12 ms·

The Battle to Define Mental Illness (2010)

78 points by Alex3917 2y ago

throw4847285 2y ago
I find the debate about the utility of the diagnostic model to be so polarizing as to be useless. You can't totally reject some of these diagnoses, regardless of how porous the boundaries, without depriving a lot of people of the care they need. On the other hand, it's hard to argue that the current diagnostic categories are working especially well for the people who aren't bullseyes. I stumbled on this paper when I was thinking about my own diagnoses of bipolar disorder and ADHD that explores why the comorbidity is so high, and ends up with a fascinating meta-analysis of how we think about diagnostic categories. I have no idea if this paper is respected, or has been totally debunked, because I don't have any context on the field. I did find it very helpful for myself, personally. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028268/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028268/
- faeriechangling 2y ago
  >You can't totally reject some of these diagnoses, regardless of how porous the boundaries, without depriving a lot of people of the care they need. Which is precisely why the DSM is a political document, designed for clinical utility, and not a scientific one. I will mention that several of the barriers to create we create to care are artificial. One of the most common fears I've heard from those with ADHD is that without their diagnosis being taken seriously they will lose access to their medication. Yet that's only an issue because we won't give people drugs, even if they find them helpful, unless prescribing physicians believes they are disordered. Consequently, there are ADHD communities who ban people diagnosed with ADHD for having too positive of a self-outlook. The entire system is deeply twisted. We've made acceptance of an intrinsically derogatory pseudoscientific nosology a gatekeeper, and put reflexively categorising patients as disordered at the centre of our care model.
da39a3ee 2y ago
No escape from the mass mind rape Play it again Jack and then rewind the tape And then play it again and again and again Until your mind is locked in Believin' all the lies that they're tellin' ya Buyin' all the products that they're sellin' ya They say, "Jump" and you say, "How high?" You brain-dead, you got a fuckin' bullet in your head
rtb 2y ago
EDIT: this was an attempt to get past the paywall, but looks like it's javascript driven, so this archived version breaks after a moment, unless you disable js https://web.archive.org/web/20240324050221/https://www.wired.com/2010/12/ff-dsmv/ https://web.archive.org/web/20240324050221/https://www.wired...
- deleted 2y ago
  [deleted]
- Myrmornis 2y ago
  Thanks. Text is at https://pastebin.com/LTbtPCsV https://pastebin.com/LTbtPCsV.
- neonate 2y ago
  https://archive.ph/XQzIG https://archive.ph/XQzIG works, for those who can access it
- Karellen 2y ago
  Reader mode works fine for me.
deanresin 2y ago
This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm" offer the species a safety net should conditions change rapidly. Should we really be trying to herd everyone back to a norm? Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete.
- selfie 2y ago
  So, this: https://xkcd.com/435/ https://xkcd.com/435/
- jalapenos 2y ago
  It's definitely a growing profession. It only came into existence fairly recently, and it continues to innovate and develop new approaches. Good psychologists can provide enourmous value to their clients, and contrary to what the drug pushers want people to believe, mental illness isn't a physiological problem but a complex problem involving much more than that.
- triumphblr 2y ago
  > Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete. That's a fundamentally reductionist perspective and assumes everything is biological in its etiology? For example, you could say we don't need a justice system once we have the biology worked out, or arts, or sports. At some level it's a fundamentally authoritarian argument as well: if you have the biology worked out, what's to keep the holders of power from altering people to whatever norm they want? Having the biology completely worked out won't magically reveal natural disorder states. The biological explication of a behavior doesn't obviate the need to have some norm for intervention decisions. Biology doesn't have norms, psychosocial systems have norms. Non-behavioral medicine is still full of ethics. And that doesn't even get into issues about whether you could ever identify any biological substrate as synonymous with a human experiential state or history.
johnea 2y ago
[dead]
0xcde4c3db 2y ago
Frances's concerns definitely aren't wrong on the whole, but I feel like he's not seeing the forest for the trees. This ultimately isn't just a question of whether this or that DSM revision is helpful. The patterns of the mental health establishment of the 21st century are oddly reminiscent of where physics and chemistry stood ca. the mid-19th century. Legitimate advances are being made, but most of the tools are still unreliable and many of the theories still fairly reek of superstition and magical thinking. Practitioners are frequently defined more by which tradition or thought leader they adhere to than by their specialization in established subfields. It's not a great situation, and I don't see many signs that it's improving. A great deal is said about "awareness" and "stigma". Phrases like "get help" have been around long enough to turn from hero to villain (i.e. from an earnest plea to close friends or loved ones to a passive-aggressive dismissal of strangers). Who's seriously talking about materially improving the situation instead of promoting an allegedly more "correct" theory? Hell if I know. Please tell me if you do. I guess I broadly agree with the article author that the DSM process is "caught between paradigms" and has "no obvious way forward", but that's a profoundly unsatisfying place to find common ground.
- triumphblr 2y ago
  Frances I think was worried about his legacy disappearing with DSM-5, because there was a big push to change things in a major way compared to DSM-IV. Ultimately I don't think that really happened; DSM-5 was a change but not the radical change I think the chairs and primary committees wanted it to be. Frances' flooding of media outlets around that time was sort of strange in certain ways. He seemed to correctly identify potential problems in the mental healthcare system but then had this idea that changing things in the DSM to address some of its issues would make everything worse. It felt as if he was co-opting concerns everyone was having to argue for not changing anything at all, and in the process turned everything on its head. The DSM is a very political document with a lot of interest groups involved at all levels, which is why it didn't change even more than it did. As a result, you had NIMH circumvent the whole process with RDoC, which then in turn seems to have had a relatively short life (maybe?) associated with changeover in its own administration. It feels as if everyone has their own schema for thinking about mental illness, and the whole field moves along without any serious consequences. There's probably a lot of reasons for this, including scientific and medical sociology, and the complexity of mental wellness and illness as a domain. But it makes me wonder if some of the distinctions that are argued to be critical are really that critical in the end.
dangle1 2y ago
It's very sad. DSM was never strictly meant to be a clinical diagnostic tool, but rather it was originally meant to define specific illnesses in a manner that would facilitate further research by allowing investigators to at least be talking about the same phenomena when comparing results. (and it unintentionally became very popular with lawyers, who argued that presence in the DSM equated to unimpeachable evidence of an illness in a client, another use that it was never designed to accommodate) It's still true that there are only on the order of 8-12 well-validated diagnoses in the manual. Increases in the number of included diagnoses over editions is primarily due to concessions to important researchers as opposed to clear identification of previously undescribed illnesses. There are lumpers and splitters in academic psychiatry. Lumpers are suspicious that there are several hundred discrete disorders of the brain that can't be more parsimoniously explained with existing, better validated illnesses.
crtified 2y ago
Is there any condition with as broad a definition as autism? It can cover anywhere from a non-verbal 9 year old with an IQ of 70, to a popular attractive valedictorian genius with incredible masking skills. A slow developing 3 year old labelled early and for life, or a perennial loner 80+ year old finally discovering that their traits are shared with many others.
- Lord-Jobo 2y ago
  I don't think there are any as broad as "autism" in general, but "ADHD" in general is close. That's why both have been divided up in recent years for the sake of precision. Seriously 5/10 people in my friends group have ADHD (some with autism too) and we all have such wildly different symptoms and struggles with it that it took quite some time for us to recognize our shared syndrome lol
- harimau777 2y ago
  I think that's likely a natural outcome of a diagnosing something that appears to be a spectrum rather than a discrete disorder. Perhaps analogous to how back pain can range from a mild inconvenience to completely debilitating. Or how there's a spectrum between someone who is harmlessly arrogant to a clinical narcissist.
- veltas 2y ago
  But autism isn't defined by intelligence or age. You might as well say 'isn't alcoholism such a broad definition, when everyone from world leaders to young people to a perennial loner 80+ year old finally discovering that their traits are shared with many others.
  - faeriechangling 2y ago
    The two extremes don't have the same traits in common whatsoever. One will clearly be unable to communicate. The other will clearly communicate but allude to an internal torment. One will struggle with the activities of daily living. The other will have a family, a full time job, commitments in the community. The two people supposedly lack the same abilities. In truth, Autism simply got tied up with entitlements and the diagnosis has been grossly abused as a lever to get access to said entitlements.
AlbertCory 2y ago
> Frances, who claims he doesn't care about the royalties (which amount, he says, to just 10 grand a year) for a writer these days, 10 grand is definitely not chump change.
raincom 2y ago
Even today, we don’t have a definition of “species”, a definition acceptable to biologists working in this domain. What is needed is a theory, and further development of that theory. Those who quibble about definitions should develop theories and test them, amend them, replace them. All these activities help understand the phenomenon in the question. When people engage in definitional disputes, it shows that intuitions about the phenomenon conflict. That’s all. To settle these issues, one should do science: that is, develop theories, derive consequences, add back ground theories to test these consequences.
- Myrmornis 2y ago
  Incidentally, the species debate is fairly simply summarized / resolved, at least for typical sexual organisms: There is nothing whatsoever in first-principles evolutionary biology that says that these can always be partitioned into discrete categories that one might call "species". What evolutionary biology says is 1. When two populations overlap in space and time and have the opportunity to interbreed, they might do so. 2. In the absence of interbreeding, populations evolve, divergently w.r.t. most markers other than the occasional selection-mediated convergence. So, divergence might be the result of lack of opportunity to interbreed (this allows genetic and phenotypic diversity to accrue, but does not itself represent a biologically real division), or it might be the result of inability to interbreed (biologically meaningful, but impossible to discern if opportunity to interbreed is absent). And that's it, for sexual organisms that is the gist. In general there's nothing to say that our systems of related populations spread through space and time can always be divided into "species". On the other hand any cursory look around a single locality shows that many discrete biological entities do exist; there's nothing wrong with giving them the name "species" as long as we acknowledge that for closely related allopatric populations the question of whether they are the same "species" is not defined. There are various problems. One is that some humans are attached to the idea that entities exist for which the word "species" is apt; or put another way they are convinced that "species" must mean _something_ and they ask what (e.g. because they like their neatly divided up bird lists). Another is that if scientists go around saying "animals can't always be divided into things which it makes sense to call 'species'" then it significantly weakens certain arguments for the protection of populations in conservation biology / legal contexts, since these invariably name the species-level taxa they are intended to protect. Since the modern trend is towards splitting subspecies (i.e. geographical races) into species (as opposed to lumping), many conservation initiatives are based on protecting "species" for which the species designation is subjective. That doesn't mean they are flawed of course -- they are nearly always protecting valuable ecosystems. It's just that as we split geographical races, we (by definition) create rarer and more vulnerable taxa, and so conservation initiatives arise around these.
transkillskids 2y ago
[flagged]
deleted 2y ago
[deleted]
deleted 2y ago
[deleted]
matrix87 2y ago
It's kind of strange that psychology has this dual role of both giving advice to the sane and managing the insane. The same division was a thing in psychoanalysis too with neurotics vs psychotics Why does it do both? Why do people use it as a go-to source for life advice? People will go to a psychologist for marriage troubles, and they'll also go to a psychologist for psychosis. Seems like a weird place to go to marriage help for unless your wife is psychotic It's like psychologists have been given this role that religion used to occupy
- gverrilla 2y ago
  It is exactly the role religions used to play - more so in the past, yes, but still pretty much in scene today still, although perhaps weaker - so this answer your question: > Why does it do both? Demand. For what? For adaptation to the current metagame. While writing this reply, I remembered a few passages from a great thinker, that I think may contribute and expand the conversation, for those interested: "Art, ethics, philosophy bear witness: under the crust of words and concepts, the living reality of non-adaptation to the world is always crouched, ready to spring. Since neither gods nor words can manage to cover it up decently any longer, this commonplace creature roams naked in railway stations and vacant lots; it confronts you at each evasion of yourself, it touches your elbow, catches your eye; and the dialogue begins." [0] "After all, if an individual refuses both to adapt to the violence of the world, and to embrace the violence of the unadapted, what can he do? If he doesn't raise his will to achieve unity with the world and with himself to the level of coherent theory and practice, the vast silence of society's open spaces will raise around him the palace of solipsist madness." [1] "People are bewitched into believing that time slips away, and this belief is the basis of time actually slipping away. Time is the work of attrition of that adaptation to which people must resign themselves so long as they fail to change the world." [2] Raoul Vaneigem 0, 1: https://www.darkmatterarchives.net/wp-content/uploads/2013/06/Vaneigem.pdf https://www.darkmatterarchives.net/wp-content/uploads/2013/0... 2: https://voidnetwork.gr/wp-content/uploads/2016/09/The-Revolution-of-Everyday-Life-by-Raoul-Vaneigem.pdf https://voidnetwork.gr/wp-content/uploads/2016/09/The-Revolu...
  - throw4847285 2y ago
Log_out_ 2y ago
The problem of classification is one not useful by defect. In stead it should go by effect, on the individual and on society, as it cycles through the situations encountered by a old, tribal, militaristic clan based society. The adaptations we define as ails today were useful back then in the role of * and gave the individual a place as *. It helps to understand what it was of yore.

78 points by Alex3917 2y ago

I find the debate about the utility of the diagnostic model to be so polarizing as to be useless. You can't totally reject some of these diagnoses, regardless of how porous the boundaries, without depriving a lot of people of the care they need. On the other hand, it's hard to argue that the current diagnostic categories are working especially well for the people who aren't bullseyes. I stumbled on this paper when I was thinking about my own diagnoses of bipolar disorder and ADHD that explores why the comorbidity is so high, and ends up with a fascinating meta-analysis of how we think about diagnostic categories. I have no idea if this paper is respected, or has been totally debunked, because I don't have any context on the field. I did find it very helpful for myself, personally. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028268/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028268/

faeriechangling 2y ago
>You can't totally reject some of these diagnoses, regardless of how porous the boundaries, without depriving a lot of people of the care they need. Which is precisely why the DSM is a political document, designed for clinical utility, and not a scientific one. I will mention that several of the barriers to create we create to care are artificial. One of the most common fears I've heard from those with ADHD is that without their diagnosis being taken seriously they will lose access to their medication. Yet that's only an issue because we won't give people drugs, even if they find them helpful, unless prescribing physicians believes they are disordered. Consequently, there are ADHD communities who ban people diagnosed with ADHD for having too positive of a self-outlook. The entire system is deeply twisted. We've made acceptance of an intrinsically derogatory pseudoscientific nosology a gatekeeper, and put reflexively categorising patients as disordered at the centre of our care model.

da39a3ee 2y ago

No escape from the mass mind rape Play it again Jack and then rewind the tape And then play it again and again and again Until your mind is locked in Believin' all the lies that they're tellin' ya Buyin' all the products that they're sellin' ya They say, "Jump" and you say, "How high?" You brain-dead, you got a fuckin' bullet in your head

rtb 2y ago

EDIT: this was an attempt to get past the paywall, but looks like it's javascript driven, so this archived version breaks after a moment, unless you disable js https://web.archive.org/web/20240324050221/https://www.wired.com/2010/12/ff-dsmv/ https://web.archive.org/web/20240324050221/https://www.wired...

deleted 2y ago
[deleted]
Myrmornis 2y ago
Thanks. Text is at https://pastebin.com/LTbtPCsV https://pastebin.com/LTbtPCsV.
neonate 2y ago
https://archive.ph/XQzIG https://archive.ph/XQzIG works, for those who can access it
Karellen 2y ago
Reader mode works fine for me.

deanresin 2y ago

This conundrum reminds me of a thought experiment. You have people use a mental illness as a defense in courts of law. But could you not plausibly define anyone who commits major crimes to be mental ill? Mental illness could also be defined by a person's ability to function in their community and social constructs. But a healthy species, evolutionary speaking, requires these outliers. These deviations from the "norm" offer the species a safety net should conditions change rapidly. Should we really be trying to herd everyone back to a norm? Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete.

selfie 2y ago
So, this: https://xkcd.com/435/ https://xkcd.com/435/
jalapenos 2y ago
It's definitely a growing profession. It only came into existence fairly recently, and it continues to innovate and develop new approaches. Good psychologists can provide enourmous value to their clients, and contrary to what the drug pushers want people to believe, mental illness isn't a physiological problem but a complex problem involving much more than that.
triumphblr 2y ago
> Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete. That's a fundamentally reductionist perspective and assumes everything is biological in its etiology? For example, you could say we don't need a justice system once we have the biology worked out, or arts, or sports. At some level it's a fundamentally authoritarian argument as well: if you have the biology worked out, what's to keep the holders of power from altering people to whatever norm they want? Having the biology completely worked out won't magically reveal natural disorder states. The biological explication of a behavior doesn't obviate the need to have some norm for intervention decisions. Biology doesn't have norms, psychosocial systems have norms. Non-behavioral medicine is still full of ethics. And that doesn't even get into issues about whether you could ever identify any biological substrate as synonymous with a human experiential state or history.

johnea 2y ago

[dead]

0xcde4c3db 2y ago

Frances's concerns definitely aren't wrong on the whole, but I feel like he's not seeing the forest for the trees. This ultimately isn't just a question of whether this or that DSM revision is helpful. The patterns of the mental health establishment of the 21st century are oddly reminiscent of where physics and chemistry stood ca. the mid-19th century. Legitimate advances are being made, but most of the tools are still unreliable and many of the theories still fairly reek of superstition and magical thinking. Practitioners are frequently defined more by which tradition or thought leader they adhere to than by their specialization in established subfields. It's not a great situation, and I don't see many signs that it's improving. A great deal is said about "awareness" and "stigma". Phrases like "get help" have been around long enough to turn from hero to villain (i.e. from an earnest plea to close friends or loved ones to a passive-aggressive dismissal of strangers). Who's seriously talking about materially improving the situation instead of promoting an allegedly more "correct" theory? Hell if I know. Please tell me if you do. I guess I broadly agree with the article author that the DSM process is "caught between paradigms" and has "no obvious way forward", but that's a profoundly unsatisfying place to find common ground.

triumphblr 2y ago
Frances I think was worried about his legacy disappearing with DSM-5, because there was a big push to change things in a major way compared to DSM-IV. Ultimately I don't think that really happened; DSM-5 was a change but not the radical change I think the chairs and primary committees wanted it to be. Frances' flooding of media outlets around that time was sort of strange in certain ways. He seemed to correctly identify potential problems in the mental healthcare system but then had this idea that changing things in the DSM to address some of its issues would make everything worse. It felt as if he was co-opting concerns everyone was having to argue for not changing anything at all, and in the process turned everything on its head. The DSM is a very political document with a lot of interest groups involved at all levels, which is why it didn't change even more than it did. As a result, you had NIMH circumvent the whole process with RDoC, which then in turn seems to have had a relatively short life (maybe?) associated with changeover in its own administration. It feels as if everyone has their own schema for thinking about mental illness, and the whole field moves along without any serious consequences. There's probably a lot of reasons for this, including scientific and medical sociology, and the complexity of mental wellness and illness as a domain. But it makes me wonder if some of the distinctions that are argued to be critical are really that critical in the end.

dangle1 2y ago

It's very sad. DSM was never strictly meant to be a clinical diagnostic tool, but rather it was originally meant to define specific illnesses in a manner that would facilitate further research by allowing investigators to at least be talking about the same phenomena when comparing results. (and it unintentionally became very popular with lawyers, who argued that presence in the DSM equated to unimpeachable evidence of an illness in a client, another use that it was never designed to accommodate) It's still true that there are only on the order of 8-12 well-validated diagnoses in the manual. Increases in the number of included diagnoses over editions is primarily due to concessions to important researchers as opposed to clear identification of previously undescribed illnesses. There are lumpers and splitters in academic psychiatry. Lumpers are suspicious that there are several hundred discrete disorders of the brain that can't be more parsimoniously explained with existing, better validated illnesses.

crtified 2y ago

Is there any condition with as broad a definition as autism? It can cover anywhere from a non-verbal 9 year old with an IQ of 70, to a popular attractive valedictorian genius with incredible masking skills. A slow developing 3 year old labelled early and for life, or a perennial loner 80+ year old finally discovering that their traits are shared with many others.

Lord-Jobo 2y ago
I don't think there are any as broad as "autism" in general, but "ADHD" in general is close. That's why both have been divided up in recent years for the sake of precision. Seriously 5/10 people in my friends group have ADHD (some with autism too) and we all have such wildly different symptoms and struggles with it that it took quite some time for us to recognize our shared syndrome lol
harimau777 2y ago
I think that's likely a natural outcome of a diagnosing something that appears to be a spectrum rather than a discrete disorder. Perhaps analogous to how back pain can range from a mild inconvenience to completely debilitating. Or how there's a spectrum between someone who is harmlessly arrogant to a clinical narcissist.
veltas 2y ago
But autism isn't defined by intelligence or age. You might as well say 'isn't alcoholism such a broad definition, when everyone from world leaders to young people to a perennial loner 80+ year old finally discovering that their traits are shared with many others.
- faeriechangling 2y ago
  The two extremes don't have the same traits in common whatsoever. One will clearly be unable to communicate. The other will clearly communicate but allude to an internal torment. One will struggle with the activities of daily living. The other will have a family, a full time job, commitments in the community. The two people supposedly lack the same abilities. In truth, Autism simply got tied up with entitlements and the diagnosis has been grossly abused as a lever to get access to said entitlements.

AlbertCory 2y ago

> Frances, who claims he doesn't care about the royalties (which amount, he says, to just 10 grand a year) for a writer these days, 10 grand is definitely not chump change.

raincom 2y ago

Even today, we don’t have a definition of “species”, a definition acceptable to biologists working in this domain. What is needed is a theory, and further development of that theory. Those who quibble about definitions should develop theories and test them, amend them, replace them. All these activities help understand the phenomenon in the question. When people engage in definitional disputes, it shows that intuitions about the phenomenon conflict. That’s all. To settle these issues, one should do science: that is, develop theories, derive consequences, add back ground theories to test these consequences.

Myrmornis 2y ago
Incidentally, the species debate is fairly simply summarized / resolved, at least for typical sexual organisms: There is nothing whatsoever in first-principles evolutionary biology that says that these can always be partitioned into discrete categories that one might call "species". What evolutionary biology says is 1. When two populations overlap in space and time and have the opportunity to interbreed, they might do so. 2. In the absence of interbreeding, populations evolve, divergently w.r.t. most markers other than the occasional selection-mediated convergence. So, divergence might be the result of lack of opportunity to interbreed (this allows genetic and phenotypic diversity to accrue, but does not itself represent a biologically real division), or it might be the result of inability to interbreed (biologically meaningful, but impossible to discern if opportunity to interbreed is absent). And that's it, for sexual organisms that is the gist. In general there's nothing to say that our systems of related populations spread through space and time can always be divided into "species". On the other hand any cursory look around a single locality shows that many discrete biological entities do exist; there's nothing wrong with giving them the name "species" as long as we acknowledge that for closely related allopatric populations the question of whether they are the same "species" is not defined. There are various problems. One is that some humans are attached to the idea that entities exist for which the word "species" is apt; or put another way they are convinced that "species" must mean _something_ and they ask what (e.g. because they like their neatly divided up bird lists). Another is that if scientists go around saying "animals can't always be divided into things which it makes sense to call 'species'" then it significantly weakens certain arguments for the protection of populations in conservation biology / legal contexts, since these invariably name the species-level taxa they are intended to protect. Since the modern trend is towards splitting subspecies (i.e. geographical races) into species (as opposed to lumping), many conservation initiatives are based on protecting "species" for which the species designation is subjective. That doesn't mean they are flawed of course -- they are nearly always protecting valuable ecosystems. It's just that as we split geographical races, we (by definition) create rarer and more vulnerable taxa, and so conservation initiatives arise around these.

transkillskids 2y ago

[flagged]

deleted 2y ago

[deleted]

deleted 2y ago

[deleted]

matrix87 2y ago

It's kind of strange that psychology has this dual role of both giving advice to the sane and managing the insane. The same division was a thing in psychoanalysis too with neurotics vs psychotics Why does it do both? Why do people use it as a go-to source for life advice? People will go to a psychologist for marriage troubles, and they'll also go to a psychologist for psychosis. Seems like a weird place to go to marriage help for unless your wife is psychotic It's like psychologists have been given this role that religion used to occupy

gverrilla 2y ago
It is exactly the role religions used to play - more so in the past, yes, but still pretty much in scene today still, although perhaps weaker - so this answer your question: > Why does it do both? Demand. For what? For adaptation to the current metagame. While writing this reply, I remembered a few passages from a great thinker, that I think may contribute and expand the conversation, for those interested: "Art, ethics, philosophy bear witness: under the crust of words and concepts, the living reality of non-adaptation to the world is always crouched, ready to spring. Since neither gods nor words can manage to cover it up decently any longer, this commonplace creature roams naked in railway stations and vacant lots; it confronts you at each evasion of yourself, it touches your elbow, catches your eye; and the dialogue begins." [0] "After all, if an individual refuses both to adapt to the violence of the world, and to embrace the violence of the unadapted, what can he do? If he doesn't raise his will to achieve unity with the world and with himself to the level of coherent theory and practice, the vast silence of society's open spaces will raise around him the palace of solipsist madness." [1] "People are bewitched into believing that time slips away, and this belief is the basis of time actually slipping away. Time is the work of attrition of that adaptation to which people must resign themselves so long as they fail to change the world." [2] Raoul Vaneigem 0, 1: https://www.darkmatterarchives.net/wp-content/uploads/2013/06/Vaneigem.pdf https://www.darkmatterarchives.net/wp-content/uploads/2013/0... 2: https://voidnetwork.gr/wp-content/uploads/2016/09/The-Revolution-of-Everyday-Life-by-Raoul-Vaneigem.pdf https://voidnetwork.gr/wp-content/uploads/2016/09/The-Revolu...
- throw4847285 2y ago

Log_out_ 2y ago

The problem of classification is one not useful by defect. In stead it should go by effect, on the individual and on society, as it cycles through the situations encountered by a old, tribal, militaristic clan based society. The adaptations we define as ails today were useful back then in the role of * and gave the individual a place as *. It helps to understand what it was of yore.