10 ms·

A psychiatrist who didn’t believe in mental illness (2013)

95 points by mastazi 8y ago

tcj_phx 8y ago
The quakers figured out that most people could recover from what are now called "psychotic breaks" by being put in a safe place ("asylum") and provided 4 meals a day [2]. Much of the current problems of Psychiatry stem from the split of neurology and psychiatry [0]. Over the last 60+ years investigators have found many physiological considerations for the so-called "mental" disorders. The core of the resistance against psychiatry (slandered as "antipsychiatry") are the experiences of patients whose conditions deteriorate from medications that do not address the cause of their conditions. Stress is one of the most important factors in every psychiatric diagnosis. Malnutrition is a type of stress; emotional stress and genetic mutations [1] creates a need for more of certain nutrients. [0] https://en.wikipedia.org/wiki/Neuropsychiatry https://en.wikipedia.org/wiki/Neuropsychiatry [1] https://www.gxsciences.com/methylation-testing-s/2.htm https://www.gxsciences.com/methylation-testing-s/2.htm [2] https://en.wikipedia.org/wiki/Moral_treatment#England https://en.wikipedia.org/wiki/Moral_treatment#England I appreciate Szasz's comment about the crucifixion of Ignaz Semmelweis, the Hungarian obstetrician who had the audacity to suggest that his fellow doctors should wash their hands between autopsies and childbirths: "It taught me, at an early age, the lesson that it can be dangerous to be wrong, but, to be right, when society regards the majority’s falsehood as truth, could be fatal. This principle is especially true with respect to false truths that form an important part of an entire society’s belief system. In the past, such basic false truths were religious in nature. In the modern world, they are medical and political in nature." (emphasis added) The enduring mistreatment of those labeled as "mentally ill" is one of the great tragedies of our time. edit: added reference [2] edit2: extraneous words removed
- themodelplumber 8y ago
  Most people do not know a lot of basic but important things about stress. - Change increases stress - To-Do list items are also known as "stressors" - Implementing someone else's suggested "happiness plan" in your life could easily kill you, simply because it's new to _you_ and requires dramatic change To be "right" as per Szasz means to fit into and apply a preferred template in order to bring about that template's preferred outcome more than it means to be true. It is the difference in template that causes the fatal dynamic, not any difference in truth. More true does an individual feel, the more their acted-out template matches their own psychology, and the more they see the template benefiting others who are amenable to its way of framing things. More do they demonstrate alarming symptoms, the more their preferred, best, most trusted template is overridden both objectively and within their subjective experience. To make all of HN go "mentally ill" simply confine its membership to Facebook fashion groups or the neighborhood butcher shop or the religious cult. The method of or reason for confinement or the place of confinement will always differ, but the result will be the same--absolutely devastating symptoms and strange diseases, etc. Just change, and unknowingly set at an unsustainable pace right from the start. The illness model has its leverage points in e.g. its natural provision for quick social exits, but other models also contribute much to our self care and other-care.
  - jacobush 8y ago
    - Stay in an abusive (doesn't even have to look too bad) relationship and try to live the other's "happiness plan"
    - themodelplumber 8y ago
      Good example! And a deep topic...
  - kian 8y ago
    >To make all of HN go "mentally ill" simply confine its membership to Facebook fashion groups or the neighborhood butcher shop or the religious cult. This fascinating statement makes me wonder about the rise of mental illness in children. I've tended to fall on the side of prior under-diagnosis, but I wonder if some is actually a result of the children being 'trapped' by modern helicopter parenting and educational systems by removing the time they would need to remain sane by engaging in free, unstructured, self-directed play?
- rjf72 8y ago
  There's one critical nuance here on the physiological issue. Physiological differences imply that an issue is a product of biological, physical, or other sources outside of individual choice or mental mechanisms, but this is not necessarily so. A great example of this is the difference between amateur and master chess players. An entirely different area of the brain is used when masters analyze a position than when amateurs do. So the knee-jerk reaction there would be to say that then that's evidence that masters are just somehow physiologically different. Of course that's false. Everybody begins with the 'amateur brain'. It's just that dedicated training and development physiologically changes the individual. So the problem here is that our ability to observe physiological differences, particularly given the development of EEG/MRI/CT/etc, has radically outpaced our ability to have any clue what they mean. The point being that just because a "condition" has a physiological manifestation in no way whatsoever then directly implies that the condition is therefore physical or can even be realistically 'treated'. For instance, we're not going to develop a drug to make you a strong chess player anytime in the foreseeable future. And while perhaps you could create a drug to make a master a weak player again, it would almost certainly be little more than a glorified lobotomy.
  - dalbasal 8y ago
    Got a link (or name) for that chess brain mapping study? Sounds interesting? (sorry, tangent)
    - rjf72 8y ago
      There are an immense amount. The chess player's brain is apparently a popular topic of study! Here's a Google Scholar link for 'chess brain' which turns up lots of relevant studies: https://scholar.google.com/scholar?q=chess+brain https://scholar.google.com/scholar?q=chess+brain
      - dalbasal 8y ago
        Know which of these deals specifically with the differences between amateur and titled players?
pizza 8y ago
Szasz's opinions on addiction and 'the therapeutic state' were some of the most clear of any from the field of psychiatry I've heard yet. https://en.wikipedia.org/wiki/Thomas_Szasz#Szasz's_main_arguments https://en.wikipedia.org/wiki/Thomas_Szasz#Szasz's_main_argu...
- pmoriarty 8y ago
  A lot of this echoes Foucault. You might find his work interesting.
- TheOtherHobbes 8y ago
  This is fine as far as it goes, but some psychotic people really are dangerous. A percentage become murderous and violent, and criticising the admittedly poor state of psychiatric understanding doesn't make them less likely to harm themselves or others. Of course the problem is related to wider social issues about permissive violence. If one person murders another because of their delusions, it's a crime and a medical failure. If an entire country declares war on another for similar reasons we assume we're in the realm of politics and history, not mass mental illness. We're far too harsh on individuals and far too lenient on mass systems of thought and belief that have horrific outcomes.
  - coldtea 8y ago
    >This is fine as far as it goes, but some psychotic people really are dangerous. A percentage become murderous and violent Sure, but then again most non-psychotic people are as well. It's not like the majority of murders is done by psychotic people.
    - eigenstuff 8y ago
      In fact, those with psychotic disorders are far more likely to be VICTIMS of violence than perpetrators. Psychosis comes in a wide variety of flavors. I have a psychotic disorder and have occasional psychotic episodes. It feels like my brain is short circuiting and my thoughts become too rapid fire and disorganized for me to do anything but stare into space and just ride it out and go to bed. Its pretty frightening to feel like you've lost control of your own brain like that if you don't know what's happening. About once a year or so I'll have a paranoid episode, I just get really combative and accusatory and start trying to pick (text, verbal) fights with my friends but fortunately it's so out of character for me that everybody can tell something is wrong. The next morning I'll wake up just fine and dandy like it never happened, minus feeling really embarrassed and apologizing profusely to whoever I was trying to pick fights with.
honkycat 8y ago
Of course the #hustle obsessed hacker news crowd would love this title. "Mental illness is fake! Mentally different people are just whiny and inferior, not a legitimate illness. Depressed people need to just stop it." What a load of crap. This article does a poor job of laying out Szasz's actual beliefs. Szasz sounds like a right-wing wonk and little else. He has since been proven completely wrong in the 50 years since publication: There is a biological component to mental illness. It focuses on his persecution complex as a right-wing libertarian in a laregly liberal field. They bring up the completly irrelevant Semmelweis to attach an air of legitimately to his crackpot beliefs. They do it again with Arendt.
- dang 8y ago
  Can you please stop posting rants to HN? They're not what this site is for, and you've done it a lot, unfortunately. Your non-rant comments are fine. HN is for intellectual curiosity—see https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html.
  - OpenBSD-supreme 8y ago
    Wooo wooo Wooo wooo! dang, the fun police, has arrived!
  - austinjp 8y ago
    Personally I read their comment as impassioned rather than ranting.
    - dang 8y ago
      What I meant is that it was unsubstantive (i.e. contains little information) and calls names. That's what makes it a bad comment for HN.
  - golergka 8y ago
    I have read this comment and I perceive it as a well-argumented, although may be a little bit emotional, critique. It has served my intellectual curiosity. If it had been on a topic that HN has a different consensus (like climate change) it still could've been the top comment, despite the tone.
a_parrot 8y ago
It's a pretty simple equation, and you feel the business end of it when you question a medical doctor regarding something as simple as an antibiotics prescription. Fields are designed to protect the degreed professional. The words are crafted as weapons forged in the defense of each thesis. Everything you confront is the product of some long-dead intellectual chess match conducted in an ivory tower, and from that moment forward concepts are, by turns, weaponized. This principle extends to all fields, economics, sociology, psychology, biology, chemistry, physics, math. Don't believe me? Try on the "divide by zero" argument for size. It's just notation, to communicate expressions, that relay ideas. If you were to have nothing, and hypothetically cut nothing into a number of parts, you'd still have nothing. If you have something, and divide it into zero parts, then that too, is nothing. But people have a professional stake in fighting such compromises. Having won an argument in the past means their reputation rests on defending that stance until they finally die and get out of the way. It's pretty easy to let an expression that communicates division with zero exist. But because we have an academic norm standing in the way, the conversation of whether or not we should serves better to reveal the brainwashed drones, parroting their instructors until death.
bellerose 8y ago
The more I read of psychiatry makes me lean towards the majority of it being pseudoscience. Finances play the most important role in suicidal ideation but nothing is ever done for the people suffering from suicide attempts besides placing them in a facility for an extended period and medicating them. Some of the drugs have even been shown to induce gambling. How in the world does someone escape a life where all the cards are dealt against them is unknown to me. In this world you spend more money when poor to live healthy than if starting out rich and it’s harder to save or increase your holdings while poor. Stress is definitely the deciding factor in if a person can stay happy and happiness is the only factor to really care about; besides physical health but they come hand in hand. I think the field is improving but I have a bias by living in a progressive city where the old beliefs are highly questioned and rarely followed. I think psychiatry will go down in history next to the holocaust. Too many people were ruined compared to being helped.
- Bjartr 8y ago
  > Stress is definitely the deciding factor in if a person can stay happy You make some interesting points, but I will say that you can absolutely become, and remain, unhappy even while living a stress-free life. So while stress is absolutely an important factor, it is not "the deciding factor"
elbasti 8y ago
Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying." This isn't what he says in the book at all. Rather, his argument is more along the lines of: 1. The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. Cancer, the flu, hyperparathyroidism--all map to causes. 2. The conditions which we call mental illness don't have a knowable cause. They are symptoms which we pattern match against. 3. Corollary: Illnesses should be hypothetically curable. There may be a cure for cancer. But there cannot be a "cure" for most "mental illnesses" because there is no shared, physical cause that underlies say, all cases of "bipolar disorder". 3. So we shouldn't call them "illnesses". We should call them something else. Unfortunately that's about as much as I remember of his argument, but it's very different than the common accusation... And it also strikes me as accurate. The problem with naming things is that it makes them real. I think often the hacker news crowd forgets how ill-informed most of the world is, and the degree to which people crave certainty. When a person is told by a psychiatrists "Your 8 year has depression so we'll put her on X pill" or "You have bipolar type 2, so I recommend Y medicine", it has a certain finality. Most people don't think "The doctor is telling me that my behavior matches some patterns. That is it. She does not know why, and we may never know why, there may not even be a reason why. So we should think about what we can do to mitigate this." No. The we think "I've been diagnosed with a disease. (Sorry I'm being an a-hole|I won't go to your party|didn't get out of bed), I suffer from bipolar and there's no cure".
- dragonwriter 8y ago
  > The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying." Even at the more generous level of “mental illness is different from physical illness” it is wrong, and dangerously so. > The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. This has never been what “illness” means; illness (both in general and in specific named instances) is often recognized and identified long before causes. > The conditions which we call mental illness don't have a knowable cause. They don't usually have a known cause. That they don't have knowable cause is an unwarranted conclusion. Plenty of physical illness don't have known mechanisms, and most of those that do were noticed and given names as illnesses before (sometimes centuries before) the mechanism was identified. This doesn't mean they don't generally have knowable causes, as is evident from the ones whose causes were later learned. > Illnesses should be hypothetically curable. That doesn't even remotely follow. Having a know cause doesn't imply curability because causes are not necessarily reversible. > I think often the hacker news crowd forgets how ill-informed most of the world is True. It's easy to forget that many people do not even realize that pattern matching on symptoms is how much diagnosis of physical illness is done, and that even where causes are known it's often not worthwhile (and sometimes not practical) to actually test for them directly.
Legogris 8y ago
An article on the book from 1970: https://jamanetwork.com/journals/jama/article-abstract/356561 https://jamanetwork.com/journals/jama/article-abstract/35656...
gmfawcett 8y ago
I wish I could remember the title and author, but this reminds me of an (unrelated) book on pain management, where the author's thesis is that most musculoskeletal pain is psychosomatic: you can essentially will yourself out of chronic pain once you accept this statement as fact. Does anyone recall the book I'm talking about?
- briancleland 8y ago
  John Sarno perhaps? I found his method very effective. https://www.youtube.com/watch?v=6JVDj2rEOas https://www.youtube.com/watch?v=6JVDj2rEOas
  - gmfawcett 8y ago
    Yes, thank you, I think that's the one! I had no idea there was a documentary film about him. Thanks very much for sharing that.
- wiry-bulb 8y ago
  http://www.neuroplastix.com/styled-4/aboutus.html http://www.neuroplastix.com/styled-4/aboutus.html Maybe Dr. Moskowtizs. His technique is the subject of chapter 1 in Norman Doidge’s “The Brain’s Way of Healing”
  - gmfawcett 8y ago
    Thank you for this.
TheTruestKyle0 8y ago
How about you stop being a little cunt? You ever think about that bitch?

95 points by mastazi 8y ago

The quakers figured out that most people could recover from what are now called "psychotic breaks" by being put in a safe place ("asylum") and provided 4 meals a day [2]. Much of the current problems of Psychiatry stem from the split of neurology and psychiatry [0]. Over the last 60+ years investigators have found many physiological considerations for the so-called "mental" disorders. The core of the resistance against psychiatry (slandered as "antipsychiatry") are the experiences of patients whose conditions deteriorate from medications that do not address the cause of their conditions. Stress is one of the most important factors in every psychiatric diagnosis. Malnutrition is a type of stress; emotional stress and genetic mutations [1] creates a need for more of certain nutrients. [0] https://en.wikipedia.org/wiki/Neuropsychiatry https://en.wikipedia.org/wiki/Neuropsychiatry [1] https://www.gxsciences.com/methylation-testing-s/2.htm https://www.gxsciences.com/methylation-testing-s/2.htm [2] https://en.wikipedia.org/wiki/Moral_treatment#England https://en.wikipedia.org/wiki/Moral_treatment#England I appreciate Szasz's comment about the crucifixion of Ignaz Semmelweis, the Hungarian obstetrician who had the audacity to suggest that his fellow doctors should wash their hands between autopsies and childbirths: "It taught me, at an early age, the lesson that it can be dangerous to be wrong, but, to be right, when society regards the majority’s falsehood as truth, could be fatal. This principle is especially true with respect to false truths that form an important part of an entire society’s belief system. In the past, such basic false truths were religious in nature. In the modern world, they are medical and political in nature." (emphasis added) The enduring mistreatment of those labeled as "mentally ill" is one of the great tragedies of our time. edit: added reference [2] edit2: extraneous words removed

themodelplumber 8y ago
Most people do not know a lot of basic but important things about stress. - Change increases stress - To-Do list items are also known as "stressors" - Implementing someone else's suggested "happiness plan" in your life could easily kill you, simply because it's new to _you_ and requires dramatic change To be "right" as per Szasz means to fit into and apply a preferred template in order to bring about that template's preferred outcome more than it means to be true. It is the difference in template that causes the fatal dynamic, not any difference in truth. More true does an individual feel, the more their acted-out template matches their own psychology, and the more they see the template benefiting others who are amenable to its way of framing things. More do they demonstrate alarming symptoms, the more their preferred, best, most trusted template is overridden both objectively and within their subjective experience. To make all of HN go "mentally ill" simply confine its membership to Facebook fashion groups or the neighborhood butcher shop or the religious cult. The method of or reason for confinement or the place of confinement will always differ, but the result will be the same--absolutely devastating symptoms and strange diseases, etc. Just change, and unknowingly set at an unsustainable pace right from the start. The illness model has its leverage points in e.g. its natural provision for quick social exits, but other models also contribute much to our self care and other-care.
- jacobush 8y ago
  - Stay in an abusive (doesn't even have to look too bad) relationship and try to live the other's "happiness plan"
  - themodelplumber 8y ago
    Good example! And a deep topic...
- kian 8y ago
  >To make all of HN go "mentally ill" simply confine its membership to Facebook fashion groups or the neighborhood butcher shop or the religious cult. This fascinating statement makes me wonder about the rise of mental illness in children. I've tended to fall on the side of prior under-diagnosis, but I wonder if some is actually a result of the children being 'trapped' by modern helicopter parenting and educational systems by removing the time they would need to remain sane by engaging in free, unstructured, self-directed play?
rjf72 8y ago
There's one critical nuance here on the physiological issue. Physiological differences imply that an issue is a product of biological, physical, or other sources outside of individual choice or mental mechanisms, but this is not necessarily so. A great example of this is the difference between amateur and master chess players. An entirely different area of the brain is used when masters analyze a position than when amateurs do. So the knee-jerk reaction there would be to say that then that's evidence that masters are just somehow physiologically different. Of course that's false. Everybody begins with the 'amateur brain'. It's just that dedicated training and development physiologically changes the individual. So the problem here is that our ability to observe physiological differences, particularly given the development of EEG/MRI/CT/etc, has radically outpaced our ability to have any clue what they mean. The point being that just because a "condition" has a physiological manifestation in no way whatsoever then directly implies that the condition is therefore physical or can even be realistically 'treated'. For instance, we're not going to develop a drug to make you a strong chess player anytime in the foreseeable future. And while perhaps you could create a drug to make a master a weak player again, it would almost certainly be little more than a glorified lobotomy.
- dalbasal 8y ago
  Got a link (or name) for that chess brain mapping study? Sounds interesting? (sorry, tangent)
  - rjf72 8y ago
    There are an immense amount. The chess player's brain is apparently a popular topic of study! Here's a Google Scholar link for 'chess brain' which turns up lots of relevant studies: https://scholar.google.com/scholar?q=chess+brain https://scholar.google.com/scholar?q=chess+brain
    - dalbasal 8y ago
      Know which of these deals specifically with the differences between amateur and titled players?

pizza 8y ago

Szasz's opinions on addiction and 'the therapeutic state' were some of the most clear of any from the field of psychiatry I've heard yet. https://en.wikipedia.org/wiki/Thomas_Szasz#Szasz's_main_arguments https://en.wikipedia.org/wiki/Thomas_Szasz#Szasz's_main_argu...

pmoriarty 8y ago
A lot of this echoes Foucault. You might find his work interesting.
TheOtherHobbes 8y ago
This is fine as far as it goes, but some psychotic people really are dangerous. A percentage become murderous and violent, and criticising the admittedly poor state of psychiatric understanding doesn't make them less likely to harm themselves or others. Of course the problem is related to wider social issues about permissive violence. If one person murders another because of their delusions, it's a crime and a medical failure. If an entire country declares war on another for similar reasons we assume we're in the realm of politics and history, not mass mental illness. We're far too harsh on individuals and far too lenient on mass systems of thought and belief that have horrific outcomes.
- coldtea 8y ago
  >This is fine as far as it goes, but some psychotic people really are dangerous. A percentage become murderous and violent Sure, but then again most non-psychotic people are as well. It's not like the majority of murders is done by psychotic people.
  - eigenstuff 8y ago
    In fact, those with psychotic disorders are far more likely to be VICTIMS of violence than perpetrators. Psychosis comes in a wide variety of flavors. I have a psychotic disorder and have occasional psychotic episodes. It feels like my brain is short circuiting and my thoughts become too rapid fire and disorganized for me to do anything but stare into space and just ride it out and go to bed. Its pretty frightening to feel like you've lost control of your own brain like that if you don't know what's happening. About once a year or so I'll have a paranoid episode, I just get really combative and accusatory and start trying to pick (text, verbal) fights with my friends but fortunately it's so out of character for me that everybody can tell something is wrong. The next morning I'll wake up just fine and dandy like it never happened, minus feeling really embarrassed and apologizing profusely to whoever I was trying to pick fights with.

honkycat 8y ago

Of course the #hustle obsessed hacker news crowd would love this title. "Mental illness is fake! Mentally different people are just whiny and inferior, not a legitimate illness. Depressed people need to just stop it." What a load of crap. This article does a poor job of laying out Szasz's actual beliefs. Szasz sounds like a right-wing wonk and little else. He has since been proven completely wrong in the 50 years since publication: There is a biological component to mental illness. It focuses on his persecution complex as a right-wing libertarian in a laregly liberal field. They bring up the completly irrelevant Semmelweis to attach an air of legitimately to his crackpot beliefs. They do it again with Arendt.

dang 8y ago
Can you please stop posting rants to HN? They're not what this site is for, and you've done it a lot, unfortunately. Your non-rant comments are fine. HN is for intellectual curiosity—see https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html.
- OpenBSD-supreme 8y ago
  Wooo wooo Wooo wooo! dang, the fun police, has arrived!
- austinjp 8y ago
  Personally I read their comment as impassioned rather than ranting.
  - dang 8y ago
    What I meant is that it was unsubstantive (i.e. contains little information) and calls names. That's what makes it a bad comment for HN.
- golergka 8y ago
  I have read this comment and I perceive it as a well-argumented, although may be a little bit emotional, critique. It has served my intellectual curiosity. If it had been on a topic that HN has a different consensus (like climate change) it still could've been the top comment, despite the tone.

a_parrot 8y ago

It's a pretty simple equation, and you feel the business end of it when you question a medical doctor regarding something as simple as an antibiotics prescription. Fields are designed to protect the degreed professional. The words are crafted as weapons forged in the defense of each thesis. Everything you confront is the product of some long-dead intellectual chess match conducted in an ivory tower, and from that moment forward concepts are, by turns, weaponized. This principle extends to all fields, economics, sociology, psychology, biology, chemistry, physics, math. Don't believe me? Try on the "divide by zero" argument for size. It's just notation, to communicate expressions, that relay ideas. If you were to have nothing, and hypothetically cut nothing into a number of parts, you'd still have nothing. If you have something, and divide it into zero parts, then that too, is nothing. But people have a professional stake in fighting such compromises. Having won an argument in the past means their reputation rests on defending that stance until they finally die and get out of the way. It's pretty easy to let an expression that communicates division with zero exist. But because we have an academic norm standing in the way, the conversation of whether or not we should serves better to reveal the brainwashed drones, parroting their instructors until death.

bellerose 8y ago

The more I read of psychiatry makes me lean towards the majority of it being pseudoscience. Finances play the most important role in suicidal ideation but nothing is ever done for the people suffering from suicide attempts besides placing them in a facility for an extended period and medicating them. Some of the drugs have even been shown to induce gambling. How in the world does someone escape a life where all the cards are dealt against them is unknown to me. In this world you spend more money when poor to live healthy than if starting out rich and it’s harder to save or increase your holdings while poor. Stress is definitely the deciding factor in if a person can stay happy and happiness is the only factor to really care about; besides physical health but they come hand in hand. I think the field is improving but I have a bias by living in a progressive city where the old beliefs are highly questioned and rarely followed. I think psychiatry will go down in history next to the holocaust. Too many people were ruined compared to being helped.

Bjartr 8y ago
> Stress is definitely the deciding factor in if a person can stay happy You make some interesting points, but I will say that you can absolutely become, and remain, unhappy even while living a stress-free life. So while stress is absolutely an important factor, it is not "the deciding factor"

elbasti 8y ago

Szasz's "The Myth of Mental Illness" is one of those works which is completely and utterly misinterpreted simply because of the title. I don't have the book available at the moment, but in the introduction he says something to the effect of "I don't regret writing this book, but I regret calling it what I did, because people judge it without reading it." The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying." This isn't what he says in the book at all. Rather, his argument is more along the lines of: 1. The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. Cancer, the flu, hyperparathyroidism--all map to causes. 2. The conditions which we call mental illness don't have a knowable cause. They are symptoms which we pattern match against. 3. Corollary: Illnesses should be hypothetically curable. There may be a cure for cancer. But there cannot be a "cure" for most "mental illnesses" because there is no shared, physical cause that underlies say, all cases of "bipolar disorder". 3. So we shouldn't call them "illnesses". We should call them something else. Unfortunately that's about as much as I remember of his argument, but it's very different than the common accusation... And it also strikes me as accurate. The problem with naming things is that it makes them real. I think often the hacker news crowd forgets how ill-informed most of the world is, and the degree to which people crave certainty. When a person is told by a psychiatrists "Your 8 year has depression so we'll put her on X pill" or "You have bipolar type 2, so I recommend Y medicine", it has a certain finality. Most people don't think "The doctor is telling me that my behavior matches some patterns. That is it. She does not know why, and we may never know why, there may not even be a reason why. So we should think about what we can do to mitigate this." No. The we think "I've been diagnosed with a disease. (Sorry I'm being an a-hole|I won't go to your party|didn't get out of bed), I suffer from bipolar and there's no cure".

dragonwriter 8y ago
> The gut-reaction to such a title is to think the writer is saying "depression doesn't exist" or "schizophrenia doesn't exist" or "manic depressives are lying." Even at the more generous level of “mental illness is different from physical illness” it is wrong, and dangerously so. > The word "illness" should be used to represent a cause-- and resolving the cause should cure the illness. This has never been what “illness” means; illness (both in general and in specific named instances) is often recognized and identified long before causes. > The conditions which we call mental illness don't have a knowable cause. They don't usually have a known cause. That they don't have knowable cause is an unwarranted conclusion. Plenty of physical illness don't have known mechanisms, and most of those that do were noticed and given names as illnesses before (sometimes centuries before) the mechanism was identified. This doesn't mean they don't generally have knowable causes, as is evident from the ones whose causes were later learned. > Illnesses should be hypothetically curable. That doesn't even remotely follow. Having a know cause doesn't imply curability because causes are not necessarily reversible. > I think often the hacker news crowd forgets how ill-informed most of the world is True. It's easy to forget that many people do not even realize that pattern matching on symptoms is how much diagnosis of physical illness is done, and that even where causes are known it's often not worthwhile (and sometimes not practical) to actually test for them directly.

Legogris 8y ago

An article on the book from 1970: https://jamanetwork.com/journals/jama/article-abstract/356561 https://jamanetwork.com/journals/jama/article-abstract/35656...

gmfawcett 8y ago

I wish I could remember the title and author, but this reminds me of an (unrelated) book on pain management, where the author's thesis is that most musculoskeletal pain is psychosomatic: you can essentially will yourself out of chronic pain once you accept this statement as fact. Does anyone recall the book I'm talking about?

briancleland 8y ago
John Sarno perhaps? I found his method very effective. https://www.youtube.com/watch?v=6JVDj2rEOas https://www.youtube.com/watch?v=6JVDj2rEOas
- gmfawcett 8y ago
  Yes, thank you, I think that's the one! I had no idea there was a documentary film about him. Thanks very much for sharing that.
wiry-bulb 8y ago
http://www.neuroplastix.com/styled-4/aboutus.html http://www.neuroplastix.com/styled-4/aboutus.html Maybe Dr. Moskowtizs. His technique is the subject of chapter 1 in Norman Doidge’s “The Brain’s Way of Healing”
- gmfawcett 8y ago
  Thank you for this.

TheTruestKyle0 8y ago

How about you stop being a little cunt? You ever think about that bitch?