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> to defeat this othering and reduce stigma, clinical practice needs to move away from biogenetic causal language This is a pretty big assertion that the piece

• DataWorker 6y ago
  If we don’t know then we don’t know. Calling it a chemical imbalance implies knowledge that does not exist.
  • fit2rule 6y ago
    In fact, isn't the point that the 'ideation' of mental illness as a chemical process seems to further the process somewhat, and therefore some degree of refactoring needs to be done of the language used so that we 'un-know' the details well enough to treat it subjectively? Fascinating conundrum.
• akurzon 6y ago
  >This is a pretty big assertion that the piece casually drops without backing My understanding was that the results of the author's interviews were the backing for this assertion: >As the interviews made clear, people adopted the biogenetic account because they thought it was based in science. The interviews also show how this account undermines the kinds of introspection and self-examination that can lead to meaningful self-knowledge. >Mental health treatment needs to re-engage with the language of persons. This means suspending the detached, third-person stance toward patients, and attending to their actual experience and circumstances. And it means encouraging patients themselves to avoid this stance and draw on the normal ways that people make sense of their emotions and actions. Or do you mean that the conclusion the author reaches, that we should be attending to people's experiences instead of using "biogenetic causal language," isn't justified by the results of the interviews?
• jml7c5 6y ago
  I'd like to pull the full quote, which is more nuanced: >As I argue in my book Chemically Imbalanced (2020), to defeat this othering and reduce stigma, clinical practice needs to move away from biogenetic causal language. Psychiatric research doesn’t support the notion of simple cause and effect in mental health, instead uncovering a far more complex and indeterminate picture of vulnerabilities. There is no evidence to justify the continued promotion of one-dimensional theories such as ‘chemical imbalance’. Nor does the beneficial use of psychiatric medicines require it. In fact, their precise mechanism of action and relation to troublesome experience remains a mystery. It would be more truthful for mental health professionals and public health campaigns to acknowledge this. It's helpful to note the flipped the burden of proof here: the author argues there is no evidence for "chemical imbalance" language, not that there is evidence against "chemical imbalance" language. I see it as an admission of uncertainty rather than claim of knowledge; the use of the somewhat tepid phrases "need to move away from", and "complex and indeterminate picture" are a further sign the statements are not categorical. Though I could have misunderstood their thesis. I'll find out once I've read the book, I suppose. :-)
• Barrin92 6y ago
  'Chemical imbalance' as a causal explanation seems to me almost useless because every severe change in behaviour pretty much by definition corresponds to change in the brain. How else is it supposed to be manifest? Is there supposed to be drastic change in psychology without change in the brain? There can be a company pouring lead into a river, psychological hazard during a civil war, and it will always manifest in the brain, what kind of explanation is this? Of course these things can be found in the brain, it would be crazy if they didn't. That's not to say there's no diseases that are actual individual pathologies of the brain of course, but to use 'chemical imbalance' as a sort of first order response to what may have actual social or environmental reasons say, is entirely circular reasoning.
  • numpad0 6y ago
    “It’s not a bug, it’s electronic misplacement”
  • koheripbal 6y ago
    "People in distress" is even more useless. "in distress" could mean anything from having fallen down the stairs, to running out of gas on the highway. I don't mind changing language, as long as we're become more precise, not less. If "chemical imbalance" is bad, suggest something better. I think a bigger problem is that people are fixated on word definitions and offending others instead of solving problems.
    • horsawlarway 6y ago
      >I think a bigger problem is that people are fixated on word definitions and offending others instead of solving problems. I agree, and this is pretty much unavoidable when the current clinical term is vague enough to be used as a generic insult. The general pattern I see 1. A vague term is used to describe symptoms of an issue we have a poor understanding of. 2. That term becomes associated with the symptoms, but is vague enough to be used as a generic insult (ex: playground school children yelling it at each other) 3. That term develops a stigma as an insult, and becomes more and more controversial 4. That term is replaced with a new term, rinse and repeat. We've seen this before ex: Moron, Imbecile, and Retard all once had vague clinical meanings. Then we went to mentally challenged, special needs, etc. Now even those are fairly loaded terms. In all of these cases, the word/phrase describes something that people would rather not have or be, but it does it without clarity. It will develop a stigma. I find the folks who constantly advocate for changing these names well-intentioned, but basically a waste of time.
• abnry 6y ago
  It's interesting the author argues dropping the term to reduce stigma because many people argue for using the term in order to reduce stigma. That is, if you can explain what is going on with you with some biological case, it seems so much less of a personal indictment than if the case is considered to be psychological. That said, I completely agree that the explanation should be dropped because we really have little to no evidence for it.
• bjornsing 6y ago
  > If we do not understand the processes, how can the author make the assertion that the characterization they are against is wrong? Generally, in a scientific context, characterizations are wrong if they lack any scientific basis.