7 ms·

> Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understa

> Also, psychology is a dying profession. A mental illness is described as a set of symptoms manifested from physical biological systems we don't fully understand yet. But once understood, psychology becomes obsolete. That's a fundamentally reductionist perspective and assumes everything is biological in its etiology? For example, you could say we don't need a justice system once we have the biology worked out, or arts, or sports. At some level it's a fundamentally authoritarian argument as well: if you have the biology worked out, what's to keep the holders of power from altering people to whatever norm they want? Having the biology completely worked out won't magically reveal natural disorder states. The biological explication of a behavior doesn't obviate the need to have some norm for intervention decisions. Biology doesn't have norms, psychosocial systems have norms. Non-behavioral medicine is still full of ethics. And that doesn't even get into issues about whether you could ever identify any biological substrate as synonymous with a human experiential state or history.

0xcde4c3db 2y ago
The shape of that argument works equally well for unduly centering psychosocial mechanisms, though. That's how we got pseudoscientific garbage like the "refrigerator mother" theory of autism, the "anal retentive" theory of OCD, "tabula rasa" theories of social behavior, and so on. Maybe what I'm getting at is that double standards abound when it comes to mental illness, and it's fucking exhausting work to even attempt to avoid them. I'm not blaming anybody (least of all you). I suppose it's just one of those Lovecraftian/Cronenbergesque sorts of things where once you see it, the world never quite makes sense again.
- faeriechangling 2y ago
  Regarding the refrigerator mother theory, autism as a diagnosis has expanded over 100x since that was first debunked and I have no idea why people have any confidence whatsoever that bad parenting cannot cause Autism. This was from a time before people as functional as "Rain Man" were the norm. Twin/Sibling studies were used to debunk this but twin studies don't totally control for shared environmental influences. It seems more like a politically controversial thing than something which has been seriously scientifically examined either way. It can't be the smoking gun only cause but I see no actual evidence that it's impossible that parental neglect can't be a contributing cause. I will note that it is more politically convenient to simply blame a child's inherent defects instead of parental neglect, since the children relative to their parents lack political power. I'll also point out that contemporary autism diagnosis relies on parent reports to establish a diagnosis, and people often only get diagnosed if a parent actively seeks out a diagnosis. Autism is also based on observation, if somebody was socially impaired due to neglect, how exactly would an examiner know the difference between that and somebody being socailly impaired due to say epigenetics? I would be rather surprised if who raised somebody doesn't have a rather large impact on if somebody will end up with an autism diagnosis. As in an especially well resourced and attentive parent might mean somebody who would be considered autistic might not be, and somebody who was overstretched and inattentive might have a child who would otherwise not be considered autistic be considered autistic.
deanresin 2y ago
If you understand the systems that manifest a mental illness then you can treat it more directly with medicine, you can test for the mental illness directly with physical sampling. We've already seen this shift from psychology to medicine with the invention of anti-depressants. Less people are seeking counsel from psychologists and instead just getting a prescription from their doctor. While the systems and even antidepressants aren't fully understood we have seen the shift away from psychology due to advances in treating the physical biological system. Simply projecting this natural trend to its limit is not reductionist IMO.
- xboxnolifes 2y ago
  Even if we, as humans, collectively have the knowledge to reduce something down to some fundamental axioms, it does not mean there is no value to separating the disciplines. All fields of engineering are fundamentally just physics, math, and some civil knowledge. Likewise, being a biologist doesn't necessarily qualify you to be a doctor.
- triumphblr 2y ago
  Sure, people are prescribed psychotropic medication for depression. But as more stringent scrutiny has been paid to those, the effect sizes have gone down over time and with more adjustment for publication bias. There's no shortage of demand for psychotherapy services, and head-to-head they are comparable and both in combination fare best. There is no blood test for depression, and if there is, no one uses it in practice. Sure, we're seeing this sort of thing with alzheimer's dementia but that's one thing that has never been amenable to psychotherapy, and even then there's a lot of psychotherapy around it in a palliative and coping sense because it's still uncurable. FWIW, I was involved in the creation of DSM-5 so I'm very familiar with the whole area of mental healthcare.
  - fakeart 2y ago
    How familiar are you with factor analysis? I worry that because the best mathematical minds are often not attracted to psychology as a field, that psychologists as a group are somewhat blind to implications of statistical choices and assumptions that they inherit or make.

0xcde4c3db 2y ago

The shape of that argument works equally well for unduly centering psychosocial mechanisms, though. That's how we got pseudoscientific garbage like the "refrigerator mother" theory of autism, the "anal retentive" theory of OCD, "tabula rasa" theories of social behavior, and so on. Maybe what I'm getting at is that double standards abound when it comes to mental illness, and it's fucking exhausting work to even attempt to avoid them. I'm not blaming anybody (least of all you). I suppose it's just one of those Lovecraftian/Cronenbergesque sorts of things where once you see it, the world never quite makes sense again.

faeriechangling 2y ago
Regarding the refrigerator mother theory, autism as a diagnosis has expanded over 100x since that was first debunked and I have no idea why people have any confidence whatsoever that bad parenting cannot cause Autism. This was from a time before people as functional as "Rain Man" were the norm. Twin/Sibling studies were used to debunk this but twin studies don't totally control for shared environmental influences. It seems more like a politically controversial thing than something which has been seriously scientifically examined either way. It can't be the smoking gun only cause but I see no actual evidence that it's impossible that parental neglect can't be a contributing cause. I will note that it is more politically convenient to simply blame a child's inherent defects instead of parental neglect, since the children relative to their parents lack political power. I'll also point out that contemporary autism diagnosis relies on parent reports to establish a diagnosis, and people often only get diagnosed if a parent actively seeks out a diagnosis. Autism is also based on observation, if somebody was socially impaired due to neglect, how exactly would an examiner know the difference between that and somebody being socailly impaired due to say epigenetics? I would be rather surprised if who raised somebody doesn't have a rather large impact on if somebody will end up with an autism diagnosis. As in an especially well resourced and attentive parent might mean somebody who would be considered autistic might not be, and somebody who was overstretched and inattentive might have a child who would otherwise not be considered autistic be considered autistic.

deanresin 2y ago

If you understand the systems that manifest a mental illness then you can treat it more directly with medicine, you can test for the mental illness directly with physical sampling. We've already seen this shift from psychology to medicine with the invention of anti-depressants. Less people are seeking counsel from psychologists and instead just getting a prescription from their doctor. While the systems and even antidepressants aren't fully understood we have seen the shift away from psychology due to advances in treating the physical biological system. Simply projecting this natural trend to its limit is not reductionist IMO.

xboxnolifes 2y ago
Even if we, as humans, collectively have the knowledge to reduce something down to some fundamental axioms, it does not mean there is no value to separating the disciplines. All fields of engineering are fundamentally just physics, math, and some civil knowledge. Likewise, being a biologist doesn't necessarily qualify you to be a doctor.
triumphblr 2y ago
Sure, people are prescribed psychotropic medication for depression. But as more stringent scrutiny has been paid to those, the effect sizes have gone down over time and with more adjustment for publication bias. There's no shortage of demand for psychotherapy services, and head-to-head they are comparable and both in combination fare best. There is no blood test for depression, and if there is, no one uses it in practice. Sure, we're seeing this sort of thing with alzheimer's dementia but that's one thing that has never been amenable to psychotherapy, and even then there's a lot of psychotherapy around it in a palliative and coping sense because it's still uncurable. FWIW, I was involved in the creation of DSM-5 so I'm very familiar with the whole area of mental healthcare.
- fakeart 2y ago
  How familiar are you with factor analysis? I worry that because the best mathematical minds are often not attracted to psychology as a field, that psychologists as a group are somewhat blind to implications of statistical choices and assumptions that they inherit or make.