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I agree it isn't straightforward.

Some things can lead to benefits, without themselves being beneficial.

In psychology, diagnosis is sometimes like that. It can lead to treatment, accommodation, and funding, but the diagnosis on its own may not be beneficial, may cause harm through stigma, and may not be necessary to access the benefits.

The alternative: when possible, provide the benefits without labeling the person as disordered.

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2 年前議論

By saying why bother, I meant to discourage diagnosis, while acknowledging its benefits and costs.

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2 年前議論

I agree that knowing about something, and accepting it, is better than the alternative. Does that mean we need to diagnose it as a disorder? For instance, I have an introverted personality, and I accept that, even though I didn't receive a diagnosis of introverted. On a more serious note, I have friends who I know and accept as gay, but I don't consider them disordered. The diagnostic and statistics manual used to include gay as a disorder; removing it as a disorder reduced the stigma, and I don't think it reduced the societal or self-acceptance of gay people. Quite the opposite. So like you I love self-knowledge; I only take issue with "diagnosis" as the way to gain it.

You make a good point about the benefits of receiving treatment. I personally have received training in social skills, goal setting, relaxation exercises, and realistic thinking. I learned those skills to overcome specific challenges. I had some anxiety, like every normal person does, so I learned a skill for that. I had trouble dating, so I learned skills for that. I felt overwhelmed, so I learned goal setting for that. I thought I was stupid, so I learned realistic thinking to avoid overgeneralizing and labeling. Throughout that process, I brought my challenges to a psychologist, and the psychologist taught me skills. That approach offers a way to help people without diagnosis, by suggesting treatments for specific challenges.

Can we keep the early treatment and drop the diagnosis?

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2 年前議論

It sounds like the diagnosis marked a point of positive transformation. Before the diagnosis, your daughter attributed her math challenges to global stupidity and laziness. After the diagnosis, she attributed it to a specific difficulty with math. That reframing does sound healthy and helpful. It also sounds like the diagnosis helped you accept the situation and adapt your teaching modality.

Certainly, funding for treatment and acceptance of accommodation can make a life-changing difference. That in part motivates many caring and concerned practitioners to widen diagnostic criteria, so that more people can access benefits. I can see how I came across as trivializing those benefits. Quite the contrary, though, I meant to express that yes, diagnostic labels can bring positive results, and we need to weigh those against the negative results, especially when other options exist.

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2 年前議論

Why bother? Given the breadth of diagnostic classes these days, there's a good chance you can find a practitioner[0] willing to make a diagnosis. That said, aside from getting funding for treatment or acceptance of accommodations, receiving a label of disordered often does not help, but does add harmful stigmatization. The OP's son seems normal, functioning, and isn't harming anyone. On the other hand, the diagnosing practitioner may need to be tested for Overpathologization Disorder[0].

[0]: http://www.psychologysalon.com/2012/01/overpathologization-d...

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2 年前議論

Your suggestion of housing density with retail and shops fits the description of my current neighborhood. I love it so much that I changed careers to find ways to support more of this kind of community.

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2 年前議論

Thanks for the thorough analysis. In British Columbia, and specifically where I live, much of our electricity comes from hydro electric, we have suitable pathways-with-boulevards for walking, and the streets have segregated or low traffic bike lanes. That leave us with an almost idyllic situation for walking, biking, and EVs. Not only does that support a reduction in my CO2 production, but also it support my personal well-being with neighbors, exposure to nature, and exercise.

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2 年前議論

Nice initiative. Particularly for civilians doing daily activities, biking and walking seem like the best forms of transportation. They enhance personal happiness, increase community connections, make streets safer, and promote beautiful surroundings.

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2 年前議論

Good. If we want cleaner air and quieter cities, we have several alternatives to gasoline cars. I imagine a graph of CO₂ production goes a bit like this:

  Walk         - 
  Bike         -
  Train        ------
  Electric Car ------------
  Gasoline Car ------------------------------

On the one hand, it seems silly to debate electric cars versus trains while we have gasoline cars on the streets. On the other hand, I like that we focus our news on the low emitters, so gasoline cars drop out of popular culture. To change a paradigm, it helps to speak with assurance from the new one.

(Edits: formatting, pith)

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2 年前議論

Unlike those in public high school, students who aren't serious about medical school won't have earned the entrance grades. So at least in first year, most students will have a serious attitude. Are you suggesting that someone will bust their ass for four years, only to start slacking once in medical school? Or that medical school entrance grades don't require serious study?

I can see what you mean about the halfway point. Maybe undergrad came easily, and at the halfway point, the student realizes that medical school simply isn't a good fit, or it's more work than they thought it would be. So they drop out. This is probably a good thing, to prevent people becoming doctors who don't have the chops or the attitude for it. Unfortunately, the school does lose some money on a candidate they ought to have filtered out in the interview.

Happily it's an empirical question, and we can circle back in a few years to see if the drop out rate increased or not. Maybe the drop out rate increases at first, and then the entrance interview becomes more stringent.

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2 年前議論

One way to have skin in the game is to pay a considerable sum of money to join medical school. This reminds me of the Commitment and Consistency chapter in Cialdini's book Influence. In part it says we stick with things more after we exert effort and especially so after public effort. With free tuition we take away some of the skin in the game, but students will still have to expend considerable effort to achieve high enough grades. That probably fosters commitment (and might explain why people with scholarships still tend to value school). In any case, we already have doctors whose parents paid for school, so even when free schooling does reduce commitment (and it probably will sometimes), at least this evens the playing field.

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2 年前議論

I like this because it encourages affluent people to adopt electric vehicles. If we want to live in cities with clean air, quiet streets, and fewer gasoline stations, then it makes sense to encourage electric vehicle adoption. Many people look to the wealthy as role models, and many wealthy people seek status, so this seems like a win.

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2 年前議論

I find this useful on myself and with others. It gives an approach when someone (or my own mind) says, "None of this is my fault, so I shouldn't have to change."

From the article:

> In effect, our client is operating from a justice model... pleading their case before a court, [so] the party ultimately found guilty will... change.

> The challenge is that [life] is not a courtroom... the guilty party is usually neither present nor inclined to alter their behavior... [and so] the client will remain helpless.

I sometimes only use the first few steps, and have found them useful when acting as a friend, manager, or colleague.

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2 年前議論

That doesn't sound fair to me either. The subset of people who have benefitted from polluting won't have to foot the clean-up bill. So those who want lush, temperate, and healthy surroundings may have to take charge, even though it isn't fair. I certainly feel grumpy about those who benefit from polluting, when others have to deal with the effect. It would be nice if they were more responsible, so we didn't have to figure this all out. I gave up on that happening, and instead have started to change my own part in this. It's a shift from the justice model to the effectiveness model.

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2 年前議論

I feel convinced to participate in climate change in my work. I don't know whether we can reverse it or whether tech will solve it, but I do believe in its importance, and I want to understand it. I have incorporated all of this change into my worldview by finding ways to improve morale in the community, and recently, by switching careers from software development into sustainable innovation.

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2 年前議論

Thanks for the comment. It looks like we mostly agree.

> The purpose of the "disorder" is to group common pathologies and their respective treatments (methods to improve).

So nice to see this expressed. Classification helps when it lets us find effective treatment approaches. We do want to give people effective tools to face life difficulties.

That said, a problem happens when a classification has many different presentations. Person A with high functioning autism might need help staying focused on disliked tasks. Person B with high functioning autism might have trouble expressing emotions (but do fine with disliked tasks). As the classification widens, so does the range of presentations, and that increases the risk of treating people like B for difficulties that they don't have.

We can remove that risk if we treat the difficulty directly. Instead of `person -> classification -> difficulties -> treatments` we go `person -> difficulty -> treatment`. Simply match difficulties to treatments directly.

"Lots of people have difficulty staying focused on tasks they don't like. These things tend to help... "

> Many people with high functioning autism don't see it as a disorder and view it as a "different thinking style".

It's just so nice to see that. Happily, the DSM may remove high functioning autism, at least in part. Good! We did the same with homosexuality in 1973. The classification was the stigma.

It looks like we agree that classifications can help, if it points to effective treatment. I like to point out that wide categories obscure effective treatments and also introduce stigma. By dropping the classification, we can focus on the person, their real difficulties, and to normalizing their human experience.

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2 年前議論

The video argues that yes, greater awareness has happened, and also, we have widened our pathological categories to include normal functioning. First we invented autism (etc), then we widened the definition(s).

Widening the disorder criteria seems to cause more harm than good. We could already improve ourselves without identifying as disordered. And we usually do better when we identify as normal, healthy humans.

Fortunately, we can recognize the absurdity of the widening criteria and opt-in to identifying as normal, like most people are.

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2 年前議論

From the video description:

> Once upon a time there was a field called Personality Psychology, which concerned itself with normal-range individual differences between people, as distinct from dysfunction-inducing extremes classified as psychopathologies. Over the last 40 years, however, mental health diagnostic categories have broadened markedly, making the range of what we used to think of as "normal" much narrower. Diversity has become disorder. Although intended to broaden the availability of mental health services to more people, there is no evidence that this trend has contributed to improvements in population mental health - indeed, the opposite seems to be true.

Edit: clarified that this quotes the video description.

投稿

Justice vs. Change: Helping Clients Find Their Power

Psychopathology Ate Personality: The Thickening DSM and Erosion of Normality [video]

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