I’d like to start with a few disclaimers. This is not an anti-psychiatry post. This is also not the place to ask or receive advice about your mental health, or what nowadays is called “mental health”.
For some time now I’ve been feeling like I live in a different world than most people I know. It has come to a point where I have to face an awkward alternative: Either most people I know are wrong (including learned men and experts) or I am insane. As I don’t believe I have lost my sanity, and as I believe that I have very strong arguments to hold my ideas against all reasonable counterarguments; I think it’s about time I sit down and share my ideas more or less publicly. This is one of such ideas. What follows is the summary of my academic studies, my professional experience working in the field of mental health, my own personal thoughts, and the influence of several authors, chiefly Georges Canguilhem and Jacques Lacan.
The APA defines psychopathology as “the scientific study of mental disorders, including their theoretical underpinnings, etiology, progression, symptomatology, diagnosis, and treatment”. It is a jurisdiction of medicine, although that does not exclude other disciplines from delving into it as well. It is intrinsically linked to psychiatry, to the point where one cannot exist without the other. But psychiatry itself is a rather contradictory branch of medicine, because while every other specialization of medicine has built its own object of study by exploring a specific organ or function from the body, psychiatry exists only by virtue of that which it ignores. In its origins, psychiatry was born to deal with what has been classically classified as insanity, those people described by Descartes who believed they were made of glass or who fancied themselves to be pitches of water. These outlandish delusions have always caused turmoil in society because nobody really knows where they come from, what they mean and, most importantly, what to do with them. Insane people clearly need help but they do not want it, or what help they are willing to receive it’s impossible for other people to give. They break the law but they are not criminals, or at least they are bening. They behave like savages but are human beings and deserve to be treated as such.
Now enter the Enlightenment: Lady Reason triumphs all over the Western world, everything now has or will have a place and an explanation in the encyclopedia of universal knowledge. And what we understand we control. There are now a bunch of physicians who have little evidence but little doubt that these people are sick and that it is their task to heal them. And that they’ll try with all their available resources, but with little success. So while neurology developed from the study of the brain, cardiology from that of the heart and so on, psychiatry was born out of sheer embarrassment. It is the branch of medicine that studies mental disorders. However, being a part of modern scientific medicine, it cannot but assert that mental disorders can be explained by studying the body, the contradiction being that the day psychiatry discovers the bodily cause of mental disorders will be the day that it ceases to exist as a specialization of medicine, for said cause would fall under the jurisdiction of another specialization: If it’s in the brain then it would be neurology, if it’s in the genes it would be medical genetics, and if we were to discover a new organ in the body then a new specialization will be born to study it, leaving psychiatry in the past.
Therefore, psychiatry exists only because we do not know what mental disorders are. In fact, we don’t even know if the mind is real or not, much less whether it can get sick. What do we actually know then? We know that 1. there are people who need help, and 2. that there are means to help them. So it becomes a matter of administering a scarce resource. This is what psychopathology really is: It is not a science of mental pathology, it is the art of distributing psychiatric drugs and psychological treatments.
There used to be psychopathology. Classic psychiatrists wrote impressive treaties on the subject, with thousands of pages explaining in detail and classifying the behavior of their patients. The mountains really were in labour, alas, only a mouse was born: No progress was made regarding the causes, and most importantly the treatment of such behaviors. This last problem was drastically improved by the invention of psychopharmacology. Suddenly psychiatrists had a powerful tool to treat the symptoms of insanity, so even though they weren’t any close to understanding these symptoms, they changed their ideas on the subject to reflect the influence of psychiatric drugs. These influences can be accurately gauged by the changes on the DSM. The first DSMs included theories about the origin and nature of mental disorders, the last DSMs only mention the clinical symptoms necessary to prescribe a treatment. When a patient is diagnosed with depression the only relevant information that is learned is that said patient will start a treatment for depression.
So are mental disorders real? Of course they are. Whether they are mental or disorders, that’s another question. They are real because they are a set of behaviors that have been observed to occur together: Feelings of sadness, self-harming ideas or behaviors, inability to feel pleasure, these are all things that are real, observable, measurable, and treatable. But are these symptoms a mental problem? Are they a medical problem, or a problem at all? This is highly debatable, and in any case, not a solid foundation for a science.
If a person feels sad all the time, it is only natural for them to think that this life is not worth living. But the opposite is also true: If a person is convinced that there is nothing good in this world, then they will feel sad and hopeless all the time. So what comes first? Should we treat the sadness or the thoughts? And what if the person likes to feel sad, if they don’t want any help? Should we force them? And to make matters worse, it turns out that both psychiatric drugs and psychotherapy are effective*. And this is only to talk about those treatments that have empiric evidence to back them up and are approved by psychiatry, because, under the right circumstances, literally everything can be therapeutic: There’s horse therapy, art therapy, music therapy, dog therapy, video-game therapy, you name it.
There are some who believe in the demon deceptor, a person, or a group of people, who control our reality and make lies pass for truth, usually with malicious intent. These people believe that the pharmaceutical industry has created mental disorders only to sell drugs, and that psychologists and psychiatrists are their accomplices. For my part, I think it is overly optimistic to believe that someone has such a degree of control over the situation as to make it bend to their will. I believe that people are just confused, and with good reason, because being human is quite a bizarre experience. There are of course those who profit from the confusion of their fellow man, and prey on their ignorance. But even evil has its limits, and nobody can summon such perfect wickedness that no good may come of it. The truth is that for all the confusion that our idea of psychopathology entails, the treatment and the care for people with mental disorders has progressed a great deal in the last decades.
On the other hand there are the encyclopedists, who will argue that the fact that we haven’t discovered the bodily sources of mental disorders does not mean that we won’t succeed in the future. We have certainly made discoveries in this direction: Not only do we know now that it is impossible to be sad or mad without a brain, but we also know what specific brain part or substance is required. But even after all the advances in neurology, still no neurologic exam is indicated for the diagnoses of mental disorders, and for good reason. Because ultimately, what decides if someone has a mental disorder or not are arbitrary criteria. The fact that homosexuality is no longer a mental illness is only because of the fact that society has shifted its values towards the acceptance of diverse sexual orientations, were it not for that fact we would speak about the “homosexual brain” just as we know speak about “the depressed brain”. We could also speak about “the carpenter brain” or “the the writer’s brain”, and treat all of those conditions as illnesses.
In conclusion, I believe that contemporary psychopathology is a case of finding a hammer and suddenly realizing we are surrounded by nails. If something can be treated as an illness it will be treated as an illness, because that is l’esprit de l’époque. Classifying something as an illness, assigning it a part of the brain, and prescribing it a drug as treatment makes it real and important, so politicians, scientists, and the general public are aware of its existence and direct resources its way. This is why everyday we “discover” that there are more things linked to mental health: Poor housing, poor nourishment, the weather, sexual orientation, racial discrimination, political ideologies… and as there is no psychopathology there’s no limit to psychic pathologies. There’s a drug for everything or a therapy for everything. It’s no coincidence that we now have the most effective treatments in history and the highest rate of accessibility to mental health services ever, but the rates of mental disorders are soaring well. And despite all the advances in psychotherapy and psychopharmacology, no breakthroughs have been made in psychopathology.
I’m convinced that in the future people will look at our ideas on psychopathology as we now look at humorism.
Sources:
APA Definition of Psychopathology: https://dictionary.apa.org/psychopathology
*Psychotherapy just as effective as pharmacotherapy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5244449/
Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.
Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.
The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
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Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
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Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
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Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
-
Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
-
Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
-
Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
-
Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.
There has been a lot of CW discussion on climate change. This is an article written by someone that used to strongly believe in anthropogenic global warming and then looked at all the evidence before arriving at a different conclusion. The articles goes through what they did.
I thought a top-level submission would be more interesting as climate change is such a hot button topic and it would be good to have a top-level spot to discuss it for now. I have informed the author of this submission; they said they will drop by and engage with the comments here!
Tyger Tyger, burning bright,
In the forests of the night;
What immortal hand or eye,
Could frame thy fearful symmetry?
William Blake.
Our modern society is in love with Darwin. Our ideas about nature, evolution, society and ourselves have been shaped by this man. It seems like every reasonable person in the world agrees that Darwin’s theory is correct and useful. Darwin’s theory aims at explaining how species evolve and become new species through the means of what he called “Natural Selection”, which was defined by him as follows: “This preservation of favourable individual differences and variations, and the destruction of those which are injurious, I have called Natural Selection”. In other words, traits that benefit the individual tend to be preserved over time, while injurious traits tend to disappear. Traits that are not beneficial or detrimental are not affected by Natural Selection.
The accusation that this definition is tautological is nothing new and is well known, but it is generally ignored. A tautology is a statement that is true in every possible case. For instance, a statement like “The car is red because it’s not green” can’t be false because everything that is red is, by definition, not green. This statement is true but it’s useless as an explanation because it doesn’t give any information other than what is implied by its terms. Darwin’s critics accuse him of crafting a tautological statement because in his definition “favourable” or “beneficial” traits are defined as those that are preserved, and traits that are preserved are of course those that are favourable or beneficial. In other words, what Darwin says is that traits that are preserved are preserved. For instance: A Darwinist would say that human thumbs exist because they provide an advantage for the survivability of the species, so humans with thumbs have always been more successful at being alive and passing on their genes than human species without them. But if humans had no thumbs we could make the exact same argument, mutatis mutandis. Because of course what already exists has a higher chance of continuing to exist than things that no longer exist or that have never existed. Another example: Individuals who are born with healthy reproductive organs are more likely to pass on their genes than individuals who are born infertile. In both cases we can see “natural selection” in action. Both “explanations” are obviously true, but they are tautological, they don’t add any new information.
So the theory of Natural Selection explains nothing, and while scientists and biologists may admire Darwin and “believe” in Natural Selection, especially in opposition to creationist explanations, the truth is that Darwin’s book On The Origin of Species is an artifact of the past and university curriculums hardly devote any time to it. If people were to suddenly forget all about Darwin our understanding of evolution would remain roughly the same - although we would lose his contributions in other fields. Nowadays people seem to think that “evolution” and “natural selection” are synonyms but that’s not true at all. Evolution wasn’t a new concept to educated people back in the XIXth century, and everyone grasped the concept of heritability. So why was it so important, or why was it considered important, and why did it cause such a revolution in our understanding of nature? The answer is: Because of the concept of struggle for existence. People have always known that animals and humans change throughout the generations, but Darwin’s theory asserted that everything in nature, both animal and human, is determined by a struggle for scarce resources, that is, by an economic problem. Again, this is something that everyone who has felt hunger or desire to reproduce has understood to some degree, but before Darwin nature was much more than simply being alive and reproducing yourself. It was a divine creation, it had meaning, it had truth, it spoke in a rich language understandable to humans. Darwin’s theory made this language unintelligible, because it showed that an economic mindset was enough to understand nature for the purpose of fulfilling our needs. If a car is red, we don’t need to know the owner’s preferences or the manufacturer’s motivations in order to know that it is not green, and this knowledge is enough to use it. The fact that humankind descends from apes was polemic only because it showed that humans and apes have the same needs and aspirations, even if they had different evolutionary strategies to acquire them. But this is the conscious part, the part that everyone acknowledges. There’s also an unconscious consequence of the theory of natural selection: That nothing exists outside the struggle for existence.
This last idea is what makes Darwin’s theory so apt for the modern world. Science can overcome Darwin, modern society seemingly cannot. And even though biologists don’t pay much attention to him, Darwin is still quite popular in politics, philosophy, and social sciences. Because if there’s something at which modern society is particularly good, it’s at providing the means for existence and reproduction. So a theory of nature that asserts that this is all there is to it it’s bound to be popular, because it justifies the current state of affairs and exalts it as the best possible outcome of a long evolution towards an efficient society. All other possible alternatives are overcomed, and any possible development can only follow its example. Politically, liberals love it because it justifies and naturalizes their belief in the free market, and marxists love it because it promises future and exciting developments when men conquer the course of the evolution of their species with their own hands. Philosophically it solves the problem of how living creatures were created out of lifeless things, and it solves it in such a way that is comprehensible for human cognition. But the most peculiar development comes from the social sciences. First, came the social Darwinists who tried to apply the principle of survival of the fittest quite literally, but after WWII this became impossible for political reasons. We now have evolutionary psychology, a field that instead of trying to control human behavior creates a mythology around it, providing panglossian theories for human behavior that explain nothing and are therefore impossible to prove or disprove, but that provide a common ground between the general public and solicitors, drivelers, quacks, pickup artists - in a world, charlatans of all kinds. Everybody wants the secret to “hack” human behavior. There’s a particular internet subculture of men who are frustrated with modern society and with the changes in gender roles, and who look in evolutionary psychology for mating strategies to end their loneliness, believing that the atavistic caves where man supposedly learned to be man are like the rooms in which they spend most of their lives, without realizing that it is the selfishness of modern society that created this idea of the primitive caveman and that erodes human connections by reducing them to a mere survival strategy.
But it is clear that man became man not by surviving or by conquering the means to preserve and reproduce himself, but by the conquest of the unnecessary. As Gaston Bachelard(1) puts it: “Man is a creation of desire, not a creation of necessity”. Furthermore, there’s no evidence for the existence of a “survival instinct” anywhere in nature. We believe ourselves to be smarter than animals because they risk their lives in pointless endeavors, they are mostly unable to plan ahead and to cooperate for their survival as we do. But who said they needed to? If everything life needed is to survive, then asexual organisms would be the pinnacle of evolution, everything that has come after it is useless and inferior by this standard. While it is true that a struggle is necessary to exist, if existence were its only goal, if one could not risk even existence itself in exchange of something else, this struggle would be meaningless. Sexual reproduction is an example of a struggle where individual existence is put into question, because it bridges the gap between two individuals and creates something new. It is luxurious and exuberant, as life itself. This is something that has always been quite clear for humans since the dawn of time, but that seems incomprehensible now. Biology can progress through Darwinism but only by obscuring the mystery of life, turning it into something miserable and petty, like human economy. This progress is nothing but a change of perspective, focusing one thing and ignoring another. But as all perspectives are, in principle, equally valid, it’s only desire what moves us towards something else and something better than our trivial everyday existence and its meaningless struggles. Is it not, as Georges Bataille puts it, the tiger’s fruitlessness what makes it the king of the jungle? By predating on other animals, that eat other animals, that eat plants, and so on, the tiger splurges a huge amount of the jungle’s resources. Some would say that it serves the purpose of maintaining the balance of the ecosystem, but couldn’t this balance be imposed by the tiger itself? Its existence would then be more than a struggle for existence, it would be a struggle to impose its own norm, its own will, its right to splurge. This struggle would be unintelligible without the base of mere existence, because individual existence imposes a period of activity and silence, a discrete grammar for the tiger’s individuality to express itself, but the meaning of the tiger’s behavior can only be confused with its grammar by a fool. The tiger itself is but an echo of something infinite.
(1)Gaston Bachelard, The Psychoanalysis of Fire.