[km3k]

I haven't read the book, but from your summary it sounds like the argument is that for illnesses that we don't yet understand well enough to cure or even have a potential cure, we should use a different word. That sounds pedantic.

There's many non-mental diseases that we don't yet understand fully enough to know how to cure completely. There are many diseases where there are varied causes of the disease, where we are still learning these causes, and still learning what could be a cure. Should all these not be called an illness too?

The disease like this that I'm most familiar with is Cystic Fibrosis. 35 years ago, doctors had no idea what caused it. Now we know it is genetic. However, the disease is caused by many different possible combinations of gene mutations and we're still discovering more that can cause it. There's currently over a thousand gene mutations that cause Cystic Fibrosis. While a lot of progress in slowing disease progression has been made, there is no cure. We're not even certain about what would be needed for a full cure as science is still learning about the full extent of the disease. Cystic Fibrosis does not meet your criteria for an illness either. Should we not call it as such? I think that would be absurd. It is clearly an illness.

Just because we don't fully understand a disease yet doesn't mean it can't be called an illness. If you want to come up with a new word that can clarify the fact that we don't fully understand it yet, I guess that's fine, but I don't like confusing people by trying to deny the common understanding of a word.

[elbasti]

> but I don't like confusing people by trying to deny the common understanding of a word.

I think that's actually the crux of the argument. The phrase "mental illness" IS the perversion of a common understanding of a word. When people hear "illness" they think "thing that is broken". Is a runny nose an illness? No, the flu is an illness.

I don't think it's about whether we fully understand the cause or not; I think it's about whether or not we think there probably is a single, physical cause.

So we absolutely should call Cystic Fibrosis an illness even if we don't know the cause, because we think there probably IS one. And heck, there may be two causes! And then... well, then it would be TWO illnesses with similar symptoms, not one.

At this point I'm straying from the book because I don't remember it too well, so this is editorializing: I don't think that holds for many mental illnesses.

"Depression"--do we think there's one, or few, underlying physical causes of it? Highly doubtful. And we know it's highly doubtful because the treatments that make the symptoms go away are so varied in their mechanisms of action and effectiveness. Exercise. Sunlight. Changing jobs. Medication. Time. Talk therapy. All these things "work", to some degree or another, but the odds that they are targeting the same underlying, malfunctioning, physical mechanism are very slim. So one would say "depression is not an illness, the same way a runny nose is not an illness. It's a pattern."

[Digit-Al]

If I'm understanding your argument correctly then you are basically saying that what we currently call mental illnesses are in fact symptoms and we have yet to determine what they are symptoms of.

Would that be a correct interpretation of your thoughts?

[Kalium]

> I haven't read the book, but from your summary it sounds like the argument is that for illnesses that we don't yet understand well enough to cure or even have a potential cure, we should use a different word. That sounds pedantic.

Yes. You are absolutely correct! It is pedantic.

It's also pedantry in pursuit of a point. By characterizing a group of symptoms as a disease, we coerce it into the mental model of a germ-caused disease. Which is to say there's one unifying and underlying cause, which can be ideally be addressed in a unified way that reflects the singular cause.

Szasz would not agree that Cystic Fibrosis is an illness. He would argue that it's thousands of illnesses with the same set of symptoms. His point would be that calling Cystic Fibrosis "an illness" is misleading and confuses people by denying the common understanding of a word.

The underlying point from Szasz being that illnesses need to be conceptualized in a meaningfully narrow way so that causes can be identified and a way to address them found. Otherwise medicine might wind up deeply invested in a quest to cure coughing and ignoring what coughing might be a symptom of.

Again, you're absolutely correct. The point at hand is incredibly pedantic. Might it also, perhaps, be a useful one as well?