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Mental Disorders and Religious Sentiment...

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stamenflicker  
I've made the claim before that I do not "believe" in mental disorders. With only a few exceptions, most of the DSMIV labels are just that-- labels. The notion that they represent real conditions is absurd to me.

I think you may be surprised to know that your view is a common one among people like myself who have a major mental illness. Of course, I never measured the opinions in a scientific manner. I can say with absolute certainty,however, that many of the people with whom I've personally shared a hospital room, or sat beside in the mental health clinic, or suffered through therapy with, have often denied having a mental illness of any kind. But denying the truth is useless to us. I can wish I wasn't the way I am. I try not to be. But the end result is always,always, always that I cannot function unless I take medications for bi-polar illness. I could measure my illness in a financial way perhaps, IF I'd ever kept records of all the things I've lost in my life due to being bi-polar. I could probably measure my IQ as a young girl and what it is now after years of living as a bi-polar person. Are those things measurable proof to someone like you? They get my attention whenever I decide that I'm not really bi-polar or that I can pull myself up by my bootstraps and stop having unstable moods, wild plans and ideas, and everything else that goes with my illness.

I don't think you comprehend the amount of cruelty and prejudice you are encouraging with smug statements like the one you made here. I know you don't understand anything at all about mental illness if you really believe what you've posted.

You are fortunate that you are able to make a decision to not believe in mental illness. I can't. Millions of us aren't given that opportunity. So I think that to try to make a funny little debate about human suffering for your entertainment is just wrong.

Saint Dymphna
 
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I'm sorry. A double post.

Typical dumb bi-polar thing to do.

Peace,

Saint Dympha
 
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I'm sorry. A double post.

Typical dumb bi-polar thing to do.

Peace,

Saint Dympha

Hi and welcome!

We have to be mindful that insanity is a legal term, and not a medical one.
Yeah, and I agreed with your earlier posts.
I'm comfortable with just 'crazy', the company is pretty good and it has a nice informal feeling to it. :)
 
One of the things about psychiatrists is that the get good at the 'reality pill'. Patients lie about having a psychiatric illness because they believe they will have an excuse for some incident, usually criminal. Or they want to take a break from something. The term is 'malingering'. Psych 101 is to look for certain tells.

But this is not significantly different than other parts of medicine. I worked in Emerg on weekends for about two years straight at an inner-city hospital (St. Paul's, for those in Vancouver who would recognize it) and the #1 fake complaint was "I have a stomach ache." This does not invalidate the entire field of internal medicine, most of whose illnesses harbinger with this primary complaint. The second most common complaint was "I have a headache", followed by chest pains, blindness, and so on.

These guys are all looking for a free meal and a soft mattress, and have chosen conditions that require a few hours of 'observation' in the overnight wing of emerg. So, we give 'em an egg-salad sandwich, four hours of sleep, and they're on their way.

Such is medicine.

Ah the ' three hots and a cot' eh, there is also deliberate med seeking, back pain, and anxiety where the person knows the medication they prefer and demand it in triage.

I have to say I have a real respect for any one who works in the ED, I am just a monthly vistor who fills in magic papers and makes the pesky 'psych evals' disappear.
 
snip...

I don't think you comprehend the amount of cruelty and prejudice you are encouraging with smug statements like the one you made here. I know you don't understand anything at all about mental illness if you really believe what you've posted.

You are fortunate that you are able to make a decision to not believe in mental illness. I can't. Millions of us aren't given that opportunity. So I think that to try to make a funny little debate about human suffering for your entertainment is just wrong.

Saint Dymphna


Hear hear, light shines upon the Cosmic Midden and says , here is filth and corruption.

I hope that you are well and that your life is fine, I work both sides I am a mental health worker and a patient.

Fie on stigma , fie.
 
Finally, Katana and Blutoski also make the very good point that mental disorders respond to medication, while religious feelings don't. Of course, there are a few threads on this forum about the new mushroom that will induce such experiences for you (curiously enough, not in all people who try it, and not in the same way), but we yet know of nothing that would take them away (and we do know of other substances that induce mental disorders. Alcohol, for instance.) I'm restating what they said, because it bears repeating.

Hey, thanks, Avita!

After reading the rest of the posts, many have made points that I would have, but we're clearly not making a dent in the mistaken beliefs of someone who seems quite attached to them.

Perhaps he will better understand that conditions based on subjective complaints are legit someday if he has to come into an ER or clinic with subjective back pain for which no explanation can be found, an unfortunate fact for many people with back pain. I hope that his doc takes it just as seriously as he does mental illness.
 
Cross-cultural differences in psychology, psychological self-expression, and psychological classifications, are endlessly interesting. But you seem to be claiming that because people in different cultures have a prevalence of one or another disorder, then that somehow proves that the disorder is not "real."

That's pretty close to my position. It's not that there is "not" anything happening. It's that the way we choose to classify what is happening is indicative of our cultural values. That we make the attempt of objectifying these moods and making them into real things doesn't say so much about what is happening in the patient, as it says about us.

We scoff at the use of leeches in the middle ages, or scoff at less developed cultures who resort to all sorts of insanity when dealing with medical conditions, why? Because we now have a scientific understanding what is going on. This is not the case with moods. We really don't know, but we've created some labels that make organizing what we do know easier.

It's real, though in a sense, "created" by the surrounding environment.

I agree with this statement. Mood disorders are real, but as I said above-- "a real what?" I think they are a real social construction.

Second, the environment itself can create conditions for developing certain mental diseases, which continue existing long after the initial environment has changed (e.g., people obsessed about money long after the Great Depression has passed; immigrants from the former Soviet Union who continue to be paranoid).

We are very close to agreeing here. If I interpret you correctly, then at least part of any "mood disorder" is social construction.

It's hard to tell, but at times your position seems to be that unless there's one single test to determine if a disease exists, it's not a disease - unless it's a "physical" disease, in which case never mind. If that's not your position, please make that clearer.

I'm only saying it loses credibility as a physical disease. My hope is that one day nueroscience will be able to answer these questions. However, I find that highly unlikely.

What is more likely to occur is another "wonder drug" marketed to the public, which "cures" all our bad moods. I for one, am uncertain that such a "wonder drug" will be a great idea to mass produce.

Look, we've already seen it with Ritalin. 1/3 of American boys are on it. That number is staggering. I believe in the future, if afforded such an opportunity, we will look back in disgust, not unlike looking back at the leeches used 1,000 years ago. We'll see over-medication as a form of human slavery.

What others and myself are arguing is that you're setting an impossible standard for mental illness.

I'm not setting any standard so much as stating that such a standard is already impossible.

The DSM, contrary to popular opinion, is not out to demonize certain kinds of experience.

Of course its not. It's only a reflection of what deem to be valuable, demonstrated by the strong language of the original versions against homosexuality.

My science textbooks disagree with you.

I'm not surprised.

Yes, there must be many more precautions taken when the phenomenon is not objectively quantifiable, but if we limited ourselves to just those phenomena, we strongly limit what we can learn about the world.

I'm not saying that we shouldn't. I'm saying that the areas that we "should" are not always chosen logically and that such choices once again, tell us more about ourselves than the object we wish to study.
 
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I don't think you comprehend the amount of cruelty and prejudice you are encouraging with smug statements like the one you made here. I know you don't understand anything at all about mental illness if you really believe what you've posted.

You are fortunate that you are able to make a decision to not believe in mental illness. I can't. Millions of us aren't given that opportunity. So I think that to try to make a funny little debate about human suffering for your entertainment is just wrong.

Saint Dymphna

Jeez. According to the logic of modern pyschology, I'm suffering from "Christianity" but that doesn't stop people from asking questions on a skeptic board does it?

You and Dancing Dave and others make it sound like I have no experience in these matters. I'm married to a psychologist. I've worked as a chaplain in mental institutions-- in fact, I did my residency at one. And I have a member of my family who has been homeless for 8 years, who has been determined to have "bi-polar disorder."

You seem to believe that because I made a free choice to question something with no empirical evidence, that somehow I am a cruel person.

I also find it interesting that the people this issue seems to matter most to are the ones either a) suffering from, or b) working in the subject matter.
 
Ah the ' three hots and a cot' eh,

That's why we give egg salad sandiwches - they're the least popular. However, if you're so hungry that one of these is a good meal, and a flat cot in a busy, bright, emergency ward is a good sleep, then who am I to withold, and god bless.



...there is also deliberate med seeking, back pain, and anxiety where the person knows the medication they prefer and demand it in triage.

You can see word of mouth in action: one patient manages to sell his story to the new guy, tells his friends, and the next night, there's a rash of "... only thing that works to reduce my seizures is Tylenol 3s." Nice try.




I have to say I have a real respect for any one who works in the ED, I am just a monthly vistor who fills in magic papers and makes the pesky 'psych evals' disappear.

Fortunately, I don't have to anymore. And I don't want to give the misleading impression that I was medical staff - I worked in a support role. My first job there was housekeeping.
 
Jeez. According to the logic of modern pyschology, I'm suffering from "Christianity" but that doesn't stop people from asking questions on a skeptic board does it?

I think you know this is crap. There's no "logic of modern psychology" that says you're suffering from Christianity.



You and Dancing Dave and others make it sound like I have no experience in these matters. I'm married to a psychologist. I've worked as a chaplain in mental institutions-- in fact, I did my residency at one. And I have a member of my family who has been homeless for 8 years, who has been determined to have "bi-polar disorder."

You seem to believe that because I made a free choice to question something with no empirical evidence, that somehow I am a cruel person.

Because it sounds ignorant, and we're used to this approach with other issues. eg: people who have never cracked a science textbook are the rank and file of evolution-denial.

Question: do you tell your wife her career is meaningless, or is there common-ground somewhere?





I also find it interesting that the people this issue seems to matter most to are the ones either a) suffering from, or b) working in the subject matter.

ie: Stakeholders? Experts? Is this unexpected? Again, we see this with evolution-deniers: "The only people defending evolution are these scientitsts - what's with that, hmmm?"

Question: do you have perhaps a vested interest in dismissing psychiatric interpretations, as it obviously competes with ministry? Is it a coincidence that the publication you suggested is a religious screed (from the Church of Scientology, which also competes economically with psychiatrists?)

Do you want to perhaps steer the conversation away from ad hominem attacks and get on with a real debate?



I'm also a little confused sometimes with your approach:
Mood disorders are real, but as I said above-- "a real what?" I think they are a real social construction.
versus:
There is no difference between mood and mood disorder. They are both just moods. That we treat the bad ones as an objective entity while simultaneously treating the good ones as "pie in the sky" crazy talk is not logical.

It's hard to actually understand what you're saying, and mount a debate strategy.

However, to address the two statements above: they're actually different questions, both relevant to other scientific pursuits.

The first question is one of reification. Gould approaches this in great detail in Mismeasure of Man. He asks: is there such a thing as intelligence? We seem to know that there is, but is it a real thing? This is an ontological question that science handles downstream from metaphysics. Is there such a thing as species? There's no scientific definition of species, yet we're pretty sure that cats and dogs are different species.

The second question has already been addressed, and you seem to have conceded, then reversed your view. This is the fallacy of the corrupt continuum. Just because there isn't a clear distinction between moods and mood disorders (extreme moods) doesn't mean that there is no distinction. There is no clear distinction between child and adolescent, adolescent and adult, but we have no reservation about saying that children shouldn't drive on the freeway. It's a little blendy in the middle, but denying that they're different things is a logical fallacy.

What I'm saying is that this argument is itself unscientific, yet it's central to your claim that psychiatry is not scientific. Thus, my confusion.


This is also part of what other participants have identified as a strange focus: other sciences are even flakier: we don't know how statins work, but we prescribe them to address an arbitrary metric ("high" blood pressure - levels chosen for unscientific reasons, which vary from country to country). In any case, we prescribe them because we believe they will reduce suffering and/or extend life expectancy. Well, where's the scientific 'fact' that we need to do this? It's a social choice (and a choice that some communities do not make, incidentally.) It's still valid medicine.

There is a third problem with the assertion that because there is a cultural input to the definitions (and we're all aware that 50 years ago, 'homosexual' was a diagnoseable disorder) that they are useless. This is also a logical fallacy related to corrupt continuum, but is caused by the erroneous belief that cultures are entirely random. One thing we have learned is that cultural concepts of mental illness, moods, and so on, are very consistent - it is their attitude toward treatment of these sufferers which varies.
 
Originally Posted by stamenflicker
I also find it interesting that the people this issue seems to matter most to are the ones either a) suffering from, or b) working in the subject matter

Interesting? Well I wonder why?

Jeez. According to the logic of modern pyschology, I'm suffering from "Christianity" but that doesn't stop people from asking questions on a skeptic board does it?

But I don't consider being a member of the Christian religion is the same thing as having delusions involving religion, nor have I met anyone who holds that belief. Are you saying that you do?

You and Dancing Dave and others make it sound like I have no experience in these matters. I'm married to a psychologist. I've worked as a chaplain in mental institutions-- in fact, I did my residency

You're a chaplain?:eye-poppi And you believe what you've posted here? You've worked in a mental institution(s) as a chaplain, representing God to people who are hugely troubled .....I"m speechless and unable to write anymore.



Saint Dymphna
 
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Just so we are very clear, both of your "vested interests" apply to me - I'm currently a student therapist, and I've experienced mental disorders. The one is closely connected to the other, as having gone through that myself, I really want to understand what happened, how to stop it from happening again, and to help others do the same. And you ask why people like me are interested in the topic? Whereas you yourself are a chaplain. I am guessing that you have your own interest - you want to help people get better by encouraging them to trust God, and you believe that God will respond by helping them through their mental illness. So in wanting to help people get better, we are working towards the same goal. But all my experience shows that your approach is not enough. Mine isn't always, either, but seeing as how it's a science, it's constantly working to improve methodology.

That's pretty close to my position. It's not that there is "not" anything happening. It's that the way we choose to classify what is happening is indicative of our cultural values. That we make the attempt of objectifying these moods and making them into real things doesn't say so much about what is happening in the patient, as it says about us.
And? Psychology is the study of humans by humans. If it manages to say something about us, that's great. Nobody is telepathic. Nobody can know what is going on inside the mind of another. We can only guess, based on our own experience, and adjust the guesses as evidence comes in. Psychology is a science, because it takes the guesses of many people and compares them, and distills and classifies the most important bits, and tries to eliminate wrong guesses by experimentation. In this, it's no different from any other science.

We scoff at the use of leeches in the middle ages, or scoff at less developed cultures who resort to all sorts of insanity when dealing with medical conditions, why? Because we now have a scientific understanding what is going on. This is not the case with moods. We really don't know, but we've created some labels that make organizing what we do know easier.
Even if that was all that psychology did (as you can guess, I rather disagree), that would already be a good thing. Chemistry started that way, by looking at properties of substances and creating labels for them. Medicine started that way. A host of other sciences started that way. This is the way science progresses.


I agree with this statement. Mood disorders are real, but as I said above-- "a real what?" I think they are a real social construction.
They're a real biopsychosocial construction. Just as physical diseases are. Maybe physical diseases have a bit more emphasis on the bio aspect, psych diseases on the psych aspect, and societal rules on the social aspect, but they are all tightly intertwined, and equally "real." Incidentally, what's your opinion of sociology - is that a "real" science or not?

We are very close to agreeing here. If I interpret you correctly, then at least part of any "mood disorder" is social construction.
See above. But I think you misinterpreted my point in this example, which is that certain societal conditions can predispose people towards certain mental (and medical) diseases. Hence, why you see preponderances of different mental diseases in different societies.

What is more likely to occur is another "wonder drug" marketed to the public, which "cures" all our bad moods. I for one, am uncertain that such a "wonder drug" will be a great idea to mass produce.

Look, we've already seen it with Ritalin. 1/3 of American boys are on it. That number is staggering. I believe in the future, if afforded such an opportunity, we will look back in disgust, not unlike looking back at the leeches used 1,000 years ago. We'll see over-medication as a form of human slavery.
Sounds like a great idea for a science fiction book. In fact, I read a couple with similar premises. In real life, I see several trends leading us away from such a path, but as I can't know the future, let's just agree that time will tell.


I'm not setting any standard so much as stating that such a standard is already impossible.
This is where I have the hardest time understanding you. Why is it impossible? We have reviewed several lines of evidence that psychology is no better and no worse than many other sciences. Why do they get a pass, and psychology doesn't?


Of course its not. It's only a reflection of what deem to be valuable, demonstrated by the strong language of the original versions against homosexuality.
Remember that thing about science developing by sorting out the bad guesses from the good? That's one example. At one point, people knew very little about homosexuality, and assumed that people could be talked out of it. Now, we know differently. We also know several other ways in which homosexuality differs from, say, a paraphilia. That's because psychology is a science, and tests its assumptions. Of course, I'm not saying that the DSM has got everything perfectly right. But the people who compose it are working on it.


I'm not surprised.
So explain to me what makes you a better authority than the people who wrote the science textbooks.
 
I think you know this is crap. There's no "logic of modern psychology" that says you're suffering from Christianity.

It's not crap. There is no logic of modern psychology that says I'm suffering from Christianity because we don't have a reason to chart the vectors that encompass it.

Question: do you tell your wife her career is meaningless, or is there common-ground somewhere?

Of course not. My wife helps people. That doesn't change the fact that we have core philosophical differences. Nor does it change the fact that out of all the members of our shared family, I am the most sympathetic and compassionate to her "bi-polar" father.

ie: Stakeholders? Experts? Is this unexpected? Again, we see this with evolution-deniers: "The only people defending evolution are these scientitsts - what's with that, hmmm?"

You tell me?

Question: do you have perhaps a vested interest in dismissing psychiatric interpretations, as it obviously competes with ministry? Is it a coincidence that the publication you suggested is a religious screed (from the Church of Scientology, which also competes economically with psychiatrists?)

I have no knowledge of Szasz religious sentiments. If you dislike him, then read Mad Travelers or Multiple Personality Disorders and the Politics of Memory, both by Ian Hacking.

I'm also a little confused sometimes with your approach:

Not surprising given the subject matter.

The first question is one of reification. Gould approaches this in great detail in Mismeasure of Man. He asks: is there such a thing as intelligence? We seem to know that there is, but is it a real thing? This is an ontological question that science handles downstream from metaphysics. Is there such a thing as species? There's no scientific definition of species, yet we're pretty sure that cats and dogs are different species.

Of course I would make a somewhat similar argument for both "species" and "intelligence." I'm sure you are familiar with this:

http://en.wikipedia.org/wiki/Scientific_essentialism

One primary difference though is that we pull moods out of subjectivism and tigers from empiricism. Making it even more difficult to classify things appropriately.

Just because there isn't a clear distinction between moods and mood disorders (extreme moods) doesn't mean that there is no distinction.

What it means is that there is a distinction because we chose to make one.

There is no clear distinction between child and adolescent, adolescent and adult, but we have no reservation about saying that children shouldn't drive on the freeway. It's a little blendy in the middle, but denying that they're different things is a logical fallacy.

Again, it all comes back to what we do with the distinction we make, right? It says nothing about a geniune distinction.

What I'm saying is that this argument is itself unscientific, yet it's central to your claim that psychiatry is not scientific. Thus, my confusion.

I never claimed to have a scientific argument, only a philosophical problem when the dogma which says it is scientific to believe in one set of things that don't empirically exist verses any other set of things, which may or may not be of equal value but are never tested due to what we deem to be of value.

This is also part of what other participants have identified as a strange focus: other sciences are even flakier: we don't know how statins work, but we prescribe them to address an arbitrary metric ("high" blood pressure - levels chosen for unscientific reasons, which vary from country to country). In any case, we prescribe them because we believe they will reduce suffering and/or extend life expectancy. Well, where's the scientific 'fact' that we need to do this? It's a social choice (and a choice that some communities do not make, incidentally.) It's still valid medicine.

There is no scientific fact that we must reduce suffering. We have a moral obligation to do so. Unless (or perhaps until) it can be demonstrated that my moods carry an equal empirical weight as my blood (which incidently I can see, smell, and taste) then I doubt seriously you can convince me that we are talking about the same things with the same level of objectivity.

There is a third problem with the assertion that because there is a cultural input to the definitions (and we're all aware that 50 years ago, 'homosexual' was a diagnoseable disorder) that they are useless. This is also a logical fallacy related to corrupt continuum, but is caused by the erroneous belief that cultures are entirely random. One thing we have learned is that cultural concepts of mental illness, moods, and so on, are very consistent - it is their attitude toward treatment of these sufferers which varies.

Is that why many communities used to care for their own mentally ill before psychiatry came along, as opposed to keeping them drugged and locked away from the "normal" people?
 
But I don't consider being a member of the Christian religion is the same thing as having delusions involving religion, nor have I met anyone who holds that belief. Are you saying that you do?

Suppose one day Christianity is outlawed? And psychiatrists, with their new found scientific powers can point to the exact defect in the person with any sort of religious sentiment. It's illegal. We have identified the "disorder," now what?

Public nudity is now outlawed in parts of the United States. A person from another country may walk around without a top on, wearing only a thong. We might lock that person up if she went shopping topless. If she refused to wear a top because she believed it was her right not to, we might lock her up even longer. But is she crazy? Or does she just fall outside our lines of demarcation for sanity?

Given the right magical criteria, a future society could deem anything it wanted to be an illness. What about homosexuality? By the mighty DSM itself we could be locking up gays right now using "scientific" evidence had we not changed our values in this country. Why is this so hard to understand?

Again, we are using the same subjective criteria to determine the sanity of homosexuality or religious sentiment. We're relying on drawing up vectors of our choosing and placing them around "a problem" that may or may not exist. When the criteria-making becomes scientific, we can justify about anything in the name of taking away the poor person's suffering.

It's a classic "leaving the barn door open" mentality when we claim there is anything scientific about our decisions in these matters.
 
Remember that thing about science developing by sorting out the bad guesses from the good? That's one example.

While I'm certain that I agree with you that removing this from the DSM was a good thing, by what scientific criteria did psychology sort? Why was incest or necrophilia not also sorted? Under what scientific auspices do we make these decisions? Or can't we just agree that they are not scientific at all?

So explain to me what makes you a better authority than the people who wrote the science textbooks.

Never claimed to be. Why do your science books with all their authority never ask these kinds of questions?
 
Given the right magical criteria, a future society could deem anything it wanted to be an illness.
This is absolutely true. A future society will be different than the present one, and therefore also have a different understanding of what illness is. It will also have other illnesses that we don't have. There will be many things that we don't consider illnesses and that future people will consider illnesses, and there will also be things that we consider illnesses today and they won't consider them as such.

Whether there are objective criteria to measure those conditions, or whether they are subjective experiences, is however completely irrelevant to the decision what is and is not an illness.

Why is this so hard to understand?
This is not at all hard to understand. It is just completely irrelevant.

Under what scientific auspices do we make these decisions? Or can't we just agree that they are not scientific at all?
Those decisions are based on scientific data, but they are ultimately value judgements. Just as science can't answer what is good and what is evil, it cannot answer what is healthy and what is sick. Simply because that is not a scientific question.

Science can describe a condition, and can invent ways to manipulate it. But for many conditions there are always two ways of looking at it: the Medical Model, and the Social Model.

The Medical Model sees human suffering as a result of a condition in which a person's body is in. Therefore it is assumed that this person's body must be altered to relieve the suffering.

The Social Model sees human suffering as a result of society. A person may have a condition, but his suffering is caused by the fact that society does not accomodate a person with that condition.

A good example of the clash between those two views is Deafness. In the Medical Model, deafness is seen as a handicap and as something that needs to be corrected physically. Many Deaf people whoever object to this view and insist on the Social Model: they do not suffer from a handicap, but from social discrimination. They have their own language and culture, which they consider to be in no way inferior to hearing culture. They are obviously physically different from hearing people, but black people are also physically different from white people.

Even though deafness can in most cases be objectively measured, even if it is obvious that deaf people lack something that most people do have, science can't tell us whether it is an illness or a just a variation. It is a value judgement, and medicine is full of them.

You insist on a social model for mental illness. You point out that mental illness is defined and created by society. In many cases you are right, but you forget one thing: that social model is just one way of looking at it. Just because a condition exists because of societal influences and it is diagnosed on subjective experience does not defeat the medical model: the people suffering from it may still have objectively measureable differences from others and physical intervention on them can still relieve their suffering.

Future societies will certainly make different value judgements on whether mental or physical conditions need to be seen primarily through the medical or the social model. Perhaps a future ultra-Atheist society will indeed consider your Christianity a mental illness. Perhaps it will consider it a minor problem, such as hearing voices. Or maybe it will consider it a serious disorder requiring intervention. However it is considered by a future society, science will not have the last word on what it is. But it may discover what objectively measureable differences there are between the brain of a Christian and a non-Christian.
 
Apologies if this has been addressed before,

"On being sane in insane places"

Rosenhan's study [1972] consisted of two parts. The first involved the use of healthy associates or 'pseudopatients', who briefly simulated auditory hallucinations in an attempt to gain admission to 12 different psychiatric hospitals in 5 different states in various locations in the United States. The second involved asking staff at a psychiatric hospital to detect non-existent 'fake' patients. In the first case hospital staff failed to detect a single pseudopatient, in the second the staff falsely detected large numbers of genuine patients as impostors. The study is considered an important and influential criticism of psychiatric diagnosis.

The study concluded "It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals" and also illustrated the dangers of depersonalization and labelling in psychiatric institutions. It suggested that the use of community mental health facilities which concentrated on specific problems and behaviors rather than psychiatric labels might be a solution and recommended education to make psychiatric workers more aware of the social psychology of their facilities.

All eight were admitted, seven with a diagnosis of schizophrenia, the last with manic depression. None of the pseudopatients was detected during their admission by hospital staff, although other psychiatric patients seemed to be able to correctly identify them as impostors.

I always found that bit interesting! :)

During their stay, hospital notes indicated that staff interpreted much of the pseudopatient's behaviour in terms of mental illness. For example, the note-taking of one individual was listed as "writing behaviour" and considered pathological.

Criticism of the study:
[psychiatrist Robert Spitzer]

"If I were to drink a quart of blood and, concealing what I had done, come to the emergency room of any hospital vomiting blood, the behaviour of the staff would be quite predictable. If they labelled and treated me as having a peptic ulcer, I doubt I could argue convincingly that medical science does not know how to diagnose that condition."

However, Spitzer believed that despite the perceived shortcomings of Rosenhan's study, there was still a laxness in the field. He played an important role updating psychiatric diagnosis, eventually resulting in the DSM-IV, in an attempt to make it more rigorous and reliable.
 
This is absolutely true. A future society will be different than the present one, and therefore also have a different understanding of what illness is. It will also have other illnesses that we don't have. There will be many things that we don't consider illnesses and that future people will consider illnesses, and there will also be things that we consider illnesses today and they won't consider them as such.

Whether there are objective criteria to measure those conditions, or whether they are subjective experiences, is however completely irrelevant to the decision what is and is not an illness.

This is not at all hard to understand. It is just completely irrelevant.

Those decisions are based on scientific data, but they are ultimately value judgements. Just as science can't answer what is good and what is evil, it cannot answer what is healthy and what is sick. Simply because that is not a scientific question.

Science can describe a condition, and can invent ways to manipulate it. But for many conditions there are always two ways of looking at it: the Medical Model, and the Social Model.

The Medical Model sees human suffering as a result of a condition in which a person's body is in. Therefore it is assumed that this person's body must be altered to relieve the suffering.

The Social Model sees human suffering as a result of society. A person may have a condition, but his suffering is caused by the fact that society does not accomodate a person with that condition.

A good example of the clash between those two views is Deafness. In the Medical Model, deafness is seen as a handicap and as something that needs to be corrected physically. Many Deaf people whoever object to this view and insist on the Social Model: they do not suffer from a handicap, but from social discrimination. They have their own language and culture, which they consider to be in no way inferior to hearing culture. They are obviously physically different from hearing people, but black people are also physically different from white people.

Even though deafness can in most cases be objectively measured, even if it is obvious that deaf people lack something that most people do have, science can't tell us whether it is an illness or a just a variation. It is a value judgement, and medicine is full of them.

You insist on a social model for mental illness. You point out that mental illness is defined and created by society. In many cases you are right, but you forget one thing: that social model is just one way of looking at it. Just because a condition exists because of societal influences and it is diagnosed on subjective experience does not defeat the medical model: the people suffering from it may still have objectively measureable differences from others and physical intervention on them can still relieve their suffering.

Future societies will certainly make different value judgements on whether mental or physical conditions need to be seen primarily through the medical or the social model. Perhaps a future ultra-Atheist society will indeed consider your Christianity a mental illness. Perhaps it will consider it a minor problem, such as hearing voices. Or maybe it will consider it a serious disorder requiring intervention. However it is considered by a future society, science will not have the last word on what it is. But it may discover what objectively measureable differences there are between the brain of a Christian and a non-Christian.

I think you've given us a great response here Earthbind, kudos. I enjoyed most every part of it.

I do however disagree that this issue is not relevant. Because, so long as psychology can pass itself off as science, it has greater legitimacies in courts of law, in restrictions of freedom, health care reform, in guiding politics and world decision making, etc.

Any of these can at any time be used to take my freedoms or fortunes away. And in many cases, it is already being used. As in the case of my grandmother's "dementia."

You insist on a social model for mental illness. You point out that mental illness is defined and created by society.

No, I don't really insist on it. I'm only saying that the evidence that it is medical is not enough to convince me at this time, again with a few exceptions.
 

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