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Fascinating article. Who decides the mission of a psychologist? Is it to maximize happiness of patients' lives as a whole? Is it to help patients to reach th

Fascinating article. Who decides the mission of a psychologist? Is it to maximize happiness of patients' lives as a whole? Is it to help patients to reach their full potential as productive members of society? Is it to help them to conform to societal standards of behavior or belief? If I wasn't on guard, prepared to devote thought to the question, I'd have accepted any of those answers - but this article makes it easy to see how those different goals can be in conflict. If I had to come up with the best answer I could, I think I'd settle on "A psychologist's mission should be to prevent a person from actively harming the physical health of themselves or others, even taking into account reasonable expectations of future harm based on current activities. And additionally to help make any adjustments that the patient requests." So, sometimes it's okay to involuntarily treat, but only if there's a present or soon-to-be present physical danger. Otherwise, only help them with the things they want fixed. (Note: I once had a long and coherent conversation with a guy who knew he was the messiah promised to the jews, descendant of david, future king of the world. It was an unavoidable fact. Him being a young, black presbyterian had no bearing on the issue. He had lots of evidence, much of it delusional, and much of his reasoning was based on bad information that he was literally incapable of doubting. But in the end, his delusion was immensely satisfying to him, and his life was otherwise boring, banal, and from an outside perspective, depressing as hell. And from what I can tell, as long as he doesn't travel to Israel and get a jewish girlfriend, the more dangerously bizarre parts of his prophecies won't begin, so I just decided to wish him well and let it go.)

ErikAugust 10y ago
I am fascinated as to why psychosis so often takes such a religious bend.
- bryondowd 10y ago
  Purely speculatively, I would guess that is doesn't, naturally. But religious indoctrination is extremely common. So, it makes sense that if any given person is experiencing a mental break that there's a reasonably high chance they will have a religious background rife with grand concepts to pull from. The one person I knew personally who broke with reality wasn't religious, and instead seemed to be pulling ideas from her previous goals and highlights of her life. She described a sort of ideal version of her life, the best things she could think of in the moment, regardless of consistency or reality. It makes sense that if one were raised in a religious household, one would talk about being chosen by God or some such instead of how you were getting straight A's in school and getting hired by 5 different places.
  - acqq 10y ago
    One prophet whom I will not name here initially believed to be possessed by the evil spirits but his wife, which had the monotheistic upbringing, made him believe it was an angel of the God. There's a touching scene where she makes him sit on her one and then another leg, and then she makes him sit on her lap and undresses. As the "images" he saw disappeared at that moment she "proved" him that it's not an evil but the "holy" power that possesses him. She probably just wanted to calm him down and make him see the world more positive. Eventually it wasn't positive for his opponents and the world. He started to believe he has the direct connection with the God and that therefore anything he does, even the killings and tortures, were directly supported by the God. He turned out to be a "successful" prophet based on the impact he made.
    - dTal 10y ago
      I am by no means a religious expert but it's sad that your very reluctance to name the prophet in question made him easy to guess. And it led me down a bit of a rabbit hole: https://wikiislam.net/wiki/Muhammad%27s_Just_In_Time_Revelations https://wikiislam.net/wiki/Muhammad%27s_Just_In_Time_Revelat...
      - acqq 10y ago
        And on and on: http://quotingislam.blogspot.co.at/2011/06/muhammad-orders-torture-of-man-in-order.html http://quotingislam.blogspot.co.at/2011/06/muhammad-orders-t...
  - aomurphy 10y ago
    Cultures experience mental illness in very very different ways. http://news.stanford.edu/2014/07/16/voices-culture-luhrmann-071614/ http://news.stanford.edu/2014/07/16/voices-culture-luhrmann-... People tend to think their talking to spiritual things in some sense, but Americans heard God, or angels or demons, Indians tended to hear from ancestors or kin, Ghanaians from various spirits. Indians and Ghanaian found that many voices where helpful and positive. The Americans all found their voices to be violent and negative.
openasocket 10y ago
> So, sometimes it's okay to involuntarily treat, but only if there's a present or soon-to-be present physical danger If you weren't aware, that is the current standard for involuntary hospitalization, at least in the US. I believe the phrase is "danger to self or others."
- John23832 10y ago
  Just a question, but how strictly is that followed? If a mentally disturbed person (who presents no current physical threat) is put in front of a psychiatric professional, how often is that professional going to say "Ah, let him/her be. They aren't going to harm anyone". Especially in today's climate of preemptive responses to threats. As someone who went to Virginia Tech I've seen how that "eh, he's/she's not bothering anyone" response can go terribly wrong. And when it goes wrong, the first thing people will ask is why that professional didn't do something when they had the chance.
  - openasocket 10y ago
    Generally, professionals will not involuntarily commit patients unless the threat is current and pretty explicit, though there are exceptions. Professionals can involuntarily commit people for short periods of time for observation, to determine if they really are or are not a risk. For instance, if someone shows up in the ER with knife wounds on their wrists, that can warrant an observation period. Interactions with the police can lead to observation if the officer believes you to be mentally ill. It's a very fine line to walk between individual liberties and providing treatment to those who need it. If you're schizophrenic and you live on the streets, yell at birds all day, and eat from the garbage, you are not considered a danger to yourself, even though you have a pretty abysmal quality of life and are at serious risk of dying from disease, drugs, homicide, exposure, or starvation. It's a complicated conversation with no clear answers.
  - pmoriarty 10y ago
    One thing that wasn't addressed in the original article is that there's not a lot of room in psychiatric hospitals and not a lot of funding to keep people there long-term. So that results in a more or less tacit revolving door policy, and certainly affects the decision to involuntarily commit or not.
ChoHag 10y ago
It's worth considering that there are differing opinions on what constitutes danger. Some would consider religious indoctrination dangerous. Few would agree on the definition of indoctrination.

ErikAugust 10y ago

I am fascinated as to why psychosis so often takes such a religious bend.

bryondowd 10y ago
Purely speculatively, I would guess that is doesn't, naturally. But religious indoctrination is extremely common. So, it makes sense that if any given person is experiencing a mental break that there's a reasonably high chance they will have a religious background rife with grand concepts to pull from. The one person I knew personally who broke with reality wasn't religious, and instead seemed to be pulling ideas from her previous goals and highlights of her life. She described a sort of ideal version of her life, the best things she could think of in the moment, regardless of consistency or reality. It makes sense that if one were raised in a religious household, one would talk about being chosen by God or some such instead of how you were getting straight A's in school and getting hired by 5 different places.
- acqq 10y ago
  One prophet whom I will not name here initially believed to be possessed by the evil spirits but his wife, which had the monotheistic upbringing, made him believe it was an angel of the God. There's a touching scene where she makes him sit on her one and then another leg, and then she makes him sit on her lap and undresses. As the "images" he saw disappeared at that moment she "proved" him that it's not an evil but the "holy" power that possesses him. She probably just wanted to calm him down and make him see the world more positive. Eventually it wasn't positive for his opponents and the world. He started to believe he has the direct connection with the God and that therefore anything he does, even the killings and tortures, were directly supported by the God. He turned out to be a "successful" prophet based on the impact he made.
  - dTal 10y ago
    I am by no means a religious expert but it's sad that your very reluctance to name the prophet in question made him easy to guess. And it led me down a bit of a rabbit hole: https://wikiislam.net/wiki/Muhammad%27s_Just_In_Time_Revelations https://wikiislam.net/wiki/Muhammad%27s_Just_In_Time_Revelat...
    - acqq 10y ago
      And on and on: http://quotingislam.blogspot.co.at/2011/06/muhammad-orders-torture-of-man-in-order.html http://quotingislam.blogspot.co.at/2011/06/muhammad-orders-t...
- aomurphy 10y ago
  Cultures experience mental illness in very very different ways. http://news.stanford.edu/2014/07/16/voices-culture-luhrmann-071614/ http://news.stanford.edu/2014/07/16/voices-culture-luhrmann-... People tend to think their talking to spiritual things in some sense, but Americans heard God, or angels or demons, Indians tended to hear from ancestors or kin, Ghanaians from various spirits. Indians and Ghanaian found that many voices where helpful and positive. The Americans all found their voices to be violent and negative.

openasocket 10y ago

> So, sometimes it's okay to involuntarily treat, but only if there's a present or soon-to-be present physical danger If you weren't aware, that is the current standard for involuntary hospitalization, at least in the US. I believe the phrase is "danger to self or others."

John23832 10y ago
Just a question, but how strictly is that followed? If a mentally disturbed person (who presents no current physical threat) is put in front of a psychiatric professional, how often is that professional going to say "Ah, let him/her be. They aren't going to harm anyone". Especially in today's climate of preemptive responses to threats. As someone who went to Virginia Tech I've seen how that "eh, he's/she's not bothering anyone" response can go terribly wrong. And when it goes wrong, the first thing people will ask is why that professional didn't do something when they had the chance.
- openasocket 10y ago
  Generally, professionals will not involuntarily commit patients unless the threat is current and pretty explicit, though there are exceptions. Professionals can involuntarily commit people for short periods of time for observation, to determine if they really are or are not a risk. For instance, if someone shows up in the ER with knife wounds on their wrists, that can warrant an observation period. Interactions with the police can lead to observation if the officer believes you to be mentally ill. It's a very fine line to walk between individual liberties and providing treatment to those who need it. If you're schizophrenic and you live on the streets, yell at birds all day, and eat from the garbage, you are not considered a danger to yourself, even though you have a pretty abysmal quality of life and are at serious risk of dying from disease, drugs, homicide, exposure, or starvation. It's a complicated conversation with no clear answers.
- pmoriarty 10y ago
  One thing that wasn't addressed in the original article is that there's not a lot of room in psychiatric hospitals and not a lot of funding to keep people there long-term. So that results in a more or less tacit revolving door policy, and certainly affects the decision to involuntarily commit or not.

ChoHag 10y ago

It's worth considering that there are differing opinions on what constitutes danger. Some would consider religious indoctrination dangerous. Few would agree on the definition of indoctrination.