Psychopathology - philosophy of psychiatry

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Psychopathology - philosophy of psychiatry

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There is an increasing criticism on (the validity of) psychiatry and the general public appears to lose it's trust that psychiatry will one day meet its promise to become a valid objective science (i.e., to provide evidence for it's 'brain disease model' of psychological problems).

(2019) Psychiatric diagnosis 'scientifically meaningless'
https://www.sciencedaily.com/releases/2 ... 131152.htm

There is a great force at play to defend psychiatry. Only with a disease, it is possible to prescribe medicine and psychiatry is the biggest money maker for pharmaceutical companies. Certain psychiatric disorders make much more money even than for example cancer treatment. Despite this, it appears that people in general start to lose faith in the validity of psychiatry.

The well known medical investigative journalist Robert Whitaker from www.madinamerica.com once wrote the following to me:
Robert Whitaker wrote:Dear Arjan,

Yours is a good question. I think at the moment American society as a whole is rather confused about psychiatry. There is a growing suspicion among the public that psychiatry really doesn’t know much about the “biology” of mental disorders, despite all of its claims to the contrary, and there is a growing suspicion that the drugs aren’t all that great. Moreover, there is a growing recognition that psychiatry is totally compromised by pharmaceutical money. At the same time–and I know this is odd–the public does generally view criticism of psychiatric drugs as coming from people with a bias. So it’s a confused picture.

You’ve put your finger on an important problem. The presence of Scientologists in this debate serves to deligitimize criticism that arises from an honest examination of the science. The public has this vague sense that the criticism arises from religious principles rather than from a look at what the science really has to say.

As for the rest of the medical profession, well, doctors basically belong to a big tribe, and part of the tribal rules are that those in one discipline don’t publicly criticize the doctors in another discipline. This keeps non-psychiatrist doctors from weighing in on the matter, and as far as criticism that arises from within psychiatry, psychiatry as a field has been very successful in letting its members know that they will be ex-communicated and their careers will suffer if they speak too critically. Psychiatrists are allowed to make minor concessions, such as saying that pharmaceutical money has become too influential, but they are not allowed to say that the drugs don’t really work.

So it’s complicated. Think of a society that has bought into a medical delusion, and that’s where we’re at in the U.S. The public knows that something isn’t right, but at the same time it maintains its general belief in the medical model story.

Best,

Bob Whitaker
Psychiatry vs psychotherapy

What distinguishes a psychiatrist from a psychotherapist is a medical approach, i.e. psychopathology such as a brain disease model of psychological problems.

Psychopathology is based on causality which origin for plausibility is the Big Bang theory.
If psychiatry is really (really?) a branch of medicine, we should see the specific causal hypotheses emerge about mechanisms that cause the symptoms of mental illness. Psychopathology is to be identified as the departure of a psychological system from its proper state.
https://plato.stanford.edu/entries/psychiatry/

Note the use of 'really' in the Stanford reference on philosophy of psychiatry, which implies that it is not considered to be certain that psychopathology is valid or even justified as a theoretical concept.

Examining psychiatry may be of interest for a real world perspective of determinism.

Can causality and determinism possibly explain mind and the origin of life?

With psychopathology, one is to establish a direct 1 on 1 causal relation for psychological problems. That the environment, such as for example a neurological disease, can result in mental health problems does not by itself count as evidence for psychopathology.

In the case of humans, they have a great capacity to overcome problems in the environment with their mind. An example is the philosophy stoicism. By using stoicism, people experience life differently and can even think pain away.

(2019) Is it possible to think pain away?
https://www.colorado.edu/asmagazine/201 ... -pain-away

People who practice stoic philosophy may withstand a flu while others may take it to bed and be sick for weeks. This would be an example in which the validity of psychopathology would be undermined, because it disproves a 1 on 1 causal relation for psychological problems (e.g. the great mental suffering for weeks in the case of a flu while some others withstand it using the philosophy stoicism).

How Stoicism helped me fight the flu by Monil Shah
https://www.stevenaitchison.co.uk/stoic ... fight-flu/

Question:

Do you believe that psychopathology - causality to explain mind and psychological problems - can be valid? If so/not, why?
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Re: Psychopathology - philosophy of psychiatry

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arjand wrote: June 24th, 2021, 12:27 pm There is an increasing criticism on (the validity of) psychiatry and the general public appears to lose it's trust that psychiatry will one day meet its promise to become a valid objective science (i.e., to provide evidence for it's 'brain disease model' of psychological problems).
<snip>
Question:

Do you believe that psychopathology - causality to explain mind and psychological problems - can be valid? If so/not, why?
I think that psychiatry is doing a wonderful job of helping us to understand the divisions of mind, the parameters of mind, and behavior. It is also doing a great job of helping us to understand how to control masses of people and to sell advertising products. It is also answering a lot of questions about the "why" of things like PTSD and the riot mentality.

Do I think that one day it will meet its promise to become a valid objective science? No. Psychiatry is not a study of the brain; it is a study of mind. Mind is not objective, it is subjective. Until science can wrap it's collective mind around that simple truth, it will not be able to understand enough to do much good regarding problems of the mind.

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Re: Psychopathology - philosophy of psychiatry

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Mental care (e.g. psychology and psychotherapy) and psychiatry are often confused with each other. The mentioned successes (study and understanding of the mind and human behavior) are related to psychology.

Psychiatry is different from psychology in that it presupposes that it is (or will become) an objective science that will master the human mind. The basis of psychiatry which makes it different from psychology is psychopathology. Psychopathology is the philosophical concept that provides a psychiatrist with the status 'medical doctor'.

At question in this topic is whether psychopathology, for example as basis to describe medicine for psychological problems, is valid.

Within the concept psychopathology mental problems are not subjective (i.e. psychological) but require a scientifically valid causal hypothesis.

Psychopathology is based on causality. Ultimately, it will come down to free will vs determinism. At question will be: can causality explain mind (and its problems)?

When you say that mind cannot be objective, then you essentially say that psychopathology cannot be valid.
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Re: Psychopathology - philosophy of psychiatry

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arjand wrote: June 24th, 2021, 2:37 pm Mental care (e.g. psychology and psychotherapy) and psychiatry are often confused with each other. The mentioned successes (study and understanding of the mind and human behavior) are related to psychology.
Agreed. Generally speaking, one has to see a psychiatrist, a medical doctor, if one wants to get medicated. But in many cases, one has to see a psychologist if one wishes to be cured. Psychiatry does not cure, it controls mental problems with medication.
arjand wrote: June 24th, 2021, 2:37 pm Psychiatry is different from psychology in that it presupposes that it is (or will become) an objective science that will master the human mind. The basis of psychiatry which makes it different from psychology is psychopathology. Psychopathology is the philosophical concept that provides a psychiatrist with the status 'medical doctor'.
Psychiatry is very full of itself and supposes that it can master the mind by mastering the brain and the chemical make-up of the brain. Although psychiatry gives lip service to psychology, it uses psychopathology to connect with neurology and supposes that it has some power over mind.
arjand wrote: June 24th, 2021, 2:37 pm At question in this topic is whether psychopathology, for example as basis to describe medicine for psychological problems, is valid.
That depends on what you mean by "valid". If you are talking about cures, no, it is not a valid procedure, but if you are talking about some control, yes, it can work -- at least for a while.
arjand wrote: June 24th, 2021, 2:37 pm Within the concept psychopathology mental problems are not subjective (i.e. psychological) but require a scientifically valid causal hypothesis.
Well, there's a nice ideology -- not valid -- but interesting.
arjand wrote: June 24th, 2021, 2:37 pm Psychopathology is based on causality. Ultimately, it will come down to free will vs determinism. At question will be: can causality explain mind (and its problems)?
Using an ideology in order to validate a theory that explains a reality seems a little backward to me. It would be about the same as saying, "God" did it. Psychopathology basically says, chemistry and the brain did it.
arjand wrote: June 24th, 2021, 2:37 pm When you say that mind cannot be objective, then you essentially say that psychopathology cannot be valid.
Bingo!! Science can not seem to understand that the physical affects the mental and the mental affects the physical -- it is not one way.

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Re: Psychopathology - philosophy of psychiatry

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Gee wrote: June 24th, 2021, 9:44 pm
arjand wrote: June 24th, 2021, 2:37 pm Mental care (e.g. psychology and psychotherapy) and psychiatry are often confused with each other. The mentioned successes (study and understanding of the mind and human behavior) are related to psychology.
Agreed. Generally speaking, one has to see a psychiatrist, a medical doctor, if one wants to get medicated. But in many cases, one has to see a psychologist if one wishes to be cured. Psychiatry does not cure, it controls mental problems with medication.
arjand wrote: June 24th, 2021, 2:37 pm Psychiatry is different from psychology in that it presupposes that it is (or will become) an objective science that will master the human mind. The basis of psychiatry which makes it different from psychology is psychopathology. Psychopathology is the philosophical concept that provides a psychiatrist with the status 'medical doctor'.
Psychiatry is very full of itself and supposes that it can master the mind by mastering the brain and the chemical make-up of the brain. Although psychiatry gives lip service to psychology, it uses psychopathology to connect with neurology and supposes that it has some power over mind.
arjand wrote: June 24th, 2021, 2:37 pm At question in this topic is whether psychopathology, for example as basis to describe medicine for psychological problems, is valid.
That depends on what you mean by "valid". If you are talking about cures, no, it is not a valid procedure, but if you are talking about some control, yes, it can work -- at least for a while.
arjand wrote: June 24th, 2021, 2:37 pm Within the concept psychopathology mental problems are not subjective (i.e. psychological) but require a scientifically valid causal hypothesis.
Well, there's a nice ideology -- not valid -- but interesting.
arjand wrote: June 24th, 2021, 2:37 pm Psychopathology is based on causality. Ultimately, it will come down to free will vs determinism. At question will be: can causality explain mind (and its problems)?
Using an ideology in order to validate a theory that explains a reality seems a little backward to me. It would be about the same as saying, "God" did it. Psychopathology basically says, chemistry and the brain did it.
arjand wrote: June 24th, 2021, 2:37 pm When you say that mind cannot be objective, then you essentially say that psychopathology cannot be valid.
Bingo!! Science can not seem to understand that the physical affects the mental and the mental affects the physical -- it is not one way.

Gee
This is a gross over simplification. While it is true that only psychiatrists can prescribe medications LEGALLY, there are plenty of psychiatrists who perform and prefer psychotherapy (talk therapy) over medications, and ECT for that matter.

Over time the fields of psychiatry and psychology are getting closer and closer to neurology and neurobiology. When all four meet in the middle, then the issue being described in this thread will disappear. Ujtil then, various practitioners will try their best at helping with, admittedly few and imperfect tools and await better options. What else can be done?
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Re: Psychopathology - philosophy of psychiatry

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Gee wrote: June 24th, 2021, 9:44 pmPsychiatry is very full of itself and supposes that it can master the mind by mastering the brain and the chemical make-up of the brain. Although psychiatry gives lip service to psychology, it uses psychopathology to connect with neurology and supposes that it has some power over mind.
That 'full of itself' is actually a promise on the basis of which psychiatry has been allowed to grow. As can be seen in the reference in the OP, according to some scientists that publish about it, psychiatry's promise has turned out to be empty (as of today there is no valid scientific basis for psychiatric disorders).

Gee wrote: June 24th, 2021, 9:44 pmThat depends on what you mean by "valid". If you are talking about cures, no, it is not a valid procedure, but if you are talking about some control, yes, it can work -- at least for a while.
No, that is not correct. Psychopathology requires a causal hypothesis for psychological problems by which it can find a (path towards a) cure. Psychopathology is not about introducing a 'change agent' for the purpose of change itself, such as a therapy using psychoactive drugs. (i.e. introducing a psychological effect without a causal hypothesis).

If introducing 'change' for change itself would be the goal of psychopathology, hitting a child or laying on of hands by a paranormal therapist would be equally valid as part of psychopathology, which is not the case.

When it concerns psychopathology by which a psychiatrist acquires the status 'medical doctor', the disease model of psychological problems needs to be sound. It is only on the basis of the presence of a disease that a psychiatrist is able to prescribe medicine. Medicine is not prescribed to control psychological problems 'for a while', i.e. as 'change agent' for change itself. Psychopathology simply demands a valid causal hypothesis with the clear purpose to find a 'cure'.

While I can understand the argument that 'it helps' by which people are happy with psychiatric drugs, that would be no different than people with cancer who are happy (and feel 'cured') with laying on of hands by a paranormal therapist.

Perhaps psychiatric drugs and psychoactive drugs have a sound psycho-therapeutic value, however, that would not matter when it concerns the philosophical concept psychopathology on the basis of which a psychiatrists acquires the status 'medical doctor'.

Gee wrote: June 24th, 2021, 9:44 pm
arjand wrote: June 24th, 2021, 2:37 pm Within the concept psychopathology mental problems are not subjective (i.e. psychological) but require a scientifically valid causal hypothesis.
Well, there's a nice ideology -- not valid -- but interesting.
Psychiatry is based on that idea. If you say that psychopathology is an ideology that is not valid, you essentially say that psychiatry as a science is not valid.

Perhaps your argument is correct when considering the ongoing free will vs determinism debate. Perhaps the recent great push in favor of determinism by 'an increasing amount of scientists' is actually an attempt of psychiatry to save itself in 2020+. In order to secure their future, all that they would need to do is make a strong enough case for determinism.

(2021) The clockwork universe: is free will an illusion?
A growing chorus of scientists and philosophers argue that free will does not exist. Could they be right?
https://www.theguardian.com/news/2021/a ... n-illusion

debatingfreewill.com (2021, by professors Daniel C. Dennet and Gregg D. Caruso).

Gee wrote: June 24th, 2021, 9:44 pmUsing an ideology in order to validate a theory that explains a reality seems a little backward to me. It would be about the same as saying, "God" did it. Psychopathology basically says, chemistry and the brain did it.
Yes, and from a philosophical perspective it may be of interest to examine psychiatry and its underlying ideas, to discover insights with regard free will and determinism.

A question to get started:

How does psychiatry manage to maintain itself based on a philosophical concept that requires determinism to be true for its validity?
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Re: Psychopathology - philosophy of psychiatry

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arjand wrote
How does psychiatry manage to maintain itself based on a philosophical concept that requires determinism to be true for its validity?
Psychiatry is not a philosophical concept. Psychiatric pathologies taken up philosophically become different issues altogether as philosophy's place is to inquire about science's (soft or hard) presuppositions. Thus: what is a psychological pathology? is approached with a look to its underpinnings: e.g., pathology? What then is the standard for normalcy? Now the matter has become philosophical, for such familiar assumptions about positive states of mind free of the burden of life's entanglements are called into question. To be happy is always the summum bonum, but under what terms? Is Mill right when he puts the value of the unhappy philosopher over the unhappy pig? Such matters go to agency, the nature of inquiry and its disruption of contentment, the value of suffering, the value of knowledge, esp. existential "knowledge," and so forth.
Forget about causality and determinism: this is the least of the issues that congregate here. But just to say: causal determinism is a foregone conclusion, but is also uninteresting (that the givenness of things in coersive, passive). Choice, on the other hand, is a pragmatic actuality, that is, it is a part of the way we deal in world in a real, confrontational way, weighing alternatives, struggling with outcomes. So, what is choice? That is a philosophical question of considerable gravity.
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Re: Psychopathology - philosophy of psychiatry

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Hereandnow wrote: June 25th, 2021, 9:56 am
arjand wrote
How does psychiatry manage to maintain itself based on a philosophical concept that requires determinism to be true for its validity?
Psychiatry is not a philosophical concept.
Psychpathology or psychological pathology is a philosophical concept and it is the foundation of psychiatry by which it can consider itself a branch of medicine.

Hereandnow wrote: June 25th, 2021, 9:56 am Psychiatric pathologies taken up philosophically become different issues altogether as philosophy's place is to inquire about science's (soft or hard) presuppositions. Thus: what is a psychological pathology? is approached with a look to its underpinnings: e.g., pathology? What then is the standard for normalcy? Now the matter has become philosophical, for such familiar assumptions about positive states of mind free of the burden of life's entanglements are called into question. To be happy is always the summum bonum, but under what terms? Is Mill right when he puts the value of the unhappy philosopher over the unhappy pig? Such matters go to agency, the nature of inquiry and its disruption of contentment, the value of suffering, the value of knowledge, esp. existential "knowledge," and so forth.
Forget about causality and determinism: this is the least of the issues that congregate here. But just to say: causal determinism is a foregone conclusion, but is also uninteresting (that the givenness of things in coersive, passive). Choice, on the other hand, is a pragmatic actuality, that is, it is a part of the way we deal in world in a real, confrontational way, weighing alternatives, struggling with outcomes. So, what is choice? That is a philosophical question of considerable gravity.
When it concerns a standard for normalcy for the human mind, or an attempt thereof, I do not agree that psychopathology is applicable to such a concept since psychpathology is merely intended to provide a basis to provide psychiatry with the status 'branch of medicine'.
If psychiatry is really (really?) a branch of medicine, we should see the specific causal hypotheses emerge about mechanisms that cause the symptoms of mental illness. Psychopathology is to be identified as the departure of a psychological system from its proper state.
https://plato.stanford.edu/entries/psychiatry/

As can be seen, the whole of 'psychology' is to be removed within the concept psychopathology and it is psychiatry's task to provide a causal hypothesis on the basis of which a disease can be identified, by which a medical cure can be applicable.

In practice, since psychiatry has failed until now to provide a valid causal hypothesis and hasn't been able to start with such a hypothesis (note the use of 'really' in the Stanford reference on philosophy of psychiatry, hinting that such a hypothesis has never been proven valid until now), an attempt is made to define a standard for normalcy for the human mind with the hope or promise that psychiatry will one day be able to provide a corresponding causal hypothesis.

Essentially, the assumption that a causal hypothesis must be possible and will one day be found is used as a basis for an attempt to define a standard for normalcy for the human mind, which is then used to medicate people because that is what ultimately should be done once a causal hypothesis is found, and the only reason that psychiatry would be a branch of medicine.

Essentially, psychiatry's validity is based on a promise which is based on a philosophical concept that depends on determinism to be true for it's validity, and a concept which has not been proven valid until now after +70 years trying.

With regard the potential validity of the idea 'a standard for normalcy for the human mind'. As my footnote indicates, it may not be possible that such a state exists.

As an example, a recent study by US professor and depression authority Jerome C. Wakefield argues that depression is essential for human evolution and that it is conceptually wrong to make people believe that depression is a disease. There have been several studies that proved that depression can have a protective function. British psychiatrist Paul Keedwell argues that a severe depression can save people from the damaging effects of stress on the long term.

Many top performing people such as Winston Churchill, Abraham Lincoln, Isaac Newton and Beethoven have experienced severe depression. A depression may connect them to the other end: the ultimate level of performance. The further they reach, the deeper they may fall. When they don't understand the concept, they may simply become a victim of depression. Artists are likely to give in to the emotions in their pursuit of a authentic experience. If this would be correct, the potential for depression could hold a key for exceptional human performance.

Logically, without the potential for depression there is no potential for euphoria. From that perspective, an attempt to achieve 'normalcy' would result in flattening which may be disastrous when considered from the perspective of human evolution.
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Re: Psychopathology - philosophy of psychiatry

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arjand wrote
Psychpathology or psychological pathology is a philosophical concept and it is the foundation of psychiatry by which it can consider itself a branch of medicine.
It IS a philosophical concept because.....?
When it concerns a standard for normalcy for the human mind, or an attempt thereof, I do not agree that psychopathology is applicable to such a concept since psychpathology is merely intended to provide a basis to provide psychiatry with the status 'branch of medicine'.
Look, if you have something called a pathology, then there is an implied standard of what is not a pathology, otherwise you are speaking nonsense. So what is the standard for such a determination? What is being called into question is the very notion of normalcy itself when it comes to psychological states. The complaint about psychiatry is at the level of basic ideas, basic questions, where philosophy finds its place: you take a patient exhibiting pathological behavior, e.g., having hallucinations, delusions, irrational fears, and so on; the pathology of these experiences lies where? Certainly in the structure of norms that apply, but on what at are these norms grounded? An answer to this requires more than just a textbook. We're are looking for extratextual verification, and this puts the matter in the hands of an analysis of the terms of judgment. Hallucinations are bad? But why? Not real enough? But clearly, this is not the basis for a pathology at the level of basic questions because here, such matters of what is real are inconclusive. Perhaps if hallucinations are inherently disturbing, that is, painful in themselves, but is this possible? Firstly, the world we would call real is itself quite a painful place, but secondly, it is the claim to being more real than a hallucination that is in play: Is not reality what is there, in one's midst as a palpable presence? you could argue that there is a lack of correspondence between the hallucination and the world, but you would run up against the problem of verification beyond the experience, which is a problematic matter to say the least. My hallucination may not verifiable for others, but it certainly is for me, and what is there in others' experiences that exceeds my own in the calim to being real? Mere consensus?

As can be seen, the whole of 'psychology' is to be removed within the concept psychopathology and it is psychiatry's task to provide a causal hypothesis on the basis of which a disease can be identified, by which a medical cure can be applicable.
What causes a psychological pathology? No one wants to deny such talk has meaning, and we can talk about causality regarding all things, pathological or otherwise and make sense. In so called talk therapy, is not the psychiatrist a causal agency producing noises interpreted as meanings within a causal matrix of neurochemistry? But the point here is that causality as such as a theme for defining the discipline called psychiatry is simply unenlightening. Yes, as one causal matrix to another, we can discuss matters, but the content, the meanings exchanged, are not causal matters. They are ideational, not reducible to talk about causality. And in no way does such a discussion give disclosure "pathologies" or normalcies, or anything else. Finally, keepin mind that causality begins as a meaningful term AS an idea first. The "reality" is not really the issue. Our vocabularies are constructs of the world, not the world.
Disease?? But this is what is in question.
Many top performing people such as Winston Churchill, Abraham Lincoln, Isaac Newton and Beethoven have experienced severe depression.
Well then, you are on the threshold of agreement: a philosopher walks into a psychiatrist's office, finishes the session, and on the way out the door turns and asks, tell me doctor, why are we born to suffer and die?

Of course, this is not something the world of mental health can take on. Not its affair at all, really, just as philosophy is not the affair physics. But is such a question pathological? It produces no sense of well being, but in fact without such a question, could be estimate the value of being a person the same? Psychotics suffer, no doubt, but how do we interpret this suffering, or any suffering? this is a philosopher's question, coopted by psychiatry, implicitly at any rate: for psychiatry is the de facto authority on mental health.
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Re: Psychopathology - philosophy of psychiatry

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I would add, departure form a psychological system???? Well, that just begs for analysis, doesn't it? What is the basis for non-departure?
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Re: Psychopathology - philosophy of psychiatry

Post by Gertie »

arjand wrote: June 24th, 2021, 12:27 pm There is an increasing criticism on (the validity of) psychiatry and the general public appears to lose it's trust that psychiatry will one day meet its promise to become a valid objective science (i.e., to provide evidence for it's 'brain disease model' of psychological problems).

(2019) Psychiatric diagnosis 'scientifically meaningless'
https://www.sciencedaily.com/releases/2 ... 131152.htm

There is a great force at play to defend psychiatry. Only with a disease, it is possible to prescribe medicine and psychiatry is the biggest money maker for pharmaceutical companies. Certain psychiatric disorders make much more money even than for example cancer treatment. Despite this, it appears that people in general start to lose faith in the validity of psychiatry.

The well known medical investigative journalist Robert Whitaker from www.madinamerica.com once wrote the following to me:
Robert Whitaker wrote:Dear Arjan,

Yours is a good question. I think at the moment American society as a whole is rather confused about psychiatry. There is a growing suspicion among the public that psychiatry really doesn’t know much about the “biology” of mental disorders, despite all of its claims to the contrary, and there is a growing suspicion that the drugs aren’t all that great. Moreover, there is a growing recognition that psychiatry is totally compromised by pharmaceutical money. At the same time–and I know this is odd–the public does generally view criticism of psychiatric drugs as coming from people with a bias. So it’s a confused picture.

You’ve put your finger on an important problem. The presence of Scientologists in this debate serves to deligitimize criticism that arises from an honest examination of the science. The public has this vague sense that the criticism arises from religious principles rather than from a look at what the science really has to say.

As for the rest of the medical profession, well, doctors basically belong to a big tribe, and part of the tribal rules are that those in one discipline don’t publicly criticize the doctors in another discipline. This keeps non-psychiatrist doctors from weighing in on the matter, and as far as criticism that arises from within psychiatry, psychiatry as a field has been very successful in letting its members know that they will be ex-communicated and their careers will suffer if they speak too critically. Psychiatrists are allowed to make minor concessions, such as saying that pharmaceutical money has become too influential, but they are not allowed to say that the drugs don’t really work.

So it’s complicated. Think of a society that has bought into a medical delusion, and that’s where we’re at in the U.S. The public knows that something isn’t right, but at the same time it maintains its general belief in the medical model story.

Best,

Bob Whitaker
Psychiatry vs psychotherapy

What distinguishes a psychiatrist from a psychotherapist is a medical approach, i.e. psychopathology such as a brain disease model of psychological problems.

Psychopathology is based on causality which origin for plausibility is the Big Bang theory.
If psychiatry is really (really?) a branch of medicine, we should see the specific causal hypotheses emerge about mechanisms that cause the symptoms of mental illness. Psychopathology is to be identified as the departure of a psychological system from its proper state.
https://plato.stanford.edu/entries/psychiatry/

Note the use of 'really' in the Stanford reference on philosophy of psychiatry, which implies that it is not considered to be certain that psychopathology is valid or even justified as a theoretical concept.

Examining psychiatry may be of interest for a real world perspective of determinism.

Can causality and determinism possibly explain mind and the origin of life?

With psychopathology, one is to establish a direct 1 on 1 causal relation for psychological problems. That the environment, such as for example a neurological disease, can result in mental health problems does not by itself count as evidence for psychopathology.

In the case of humans, they have a great capacity to overcome problems in the environment with their mind. An example is the philosophy stoicism. By using stoicism, people experience life differently and can even think pain away.

(2019) Is it possible to think pain away?
https://www.colorado.edu/asmagazine/201 ... -pain-away

People who practice stoic philosophy may withstand a flu while others may take it to bed and be sick for weeks. This would be an example in which the validity of psychopathology would be undermined, because it disproves a 1 on 1 causal relation for psychological problems (e.g. the great mental suffering for weeks in the case of a flu while some others withstand it using the philosophy stoicism).

How Stoicism helped me fight the flu by Monil Shah
https://www.stevenaitchison.co.uk/stoic ... fight-flu/

Question:

Do you believe that psychopathology - causality to explain mind and psychological problems - can be valid? If so/not, why?
The correlation between mental states and brain states looks reliable, and gives us a real chance to increasingly learn how to treat psychological disorders which cause harm and suffering. Brains are ridiculously complex tho, so psychiatry is very crude for now, and seems to involve a lot of trial and error. Still, it's helped so many people, and will hopefully keep improving.

From my limited understanding pathologising 'symptoms' seems to largely be based on whether those psychological symptoms or behaviours are so severe they inhibit your ability to lead a 'normal' life. Which is probably the right approach I think, we all have similar brains and spectrum dispositions, but if harmful ones become too dominant it can mess us up. if you can't work, or you're a danger to yourself or others, can't look after yourself properly, are too depressed to self-care, are too anxious to fulfill your goals, afraid of delusions or hallucinations and so on. Otherwise what brain chemicals are up to and how 'normal' they are wouldn't much matter. But if a pill can reset your malfunctioning brain chemistry to help you lead a more happy and fulfilling life, bring it on.

That psychiatry is commercialised is a different issue, that's about how societies operate ecnomically (which will vary), and has pros and cons. When it comes to basic welfare issues like health (mental or physical) commercialisation can have serious drawbacks.

The Determinism v Therapy point raises interesting philosophical questions, but until we understand the mind-body relationship I think we just have to go with what works.
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Re: Psychopathology - philosophy of psychiatry

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Hereandnow wrote: June 25th, 2021, 12:21 pm
arjand wrote
Psychpathology or psychological pathology is a philosophical concept and it is the foundation of psychiatry by which it can consider itself a branch of medicine.
It IS a philosophical concept because.....?
Because it is defined by philosophy and has no evidence for its validity (i.e. it remains a theorethical concept).

"Psychopathology is to be identified as the departure of a psychological system from its proper state." (it is not yet).
https://plato.stanford.edu/entries/psychiatry/

Hereandnow wrote: June 25th, 2021, 12:21 pm
When it concerns a standard for normalcy for the human mind, or an attempt thereof, I do not agree that psychopathology is applicable to such a concept since psychpathology is merely intended to provide a basis to provide psychiatry with the status 'branch of medicine'.
Look, if you have something called a pathology, then there is an implied standard of what is not a pathology, otherwise you are speaking nonsense. So what is the standard for such a determination? What is being called into question is the very notion of normalcy itself when it comes to psychological states.
While that is true, as I indicated in my previous post, with psychopathology one assumes a physical origin (causality in a pure form) for mental states, e.g. brain chemistry, on the basis of which a pathology is possible and by which a medical approach becomes applicable.

A mental concept, e.g. social norms or merely an idea of what 'ought to be', is not valid as a basis for psychopathology because it would result in circle reasoning: the mental concept that is supposed to be the basis for psychopathology would require a cause within the scope of psychopathology, which is absurd.

Hereandnow wrote: June 25th, 2021, 12:21 pmThe complaint about psychiatry is at the level of basic ideas, basic questions, where philosophy finds its place: you take a patient exhibiting pathological behavior, e.g., having hallucinations, delusions, irrational fears, and so on; the pathology of these experiences lies where? Certainly in the structure of norms that apply, but on what at are these norms grounded? An answer to this requires more than just a textbook. We're are looking for extratextual verification, and this puts the matter in the hands of an analysis of the terms of judgment. Hallucinations are bad? But why? Not real enough? But clearly, this is not the basis for a pathology at the level of basic questions because here, such matters of what is real are inconclusive. Perhaps if hallucinations are inherently disturbing, that is, painful in themselves, but is this possible? Firstly, the world we would call real is itself quite a painful place, but secondly, it is the claim to being more real than a hallucination that is in play: Is not reality what is there, in one's midst as a palpable presence? you could argue that there is a lack of correspondence between the hallucination and the world, but you would run up against the problem of verification beyond the experience, which is a problematic matter to say the least. My hallucination may not verifiable for others, but it certainly is for me, and what is there in others' experiences that exceeds my own in the calim to being real? Mere consensus?


You are essentially indicating that notions about reality are by definition subjective and in a sense opinion, and thus cannot be a basis for causality or (psycho)pathology. That would be correct but it would not matter because within the concept psychopathology any form of thought or psychology would have to find a cause within the scope of causality (a physical origin).

Therefor, the concept psychopathology requires determinism to be true for its validity.

Hereandnow wrote: June 25th, 2021, 12:21 pm
As can be seen, the whole of 'psychology' is to be removed within the concept psychopathology and it is psychiatry's task to provide a causal hypothesis on the basis of which a disease can be identified, by which a medical cure can be applicable.
What causes a psychological pathology? No one wants to deny such talk has meaning, and we can talk about causality regarding all things, pathological or otherwise and make sense. In so called talk therapy, is not the psychiatrist a causal agency producing noises interpreted as meanings within a causal matrix of neurochemistry? But the point here is that causality as such as a theme for defining the discipline called psychiatry is simply unenlightening. Yes, as one causal matrix to another, we can discuss matters, but the content, the meanings exchanged, are not causal matters. They are ideational, not reducible to talk about causality. And in no way does such a discussion give disclosure "pathologies" or normalcies, or anything else. Finally, keepin mind that causality begins as a meaningful term AS an idea first. The "reality" is not really the issue. Our vocabularies are constructs of the world, not the world.
Disease?? But this is what is in question.
Without meaning, what is left to be a cause? Psychiatry seeks the cause in the brain. Thus, psychological pathology would assume that the whole of psychology has a cause within the scope of the concept causality (i.e. a physical origin), by which a medical approach for psychological problems becomes applicable.

From this perspective, when you argue on behalf of 'meaning' and for example say 'we can discuss matters, but the content, the meanings exchanged, are not causal matters. They are ideational, not reducible to talk about causality.', the response from the concept psychopathology would be simple: the thought that there is meaning finds it origin in causality. It is meaningless.

Only philosophy would be able to get beyond the argument that the perception of meaning is meaningless. It is a difficult situation because it is very easy to argue that life has no meaning because empirical evidence is impossible.

Hereandnow wrote: June 25th, 2021, 12:21 pm
Many top performing people such as Winston Churchill, Abraham Lincoln, Isaac Newton and Beethoven have experienced severe depression.
Well then, you are on the threshold of agreement: a philosopher walks into a psychiatrist's office, finishes the session, and on the way out the door turns and asks, tell me doctor, why are we born to suffer and die?

Of course, this is not something the world of mental health can take on. Not its affair at all, really, just as philosophy is not the affair physics. But is such a question pathological? It produces no sense of well being, but in fact without such a question, could be estimate the value of being a person the same?
From a psychopathology perspective deprived of any meaning that finds trust and comfort in the laws of Nature and the certain facts of science by which the human mind is to be explained in its fullest, such a question has little impact and perhaps merely whirls onto him/her as if it were a logically explainable chemical process that uses the concept wonder (negatively or positively) to propel itself into the 'great unknown' that is named future. Meaningless, yet, noteworthy within the scope of psychopathology. A medicine - if deemed needed - may reduce ones urge to explore the depths of this area of wonder in order to become what is named 'clinically stable'.

Hereandnow wrote: June 25th, 2021, 12:21 pmPsychotics suffer, no doubt, but how do we interpret this suffering, or any suffering? this is a philosopher's question, coopted by psychiatry, implicitly at any rate: for psychiatry is the de facto authority on mental health.
When one considers the concept suffering, then a pure mental form may potentially be the worst possible since it affects the center of experience itself and logically, when one reaches for the limit one can find an endless depth and essentially experiences suffering's severity into infinity (ever increasing severity).
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Re: Psychopathology - philosophy of psychiatry

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Hereandnow wrote: June 25th, 2021, 12:23 pm I would add, departure form a psychological system???? Well, that just begs for analysis, doesn't it? What is the basis for non-departure?
The source: https://plato.stanford.edu/entries/psychiatry/

Essentially, it means that with the concept psychopathology, psychology as a whole is to be explained within the scope of causality, thus requiring a physical explanation or cause. It also implies that psychopathology requires determinism to be true for its validity.

It comes down to the idea that the human mind originates from physical processes.
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Re: Psychopathology - philosophy of psychiatry

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Gertie wrote: June 25th, 2021, 3:12 pmThe correlation between mental states and brain states looks reliable
The reference in the OP argues that psychiatric diagnosis are 'scientifically worthless'.

Clinical psychology professor John Read, University of East London, said: "Perhaps it is time we stopped pretending that medical-sounding labels contribute anything to our understanding of the complex causes of human distress or of what kind of help we need when distressed."
https://www.sciencedaily.com/releases/2 ... 131152.htm

Your argument is essentially that causality (psychopathology), in specific a correlation between mental states and brain states, is evident, or at least 'possibly' or likely to be evident.

Questions:

1) What is be the basis for the idea that a causal relation between mental states and brain states is evident?

2) How can it be said that the evidence for that correlation is 'reliable'?


Gertie wrote: June 25th, 2021, 3:12 pmBrains are ridiculously complex tho, so psychiatry is very crude for now, and seems to involve a lot of trial and error. Still, it's helped so many people, and will hopefully keep improving.
The excuse "Psychiatry is still in its infancy" has been used for at least 50 years by now. Until now psychiatry has not delivered on its promise to provide evidence for validity of psychopathology (its brain disease model for psychological problems).

With regard that people feel helped. As mentioned in my reply to Gee, mental care (e.g. psychology and psychotherapy) and psychiatry are often confused with each other. At question in this topic is solely the theoretical foundation for psychiatry, a medical approach for psychological problems.

Further, that people 'feel' helped or cured is not evidence for the validity of psychiatric treatment. Thousands of people with cancer who receive laying on of hands by a paranormal therapist are also convinced that they have been 'cured'. They feel helped and are happy, yet, it is questionable that they have actually been cured.

There is evidence that mind over matter may play a bigger role than many people think. In studies with an active placebo, a placebo with a side effect by which the user feels that something happens in his/her body, 100% of the patients with a severe clinical depression recovered just as well as people that receive an antidepressant. This is evidence that the human mind may be able to overcome severe depression, simply by 'believing' in a pill.

It can be an argument that people can be misled for good, i.e. that a belief in a pill would be OK if that enables them to recover, however, when it concerns the future of humanity it may be an argument that humans should learn to make use of that potential in a proper way.

With regard the 'effectiveness' of antidepressants. The following research by professor John P. A. Ioannidis (Stanford University) shows that the idea that the pills help is based on corruption.

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?
https://philpapers.org/rec/JOHEOA-2

Gertie wrote: June 25th, 2021, 3:12 pmBut if a pill can reset your malfunctioning brain chemistry to help you lead a more happy and fulfilling life, bring it on.
How plausible is that idea really when considering that there are humans with merely 10% brain tissue that manage to live a normal, healthy life with wife, children and a job? In my opinion, the unproven chemical imbalance story for depression and other mental problems is questionable from that perspective.

Consciousness without a brain?
"Any theory of consciousness has to be able to explain why a person like that, who's missing 90 percent of his neurons, still exhibits normal behaviour," Axel Cleeremans, a professor philosophy of cognitive science from the Université Libre de Bruxelles in Belgium"
viewtopic.php?f=12&t=16742

Gertie wrote: June 25th, 2021, 3:12 pmThe Determinism v Therapy point raises interesting philosophical questions, but until we understand the mind-body relationship I think we just have to go with what works.
Psychopathology - the idea that mental states correlate with brain states - requires determinism to be true for its validity. If you believe that mind is merely brain states, then you simply must adhere to a belief in determinism.
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Re: Psychopathology - philosophy of psychiatry

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LuckyR wrote: June 25th, 2021, 3:09 amThis is a gross over simplification. While it is true that only psychiatrists can prescribe medications LEGALLY, there are plenty of psychiatrists who perform and prefer psychotherapy (talk therapy) over medications, and ECT for that matter.
A psychiatrist is a medical doctor and psychiatry as a science is based on psychopathology (causality). The field is not intended to provide psychotherapy. Psychotherapy is part of psychology and as indicated by the Stanford reference of philosophy of psychiatry, psychopathology demands the whole of 'psychology' to be removed to derive at causality.

"Psychopathology is to be identified as the departure of a psychological system from its proper state."

LuckyR wrote: June 25th, 2021, 3:09 amOver time the fields of psychiatry and psychology are getting closer and closer to neurology and neurobiology. When all four meet in the middle, then the issue being described in this thread will disappear. Ujtil then, various practitioners will try their best at helping with, admittedly few and imperfect tools and await better options. What else can be done?
Is there any evidence that mind originates in the brain? If not, then your argument is an empty promise. There is no indication that neurology and neurobiology will provide solutions for psychological problems. Evidence that this is true is the cited study in the OP.

Clinical psychology professor John Read, University of East London, said: "Perhaps it is time we stopped pretending that medical-sounding labels contribute anything to our understanding of the complex causes of human distress or of what kind of help we need when distressed."
https://www.sciencedaily.com/releases/2 ... 131152.htm

With regard the 'we cannot do better' or 'we have to do something' argument, as if it would explain brain treatment of 13% of the US population - 43 million people - against depressive emotions. That argument is not valid and is already used for +50 years.

Psychotherapy has been actively suppressed in favor of psychiatry's medical approach.

An example is the story of professor Loren Mosher (1933-2004), inventor of Soteria psychotherapy and former director of schizophrenia research at the National Institute of Mental Health (NIMH) in America, one of the highest positions in psychiatry in his day.

Prof. Dr. Loren Mosher invented a psychotherapy that could provide 90% chance of good recovery from severe psychosis (schizophrenia) without the use of antipsychotic medication. With money from the NIMH, Mosher opened the first Soteria house in Santa Clara, California in 1971.

Investigative journalist Robert Whitaker from Mad in America (MIA) noted in his book Mad in America:
Mad in America wrote:“But the difference was that the Soteria patients stayed healthy longer. Relapse rates were much lower for the Soteria group in both one and two year follup-up studies. The Soteria patients also functioned much better socially. They were better able to keep their jobs or attend school.” (Lake)
Professor Mosher's success shamed established medical psychiatry and threatened the pharmaceutical industry's profits. The National Institute of Mental Health cut funding for the Soteria house, forcing it to close. Professor Mosher resigned indignantly in a public letter, disgracing what he called "a pharmaceutical scam that unnecessarily squanders young lives."

Schizophrenia patients denied talking therapies
Thousands of people with mental health problems are being denied the best and most effective treatments, years after they were approved by the National Institute for Clinical Excellence, according to experts. Proven talking therapies are not offered to people diagnosed with schizophrenia.
https://www.independent.co.uk/life-styl ... 21713.html

A recent study in Finland named 'Open Dialogue' psychotherapy achieved 80% chance of full recovery from schizophrenia in its first version, without the use of anti-psychotic medications.
Robert Whitaker wrote:“If we follow the scientific evidence there is reason to believe Finnish Open Dialogue has achieved among the best outcomes in the world for psychosis and schizophrenia.”
http://www.madinamerica.com/2014/01/pro ... rvin-ross/

A 15 year study published in 2007 showed that people diagnosed with schizophrenia have a 40% chance of recovery without any form of treatment while the chance of recovery with psychiatric (antipsychotic medication based) treatment is 0%. (Journal of Nervous and Mental Disease, 195 (2007):406-414)

The 'we cannot do better' argument as justification for medical psychiatry is not valid.
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