4 ms·

In the last couple of decades we've dissociated autism from schizophrenia, declared homosexuality and being trans no longer a mental illness, and uncovered ther

In the last couple of decades we've dissociated autism from schizophrenia, declared homosexuality and being trans no longer a mental illness, and uncovered therapeutic techniques like cognitive behavioral therapy which has real, measured, repeat-study impact in lowering people's risk of suicide.

jokethrowaway 6y ago
That's mostly incorrect. Only Gender Identity Disorder -> Gender Dysphoria happened in the last 2 decades. CBT is great and I personally benefited from it, but it's not a recent phenomenon and its effectiveness is very hard to evaluate. There was a meta-study analysis in 2015 that pointed at a decline in its effectiveness between 1977 and 2014. I wonder whether it's because studying anything to do with a human brain is hard and we can't trust the numbers or if it's because of changes in society that caused people's personality to shift in a direction which makes CBT less effective. Autism and schizophrenia were differentiated in 1980, so that's not in the last 2 decades. Homosexuality stopped being a mental illness in 1973 (or 1987 if you include sexual orientation disturbance), so that's not in the last 2 decades. This was a great success, there were studies that pointed at a marked decrease in suicides among people in same-sex relationship over time. Gender Identity Disorder stopped being a mental illness in 2013 but I think the issue has been politicised and the outcome doesn't necessarily make a lot of sense. I can bring a personal anecdote from a friend of mine who started using a female name for a period and wanted to perform a reaffirmation surgery, who later changed his mind. - Most kids who experience gender dysphoria before puberty grow out of it. - Suicide rates are high even after reaffirmation surgery and even in western societies, which are accepting of transgenders. Moreover, if discrimination was the cause of suicide rates, I think we would see a high suicide rate in minorities. There is way more discrimination towards people of color than towards transgender. - If Gender Identity Disorder is not a mental illness, shouldn't we be consistent and label Body Integrity Dysphoria (aka people who believe they're amputee) as diversity and approve of cutting off of healthy limbs? I'm skeptical on including this as a win for the field.
- TeaDrunk 6y ago
  1) I wasn't aware couple meant literally in the past 20 years and not the past handful (which to me would be anything within recent memory). 2) Transgender people do not have the legal protections that people of color do. There have only recently been laws to protect transgender people to be employed, have healthcare, etc. on the federal level- and what protections exist can be easily stripped away due to "moral disagreement" of the employer. You cannot refuse as an employer to give a black woman healthcare because you have a "moral disagreement" with her being black.
- LudwigNagasena 6y ago
  > There was a meta-study analysis in 2015 that pointed at a decline in its effectiveness between 1977 and 2014. I wonder whether it's because studying anything to do with a human brain is hard and we can't trust the numbers or if it's because of changes in society that caused people's personality to shift in a direction which makes CBT less effective. Another theory is that methodology doesn’t matter and the result mostly depends on personal qualities of the psychiatrist. And CBT was effective because the best specialists adopted it. When the rest of the profession caught up effectiveness went down.
  - pessimizer 6y ago
    That's intriguing. Is there a name for a process like that? Because I can imagine that it happens a lot.
    - LudwigNagasena 6y ago
      In psychotherapy it is called the Dodo bird verdict: https://en.wikipedia.org/wiki/Dodo_bird_verdict https://en.wikipedia.org/wiki/Dodo_bird_verdict
- pessimizer 6y ago
  > Homosexuality stopped being a mental illness in 1973 (or 1987 if you include sexual orientation disturbance), so that's not in the last 2 decades. This was a great success, there were studies that pointed at a marked decrease in suicides among people in same-sex relationship over time. And while it's progress for psychology itself, and good for society, it's certainly not an achievement. People were killing themselves and being institutionalized because psychologists were calling them insane, and this stopped happening when psychology chose to stop calling them insane. I can't claim an important discovery in abuse prevention if I choose to stop abusing someone.

jokethrowaway 6y ago

That's mostly incorrect. Only Gender Identity Disorder -> Gender Dysphoria happened in the last 2 decades. CBT is great and I personally benefited from it, but it's not a recent phenomenon and its effectiveness is very hard to evaluate. There was a meta-study analysis in 2015 that pointed at a decline in its effectiveness between 1977 and 2014. I wonder whether it's because studying anything to do with a human brain is hard and we can't trust the numbers or if it's because of changes in society that caused people's personality to shift in a direction which makes CBT less effective. Autism and schizophrenia were differentiated in 1980, so that's not in the last 2 decades. Homosexuality stopped being a mental illness in 1973 (or 1987 if you include sexual orientation disturbance), so that's not in the last 2 decades. This was a great success, there were studies that pointed at a marked decrease in suicides among people in same-sex relationship over time. Gender Identity Disorder stopped being a mental illness in 2013 but I think the issue has been politicised and the outcome doesn't necessarily make a lot of sense. I can bring a personal anecdote from a friend of mine who started using a female name for a period and wanted to perform a reaffirmation surgery, who later changed his mind. - Most kids who experience gender dysphoria before puberty grow out of it. - Suicide rates are high even after reaffirmation surgery and even in western societies, which are accepting of transgenders. Moreover, if discrimination was the cause of suicide rates, I think we would see a high suicide rate in minorities. There is way more discrimination towards people of color than towards transgender. - If Gender Identity Disorder is not a mental illness, shouldn't we be consistent and label Body Integrity Dysphoria (aka people who believe they're amputee) as diversity and approve of cutting off of healthy limbs? I'm skeptical on including this as a win for the field.

TeaDrunk 6y ago
1) I wasn't aware couple meant literally in the past 20 years and not the past handful (which to me would be anything within recent memory). 2) Transgender people do not have the legal protections that people of color do. There have only recently been laws to protect transgender people to be employed, have healthcare, etc. on the federal level- and what protections exist can be easily stripped away due to "moral disagreement" of the employer. You cannot refuse as an employer to give a black woman healthcare because you have a "moral disagreement" with her being black.
LudwigNagasena 6y ago
> There was a meta-study analysis in 2015 that pointed at a decline in its effectiveness between 1977 and 2014. I wonder whether it's because studying anything to do with a human brain is hard and we can't trust the numbers or if it's because of changes in society that caused people's personality to shift in a direction which makes CBT less effective. Another theory is that methodology doesn’t matter and the result mostly depends on personal qualities of the psychiatrist. And CBT was effective because the best specialists adopted it. When the rest of the profession caught up effectiveness went down.
- pessimizer 6y ago
  That's intriguing. Is there a name for a process like that? Because I can imagine that it happens a lot.
  - LudwigNagasena 6y ago
    In psychotherapy it is called the Dodo bird verdict: https://en.wikipedia.org/wiki/Dodo_bird_verdict https://en.wikipedia.org/wiki/Dodo_bird_verdict
pessimizer 6y ago
> Homosexuality stopped being a mental illness in 1973 (or 1987 if you include sexual orientation disturbance), so that's not in the last 2 decades. This was a great success, there were studies that pointed at a marked decrease in suicides among people in same-sex relationship over time. And while it's progress for psychology itself, and good for society, it's certainly not an achievement. People were killing themselves and being institutionalized because psychologists were calling them insane, and this stopped happening when psychology chose to stop calling them insane. I can't claim an important discovery in abuse prevention if I choose to stop abusing someone.