On Tue, 25 Apr 2000 17:38:44 +0100, you wrote:
>Ian,
>
>
>
>
>> > > I think insanity is a largely misunderstand subject.
>> >
>> >And, excuse my impertinence, on what evidence do you base such a
>statement?
>> >Exactly how much work have YOU put into understanding mental illness? And
>> >how much work have you put into gathering the opinions of others of
>mental
>> >illness?
>> >
>>
>> Smoke screen.
>>
>> I could equally debunk the opinions of psychiatrists by saying that
>> they are financially dependant upon the existence of <treatable>
>> mental illness and therefore that their opinions are suspect.
>
>
>Agreed, we all have agendas. The best we can do is be aware of them and make
>others aware of them. The original comment shows a failure to do either.
>
>
>> Ever notice how quickly the workers in nuclear plants are to ignore
>> the effects of radiation on TV news shows?
>
>Point being?
That people get defensive when we try to take away their rice-bowl. I
could equally have used to point of drugs tzars. People who make their
living out of a status quo tend to be quick to defend it. A case of
inertia I guess.
>
>>
>> More smoke. You are not by any chance the child of a schoolteacher?
>
>
>Now now. I was just being honest with the original commenter (Geoff) in
>explaining why i found his comments difficult to accept. There is a very
>interesting conversation to be had here but it behoves people to get at
>least try to get their facts straight.
Well I disagree. I find people who start to belabour grammar and
spelling in e-mail to be more than sightly irritating. The implication
is that the basis of the argument is as unsound as the grammar and
spelling. Often this is not the case.
>
>> >Beyond that you make no real statement beyond the belief that the
>boundaries
>> >of mental illness are a human construct. Has anyone ever said otherwise?
>The
>> >normal curve (by means of which individuals are deemed 'sane' or not) is,
>by
>> >definition, a human invention. It attempts to be descriptive, applying
>rules
>> >('normalisation') where previously there was arbitration.
>
>This is my major point. You seem to have missed it.
>
>> >> I believe
>> >> insanity did not exist in ancient times when ape-men roamed the earth.
>> >
>> >With respect, your 'beliefs' are irrelevant in regard to historical
>> >accuracy. If you can show evidence that this is case, we may be able to
>have
>> >a serious discussion on this topic.
>>
>> The hypothesis stands undisputed. If you wish to debunk the hypothesis
>> it is your place to offer evidence which might illustrate that the
>> hypothesis is in error.
>
>Eh? In my world evidence is first offered in support of an hypothesis, then
>we can begin discussion. I am not about to dispute his BELIEF in something
>as I trust he is correct that these are his beliefs.
>
Given that you accept that insanity is by definition a human social
construct I can't see why you chose to suggest that evidence needs to
be offered to support the belief. If there is no defined "normal" how
can there be a deviation from that "normal"?
Apart from diagnosis of behaviours and beliefs I'm not aware of there
being a way of determining mental illness after death. What evidence
would you expect from pre literate society? It would seem that what we
now consider mental illness was looked upon as divine inspiration in
the past. Our mentally ill being our ancestors shaman.
If your case is that "psychosis" existed I do not believe that the
original post was suggesting that it did not. It was suggesting that
we <society> used a different paradigm into which we fit the
experience of psychosis. We now consider "normal" to be the superior
condition (whilst many of our best and brightest chase psychosis in
pills and other chemicals) where we once weighed these conditions by
their fruits. If you will pardon the pun.
>> in any case, look to folklore. In the past someone wandering into town
>> describing having seen faeries or having a conversation with God was
>> taken in stride. Those who were truly experiencing problems would have
>> died in a world much less sterile than the current one.
>>
>> Were a Jesus Christ, Joan of Arc, Buddha character to walk into a
>> psych ward for an evaluation do any of us believe that, barring divine
>> intervention, they would be evaluated as "normal"?> >
>
>
>Indeed. This is the interesting point. Does society abuse the concept of
>mental illness in an effort to reinforce the status quo?
I think that the evidence is staggeringly in favour of this
conclusion. The mentally ill have been used as guinea pigs for medical
science throughout the last 50 years. To achieve this required the
compliance of the psychiatric profession.
The soviets used their mental institutions to lock away dissidents. In
the UK mental health law is under review at present with some very
dangerous laws being passed. If you can't offer treatment can you call
it medicine and keep a straight face? "Above all, do no harm."
>
>
>> > > In modern society
>> > > this
>> > > still exist in some ways. It is still very hard to define the
>difference
>> > > from an insane person and a sane person
>
>> >Is it??? What is your experience in this field?? I happen to be a
>> >Psychologist and I am not sure I would agree.
>>
>> Ah. Finally the point...
>>
>>
>> >Simply put someone who is "insane" (not a term that would be used, but
>for
>> >argument's sake I will allow it) will score, on normalised tests (as
>> >prescribed by the manuals) outside the normal range. It is quite simple
>> >really.
>>
>> Um. Go to the back of the class.
>>
>> This is frightening. It says so in the book therefore it is true. QED.
>
>EXCUSE ME???? it seems like you are trying to be offensive!
>Let me take you through this 'real slow'.
Well yes. Hands up.
Just cause it says something in DSMIV doesn't make me believe it. I
can show you pages from a 1950s encyclopedia britannica that talk of
homosexuality being a mental illness. I haven't seen a copy of DSM
from the period but... I'm sure you can see where this is going.
>
>Geoff states that it is very hard to define the difference between the sane
>and the insane. In real clinical practice this is not the case. However much
>i might disagree with the system (and i do to such an extent that i am
>leaving the profession) it is the case that sanity or otherwise is
>determined by standardised tests. These are laid out by strict guidelines in
>'the book' (DSM IV....a standards manual). It is on the basis of these
>standardised, normalised tests that individuals are deemed legally sane or
>not.
Whenever I see the words "normalised" I get very concerned. When I did
my psychological profiles at work the results were "normalised". Under
the "normalised" results I showed up as a rather extrovert character.
I'm Irish and in terms of my culture I'm one of the quiet types.
In terms of what you say above anyone who is capable of understanding
what is being tested, capable of mimicking the desired results can,
dependant upon their knowledge of the tests and their whim at that
time, be classified as sane? Or does the "normalisation" take into
account some ones _perception_ of whether they are being had?
>
>Again i am not saying it should be thus but it most certainly IS.
>
Which is like defining intelligence as being that which is tested by
intelligence tests.
>> >Whether or not this is society's way of censoring individuals who
>> >may challenge the received wisdom is beside the point. That get's into
>the
>> >abuse of the system, NOT the efficiency of the system. I know the system
>to
>> >be efficient, in that it separates those pre-determined to be sane from
>does
>> >pre-determined to be insane. I suspect however that the system might well
>> >too easily allow abuse. But that is not at issue here.
>>
>> That those diagnosed as mentally ill in Europe and the United States
>> have lower recovery rates compared against the same category of
>> patient in the Pacific Rim is ignored. Far less cash, using the same
>> basic precepts of technique and higher recovery rates for the more
>> debilitating types of illness.
>
>If you want to talk about treatment (as opposed to diagnosis) fine. That,
>however, was not the original issue.
>
>
>> As I recall 10% overall and higher in the case of schizophrenia,
>> bipolar and MPD.
>
>So we maybe should learn from them.
>
>> >
>> >> but because of the certain morals of
>> >> modern society we persuade people to conform to these basic morals and
>if
>> >> they where to break these morals they would be classified as being
>insane
>> >as
>> >> Lila was in the book.
>> >
>> >
>> >Insanity tries not to concern itself with morality. It is a concept based
>in
>> >concern primarily for society and secondarily for the individual.
^^^^^^^^^^^^^^^
>
>And psychologists (often) are scathing of psychiatrists. We see them as
>being over-eager to use invasive treatments such as drugs and (in limited
>extreme cases) ECT ('shock therapy'). The fact is though that both work
>together in every mental health setting I know of. True, psychologists
>cannot 'cure' schizophrenics of their halucinations but that is why drugs
>are administered. Put simply, drug treatment is used where other methods are
>found to be ineffectual. The aim of this drug treatment is not (or at least
>SHOULD not be) primarily to 'cure' the client but to allow further
>treatment. Further treatment can be supervised by either a clinical
>psychologist or a psychiatrist. This treatment can draw from many
>disciplines to help increase the chances of full recovery. The approach is
>most often multi-disciplinery from start to finish. The advantage of this
>approach is that it allows for the possibility of changes which will PREVENT
>relapse and hopefully provide the context by which the drugs can be
>withdrawn.
Some of the legislation I alluded to earlier is the ability for a
judge to mandate the taking of <cheap> medications which WILL damage
the patient over the longer term. So we are talking about a
_profession_ that will _implement_ a _policy_ of taking away CHOICE of
whether to take HARMFUL substances. Further, a profession that will do
this and be complicate in not using the best _available_ treatments.
>
>>
>> >Do YOU think it is 'well' to cut yourself every day? To hate yourself so
>> >passionately that desire only to end your life? To shit yourself rather
>than
>> >walk five yards to the toilet?
>> >
>>
>> Just like your argument this is just emotionally loaded material. If
>> one hates oneself to the level one wants to die then one would have to
>> be pretty stupid to fail at this task.
>
>That is fairly insensitive.
I have great sympathy for anyone who suffers a loss though an event
such as this. I have greater sympathy for someone who is so alone that
this seems to be the sensible course of action.
The statement stands. If you want to kill yourself in this society it
is not really that taxing a task. I was relating to the emotive terms
you used. In truth the situation is more normally that one hates
oneself so much as one hates ones life. It's more than a subtle
distinction and I was pointing out that you were misrepresenting the
people whom you would be treating. People who want to die do not
receive treatment. People who hate their life leave open the
possibility of their life being altered. The "cry for help".
>
>> >Do you suggest that these people be left untreated?
>>
>> Unless they represent a clear and present danger to themselves or
>> others, YES. I would suggest that changing the circumstances of their
>> lives will have a far better effect upon them and their behaviour.
>
>You seem to think that treatment is not a change in the circumstances of
>their lives. It very often is. While i would be the first to acknowledge the
>need for political action to counter the inequities in modern society which
>pre-disposes poorer sections of society to health (physical and mental)
>problems, such action is, at best, preventative. There will still remain the
>question of what to do with those already afflicted. The question of
>treatment.
Build communities. The term community implies diverseness. Every town
had a village idiot and a village simpleton. There were interactions
between people. We are now building walled cities with electric gates
and demanding that other people be forcibly medicated with *harmful*
drugs.
>> >Do you understand that the vast majority of the clients I deal with (and
>I
>> >don't imagine that I am in a unrepresentative setting)
>> >1) Are clinically SICK.
>> >2) Receive treatment voluntarily
>> >3) Respond well to treatment and go on to live happy much-improved (by
>their
>> >own self-assessment of their own Quality of Life) lives
>> Call me Mr Sceptical.
>>
>> As suggested above. TIME heals.
>
>so you favour doing nothing in the HOPE that things will improve? I could
>not reconcile myself with such behaviour....
I am suggesting DO NOTHING THAT IS NOT MEASURABLY FOR THE GOOD, in the
sure and certain knowledge that "this too will change".
>
I apologise. I tend to get irritated by the whole idea of "I'm the
professional, defer to me in this." My view is that most people are
capable of understanding most things if the person explaining it is
competent. From my experience of life everything correlates and if you
know any single thing well most of what you know will be applicable to
nearly everything else. Not terribly far from Pirsig and his
experience with the mechanic.
As I get older I become more and more aware of the patterns in
*everything*.
>
>If there is defensiveness in my tone it is for this reason.
I can understand wanting to make a difference. I also understand the
not wanting someone messing with ones rice bowl.
To move where you are deployed in our society we need to move the rice
bowl, albeit temporarily. I guess I have difficulty accepting that one
in six of the population of western countries are "mentally ill" in a
given year. To my mind something that is this widespread is not an
illness it is an aspect of the "norm".
Treating depression as an illness rather than as a normal occurrence
for a human given particular circumstances I find senseless. Further
to label someone who has needed such services as having a "mental
illness" with all the baggage this carries is a disservice. The
disservice is as a DIRECT result of what the original poster talked
of. The social construct of "mental illness" and "insanity".
With Psychiatry the disservice can reach vastly more harmful extremes.
regards,
Ian
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