Is Mental Illness Defined by Society?

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Hemorrhoids? You just brought in hemorrhoids? WTF?
That is a pointless statement unless the word was on your mind for other reasons. Again, you have zero background in medicine so it makes it difficult for you to comprehend. Don't strain your brain too hard though, you may blow a blood vessel somewhere.
Take it easy, or YOU may blow a blood vessel. You know better than to have overlooked the implication. What the heck is "biologic reality"? If you have come to defense of Sioux's pov, then explain that instead of foaming at the mouth.

So if mental illness is overtreated and there are already too many providers, why are you in the field. Get out.
Non sequitur

Only the homeless with SMI are not getting the medical treatment they need? That is true because you "would say" it is. Your basis for this argument is effect sizes? Have you even heard of the biopsychosocial model? We don't medicalize normal reactions to difficult circumstances.
I did not say ONLY the homeless...that was an example. I made reference to social phobia, for instance, and medicalization of shyness. Stop distorting what I say.

Schizophrenics are people with schizophrenia. Its called language. What are you going to propose next. How about we call moms, people who provide maternal services or how about person who carried me during gestation and perhaps provided additional services?
Yes, it's language but it's a pet peeve of mine, specially when it comes to schizophrenia. I have found that it is those with severe mental illnesses who are dehumanized more often and I think defining someone by their mental illness can do that. Somehow it is less bothersome to me if you refer to some people as "the anxious" as that does not carry the same sort of stigma.

As far as reductionist. Its called science. Breaking things down to their fundamental points is ONE WAY that science works. If you notice, sluox was trying to make it 'simple' for you. You still didn't understand.
He did not simplify it. He oversimplified it.

How about sticking to forums where you actually have some comprehension of what is being discussed.
Cut out, or I'm going to report your post! Stick to the issues being discussed. I wouldn't like it if someone says psychology is bull and we better off without therapists, and I am not surprised you don't like people attacking the biological model of mental illness, overmedicating the public, etc. But I would discuss the issue if I were you. No need for ad hominem.
 
bravo, manicsleep.

This post does sound like someone is way over his/her head. This is a huge problem in psychiatry as the non-MDs read a few pamphlets, went to a few conferences, read a few articles, talk to a few MD and think they know it all.

Oh, well, case closed, why bother replying to the arguments at all!🙄
 
A) I agree that the terms "schizophrenics" and even "diabetics" have outgrown their welcomes just as "******s" and "idiots" did long ago. Language is mutable, and the meanings of words grow. "Schizophrenics" no longer just means people with schizophrenia, and as professionals who DO in fact value the experience and humanity of our patients, one small way we can do that even more is to try to use terms that apply best to the current zeitgeist.

B) OH MY GOD IF YOU ARE ONE OF THOSE SNIDE HIPSTER TOADS THAT LIKES TO CORRECT OTHER PEOPLE'S USE OF LANGUAGE BECAUSE YOUR GRADUATE SEMINARS SPENT WHOLE HOURS TALKING ABOUT THIS CRAP INSTEAD OF TEACHING SOMETHING USEFUL, YOU SHOULD GO LOOK IN THE MIRROR AND SMACK YOURSELF UNTIL YOU REMEMBER THAT SMUG PUNKS HAVE THEIR OWN LEVEL OF HELL RESERVED FOR THEM.

That is all 😀

I would for schizophrenia and a few other illnesses where people with such illnesses have been historically dehumanized over and over...and over again. I don't mind people thinking I am this or that kind of person if I correct them. I don't think anybody LOVES to be corrected and that includes me, and I dehumanize people too mindlessly sometimes so I know how it feels to be corrected. It's not exactly a narcissistic injury but I'd be lying if I said I don't like to be right all the time. :laugh:
 
A) I agree that the terms "schizophrenics" and even "diabetics" have outgrown their welcomes just as "******s" and "idiots" did long ago. Language is mutable, and the meanings of words grow. "Schizophrenics" no longer just means people with schizophrenia, and as professionals who DO in fact value the experience and humanity of our patients, one small way we can do that even more is to try to use terms that apply best to the current zeitgeist.

B) OH MY GOD IF YOU ARE ONE OF THOSE SNIDE HIPSTER TOADS THAT LIKES TO CORRECT OTHER PEOPLE'S USE OF LANGUAGE BECAUSE YOUR GRADUATE SEMINARS SPENT WHOLE HOURS TALKING ABOUT THIS CRAP INSTEAD OF TEACHING SOMETHING USEFUL, YOU SHOULD GO LOOK IN THE MIRROR AND SMACK YOURSELF UNTIL YOU REMEMBER THAT SMUG PUNKS HAVE THEIR OWN LEVEL OF HELL RESERVED FOR THEM.

That is all 😀

The only thing that constantly changing these names does is to provide a reason to marginalize and stigmatize. Diabetics and schizophrenics are people with that specific illness. Just like moms are people who are mothers.

The word and phrase mean the same. Its the action of treating the person like a human being first and foremost that is truly what matters. I can think of a schizophrenic or diabetic being a mom, you think of it as some debasing term. Cognitively the term 'people with diabetes' and 'diabetic' is processed the same way in your brain. Your perception, beliefs and attitudes are what need to change and this can only be done with education. Without doing the groundwork, constantly changing the language is pointless. Perhaps you didn't learn this while you were playing zelda or while pretending to have some knowledge of my beliefs.
 
Manic
what need to change and this can only be done with education
When did we need educating about “moms”?

Cognitively the term 'people with diabetes' and 'diabetic' is processed the same way in your brain.

Schizophrenic and person with schizophrenia, no. You need to read Vygotski or Chomsky, take your pick, or any one else to know your assertion is garbage. Not to mention the normative role that the use of words plays. Shocking stuff from some one who claims to be an "expert".
 
Fascinating thread.

I guess a way that illness, not just mental illness, can be defined by society is how we label it and how we educate others about it. I agree that the use of terms like idiots or lunatics is wrong. In the past I am sure all kinds of illnesses have been stigmatized but as we learned more about them, the stigma decreases.

As someone who has a chronic illness that has a stigma associated with it, I would agree with Manicsleep's POV rather than many of the other ones. It makes no difference if you say Molls is an epileptic or say Molls is a person with epilepsy as long as you say it appropriately and with respect. It is funny that someone brought the sexual revolution and Manic used the mom example. Such a fabulous example. Mothers are more than just mothers but they are not people who provide maternal care. I am a mother, an epileptic, a wife, a daughter, a student, a friend and so many other things. But I am an epileptic. Changing that into 'a person with epilepsy' doesn't change anything and usually is patronizing and can even be outright insulting (the same can be said for epileptic).

Its funny that the mental health profession should be the one profession that should understand this best. A rose by any other name...

So spend some of your time educating and not lobbying for name changes. The only PC should be perception change or paradigm change.
 
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Manic
what need to change and this can only be done with education
When did we need educating about "moms"?

Cognitively the term 'people with diabetes' and 'diabetic' is processed the same way in your brain.

Schizophrenic and person with schizophrenia, no. You need to read Vygotski or Chomsky, take your pick, or any one else to know your assertion is garbage. Not to mention the normative role that the use of words plays. Shocking stuff from some one who claims to be an "expert".

Can you tell me the data with chomsky. I don't know who the other guy is. Can you cite the actual source or perhaps even summarize it here.

My husband's mother is a linguist and she has usually stated that changing the 2 things so slightly has absolutely no effect. Like, it just wastes peoples times and makes them think they are doing something important. I always got the impression that it was taking away the guilt for how they really feel. They look down upon me and so they change the name which makes they feel better for a little while and then they need to change the name again.

OH BTW an FYI about the word moms. I mentioned it already but homemaker is what they thought all women should be. Moms can be more than just 'maternal care giving units' you know. But we were educated and embrace that term now. Yay!
 
Molls

I am a mother, an epileptic, a wife, a daughter, a student, a friend and so many other things

Yes, social role valorisation. The trouble is that schizophrenia has particular social, cultural and historical baggage of its own, so comparisons with other words are only the start.

For Vygotski see below especially the section on language and thought, he is the big name as far as the point under discussion is concerned.

http://en.wikipedia.org/wiki/Lev_Vygotsky


My last point was drawn from Wittgenstien

http://plato.stanford.edu/entries/wittgenstein/#Mea

All relevant but see meaning and use section.

I agree with you that language does evolve. In Japan the equivalent word has been dropped entirely but I am afraid I can not tell you what the outcome of that is if any.

To call someone Schizophrenic is a priori disrespectful imo. That is partly my point. People may choose to reclaim that word and have done so for instance maddness is a word that many people who experience psychosis have reclaimed and feel comfortable with. I think it's obvious that when you talk to someone you should use the language they feel comfortable with. One would hope people on this board of all places would understand that.
 
You know better than to have overlooked the implication. What the heck is "biologic reality"? If you have come to defense of Sioux's pov, then explain that instead of foaming at the mouth.

Psychiatrist do know better. You are right for once. Biologic basis of illness? If you don't understand what that means, I don't care to explain it to you. This is a forum for psychiatrists.

BTW, what did you say about ad hominem? Report me all you want, just don't whine how you're going to go tell on me to mommy. You DO NOT and NEVER WILL HAVE (unless you get the same training) the same comprehension of psychiatric illness as a psychiatrist. Deal with it.

Non sequitur

Just because you can't follow it? Try again.
You saying that it is oversimplified and following it up with you absurd comment about taping a child's mouth shut is utter nonsense. The fact that you can't see that indicates that you have little comprehension, are ignorant or lack the intelligence to understand the complexity of the dopamine model (even if it is far from perfect). It is you who oversimplified it and not the other way around. Again, I don't blame you as you are not a 'person who provides psychiatric care' and as such do not have the capability to understand. But perhaps you would do better in a forum where the topics discussed are more in line with your field of study and level of comprehension.


Yes, it's language but it's a pet peeve of mine, specially when it comes to schizophrenia. I have found that it is those with severe mental illnesses who are dehumanized more often and I think defining someone by their mental illness can do that. Somehow it is less bothersome to me if you refer to some people as "the anxious" as that does not carry the same sort of stigma.

Not interested in your pet peeves or any of your other issues.

If the point was to discuss how words were used, to say outright that the word schizophrenic is wrong is absurd and the alternative is 'person with schizophrenia'. Look at the word alcoholic. Members of AA have embraced who they are and are proud to say My name is XYZ and I am an Alcoholic.

This is no open and shut topic I agree but changing names of illnesses is nowhere near the top of my lists to do as an advocate for those with mental illness.
 
Molls

I am a mother, an epileptic, a wife, a daughter, a student, a friend and so many other things

Yes, social role valorisation. The trouble is that schizophrenia has particular social, cultural and historical baggage of its own, so comparisons with other words are only the start.

For Vygotski see below especially the section on language and thought, he is the big name as far as the point under discussion is concerned.

http://en.wikipedia.org/wiki/Lev_Vygotsky


My last point was drawn from Wittgenstien

http://plato.stanford.edu/entries/wittgenstein/#Mea

All relevant but see meaning and use section.

I agree with you that language does evolve. In Japan the equivalent word has been dropped entirely but I am afraid I can not tell you what the outcome of that is if any.

To call someone Schizophrenic is a priori disrespectful imo. That is partly my point. People may choose to reclaim that word and have done so for instance maddness is a word that many people who experience psychosis have reclaimed and feel comfortable with. I think it's obvious that when you talk to someone you should use the language they feel comfortable with. One would hope people on this board of all places would understand that.

So it would be better to call a schizophrenic, for example, a person who at times has hallucinations and paranoid delusions that can be disruptive to their level of functioning. Calling them a 'person with schizophrenia' really doesn't cut it because you can incorporate that into how you deal with the person. Changing the name without actually taking the time to take substantive action that would teach the public is just as disrespectful. Also, because you have actually taken time, energy and resources that could have been used elsewhere to creating this change, it is wrong.

Education/description >>> slight name alteration.
 
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ClinPsychMasters

From Manic
changing names of illnesses is nowhere near the top of my lists to do as an advocate for those with mental illness.

At least it's on the list now in an odd sort of way. So some progress. With friends like Manic advocating for you who needs enemies?
 
Manic

Apologies, I am never quite sure if you are willing to address me or not.

I don't quite follow your last post which crossed with mine. I don't doubt your sincerity for a moment but I don't get what you wrote. Could you rephrase it for me? I am just trying to understand you.

I am not advocating name change. I would be advocating eradication of the word at all but for the purposes of this discussion I am talking about usage of a word not the word itself.

Edit.
OK. You have edited your post. Fair enough thats your view.
 
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ClinPsychMasters

From Manic
changing names of illnesses is nowhere near the top of my lists to do as an advocate for those with mental illness.

At least it's on the list now in an odd sort of way. So some progress. With friends like Manic advocating for you who needs enemies?

I am glad you two see eye to eye on this one. I am also glad it is unlikely to matter to anyone.

If you see this as progress from your paradigm you are hopelessly clueless. I fight against useless wasting of resources to do things like this and fight for allocating those resources towards the education of the public and health professionals. Luckily I have been successful in allocating resources towards education that would otherwise have been wasted. In these poor economic times, unfortunately everyone is looking for a quick fix such as name change, regardless of how idiotic that may be.
 
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I fight against useless wasting of resources to do things like this and fight for allocating those resources towards the education of the public and health professionals. Luckily I have been successful in allocating resources towards education that would otherwise have been wasted. .

👍 Thank you, manicsleep.
 
I am glad you two see eye to eye on this one. I am also glad it is unlikely to matter to anyone.

If you see this as progress from your paradigm you are hopelessly clueless. I fight against useless wasting of resources to do things like this and fight for allocating those resources towards the education of the public and health professionals. Luckily I have been successful in allocating resources towards education that would otherwise have been wasted. In these poor economic times, unfortunately everyone is looking for a quick fix such as name change, regardless of how idiotic that may be.

Manic

It seems to matter a lot to you.

Note my use of the word oddly in my post to ClinPsychMasters. I am papering over a lot of cracks. The gulf between us is huge but I do understand your position now even if I find it rather strange.

I can not imagine how your fight manifests itself in practice but I would point out that policy formation is the allocation of values. That is before resources are allocated. Your values seem out of step with the tide of history. You are not still using the words ****** and idiot are you? No don't tell me. I couldn't take it.
 
Manic

It seems to matter a lot to you.

Note my use of the word oddly in my post to ClinPsychMasters. I am papering over a lot of cracks. The gulf between us is huge but I do understand your position now even if I find it rather strange.

I can not imagine how your fight manifests itself in practice but I would point out that policy formation is the allocation of values. That is before resources are allocated. Your values seem out of step with the tide of history. You are not still using the words ****** and idiot are you? No don't tell me. I couldn't take it.

You really must totally hate to lose an argument. Or you just don't get it.

Maybe its the language difference?
 
Molls

I can only assume with that last coment you are trying to be funny.

Fair enough you are not familiar with the conversation around language and thought but as you asked for clarification you could at least have a look at the the links I directed you to. If you did you would see why your coment must be an attempt at humour.

As for winning, I am not interested in winning as you put it. I have been atempting to understand Manics point of view. I find it an odd view but it lies on a spectrum of views, you could even call it a sick idea I suppose. It's manics view and he is entitled to it.

More widely the arguement is over in anycase. Manic may fight a rear gaurd action but all over the world as we become more secular and rational we are also becoming more tolerant of diverse opinion. The shift in the way we use words is a reflection of that. Hence the use of the word schizophrenic in the way Manic uses it is dying out. It is called the battle of ideas and I am on the winning side as is ClinPschMasters, BillyP and RedPakotaSea. (as I understand them of course I can't speak for them)

HMPsche would appear to agree with Manic but he has only reached the stage of developement where he can communicate with "emoticons". One day he will post two emoticons and we can all give him a little charity clap.
 
Psychiatrist do know better. You are right for once. Biologic basis of illness? If you don't understand what that means, I don't care to explain it to you. This is a forum for psychiatrists.
I think I understand what that means but I figured I could be wrong so I gave you a chance to explain yourself which you obviously refuse to do. I said hemorrhoids also have a "biologic reality" so that doesn't make them a mental illness even if it is very distressing to the person, changes the levels of various neurotransmitters in the brain, causes dysfunction, etc etc. Why did I use hemorrhoids? It seems to be far enough from the brain to make my point but it's also odd enough as a reference to make one chuckle. Of course you may substitute your own reference. Regardless, I am attacking biological reductionism, the idea that simply because there is correlation between 5-HT availability in particular synapses and certain pattern in behavior/thinking/affect, it follows that biological changes are the cause, the only cause. Nor does it follow that we should intervene at the biological level.

BTW, what did you say about ad hominem? Report me all you want, just don't whine how you're going to go tell on me to mommy. You DO NOT and NEVER WILL HAVE (unless you get the same training) the same comprehension of psychiatric illness as a psychiatrist. Deal with it.
ad hominem!

note: your future uses of ad hominem fallacy may also be subject to being labeled...(wait for it)...ad hominem.


You saying that it is oversimplified and following it up with you absurd comment about taping a child's mouth shut is utter nonsense.
Yes, I am aware that my example was odd. I chose it for a reason. Think about it. Why do we give pacifiers to babies? It shuts them up doesn't it? Taping their mouth shut could do that as well. But that's harsh, right? What a crude way to do things! And the logic, well, it's highly questionable.

And that's how I feel about "chemical imbalance" theory. You have people who have "rational" reasons to be upset, sad, fearful, angry, etc, and we put drugs in their bodies and it shuts them up...to some extent. You're suicidal because you lost your house in the economy? This is not a "normal" reaction now is it? Time to adjust your chemical levels with this SSRI, and let's just add a bit of antipsychotic for good measure, seeing how you look so pissed it can't be "functional" for you.
To be fair, not all psychiatrists do that but large enough numbers do so, enough for it to be cause for concern. Of course meds are cheap and provide immediate relief. Some psychiatrists, however, do therapy instead. Some are politically active, making sure that people's basic needs are met. And some do prescribe meds but actively search for something else they could do, something more effective, more long-lasting, and less dehumanizing. Why is it dehumanizing? Because a normal human reaction to difficult circumstances is pathologized and blamed on the person's brain. So the person's subjectivity and sense of self, his own explanations, is pushed aside and brain targeted instead, as if this were a physical wound.
I also like to point out that there are people with organic brain problems who NEED medication so that the psychiatrist is able to engage them in therapy or that they can function in their lives at first. But often this is the only thing that is done for them. Meds...and you're essentially on your own because therapy is costly and government programs fall short again and again.

Members of AA have embraced who they are and are proud to say My name is XYZ and I am an Alcoholic.
Well, I have yet to meet a person who likes to walk around, announcing proudly to the world that he is a "schizophrenic." Some do seems to feel a sense of relief as others realize that it is not them but the illness that causes their behavior but some are scared that others are going to see them as a threat or whatever. Regardless, of the people I have spoken to, and you may know better, none has said to me to call him a "schizophrenic" as opposed to "person with schizophrenia." This is not a black and white issue as you say.

Okay, I am done with this topic because I am going to be busy for the next little while but I will return to this topic in future should you take the time to make some quality posts instead of attacking me, my knowledge, intelligence, etc--in which case I won't debate you but I figured I'll clarify my position and see what happens.

Last point: There are great arguments against psychological view of mental illness as well and I am not opposed to discussing them too. However, presently it is psychiatry and pharmaceutical companies that are running the show so needless to say, they are targeted more often. Freudian psychoanalysis could face the same scrutiny in different time/place.
 
Regardless, I am attacking biological reductionism, the idea that simply because there is correlation between 5-HT availability in particular synapses and certain pattern in behavior/thinking/affect, it follows that biological changes are the cause, the only cause. Nor does it follow that we should intervene at the biological level. And that's how I feel about "chemical imbalance" theory.

You have people who have "rational" reasons to be upset, sad, fearful, angry, etc, and we put drugs in their bodies and it shuts them up...to some extent. You're suicidal because you lost your house in the economy? This is not a "normal" reaction now is it? Time to adjust your chemical levels with this SSRI, and let's just add a bit of antipsychotic for good measure, seeing how you look so pissed it can't be "functional" for you.

I will note again that I have met very few psychiatrists in the last few years using the 5-HT variability or 'chemical imbalance' model. We all know there is connectivity, dopaminnergic/adrenergic receptors, psychosocial factors involved. As a group, psychiatrists are arguably the most critical of our profession. Perhaps more so than any other specialties save for the cardiologists nowadays.

regarding the second point. I have seen a few of these patients you described above. About all came to me on these medications prescribed by their PCPs, psychiatric NPs/CrNS and neurologists for situational depression and not by psychiatrists. I want to take them off the meds but the patients believe they are effective and absolutely refuse or lack the finances for therapy. Some absolutely hate their social workers or psychologists and refuse further therapy.
 
And that's how I feel about "chemical imbalance" theory. You have people who have "rational" reasons to be upset, sad, fearful, angry, etc, and we put drugs in their bodies and it shuts them up...to some extent. You're suicidal because you lost your house in the economy? This is not a "normal" reaction now is it? Time to adjust your chemical levels with this SSRI, and let's just add a bit of antipsychotic for good measure, seeing how you look so pissed it can't be "functional" for you.

...

Last point: There are great arguments against psychological view of mental illness as well and I am not opposed to discussing them too. However, presently it is psychiatry and pharmaceutical companies that are running the show so needless to say, they are targeted more often. Freudian psychoanalysis could face the same scrutiny in different time/place.

Too bad I got suckered back into this thread.

The problem with the "psychological view of mental illness" vs. "biologic view of mental illness" debate isn't that they are two legitimate points of view. The "psychological view" that you expound is neither "psychological" (i.e. derived from experimental psychology), nor is it scientific. Essentially it's an equivalent debate between intelligent design and evolution.

Mainstream psychiatry should not be reduced to biological psychiatry, which is of course a large part. Rather, modern psychiatry should be thought of as a medical discipline and a scientific discipline that studies and the biology, psychology, sociology and policy questions regarding mental illnesses, and apply this knowledge to clinical practice to help patients. Psychotherapy, when understood and practiced within the framework of evidence based medicine and scientific rigor, is very much part of psychiatry.

Psychotherapy not based on science is not part of psychiatry. While it can be useful for some people, IMHO it's not within the scope of psychiatry to engage in a debate with non-scientific psychotherapy, as non-scientific psychotherapy is akin to playing violin or painting or novel writing. While I appreciate its value in society and believe that a strictly scientific view of the world is myopic, I do think you have sorely missed the point.

Regarding cosmetic psychiatry, I've already explained why medication is not at all "dehumanizing" in my previous post.
 
Okay, I am done with this topic
:xf: keeping hope alive.

The problem with the "psychological view of mental illness" vs. "biologic view of mental illness" debate isn't that they are two legitimate points of view. The "psychological view" that you expound is neither "psychological" (i.e. derived from experimental psychology), nor is it scientific. Essentially it's an equivalent debate between intelligent design and evolution.

Mainstream psychiatry should not be reduced to biological psychiatry, which is of course a large part. Rather, modern psychiatry should be thought of as a medical discipline and a scientific discipline that studies and the biology, psychology, sociology and policy questions regarding mental illnesses, and apply this knowledge to clinical practice to help patients. Psychotherapy, when understood and practiced within the framework of evidence based medicine and scientific rigor, is very much part of psychiatry.

Psychotherapy not based on science is not part of psychiatry. While it can be useful for some people, IMHO it's not within the scope of psychiatry to engage in a debate with non-scientific psychotherapy, as non-scientific psychotherapy is akin to playing violin or painting or novel writing. While I appreciate its value in society and believe that a strictly scientific view of the world is myopic, I do think you have sorely missed the point.

I agree with most of your post except for the psychotherapy based not on science. Unfortunately that is not yet completely true. Psychiatrists are still hanging on to antiquated ideals and occasionally the APA will endorse these.

However, for the vast majority of psychiatry, this is absolutely true. It is also becoming a greater part of psychiatry on a daily basis. The younger psychiatrists coming out of residency these days are extremely well trained. There has been a concerted effort at AADPRT meetings to continually work with the RRC in how they evaluate programs to reflect the changing climate in mental health and the progress that has been made in the field.
 
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