# Mental disorders aren't necessarily valid **URL:** \ **Category:** Great Debates\ **Created:** [October 14, 2003, 1:12pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363 "2003-10-14T13:12:43Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 15, 2003, 4:18pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/41 "2003-10-15T16:18:14Z")
> [@](#): > > \*Originally posted by j.c. \* > \*\*However, that standard for the field is to determine to what extent someone seems to be a little too far north or south on the X spectrum, \*\* What’s “a little too far north or south”? > [@](#): > > **to what extent this is messing up that poor person’s abilty to live a normal life,** “Normal” in what way? > [@](#): > > **and to move 'em toward a comfortable range.** “Comfortable” for whom? ---
**Author:** ![SentientMeat](https://avatars.discourse-cdn.com/v4/letter/s/43a26b/32.png) [@SentientMeat](https://boards.straightdope.com/u/SentientMeat)\ **Post date:** [October 15, 2003, 4:30pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/42 "2003-10-15T16:30:41Z")
**Aide** , it’s happening again. Goodbye. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 15, 2003, 5:01pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/43 "2003-10-15T17:01:00Z")
See ya. Now, everyone, do you see why the family members of people with mental disorders _need_ for the diagnoses to refer to some hypothetical physical problem? It makes the disorder easy to understand, makes it seem as if it’s something alien to the person (“my mom isn’t that way, it’s just her disease!”), and give hope it can be overcome relatively simply. The lack of scientific evidence for this claim just doens’t matter to them. That’s why NAMI has been so successful – if your family member has a physical illness, it can’t possibly be your fault. There’s no need to feel guilty. (Not that it _is_ their fault, or that they need to feel guilty. That’s not even the point.) ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 15, 2003, 5:05pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/44 "2003-10-15T17:05:15Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\* > > 1. First, we need to acknowledge that our opinions about what _should_ justify utter terror _are_ opinions. If someone seems unreasonably afraid of something, we must be aware of the possibility that they have a perfectly reasonable explanation – or if not, that our definition of “reasonable” might be at fault. > > 2. Secondly, we need to realize that what is objectively wrong is that she’s becoming utterly terrified for no reason. Without evidence for a specific physiological or psychological cause, we can’t presume any problem deeper than the behaviors and emotions we observe and use to define the problem. > > 3. Now, if her doctor tells her that she must take a certain medication because she has a problem with her brain, that claim is not objectively supported. If her doctor tells her that she must undergo cognitive-behavioral therapy to unlearn her psychological feat, that claim is not objectively supported either. > > If her doctor tells her that certain methods exist for helping people with problems similar to hers, and that she can choose whichever she feels is most appropriate (or mix them if she desires), then that is responsible and compassionate medicine. > > 1. But since it’s often much easier to get insurance to pay for medication than therapy, and since medication works more quickly than therapy (but less reliably and with a greater chance of relapse when discontinued), she’ll probably be told that she needs to take a medication instead. > \*\* just pointing out more examples of TVAA making stuff up. 1. are you assuming that “we” don’t do that? asserting it? Or just telling “us” what “we” do already? (don’t get me started on the word “need” btw) 2. again, are you assuming that “we” presume a problem deeper than the behaviors and emotions? asserting it as an opinion? fact? 3. Hard to disagree. I personally am picking up an implication that you think this is standard practice, though; and it’s not in my experience. 4. ah, here we go. This calls for facts. Otherwise I can just sit here and tell you “no it’s not, no it doesn’t, and no she wouldn’t” particularly no she wouldn’t be told that she “needs” medication. I’m right, you’re wrong, unless you can cite examples of where this is common practice. ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [October 15, 2003, 5:24pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/45 "2003-10-15T17:24:20Z")
**TVAA** , everybody admits that the science just isn’t there yet. Everyone admits that we don’t have a freaking clue what half these meds do, and why that should affect people. Psychiatry and psychology are in the medical dark ages. We can’t empericly detect most of this because we just don’t know. Next to nobody is pretending it is any different. But what else are you going to do? I question my illness. I try to figure out what is going on in my head. I try to control it. It is fucking hell and it doesn’t work. I keep getting wose and worse (progressive disease). One of these days I’m going to make it to a therapist because otherwise I will kill myself. And while that therapist doesn’t have a bunch of cold hard facts to give me, at least they’re not trying to deal with this through a veil of insanity, and at least they arn’t confronting all this for the first time. And it’s pretty doubtful they can give me something worse than my own self-medication- which usually involves alcohol, a couple dozen hours of sleep every night and constant crying. You want to treat only the behavoir. How? Give me electric shocks every time I cry? Or do nothing and let me drive myself into the ground? I agree that people should think critically about their minds and their mind’s quirks. I agree they shouldn’t leap towards med, and I abhor the “medication” culture because it trivializes what I go through, among other things. But on an individual scale, meds seem to work. And anything that keeps people away from the hell I live, I’m all for. Who am I to critisize what makes them work? Who am I to tell them they have to do everything the hard/impossible way just because that is the path I’ve chosen? No, I’m outright happy for them. Stop trying to look at it as science. It might be one day, but for now it just has the trappings. Instead, look at it as the art of helping people who are sick of being unable to function in society to be able to do so again. And sometime it is the art of giving people someone to talk to and some pills to take because they like taking pills. And sometimes it is the art of guessing what input in a great big system of unkowns will create an desired effect. And none of it is perfect nor pricise, but it’s the best option we have for people that want it. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 15, 2003, 6:23pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/46 "2003-10-15T18:23:39Z")
But there are plenty of doctors who are willing to permit their patients to retain the impression that psychiatry _isn’t_ within its Dark Ages. There are plenty of doctors who are willing to _encourage_ such an attitude. And there are even more doctors (mostly general physicians) who don’t even realize it’s not a science. But what it’s best at is giving the illusion of control. People do better when they believe their problems can be fixed; thusly, physicians conspire to delude them into thinking their problems are well-understood, so that they do better. ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 15, 2003, 8:14pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/47 "2003-10-15T20:14:12Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\*But there are plenty of doctors who are willing to permit their patients to retain the impression that psychiatry _isn’t_ within its Dark Ages. There are plenty of doctors who are willing to _encourage_ such an attitude. And there are even more doctors (mostly general physicians) who don’t even realize it’s not a science. > > But what it’s best at is giving the illusion of control. People do better when they believe their problems can be fixed; thusly, physicians conspire to delude them into thinking their problems are well-understood, so that they do better. \*\* If there are plenty, you should have no trouble finding one to cite! You should also have no trouble proving that it’s best at…control, that people do better…fixed, and, now this is a good one, There’s a _conspiracy_ ooooooooooh! You do get the irony that you’re on your soapbox about the psychiatric community providing the very thing you’re worst at, right? Proof? Maybe, just maybe you’re so sensitive about it because you know it’s a personal flaw of yours. Maybe you think because you make stuff up and present it as fact, that everyone must too. I’ts more common than you’d think, give yourself permission to consider it. ---
**Author:** ![SisterCoyote](https://avatars.discourse-cdn.com/v4/letter/s/958977/32.png) [@SisterCoyote](https://boards.straightdope.com/u/SisterCoyote)\ **Post date:** [October 15, 2003, 8:43pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/48 "2003-10-15T20:43:27Z")
BTW, **TVAA** , re your point above about psychiatrists encouraging the illusion of control: You do realize there’s a reason that regular physicians call what they do _practice_, right? ---
**Author:** ![Primaflora](https://avatars.discourse-cdn.com/v4/letter/p/898d66/32.png) [@Primaflora](https://boards.straightdope.com/u/Primaflora)\ **Post date:** [October 15, 2003, 9:41pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/49 "2003-10-15T21:41:19Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\* > > Now, everyone, do you see why the family members of people with mental disorders _need_ for the diagnoses to refer to some hypothetical physical problem? It makes the disorder easy to understand, makes it seem as if it’s something alien to the person (“my mom isn’t that way, it’s just her disease!”), and give hope it can be overcome relatively simply. > > The lack of scientific evidence for this claim just doens’t matter to them. \*\* Cite? Or did you just pull this one out of your arse as well? I’m waiting for the scientific evidence for your various claims to matter to you. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 15, 2003, 10:33pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/50 "2003-10-15T22:33:08Z")
> [@](#): > > \*Originally posted by Hentor the Barbarian \* > \*\*Can we not detect the symptoms of, in this case, bipolar disorder? If so, why not claim that it exists? \*\* Circular logic. What is it that we refer to by the name “bipolar disorder”? Although that’s not really a very good example (which I’m sure is why you chose it). There have never been very many ways of treating manic depression, and the few useful treatments have been very dangerous, very unpleasant, or both. > [@](#): > > \*\*If you could interview a bunch of people who have deep melancholy and irrational exhuberance and see in which ways they have similar things that we can also say are wrong and in which ways they are different, and determine a set of these similarities, and then see if using these similarities helps to distiguish these people from others in the problems they have, the course of their melancholy and irrational exhuberance over time, and see if other people have similar experiences using this set of similarities, and test these similarities to find out which ones really help to identify people who are going to have problems with deep melancholy and irrational exhuberance, at what point do we have a taxon? \*\* Taxon: a group or category in classfication. You can have a taxon whenever you like. The trick is finding a _valid and meaningful_ taxon. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 15, 2003, 10:36pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/51 "2003-10-15T22:36:28Z")
> [@](#): > > \*Originally posted by SisterCoyote \* > \*\*BTW, **TVAA** , re your point above about psychiatrists encouraging the illusion of control: > > You do realize there’s a reason that regular physicians call what they do _practice_, right? \*\* I’m not all that thrilled about medicine, either. It’s only recently that it’s begun to become a true science, and there are still plenty of harmful and pointless traditions floating around out there. [shrug] Well, we do what we can. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 15, 2003, 10:44pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/52 "2003-10-15T22:44:36Z")
> [@](#): > > \*Originally posted by Primaflora \* > \*\*Cite? Or did you just pull this one out of your arse as well? > > I’m waiting for the scientific evidence for your various claims to matter to you. \*\* You want cites? Go look at NAMI. Go look at discussions of autism and “refridgerator parenting”, and read parents’ outrage at being falsely and unreasonably blamed for causing their children’s condition. Then go read the countless sites that reassure parents they’re not to blame because they children have a neurological disorder. (They almost certainly do, although our ability to analyze and examine the workings of the brain is too limited to figure out what it is. Fortunately, we’ve gotten somewhat better at distinguishing between deafness and autism, and we’ve gotten a lot better at dealing with autistic kids. Hey, go read Thinking in Pictures, by Dr. Temple Grandin. One of the best descriptions of autism I’ve ever come across – and although she strongly disapproves of the inappropriate medications once given to autistic kids, she’s a strong advocate of the use of medication.) ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 15, 2003, 11:15pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/53 "2003-10-15T23:15:57Z")
Missed the part of the NAMI website that states that “there are many psychiatrists who…dark ages” also the part where the doctors encourage the attitude also the part where there’s proof that it isn’t a science. also the part about the illusion of control and how people do better when they believe their problems can be fixed. And could you point me to the conspiracy page? ---
**Author:** ![greck](https://avatars.discourse-cdn.com/v4/letter/g/7ab992/32.png) [@greck](https://boards.straightdope.com/u/greck)\ **Post date:** [October 15, 2003, 11:20pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/54 "2003-10-15T23:20:23Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\*. People do better when they believe their problems can be fixed > \*\* do you really believe this? ---
**Author:** ![Purple\_Scottie](https://avatars.discourse-cdn.com/v4/letter/p/a698b9/32.png) [@Purple\_Scottie](https://boards.straightdope.com/u/Purple_Scottie)\ **Post date:** [October 15, 2003, 11:22pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/55 "2003-10-15T23:22:51Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\* > > Although that’s not really a very good example (which I’m sure is why you chose it). There have never been very many ways of treating manic depression, and the few useful treatments have been very dangerous, very unpleasant, or both. > > \*\* There are many more options for treating bipolar disorder than there were a few years ago. It isn’t just limited to lithium anymore as many of the anticonvulsants are effective in some patients – there is depakote, trileptal, tegretol, etc. It is true that some of these drugs carry some nasty side effects (like any class of meds) but when you weigh the risk of suicide vs. the risk of a particular side effect most doctors will give the patient a prescription. I’m the first to admit that psychiatry is a fairly imprecise system. It would be great if there were blood tests that we could do to diagnose someone with OCD or depression. As we learn more about various conditions, hopefully these tests and increased use of imaging such as PET scans will become available. A problem with the DSM-IV is that its disorders have very broad defitions. Mood and anxiety disorders are probably due to a wider range of pathology than we realize. The brain has a complex system of neurotransmitters and receptors and we just aren’t at the point yet to pinpoint the specific deficets or excesses in each patient. ---
**Author:** ![Primaflora](https://avatars.discourse-cdn.com/v4/letter/p/898d66/32.png) [@Primaflora](https://boards.straightdope.com/u/Primaflora)\ **Post date:** [October 15, 2003, 11:58pm UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/56 "2003-10-15T23:58:20Z")
**TVAA** , I’m very familiar with the work on autism, neurological difference, Temple Grandin as I am raising two children diagnosed with autism. Refrigerator mothering is a long outdated theory. It’s not been current in the field of autism for decades. Got anything better to offer? I’m confused though. If you don’t buy the refrigerator mother theory why do you go on to say that parents are reassured by the neurological theory of difference? Are we not supposed to be? Are you pro or anti meds given to kids because I’m really not following which stance you take? Sometimes you seem anti and then you’re pro? Is it only OK to use meds with kids with autism? Should be avoided with kids with ODD or CD or ADHD? What about kids with co-morbid diagnoses? My brain is hurting. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 16, 2003, 1:24am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/57 "2003-10-16T01:24:43Z")
> [@](#): > > \*Originally posted by greck \* > \*\*do you really believe this? \*\* It’s common knowledge – it’s what the placebo effect is based on. All things being equal, therapies that people feel hopeful and optimistic about tend to be more successful. This isn’t some esoteric bit of knowledge, **greck**. I really don’t know what your problem is. ---
**Author:** ![TVAA](https://avatars.discourse-cdn.com/v4/letter/t/c57346/32.png) [@TVAA](https://boards.straightdope.com/u/TVAA)\ **Post date:** [October 16, 2003, 1:46am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/58 "2003-10-16T01:46:29Z")
> [@](#): > > \*Originally posted by Primaflora \* > \*\*Refrigerator mothering is a long outdated theory. It’s not been current in the field of autism for decades. Got anything better to offer? \*\* I think you’re missing my point. I’m not suggesting that the refridgerator theory is correct – in fact, it’s obviously wrong, as can be seen by even the most elementary examination of families soon after their children are diagnosed with autism. The mental and emotional exhaustion or indifference often associated with caretakers of autistic children is the effect and not the cause. My _point_ is that idiot clinicians came up with a hypothesis, assumed it was correct without seeking proof, and presented it as a known fact, causing untold misery and suffering by causing parents to blame themselves for the condition of their child. If the explanation had been correct, they would merely be guilty of presenting it poorly, but their error runs much deeper: they were _unscientific_. When it was finally made clear that the “refrigerator parenting” wasn’t worth the neural processing time it takes to learn about it, lots of people were extremely upset – and with good cause. Now, the evidence suggests that autism is some kind of neurological disorder. Unfortunately, our knowledge of the brain and imaging technology isn’t sufficient to demonstrate exactly what the problem with the brain might be, or how the symptoms of autism related to this problem. But if you read online resources for parents of austic children, you might notice a pattern that repeats itself in the discussion of lots of mental disorders: no one is to blame, as the problem is a physiological disease. Comforting, isn’t it? Instead of worrying about whether they somehow contributed, or how disturbing it is that a person feels a certain way, they can know that the condition is an external and alien thing that happens to affect their loved one. The problem is that this really isn’t known to be true. It’s a nice fiction, though, so people believe it. > [@](#): > > \*\*I’m confused though. If you don’t buy the refrigerator mother theory why do you go on to say that parents are reassured by the neurological theory of difference? Are we not supposed to be? \*\* My point is that, although autism is almost certainly a neurological disorder, there are lots of disorders where this isn’t nearly as clear, but people _want_ to believe that it is. Instead of uncertainty and ambiguity, people want simple and reassuring answers. > [@](#): > > \*\*Are you pro or anti meds given to kids because I’m really not following which stance you take? Sometimes you seem anti and then you’re pro? Is it only OK to use meds with kids with autism? Should be avoided with kids with ODD or CD or ADHD? What about kids with co-morbid diagnoses? \*\* That’s a very difficult question for adults, and the problems are much greater for children. Problems: Children can’t consent themselves (I have no problem with any competent adult doing whatever they like with their minds and bodies, but compelling anyone to be treated in a particular way is ethically troublesome). Most psychiatric medications weren’t safety-tested in children; some have been found to not have any obvious long-term effects, but only after they’d been used for years, which I do not consider to be an ethical way of determining this. Some drugs are known to be inherently dangerous, or at least somewhat risky. Substances like the antipsychotics (atypical or otherwise), lithium, etc. aren’t exactly healthy. > [@](#): > > \*\*My brain is hurting. \*\* Sister, welcome to the club. (Technically, that’s not possible: the brain doesn’t have any pain receptors. Just thought I’d point that out. 🙂 ) ---
**Author:** ![auliya](https://avatars.discourse-cdn.com/v4/letter/a/90db22/32.png) [@auliya](https://boards.straightdope.com/u/auliya)\ **Post date:** [October 16, 2003, 6:39am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/59 "2003-10-16T06:39:13Z")
> [@](#): > > \*Originally posted by TVAA \* > \*\* My point is that, although autism is almost certainly a neurological disorder, there are lots of disorders where this isn’t nearly as clear, but people _want_ to believe that it is. Instead of uncertainty and ambiguity, people want simple and reassuring answers. \*\* Where is there clear evidence that Autistic Spectrum Disorders are more likely to be neurological than anxiety or ADHD or many other psychological disorders? I have done a lot of researching of the literature in this area **TVAA** , and there are as many theories to explain the neurological and cognitive bases of functioning in autism as there are in any other disorder. Why do you choose to believe this is the case with ASDs but not with other disorders? Autism is also a DSM IV category, and the DSM and/or the ICD 10 are the standards for diagnosis, not any neurological testing ---
**Author:** ![Primaflora](https://avatars.discourse-cdn.com/v4/letter/p/898d66/32.png) [@Primaflora](https://boards.straightdope.com/u/Primaflora)\ **Post date:** [October 16, 2003, 6:47am UTC](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363/60 "2003-10-16T06:47:12Z")
**auliya** I’m still waiting for the cite which proves that parents are more comfortable with simple and reassuring answers as opposed to uncertainty and ambiguity. IME living with children with autism, there are no simple and reassuring answers and it’s all uncertainty and ambiguity. And most of the parents I know on the same journey are not reassured by the simple answers. [Previous page](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363.md?page=2) [Next page](https://boards.straightdope.com/t/mental-disorders-arent-necessarily-valid/207363.md?page=4)