[doktrin]

If I understand the parent correctly, he agrees with a certain Thomas Szasz' [1] opinions on psychiatry. Central among his opinions is the assertion that mental illness is a "myth" due to the lack of observable changes at the cellular level (or at autopsy), and that mental illness patients are "malingerers".

My opinion : the dude sounds like an ass and his opinions are eye-rolling.

[1] http://en.wikipedia.org/wiki/Thomas_Szasz

[einhverfr]

Mental illness is a really tough thing to discuss in an objective way. See the debates about the DSM-5. I personally think mental health and mental illness are socially constructed.

This being said, the experiences relating to mental illness are very real. The larger question is how we make sense of them as a society. For something like depression how much of the illness is cognitive? How much is biological? How much is social? Somehow that last question never gets asked.

[doktrin]

> I personally think mental health and mental illness are socially constructed.

> This being said, the experiences relating to mental illness are very real.

What's the logical basis for this pair of assertions? How can the "experience" be real while the illness is not?

[einhverfr]

> What's the logical basis for this pair of assertions? How can the "experience" be real while the illness is not?

What is the difference in value between a $5 bill and a $20 bill? Is this difference not both real and socially constructed?

I.e. why do you assume that what is socially constructed can't be real?

The question is, really, what goes into the experience and what are the limits to the current science. If it is socially constructed, the science is limited to the current cultural context.

[doktrin]

> I.e. why do you assume that what is socially constructed can't be real?

I'm assuming you wouldn't say "pneumonia is socially constructed". If you did, I would read that as "pneumonia isn't real".

> The question is, really, what goes into the experience and what are the limits to the current science. If it is socially constructed, the science is limited to the current cultural context.

I honestly don't know what you're trying to say.

[einhverfr]

> I'm assuming you wouldn't say "pneumonia is socially constructed". If you did, I would read that as "pneumonia isn't real".

That's a complicated question. I probably would not say pneumonia is socially constructed. I would say that health insurance is, just like any other contract.

> I honestly don't know what you're trying to say.

Ok. Let's try again.

The science of mental health, like all science, rests on assumptions which are basically unscientific aspects of our cultural worldview. The creation of scientific theories is, after all, a creative endeavor and one cannot separate the unscientific assumptions that go into interpreting the data from the theory (see Heisenberg, "Physics and Philosophy").

Now, when studying things like physics this is a significant problem. We have multiple "true" theories which are ontologically and mathematically incompatible (see for example quantum mechanics and general relativity). This works in the physical sciences because truth is given a limited meaning, namely something that has predictive value. Thus two propositions can be both true, scientifically, even of they both can't be true logically. A simple way to paraphrase this is that scientific theories are merely models of behavior and are true to the extent that the model's behavior matches the observed behavior, but do not imply any deeper truth than that. (This is exactly parallel to correlation vs causation. Just because the behavior correlates does not mean that the model functions exactly like the modelled.)

This problem is manageable in the physical sciences but it is totally unmanageable when studying the human condition. The problem is that people exist in a social context and that is formative regarding the brain. Therefore, if you are studying mental health of middle class Americans, you have no real expectation that the findings will be perfectly applicable to, say, the aborigines in Australia.

This has some important ramifications. It means that the science can never tell us how culture fits into mental illness. The science has to start off with a assumptions about mental health and illness that are by definition cultural. These definitions and assumptions are not beyond question, and therefore the conclusions one can draw from the science is limited culturally, temporally, and geographically.

[doktrin]

That's a cogent explanation. I can see where you're coming from, and I appreciate you taking the time to elaborate.

> This problem is manageable in the physical sciences but it is totally unmanageable when studying the human condition. The problem is that people exist in a social context and that is formative regarding the brain. Therefore, if you are studying mental health of middle class Americans, you have no real expectation that the findings will be perfectly applicable to, say, the aborigines in Australia.

That's reasonable.

> This has some important ramifications. It means that the science can never tell us how culture fits into mental illness. The science has to start off with a assumptions about mental health and illness that are by definition cultural. These definitions and assumptions are not beyond question, and therefore the conclusions one can draw from the science is limited culturally, temporally, and geographically.

I agree.

Your more verbose argument is reasonable and sound, and yet I find it inconsistent with your original statement.

Specifically :

"the conclusions one can draw from the science is limited culturally, temporally, and geographically"

vs.

"mental illness is socially constructed"

Perhaps I'm interpreting it too literally, but I can't find the evidence supporting that strong assertion.

For instance, most of the literature I could find does agree that there is a biochemical basis for schizophrenia. The literature also agrees that how it manifests, including prognosis and rates of remission, differs across cultures. Thus, it seems reasonable to state that certain beliefs regarding mental health are social constructs - but if there is a physical basis for the expression of the disease I don't see how it can be said that it itself is socially constructed.

For any interested, there's an interesting NYT piece on the subject[1]

[1] http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?p...

[Mz]

That last is very hard to ask because the vast majority of people are raised with either a guilt or shame model, thus asking it comes across as finger pointing.

Anyway, I need to go so cannot elaborate.

[einhverfr]

It's not a question of finger pointing so much as asking what social structures we have that make this harder.

You mentioned your kids live with you. How hard would it be if they didn't? Does the fact that we stigmatize adults living with their parents and make mental illness into an individual problem contribute to it?

[Mz]

People who are raised with a shame or guilt model will read fingerpointing into what you say whether it is there or not.

Given the problems I have, if they did not live with me, I likely would have died already.