Friday, June 6, 2014

Major affective disorder, pleasant type

This is good:
the argument that happiness be excluded from future classifications of mental disorder merely on the grounds that it is not negatively valued carries the implication that value judgements should determine our approach to psychiatric classification. Such a suggestion is clearly inimical to the spirit of psychopathology considered as a natural science. Indeed, only a psychopathology that openly declares the relevance of values to classification could persist in excluding happiness from the psychiatric disorders.
[Hat-tip to The Beetle Box, also good.]

15 comments:

  1. psychiatry isn't in the business of natural science but of medicine and by extension "health" as in health-insurance, and increasingly in the biz of behavioral health sometimes more explicitly sold as behavioral management. That said the idea that the human-doings we often refer to as natural sciences are somehow value-free is a bit out of touch in the realms of philo of science (and or science studies).
    -dmf

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    1. Yes, but there's an ideal or pretense of natural science being value-free, and that would not be a great ideal for psychiatry. That's what I took at least part of the point to be.

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    2. when the DSM stops counting as pathological effects that negatively impact social functions like work and family life that might make sense but it is what it is, no?
      http://www.medscape.com/viewarticle/818850

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    3. I'm not sure Bentall is really addressing philosophers of science, or even philosophers at all. I read him mostly as attempting to bash some of the home-grown mythologies of psychiatry as a discipline (contra the psychiatrists); both the idea that psychiatry can be value free, and that it needs to be value-free to be counted as "proper" science.

      Also, even though natural (or indeed any) science can't be value free, it seems like psychiatry as a science needs a whole lot more additional values to get it off the ground than the rest?

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    4. again psychiatry isn't a science but a field of medicine (just as engineering isn't physics) and as such doesn't need "more" additional values to get off the ground.
      back to the rough ground...
      -dmf

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    5. I'm not sure Bentall is really addressing philosophers of science, or even philosophers at all. I read him mostly as attempting to bash some of the home-grown mythologies of psychiatry as a discipline

      psychiatry isn't a science but a field of medicine (just as engineering isn't physics)

      I agree with all of this.

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    6. I don't think we disagree (despite my chronic clumsy wording). All I wanted to say was that even though science is clearly normative, psychiatry, medicine and engineering are normative in a stronger sense, they are disciplines with certain kinds of associated values and goals (one they utilize natural sciences to fulfil, or perhaps that should be "marshall [them] for a particular purpose.")

      You're right 'psychiatry as science' doesn't really get anywhere. It's only when considered as an essentially normative discipline that it starts to make sense.

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    7. (But a normative discipline which importantly still utilizes the scientific method, and thus needs to take all those values and goals on board as well. I still think, importantly, it is the *science* of making people better, just as engineering is the science of building better bridges, although yes you're right- that doesn't make it just a branch of physics.

      For starters, I'm going to want some kind of evidence that what the doctor is giving me has been shown to make people in my condition better. Like you, I'm anti relegating psychiatry to the sciences, but it is linked to them in vital ways.)

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  2. http://www.youtube.com/watch?v=oGNDSTqoufM

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    1. I can't get this to play for some reason, but I'll keep trying. Thanks.

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  3. Just saw this blog post. In general, I agree with it. But there is one thing to consider. To what extent would the behavior of classification become the behavior of lexicography? Think about it. Every single person has to have some sort of "disorder," because, to behave, they show some sort of describable pattern. Affect Disorder, Excessively Normative. Such a person blends too well. Or, Excessive Self-denial, something perhaps Mother Teresa suffered from.

    I actually think I would be better if the DSM would become like the dictionary rather than a book of affliction. It would be saying that "behavior is what behavior does." And this would allow us to see two senses of "pathology." One that involves a non-value judgment that says, in a way, even the normal are peculiar -- there's just more of them. And another that says, "these here are destructive to their own goals or are infringing on others" (i.e., injurious).

    What I want to say here is that all humans are pathological in a certain sense, but not all are injurious in their "ways." And as such, there would be merit it having a DSM that would someday be like the dictionary.

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    1. Maybe, but surely not every describable pattern (or order) is a disorder. What should count as a disorder is something that Bentall discusses. For instance, he says that, "it has been suggested that, for the purposes of psychiatric research, a disease be simply regarded as any deviation from the norm by way of excess or deficit which confers upon the sufferer some form of biological disadvantage."

      I take his argument to be a kind of reductio. One thing he seems to want to want to say is that if we think of psychiatry not as dmf rightly characterizes it but as a science, in the way that physics is a science, say, then we ought to classify happiness as a disorder. (Ergo we should not reject the kind of characterization that dmf provides above.) Another is that if we count something as ill defined as schizophrenia as a specific disorder then we ought to count happiness as one too. (Ergo we should not think that schizophrenia is a specific disorder, although doubtless the suffering of people diagnosed with schizophrenia is real enough.)

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  4. ... well, I'm not sure I can agree with Bentall. Having the epicenter be norms or regularity only imposes cultural or political criteria of the matter. It says that the pathos of the majority is the standard by which others must be said to have affliction. Surely we could imagine other species or other worlds or other courses in evolution where the behavioral norms of "regular people" (today) would not be the norm otherwise. This is a cultural construct being imposed upon brain science or whatnot. Truthfully, I would love to see the day when there develops an alternate psychiatry that classifies people who are in the norm as suffering from pedestrianism or from conformity syndrome.

    Again, my point is this: these things should be based around some idea or injury, to self or others. They shouldn't be based upon who is not like "the norm."

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    1. these things should be based around some idea or injury, to self or others.

      I think Bentall would agree. The idea that happiness is a disorder is a joke, precisely because happiness is not a form of suffering and does not cause suffering. He does argue (with his tongue in his cheek, I take it) that happiness is a disorder because it is not only not the norm but also harmful. But it clearly isn't very harmful, and is worth whatever costs it may have. At least usually.

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