• rickyk95
    53
    It seems to be that the way psychologists and psychiatrists diagnose mental illness is through conversation with the patient. The patient tells them what bothers them, what they feel, their thoughts, etc. So, if you have lost enjoyment in life, and experience constant sadness, you are diagnosed with depression (based on the things that you said to the mental health professional.) The way in which we diagnose depression seems to be way less reliable than the way that for example you would find a tumor on someones body, or a life weakening viral infection. The latter seems to have more epistemological validity than the former. What are your thoughts on this? And given this problem, can psychology really be called a science?
  • Galuchat
    809
    It seems to be that the way psychologists and psychiatrists diagnose mental illness is through conversation with the patient. — rickyk95

    Actually, mental health diagnoses are based on an interview (objective symptoms are observed) and the result of a checklist survey completed by the patient (subjective symptoms are reported). Symptoms are then mapped to a corresponding category in ICD-10, Chapter V: Mental and behavioural disorders.

    Also, Psychology (a science by virtue of the method it employs to acquire knowledge that can be rationally explained and reliably applied) is very broad (i.e., not limited to a clinical application).

    That said, there are certainly a fair number of charlatans peddling pseudo-psychology on public forums.
  • unenlightened
    9.2k
    Psychology (a science by virtue of the method it employs to acquire knowledge that can be rationally explained and reliably applied) is very broad (i.e., not limited to a clinical application).Galuchat

    It's not a very successful science. The scientific basis of medicine in other departments seems to result in cures, ameliorations, a reduction in suffering. In mental health, the exact opposite seems to happen.

    There is a very simple reason for this. In every other field, the object of study is unaffected by the theory applied to it; what the scientist thinks about electrons or fossils does not affect them at all. This cannot be said of humans. One sees the beginnings of this in physical medicine, where one must take great pains to eliminate the placebo effect in order to escape the psychological effects. But one cannot even in principle do this in psychology.

    Thus it turns out that the scientific mindset not only does not work psychologically, but is in fact a mental illness in its own right.
  • Metaphysician Undercover
    13.1k
    Also, Psychology (a science by virtue of the method it employs to acquire knowledge that can be rationally explained and reliably applied) is very broad (i.e., not limited to a clinical application).Galuchat

    I think unenlightened has the right approach here. I believe the "scientific" status of psychology is highly suspect. The scientific method verifies theories through experimentation and empirical observations of the activities in the physical world. How is it possible to account for, within the theories of psychology, the fact that the thing being observed is a free willing human being? Since free will is at the root, the foundation, of all human actions, the psychologist has no hope of any scientific understanding without a firm understanding of the nature of free will. And this we simply do not have.
  • Harry Hindu
    5.1k
    Thus it turns out that the scientific mindset not only does not work psychologically, but is in fact a mental illness in its own right.unenlightened
    So it is a mental illness to make observations and then categorize those observations? If that is the case, then every human being is mentally ill.

    It would seem to me that several philosophical stances are equivalent to a mental illness - like believing that no one but yourself exists, believing that some unseen entity loves you and that makes you important, believing that you will live forever, a gross misuse of the English language, etc.

    ...can psychology really be called a science?rickyk95
    Of course it can. It is based on observations, categorizing those observations, and sharing those observations with other psychologists in order to apply them to the masses. Psychology has been around for about 150 years and since then it has several other fields branching out from, or overlapping psychology and neuroscience - like cognitive neuroscience and physiological psychology.

    Observing your own mental states and categorizing those mental states, and then sharing those observations with others is a scientific act.
  • unenlightened
    9.2k
    Thus it turns out that the scientific mindset not only does not work psychologically, but is in fact a mental illness in its own right.
    — unenlightened
    So it is a mental illness to make observations and then categorize those observations? If that is the case, then every human being is mentally ill.
    Harry Hindu

    Science is very successful when directed outwards to the world of objects. But directed inwards at the subject that is (or isn't) scientific, it fails utterly, precisely because it must methodologically eliminate subjectivity in trying to be objective. Thus science applied to the psyche is a madness of the form of going to sea in a sieve. Sieves are great for getting the lumps out of stuff, but useless for keeping one's feet dry.
    Far and few are the lands where the Jumblies live, because they went to sea in a sieve. Not all users of sieves are mad, only those that set sail in them.
  • sime
    1.1k
    Observing your own mental states and categorizing those mental states, and then sharing those observations with others is a scientific act.Harry Hindu

    Self-categorizing one's mental state doesn't sound part of a scientific act.

    "Imagine someone saying: "But I know how tall I am!" and laying his hand on top of his head to prove it."
  • Galuchat
    809
    It's not a very successful science. — unenlightened

    The shortcomings of Clinical Psychology are acknowledged by its own practitioners. Do the so-called "hard" sciences have any shortcomings? If not, please explain mental phenomena in terms of Biology, Chemistry, or Physics.

    I would suggest the use of Physiological terms, since it is thought (by some) that Psychology can be reduced to Biology.

    I could be in favour of maintaining higher (less abstract) levels of explanation, only because it would be cumbersome to explain foreign language acquisition or culture shock in terms of quantum-mechanical interactions between elementary particles.

    However, the higher level explanations provided by Psychology are required for an exhaustive explanation of reality. These contribute new qualities (emergent properties) to mental phenomena, and are undetermined by, hence; independent of, the lower levels.
  • jkop
    893
    I see many metaphors here used against psychology, but I think they are misleading.

    The fact that experiences are ontologically subjective does not make them epistemically inaccessible. It is possible to talk meaningfully about experiences, recall, and some of that talk can be epistemically objective, supported by knowledge of physiology, chemistry and so on.
  • Cuthbert
    1.1k
    I can see that the lands where Jumblies live would be *few*, sieves being so unbuoyant, but how did they make it *far*? Oh, perhaps they set out from far away and are still far away. Yes, that must be it. That would explain why a person never meets a Jumbly.

    On the main question, we rely on conversations with others for all the measurements we make, not just assessing how we and others are feeling. Without being able to compare experiences with other people I would not know how to read a thermometer or what a thermometer is or whether the reading that I take is the same as or different from another person's reading or what kind of thing thermometers are presumed to measure. If we can reliably compare experiences of that sort and for that purpose, then I would not assume that we cannot compare experiences of mood, emotion, thought etc equally reliably and equally fallibly.
  • unenlightened
    9.2k
    Do the so-called "hard" sciences have no shortcomings?Galuchat

    They have limits. The whole notion of 'mental phenomena' is rather confused; are your posts physical phenomena or mental phenomena? I'm not sure what you are referring to.

    The shortcomings of Clinical Psychology are acknowledged by its own practitioners.Galuchat

    But they are sadly misunderstood, the way a hole in the ground might be misunderstood to be a building with shortcomings. The whole project of scientific psychology is to objectify, and thus dehumanise the person. It is thus not only impossible, but also counterproductive. It fosters a deep misunderstanding of the person, and a dehumanising and therefore maddening treatment. To try and understand others and oneself in a way that dehumanises them also dehumanises oneself, and is itself insane.

    This is not to say that psychology cannot be studied, or that people cannot be treated. It is simply to say that it must be done differently, and practitioners who are worth anything already do so.
  • Galuchat
    809
    This is not to say that psychology cannot be studied, or that people cannot be treated. — unenlightened

    By focusing on Clinical Psychology, 97% of Psychology is ignored.
  • unenlightened
    9.2k
    By focusing on Clinical Psychology, 97% of Psychology is ignored.Galuchat

    By focusing on a term that you yourself introduced, you avoid any serious response. By focusing on clinical psychology, everything else is being ignored for the moment - so the fuck what? It's the topic of the thread. But how's about addressing the argument I made which is equally applicable to any area of scientific psychology? I'll spell it out in different words for you:

    Any psychological theory, scientific or not, is an integral part of a psyche; that is it shapes the psyche. Humans are actually changed psychologically by the ways in which they regard and treat each other, and this is in turn changed by the psychological theory that they hold. Therefore, any theory that is accumulative of knowledge is an attempt to fix a nature that is radically fluid and will be as useful as nailing a river to its bed.
  • Buxtebuddha
    1.7k


    It's actually pretty easy to diagnose whether someone has depression or not. The difficulty, though, is figuring out what sort of depression someone has, why they have it, and how treatment can be applied so as to move the patient forward into a healthier future. It doesn't take a psychiatrist or a rocket scientist to tell me or anyone else that a lot of people out there are seriously mentally screwed up, and just because diagnosis and treatment doesn't always work doesn't mean we should throw everything out.

    By focusing on clinical psychology, everything else is being ignored for the moment - so the fuck what? It's the topic of the thread.unenlightened

    Uh, no it's not. Your refusal to acknowledge the practical differences between academic psychology and clinical psychology is entirely against the premise of the thread. University professors testing lab rats are not diagnosing and treating people, clinical psychologists, counselors, and therapists are, in conjunction with medical doctors.

    If you know nothing about the subject, keep your fingers still, eh?
  • jkop
    893
    There is a Wittgensteinian private language confusion at work here.sime

    Where? Are we confused when we speak about our experiences in a public language? All talk is public, one does not assume a private language by talking about one's private experiences.

    Experiences are ontologically subjective, but talk about them ontologically objective and possibly epistemically objective.

    Confusion arises from talk of the subjective and the objective which does not clearly distinguish the ontological from the epistemological (hence the many "philosophical" metaphors in this thread instead of arguments).
  • unenlightened
    9.2k
    Uh, no it's not. Your refusal to acknowledge the practical differences between academic psychology and clinical psychology is entirely against the premise of the thread.Heister Eggcart

    The topic is mental illness diagnosis, if you care to look, and I am fairly confident that that is part of clinical psychology. So kindly do not berate me for talking mainly about clinical psychology. I am well aware that there are practical differences, just as there are between medicine and medical research, but again, so the fuck what?

    If you know nothing about the subject, keep your fingers still, eh?Heister Eggcart
    I studied psychology for four years at one o them academic universities, where they play with rats, and also monkeys in the good old days. What is your qualification for wagging your fingers so strenuously?
  • BC
    13.5k
    The way in which we diagnose depression seems to be way less reliable than the way that for example you would find a tumor on someones body, or a life weakening viral infection.rickyk95

    Depression does have a specific definition (it's a collection of moods and behavior changes), but the term is also used very generally. There is a difference between "major depression" and "my life is a pile of shit and I am very unhappy about it".

    "Depression or unhappiness" generates a lot of traffic in doctor's offices, but some of the patients that report depression really do have a mood disorder called "depression".

    Consider something more specific: bi-polar or manic-depressive disorder. The visible signs of mania or severe depression do not require a patients report. Sleeplessness, severe agitation, screaming incoherently, extreme anxiety, and response to hallucinations for mania; for depression one sees flat affect, retarded movement, very slow response in speech, lack of physical care, excessive periods of sleeping, very poor task performance, and so on.

    Major and severe psychiatric conditions like paranoid schizophrenia, anxiety disorder, obsessive compulsive disorder, etc. all have obvious behavioral components.

    The diagnosis of physical maladies often begins with self-reports. If patients don't report double vision and headaches, a doctor will not order MRI or CAT scans for brain tumors. Severe headaches are invisible to MRIs or CAT scans, so a diagnosis of Migraine pretty much has to depend on patient reports. Blood tests can reveal some disorders, but not all of them, and even tumors can be mistaken for something else.
  • BC
    13.5k
    One of the problems (I think it is a problem, anyway) with psychiatric diagnosis is that way too many definitions of abnormalities have been sub-divided too often to create a very large list of disorders. Doctors and other practitioners need recognized diagnoses in order to get paid, and the DSM supplies those diagnostic numbers. The more numbers there are, the more often one can get paid for dealing with what may be extremely nebulous 'problems'.
  • Buxtebuddha
    1.7k
    The topic is mental illness diagnosis, if you care to look, and I am fairly confident that that is part of clinical psychology. So kindly do not berate me for talking mainly about clinical psychology. I am well aware that there are practical differences, just as there are between medicine and medical research, but again, so the fuck what?unenlightened

    Are you really this dumb? >:O

    I studied psychology for four years at one o them academic universities, where they play with rats, and also monkeys in the good old days. What is your qualification for wagging your fingers so strenuously?unenlightened

    You studied psychology for four years, yet you still can't figure out why it's important to distinguish between different forms of psychology. Wow. *grabs rope*
  • unenlightened
    9.2k
    What is your qualification for wagging your fingers so strenuously?
    — unenlightened

    You studied psychology for four years, yet you still can't figure out why it's important to distinguish between different forms of psychology. Wow. *grabs rope*
    Heister Eggcart

    Ah, none at all I see. Keep holding the rope.
  • Buxtebuddha
    1.7k
    Depression does have a specific definition (it's a collection of moods and behavior changes), but the term is also used very generally. There is a difference between "major depression" and "my life is a pile of shit and I am very unhappy about it".

    "Depression or unhappiness" generates a lot of traffic in doctor's offices, but some of the patients that report depression really do have a mood disorder called "depression".

    Consider something more specific: bi-polar or manic-depressive disorder. The visible signs of mania or severe depression do not require a patients report. Sleeplessness, severe agitation, screaming incoherently, extreme anxiety, and response to hallucinations for mania; for depression one sees flat affect, retarded movement, very slow response in speech, lack of physical care, excessive periods of sleeping, very poor task performance, and so on.

    Major and severe psychiatric conditions like paranoid schizophrenia, anxiety disorder, obsessive compulsive disorder, etc. all have obvious behavioral components.

    The diagnosis of physical maladies often begins with self-reports. If patients don't report double vision and headaches, a doctor will not order MRI or CAT scans for brain tumors. Severe headaches are invisible to MRIs or CAT scans, so a diagnosis of Migraine pretty much has to depend on patient reports. Blood tests can reveal some disorders, but not all of them, and even tumors can be mistaken for something else.
    Bitter Crank

    (Y)

    One of the problems (I think it is a problem, anyway) with psychiatric diagnosis is that way too many definitions of abnormalities have been sub-divided too often to create a very large list of disorders. Doctors and other practitioners need recognized diagnoses in order to get paid, and the DSM supplies those diagnostic numbers. The more numbers there are, the more often one can get paid for dealing with what may be extremely nebulous 'problems'.Bitter Crank

    This is a bit too cynical I think. Number pushing can be attributed to practically any field. To be honest, you're getting more at the fact that medical practitioners aren't themselves without problems (even though modern society holds them up now as gods.)
  • Buxtebuddha
    1.7k
    Ah, none at all I see. Keep holding the rope.unenlightened

    Only if you keep living up to your name, ;)
  • unenlightened
    9.2k
    Any chance of you dropping the ad homs now and addressing the topic?
  • Buxtebuddha
    1.7k
    I'm not addressing your topic anymore. I await the OP so the discussion can get back on track.
  • unenlightened
    9.2k
    Depression does have a specific definition (it's a collection of moods and behavior changes),Bitter Crank

    The diagnosis of physical maladies often begins with self-reports.Bitter Crank

    This is a rather important difference. In the case of physical maladies, the self report and other behaviour is explained in terms of bugs, wounds, inflammation, genes, or whatever. Absent such identifiable physical causal factors, there is a strong tendency to reach - as a last resort, for the 'psychosomatic' diagnosis.

    This good science, to look for causes of symptoms and treat them rather than the symptoms. When the causes are known, we no longer tend to call the symptoms 'mental illness'; Parkinson's, epilepsy, CJD, for examples.

    It would be nice if we could locate the causes of depression; gene therapy, or some such might become a possibility, but everything we know suggests that while there are genetic predisposing factors, and some potential environmental triggers, there is no unique physical causal agent.

    So the good scientist turns to neuroscience. And there is talk of dopamine levels and the like. But here is where the waters start to muddy. Are the chemical imbalances the cause of the depression, or the effect of the depression? Are they different things at all, or the same thing seen in different ways?

    We have a behavioural definition, and we have an associated brain state, unsurprisingly, but we still don't have a cause, and it is the lack of physical cause that makes it a classical mental illness. Exit science, muttering 'give me more research grants'.

    So we resort to psychobabble; talking therapies. There is (because it is the only possibility left) a way of looking at the world and oneself, that leads to depression - a meme. And another name for 'a way of looking at the world and oneself' is 'a psychological theory'.
  • BC
    13.5k
    This is a bit too cynical I think. Number pushing can be attributed to practically any field. To be honest, you're getting more at the fact that medical practitioners aren't themselves without problems (even though modern society holds them up now as gods.)Heister Eggcart

    I wasn't trying to be cynical, nor was I trying (here) to suggest that medical practitioners are either gods or unusually screwed up.

    If you go back a ways, say 1817, the definition of mental illness was (I am guessing here -- don't have a source) relatively simple. Over time, mental illness was differentiated into more specific diagnoses. This is useful. At some point, it started going overboard, and finding 'new' and 'different' disorders that were already listed under a different name. However, I'm not an expert on this.
  • BC
    13.5k
    So we resort to psychobabble; talking therapies. There is (because it is the only possibility left) a way of looking at the world and oneself, that leads to depression - a meme. And another name for 'a way of looking at the world and oneself' is 'a psychological theory'.unenlightened

    While there are few physical markers that exist for schizophrenia, bi-polar, psychosis, or catatonic depression--the several types of mental illness where patients need hospitalization for weeks at a time and are clearly "out of their minds" (hearing voices, having visual hallucinations, are afflicted with severe anxiety, agitation, etc.) it is the case that we are not talking psychobabble. When even high doses of major tranquilizers can't settle people down, one can conclude that one is dealing with a real problem.

    There are the major mental illnesses that afflict 1% to 2% of the population, and then there are the vague unhappinesses that afflict between 10% and 20% (at least) of the population. The major mental illnesses must have some kind of biological origin, and the many not-major mental illnesses (or not mental illnesses at all) are the result of the condition that Freud (and many others) have identified: "Happiness just isn't in the cards a good share of the time".

    Where talk therapy is helpful to people with these major mental illnesses is assisting them to cope with their serious problem that isn't going to go away, and to provide them with the comfort of an attentive listener. (And lots of ordinary people are perfectly capable of providing this kind of help.)

    For the 10% to 20%--or more--psychobabble is usually the proffered cure, along with some sort of medication.

    I am pretty sure that at least 20% of the population are quite unhappy; some of the population are profoundly unhappy. In most cases, there is nothing wrong with their "psychology". Their brains are in working order. They can concentrate, learn, remember, cope, produce, get up every day and go to work, get their laundry washed, and so on. If they are unhappy, they need to change -- their job, their family, their society, themselves, or all of the above. If they can't change, then they are going to stay unhappy, or they'll make some kind of accommodation. They don't need therapy--they need courage.
  • Metaphysician Undercover
    13.1k
    We have a behavioural definition, and we have an associated brain state, unsurprisingly, but we still don't have a cause, and it is the lack of physical cause that makes it a classical mental illness. Exit science, muttering 'give me more research grants'.unenlightened

    I think the talk of a "brain state" is somewhat misleading. "State" implies static, but the brain is continuously active. Ideas, beliefs, and concepts can be understood as static things, but I think it is a mistake to try to understand the brain in terms of states. Physicists have encountered the very same problem. They talk about quantum states, but what is being referred to is a bunch of activity, and not a state at all. So it is impossible for them to understand what they are talking about.
  • unenlightened
    9.2k
    The major mental illnesses must have some kind of biological origin, and the many not-major mental illnesses (or not mental illnesses at all) are the result of the condition that Freud (and many others) have identified: "Happiness just isn't in the cards a good share of the time".Bitter Crank

    I once spent six weeks with a schizophrenic in the full flowering of a manic episode, and without drugs. It is a distressing, baffling, frightening condition for all parties. In no sense am I a mental illness denier. However, to say that it must have a biological origin is to deny strong evidence that there is a significant social environment factor. It is well established, for example, that the the status of immigrant is a significant risk; there are also known genetic risk factors, but there is no identifiable biological cause. The situation is similar to cancers, except there is zero understanding of the (possibly) random factors that decide whether the risk will be realised or not. Not for the want of looking.

    And as you indicate, there are similar but milder versions, hearing voices or seeing hallucinations, for examples, that some people manage to live with and still function in society, with or without medication. The spectrum nature of these things make your distinctions and percentages somewhat arbitrary.

    I am pretty sure that at least 20% of the population are quite unhappy; some of the population are profoundly unhappy. In most cases, there is nothing wrong with their "psychology". Their brains are in working order. They can concentrate, learn, remember, cope, produce, get up every day and go to work, get their laundry washed, and so on. If they are unhappy, they need to change -- their job, their family, their society, themselves, or all of the above. If they can't change, then they are going to stay unhappy, or they'll make some kind of accommodation. They don't need therapy--they need courage.Bitter Crank

    But lack of courage is a failing of the psyche. What the above illustrates is that the only measure we have of mental health is a social functional one. A few million men go off to shoot each other in trenches, and we think them sane, but if one runs down the street wielding an axe, we think him mad.

    I think the talk of a "brain state" is somewhat misleading. "State" implies static, but the brain is continuously active. Ideas, beliefs, and concepts can be understood as static things, but I think it is a mistake to try to understand the brain in terms of states.Metaphysician Undercover

    I agree. It is just a shorthand for talking about the kind of global factors of neurotransmitter levels and such, that seem to be the rough physical analogues of 'moods'. I don't think brain talk in general is very illuminating, but one has to engage with it when conversing with physicalists.
  • sime
    1.1k
    I am pretty sure that at least 20% of the population are quite unhappy; some of the population are profoundly unhappy. In most cases, there is nothing wrong with their "psychology". Their brains are in working order. They can concentrate, learn, remember, cope, produce, get up every day and go to work, get their laundry washed, and so on. If they are unhappy, they need to change -- their job, their family, their society, themselves, or all of the above. If they can't change, then they are going to stay unhappy, or they'll make some kind of accommodation. They don't need therapy--they need courage.Bitter Crank

    lol. So in other words, if 'perfectly healthy' miserable people continue to kill themselves and others because their psychological needs are ignored by psychiatry who should only concentrate on a minority of major depression disorder cases, then society's response should be a post-hoc sermon of "oughts".
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