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It not only deters healing, it makes people act ill when they are not. Social media is filled with people pretending to be sick. If you want some of the most bl

It not only deters healing, it makes people act ill when they are not. Social media is filled with people pretending to be sick. If you want some of the most blatant see [0] the disability there isn't three broken ribs requiring a ventilator. Reminds me of Luis the 14th and his anal fistula [1]. Courtiers started faking anal fistulas after the king had an operation to remove his. It got to the point where they would get treatment for them, or fake getting the treatment, regardless of health. This was not a simple operation at the time. Chances of death were high, to the point where the first was performed on a condemned criminal who was pardoned if he survived. [0] https://www.insider.com/who-is-youtube-star-nikocado-avocado-2020-1 https://www.insider.com/who-is-youtube-star-nikocado-avocado... [1] https://tidsskriftet.no/2016/08/sun-kings-anal-fistula https://tidsskriftet.no/2016/08/sun-kings-anal-fistula

thaumasiotes 4y ago
See also: https://astralcodexten.substack.com/p/book-review-crazy-like-us https://astralcodexten.substack.com/p/book-review-crazy-like... > Around the Meiji Restoration, when everyone was obsessed with how great foreign stuff was, Japanese medical students went to Germany, learned psychiatry, came back to Japan, and told everyone they were neurasthenic. Being neurasthenic became first a fashion, then a class marker. The idea was that neurasthenics were people who were working too hard (good, admirable), and who were so smart and doing so much furious intellectual activity that it was straining their nerves (impressive). Also, they were probably sensitive souls too pure for this world. The most embarrassing extreme of this happened in 1903, when some photogenic Japanese youth carved a poem in a tree, went to a beautiful waterfall, and leapt to his death. Everyone praised him for how sensitive and artistic and neurasthenic this was, and turned him into a posthumous national hero. Meanwhile, “in 1902 an article reported that fully one-third of patients visiting hospitals for consultations were suffering from the new disease.” > Eventually Japanese psychiatrists got fed up, and started announcing that actually neurasthenia sucked and you should not have it. From a 1906 Japanese neurology journal: >> These days, young students talk about such stuff as “the philosophy of life”. They confront important and profound problems of life, are defeated, and develop neurasthenia. Those who jump off a waterfall or throw themselves in front of a train are weak-minded. They do not have a strong mental constitution and develop mental illness, dying in the end. How useless they are! Such weak-minded people would only cause harm even if they remained alive. > Finally everyone struck a compromise and agreed that most of the lower-class patients weren’t real neurasthenics (hard-working, intelligent, sensitive, admirable), but had a similar condition, imitating the symptoms of neurasthenia, based on being too weak and pathetic to cope. This seemed to do the trick, and people stopped coming to the hospital with neurasthenia symptoms. Watters writes: >> Looking back on the debate, it seems as if acceptance of neurasthenia had been so successful that psychiatrists felt obligated to restigmatize this mental disorder in hopes of limiting its adoption. By the end of World War II the diagnosis had almost completely gone out of style among both psychiatrists and the population at large. > He who has ears to hear, let him listen. Glorifying illness causes a lot of harm.
- majormajor 4y ago
  That story doesn't exactly end "and then everyone was mentally healthy in Japan happily ever after," though, does it?
- dane-pgp 4y ago
  > psychiatrists felt obligated to restigmatize this mental disorder in hopes of limiting its adoption Or, to put it another way, they felt obligated to shame people into not seeking treatment, in hopes of not having to admit that they didn't know how to help their patients. Fewer patients, happier doctors, better metrics. Everyone wins, right?
  - bobsmooth 4y ago
    > that fully one-third of patients visiting hospitals for consultations were suffering from the new disease People have been making shit up for attention for at least the last 120 years.
  - thaumasiotes 4y ago
    > to put it another way, they felt obligated to shame people into not seeking treatment, in hopes of not having to admit that they didn't know how to help their patients. On the contrary, shaming people into not seeking treatment is how they were helping them. Prevention is the best cure, after all.
    - dane-pgp 4y ago
      I get the point that psychiatrists wanted to avoid over-diagnosing/over-prescribing, but what if they ended up over-prescribing societal shame itself, which is after all a very blunt instrument? This is particularly likely to occur if the incentives are aligned to make the problem seem to go away rather than doing the hard work of actually fixing things. In other words, they may not have been preventing or curing anything (at least for the patients who needed the most help).
      - thaumasiotes 4y ago

thaumasiotes 4y ago

See also: https://astralcodexten.substack.com/p/book-review-crazy-like-us https://astralcodexten.substack.com/p/book-review-crazy-like... > Around the Meiji Restoration, when everyone was obsessed with how great foreign stuff was, Japanese medical students went to Germany, learned psychiatry, came back to Japan, and told everyone they were neurasthenic. Being neurasthenic became first a fashion, then a class marker. The idea was that neurasthenics were people who were working too hard (good, admirable), and who were so smart and doing so much furious intellectual activity that it was straining their nerves (impressive). Also, they were probably sensitive souls too pure for this world. The most embarrassing extreme of this happened in 1903, when some photogenic Japanese youth carved a poem in a tree, went to a beautiful waterfall, and leapt to his death. Everyone praised him for how sensitive and artistic and neurasthenic this was, and turned him into a posthumous national hero. Meanwhile, “in 1902 an article reported that fully one-third of patients visiting hospitals for consultations were suffering from the new disease.” > Eventually Japanese psychiatrists got fed up, and started announcing that actually neurasthenia sucked and you should not have it. From a 1906 Japanese neurology journal: >> These days, young students talk about such stuff as “the philosophy of life”. They confront important and profound problems of life, are defeated, and develop neurasthenia. Those who jump off a waterfall or throw themselves in front of a train are weak-minded. They do not have a strong mental constitution and develop mental illness, dying in the end. How useless they are! Such weak-minded people would only cause harm even if they remained alive. > Finally everyone struck a compromise and agreed that most of the lower-class patients weren’t real neurasthenics (hard-working, intelligent, sensitive, admirable), but had a similar condition, imitating the symptoms of neurasthenia, based on being too weak and pathetic to cope. This seemed to do the trick, and people stopped coming to the hospital with neurasthenia symptoms. Watters writes: >> Looking back on the debate, it seems as if acceptance of neurasthenia had been so successful that psychiatrists felt obligated to restigmatize this mental disorder in hopes of limiting its adoption. By the end of World War II the diagnosis had almost completely gone out of style among both psychiatrists and the population at large. > He who has ears to hear, let him listen. Glorifying illness causes a lot of harm.

majormajor 4y ago
That story doesn't exactly end "and then everyone was mentally healthy in Japan happily ever after," though, does it?
dane-pgp 4y ago
> psychiatrists felt obligated to restigmatize this mental disorder in hopes of limiting its adoption Or, to put it another way, they felt obligated to shame people into not seeking treatment, in hopes of not having to admit that they didn't know how to help their patients. Fewer patients, happier doctors, better metrics. Everyone wins, right?
- bobsmooth 4y ago
  > that fully one-third of patients visiting hospitals for consultations were suffering from the new disease People have been making shit up for attention for at least the last 120 years.
- thaumasiotes 4y ago
  > to put it another way, they felt obligated to shame people into not seeking treatment, in hopes of not having to admit that they didn't know how to help their patients. On the contrary, shaming people into not seeking treatment is how they were helping them. Prevention is the best cure, after all.
  - dane-pgp 4y ago
    I get the point that psychiatrists wanted to avoid over-diagnosing/over-prescribing, but what if they ended up over-prescribing societal shame itself, which is after all a very blunt instrument? This is particularly likely to occur if the incentives are aligned to make the problem seem to go away rather than doing the hard work of actually fixing things. In other words, they may not have been preventing or curing anything (at least for the patients who needed the most help).
    - thaumasiotes 4y ago