7 ms·

> Just because you can't identify what's going wrong to make someone's car have unresponsive steering (the etiology), doesn't mean you can't precisely identify

> Just because you can't identify what's going wrong to make someone's car have unresponsive steering (the etiology), doesn't mean you can't precisely identify the car as having unresponsive steering (the symptoms.) Except in this case there is a (vague) diagnosis - something is wrong with the car's computer (psychological issues). > Psychology is just fine at recognizing symptoms (and complexes of symptoms that go together, a.k.a. "syndromes") You don't need psychology to recognise symptoms. Unless you're saying psychology has it's own set of symptoms and it's own terminology - which is just a truism. > and also very good at treating symptoms/syndromes, such that they go away. Very debatable, and very provably false for most of psychology's existence. > Often, an understanding of the etiology isn't involved, How often? > but also isn't needed, because it's the symptoms/syndrome that are the problem, and the underlying pathology is otherwise benign. So,the symptoms are a problem, but the causes of the symptoms are not? How could you claim that the 'underlying pathology is benign' without even knowing what it is? Imagine if this level of rigour was applied to cancer - 'here take these sedatives and painkillers to get rid of your symptoms... don't worry the causes are totally benign'. It's absurd. > There're very few psychological diseases that have an organic origin, where treating the symptoms but not the disease will lead to the disease progressing and killing you. Except you really have no idea how many 'psychological diseases' could be progressing and/or affecting you while you mask the symptoms. How do you know such a disease isn't present and progressing, if, as you said, you aren't even able to identify the disease if it existed.

derefr 5y ago
> You don't need psychology to recognise symptoms. Unless you're saying psychology has it's own set of symptoms and it's own terminology - which is just a truism. Psychology precisely defines syndromes (clusters of symptoms), and then, in terms of syndromes, provides both: • tests qualifying patients into those syndromes (usually in the form of various rating scales) • specific flowcharts for known-effective treatments for patients qualified into a given syndrome It's not the rigor of physics, but rather the rigor of engineering or civic planning: making rules for doctors to follow that have been found in clinical practice to optimize for population-wide outcomes. > How could you claim that the 'underlying pathology is benign' without even knowing what it is? Because we have figured out what the underlying pathology is in many (not the majority, but many) cases, and almost every underlying pathology we've discovered is something benign: e.g. a genetic mutation that causes your synapses to produce less of some messenger-chemical. Such mutations have no long-term effect on your health, other than affecting your psychology. (And most of the cases we don’t understand present the same, are treated the same, and have the same long-term health outcomes if treated or ignored, and so are very likely to be similar in etiology to known diseases, despite not having yet been specifically researched.) Also, as I said, psychiatrists pre-screen for non-benign pathologies first, often too widely. You can't get diagnosed with clinical depression (by a psychiatrist who's doing their job) until you've been checked for vitamin deficiencies, hypothyroidism, anemia, diabetes, etc. Even in cases where you have 100% of the symptoms of clinical depression, including ones that have no organic basis. They'll still do the pre-screen, just to be sure you don’t have clinical depression and one of those things. But once you're known to not have any of the known-malignant pathologies, then they can and will treat the symptoms, because at that point the only problem they have left to treat is the symptoms. (What else would you expect them to do? Drill a hole in your skull to biopsy your brain tissue, to figure out what step in amine metabolism is failing—just to end up with the same treatment they’d get to from looking at the symptoms?) > Except you really have no idea how many 'psychological diseases' could be progressing and/or affecting you There is the simple observation that these syndromes aren't degenerative. People can have e.g. untreated ADHD all their lives, and they won't live less long or end up in the hospital more often than people without ADHD. That’s despite ADHD being a syndrome with potentially dozens of etiologies. Everything that causes that cluster of symptoms, and only that cluster of symptoms, is equally non-degenerative, because it’s all equally being expressed solely as the same kind of non-long-term-harmful down-line effect. A degenerative neurological disease makes itself pretty obvious. Neurosyphilis is easy to recognize the symptoms of, to the point that even doctors in the 1700s could make the correlation that patients with that set of symptoms at age 60, were the same people having a lot of casual sex at age 20. > while you mask the symptoms When we treat a syndrome, what we're treating for usually is our best understanding of the etiology. Sometimes we're "sawing off one leg to make it even with the other" (e.g. you have too few dopamine receptors, so instead of telling your brain to make more — which we don't know how to do — we tell your brain to make less dopamine), but the treatment chosen is still putting the upstream system into a new (and beneficial!) equilibrium state, rather than “masking” down-line symptoms in the way that e.g. painkillers do. (Though I would note that even painkillers are therapeutic in some cases — as often pain itself can have negative short- or long-term consequences, e.g. acute inflammation or acute increase in blood pressure in response to the pain. A non-negligible part of the reason that people are given opioids when they’re in severe pain, is to decrease the risk of them having a heart attack or going into shock.)
- mioasndo 5y ago
  > It's not the rigor of physics, but rather the rigor of engineering or civic planning: I would say engineering has more rigour because almost everything that really matters is based on rigorous science. Engineering also includes a certain amount of artistry, but that's generally within a rigorous framework that allows this. But, yeah, as I said, psychology is pseudo-science. > Because we've figured out what the underlying pathology is many (not the majority, but many) cases Again, how many cases? If you've figured out the underlying pathology for 1% of cases (which is still many), how can you claim that underlying pathology is 'almost always benign'? > and almost every underlying pathology we've discovered is something benign: e.g. a genetic mutation that causes your synapses to produce less of some messenger-chemical. Such mutations have no long-term effect on your health, other than affecting your psychology. First of all I would question the accuracy of these diagnoses. Second, I would question the classification of these pathologies as benign - a more accurate statement is probably 'we don't know'. Third, you say 'other than affecting your psychology' - so they often do actually have long term effects on the person? > Like I said, psychiatrists pre-screen for non-benign pathologies first, often too widely. You can't get diagnosed with clinical depression (by a psychiatrist who's doing their job) until you've been checked for vitamin deficiencies, hypothyroidism, anemia, diabetes, etc. Even in cases where you have 100% of the symptoms of clinical depression, including ones that have no organic basis. They'll still do the pre-screen, just to be sure. This is the only reason why psychology is even able to exist - because all of the heavy lifting is done in the realm of real science, and once real, understood pathologies are excluded the psychologists/psychiatrists can do their thing. That is, until yet another real pathology is discovered and the guidelines have to be updated such that psychologists don't end up mistreating people with the condition as they were up until then. > But once you're known to not have any of the known-malignant pathologies, then they can and will treat the symptoms, because at that point the only problem they have left to treat is the symptoms. So, basically, once the real medicine and science find they cannot solve the problem, the patient is left with the psychologist, who drugs the patient to mask the symptoms? > (What else would you expect them to do? Biopsy your brain?) Well, I don't expect a psychologist to have enough expertise for a biopsy, but could I expect to at least have a couple holes drilled in my skull, or maybe some electroshock therapy? > There's also just by the simple observation that these syndromes aren't degenerative. People can have e.g. untreated ADHD all their lives, and they won't live less long or end up in the hospital more often than people without ADHD. ADHD isn't a pathology, and 'live less long & end up in the hospital more' are not the only criteria I would consider required to label a disease as benign - they must have ongoing issues affecting their qualify of life in order to be diagnosed with ADHD in the first place. That being said, your statement is a pretty good argument for why psychology is irrelevant. > When we treat a syndrome, what we're treating for usually is our best understanding of the etiology. When you say 'our best understanding' you mean a psychologists best understanding? The question is how good is this 'best understanding' really? There are many different fields involved in modern medicine - biology, chemistry, neuroscience, physics, statistics, etc. What does psychology add? From where I'm sitting it adds absolutely nothing, and is far less rigorous.

derefr 5y ago

> You don't need psychology to recognise symptoms. Unless you're saying psychology has it's own set of symptoms and it's own terminology - which is just a truism. Psychology precisely defines syndromes (clusters of symptoms), and then, in terms of syndromes, provides both: • tests qualifying patients into those syndromes (usually in the form of various rating scales) • specific flowcharts for known-effective treatments for patients qualified into a given syndrome It's not the rigor of physics, but rather the rigor of engineering or civic planning: making rules for doctors to follow that have been found in clinical practice to optimize for population-wide outcomes. > How could you claim that the 'underlying pathology is benign' without even knowing what it is? Because we have figured out what the underlying pathology is in many (not the majority, but many) cases, and almost every underlying pathology we've discovered is something benign: e.g. a genetic mutation that causes your synapses to produce less of some messenger-chemical. Such mutations have no long-term effect on your health, other than affecting your psychology. (And most of the cases we don’t understand present the same, are treated the same, and have the same long-term health outcomes if treated or ignored, and so are very likely to be similar in etiology to known diseases, despite not having yet been specifically researched.) Also, as I said, psychiatrists pre-screen for non-benign pathologies first, often too widely. You can't get diagnosed with clinical depression (by a psychiatrist who's doing their job) until you've been checked for vitamin deficiencies, hypothyroidism, anemia, diabetes, etc. Even in cases where you have 100% of the symptoms of clinical depression, including ones that have no organic basis. They'll still do the pre-screen, just to be sure you don’t have clinical depression and one of those things. But once you're known to not have any of the known-malignant pathologies, then they can and will treat the symptoms, because at that point the only problem they have left to treat is the symptoms. (What else would you expect them to do? Drill a hole in your skull to biopsy your brain tissue, to figure out what step in amine metabolism is failing—just to end up with the same treatment they’d get to from looking at the symptoms?) > Except you really have no idea how many 'psychological diseases' could be progressing and/or affecting you There is the simple observation that these syndromes aren't degenerative. People can have e.g. untreated ADHD all their lives, and they won't live less long or end up in the hospital more often than people without ADHD. That’s despite ADHD being a syndrome with potentially dozens of etiologies. Everything that causes that cluster of symptoms, and only that cluster of symptoms, is equally non-degenerative, because it’s all equally being expressed solely as the same kind of non-long-term-harmful down-line effect. A degenerative neurological disease makes itself pretty obvious. Neurosyphilis is easy to recognize the symptoms of, to the point that even doctors in the 1700s could make the correlation that patients with that set of symptoms at age 60, were the same people having a lot of casual sex at age 20. > while you mask the symptoms When we treat a syndrome, what we're treating for usually is our best understanding of the etiology. Sometimes we're "sawing off one leg to make it even with the other" (e.g. you have too few dopamine receptors, so instead of telling your brain to make more — which we don't know how to do — we tell your brain to make less dopamine), but the treatment chosen is still putting the upstream system into a new (and beneficial!) equilibrium state, rather than “masking” down-line symptoms in the way that e.g. painkillers do. (Though I would note that even painkillers are therapeutic in some cases — as often pain itself can have negative short- or long-term consequences, e.g. acute inflammation or acute increase in blood pressure in response to the pain. A non-negligible part of the reason that people are given opioids when they’re in severe pain, is to decrease the risk of them having a heart attack or going into shock.)

mioasndo 5y ago
> It's not the rigor of physics, but rather the rigor of engineering or civic planning: I would say engineering has more rigour because almost everything that really matters is based on rigorous science. Engineering also includes a certain amount of artistry, but that's generally within a rigorous framework that allows this. But, yeah, as I said, psychology is pseudo-science. > Because we've figured out what the underlying pathology is many (not the majority, but many) cases Again, how many cases? If you've figured out the underlying pathology for 1% of cases (which is still many), how can you claim that underlying pathology is 'almost always benign'? > and almost every underlying pathology we've discovered is something benign: e.g. a genetic mutation that causes your synapses to produce less of some messenger-chemical. Such mutations have no long-term effect on your health, other than affecting your psychology. First of all I would question the accuracy of these diagnoses. Second, I would question the classification of these pathologies as benign - a more accurate statement is probably 'we don't know'. Third, you say 'other than affecting your psychology' - so they often do actually have long term effects on the person? > Like I said, psychiatrists pre-screen for non-benign pathologies first, often too widely. You can't get diagnosed with clinical depression (by a psychiatrist who's doing their job) until you've been checked for vitamin deficiencies, hypothyroidism, anemia, diabetes, etc. Even in cases where you have 100% of the symptoms of clinical depression, including ones that have no organic basis. They'll still do the pre-screen, just to be sure. This is the only reason why psychology is even able to exist - because all of the heavy lifting is done in the realm of real science, and once real, understood pathologies are excluded the psychologists/psychiatrists can do their thing. That is, until yet another real pathology is discovered and the guidelines have to be updated such that psychologists don't end up mistreating people with the condition as they were up until then. > But once you're known to not have any of the known-malignant pathologies, then they can and will treat the symptoms, because at that point the only problem they have left to treat is the symptoms. So, basically, once the real medicine and science find they cannot solve the problem, the patient is left with the psychologist, who drugs the patient to mask the symptoms? > (What else would you expect them to do? Biopsy your brain?) Well, I don't expect a psychologist to have enough expertise for a biopsy, but could I expect to at least have a couple holes drilled in my skull, or maybe some electroshock therapy? > There's also just by the simple observation that these syndromes aren't degenerative. People can have e.g. untreated ADHD all their lives, and they won't live less long or end up in the hospital more often than people without ADHD. ADHD isn't a pathology, and 'live less long & end up in the hospital more' are not the only criteria I would consider required to label a disease as benign - they must have ongoing issues affecting their qualify of life in order to be diagnosed with ADHD in the first place. That being said, your statement is a pretty good argument for why psychology is irrelevant. > When we treat a syndrome, what we're treating for usually is our best understanding of the etiology. When you say 'our best understanding' you mean a psychologists best understanding? The question is how good is this 'best understanding' really? There are many different fields involved in modern medicine - biology, chemistry, neuroscience, physics, statistics, etc. What does psychology add? From where I'm sitting it adds absolutely nothing, and is far less rigorous.