly believe it. But I think that's mainly because you haven't looked. Plenty of people have talked about rampant overdiagnosis of ADHD in the US because putting everybody on stimulants makes classrooms easier to control. Overdiagnosis here means taking healthy but inconvenient behavior and pathologizing it. If people only have "dysfunction" in particular classroom environments with particular teachers, I think it's reasonable to suggest that what's dysfunctional is the environment and the expectation of universal conformity, not the people who are different. It seems like we are mainly talking in circles here, and given that this is a topic on which I have paid attention to for a couple of decades and also have direct experience, your arguments from Wikipedia theory links aren't going to do much for me. Maybe we should stop now?