I like being on the same side as Finn. 
Smash is a tool. It’s great to be an advocate for the mentally ill and the homeless. Where the asshattery comes in is when you claim that they are doing it the right way and everyone else is wrong.
He’s the president of a panhandlers union. If you have to panhandle to live that’s one thing but panhandling as a profession is bullshit. Panhandlers contribute jackshit to society and should not be encouraged.
You Googled “Nietzsche quotations.” That quote’s on the first hit.
Wow, it sure takes a lot of intelligence to use Google. We’re all impressed.
When are you leaving?
My neighbour’s dog chased a squirrel up a tree for no good reason, and then sat down and licked his own butt. That’s prolly science right there.
And of course, we could have had this whole mess avoided if our resident superior, well read, wise members of the intelligentsia had simply known wtf they were actually arguing and had stated “Yeah, you’re right about what science is and what it can do. And sure, hearing voices, having paranoid delusions and being unable to process or communicate information are symptoms of an illness. But we shouldn’t force treatment on everybody who has those symptoms.”
Instead we get this preening, arrogant, ignorant blabber about “the knowledge of the world” and other such rot.
Of course, we also have a heavy dose of woo from people who obviously don’t understand epistemology at all. No, there are no other means of knowing than how we go about knowing things. And “It came to me in a vision!” is not, lo and behold, epistemologicaly valid (who’d a thunk it?). We could’ve had an interesting discussion as to how various conditions should be treated without all this “I are so smart and u are not u neckbeard, shamans are awesome and u are lame, ROFL! And also, I’ve read Voltaire. Neitzche too! P.S… semiotics!”
Of course as they’re folks who read lots, understand less, quote a bunch and understand none, they don’t understand that intuition/imagination are perfectly valid ways of coming up with new hypotheses… but whether or not a hypothesis turns out to be valid and sound is based on testing and refutation. The structure of benzine would be a ring whether or not someone flashed to that fact in a dream. The fact that someone intuited it with dream logic doesn’t mean that dream logic is a way of knowing anything, but that it’s a way of guessing the whole from its parts and may, or may not, be proven accurate. And that’s to be done experimentally and experentially.
Evidently our arrogant dilettantes (or at least the only one who’s deigned to defend his position) really meant to be arguing that “Medicine can’t say whether or not it should be personally worth it to someone to trade smoking now for cancer later.”
Well, no shit. (And yet of course that doesn’t mean that lung disease isn’t an illness)
But since Kimmy is a pretentious git with the intellect and communicative powers of a yapping chihuahua, instead we get this bullshit about how we can’t define “illness”, and certain forms of “knowing” have more utility than “materialism”, and so on and so on. I may’ve missed it, but I’d put money on the word “sciencism” being used in this thread or the other.
And he thinks it’s other people’s fault that his point was poorly argued, defined, and supported. :smack:
I think we’re approaching a point where this can be resolved. You’re the one who wants testing, refutation, experiment and experience. If you’ll just drop the first three and use his version of the fourth, you’ll both be on the same page. We’re 25% of the way to reaching an agreement!
But when your BATNA is heaping on well-deserved abuse, I wouldn’t waste too much time trying to reach an agreement.
Don’t want to hijack this every-so-lovely thread, but your ideas intrigue me and I wish to subscribe to your newsletter. Well, okay, I’m actually just curious what you mean, but further explanation would still be appreciated.
That’s fine, but the example of homosexuality is a good one for this question.
What, apart from social disapproval, makes homosexuality a dysfunction? (Leaving aside questions about Darwinian reproductive success, which doesn’t generally come into play for individuals.) Very little, frankly - the only problem, by and large, comes from other people disapproving of homosexuality.
What, apart from social disapproval, makes schizophrenia a dysfunction? All kinds of things, as others in the thread have pointed out. It hurts, and schizophrenics are very often miserable as a result. And this is true even in societies who define schizophrenics as shamans. Schizophrenic shamans still live fairly marginalized lives, even if they have a social role to fulfill. And impaired cognitive function and hearing voices that aren’t there and inappropriate affect are dysfunctional even if people think you are in touch with the spirit world.
Likewise the discussion about Deaf culture. Sure, ASL is just as valid a language as English or Arabic. But deaf people still can’t hear car horns or bird songs or rattlesnakes as well as hearing people. Therefore, deafness is a dysfunction.
Certainly it can be true that “the cure is worse than the disease”. But the fact that a disease is incurable doesn’t mean that it doesn’t exist, or that its symptoms aren’t really so bad. And not all of those who have a disease agree that they need treatment. Typhoid Mary didn’t like being locked up - she wanted to go out and cook again. But that wasn’t going to happen.
If you want to take a strictly libertarian approach and say that people can be schizophrenic if they want, that is a possible attitude. But I think you do your position a disservice if you argue that schizophrenics don’t really have anything wrong with them. That’s a different issue from “should we let people live on the street and eat out of garbage cans if they want to?”
Regards,
Shodan
My wife and daughters learned ASL (and are not deaf) and what I get from them is that dysfunction means having problems getting along in society. Sure they can’t hear birds, but I can’t smell the stuff my dog can, and I manage. My hearing is not anywhere as sensitive as that of a a blind person, and I don’t have facial vision. I think they object to a different set of abilities being labeled as inferior. There is also some degree of deaf identity, which is the reason there is opposition to lip reading in the deaf community.
I’m definitely not saying all claims of dysfunction are false, btw.
A different set of abilities is not necessarily inferior. Lacking a fundamental sense is (and the extent to which blind people’s hearing is better than yours is ridiculously exaggerated - the difference is very minor.) Pretending deafness is not a disability, or suggesting that admitting it is is somehow labelling anyone as “inferior,” is just silliness.
And no, you can’t smell the way your dog can. You also can’t fly like a bird. That’s because you are not a dog or a bird.
Thank Gawd for that. Otherwise we’d have people commenting on the rankness of a wet Jackmannii. 
We’re too polite to say anything, Jackmannii.
Regards,
Shodan
Malthus:
However, in the case of schizophrenia (and many other psychological “disorders” for that matter), there are no “signs”; only symptoms. After nearly a century of intense research, psychiatrists have been unable to discover a single physical anomaly that can be reliably correlated with schizophrenia.
So, granting that the cluster of symptoms described in the DSM IV do co-occur regularly enough to denote the presence of some sort of underlying common cause – and there are plenty of researchers who question that assertion, by the way – we still have at best a “syndrome,” rather than a “disease” or “illness.” (A syndrome, by the way, is defined as a cluster of symptoms with no known underlying cause.)
The DSM IV, by the way, sidesteps this debate by calling all psychological diagnoses “disorders.” This allows it to remain agnostic in terms underlying cause. But it’s worth noting that the previous edition, DSM III, actually stated that to be diagnosed as schizophrenic, the clinician needed to rule out the possibility that the symptoms had an underlying physical cause (like physical brain trauma, for example). I guess they didn’t realize this criteria meant you could never classify schizophrenia as an “illness”. I seem to remember reading somewhere that this criteria was removed in the DSM IV due to a successful lobbying effort on the part of the “neo-Kraeplinians”, whose research paradigm specifically precludes explanations of psychological dysfunction that are not firmly grounded in biology. These are the fellows that have the monopoly on research these days, by the way.
You must excuse my jaded cynicism (I’ve worked in the field of mental health for well over a decade now), but believe me when I tell you that at least out here in the bush, these sorts of evaluations are anything other than “scientific.”
I am not a doctor, but it strikes me that an insufficient amount is known about how the brain functions to rule out a “physical” cause for an illness/syndrome/whatever-you-wish-to-call-it like schizophrenia.
Indeed, on the contrary, while it is true that at present physicians do not have the ability to directly observe the physical “signs” of the disease in living patients(these being internal to living brains) they have as a matter of fact observed the “signs” in the brains of cadavers.
http://www.medicalnewstoday.com/articles/141084.php
I am not sure that what you say about diagnosis is likely to be true in the near future, either. The latest research seems to indicate that science is, in fact, on the cusp of being able to diagnose the disease from clinical “signs” as well as from the more traditional “symptoms”. From the same study report:
It would appear quite likely that the illness is, in fact, “grounded in biology”. If the “illness” is not “grounded in biology”, exactly what else do the non-“neo-Kraeplinians” believe this particular psychological dysfunction is “grounded” in?
In summary, while it is true that mental health may be the last area in which medical art has yet to give way to a firm grounding in science, actual evidence indicates that this situation is changing, and science will do the job in the end; in the same way as chemistry derives from alchemy, science in medicine derives from older traditions which were required because of the lack of better knowledge; the fact that science cannot yet explain all things does not mean it is not, in the end, the best tool to use in the long run.
Not that medical art will cease to be useful, mind. A diagnosis will always have an element of the subjective. But that subjective evaluation will be strengthened and deepened by an understanding of the physical causes of disease - claiming that there are none and that it is not a “disease” at all because the means to observe them were lacking in the past strikes me as unhelpful.
It would seem that we’re making some progress in linking biology with schizophrenia. BBC NEWS | Health | Gene 'has key schizophrenia role'
I appreciate your jaded cynicism, however. As a science, Psychology suffers from Physics Envy. Furthermore, much of what falls under the umbrella of “Psychology” is not scientific. Like what Malthus discussed, it’s in a similar vein (but probably greater in degree) as to how much of Medicine involves clinical experience rather than rigorous biological research. Conflation abounds when discussing the validity of psychological knowledge.
I’m not particularly concerned over whether or what any biological basis for mental conditions might be anyway, insofar as discussing current treatment practices and how society (currently/historically) views schizophrenia, homosexuality, or left-handedness.
Eventually, with advancements in neuroscience, we’ll find biological connections, physical factors that influence/generate all sorts of thought processes. Greater understanding of of the objective processes that shape our subjective experience will certainly aid in understanding schizophrenia. However, the fact that the little homonculus that connects our subjective worlds with our brains turns out to be a little bit more complicated than we thought centuries ago doesn’t really say much one way or the other about the validity of any particular cluster of symptoms grouped together in the DSM.
Malthus:
Oh. I’m not ruling out a physical cause for the illness/syndrome/whatever. Not at all. I’m saying that there is a school of psychiatry, probably the most prominent one these days, that rules out possible explanations other than the biological a priorí. It’s a part of the paradigm, which consists of nine tenets. For a brief overview, go here. I disagree with most of these tenets myself, but specifically I’m referring to number 6: “The focus of psychiatric physicians should be on the biological aspects of illness.”
But just to be clear, understand that it is the researchers themselves who are ruling out other possible explanatory models other than the biological, without regard to the evidence for or against such alternative models. Does that approach strike you as very scientific? It sure doesn’t look like it from my vantage point.
Did you not notice the use of the word “could” in your quote? Believe me, I’ve read – well, probably, hundreds of these sorts of reports. They always say they’re on the brink of discovering where the problem lies. They’ve been saying that for over 50 years. The article you cite even admits as much, in the second paragraph:
But even so, being on the verge of identifying “signs” of the illness is not the same as actually being able to, which was your previous assertion. That’s what I was responding to. You’ve claimed that schizophrenia is an illness. An illness has both signs and symptoms. I’m not trying to be an ass, I’m just trying to point out that, actually, schizophrenia doesn’t have any known signs at the moment, and, in fact, it has never in it’s entire history ever had a sign. Period. Yet most people call it an illness, which is rather illogical and to me indicates a somewhat irrational relationship to the phenomenon in question. YMMV.
Well, obviously, something psychological: childhood trauma, possibly cumulative, or early sexual abuse, or something else along those lines.
How many issues of Schizophrenia Bulletin have you read, may I ask, that led you to this particular summation of the “evidence”?
Any real acquaintance with the actual historical evidence would probably indicate the opposite. They’ve been pursuing these ghosts, and promising breakthroughs, for nigh on 80, 90 years now. I’m not saying they should stop looking; I’m just saying that they maybe could broaden their horizons a bit. But the more cynical among us might also wonder…hmmm, could there be other motives that have led to this state of affairs?
Depending on what you mean when you use the word “science”, we’re basically in agreement here. I am at least a very big believer in empirical research, but I am also aware of its very serious deficiencies, especially in this particular field.
The problem with this statement from my perspective is that you’ve put your cart in front of your horse: you assume it’s a disease first, and then go out looking for evidence to support that assertion second. In truth, it may not be a “disease” at all, and all research in that direction may prove to be a dead end.
But please don’t misinterpret anything I’ve written above to mean that I am anti-science. My beef is really just with the current direction of research.
I’ll put it on my to-do list. Usually only takes me a few months to actually start a thread once I decide to do it, although a bit longer when it’s something complicated like the difference between goats and sheep.
Disability is the condition of being unable to perform. Deafness is clearly a disability in the sense of hearing, but is it one in the sense of being able to perform in society? Sure there are things that they can’t do, but I’m tone deaf and would be pretty unlikely to make it as a musician. This is a pretty sensitive issue. You might not want to wander on a campus of a school for the deaf and call them disabled - they have very strong fingers.
I’m in no position to defend this school of thought; though it does make sense to me that every aspect of what we do has some biological explaination, insofar as we are biological organisms. That being said, I’d need to see what these “alternative models” are that are being “ruled out” so summarily.
I did; certainly this isn’t a well-settled area by any means. Though the fact that it hasn’t been settled for 50 years does not mean that it will never be settled. The article indicates significant progress and has identified physical differences, which is somewhat contradictory to the claim that there are no “signs”.
What it had in its “history” is quite irrelevant. The fact is that it does, according to the latest research, apparently have “signs” indicates that those characterising it as an “illness” were, in point of fact, correct to do so.
This isn’t incompatable with a “biological” factor, though the fact that the disease apparently has some sort of genetic component seems to argue that at least in part it has a “biological” explaination - perhaps triggered by trauma, drug use, etc.
How much of an “authority” do I have to be to be able to comment, in your opinion?
Appeal to authority is the weakest of arguments online, IMHO. I’ve said I’m not a doc, just someone with a passing interest.
If you wish to state that you know better because of your extensive study of the subject, you may do so, but it isn’t a very convincing method of argument. Logic and evidence is preferable.
The fact is that 80, 90 years ago scientists weren’t even aware of the existance of DNA, and were much less cognizent of the workings of the brain.
What cynical motives are you hinting at? I assure you that whatever they are, as a non-physician and non-researcher I do not share them.
The main “deficiency” is that the workings of the human brain remain, to a degree, mysterious. I am idealistic enough to believe that this will not always be the case.
We are in a state similar to that of Darwin. He could observe the effects of genetics, but did not understand the actual mechanism of genetics. Similarly, we can observe the effects of certain mental diseases, but cannot for certainty state their cause. This does not mean that there is no physical cause, just that we are not yet in a position to understand them fully - since we do not, in point of fact, know fully how the brain actually works.
It may well be that you are correct and that this condition has no physical cause. I doubt it, based on the evidence, but it is possible. Assuming that is a possibility, the only way to prove it is to do exactly what you criticize - that is, assume it does have a physicial cause and set out to track each and every possibility down and attempt to disprove it.
Malthus:
Well, you gave a definition of illness as something constituting both signs and symptoms. I think the definition you gave is a bit simplified from my readings, but good enough for government work, as they say. But just because some researchers claim that they might have found signs of schizophrenia doesn’t really have much bearing on your argument, if you insist on the definition of illness you proposed. At best, until we have strong confirmation of these signs, schizophrenia should be understood as a syndrome. But it’s actually much more complicated than that, because a lot of researchers question whether it is really accurate to claim that the symptoms of schizophrenia always show up as a discrete cluster. In fact, the symptoms of schizophrenia have evolved over time, and you probably wouldn’t recognize some of the earlier descriptions of schizophrenia. So then you come to the next methodological question, which is (for example) how did the researchers you cite decide who was schizophrenic and who wasn’t, prior to testing their genetic hypothesis? This stuff can get very complicated very quickly.
There are in fact some researchers who are arguing that we should drop our consideration of symptoms from the picture altogether, and simply concentrate on diagnosing the condition based on observable differences in brain function/chemistry/structure. Which means, following their logic, that you could be diagnosed as schizophrenic even without symptoms.
Of course not. I’m saying that it is entirely possible that schizophrenia is purely biological. It’s entirely possible that it is an illness. The problem is we just don’t know that yet, and yet the overwhelming majority of research in the field simply assumes it to be the case.
This is no appeal to authority. It is an appeal to evidence. If you were to peruse a few back issues of SB, you’d discover that your statement is incorrect. But I’m not going to list all the the hundreds of articles to be found there that claim they’ve just made a new breakthrough in understanding schizophrenia, or that such a breakthrough is right around the corner. They’re there though, believe me. And if you don’t, read em.
No no! I never meant to insinuate that you shared them!
But I mean that they are there. I’ll just be frank. First there’s the “physics envy” Orr referred to above, only in psychiatry, it’s “medicine envy.” Psychiatry has struggled for years to be accepted as a valid branch of medicine. Then, there’s the financial side. The market for pharmaceutical treatments is huge. There is a significant economic interest involved in the one-sided focus on schizophrenia as a biological illness.
This is like maybe the fifth time in this conversation that I’ve tried to tell you that I am agnostic with regard to the causes of schizophrenia. I’m not saying it doesn’t have a physical cause. I’m saying we don’t know what causes it, and it is therefore premature to insist that it does have a physical cause. In fact, the first sentence in my last response to you read, "Oh. I’m not ruling out a physical cause for the illness/syndrome/whatever. Not at all."