[julienmarie]

Something interesting is making a mental "disorder" a sickness. A mental trait becomes a disorder when this trait no more compatible with social norms ( it breaks the order of things, hence disorder ). Hence the pain. And we assume a pain is a sickness that can be cured, medicated.

Medication do not solve the root of the pain. Our brain is more than a chemical balance. It's a neural network, trained on the training set of our childhood. There is this fundamental age around 6-7 years old where the child creates its identity picture, its definition of self, which becomes the blueprint of its personality trait and evolution. This blueprint causes what psychoanalysts call "neurosis". When digging into it, there are so many things that makes sense in the field of psychoanalysis, and the parallels with neurosciences and even AI are staggering.

Little nuggets I found enlightening in my day to day perception of life :

- We learn language and the meaning of things from others ( our parents usually ). As a consequence, we naturally expect truth and meaning to come from outside. That's why we look for confirmation from others. That's why we expect the people we fall in love with to give our life meaning.

- We create our identities based on our environment. We define ourselves against the others as to define is to draw a boundary, a difference. That's why you'll often see the cliché in family where if the elder's dominant trait/definition is to be good at school, then the second child will take the opposite route.

- Our neurosis is mostly our limiting factor to approach life. This is what we fight against everyday, this is the wall between what we can be and what we are.

I understand this can be seen as a controversial view for many.

I'm no psychiatrist or psychoanalyst, but was raised in a psychiatrist / psychoanalyst family. A weird but enriching experience.

[thomasfedb]

> A mental trait becomes a disorder when this trait no more compatible with social norms (it breaks the order of things, hence disorder).

Your definition is close, but not quite in keeping with the medical world.

Broadly, something would become a disorder if it results in a) distress, or b) dysfunction.

Distress is usually self-reported, dysfunction can also be observed (e.g. unable to eat, sleep, care for self).

I'm a student doctor, currently on rotation in psychiatry.

[wpietri]

Sure, but I think their point here is that many things are called a disorder when the the problem is a trait combined with social norms. Yes, the person is distressed or unable to function, but that determination is made on the basis of the person's experience in a highly constructed environment.

For example, look at the way gay and lesbian people were treated. Now we understand that there's nothing wrong with them; it's a natural human variation. But for quite a while it was treated as both a social and a medical problem. [1] And some of the evidence used to medicalize the issue came from the way society mistreated those they saw as deviant.

You can see the same dynamic playing out today with trans people. The trans suicide rate is absurdly high, and there's all sorts of comorbidity. Anti-trans campaigners will use that to suggest that trans-ness is the problem. Trans people themselves will tell you that the problem is society's relentless and often vicious gender policing, where trans people are forced into societal roles that don't suit them.

The same applies to people who aren't neurotypical. The tech industry has been a haven for me. I grew up as the nerd, the weird kid, the eternal outsider. When I first turned up in San Francisco 20 years ago, it was a fucking relief. Early on I spent most of 3 days at our colo on a big project, and I still remember seeing all my fellow sysadmins come in and out. They talked like me, they looked like me, they dressed like me. It was such a huge relief: I had finally come to a place where I didn't stick out all the time. Instead of people wanting to medicate me for my ADD, etc, I got to join an industry where the unusual way I thought was a positive.

So although in theory your distinction is correct, it's not so neat in the real world. Being incompatible with social norms is a huge mental burden, causing distress and dysfunction. Does that mean the trait is a disorder? Your colleagues have often declared it so. Note how in the 30s and 40s left-handedness was seen by prominent psychiatrists as a serious condition in need of correction. They have come around on that, and on some GLBT issues. But I see no reason to think that we have eliminated the class of problem. I think medicalization of deviance is still an ongoing issue.

[1] http://digitalhistory.hsp.org/anonymous-no-more/essay/medica...

[exolymph]

> Medication do not solve the root of the pain.

Contradictory anecdata: Therapy never helped me until after I started taking venlafaxine (generic Effexor) which took away my anhedonia and made it possible to process my trauma productively, rather than continuing to wallow in misery and dysfunction.

[copperx]

Another Effexor success story here. After spending most of my life suffering through mood changes for no reason (e.g., sometimes I got sad after seeing a color, or the way that something was arranged -- I've called this "emotional synesthesia"), Effexor has made me a normal person again. I've been taking the lowest dose for 7 years now, with no side effects besides dulling of emotions (interestingly, it makes decision making hard -- for me, it now requires me to write a pro/con list when facing a decision because there are few emotions involved, even when buying something that should be slightly exciting, like a new car). As someone who had a great childhood and no major traumas, it makes me wonder if I'm one of the people who have a legitimate "chemical imbalance".

[iamnothere]

> (interestingly, it makes decision making hard -- for me, it now requires me to write a pro/con list when facing a decision because there are few emotions involved, even when buying something that should be slightly exciting, like a new car)

This is actually a known phenomenon! Emotions are key to the decision-making process, and when they are impaired for whatever reason then you are more likely to make suboptimal decisions. I recommend Antonio Damasio's book Descartes' Error for a good picture of how this works.

[copperx]

Thanks for the book suggestion. I'm now wondering whether an overactive emotion circuitry makes one an even better decision maker or does it impair it? Perhaps the book will provide some insight.

[arkades]

This, btw, is the standard perspective on medication in the psychiatric community. It's uncommonly the answer in itself, but it puts the person neuropsychiatric state in a mode that is amenable to improvement.

The data tend to support that medication + therapy is significantly better than either alone for mood disorders, which is what gives rise to that conclusion. Spend a week on an inpatient ward with really sick people that were failing on outpatient therapy and meds, and see how quickly they improve in therapy once their meds are appropriately modified. Or look at folks with something like bipolar disorder, where only medication (and only a subset of that) has been shown to decrease the (upsettingly high) rate of completed suicide.

The OP video's assertion that medication is useless is baffling to me; I can only assume that they spent their career with reasonably functional personality/mood disorders in a primarily outpatient setting. Which is another way of saying, if you only ever see the common cold, of course you'd think IV antibiotics are useless overkill.

[PavlovsCat]

> As a consequence, we naturally expect truth and meaning to come from outside. That's why we look for confirmation from others.

Yes, we look for confirmation, just like we give it, but that's not all, we also decide how to weigh opinions based on our opinion of the people holding that opinion. I mean, how can others give you confirmation, if they in turn get their truth and meaning from the outside? That'd just be pointers going in a loop. By the same token "the outside" can tell you anything, you can tell "it" anything.

[usgroup]

Agrippa's trilemma, used as a reductio in your argument. Unfortunately, it applies to pretty much all claim to knowledge not just the case you're using it in.

[PavlovsCat]

I'm not "using" anything, I asked something.

> how can others give you confirmation, if they in turn get their truth and meaning from the outside?

When someone says something like "we get truth and meaning from the outside", I think it's a fair question.

[smhost]

That comes later. Our world would be nothing but confusion and trauma if we all came into the world as aware as we are now.

[PavlovsCat]

For some it never comes, that's the problem. edit: apart from "being aware" being kinda unrelated to anything I wrote, since you can still be unaware or aware as "your own person" or as someone who "gets meaning and truth from the outside".

> that's why we expect the people we fall in love with to give our life meaning

Surely that doesn't describe infants.

In that comment I just see things about either getting meaning from others, or trying to be different from others, which is claimed to be our main "limiting factor in life". "Imitating someone" and "trying to be different from someone" are two sides of the same coin, and while necessary for early development, not all there is. Come to think of it:

> The emergence of the stranger and his externalization stands in direct relationship to the degree of impairment of that which is most personal - namely, a person's identity. But how can inner development take place in children if everything that makes up their individuality is rejected and made foreign? Then identity is reduced to adaptation to those external circumstances that insure a child's psychic survival. Children do everything to fulfil their parents' expectations, and the way they do this is to identify with their parents, but then the child's individuality is replaced by a foreign element. That is why the 18th Century English poet Edward Young wrote: "We are born as originals, die as copies".

> An identity that develops in this manner is not oriented to its own needs but to the will of an authority.

[..]

> I want to emphasize that the "stranger" in us is bred by a culture that won't accept the spontaneous expression of children's aliveness and vitality. This aspect of a culture gives rise to violent behavior and is responsible for the development of deficient identities. Personalities formed by the processes producing the inner stranger were never able to develop trust as an underlying component of their personality. Instead, they take on a "false identity" that makes them idealize repressive authorities in the hope that they will be rescued by the very people who are their tormentors.

-- Arno Gruen, "The Need to Punish - The Political Consequences of Identifying with the Aggressor"

And that's what I hear when I read that "we" expect people we fall in love with to give our meaning life, as if it relieves us from the pain of pointlessly seeking to be different, which just limits us. As if uniqueness, unpredictability, wasn't what makes us human, but what keeps us from reaching our full potential.

I would never ever put that sort of onus on someone, much less someone I loved. I would not want to be with someone whose life had no meaning if I was run over by a bus, either.

[smhost]

i ultimately agree with your politics, but i don't think it's a matter of simply deciding to be somehow self-contained. you can decide to give yourself whatever meaning you want about yourself, but so long as society doesn't recognize your meaning and see you as you see yourself, that meaning has no meaning outside yourself. and there's also another problem with denouncing the other, which is that you close them off to the possibility of realizing themselves through you, and so they can never be a part of whatever society you decide to create for yourself.

[PavlovsCat]

> i don't think it's a matter of simply deciding to be somehow self-contained

Neither I nor Gruen said anything like that. I read the comment I responded to as claiming it's all from the outside, all from society, and I simply ask what IS society, when they all just get it from the outside. And I say there's not just the outside -- and the only way that can get heard is as me claiming "there's only the inside"? That's frustrating. It may may be "politics" to others, but to me it's simply a question of awareness, and Socrates-style question that are intended to be answered, not to make a point first and foremost..

You said making your own decisions "comes later", which as I pointed out doesn't fit the comment I replied to, since that was also talking about getting your meaning from others as an adult, e.g. falling in love. Also, Gruen and others mention the individuality of infants being suppressed -- so is there something to suppress, or does that "come later"?

What's the youngest age a human can approach or retract from a stimulus? I'd say then at the latest it becomes a two-way street, but it's probably one from the first cell division. If anything, that's what I'm arguing.

> so long as society doesn't recognize your meaning and see you as you see yourself, that meaning has no meaning outside yourself.

"Society" cannot do that anyway, since it's not an individual human being. We can use society as a shorthand for actually existing humans, but "society" as such is an abstraction, it doesn't really act or think or feel or understand or mean anything, like any group.

And yes, the meaning we have in life is for us only, but how is that a problem? What's the alternative? A "common" delusion, or people saying the same words as if that makes them the same inside?

> there's also another problem with denouncing the other, which is that you close them off to the possibility of realizing themselves through you, and so they can never be a part of whatever society you decide to create for yourself.

There's a poem I like, but I don't quite remember it, something about being "alone like a tree, and brotherly like a forest". I think true friendship, love, and/or a society of adult citizens, "achieves its full flower" with individuals who stand on firm inner ground, so to speak.

The closest two eggs can get is when their shells touch -- if you make omelette, they're no longer eggs in that sense, and to me that's not two eggs coming really close, but two eggs disappearing and being replaced by something that's less than each of them.

[smhost]

you're making a domain error when you conflate the forces of physical chemistry during first mitosis with higher level cognitive phenomenon of self-perception and identity. i hope you recognize that.

and you're entirely wrong about society being a fiction and therefore it not being real enough to matter. try telling black americans during the civil right era that society is just a fiction anyway and they just need to find meaning within themselves. it's a profane asymmetric insult for you to enjoy all the benefits of being recognized by the dominant fictions of society in the form of powerful institutions at every level of society, and then to deny that same recognition to people who are not you. meaning within fiction matters, "common delusion" matters, and it matters more and in more powerful ways than any individual can provide themselves.