• boethius
    318
    You can say that about any powerful first world society.Anaxagoras

    How so?

    Which is what I've done during my residency yet according to you, psychiatrists/psychologists are agents of oppression.Anaxagoras

    Please read my comments, I am pretty clear that my view is psychiatrists/psychologists are agents of oppression in an oppressive state, and that my view is effective democracy solves the problems of the dangers of behavioral sciences used to manipulate society; just as effective democracy solves the problem of the dangers of police and military institutions.

    If you want to argue no states on earth are oppressive that would be another debate; if true (that there are no oppressive states) then my points here would be hypothetical. If you want to argue your particular government is not oppressive, that would be another debate. Both debates would be relevant, but it is not the issue I am addressing here.

    I am not arguing a just society should not have police or soldiers or psychiatrists/psychologists, and that these would not be agents of justice in a just society.

    pray tell what system do you refer?Anaxagoras

    My arguments are on the level of principle. If we agreed in principle then it would make sense to start discussing particulars. The principle I am arguing in the instance you cite is "even in a system that does more harm than good, an individual psychiatrist can be doing more good than harm". I'm not referring to a particular system.
  • boethius
    318
    I’m talking about individuals. You’re talking about generalities.Noah Te Stroete

    Which individuals? Please point them out.

    [Edit] to make my point perfectly clear: are you referring to individuals such as you and me specifically, or individuals in the general sense?
  • Noah Te Stroete
    2.1k
    You, me, Dr. Israelstam, and the head psychiatrist at UW.
  • boethius
    318
    You, me, Dr. Israelstam, and the head psychiatrist at UW.Noah Te Stroete

    Yes, I am interested in what principles, if any, would be true in all circumstances.

    I am not so interested in morally evaluating you, Dr. Israelstam, or the head psychiatrist at UW. As I mention in a post above, morally evaluating the actions of specific individuals is a very lengthy task.

    I am of course interested in evaluating my own actions; though I would agree I am highly unlikely to single handedly change the world and vanquish all the oppressors out there, I believe I am able to make a contribution to a community that may, some day, if not eliminate, at least significantly reduce oppressive circumstances in the world.
  • andrewk
    2.1k
    I cited Leo's mention of Nazismboethius
    Are you sure that was your first reference to it? According to the site's search function you were the first user. It's possible that it's malfunctioning or I am using it wrong.
    No one here is calling anyone else a Nazi, so you're not even using Godwin's law correctly to begin with.boethius
    Godwin's law is about the probability of a comparison to the Nazis. That is what you did above when you said there were parallels.

    The point is that if you had a rational argument you wouldn't need to play the Nazi card, which is always rhetorical. If something is wrong, it can be argued to be wrong on its merits. The rational basis for the argument is in no way helped by saying that the Nazis did it - like listening to Wagner, dressing up and in some cases, being vegetarian. :scream:
  • Anaxagoras
    349
    How so?boethius

    The United States have used race to oppress people. Portugal more specifically King Leopold II used religion (in addition to race) to oppress.

    and that my view is effective democracy solves the problems of the dangers of behavioral sciences used to manipulate society; just as effective democracy solves the problem of the dangers of police and military institutions.boethius

    That remains to be seen. I never experienced what effective democracy looks like, and considering that any political system that stems from a human is flawed so I look at your worldview with much skepticism. The problem with your view is that you lack understanding to the nature of various psychological illnesses and conditions. Your so-called explanation does not address the generations of psychological/physiological disorders and diseases people of have contracted, nor does it explain how the removal of the systems of oppression will prevent future mental distress and the necessary removal of psychiatrists/psychologists.

    How does effective democracy answer for ADHD, Down Syndrome, Anti-Social Personality Disorders (which research has indicated that some children have experienced behaviors associated with it)?

    I'm not referring to a particular system.boethius

    If not a system then what is effective democracy then?
  • boethius
    318
    The United States have used race to oppress people. Portugal more specifically King Leopold II used religion (in addition to race) to oppress.Anaxagoras

    And you would say this of all first world nations?

    That remains to be seen. I never experienced what effective democracy looks like, and considering that any political system that stems from a human is flawed so I look at your worldview with much skepticism.Anaxagoras

    Please revisit my points. I do not say an effective democracy is without flaws and humans would be perfect within it; I say democracy can solve the issue of dangerous state organs, as with the police and military.

    The problem with your view is that you lack understanding to the nature of various psychological illnesses and conditions. Your so-called explanation does not address the generations of psychological/physiological disorders and diseases people of have contracted, nor does it explain how the removal of the systems of oppression will prevent future mental distress and the necessary removal of psychiatrists/psychologists.Anaxagoras

    This is not my view at all. I do not say removing oppression would remove mental illness, nor that removing psychiatrists/psychologists would remove oppression. Where do you get that from?

    I also say that even in an oppressive system, successes could be pointed to of effective mental health treatment.

    I do not deny mental health is a thing and people can be mentally ill, my point is that under an oppressive state, dissidents, mentally healthy people subject to intolerable conditions (i.e. the oppressed), and the mentally ill, are all grouped together and the state does not employ (or tolerate the employment of such people by others) people interested in distinguishing these categories.

    How does effective democracy answer for ADHD, Down Syndrome, Anti-Social Personality Disorders (which research has indicated that some children have experienced behaviors associated with it)?Anaxagoras

    Again, this is not my position and I don't see which of my statements would lead you to believe I am advocating that under an effective democracy all mental illness would disappear.

    However, the difference with a oppressive state is that an effective democracy would consider and debate all aspects of these issues and try to tease out ethical nuances as well as allow different opinions from both professionals and laypersons to be voiced as to the causes due to environment and social organization that better government policy can do something about.

    A fully totalitarian oppressive state will not allow for any discussion that challenges state policy, much less have people vote on anything, and will likely (being oppressive) have terrible conditions contributing immensely to genuine mental health issues as well as, mentioned above, group all dissidents and "disruptive elements" into the same mentally ill category. If treatments reduce disruption then they are successful and there is good empirical evidence that the "treatments work".

    Of course, there's a large spectrum between complete totalitarianism and what I call an effective democracy, and a mix of democratic elements and oppressive elements can exist in which case things can be more complicated than the above examples.
  • Hanover
    5k
    If community values are indeed reflected in an effective democratic system where no one is disenfranchised and everyone has equal say and political dialogue is open without parties with disproportional external or internal manipulative or obstructionist force, then I would expect mental health professionals to be in constructive dialogue with society to manage the issues outlined above without any fear of career repercussions of criticizing current policies as potentially unethical.

    Yes, if mental health professionals are engaged in creating and/or enforcing state propaganda, directly or through all sorts of subtle ways their profession in organized, I place a tremendous amount of moral responsibility on them for their participation.
    boethius

    We don't have to live in a Utopian state in order to allow psychologists (or anyone for that matter) to provide input into the democratic process. Psychologists are but one voice among many, and their power is checked by the multitude of other interests in society.
    There was no incompatibility between the Nazi value system and the science of mental or physical health.boethius

    The Nazi example does not stand for the proposition that psychiatry is bunk or that it is only a weapon for the corrupt. The Nazis believed Jews (and many others) non-human and devoid of any value. That determination was not made by the Nazi version of the American Psychological Association. The Nazis used everything in their power to destroy Jews. The propaganda advanced by psychologists against Jews, whatever it might have been, was the least of the Jews' worry at that time.

    But to the point of whether a government can misapply science in all its forms (including psychology) to advance evil, of course. There's no limit to human evil.
    The German psychiatrists and psychologists had all sorts of "science based" theories on why some people needed to be put in concentration camps, developed the criteria for putting people in camps and, once in camps, criteria for distinguishing "good laborers" from the bad. They also experimented on and found chemicals to help people adapt to the conditions in the camp without challenging authority as much.boethius

    The primary theory of why someone needed to be put into a concentration camp was that they were Jewish. Often the decision of where they'd be sent was made by a Nazi soldier who simply pointed which direction they would go. You make it sound like the Nazis kept charts by each person's bed and they reviewed each case closely and made careful deliberate decisions, thinking they had to justify each patient's case on a case by case basis.

    Nazi Germany can be used to show the depravity of mankind no doubt. I'm just curious why you think it has special application to psychology as science. I can't imagine that Nazi dentists, for example, treated Jews very well. Why don't you discuss how we should therefore now be highly suspicious of dentistry?
    However, the justification of mental health interventions rests on the justification of the government policies, both in the specific systems that deploy mental health but also in the general good governing sense.boethius

    Mental health intervention occurs only with judicial oversight and its not a matter of a psychiatrist just forcing people into institutions. The likelihood of someone being forced unwillingly into a bed is far lower than someone in need of a bed not finding one.

    So I don't see what you're suggesting, that it was some voluntary shift of a system that "worked" (to avoid uncomfortable but ultimately unfounded criticism?) to the sad only alternative of increasing punishment, decreasing all forms of rehabilitation (which, again, is a false equivalence with psychiatry and mental health to begin with), and increasing the prison population as a whole?boethius

    The point is that the psychologists themselves, who you are suggesting are drunk with power to control society, arrived at the conclusion that forced psychiatric treatment was ineffective in resolving criminal propensities. The findings of psychologists resulted in turning the system into one more retributive than rehabilitative and therefore reduced their own influence.
    Are the Chinese mental health professional that are helping to track and predict using integrated surveillance and AI systems to minimize disruptive Muslim behaviour doing good work (are they potential terrorists with the mental culturally wide health conditions the Chinese government claims, or legitimate political actors seeking self-determination, as most other nations did at some point)?boethius

    I'm not in favor of anyone who violates basic human rights, tortures, brainwashes, or does generally terrible things. That would be the case whether they were psychologists, physicians, plumbers, or philosophers.
  • Anaxagoras
    349
    And you would say this of all first world nations?boethius

    No, I'm just saying that first world nations have used these tactics to oppress people therefore implying that being a part of a first world nation does not mean its success wasn't realized without oppressing people.

    I do not say an effective democracy is without flaws and humans would be perfect within it; I say democracy can solve the issue of dangerous state organs, as with the police and military.boethius

    I have revisited your argument and it is flawed. I live in a so-called democratic republic called the United States, and so far I don't see any difference from what you're saying and what I'm currently living in.

    This is not my view at all. I do not say removing oppression would remove mental illness, nor that removing psychiatrists/psychologists would remove oppression. Where do you get that from?boethius

    This is what you've seem to imply, at least to me.

    I also say that even in an oppressive system, successes could be pointed to of effective mental health treatment.boethius

    Yes you did, but if the system is oppressive how is there success? since we are discussing the United States, if we are looking at oppressive systems it takes a certain amount of gall, to fight against the system to establish equity. So far again nothing what you've said is substantial enough to where it would distinguish itself from the current state of affairs in the U.S. or elsewhere.

    under an oppressive state, dissidents, mentally healthy people subject to intolerable conditions (i.e. the oppressed), and the mentally ill, are all grouped together and the state does not employ (or tolerate the employment of such people by others) people interested in distinguishing these categories.boethius

    This is your problem is that going back and reading you're very vague and not too descriptive on how something is oppressive yet allude to the state of affairs concerning perhaps the pharmaceutical industry. What I'm saying is regardless whether you change society, mental illness will always be a byproduct of human existence. Much research has indicated our environment playing a factor. So regardless whether you change the government, change the way people think, change the way people eat, drink, and live, mental illness will always be a factor and you need specialists to mitigate those behaviors with coping mechanisms to modify them which is where therapists come in.

    However, the difference with a oppressive state is that an effective democracy would consider and debate all aspects of these issues and try to tease out ethical nuances as well as allow different opinions from both professionals and laypersons to be voiced as to the causes due to environment and social organization that better government policy can do something about.boethius

    THIS IS WHAT WE DO IN GRADUATE SCHOOL!!!!!!!!!!

    This is what the APA do annually with meetings concerning different therapeutic models that work. This is the problem with you people who have never been to a graduate program or what you think you know about psychology/psychiatry. You sit there at your computer and theorize and have no stepped one foot on campus to actually see exactly this is the shit we do. It really pisses me off online that a bunch of nobodies on a chat forum who have never actually written research can sit there and try to make dialectical arguments to destroy something we've built online as if we aren't making a difference in the world.

    Here is a suggestion for you.....

    Have the balls to apply to a doctoral program as I did, make sure you have the grades, the letters of recommendation, as well as the background to support your excellent character. Get in, complete the program as well as residency. Get on the APA board and change the game from within. Getting on an online philosophy forum does shit to change the system. I at least put in the work to try and make a difference in the system and yes there is plenty to debate and disagree with, but for certain I've seen an excellent group of board members who are listening to people in psychiatric distress and we are evolving better methods of producing a better way in treating the human condition.
  • Anaxagoras
    349
    The point is that the psychologists themselves, who you are suggesting are drunk with power to control society, arrived at the conclusion that forced psychiatric treatment was ineffective in resolving criminal propensities.Hanover

    Right, I read into that and it pissed me off. I have fucking taken my work home with me in hoping how to better help people and their conditions.
  • Hanover
    5k
    Have the balls to apply to a doctoral program as I did, make sure you have the grades, the letters of recommendation, as well as the background to support your excellent character. Get in, complete the program as well as residency. Get on the APA board and change the game from within. Getting on an online philosophy forum does shit to change the system. I at least put in the work to try and make a difference in the system and yes there is plenty to debate and disagree with, but for certain I've seen an excellent group of board members who are listening to people in psychiatric distress and we are evolving better methods of producing a better way in treating the human condition.Anaxagoras

    In response to this ad hom diversion, I'll present my own:

    I really fail to see why you take such challenge to the posters on this board, constantly feeling the need to prove your credentials and authority on such matters. It doesn't sway any opinions and it just makes you look pissed off for not being taken as seriously as you demand. I'm just suggesting that the tact of explaining what it is that psychiatrists do in helping the world is a better approach than telling people they're dumbasses for criticizing that which they don't understand.
  • boethius
    318
    We don't have to live in a Utopian state in order to allow psychologists (or anyone for that matter) to provide input into the democratic process. Psychologists are but one voice among many, and their power is checked by the multitude of other interests in society.Hanover

    Did I say anything remotely like this: that only in a utopian state can psychologists (or anyone have input) into the democratic process?

    Psychologists are but one voice among many, and their power is checked by the multitude of other interests in society.Hanover

    Yes, we agree. If democracy is working effectively everyone can have a voice; both psychologists/psychiatrists can voice their ethical concerns about mental health policy, as well as anyone else. I go to some lengths to explain why the danger of mental health workers acting as enforcement of oppressive state policies is significantly less dangerous in a an effective democracy.

    The questions then boils down to what is effective democracy. I think it's clear most posters here are only thinking about the US; however, I have written here mostly about principles (as well as noting a global perspective where there are places like China with "re-education" camps right now).

    If one is not convinced one is living in an effective democracy, then my argument is psychology/psychiatry play an important roll (are a powerful tool) in achieving a wide range of state policy objectives; both in relation to passifying individuals who may otherwise become politically active, a roll in punishing people who become politically active, as well as a roll in forming public discourse (i.e. justifying the policies to begin with, by appeals to "expertise").

    Now, as for the US, the question of whether the US is an effective democracy where the power of powerful individuals or groups, like psychiatry or pharmacology interests (not to say they are the "most powerful"), is actually checked by the multitude of other interests, is another debate, one which I am sure is suitable for thrphilosophyforum.

    My point here, is that all the issues discussed in this thread very much depend on one's opinion of the government in question. If one finds the government sufficiently just and fair, then it's reasonable to trust that the rules and norms being expressed through psychology/psychiatry ("helping people adapt to society") are just and fair. If one feels one's government is not sufficiently just and fair, then one should expect such a government to use the tools of psychology/psychiatry and mental health sphere to maintain the power relations, where ever possible.

    The point is that the psychologists themselves, who you are suggesting are drunk with power to control society.Hanover

    No, this is not my point. No where did I say psychologists are drunk with power to control society. What I say was that an oppressive government is going to have oppressive policy objectives and will train for and select for psychologists and psychiatrists that are effective at achieving those objectives, just as with the police and military (which doesn't imply "all police are bad" or "the science of criminology doesn't exist" or that the only solution is a "utopia, and until we have utopia we must get rid of police, soldiers or psychologists").

    The findings of psychologists resulted in turning the system into one more retributive than rehabilitative and therefore reduced their own influence.Hanover

    Again, no where did I say it was psychologists dictating justice system policy. You seemed to present the thesis that there was a link between abandoning the policy of relying heavily on mental health diagnosis in dealing with and "rehabilitating" criminals (that turned out to be based a lot of unrepeatable "science") and the next policy to increase punishment, decrease all methods of rehabilitation, and increase the prison population. The implication seemed to be that "criticism" of psychology/psychiatry roll in the justice system at that time led to a worse system.

    My rebuttal is that, first of all, there is no logical link between these events; presented as you did, your argument is a false dichotomy. Whatever problems in the academic literature (what was widely considered fact ... but turns out it wasn't) as well as in the structure of mental health for prisoners could have been solved, improving mental health services for inmates, while employing all sorts of other policy changes that increase rehabilitation rates, as well as policy changes that lower the prison population (i.e. abandoning the "war on drugs").

    My secondary point, tangentially related to the main issues of the debate, is that I view a direct link between the civil rights movement, the dissident scientists challenging the status quo of psychiatry (it was certainly not the psychology/psychiatry community as a whole that suddenly abandoned pseudo-scientific theories justifying segregation and other social injustices), and a direct link with features of American society that are part of what I would call effective democracy (freedom of speech, independent press, etc.). However, the struggle against oppression is ongoing; today, I would say a new problem has arisen, in particular in pharmacology, where it is possible to influence the scientific review process (i.e. vast webs of conflicts of interest, revolving door, captured regulators) and also influence society's view of what mental health is and what needs treatment. For instance, in the 70s, a lot of the dissident scientists challenging the status quo could perform very cheap experiments (for instance, walking into an asylum and seeing what happens, is a cheap experiment to do); today, a lot of the studies are extremely expensive to repeat, and so a scientist without conflicts of interest that wants to do repeat studies needs government funding (in an effective democracy, I would expect the government to be like "yes, we definitely want to give a lot of money to those guys trying to keep everything honest and on really firm observational and statistical grounds"; in an oppressive / corrupt system, the government may not like these kinds of people, and may not promote them to positions of influence from which they can direct funding for verification purposes as well as cry foul if they see systemic weaknesses in the process of both validation and implementation of regulation and policy).
  • Hanover
    5k
    Did I say anything remotely like this: that only in a utopian state can psychologists (or anyone have input) into the democratic process?boethius

    Yes. This is what you said:

    "If community values are indeed reflected in an effective democratic system where no one is disenfranchised and everyone has equal say and political dialogue is open without parties with disproportional external or internal manipulative or obstructionist force, then I would expect mental health professionals to be in constructive dialogue with society to manage the issues outlined above without any fear of career repercussions of criticizing current policies as potentially unethical."

    That view of a democracy is Utopian. There is not any such democracy nor could there be. It's an ideal you've posited.
    If one feels one's government is not sufficiently just and fair, then one should expect such a government to use the tools of psychology/psychiatry and mental health sphere to maintain the power relations, where ever possible.boethius

    This complaint is a universal objection, having no more to do with psychology than any other science, religion, political theory, or common mythology. Bad people use recognized authorities to persuade others to their view. There's no reason to target psychology in this attack over any other group of alleged experts or authorities.
    What I say was that an oppressive government is going to have oppressive policy objectives and will train for and select for psychologists and psychiatrists that are effective at achieving those objectives, just as with the police and military (which doesn't imply "all police are bad" or "the science of criminology doesn't exist" or that the only solution is a "utopia, and until we have utopia we must get rid of police, soldiers or psychologists").boethius

    I'll concede the tautology. Oppressive governments will be oppressive. I just don't see how that translates into oppressive governments being more likely to use psychologists than they will plumbers to get what they want. Why are you targeting psychologists as the masterminds for the oppressive governments? If you think, for example, that today's America is manipulated by the government (and some surely do), that doesn't mean that this manipulation was orchestrated by a team of dark psychologists. What it means is that the people in power have manipulated people by the rhetoric and whatnot. They've not had their opposition institutionalized into psychiatric hospitals and declared crazy.
    My secondary point, tangentially related to the main issues of the debate, is that I view a direct link between the civil rights movement, dissident scientists challenging the status quo of psychiatry (it was certainly not the psychology/psychiatry community as a whole that suddenly abandoned pseudo-scientific theories justifying segregation and other social injustices), and a direct link with features of American society that are part of what I would call effective democracy (freedom of speech, independent press, etc.).boethius

    The reason rehabilitative approaches were abandoned in the 1970s wasn't because dissident scientists challenged the status quo. It was because crime surged in the 1970s and it was felt we needed stricter punitive measures to being society under control. https://en.wikipedia.org/wiki/Crime_in_the_United_States ; <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762476/" target="_blank" rel="nofollow">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762476/</a>

    You make it sound like the move toward retributive policies was an outgrowth of liberal ideas and a recognition of the damage done by psychologists. The move toward retributive policies was a turn to the right, with an emphasis on law and order, punishment, and personal responsibility. Today, due to issues of overcrowding and expense, we're moving back toward a less punitive model, which is considered a liberalizing of the criminal justice system. It may in fact be, but I'd submit it's motivated by pragmatics more than anything else.
  • boethius
    318
    That view of a democracy is Utopian. There is not any such democracy nor could there be. It's an ideal you've posited.Hanover

    I outline a "cause / effect" relationship. If the conditions I present exist, then I argue my expectations would follow. I do not say "we can achieve perfect democracy, and only in a perfect democracy will psychology and psychiatry be non-oppressive". In other words, I am presenting the features of democracy that I feel mitigate the problem. The more we approach such conditions, the more the problem diminishes.

    This complaint is not a universal objection, having no more to do with psychology than any other science, religion, political theory, or common mythology. Bad people use recognized authorities to persuade others to their view. There's no reason to target psychology in this attack over any other group of alleged experts or authorities.Hanover

    I am not targeting "only psychologists", I even mention police and soldiers who also maintain the power structure. In an oppressive society, some people are the oppressors, some the agents of oppression (how else does the system maintain itself?), and some the oppressed.

    But it's best viewed as a spectrum, with some rolls very clearly the "oppressor" (dictator, top brass of secret police, and the like), some rolls are clearly agents of oppression (guy who rounds people up for torture), and some rolls are clearly the oppressed (slaves, poor farmer, factory workers); however, many rolls can be in various grey areas, perhaps contributing to oppression one day and undermining it a bit the next (if the activity is not particularly dangerous, the state cannot devote much energy to optimizing it's oppressive effect; i.e. an oppressive state will devote a lot more energy to controlling journalists and micro-managing what they say than to controlling how a plumber goes about his or her day).

    My general framework here is that not all jobs are equal in an oppressive society, everyone just "trying to get by"; that, for instance, the torturer or executioner is just "doing a job". There is a moral dimension to what one does in society; now, passing moral judgement requires a lot more information than simply what nominal roll one is doing (and considering the state will select people for oppressive rolls that don't see their roll as oppressive but just a "job that needs doing" just like farming or anything) it makes moral evaluation even more difficult. However, though it's an important element to the discussion (since we must, at least, evaluate our own roll and decision), my main interest here is to argue that psychology/psychiatry is a particularly dangerous tool of oppression (like the police and soldiers are a particularly dangerous tool of oppression; why there was a movement against standing armies during the emergence of modern democracies).

    I also mention, that most improvements to conditions in society is not by defeating the agents of oppression but by convincing enough of them to join the cause of justice and democracy of the day. The purpose of such analysis is that anyone wanting more justice and more democracy is more effective if they understand better the current structure of society what different rolls do in relation to existing oppressive features; how to actually go about changing things is another debate.
  • unenlightened
    4k
    It seems like you think you can have an impact on societal affairs. If so, that sounds an awful lot like delusions of grandeur.
    — Noah Te Stroete

    Really? That's what you understood from my comments.
    boethius

    Ooh, me sir, please sir, I have delusions of grandeur, sir. Why would anyone talk at all if it had no impact? I'm not certain, but I hope at least, that if I can hold to the best truth I can find and keep an open mind, then you and I and another can influence each other for the good. I call it 'therapy', or sometimes 'philosophy'.

    Some people, such as the op, call such delusions of grandeur, 'incurable hubris'.

    The pointy finger points and having pointed does not listen. I, you, they, suffer from delusions - there's no value in accounts of delusions, except as manifestations of pathology; they do not communicate. And so we expose in such topics our pathologies and each analyses with more or less sympathy the other. Here is a smart cookie, here is a clever dick, and here is just a Kookie.
  • boethius
    318
    I'll concede the tautology. Oppressive governments will be oppressive. I just don't see how that translates into oppressive governments being more likely to use psychologists than they will plumbers to get what they want. Why are you targeting psychologists as the masterminds for the oppressive governments? If you think, for example, that today's America is manipulated by the government (and some surely do), that doesn't mean that this manipulation was orchestrated by a team of dark psychologists. What it means is that the people in power have manipulated people by the rhetoric and whatnot. They've not had their opposition institutionalized into psychiatric hospitals and declared crazy.Hanover

    Yes, this is my central contention, that psychiatry/psychology is a better tool of oppression than plumbing, that there will be more attention paid to who gets to be a psychiatry/psychologists (that their beliefs are compatible with state policy) than who gets to be a plumber. Plumbers are a group I would argue most oppressive states categorize as general population needing to be generally controlled.

    For instance, using pharmacology to make bad working conditions more tolerable, I would argue is a mechanism of oppression in an oppressive state; part of the control system. From the perspective of psychiatrists implementing this policy, people feel better at work, they feel they've "done good". This is not to pass moral judgement, as they may not have any information (thanks to control of media) to criticize what they are doing; but from the outside analyzing such a situation we can very much doubt if they are really "doing good".
  • unenlightened
    4k
    For instance, using pharmacology to make bad working conditions more tolerable,boethius

    Or, perhaps more familiar, to make bad schooling ( and maybe home) conditions more tolerable. I refer to what used to be known informally as cabin fever, but is now called ADHD.
  • leo
    648
    If you think, for example, that today's America is manipulated by the government (and some surely do), that doesn't mean that this manipulation was orchestrated by a team of dark psychologists.Hanover

    Again I feel examples go more clearly to the heart of the point. It used to be a mental illness to be a slave wanting to escape, and it used to be a mental illness to be homosexual. People wanted to have slaves, they saw their slaves as lesser beings, they wanted them to be good slaves, so wanting to escape was a defect to correct, a mental illness. People had an aversion towards homosexuals, they found them disgusting, saw them as an error of nature, so homosexuality was a defect to correct, a mental illness.

    Then in a society where Science is venerated as giving access to Truth, once you carry out scientific research and studies that refer to these unwanted behaviors as mental illnesses, you legitimize this characterization of mental illness as having a scientific basis, as being grounded in truth, as being something to believe in. Then the psychiatrists who are the trained specialists in diagnosing and curing mental illness are the authority to believe in on the subject, so if they say that your behavior is a defect that needs to be corrected, you have to believe them, you must comply, and if you don't comply, if you defy this authority you are deemed to have an additional disorder, an additional mental illness, an additional defect that must be corrected.

    The people who have power over others for whatever reason (they govern people, they belong to a majority, they are able to influence public opinion, ...) have the power to characterize specific behaviors as defects that need to be corrected, then children grow up in a society where they are taught that such or such behavior is a defect, and it becomes the truth.

    If you're a homosexual and the society lets you be a homosexual in peace, doesn't discriminate against you, then you feel good. If however you're oppressed, pointed at, ridiculed, insulted, if you have to hide to be who you are, if you have to live in constant fear, then you suffer, and the trained specialists on mental illnesses can tell you "look, you can see that you suffer, that you suffer because you're a homosexual, you can see this is a defect that makes you suffer, but you will feel better if we can cure this illness you have in you", then all kinds of experiments may be carried out on these people to cure their 'illness'. Maybe these people then need to ingest pills every day for the rest of their lives because the causes of the illness are "not yet well understood", many factors are at play and more research is required. Then the specialists who work to 'cure' these people say they are helping them, they are helping them function 'better', even if they aren't happy at least their defect has been partially corrected and that's the most important.

    In some societies today it's obvious that homosexuals aren't mentally ill, it's obvious that treating it as a mental illness was pseudoscience but now we know better, we won't make the same mistake! And yet back then it was as obvious that homosexuality was a mental illness.

    Most people don't need to ingest pills to feel better and cure or hide their 'mental illness'. They simply need to be accepted, respected, listened to, supported. If mental health practice was focused first of all on that, I'm sure it would be much much more effective.
  • Hanover
    5k
    All that you're saying is that corrupt people will use corrupt means to corrupt. That is true regardless of the means. It's irrelevant who or what they use to corrupt, whether that be physicians, psychologists, priests, police officers, judges, military personnel, or whoever. I get that psychologists, as recognized authorities, wield certain power, but so do all sorts of people. I just don't see that psychologists have that much power over policy in today's society or that they are a particular group that needs to singled out as oppressors.

    Sure, it used to be considered a psychiatric illness to be homosexual, but it was hardly psychologists who first vilified homosexuals. They were pretty much just parroting the ideology of the times. Today's psychologists seem to be much farther left than right, being a force for greater human rights.
    Most people don't need to ingest pills to feel better and cure or hide their 'mental illness'. They simply need to be accepted, respected, listened to, supported. If mental health practice was focused first of all on that, I'm sure it would be much much more effective.leo

    And what do you base your suggestion that the majority in the mental health field reject, disrespect, ignore, and refuse to support their patients? If you have arrived at a method to cure most people's mental illness, why don't you publish it so that it can be implemented if you're sure your method would be much much more effective?

    Why is mental illness in quotes? Does it not really exist?3u6ya65l2ps0xndc.jpg
  • unenlightened
    4k
    Sure, it used to be considered a psychiatric illness to be homosexual, but it was hardly psychologists who first vilified homosexuals. They were pretty much just parroting the ideology of the times. Today's psychologists seem to be much farther left than right, being a force for greater human rights.Hanover

    Thing is, what this demonstrates is that there is no essential difference between mental illness and social stigma. And when I say 'essential' I mean a difference that allows psychologists, psychiatrists, philosophers or anyone else to reliably tell them apart. And that means, that when anyone talks about 'mental illness', they literally do not know whereof they speak. And that's why it is in quotes and should be in quotes.

    Now suppose the profession were to actually bite this bullet. Then we could stop talking about illness, and simply talk about distress as a manifestation of broken relationship. Perhaps we can ease the distress with drugs, perhaps we can work to make a better relationship. Perhaps the individual needs to change, or perhaps the environment needs to change. perhaps both. Not much would change, but the relationship between professional and client would change, and so everything would change.
  • csalisbury
    2k
    Why is mental illness in quotes? Does it not really exist?Hanover

    Well, based on the context, the quotes are clearly meant to differentiate it from physical illnesses, and associated approaches to curing them. The picture of the Aurora guy is lurid and eye-grabbing, but based on what Leo's saying, it seems clear to me that he isn't suggesting the aurora guy was ok, mostly. He's suggesting that pills would help less than acceptance, respect, support and a listening ear. The best diagnosis they had for aurora guy was borderline personality disorder, something famously resistant to pills, or any attempt to treat it as some kind of contingent affliction which can be treated in isolation from the person as whole. It's a very serious 'mental illness' which takes a long time to treat, and the success of which treatment depends on very, very careful handling. Which, to be fair, the last psychiatrists he came into contact implicitly admitted, by wiping her hands of him after he repeatedly sought help, saying she thought trying to treat him would just make him mad.

    And what do you base your suggestion that the majority in the mental health field reject, disrespect, ignore, and refuse to support their patients? — Hanover, just before posting a pic of James Holmes as a trump card

    Anyway, this is not an unusual approach to people who present with BPD, as any in-the-trenches psychiatrist will tell you. This is very clearly a bad example, not in service of you argument. So why did you choose it?

    I think it's telling that your response to someone who is discussing how people with mental illness are shamed and stigmatized, making their problems worse - how the response is to post a highly inflammatory image meant to evoke the worst fears that people have about mental illness (fears shared by the mentally ill themselves.) Damn you're right, that's the aurora guy for christ's sake, look at his eyes, people really do have mental illness, they have them bad, so it is a good thing the mental health community was there to say 'we can't help' and help ingrain an idea of unable-to-be-helped' into his sense of who he was and what he was dealing with. Checkmate, new age Laingians.

    It's this approach, and others like it, that leads to such stuff like: a pilot can be grounded if it comes out they have mental illness because fears of suicide-by-plane, so they hide their mental illness, so they can't work through it, so they get worse, which makes them more like to commit suicide by plane, which they're able to do, because they haven't revealed they have mental illness, so they're not grounded. (moral: even if you don't want to yield to some virtue-signalling idea that we should be concerned for the well-being of one person, because that's less important than the safety of society as a whole, you still make it unsafe for society as a whole. Arguing brass tacks here ultimately makes you defend Ideas at the expense of brass tacks.)

    [edit: fired up, because this is a personal topic for me. I was lost for a long time in the system, out of the system, back in the system - untiI Ifound a therapist who actually seemed to care, or think me as something other than an in-the-wild example of a DSM species. The mental health industry in the US is terrible, from everything I've seen. There are exceptions, but they're exceptions. Most seasoned psychiatrists will admit this off-the-record. I don't know if anyone's to blame - but its a fact.
  • leo
    648
    And what do you base your suggestion that the majority in the mental health field reject, disrespect, ignore, and refuse to support their patients?Hanover

    You completely misinterpreted my post, I suggest you re-read what I wrote, if you actually care about understanding my point of view.

    I gave the example that many homosexuals suffered not because they were homosexuals, but because of how society treated them for being homosexual. And that the solution that ultimately helped them was not the latest drug or therapy or whatever, it was for society to accept them, respect them, listen to them, support them.

    As to why mental illness was in quotes, if you had cared to read my post seriously you would have seen the examples where being a slave wanting to escape and being homosexual were mental illnesses. Do these mental illnesses really exist to you, are they due to a defect in the brain of these individuals, or were they a fiction in the minds of the people who wanted their slaves to behave and who didn't like homosexuals?

    Then if you believe that these were mistakes of the past but there is nothing of the sort in the mental health practice of today, here is an interesting article I have come across which gives good insights as to why people who are anti-authoritarians are much more likely to be diagnosed with some mental illness. Not because there is something wrong in their brain, but because of how society and psychiatrists treat them. https://www.madinamerica.com/2012/02/why-anti-authoritarians-are-diagnosed-as-mentally-ill/
  • boethius
    318
    All that you're saying is that corrupt people will use corrupt means to corrupt. That is true regardless of the means. It's irrelevant who or what they use to corrupt, whether that be physicians, psychologists, priests, police officers, judges, military personnel, or whoever. I get that psychologists, as recognized authorities, wield certain power, but so do all sorts of people. I just don't see that psychologists have that much power over policy in today's society or that they are a particular group that needs to singled out as oppressors.Hanover

    You seem to be either arguing against a strawman, or then that the fact there are other means of oppression as well somehow dilutes the ethical implications of any particular means of oppression.

    As for the srawman, I don't see @leo or anyone else trying to single out psychologists as necessarily more oppressive than other means of oppression.

    As for some sort of "nothing to see here, plenty of oppressive rolls exist or can exist", if this is your argument, please elaborate. What's it's basis?

    I don't think anyone here disagrees that there are other means of oppression available.

    Nor is anyone saying, as far as I can tell, that psychologists / psychiatrists form as a group the intention to oppress society.

    As I mentioned, the (oppressive) state will try to select for psychologists / psychiatrists who see no problem with state mental health policies, either because they genuinely believe the state is not-oppressive or because they see it as a job that needs to be done (mentally ill do exist; participating in an oppressive system is necessary to help the genuinely mentally ill) or because they simply support an oppressive state and its policies and enforcing compliance they view as simply a good thing (that it's needed to have a "strong country" for instance). And, in terms of moral evaluation, because they are selected for these qualities, moral evaluation becomes more problematic (just as if secret police are selected for brutal and sociopathic qualities, moral evaluation is complicated; "just following orders" becomes a viable defense, that a given agent of oppression is too a victims of oppression is very viable, depends on the particulars).

    However, if you are not arguing the above points, we seem to be in agreement that as a position of authority, both in a particular form of deciding how the state deals with particular problematic individuals (either dissidents or "maladapted" to productive life in a oppressive state), as well as a social form in participating in appeals to moral and expert authority of psychiatry to justify oppressive state policies (to for instance label enemies of the state as mentally ill: delusional, maladapted, inherently violent, unproductive due to some mental or moral defect, or or what have you), that they are indeed agents of oppression.

    So we agree here, but you seem to want to then imply that because there are other means of oppression, that it is not interesting to discuss any particular roll in an oppressive state.

    If this is your point, then we disagree. For people wanting to make their society, as well as contribute to analysis that can help others in other societies, less oppressive, understanding how systems of oppression work, what rolls do what to either maintain the status quo or regress further into despotism, is a prerequisite for effective action.

    If it is simply uninteresting to you to carry out such analysis as you don't see a problem where you live, I trust you can agree that it is not therefore uninteresting or useful to all?

    If you don't quite see what roll psychiatrists / psychologists can play in oppression, though agree in the abstract that they may play a roll, that is one of the main subject of debate here, and I can offer more examples if your skepticism is on the mechanisms that maybe employed through the practice psychology / psychiatry to enforce compliance to government policy.

    If you view all the arguments presented as implicitly against the US system, then it's best to qualify your arguments as "perhaps elsewhere, but not in the US of A". If we are in agreement in principle, then it is a constructive extension of the debate to consider the example of the US: in what ways democracy maybe ineffective and to what extent that could impact the practice of psychology / psychiatry as well as it's public perception.

    However, if it is only to circle back to an argument that no one could be responsible anyways, or that contributions of psychiatry and psychology to oppressive mechanisms would be insignificant anyways, then we should first discuss these principles.
  • csalisbury
    2k
    @Anaxagoras You're getting ready to venture out into the jungle. What are your thoughts on borderline personality disorder (or NPD, HPD etc)?
  • Hanover
    5k
    Thing is, what this demonstrates is that there is no essential difference between mental illness and social stigma. And when I say 'essential' I mean a difference that allows psychologists, psychiatrists, philosophers or anyone else to reliably tell them apart.unenlightened

    Perhaps there simply never was a meaningful basis to claim homosexuality was a mental illness, but that it was actually only so categorized due to reliance upon the morality of the time. Is the same true of schizophrenia though? Do you believe we consider a man who believes he is Jesus, who talks to a person who is not there but who he thinks is, and who meticulously stores all his fingernail clippings so that he can have them tested for the drugs he is certain the CIA is injecting into him when he sleeps simply someone we have socially stigmatized but who in a more enlightened time will be considered healthy?

    My point here is simply to concede the fallibility of the profession in having in the past medicalized what really were simply moral judgments, but to also recognize that some people really are terribly mentally ill regardless of how liberal or conservative we might be in our political beliefs.

    This seems like a typical categorization problem we always have with most things we do, where there is one group of things we call X, another not X, and the last maybe X. So, there are certain behaviors that are healthy, some clearly not healthy, and the last, maybe healthy, maybe not. I can't buy into the argument, though, that Charles Manson was essentially fine and that I can't reliably tell him apart from the average man next door.
  • Hanover
    5k
    Well, based on the context, the quotes are clearly meant to differentiate it from physical illnesses, and associated approaches to curing them.csalisbury

    I disagree that that's why it was in quotes. The way one differentiates between mental and physical illness is simply to use the word "mental" or "physical." The reason mental illness was put in quotes was to question whether there really was such a thing.
    think it's telling that your response to someone who is discussing how people with mental illness are shamed and stigmatized, making their problems worse - how the response is to post a highly inflammatory image meant to evoke the worst fears that people have about mental illness (fears shared by the mentally ill themselves.)csalisbury

    The posting of the image was to respond to the poster's suggestion that there really wasn't any such thing as mental illness. The image chosen was just because it was dramatic, not because it was of a homicidal maniac. I could just as much made my point posting someone clearly breaking from reality in a non-violent way. My point is just that there really is a thing called mental illness, and while I'll concede there are the hard cases where we're not sure if the behavior is to be designated an illness, there are many cases that are abundantly clear.

    I was lost for a long time in the system, out of the system, back in the system - untiI Ifound a therapist who actually seemed to care, or think me as something other than an in-the-wild example of a DSM species.csalisbury

    I have sympathy for your personal experiences, but this comment seems to admit to the two things I was arguing for (1) that there is such a thing as mental illness, and (2) psychologists can and do help. Your complaint seems to be that you were burdened with some really bad therapists, but if you're acknowledging there is such a thing as good therapy, then the failure is in systematizing it so that it can be predictably available to everyone.
  • Hanover
    5k
    As to why mental illness was in quotes, if you had cared to read my post seriously you would have seen the examples where being a slave wanting to escape and being homosexual were mental illnesses. Do these mental illnesses really exist to you, are they due to a defect in the brain of these individuals, or were they a fiction in the minds of the people who wanted their slaves to behave and who didn't like homosexuals?leo

    I fully understand your post. It generalizes to the profession from a few examples. It just doesn't logically follow that because you have examples of past errors that the entire enterprise is failed. Or, more concretely, the fact that slaves were once diagnosed as mentally deranged because they sought emancipation does not mean that Charles Manson is sane. I agree entirely that anyone in a position of influence, from doctors to Indian chiefs, should exercise prudence when reaching their decisions because what they decide matters.

    Regarding the article you posted, the author begins with this paragraph:

    "In my career as a psychologist, I have talked with hundreds of people previously diagnosed by other professionals with oppositional defiant disorder, attention deficit hyperactive disorder, anxiety disorder and other psychiatric illnesses, and I am struck by (1) how many of those diagnosed are essentially anti-authoritarians, and (2) how those professionals who have diagnosed them are not."


    This is non-scientific anecdotal opining. If you want to know what makes the profession unscientific, it's stuff like this. If they actually can show that the diagnoses of these disorders correlates simply with volitional objections to authority, then that might be cause to reconsider the current treatment and categorization of these behaviors as disorders.

    I personally do question the ADD diagnoses that are often placed upon children, and I agree that it should be studied more and maybe reconsidered. I've often thought it better stood for Adult Discipline Disorder, where the problem really rested on poor parenting and not mentally troubled kids.
  • Galuchat
    686
    Thing is, what this demonstrates is that there is no essential difference between mental illness and social stigma.

    Now suppose the profession were to actually bite this bullet. Then we could stop talking about illness, and simply talk about distress as a manifestation of broken relationship.
    unenlightened

    What kind of social environments produce autism and catatonia?

    Also, if there are anatomical and/or physiological causes of atypical behaviour, and there is not a widely accepted general definition of the noun phrase "mental illness", would it be more appropriate to refer to neuro-behavioural typicality and atypicality?
  • sime
    416
    Isn't the Hippocratic oath and the entire practice of medicine a political practice? Accusations that the practice of clinical psychology is political therefore require nuance and elaboration. The very ethical notion of "harm" is relative to metaphysical ideas about the self, the state and personal mortality. In a world in which everyone rejected the idea of personal mortality and prioritized the health of the state, a painless suicide wouldn't necessarily be recognized as harm.

    If the practice of clinical psychology was politically "neutral", psychologists would able to prescribe financial gifts, holiday cruises and supermodel escorts as remedies for treating depressed patients, as opposed to prescribing them "numbing" medications and talk therapies ....but this runs up against society's need to prioritize it's finite resources. So there cannot be a politically neutral practice of psychology.

    The notions of mental illness, diagnosis and treatment, are better understood holistically from a utilitarian perspective. It is never the lone individual who is diagnosed and treated for a mental illness, but the individual as part of a wider cross-section of society whose broader interests are often in conflict with the individual. The particular interests of the psychology profession are but one component of this greater good.
  • unenlightened
    4k
    I can't buy into the argument, though, that Charles Manson was essentially fine and that I can't reliably tell him apart from the average man next door.Hanover

    Then don't make the argument. It's certainly not one that I make. One can fairly reliably tell the difference between a homosexual and a heterosexual. Diagnosis is not the the problem. You like going for the scary extremes don't you. I'm not that familiar with Manson, but if I remember, the case was actually very much to do with the social environment - the creation of an oppositional social sub-group, amplified by drugs. Rather a good example of how limited an understanding one gets from looking at individual behaviour in isolation. It's not that one cannot spot a murderous paranoid schizophrenic, or that one ought ideologically to pretend not to notice. And no one would be so silly as to try and suggest that. So remove the stuffing from your straw man and put it on the compost heap.

    What kind of social environments produce autism and catatonia?

    Also, if there are anatomical and/or physiological causes of atypical behaviour, and there is not a widely accepted general definition of the noun phrase "mental illness", would it be more appropriate to refer to neuro-behavioural typicality and atypicality?
    Galuchat

    Indeed, I don't know how it goes generally, but my limited experience is that when an organic, neurological condition can be identified, one does not talk much about mental illness, but neuro-atypicality or disability, or some such, and one does not so much focus on treatment as on careful education and adapting the social environment. To be clear, I am saying that one should look at mental distress as relational, I am not saying it is all the environment, but that it is always in relation to an environment. Thus homosexuals still suffer distress because they still live in a society that condemns them. They are shamed, and that is traumatic, maybe depressing, etc.

    Again, PTSD is a condition defined as a neurological/physical change produced by the environment. It doesn't quite fit the Hanoverian serial killer paradigm, but is much more common. Childhood abuse, and the stress of combat -environmental factors - are typical causes, an neurological conditions are the result. Treatment may involve palliative drugs, talking (mind-changing?) cures, and special environments of quiet and safety.
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