Psychopathology - philosophy of psychiatry

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Re: Psychopathology - philosophy of psychiatry

Post by mystery »

Interesting topic.

Another datapoint is:
https://en.wikipedia.org/wiki/Political ... psychiatry

A Psychiatrist together with a Judge can take almost anything from anyone, legally.
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Re: Psychopathology - philosophy of psychiatry

Post by Gertie »

Arjand
Gertie wrote: ↑Yesterday, 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'?
1) I didn't say the relationship is causal, I said there is a correlation. No-one knows what the nature of the correlation is rooted in.


2) It's simply what neuroscientists, anaesthetists and others have found by looking and poking. A scanner can very crudely note which specific neural activity occurs when specific stimuli are applied. Stick a pin in your toe, certain patterns of neurons fire and you report pain in your toe. When it happens the same way with a thousand people, it looks like you've found a reliable rough neural correlation.

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.
The excuse "Psychiatry is still in its infancy" has been used for at least 50 years by now.
Human brains are the most complex known things in the universe. The technology is improving, but still far too crude. That's just a fact. Hence drug treatments can be narrowed down to an extent according to symptons, but there is still necessarily some trial and error. If you report psychotic symptoms for example, the psychiatrist might try a range of anti-psychotics with you before finding one which significantly helps, as different drugs affect brain chemistry in different ways. And we don't have the fine grained information of what's going on in your brain required to pick the best one.

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.
I'm not confused.

Further, that people 'feel' helped or cured is not evidence for the validity of psychiatric treatment.

Well yes it is. It's the psychological symptoms which cause people problems, if medication alleviates the symptoms, job done. Unlike cancer for example, where masking the symptoms doesn't solve the underlying problem. Placebo effects may play some part too, but that's always a factor with any type of medication. And I wouldn't be at all surprised if some companies introduce bias into their testing, and generally oversell the effectiveness of their drugs. Again, I expect that applies to lots of types of medication. As I previously agreed, commercial interests can be a problem.

Gertie wrote: ↑Yesterday, 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.
We will have to agree to differ on the relevance of that claim.

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.
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.

The correlation has been observed, not explained, there is no accepted scientific position on the underlying nature of the mind-body relationship, just that there is one. And this knowledge of the correlation itself gives us something tangible to work with. We can, very crudely, get a rough idea of how brains work, note the correlation with psychological states, and have a rough idea of what the right track might be to alleviate psychological problems, then try treatments out and see what works. It's not dissimilar to taking a pain killer which affects pain receptors, adjusting your brain chemistry to ease unpleasant symptoms.


The nature of the mind-body relationship is something Philosphy of Mind tries to tackle, and there are plenty of hypotheses, some of which suggest some sort of causal relationship. Others take different approaches. The observed correlation is a clue, not an answer.
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Re: Psychopathology - philosophy of psychiatry

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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'.
Wikipedia aligns psychopathology with psychology and sociology. Not that that makes them right, of course.


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.
QED? 😉
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Re: Psychopathology - philosophy of psychiatry

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Gertie wrote: June 26th, 2021, 10:50 am1) I didn't say the relationship is causal, I said there is a correlation. No-one knows what the nature of the correlation is rooted in.
That would be no different than throwing a ball at someone and observing that humans blink their eyes 99 out of 100 cases. Yet, the human can 'not blink' based on diverse psychological factors by which a causal relationship between blinking and throwing a ball is rendered invalid.

When it concerns a brain-disease model as cause for psychological problems one is simply to establish a causal relation. A correlation between whatever is not a valid ground for the diagnosis of a medical disease.

There have been studies that showed that the brain can 'rewire itself' and the cited case of a French man with merely 10% brain tissue that lives a healthy and normal human life with wife, children and a job, shows how profoundly the brain can rewire itself.

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

In a study with eye-sight, when people are made blind as part of a study for a longer period of time, the area that is 'correlated' with eyesight completely rewires itself and starts to process touch among other things. This is evidence that a 'correlation' in the brain is not a valid ground to determine a causal relation for psychological problems.

When the brain can rewire the part that is normally used for eye-sight to do something completely different, in the scope of psychology, much more is likely possible.

People with autism for example, appear to merely 'use their brain differently' by which some (Savants) acquire amazing capabilities, such as a photographic memory that enables him/her to draw a city with high precision after a few hour helicopter flight.

Autistic savant draws Manhattan panorama from memory after one helicopter ride
https://anthillonline.com/autistic-sava ... pter-ride/

Jabob Barnett from Indiana, USA intends to unlock the idea that 'thinking differently' can enable any normal human to become a genius.

Upon the diagnosis autism doctors told his parents that he would probably never be able to tie his own shoes. His mother didn't accept the generally accepted psychiatric disease perspective and instead, decided to let her son be himself. His mother decided to educate her son at home and at 14 years old his IQ was estimated at 170, higher then that of Albert Einstein.

In 2012 Jacob attended a TED talk in which he explained that any normal child can become a genius by thinking differently.

14 y/o with 170 IQ: Forget what you know - “Stop learning and start thinking
http://www.youtube.com/watch?v=Uq-FOOQ1TpE
https://blog.theautismsite.greatergood. ... -you-know/

When thinking can change brain states, then, the brain-disease model of psychological problems would be rendered invalid.

Gertie wrote: June 26th, 2021, 10:50 am2) It's simply what neuroscientists, anaesthetists and others have found by looking and poking. A scanner can very crudely note which specific neural activity occurs when specific stimuli are applied. Stick a pin in your toe, certain patterns of neurons fire and you report pain in your toe. When it happens the same way with a thousand people, it looks like you've found a reliable rough neural correlation.
As mentioned above, that 'correlation' isn't as fixed as is assumed, rendering any conclusion with regard psychology invalid.

Stick in a pen in your toe as a stoic philospher, or someone who has mentally developed his/herself in a specific way, and the brain shows different activity. That activity is not the 'cause' or origin (i.e. a 'disease' when compared with others), but for example stoic philosophy, or a certain psychological system/thinking.

Correlation between brain states and the physical body can be no ground to argue that psychological problems are 'caused' in the brain, or that certain correlated brain activity is a 'medical disease'.

Gertie wrote: June 26th, 2021, 10:50 amHuman brains are the most complex known things in the universe. The technology is improving, but still far too crude. That's just a fact. Hence drug treatments can be narrowed down to an extent according to symptons, but there is still necessarily some trial and error. If you report psychotic symptoms for example, the psychiatrist might try a range of anti-psychotics with you before finding one which significantly helps, as different drugs affect brain chemistry in different ways. And we don't have the fine grained information of what's going on in your brain required to pick the best one.
That is assumptious thinking, i.e. "once we have the technology, we will be able to prove our idea's" and it is not a valid ground to medicate the brain, also in the case of psychotic problems.

The idea that antipsychotics cure a brain disease is invalid according to many scientists. In fact, antipsychotics are said to cause brain damage by which the problems become chronic while without any treatment there is a 40% chance of recovery within 4 years time and with some psychotherapies without medication, 80-90% recovery has shown to be possible, while those innovations have been actively suppressed and developed with little money, indicating that much better may be possible when the billions of USD of research funding that currently is invested in psychiatry, would be made available to explore psychotherapy solutions.

Gertie wrote: June 26th, 2021, 10:50 amI'm not confused.
I merely intended to indicate that psychiatry is merely about the 'medical' part of mental care and for talking therapies, social help and other care there are other specialists that do not require a medical degree.

Gertie wrote: June 26th, 2021, 10:50 am
Further, that people 'feel' helped or cured is not evidence for the validity of psychiatric treatment.
Well yes it is. It's the psychological symptoms which cause people problems, if medication alleviates the symptoms, job done. Unlike cancer for example, where masking the symptoms doesn't solve the underlying problem. Placebo effects may play some part too, but that's always a factor with any type of medication. And I wouldn't be at all surprised if some companies introduce bias into their testing, and generally oversell the effectiveness of their drugs. Again, I expect that applies to lots of types of medication. As I previously agreed, commercial interests can be a problem.
I do not agree that it is that simple and it is certainly not a justification for medical treatment. One can argue on behalf of psycho-therapeutic value but a lot is possible within that scope and there is nothing medical about it.

When it concerns medicine, there are certain qualities to adhere to, such as the presence of valid causal hypothesis for psychopathology that justifies medical treatment.

Using medicine to alter ones mind is not much different than a shaman or paranormal therapist that intends to do the same with psycho-active drugs or paranormal therapy.

Again, there is nothing wrong with it when people are happy with it, but that is not at question in this topic. When people are happy with psychiatry, then that is OK, to be respected and perhaps it is good/best for their lives.

At question is the fundament on the basis of which psychiatry is able to consider itself a branch of medicine. Using psycho-active substances to alter ones mind is not possibly justified within the scope of medicine since it lacks a sound causal hypothesis to justify such treatment, and without such a hypothesis, it is impossible to argue that it is known what is being done, i.e. that people are 'cured' using medical intervention.

In the mentioned example, thousands of people who receive laying on of hands by a paranormal therapist feel 'cured' and are happy, which is totally OK. But when it concerns a scientific perspective, surely, paranormal therapists are not welcomed as part of medicine. Equally, psychiatry has to be able to justify it being a branch of medicine.

Gertie wrote: June 26th, 2021, 10:50 amWe will have to agree to differ on the relevance of that claim.
Why? If the brain can re-wire itself to such an extend, what would make it valid to hold on to the idea that a simple 'chemical imbalance' would be the 'cause' of for example depressive emotions?

The brain can enable a human with merely 10% brain tissue to overcome his/her situation and live normal/healthily. Fall in love, make and raise children, hold a job etc.

Most logical is that people with depressive emotions can do amazing things with their 100% intact brain and studies with an active placebo (pill with a side-effect so that people feel that something happens) have proven that 100% recovery of severe clinical depression is possible with a fake pill, which is evidence that the solution for the problem is possible with thinking / psychology, even in the case of severe depression.

One can then simply wonder: what justification is possible to medicate the brain of 43 million people in USA for depressive emotions? What is the 'good intention' of that?

That people feel happy cannot be a ground to allow psychiatry to consider itself a branch of medicine since otherwise paranormal therapist are allowed to join as well.

Gertie wrote: June 26th, 2021, 10:50 amThe correlation has been observed, not explained, there is no accepted scientific position on the underlying nature of the mind-body relationship, just that there is one. And this knowledge of the correlation itself gives us something tangible to work with. We can, very crudely, get a rough idea of how brains work, note the correlation with psychological states, and have a rough idea of what the right track might be to alleviate psychological problems, then try treatments out and see what works. It's not dissimilar to taking a pain killer which affects pain receptors, adjusting your brain chemistry to ease unpleasant symptoms.
Suppressing psychological symptoms is not medicine since it lacks a causal hypothesis that justifies a medical intervention. Perhaps it can be considered on the edge when compared with pain treatment, but when it concerns psychology compared with pain sensation, psychology is much more complex and a simple 'suppression' from that perspective may not be something of what it can be said to be a solution or 'cure'.

My personal idea is that humans should learn to overcome psychological problems with their mind, in order to become 'stronger'. With each solved problem, the mind becomes stronger and people share their knowledge with people around them, enhancing human resilience and its chance of long term successful survival.

The idea: "Without overcoming problems there is no progress in life. Overcoming problems is vital for successful evolution".
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Re: Psychopathology - philosophy of psychiatry

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Pattern-chaser wrote: June 26th, 2021, 12:06 pmWikipedia aligns psychopathology with psychology and sociology. Not that that makes them right, of course.
In the case of psychiatry, psychopathology is intended as theoretical basis by which psychiatry is a branch of medicine. Therefor, within the scope of psychiatry or medicine, psychopathology requires causal hypothesis, for example a brain disease model of psychological problems.

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

relative to:

"If psychiatry is really a branch of medicine, we should see the specific causal hypotheses emerge about mechanisms that cause the symptoms of mental illness."

https://plato.stanford.edu/entries/psychiatry/

Pattern-chaser wrote: June 26th, 2021, 12:06 pm
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.
QED? 😉
Not so fast! The validity of psychopathology as foundation for the status 'branch of medicine' is up for discussion.

As of today, it is simply unknown what causes / can explain consciousness and mind. From that perspective, psychiatry's vision and determinism could be correct and psychiatry should be provided with the opportunity to prove itself.
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Re: Psychopathology - philosophy of psychiatry

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mystery wrote: June 26th, 2021, 7:38 am Interesting topic.

Another datapoint is:
https://en.wikipedia.org/wiki/Political ... psychiatry

A Psychiatrist together with a Judge can take almost anything from anyone, legally.
Yes, one could wonder: how is that even possible? How is it possible to 'abuse' a medical diagnosis for political motives?

In China, the use of electroshock as a means of punishment and repression had made a reappearance a few years ago. Children and young people were taken by their parents to psychiatric clinics where they were forcibly administered electroshocks (ECT) in a months-long "therapy". After the shocks, the youngsters lost their memory for several weeks.

In the clinic, the electroshocks were used not only to 'reset' the brain, but also as punishment. The Chinese web newspaper China.org.cn reported that violations of the clinic's rules were punishable by electroshock. These include eating chocolate, locking the bathroom door, or sitting in the psychiatrist's chair without permission.

The goal of the psychiatric treatment was to get the children to admit that they are addicted to the Internet. As soon as they admitted this, they were declared 'cured' by the psychiatrist.

The Chinese Ministry of Health has stopped the treatment for safety reasons.

How is it possible that a medical field would allow for such practices, in this case 'shocking the brains of children' for internet addiction and as punishment for bad behavior?

In my opinion the origin of the problem is the theoretical fundament of psychiatry that allows for abuse, not just the political abuse.

My perspective is: when you give a teacher a stick to hit children, he will hit children with it.
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Re: Psychopathology - philosophy of psychiatry

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Arjand,

One of the things treatments that cross over into psychiatry could be mushrooms, psilocybin.
https://www.scientificamerican.com/arti ... framework/
https://fantasticfungi.com/

Actually rewires and possibly FIXES mental issues in the core. It may help to rewire social events processing.

This is an area that it makes sense for psychiatry to work on. Something that may actually create lasting solutions for persons that have processing that is not standard or said differently abnormal. Abnormal meaning not like most ppl.

As to answer your question about why things are allowed that seem immoral, usually greed.

In psychiatry and law, we have given the right to take the rights of another for thinking in a different way and at the same time, we allow terrible crimes to go without compensation because a psychiatrist chooses. Literally, the power of life and death over others, even if they can prove nothing.
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Re: Psychopathology - philosophy of psychiatry

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arjand wrote: June 27th, 2021, 1:18 am How is it possible that a medical field would allow for such practices, in this case 'shocking the brains of children' for internet addiction and as punishment for bad behavior?
This action was surely a political one? It's hard to see how the medical profession could be responsible for this.
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Re: Psychopathology - philosophy of psychiatry

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mystery wrote: June 27th, 2021, 6:06 amOne of the things treatments that cross over into psychiatry could be mushrooms, psilocybin.
https://www.scientificamerican.com/arti ... framework/
https://fantasticfungi.com/
The use of psycho-active substances to 'alter' ones mind can be part of a psychotherapy but it is not a medical practice. A sound medical practice simply requires a valid causal hypothesis for a medical disease.

People can feel better by smoking sigarettes. It can reduce stress among other things. Would it be valid for a general practitioner or a medical doctor to prescribe smoking sigarettes? No, a medical doctor prescribes treatments on the basis of a sound causal hypothesis for medical diseases. Medical doctors do not prescribe drugs to give people a nice feeling or the idea that they enhance their mind. (an individual doctor may do so based on 'beliefs' about what is good for someone, but that is something different from general practice by a medical field in general).

People who do 'love drugs', cocaine, mushrooms or psilocybin often claim that it has changed their mind for life, for the better. People who smoke marihuana (weed) may claim the same.

While it is difficult to validate such claims and they may in fact be correct, it doesn't mean that the prescription of such substances is valid as part of medicine.

Only with the idea that the mind originates from the physical (causality), such a practice could potentially be valid, but it simply requires a causal hypothesis BEFORE such substances are prescribed.

The argument "the brain is very complex, one day we have the technology to prove our ideas" is not valid. The promise has turned out to have been empty after 70+ years trying to prove it.
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Re: Psychopathology - philosophy of psychiatry

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Pattern-chaser wrote: June 27th, 2021, 8:19 am
arjand wrote: June 27th, 2021, 1:18 am How is it possible that a medical field would allow for such practices, in this case 'shocking the brains of children' for internet addiction and as punishment for bad behavior?
This action was surely a political one? It's hard to see how the medical profession could be responsible for this.
As my logic indicated: when you give a teacher a stick to hit children, he will hit children with it.

It is not possible to abuse a medical diagnosis when the causal hypothesis for a disease is sound.

The problem is that with psychiatry, 'disease diagnoses' are essentially based on opinion, by which they can be applied to anyone.

In the Netherlands a big corruption case highlighted the problem.

In the Netherlands there is a system in which independent care givers can receive a 'care budget' (PGB) which can be significant. A bed in a hospital can cost 750 to 1,500 Euro per day. The idea is that by providing +10,000 Euro per month per patient to independent care givers, that a lot of money can be saved. It resulted in flourishing independent care business by small entrepreneurs.

A psychiatric diagnosis such as schizophrenia qualifies for the care budget and two psychiatrists from Rotterdam, the Netherlands literally made tens of millions of Euro's with fake schizophrenia diagnosis AND THEY GOT AWAY WITH IT by saying that they couldn't know that their patients were faking the disease.

https://www.facebook.com/photo?fbid=668 ... 3155497649

The only punishment that the psychiatrists ultimately received after a tough legal battle with the 'National Medical Inspection' was a reprimand by the National Psychiatry Association (similar to the APA in the US) that they are no longer allowed to practice psychiatry.

The psychiatry association communicated: "The psychiatrists have damaged the credibility of psychiatry" but other than that, they received no punishment and went free with +10 million Euro in fraud by 'being able' to say that they could not know that their patients were faking a disease.

That 'could not know' aspect, which was tested in this legal case, is at question in this topic.

Should it be possible that psychiatry diagnoses a 'real' medical disease without a valid causal hypothesis that enables to test validity of the diagnosis?

Further, how likely is the theoretical fundament of psychiatry valid when considering that it requires determinism to be true for its validity?
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Re: Psychopathology - philosophy of psychiatry

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Additional: the two psychiatrists from Rotterdam actually received +100,000 Euro in damages because they were falsely ordered to stop practice by the National Medical Inspection.
The Healthcare Inspectorate must pay the of tens of millions of Euro's fraud suspected psychiatrist ... 100,000 Euro compensation. Despite the fact that the man was suspected of making fake diagnoses to rake money, the inspection was not allowed to order him to stop practice. According to the highest administrative court, the inspection should first have to investigated whether ... made invalid diagnosis, when they ordered him to stop practice in 2011. Apparently it was not serious enough that justice suspected the psychiatrist for tens of millions of Euro's fraud, by diagnosing schizophrenia in healthy patients.
Could the medical inspection possibly have verified the diagnosis? It may be an interesting case with regard the consequences of the ability to test the validity of a psychiatric diagnosis. How are insurance related organizations handling the situation?

When an insurance related organization questions a psychiatric diagnosis, it will drive the whole of psychiatric establishment into its harness. Therefor, most keep silent and simply do not question the validity of a psychiatric diagnosis. This specific case however, was an extreme which makes it interesting to see how it was handled.
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Re: Psychopathology - philosophy of psychiatry

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LuckyR wrote: June 25th, 2021, 3:09 am
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.
There is a lot of truth in what you say, but Arjand was looking at the specific training that categorized the different types of treatment. Generally speaking, a psychiatrist is an MD, who studies disease and prescribes medication; a psychologist studies the mind and looks to different therapies to resolve the problems of mind; a social worker gives help and solutions to the practicalities of living with the patient's problem and in negotiating the real world.

Can some people do the work of all three? Probably. The best work that I ever saw came from a clinic that used all three types of workers -- I referred a lot of people to them over the years. They employed one psychiatrist, to prescribe medications, and six different analysts/therapists, who had a variety of skills, and a few social workers, who all worked together as a team. One would do a two hour intake, then bring that information to a meeting where recommendations and treatments would be discussed and whoever felt they could connect with the patient, would be selected.

They did some very good work, but that clinic is closed now. No one wants to pay six or eight people when you can solve the problem with a pill.
LuckyR wrote: June 25th, 2021, 3:09 am 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?
A lot of people believe this, but it is simply not true. As long as neurology continues to believe that consciousness is produced by the brain, there will be no help from that quarter.

I did some studying on Freud a few years back and was surprised to discover that he was not a trained psychologist, or a trained psychiatrist -- he was a neurologist. A scientist, and it was his most fervent wish that psychiatry/psychology would be an accepted science one day. Back in his day, psychiatry/psychology was too much voodoo and "the devil made me do it" to be considered science.

So he gave us the divisions of mind, then he tried to explain the divisions by referencing different parts of the brain, but he was almost completely unsuccessful. I think there was one part that he got pretty close to right, but he did not have the equipment that we have now. Anyway, if you go to the science forums, they will tell you that Freud was a quack because he got everything wrong when assigning parts of the brain to aspects of the mind -- he established no valid association there. Now this thread tells me that psychopathology is valid and that it validates psychiatry -- because of a "promise". Has everybody lost their minds?

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Re: Psychopathology - philosophy of psychiatry

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arjand wrote: June 27th, 2021, 12:27 pm
mystery wrote: June 27th, 2021, 6:06 amOne of the things treatments that cross over into psychiatry could be mushrooms, psilocybin.
https://www.scientificamerican.com/arti ... framework/
https://fantasticfungi.com/
The use of psycho-active substances to 'alter' ones mind can be part of a psychotherapy but it is not a medical practice. A sound medical practice simply requires a valid causal hypothesis for a medical disease.

People can feel better by smoking sigarettes. It can reduce stress among other things. Would it be valid for a general practitioner or a medical doctor to prescribe smoking sigarettes? No, a medical doctor prescribes treatments on the basis of a sound causal hypothesis for medical diseases. Medical doctors do not prescribe drugs to give people a nice feeling or the idea that they enhance their mind. (an individual doctor may do so based on 'beliefs' about what is good for someone, but that is something different from general practice by a medical field in general).

People who do 'love drugs', cocaine, mushrooms or psilocybin often claim that it has changed their mind for life, for the better. People who smoke marihuana (weed) may claim the same.

While it is difficult to validate such claims and they may in fact be correct, it doesn't mean that the prescription of such substances is valid as part of medicine.

Only with the idea that the mind originates from the physical (causality), such a practice could potentially be valid, but it simply requires a causal hypothesis BEFORE such substances are prescribed.

The argument "the brain is very complex, one day we have the technology to prove our ideas" is not valid. The promise has turned out to have been empty after 70+ years trying to prove it.
I can understand your points. If you have not, sometimes if you get the chance watch that fatasicfungi documentary. The suggested problem/solution is interesting as it addresses the issue(s) that other methods avoid or tell are not fixable.

It seems like that in the past when mental control was being actively studied for military reasons much faster progress happened. Perhaps it is a motivation problem that holds us back.
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LuckyR
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Re: Psychopathology - philosophy of psychiatry

Post by LuckyR »

Gee wrote: June 27th, 2021, 7:39 pm
LuckyR wrote: June 25th, 2021, 3:09 am
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.
There is a lot of truth in what you say, but Arjand was looking at the specific training that categorized the different types of treatment. Generally speaking, a psychiatrist is an MD, who studies disease and prescribes medication; a psychologist studies the mind and looks to different therapies to resolve the problems of mind; a social worker gives help and solutions to the practicalities of living with the patient's problem and in negotiating the real world.

Can some people do the work of all three? Probably. The best work that I ever saw came from a clinic that used all three types of workers -- I referred a lot of people to them over the years. They employed one psychiatrist, to prescribe medications, and six different analysts/therapists, who had a variety of skills, and a few social workers, who all worked together as a team. One would do a two hour intake, then bring that information to a meeting where recommendations and treatments would be discussed and whoever felt they could connect with the patient, would be selected.

They did some very good work, but that clinic is closed now. No one wants to pay six or eight people when you can solve the problem with a pill.
LuckyR wrote: June 25th, 2021, 3:09 am 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?
A lot of people believe this, but it is simply not true. As long as neurology continues to believe that consciousness is produced by the brain, there will be no help from that quarter.

I did some studying on Freud a few years back and was surprised to discover that he was not a trained psychologist, or a trained psychiatrist -- he was a neurologist. A scientist, and it was his most fervent wish that psychiatry/psychology would be an accepted science one day. Back in his day, psychiatry/psychology was too much voodoo and "the devil made me do it" to be considered science.

So he gave us the divisions of mind, then he tried to explain the divisions by referencing different parts of the brain, but he was almost completely unsuccessful. I think there was one part that he got pretty close to right, but he did not have the equipment that we have now. Anyway, if you go to the science forums, they will tell you that Freud was a quack because he got everything wrong when assigning parts of the brain to aspects of the mind -- he established no valid association there. Now this thread tells me that psychopathology is valid and that it validates psychiatry -- because of a "promise". Has everybody lost their minds?

Gee
Not true? I was describing a future possibility. No one said it was true.

I see you did some studying on Freud a few years back. There has been a lot of progress since 1939.
"As usual... it depends."
Gertie
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Re: Psychopathology - philosophy of psychiatry

Post by Gertie »

Gee wrote: June 27th, 2021, 7:39 pm
LuckyR wrote: June 25th, 2021, 3:09 am
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.
There is a lot of truth in what you say, but Arjand was looking at the specific training that categorized the different types of treatment. Generally speaking, a psychiatrist is an MD, who studies disease and prescribes medication; a psychologist studies the mind and looks to different therapies to resolve the problems of mind; a social worker gives help and solutions to the practicalities of living with the patient's problem and in negotiating the real world.

Can some people do the work of all three? Probably. The best work that I ever saw came from a clinic that used all three types of workers -- I referred a lot of people to them over the years. They employed one psychiatrist, to prescribe medications, and six different analysts/therapists, who had a variety of skills, and a few social workers, who all worked together as a team. One would do a two hour intake, then bring that information to a meeting where recommendations and treatments would be discussed and whoever felt they could connect with the patient, would be selected.

They did some very good work, but that clinic is closed now. No one wants to pay six or eight people when you can solve the problem with a pill.
LuckyR wrote: June 25th, 2021, 3:09 am 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?
A lot of people believe this, but it is simply not true. As long as neurology continues to believe that consciousness is produced by the brain, there will be no help from that quarter.

I did some studying on Freud a few years back and was surprised to discover that he was not a trained psychologist, or a trained psychiatrist -- he was a neurologist. A scientist, and it was his most fervent wish that psychiatry/psychology would be an accepted science one day. Back in his day, psychiatry/psychology was too much voodoo and "the devil made me do it" to be considered science.

So he gave us the divisions of mind, then he tried to explain the divisions by referencing different parts of the brain, but he was almost completely unsuccessful. I think there was one part that he got pretty close to right, but he did not have the equipment that we have now. Anyway, if you go to the science forums, they will tell you that Freud was a quack because he got everything wrong when assigning parts of the brain to aspects of the mind -- he established no valid association there. Now this thread tells me that psychopathology is valid and that it validates psychiatry -- because of a "promise". Has everybody lost their minds?

Gee
If we get down to the basics of what medicine is supposed to be about, it's helping people with medical problems, right?

Now if there are medicines which can help people with psychological problems, that's a good thing. It might not always work, it might not be perfect, it might be less effective than other approaches, it might not be a long term cure, it will depend on the individual patient. And we want people who are good at advising on what the best treatment might be, while bearing in mind there is no perfect algorithm and a lot of 'try it and see' could be involved. And ultimately, no treatment might be successful.

We don't know much about the intricate workings of brains, more than Freud but that's not saying much. But we do know that brain states seem to correlate with psychological states, change one and you change the other. Nobody knows why, but it does give us a way in to treat psychological problems by changing brain processes associated with the problem. The state of our knowledge means it's akin to using a hammer to do a jigsaw in some ways, but if it works, it can save misery and death for many people. And people should have that choice if they want it.

As I understand it some talking therapies use this knowledge of correlation too, by effectively 'practising' new ways of thinking which weaken existing unhealthy neural connections and build up healthier ones. That too is hit and miss, but that's where we're at. The very limited knowledge we have shouldn't be ignored if it can be helpful anyway.

The clinic you mention sounds like the right approach to me, but money often rules. And there are plenty of fair criticisms to be made of psychiatry. 'Professional' status building crap is irrelevant, labels should serve the basic goal of helping people, over-selling benefits for profit is wrong, fiddling research should be regulated and get you banned, their are ethical questions around sectioning people and forcible treatment 'for your own good', etc. The whole issue of messing with someone's mind raises all types of questions. Informed consent is the best we can do I think, even if the information is messy.

We can acknowledge all the problems without throwing the useful baby out with the crappy bathwater. And millions have found psychiatry helpful, some life saving. Look at areas where we don't have medical treatment like Alzheimers, it's tragic. If we had a pill which could help, we should give people that choice.
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