Hi, Once again I'm really not sure what relevance this has to the underlying pathology of schizophrenia. Did you know that an eight-limbed girl was born in India a few years ago? Her village worshipped her as the incarnation of some god. Well she recently had a surgery to correct the problem. Does that mean that having eight limbs is not pathological? It probably means nothing that's relevant to the surgeons...
The notion of pathology is value-laden, and it does depend upon social and historical context. Whether eight-limbedness is pathological depends upon the extent to which it deviates from an ideal type, and whether this deviation is considered good or bad. There are many other sorts of deviations, which are fundamentally biological, which we do not consider pathology.
Extreme height would be an example. Being 8 feet tall may be more uncommon than mental illness, and may result from having an extremely active pituitary gland, but does that make it pathological? The answer to this depends upon whether it affects the functioning of the individual as the first criterion, which is fundamentally a social question.
Why is it a social question? Because the notion of functionality depends upon the social structures in which one is expected to function. 8-limbedness is not necessarily dysfunctional if it exists within a context that promotes and idealizes it, because all basic biological needs (and more) will be taken care of in the 8-limbed individual. You might argue that if it leads to early death, then it is pathological.
But other things that lead to early death in this society are not considered pathological. Such as the choice to become a doctor. Should we analyze the genetic constitution that leads us, therefore, to become doctors, to push ourselves and shorten our lifespan?
Moreover, this society may not even take a worldview according to which longevity is valued but rather spiritual salvation and virtue have primacy. How can we apply Western conceptions of health when that society disagrees? One may make the argument that such a society is neurotic, but that is a discussion for another time.
Yeah, that is a fact... well how is that different than any other disease?
It's not different than any other disease, actually, but psychiatry has unique ramifications (though not any more pressing than other areas of biomedicine) for the individual and for the society in which it is constituted. That's why this is an important issue. Psychiatry is a discourse about experience, about suffering, and about our lives, which has concrete social and institutional effects upon large numbers of people. To understand the construction of illness categories, the particular context in which they are constructed, and what social role they serve is therefore important if we are to understand what directions psychiatry can take in the future and how we can make it better.
Well, it doesn't matter whether the delusions are falsifiable or not... A delusion about demonic possession will not be falsifiable. A delusion about alien implants is falsifiable. This doesn't lead to any dichotomy within the pathology of schizophrenia itself. The patient takes their delusion to be true regardless of empirical evidence.
If something isn't falsifiable, it can't be rebutted by empirical evidence.
Hey, the fact that misdiagnosis occurs is not unique to psychiatry. The only difference between psychiatry and the rest of medicine in this context is involuntary treatment... but this is a social policy, not a fact about the diseases themselves.
My contention is that the capacity for misdiagnosis lies within the diagnostic criteria and the role they play in the institution itself. Diagnosis is decontextualized from the social conditions that give rise to it and the experience of the patient; this nebulous notion of schizophrenia (not a homogenous disease state; in fact, nobody knows what it is; academic psychiatrists are the most skeptical) serves certain social functions within society. The theoretical knowledge of schizophrenia, as it is understood according to naive psychiatry (somehow coming about from nothing, or inchoately from "triggers") is so constituted according to the practicable social role that psychiatry fulfills, probably less so than describing some kind of biological reality, and more so categorizing clusters of transient deviances so that they can be instrumentalized against to promote their normalization. Also, I'm not implying that "psychiatry" is naive but that there are different sorts of psychiatrists, those less privy to theoretical issues and those on the cutting edge. Naive psychiatry takes the DSM for granted. This is the biggest mistake.
The DSM is not some champion medical accomplishment, nor should it guide theoretical discussion. If anything, it is peripheral to genuine theoretical discussion, and should mostly be addressed in terms of the ways it can be reformed, rather than as a theoretical groundwork from which we can competently discuss the field. Importantly, if the faults of the DSM are based in the faults of psychiatry, then reform of psychiatry itself should occur and should precede the reform of the DSM.
Well I'm not sure about this. You can be schizophrenic on a deserted island too... It would be a pretty life threatening condition if your thoughts are so disorded that you can't forage for food, or whatever.
A few things here. First, humans are inherently social creatures. Social input is one of the most integrally important elements in how we function, in how we are conscious, and so on. So even being on a deserted island is social; it is the absence of society and has profound ramifications on how this individual will live his life, construct his identity and reality, and so on.
Next, this goes back to what I was saying before, and this argument is two-tiered, so I will address the tiers in order. a) If the schizophrenia category is socially constructed, then someone can't be "schizophrenic," per se, on a deserted island. If schizophrenia is a category produced for a certain social context, then the process of "being schizophrenic," in both the social and the phenomenological senses, is related integrally to the social conditions that are brought to bear on the person by virtue of their diagnosis and is not, then, merely a disease process.
They can, however, have marked deviations from the norm in their brains, which may potentially be measured in the future (this is a claim I am not critical of). Which brings one to the next point. b) Mental illness does not simply come about "by itself" or as a fluke accident of development (though it may in some cases; see below). Cortisol, testosterone, estrogen, dopamine, serotonin, and so on, have roles critical in modulating our social behavior. Studies bear out the contention that they are themselves modulated by social input. How remarkable it must be that we are fine-tuned to our environment.
The argument made, then, is that mental illness is a "spiraling out of control" of these feedback circuits with environment, though I contend that this is not necessarily the case, that life is difficult, can be oppressive, and can cause someone to become transiently dysfunctional (with the correlates in consciousness of distress) or even chronically so. In some cases, however, we must say that there may be inherent developmental abnormalities in some individuals, that feedback systems are inherently disrupted by virtue of deleterious mutation. But the problem is that psychiatry not only lumps together multiple disease processes into unitary categories in which they do not fit, but that it does not even make the theoretical attempt to tease apart inherent problems with development from "personal" problems. The problem is that it makes psychological suffering seem as if it came about from nowhere, from biology alone, from the individual, without account to circumstances; the DSM says very little about circumstance that is meaningful to a human reader. Yes, it is my contention that even psychoses can be induced, in normal people, by profoundly distressing situations, and I have seen this firsthand. But let us also not forget that we are constructing a false dichotomy here, that aberrant development may be amenable to social conditions in certain cases, and that normal development may necessarily result in chronic mental illness by virtue of a person's inherent inability to find their niche.
. I wonder where he got his information from. He, in fact, advised him to read a book called "Mind Power". I was so incensed that I wanted to go and smack him in his face
