The impact of coincidence on psychiatric diagnosis

Benj96

Suppose someone has an odd or “delusional” thought which becomes the Center point of their understanding of reality (as does in patients with psychosis). Suppose that addressing said notion is Of paramount Importance to their goal - for example they believe “criminals are chasing them”, they can “see the future” and their goal to be addressed is that they “want to protect their family” .

So they naturally want to tell their family to warn them that criminals are after them. They consider that their family won’t believe them but do so anyways out of concern. Their family are shocked. Where is this coming from they ask? And hastily seek psychiatric help for the individual.

In the meantime one night thief’s break into their house and attack them before stealing all their stuff. Whether by total coincidence or not the psychotic patient has somehow correctly predicted a situation before the fact.

What is to be said for this affirmation of their beliefs. Before the event it was psychotic and afterwards it is somewhat a little bit more rational as what they said would happen did indeed happen. Does the psychiatrist have to write off the delusion or merely consider it a coincidence.

Upon meeting with the patient the psychiatrist continues as trained with the belief that the patient couldn’t have possibly in a scientific sense predicted these events but the patient turns around and says “can you scientifically disprove The existence of premonitions?” and if so “show me how?”. The psychiatrist of course cannot strictly disprove that premonitions are impossible. There is no scientific evidence to support that premonitions definitively cannot exist. How do we proceed? How should the patient be dealt with?

Jack Cummins

↪Benj96

Your question is a bit complicated because it has two possible underlying assumptions or questions.

Firstly, it involves the one of premonitions. In your final statement you are implying that there is no scientific proof to suggest that premonitions can exist. On the other hand, is there scientific evidence that premonitions cannot exist? It is a grey area, open to speculation and interpretation of personal testimonies.

Also, you are suggesting that the psychiatrists would definitely be regarding the existence of premonitions as psychosis. I would say that many psychiatrists are inclined to diagnose people who explain unusual experiences as psychosis, but that is not to say that all have fixed views about matters of the unknown.

I would say that I have engaged with psychiatrists, and other mental health professions, in work and situations, on the subject of premonitions and other unusual topics and some of them are have very unique points of view.

I would say that psychiatrists would differ in how to respond to your scenario. It may also depend how the patient explained the story. I certainly feel it would be mistaken if the person was diagnosed on the basis of the scenario, unless there were other sources of concern. Of course, I am not a psychiatrist but have worked in mental health care and been involved in the psychiatric assessment process. I think that it would be unfortunate if your person acquired a diagnosis and ended up on antipsychotic medication. Perhaps a bit of counselling support to discuss the whole coincidence would be the best start and some follow up to see if there were any further indications of psychosis beyond this would provide a fuller picture, as ongoing assessment.

Wayfarer

This is a philosophy forum, such questions are out of scope.

Jack Cummins

↪Wayfarer

In some ways, I see your point and it was not me that began the thread. However, if that is the case then many of the active threads would be beyond the scope of philosophy. So, how does one go about defining where philosophy begins and ends?

Wayfarer

↪Jack Cummins

yes but discussion of psychiatric disorders are a special case because they need specialist attention. It's impossible to generalise about such instances because by their very nature it's highly idiosyncratic to the subject. No fault on anyone's part, I'm just saying, it's a rabbit-hole, better not to go down it.

Jack Cummins

↪Wayfarer

I would say that psychiatric disorders is a very specialist area and it would be very worrying if people just leapt in with opinions and I hope that I was not doing that. My attempt to answer the question, apart from my work background, was based on my own personal experience of premonitions as a teenager. I actually referred myself to a psychiatrist about it and he did not give me a diagnostic label. In a way, it is a coincidence that it was me who read and responded to the question.

However, I have no idea of the original thread writer's intentions. I would be wary of starting a thread on psychiatry, but it is not as if aspects of it are not discussed at all. It is such a central aspect of life and so many people have psychiatric problems of some kind. I have experienced clinical depression and think it is likely that some other members of the forum may have experience some mental health problems at some point in life. So, I am not sure that psychiatry should be out of bounds because it is specialised. I would say that it needs to be handled with care. But, part of the issue is that any thread can have unhelpful and insensitive opinions.

Perhaps the person who created the thread will be able to explain the rationale of why they wrote it in the first place.

Benj96

However, I have no idea of the original thread writer's intentions. I would be wary of starting a thread on psychiatry — Jack Cummins

I understand the sensitivities surrounding the philosophy of psychiatry but I do not believe we can censor or put limits on to the scope of discussion and reasoning. Psychiatry addresses the maladies of the mind and philosophy is very much mind - orientated, so perhaps it has something to say perhaps not.

My intention was maybe poorly explained. I was trying to outline a conundrum that occurs in psychiatry of “sanity” or maybe a better word is “logical reasoning/clarity of mind” with “chronology of events” - ie. can something that was previously illogical and delusional come to be acceptable if events come to align with it in hindsight.

It’s really about hindsight and foresight’s interplay on the credibility of a belief.

It’s also about how we approach the “sanity” (I don’t particularly like this word but can’t find a better way to say it) of someone in examples like “someone believed to be delirious/ deluded” says they are delirious/ deluded and points to Valid examples Of why they believe so” which paradoxically means they have the capacity to understand what being deluded is and therefore can we say they are in fact deluded or actually rational?

The impact of coincidence on psychiatric diagnosis

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