Turning psychiatric labels into identities(newyorker.com)
newyorker.com
Turning psychiatric labels into identities
https://www.newyorker.com/magazine/2024/05/13/why-were-turning-psychiatric-labels-into-identities
126 comments
The article cites Hacking but doesn't give a source. I think they are mainly using this old article: https://web.ics.purdue.edu/~drkelly/HackingMakingUpPeople198..., maybe they also gave his work on MPD a brief skim.
It's kind of weird to say that a news article discussing different perspectives should not mention a well-sourced article that has gathered 3888 citations, on the basis of "qualifications". For the pop-sci "new study finds X" pieces the bar is basically "published in a journal", which of course Hacking's paper satisfies. I did a brief search and there aren't any obvious modifications to his work. Sure, there are papers like https://www.frontiersin.org/journals/psychiatry/articles/10.... and https://www.tandfonline.com/doi/full/10.1080/09687599.2020.1..., but nothing with thousands of citations, and these more recent papers build on Hacking's theory rather than attacking it. Uncritically accepting Hacking's theory is not "begging the question", it is more like "if the shoe fits, wear it". And in this case there are not any obviously better shoes.
It's kind of weird to say that a news article discussing different perspectives should not mention a well-sourced article that has gathered 3888 citations, on the basis of "qualifications". For the pop-sci "new study finds X" pieces the bar is basically "published in a journal", which of course Hacking's paper satisfies. I did a brief search and there aren't any obvious modifications to his work. Sure, there are papers like https://www.frontiersin.org/journals/psychiatry/articles/10.... and https://www.tandfonline.com/doi/full/10.1080/09687599.2020.1..., but nothing with thousands of citations, and these more recent papers build on Hacking's theory rather than attacking it. Uncritically accepting Hacking's theory is not "begging the question", it is more like "if the shoe fits, wear it". And in this case there are not any obviously better shoes.
> People more qualified than a philosopher have argued many perspectives about DID diagnosis.
Idk why you'd think a medical practitioner would be more qualified than a philosopher of science about when it comes to methodological issues, but you're wrong.
Idk why you'd think a medical practitioner would be more qualified than a philosopher of science about when it comes to methodological issues, but you're wrong.
Perhaps because without having their theories reality-checked on a regular basis, a philosopher of science effectively turns into a protein-based LLM: saying convincing things, but unable to realize when some of it is wrong and invalidates everything said from that point on.
Medical practitioners live and breathe methodology; they experience both the process and its output. They are the reality test.
Medical practitioners live and breathe methodology; they experience both the process and its output. They are the reality test.
I also have an extreme bias towards practitioners in terms of any practice being the exegesis of whatever the embedded epistemology is.
However, I believe you’re over indexing on this in that across pretty much every industry that I’ve ever dealt with, practitioners are notoriously terrible at implementing anything close to theoretical optimization
Why? simply because the organization does not incentivize that, so if we were then to use this as our standard, then we would be betraying what is effectively the idealized implementation of some epistemological process
instead you’re simply lowering the bar on what is a more correct way to do things
I think this is one of the few places where from a philosophical perspective The categorical imperative is actually very helpful - that is to say a medical professionals epistemology should be the highest standard and all other standards of rationality or let’s say decision-making should strive for
In short, much like practitioners need to keep the philosophers grounded , philosophers need to keep practitioners from lowering the bar on the epistemological robustness
However, I believe you’re over indexing on this in that across pretty much every industry that I’ve ever dealt with, practitioners are notoriously terrible at implementing anything close to theoretical optimization
Why? simply because the organization does not incentivize that, so if we were then to use this as our standard, then we would be betraying what is effectively the idealized implementation of some epistemological process
instead you’re simply lowering the bar on what is a more correct way to do things
I think this is one of the few places where from a philosophical perspective The categorical imperative is actually very helpful - that is to say a medical professionals epistemology should be the highest standard and all other standards of rationality or let’s say decision-making should strive for
In short, much like practitioners need to keep the philosophers grounded , philosophers need to keep practitioners from lowering the bar on the epistemological robustness
I think the scoreboard indicates differently. I've never once come across a meaningful problem outside of philosophy addressed or solved by a philosopher
You haven't looked very hard then
Okay, name three examples then. Bonus points if they happen to be pure philosophers, not philosopher-practitioners.
Are you not a practitioner if you contribute to the field...? Seems impossible to meet your criteria.
What's a pure philosopher? Are Frege and Decartes not philosophers because they also did math? Does Alan Turing count? What about Popper and Kuhn? Are they philosophy enough for the philosopher club? Where, when, how and by whom do you think the concept of 'empirical science' was derived?
To be clear, everyone, including scientists, do philosophy every single day. You don't think Darwin did some philosophy in on the origin of species?
What's a pure philosopher? Are Frege and Decartes not philosophers because they also did math? Does Alan Turing count? What about Popper and Kuhn? Are they philosophy enough for the philosopher club? Where, when, how and by whom do you think the concept of 'empirical science' was derived?
To be clear, everyone, including scientists, do philosophy every single day. You don't think Darwin did some philosophy in on the origin of species?
Sure you can argue about the specificity of the question but do you have any examples of pure philosophers?
Jerry Fodor? Noam Chomsky? Hilary Putnam? Patricia Churchland
What is a pure philosopher??!? I'm not arguing the specificity of the question, I'm saying that question is nonsensical.
What is a pure philosopher??!? I'm not arguing the specificity of the question, I'm saying that question is nonsensical.
Someone who does not test hypotheses
The characterization of the scientific method as proposing hypotheses and then putting them to test was given by a philosopher in the previous century. While the hypotheses that this is the character of the scientific method is still very common, it was refuted long ago, both by observations and by logic reasoning.
-Feynmann
-Von Neumann
-Say
-Frege
-Pasteur
-Darwin
Like I could literally go forever because most breakthrough practitioners started as philosophers- note the PhDs
“Doctor of Philosophy”
I mean JFC people this is basic science history
But you know I’m sure that won’t satisfy somebody who doesn’t even understand the epistemological distinction between what a philosopher is or does and what somebody who’s actually doing experimental testing that turns into something great is because the distinction is basically zero
Like I could literally go forever because most breakthrough practitioners started as philosophers- note the PhDs
“Doctor of Philosophy”
I mean JFC people this is basic science history
But you know I’m sure that won’t satisfy somebody who doesn’t even understand the epistemological distinction between what a philosopher is or does and what somebody who’s actually doing experimental testing that turns into something great is because the distinction is basically zero
The distinction is that one of them actually tests hypotheses
I’m not aware of this scoreboard
Please provide a link or otherwise reference to this scoreboard
Unless you were writing metaphorically in which case you’ll need to write a lot more to describe it
Please provide a link or otherwise reference to this scoreboard
Unless you were writing metaphorically in which case you’ll need to write a lot more to describe it
Sorry thought it was clear but maybe a little poorly phrased. My point is: the number of meaningful solutions to problems by practitioners is infinity. The number of meaningful solutions to problems by non-practicing philosophers is zero as far as I know. Open to it being non-zero, but don't think the score is remotely close
edit: I think often theoreticians are unable to appreciate the constraints or nuance of actually "doing it" so frequently their "solutions" don't survive impact with reality
edit: I think often theoreticians are unable to appreciate the constraints or nuance of actually "doing it" so frequently their "solutions" don't survive impact with reality
Can you differentiate between implementation quality of a tool?
The “platonic wheel” is not a concern for someone trying to make money selling tires - but nor do those tires by being a function of successful commerce describe a “platonic wheel”
Perhaps the platonic wheel is in some intersectional saddle point between theory and practice but to say that only that which is commonly adopted has measure ignores the philosophical genesis that precedes and impregnates the production process.
The “platonic wheel” is not a concern for someone trying to make money selling tires - but nor do those tires by being a function of successful commerce describe a “platonic wheel”
Perhaps the platonic wheel is in some intersectional saddle point between theory and practice but to say that only that which is commonly adopted has measure ignores the philosophical genesis that precedes and impregnates the production process.
"Are turning" implies some sort of novelty.
But it is the same as it ever was.
We've had the xuè-qì, humors, hysteria, the zodiac signs, witch hunts, the "sensitive" type, type A, temperaments, IQ tests, Freud, Rorschach, Jung, Myers-Briggs ...
People will always try to "fix" themselves and others to a particular set of traits and then predict and analyze their future behavior through that "fixed" lens.
We're barely a century removed from phrenology being an accepted criminal forensic tool.
We have always been susceptible to the simplicity of psychiatric labels.
But it is the same as it ever was.
We've had the xuè-qì, humors, hysteria, the zodiac signs, witch hunts, the "sensitive" type, type A, temperaments, IQ tests, Freud, Rorschach, Jung, Myers-Briggs ...
People will always try to "fix" themselves and others to a particular set of traits and then predict and analyze their future behavior through that "fixed" lens.
We're barely a century removed from phrenology being an accepted criminal forensic tool.
We have always been susceptible to the simplicity of psychiatric labels.
It's not about "labels", it's about people embracing those labels as an identity.
Historically, only a small proportion of the population would identify themselves by their zodiac sign, their temperament, whatever.
Now, a growing, significant proportion are identifying themselves AS their disorder. That in itself, could be seen as a meta-disorder, as people are, and should be, more complex than a single label, let alone a disorder.
Historically, only a small proportion of the population would identify themselves by their zodiac sign, their temperament, whatever.
Now, a growing, significant proportion are identifying themselves AS their disorder. That in itself, could be seen as a meta-disorder, as people are, and should be, more complex than a single label, let alone a disorder.
I think it is helpful for people to find that what is wrong with them isn't a unique character flaw but a well-known problem, so they can feel less guilty and maybe find known ways to cope. But that is all.
What I don't like are things like using the label to reject responsibility for one's own actions because "all X are like that", being upfront about the label where it isn't necessary, glorifying the label ("X are good at Y"), and yes, forming an identity around the label. I guess it's kind of the zeitgeist what with identity politics and all that.
What I don't like are things like using the label to reject responsibility for one's own actions because "all X are like that", being upfront about the label where it isn't necessary, glorifying the label ("X are good at Y"), and yes, forming an identity around the label. I guess it's kind of the zeitgeist what with identity politics and all that.
That's exactly what it was for me.
It's a lot easier to work on a problem when you know what it stems from, have a vocabulary to describe it, and can rely on proven fixes from people in the same situation.
Hell, it's nice just to know that others are in a similar predicament and make relatable memes about it.
It's a lot easier to work on a problem when you know what it stems from, have a vocabulary to describe it, and can rely on proven fixes from people in the same situation.
Hell, it's nice just to know that others are in a similar predicament and make relatable memes about it.
> Historically, only a small proportion of the population would identify themselves by their zodiac sign, their temperament, whatever.
I don't think is true.
Even Mensa, which by design is expected to be very exclusive, reportedly has over a hundred thousand members.
Mensa is also one of many IQ-based social organizations.
You also mention "small proportion of the population would identify themselves by their zodiac sign" but the horoscope was ever present in mainstream newspapers and is even published in dedicated magazines.
I don't think is true.
Even Mensa, which by design is expected to be very exclusive, reportedly has over a hundred thousand members.
Mensa is also one of many IQ-based social organizations.
You also mention "small proportion of the population would identify themselves by their zodiac sign" but the horoscope was ever present in mainstream newspapers and is even published in dedicated magazines.
I'm not sure what point is being made here. I agree that many people will mindlessly and uncritically accept labels. But this comment feels cynically critical of any attempt to study psychology. Psychology is hardly the only science with an embarrassing history and many mistakes.
My point wasn't to slam on psychology; just the article seems to imply identity through shallow psychological labels is a new phenomenon, when it is as old as civilization itself.
And it’s not even just psychological labels, either. In East Asia, mostly Japan, blood types are used as a form of astrology (literally type A personalities). And in other contexts modern people sometimes self-identify based on their supposed chronotype or whether they’re an endomorph or an exomorph in order to retroactively explain their nature or behaviors. Self-identity is often used for self-justification.
> We're barely a century removed from phrenology being an accepted criminal forensic tool.
This, specifically, is a bad argument.
Medicine is barely a century removed from using mercury salts to treat syphilis, but as it stands, can completely cure it with modern treatments, the rise of drug-resistant strains notwithstanding.
If modern psychopathology is still largely prescientific, which one can make a strong case for, this is because of psychopathology now, not psychopathology a century ago.
This, specifically, is a bad argument.
Medicine is barely a century removed from using mercury salts to treat syphilis, but as it stands, can completely cure it with modern treatments, the rise of drug-resistant strains notwithstanding.
If modern psychopathology is still largely prescientific, which one can make a strong case for, this is because of psychopathology now, not psychopathology a century ago.
> Medicine is barely a century removed from using mercury salts to treat syphilis
A very good point, worth reminding ourselves regularly in general[0]: almost everything around you and me, everything that our lives depend on, or that helps us day-to-day, almost everything we see or interact with that isn't wild nature - all that has been made possible in the past ~200 years. Most of that in less than 100. Science as we understand it today, is less than 200 years old. Medicine stopped being voodoo less than a century ago. Petroleum chemistry and materials engineering have defined most of how modernity looks in general; like every other field of endeavor, they really kicked into gear ~100 years ago.
Circling back to GP's statement:
>> We're barely a century removed from phrenology being an accepted criminal forensic tool.
That's because we're barely a century removed from being a proper technological civilization - one that follows knowledge in a systematic fashion, instead of folklore in a haphazard way.
--
[0] - Especially when playing with notions that current age is no different than all the ages before. It really is.
A very good point, worth reminding ourselves regularly in general[0]: almost everything around you and me, everything that our lives depend on, or that helps us day-to-day, almost everything we see or interact with that isn't wild nature - all that has been made possible in the past ~200 years. Most of that in less than 100. Science as we understand it today, is less than 200 years old. Medicine stopped being voodoo less than a century ago. Petroleum chemistry and materials engineering have defined most of how modernity looks in general; like every other field of endeavor, they really kicked into gear ~100 years ago.
Circling back to GP's statement:
>> We're barely a century removed from phrenology being an accepted criminal forensic tool.
That's because we're barely a century removed from being a proper technological civilization - one that follows knowledge in a systematic fashion, instead of folklore in a haphazard way.
--
[0] - Especially when playing with notions that current age is no different than all the ages before. It really is.
It’s not surprising. People seek identities to confirm who they are, find companionship and community, and attach themselves to something bigger than one can figure out for one’s self. We see it in people who are “healthy” as an identity, now in “nerds”… so for mental issues it makes you feel bigger than just yourself. I think less-clear identities are part of the big culture war struggle in the US… the inability to handle a plurality.
This article is so insulting to anyone suffering from a psychiatric illness. The reason people "cling" to labels, is because when you're suffering from something as severe and difficult to live with in normal society such as complex/chronic PTSD, answering the question "What the hell is wrong with you?" becomes extremely difficult without these labels, and will drive one to despair trying to explain and maintain normal relationships. That's why people are so happy finally being given one, because they themselves have had no real explanation for a long time to their friends/family as to what's going on, get labeled as "crazy" or "unstable" or all the other million horrible words people use to describe someone undergoing mental issues. This isn't even to mention that these labels are often useful in obtaining the care you actually need rather than the care the doctor thinks you need based on his biases, which may or may not be correct (often it isn't).
More than that though, using the PTSD example - it becomes an identity because when you suffer from something like that it informs every waking moment of your existence and needs to be considered before nearly any activity. How else would you expect someone to cope? That is their identity, they have to live with it every day of their lives, unlike the author of this ludicrous, puffy "thought" piece.
/rant
More than that though, using the PTSD example - it becomes an identity because when you suffer from something like that it informs every waking moment of your existence and needs to be considered before nearly any activity. How else would you expect someone to cope? That is their identity, they have to live with it every day of their lives, unlike the author of this ludicrous, puffy "thought" piece.
/rant
> The reason people "cling" to labels, is because when you're suffering from something as severe and difficult to live with in normal society such as complex/chronic PTSD, answering the question "What the hell is wrong with you?" becomes extremely difficult without these labels, and will drive one to despair trying to explain and maintain normal relationships.
I think this point of view ignores the main point of the article: the social labels, not the trait that substantiates those social labels.
There are people who self-assign those labels in spite of not actually having been diagnosed with any condition, and go as far as making the label a central part of their identity. The fact that using these labels is not necessarily correlated with actually having the conditions is the key aspect.
I think this point of view ignores the main point of the article: the social labels, not the trait that substantiates those social labels.
There are people who self-assign those labels in spite of not actually having been diagnosed with any condition, and go as far as making the label a central part of their identity. The fact that using these labels is not necessarily correlated with actually having the conditions is the key aspect.
> There are people who self-assign those labels in spite of not actually having been diagnosed with any condition
so what?
>The fact that using these labels is not necessarily correlated with actually having the conditions is the key aspect.
fact according to who? the evidence in this article is weak. and even if you assume it is actually true, what is the actual problem here? you cannot simultaneously proclaim that self diagnosis is invalid while proclaiming that the same DSM professionals use to make diagnoses is invalid, without doing a lot of explaining and gap-filling. It is one or the other.
so what?
>The fact that using these labels is not necessarily correlated with actually having the conditions is the key aspect.
fact according to who? the evidence in this article is weak. and even if you assume it is actually true, what is the actual problem here? you cannot simultaneously proclaim that self diagnosis is invalid while proclaiming that the same DSM professionals use to make diagnoses is invalid, without doing a lot of explaining and gap-filling. It is one or the other.
> so what?
So that's exactly the whole point of this discussion: turning psychiatric labels into identities.
> fact according to who?
According to the fact that people do self-portray and self-identify as labels in spite of not even subjecting themselves to a diagnose or even actually any condition.
To deny this fact you need to deny things like for example Munchausen syndrome or even hypochondria.
So that's exactly the whole point of this discussion: turning psychiatric labels into identities.
> fact according to who?
According to the fact that people do self-portray and self-identify as labels in spite of not even subjecting themselves to a diagnose or even actually any condition.
To deny this fact you need to deny things like for example Munchausen syndrome or even hypochondria.
> So that's exactly the whole point of this discussion: turning psychiatric labels into identities.
So, I still have the question - what is your problem with this?
I guess I don't really have anything else to say without violating site rules other than you are the exact reason mental illness stigma exists to the degree it does today.
So, I still have the question - what is your problem with this?
I guess I don't really have anything else to say without violating site rules other than you are the exact reason mental illness stigma exists to the degree it does today.
Everything you say is pure rhetoric, meant to gatekeep who gets to "justify" their struggles with mental illness, which is what this whole debate is always about.
You can't just f-ing assume that people are "making the label a central part of their identity" spontaneously as though you know what's going inside their minds better than they do. It's ridiculously disrespectful and dismissive of the likely issues leading them to do so. And not everyone is capable of getting a diagnosis for a number of reasons.
You can't just f-ing assume that people are "making the label a central part of their identity" spontaneously as though you know what's going inside their minds better than they do. It's ridiculously disrespectful and dismissive of the likely issues leading them to do so. And not everyone is capable of getting a diagnosis for a number of reasons.
> Everything you say is pure rhetoric, meant to gatekeep who gets to "justify" their struggles with mental illness, which is what this whole debate is always about.
Exactly - and there's no winning this argument at all with people like this. Say this hypothetical person (causing harm to who?) finally gets a real diagnosis from a real professional - people like this will often dismiss the diagnosis out of hand, with vague comments about how the DSM isn't "science" or that the doctor was incompetent, etc. I cannot help but feel that the root sentiment behind this stuff is a deep loathing for people struggling with mental illness - or at the very least a profound lack of empathy. I have never really understood it.
Exactly - and there's no winning this argument at all with people like this. Say this hypothetical person (causing harm to who?) finally gets a real diagnosis from a real professional - people like this will often dismiss the diagnosis out of hand, with vague comments about how the DSM isn't "science" or that the doctor was incompetent, etc. I cannot help but feel that the root sentiment behind this stuff is a deep loathing for people struggling with mental illness - or at the very least a profound lack of empathy. I have never really understood it.
> Everything you say is pure rhetoric, (...)
Do people self-assign those labels in spite of not actually having been diagnosed with any condition?
Yes or no?
If the answer is "no" then your post is just nonsense.
Do people self-assign those labels in spite of not actually having been diagnosed with any condition?
Yes or no?
If the answer is "no" then your post is just nonsense.
One mental health problem not mentioned here is schizophrenia. Having a family member afflicted, I don't think having a label makes things much better. The schizophrenia treatments available just make me feel that we understand so little about it. The drugs used are such blunt weapons that can be debilitating in themselves.
We’re trapped once we believe a common set of symptoms means the same cause- it just ain’t so. It helps even less to confuse biological correlations to the mental/behavioral symptoms as the causes of those symptoms, as if seeing a state of love in an MRI leads use to think it’s a brain disease
> The schizophrenia treatments available just make me feel that we understand so little about it. The drugs used are such blunt weapons that can be debilitating in themselves.
It's interesting to point out that this is also true in most health fields. For example, dentists still base their practice around drilling and pulling teeth. Wooden dentures have been replaced with the same concept using fancier materials.
It's interesting to point out that this is also true in most health fields. For example, dentists still base their practice around drilling and pulling teeth. Wooden dentures have been replaced with the same concept using fancier materials.
my theory is that schizophrenia is so difficult that most people prefer not to think about it. People seem to have a mental block or resistance about the fact that some people have the disease of schizophrenia, and about what its symptoms and prognosis look like.
if true, maybe that’s why it’s usually not mentioned in discussions about the politics of mental health, and why people don’t even consider “schizophrenia” when they see someone behaving strangely.
if true, maybe that’s why it’s usually not mentioned in discussions about the politics of mental health, and why people don’t even consider “schizophrenia” when they see someone behaving strangely.
I sometimes wonder how much of the incurability of some of these illnesses or mental states is a product of people making them a part of their identity, or having that identity forced upon them by others. Because as pg quipped on Twitter the other day: “Never make a fixable problem a part of your identity, because then you’ll never fix it!”
Having an understanding of what was wrong with me was an important part of understanding how to fix it, or more properly, how to work around it.
I struggle plenty with depression and anxiety in the mental-illness sense of those words (as opposed to the current-emotional-state sense). What that means is that my brain is always over-sensitive to negatives and assumes bad outcomes in cases of ambiguity, to a degree that isn't rationally justifiable. I can't control that fact; it doesn't occur on a conscious level and those are inputs to my cognition, not outputs of it.
But what I can do is recognize that because I am helpless to change those inputs, I need to know that they're warped and know how to compensate for them. I know that my brain will serve me aggressively negative examples and downplay positive ones, so I needed to practice both (a) not listening to it and (b) consciously recalling positive examples to counterbalance it. I know my brain will make me nervous and jittery, so I needed to consciously train myself to think "okay, even if I totally screw this up, it isn't the end of the world". I know I tend to avoid things that scare or stress me, so I needed to train myself to confront or remove them.
What my brain tells me still "feels" right to me, and it probably always will, and in that sense I cannot not have the mental health struggles I do. They are, in that sense, cognitively incurable (and so far I have not found a medication that lastingly cures them either). But understanding the fact that that is a fundamental part of the mental world in which I live has given me a lot of tools to do better than I could in the past.
I struggle plenty with depression and anxiety in the mental-illness sense of those words (as opposed to the current-emotional-state sense). What that means is that my brain is always over-sensitive to negatives and assumes bad outcomes in cases of ambiguity, to a degree that isn't rationally justifiable. I can't control that fact; it doesn't occur on a conscious level and those are inputs to my cognition, not outputs of it.
But what I can do is recognize that because I am helpless to change those inputs, I need to know that they're warped and know how to compensate for them. I know that my brain will serve me aggressively negative examples and downplay positive ones, so I needed to practice both (a) not listening to it and (b) consciously recalling positive examples to counterbalance it. I know my brain will make me nervous and jittery, so I needed to consciously train myself to think "okay, even if I totally screw this up, it isn't the end of the world". I know I tend to avoid things that scare or stress me, so I needed to train myself to confront or remove them.
What my brain tells me still "feels" right to me, and it probably always will, and in that sense I cannot not have the mental health struggles I do. They are, in that sense, cognitively incurable (and so far I have not found a medication that lastingly cures them either). But understanding the fact that that is a fundamental part of the mental world in which I live has given me a lot of tools to do better than I could in the past.
Great comment, thanks for taking the time to write it out. Why do you think you're able to do this (consciously compensate for the bias your brain is generating) and many others struggle to? Have you practiced mindfulness or other things like that?
One of the biggest legs up that I have is that my life has gone through extremely sharp swings. Sometimes it's easier to see a distortion if you can see something moving behind it, and when things move faster it's easier to see. When I went from "nowhere in life" to "working really hard at an exciting job where I was making rapid progress" but kept having approximately the same thoughts, that was a clue that those thoughts weren't really about my life in the first place. I'm a person who likes to think I'm logical, so my emotions like to cloak themselves in logic, but that's not what they're really about. And seeing my life go up and down over its long course has made it harder to feel like anything is "forever", which is a useful experiential defense against what depression wants to tell you.
While I've never found a medication that kept working, I did find one that worked temporarily, and it was a moment of profound realization for me. I was still me, my conscious mind worked the same way, I still liked the same things and had the same values, and my life was still a mess. But all of a sudden that constant scream of self-hate in my head went quiet. It taught me that another way to be was possible, showed me what the goal was, even if I didn't know how to get there yet, and shifted me from thinking of myself as morally bad and towards thinking of myself as just someone struggling with a painful condition. I genuinely did not realize until that point just how much hate I was enduring every day of my life, or that that wasn't a normal way to be. I remember making some simple mistake that, normally, I'd have felt bad about for many hours, but that day I just went "oh, that was dumb" and then didn't think about it anymore. I'd never been able to do that before. Nor had I previously understood that there was a difference between "I feel bad and my life is not what I want it to be" and "I'm a failure and deserve it".
To your last question: I haven't exactly practiced mindfulness in any structured conventional way, but I've certainly practiced trying to listen to my own emotions a little better. To treat them as a healthy and welcome part of myself and not as a thing to be argued with, and to understand that my power to control them is limited. If I'm afraid, I try to feel that fear, acknowledge it, and let it play itself out, rather than exhausting myself trying to hold it at bay. And then I can address it - "okay, if I screw up X, the worst that can happen is Y, and Y isn't that bad".
All that being said, I don't always win this fight. Sometimes I struggle, a lot. But even the losses are less damaging, because I can accept that it's OK that some days I'm not as productive or I don't feel as good. I often describe it as like sailing a boat. Sometimes the winds blow the right way, and there's a skill to catching those winds to move you forward. Sometimes the winds blow the wrong way, and you drop anchor, lower your sails, and hide below decks until the storm passes. Sure, you might wish you could just power through, but that's not the way the water works. You do what you can with what you have.
While I've never found a medication that kept working, I did find one that worked temporarily, and it was a moment of profound realization for me. I was still me, my conscious mind worked the same way, I still liked the same things and had the same values, and my life was still a mess. But all of a sudden that constant scream of self-hate in my head went quiet. It taught me that another way to be was possible, showed me what the goal was, even if I didn't know how to get there yet, and shifted me from thinking of myself as morally bad and towards thinking of myself as just someone struggling with a painful condition. I genuinely did not realize until that point just how much hate I was enduring every day of my life, or that that wasn't a normal way to be. I remember making some simple mistake that, normally, I'd have felt bad about for many hours, but that day I just went "oh, that was dumb" and then didn't think about it anymore. I'd never been able to do that before. Nor had I previously understood that there was a difference between "I feel bad and my life is not what I want it to be" and "I'm a failure and deserve it".
To your last question: I haven't exactly practiced mindfulness in any structured conventional way, but I've certainly practiced trying to listen to my own emotions a little better. To treat them as a healthy and welcome part of myself and not as a thing to be argued with, and to understand that my power to control them is limited. If I'm afraid, I try to feel that fear, acknowledge it, and let it play itself out, rather than exhausting myself trying to hold it at bay. And then I can address it - "okay, if I screw up X, the worst that can happen is Y, and Y isn't that bad".
All that being said, I don't always win this fight. Sometimes I struggle, a lot. But even the losses are less damaging, because I can accept that it's OK that some days I'm not as productive or I don't feel as good. I often describe it as like sailing a boat. Sometimes the winds blow the right way, and there's a skill to catching those winds to move you forward. Sometimes the winds blow the wrong way, and you drop anchor, lower your sails, and hide below decks until the storm passes. Sure, you might wish you could just power through, but that's not the way the water works. You do what you can with what you have.
Thanks for this and your other comments in the thread. Changed how I was perceiving these things, really appreciate you making the effort and if i'm anything like the typical reader you likely changed their views for the better
A problem with the article is the lack of differentiation, for stated or implied diagnoses, between potentially curable conditions and those that are developmental.
Yeah, that's why I always raise an eyebrow when people self describe as say a java dev or a rubyist.
I feel this is something you do early on, as it generates drive and gives some sense of belonging (and faux us-vs-them conflicts that can pump a lot of motivation). Eventually, you learn and experience enough to transcend identifying yourself with a single set of tools.
The reason I had to make it my identity is to get other people to understand that it isn't just something I can change, ignore, or just do differently.
I have struggled to find a label that accurately describes myself. While diagnosed with ADHD before, I don’t really feel that is accurate. There is a huge difference in diagnosis in the US vs the EU. I currently go with “gifted” or 2e which I understand as high IQ, some amount of ADHD and/or some amount of ASD. However gifted has a couple issues, one being as a label it implies I’m better than, so is less socially acceptable than a “disorder”. It also is currently being done away with in schools because IQ is racist or something. If there was a high IQ disorder, this would be a perfect label as it acknowledges the drawbacks. Neurodivergent is currently where I’m at just to acknowledge I’m different but not the exact reason why.
Sometimes the 'label' seems to be an excuse to continue behaviours that, were they not-yet-labeled, an individual would be encouraged to change.
The label can be a shield against change or a weapon used to slay any accusation of weakness of discipline or laziness. It can be used as a security blanket to maintain the lifestyle to which one has become accustomed, justify all the bad habits involuntarily picked up from bad parenting and the ubiquity of entertainment and communication with friends and the complete lack of familiarity with being alone with only ones thoughts for company for any period of time.
I know, for myself, there are easy and hard choices. I'm sure there are impossible choices for some states of mind, but they're a long way from my experience, and so all of the above may sound incredibly insensitive to those to whom I cannot even fake to relate with. I mean no offense, I'd like to have it explained.
Is mental illness ever a learnt behaviour?
Is mental illness a crystallisation of habits we unknowingly locked ourselves into?
What is mental illness and what is just unfamiliar, not yet modelled behaviour and reactions to behaviour?
Can any of the spectrums be navigated downwards through the smallest of steps over a long enough time period?
What if "domestic violence" was actually a mental illness?
(I ask the above to invoke thoughtfulness about our definitions and limitations and reactions to labels. I do not justify domestic violence, but that's because I believe there is always some amount of choice in how a human can react to a situation).
The label can be a shield against change or a weapon used to slay any accusation of weakness of discipline or laziness. It can be used as a security blanket to maintain the lifestyle to which one has become accustomed, justify all the bad habits involuntarily picked up from bad parenting and the ubiquity of entertainment and communication with friends and the complete lack of familiarity with being alone with only ones thoughts for company for any period of time.
I know, for myself, there are easy and hard choices. I'm sure there are impossible choices for some states of mind, but they're a long way from my experience, and so all of the above may sound incredibly insensitive to those to whom I cannot even fake to relate with. I mean no offense, I'd like to have it explained.
Is mental illness ever a learnt behaviour?
Is mental illness a crystallisation of habits we unknowingly locked ourselves into?
What is mental illness and what is just unfamiliar, not yet modelled behaviour and reactions to behaviour?
Can any of the spectrums be navigated downwards through the smallest of steps over a long enough time period?
What if "domestic violence" was actually a mental illness?
(I ask the above to invoke thoughtfulness about our definitions and limitations and reactions to labels. I do not justify domestic violence, but that's because I believe there is always some amount of choice in how a human can react to a situation).
> The label is a shield against change
Surely it could be used for that. But it could also be used to get people who seem to fit the label to connect and discuss their own puzzling patterns of behavior, perhaps better understand why they never fit in no matter how hard they tried and so on. What is absolutely clear to me is that we as a population aren’t uniform at all in thinking and operating; being a minority could be a painful experience as you’re expected to conform to the norm. I think most discussion that expands this understanding is useful.
Surely it could be used for that. But it could also be used to get people who seem to fit the label to connect and discuss their own puzzling patterns of behavior, perhaps better understand why they never fit in no matter how hard they tried and so on. What is absolutely clear to me is that we as a population aren’t uniform at all in thinking and operating; being a minority could be a painful experience as you’re expected to conform to the norm. I think most discussion that expands this understanding is useful.
For official diagnoses I think labels can be a useful way to begin conversations about improvement. However what looks like a growing trend is self-diagnoses. In those cases what seems to be happening more often is the label becomes an excuse and an identity to try to live up to.
I don't think self-diagnosis is something that should be encouraged or lauded in any way. It seems more harmful than good so far.
I don't think self-diagnosis is something that should be encouraged or lauded in any way. It seems more harmful than good so far.
Growing up in the 80s, kids usually weren’t diagnosed with autism unless it was severe. There’s no cure/medication, so seeking an official diagnosis is of no real benefit. But many people eventually connect the dots as adults, maybe do some reading, and suddenly make sense of their struggles and behaviors. Are they really less ‘valid’ than those with an ‘official’ diagnosis?
I need to do something and this is something is not usually a good justification for anything.
It takes literally years of experience to properly diagnose someone, so yes, I do think it is potentially less valid than an official diagnosis. Self diagnosis has an effect of becoming a self fulfilling prophecy many times. Therapists have to get training in avoiding leading a patient into a wrong diagnosis because it leads to some terrible outcomes. It's called "iatrogenic illness" in the literature. Self diagnosing patients have none of that training and are at significantly higher risk of causing it to themselves.
It takes literally years of experience to properly diagnose someone, so yes, I do think it is potentially less valid than an official diagnosis. Self diagnosis has an effect of becoming a self fulfilling prophecy many times. Therapists have to get training in avoiding leading a patient into a wrong diagnosis because it leads to some terrible outcomes. It's called "iatrogenic illness" in the literature. Self diagnosing patients have none of that training and are at significantly higher risk of causing it to themselves.
> Therapists have to get training in avoiding leading a patient into a wrong diagnosis because it leads to some terrible outcomes.
I suffered incredibly negative consequences to my life after being incorrectly diagnosed as bipolar 2.
It shattered my confidence and belief in myself as I was continually told the things I believed and the decisions I made were from a position of mania. It’s too hard to explain in a short comment but it’s potentially one of the most damaging medical interactions I’ve ever had in terms of what it did to my life.
I suffered incredibly negative consequences to my life after being incorrectly diagnosed as bipolar 2.
It shattered my confidence and belief in myself as I was continually told the things I believed and the decisions I made were from a position of mania. It’s too hard to explain in a short comment but it’s potentially one of the most damaging medical interactions I’ve ever had in terms of what it did to my life.
Self diagnosis seems completely natural when mental health care is unavailable because of a shortage of providers, or expense. What else are people going to do?
Worse, in mental care you're better off doing g some self-diagnosis to narrow down the possibilities and know which specialist to go first. If you just go to the first general psychiatrist you can find, it's likely they'll first want you explore depression.
The problem with the above is, treating depression is a long process that can take years to yield perceptible results. If you try to explore it first, chances are you'll never explore anything else. Many of the other diagnoses can be tested and ruled out much faster, possibly in days to weeks (e.g. ADHD), so this is what you'd be better off starting with - but you have to suspect it first to know to seek out a psychiatrist specializing in that particular condition and ask them for an evaluation specifically.
The problem with the above is, treating depression is a long process that can take years to yield perceptible results. If you try to explore it first, chances are you'll never explore anything else. Many of the other diagnoses can be tested and ruled out much faster, possibly in days to weeks (e.g. ADHD), so this is what you'd be better off starting with - but you have to suspect it first to know to seek out a psychiatrist specializing in that particular condition and ask them for an evaluation specifically.
I didn't say it wasn't understandable. I just don't think it's a good idea or something to encourage. If it actually makes things worse, even if it sounds like a good idea, it's not something that should be encouraged. And I do think it has a tendency to make things worse.
Your first two questions I'd answer with, "Yes, trauma."
Additionally, I suspect an expert would say, "Domestic Violence is a crime caused by mental illness."
Additionally, I suspect an expert would say, "Domestic Violence is a crime caused by mental illness."
Some conditions can make it very difficult for a person to figure out who they even are. Undiagnosed autists and others can go decades trying and failing to be as successful and "normal" as others and may see it as failure on their part. For a lot of those people finally having a label that explains who they are and why can be a huge step for improving their life. Can such labels/identities be used as an excuse? Sure. But often it's also a legitimate explanation, and I think it's actually helpful in at least as many cases. To be fair it can be difficult for people to judge whether an affected person uses it as excuse or honest explanation, partly because they don't know the symptoms let alone understand them.
There’s no question kids (and immature young adults) identity shop, they always have, and DSM diagnosis is a nifty badge. And there’s always profit in this desire to be unique just like everyone else. Whether it is a mall store that sells specific identity adornments, or today, doctors who will sign a prescription, both are ways to profit off kids anxiety at being individuals.
But today’s social media (even HN) is dominated by this generation so it is hard to discuss it without being downvoted into oblivion.
But today’s social media (even HN) is dominated by this generation so it is hard to discuss it without being downvoted into oblivion.
Perhaps the pendulum has swung too far, but for me as a kid psychiatric treatment and diagnosis was shameful. Before my time, it was grounds to send people to be locked away forever (which is probably why it was shameful in my childhood).
The new era where everyone has a disorder is, in my opinion, preferable to the one where any disorder was viewed as inherent weakness that needs to be toughed through, even if that means some are diagnosed (or claiming diagnosis) undeservedly.
It means that those that actually need these services (and yes, it's more than just make believe) have an easier and more socially acceptable route.
I view it much the same way I view allergies. Sure, some people are "faking it" to be special, but enough aren't and allergens are a major problem for them. I have a family member that has been hospitalized multiple times because someone decided to test if they really had their allergy.
The new era where everyone has a disorder is, in my opinion, preferable to the one where any disorder was viewed as inherent weakness that needs to be toughed through, even if that means some are diagnosed (or claiming diagnosis) undeservedly.
It means that those that actually need these services (and yes, it's more than just make believe) have an easier and more socially acceptable route.
I view it much the same way I view allergies. Sure, some people are "faking it" to be special, but enough aren't and allergens are a major problem for them. I have a family member that has been hospitalized multiple times because someone decided to test if they really had their allergy.
[deleted]
I don't think most mental health professionals would say that mental illness is a reason to maintain a damaging lifestyle. Quite the opposite - damaging normal healthy function is one of the defining traits of a mental illness, and one of the ways that mental illness is distinguished from normal variance in human cognition and emotion.
But mental illness, as a framing, suggests a different course of action.
When I was severely depressed many years ago, I was constantly trying to force myself to take more actions, to do more to change my life circumstances. I was nearly always screaming at myself inside my head to JUST DO SOMETHING AHHHHH. But that didn't work.
It wasn't that I didn't want to do things. It was that I was, in a local sense, incapable of doing them. Not in the sense that I physically could not, say, move my muscles to go clean up my kitchen, but in the sense that I could not trigger the series of brain processes required to do that. The analogy I used a lot at the time was that it felt like being one of those old cord-pull lawn mowers. I could pull and pull and pull and pull and all I'd ever hear was the engine sputtering, and it was the most frustrating thing in the world.
But today, here's how I'd frame the state I was in:
* I was under significant stress from my living situation and self-criticism.
* I was under too much stress to emotionally cope with, so
* I disengaged from feeling anything too strongly about my life or the world around me,
* Which drained the positive and negative reward structures that feed into motivation, and
* I spent so much energy trying to fend off those thoughts that
* I didn't have sufficient mental energy for anything else, so
* I couldn't do the daily maintenance tasks needed to avoid further deterioration
Put another way, ability to overcome one's natural tendencies is a finite resource, and I was exhausting mine completely just getting through the day without losing it, which was disabling my ability to fix my situation.
I didn't need to yell at myself more. What I needed was an environment that wasn't constantly stressing me out, and to train myself not to burn all my mental energy hating myself. Once I got that environment, once I understood that motivation is only very weakly under my direct control, and once I trained myself to maintain an environment that didn't add stress to my life, my mental health struggles abated.
-----
To put this in more HN-y terms, mental illness has a lot of similarities to working with a crappy external API (that's the mental illness bit) and to technical debt (that's the life-state bit).
You can't go fix someone else's API. It's going to feed you crappy poorly-structured unreliable data all day long and there's nothing you can do about it. But you can build a wrapper around it. You can validate it. You can learn to view what it tells you with a critical eye, and to correct for its common errors.
And you can't fix technical debt today. Today you just have to engineer around it. But if that's all you ever do, the debt keeps accumulating and the problem gets worse. But if you can free up some time to go fix things, that frees up even more time to fix even more things, and you can find yourself on a more positive feedback loop that brings you back into a healthy place.
The way you're framing this, BLKNSLVR, is like saying "it's possible to build software on top of this foundation, so just do it". And it is possible. But it isn't easy, it burns far more resources than it should, and it doesn't fix the problem. The proper solution is to figure out a way to not be on fire today, then fix the underlying problem so you're not on fire tomorrow.
But mental illness, as a framing, suggests a different course of action.
When I was severely depressed many years ago, I was constantly trying to force myself to take more actions, to do more to change my life circumstances. I was nearly always screaming at myself inside my head to JUST DO SOMETHING AHHHHH. But that didn't work.
It wasn't that I didn't want to do things. It was that I was, in a local sense, incapable of doing them. Not in the sense that I physically could not, say, move my muscles to go clean up my kitchen, but in the sense that I could not trigger the series of brain processes required to do that. The analogy I used a lot at the time was that it felt like being one of those old cord-pull lawn mowers. I could pull and pull and pull and pull and all I'd ever hear was the engine sputtering, and it was the most frustrating thing in the world.
But today, here's how I'd frame the state I was in:
* I was under significant stress from my living situation and self-criticism.
* I was under too much stress to emotionally cope with, so
* I disengaged from feeling anything too strongly about my life or the world around me,
* Which drained the positive and negative reward structures that feed into motivation, and
* I spent so much energy trying to fend off those thoughts that
* I didn't have sufficient mental energy for anything else, so
* I couldn't do the daily maintenance tasks needed to avoid further deterioration
Put another way, ability to overcome one's natural tendencies is a finite resource, and I was exhausting mine completely just getting through the day without losing it, which was disabling my ability to fix my situation.
I didn't need to yell at myself more. What I needed was an environment that wasn't constantly stressing me out, and to train myself not to burn all my mental energy hating myself. Once I got that environment, once I understood that motivation is only very weakly under my direct control, and once I trained myself to maintain an environment that didn't add stress to my life, my mental health struggles abated.
-----
To put this in more HN-y terms, mental illness has a lot of similarities to working with a crappy external API (that's the mental illness bit) and to technical debt (that's the life-state bit).
You can't go fix someone else's API. It's going to feed you crappy poorly-structured unreliable data all day long and there's nothing you can do about it. But you can build a wrapper around it. You can validate it. You can learn to view what it tells you with a critical eye, and to correct for its common errors.
And you can't fix technical debt today. Today you just have to engineer around it. But if that's all you ever do, the debt keeps accumulating and the problem gets worse. But if you can free up some time to go fix things, that frees up even more time to fix even more things, and you can find yourself on a more positive feedback loop that brings you back into a healthy place.
The way you're framing this, BLKNSLVR, is like saying "it's possible to build software on top of this foundation, so just do it". And it is possible. But it isn't easy, it burns far more resources than it should, and it doesn't fix the problem. The proper solution is to figure out a way to not be on fire today, then fix the underlying problem so you're not on fire tomorrow.
Thank you for the detailed reply. I have very shallow experience with some of what you said above, and the way you explained it makes the 'stuck' feeling make more sense.
I've treated it, in the past, as "you've gotten over it before, you'll get over it again, try not to take it out on other people in the meantime", which is treating the symptoms not the cause.
I'll re-read this a few times.
Thank you.
I've treated it, in the past, as "you've gotten over it before, you'll get over it again, try not to take it out on other people in the meantime", which is treating the symptoms not the cause.
I'll re-read this a few times.
Thank you.
There are "causes," and "effects."
A lot of "effects" are actually expressions of coping mechanisms. Things like drug use, spousal abuse, excessive sexual promiscuity, hoarding, having three hundred cats, etc., are, quite possibly, self-prescribed ways to deal with the pain created by inner "causes."
Very often, these coping mechanisms cause more problems, that also need to be coped/fixed.
Say we steal a hat.
We're a "thief." Simple, straightforward, and solves society's problem.
But why did we steal the hat?
Did we steal it to keep the sun off our head? That means we wanted it for personal security.
Did we steal it because it's a cool hat, with a cool logo, and will impress our companions? That means we stole it to improve our social standing.
Did we steal it, because we think that it will impress $MEMBER_OF_SEX_WE_LIKE? That means we stole it, because we wanted to have more sex.
We could also have stolen it, because we are compulsive thieves, and just had to steal it; for no other reason, than we could. Stealing the hat was a coping mechanism for the inner pain, created by not stealing it.
The first three causes are motivations, and aren't necessarily any indication of a particular psychiatric disorder (but there's still stuff needs to be dealt with). There's a pretty good chance that consequences can be factored into the decision to steal, mitigating the problem.
The last one, though, is straight from the DSM, and jail isn't really going to do anything to solve the problem. It will still be there, when we get out. Same goes for many people that are lifelong predators/offenders.
I'm a big believer in addressing root causes, and not just playing Whack-A-Mole with effects. This applies for finding and fixing software bugs, as well as my own pathologies. I like to fix the bug at its deepest level. When I was younger, I tended to apply the fix at the shallowest possible point.
That means that I need to be excruciatingly self-honest. We look at diagnoses of mental illness or personal pathology as "investments," and tend to deliberately deny any data that may indicate that our diagnosis is wrong, or incomplete. Basic human nature. I have close family with extremely serious mental illness, and have been watching this play out, with highly educated therapists.
Reality really doesn't give a crap about what we think. It just is. There's no "moral" component. There's no need for accolades or approval. There's no money to be made.
It. Just. Is., no matter what we do to bend it into our own worldview.
If we're good with the shallow fix (and, in many cases, that's fine), then we can go for the easy fix, and we don't need to disturb our carefully-cultivated theories.
If we really want to understand the cause, though, and apply the fix at a deep level that will ensure a robust and lasting solution, we need to be absolutely brutal about cleaning house, inventorying our own points of view, and avoiding sacred cows and third rails[0].
[0] https://littlegreenviper.com/miscellany/sacred-cows-and-thir...
A lot of "effects" are actually expressions of coping mechanisms. Things like drug use, spousal abuse, excessive sexual promiscuity, hoarding, having three hundred cats, etc., are, quite possibly, self-prescribed ways to deal with the pain created by inner "causes."
Very often, these coping mechanisms cause more problems, that also need to be coped/fixed.
Say we steal a hat.
We're a "thief." Simple, straightforward, and solves society's problem.
But why did we steal the hat?
Did we steal it to keep the sun off our head? That means we wanted it for personal security.
Did we steal it because it's a cool hat, with a cool logo, and will impress our companions? That means we stole it to improve our social standing.
Did we steal it, because we think that it will impress $MEMBER_OF_SEX_WE_LIKE? That means we stole it, because we wanted to have more sex.
We could also have stolen it, because we are compulsive thieves, and just had to steal it; for no other reason, than we could. Stealing the hat was a coping mechanism for the inner pain, created by not stealing it.
The first three causes are motivations, and aren't necessarily any indication of a particular psychiatric disorder (but there's still stuff needs to be dealt with). There's a pretty good chance that consequences can be factored into the decision to steal, mitigating the problem.
The last one, though, is straight from the DSM, and jail isn't really going to do anything to solve the problem. It will still be there, when we get out. Same goes for many people that are lifelong predators/offenders.
I'm a big believer in addressing root causes, and not just playing Whack-A-Mole with effects. This applies for finding and fixing software bugs, as well as my own pathologies. I like to fix the bug at its deepest level. When I was younger, I tended to apply the fix at the shallowest possible point.
That means that I need to be excruciatingly self-honest. We look at diagnoses of mental illness or personal pathology as "investments," and tend to deliberately deny any data that may indicate that our diagnosis is wrong, or incomplete. Basic human nature. I have close family with extremely serious mental illness, and have been watching this play out, with highly educated therapists.
Reality really doesn't give a crap about what we think. It just is. There's no "moral" component. There's no need for accolades or approval. There's no money to be made.
It. Just. Is., no matter what we do to bend it into our own worldview.
If we're good with the shallow fix (and, in many cases, that's fine), then we can go for the easy fix, and we don't need to disturb our carefully-cultivated theories.
If we really want to understand the cause, though, and apply the fix at a deep level that will ensure a robust and lasting solution, we need to be absolutely brutal about cleaning house, inventorying our own points of view, and avoiding sacred cows and third rails[0].
[0] https://littlegreenviper.com/miscellany/sacred-cows-and-thir...
The problem with brutally honest introspection is that coping mechanisms exist for a reason.
The people who would benefit the most from self-honesty are the people most vulnerable to not being able to handle the truth, and potentially leaning even harder into unhealthy coping.
The people who would benefit the most from self-honesty are the people most vulnerable to not being able to handle the truth, and potentially leaning even harder into unhealthy coping.
> not being able to handle the truth
That's why we shouldn't do it on our own. There are many frameworks for rigorous self-evaluation.
That's why we shouldn't do it on our own. There are many frameworks for rigorous self-evaluation.
Please share your recommendations.
What worked for me, may not work for others. It would be irresponsible to make any recommendations.
It's fairly important for each of us to take the initiative to find our own path, as that helps us to stay on-beam.
I will say that any successful path will be difficult. It has been my observation and experience, that nothing worthwhile comes easy.
It's fairly important for each of us to take the initiative to find our own path, as that helps us to stay on-beam.
I will say that any successful path will be difficult. It has been my observation and experience, that nothing worthwhile comes easy.
> Is mental illness a crystallisation of habits we unknowingly locked ourselves into?
This has to be trolling. You have to deny even the most extreme forms of mental illness, like schizophrenia with persistent hallucinations, to be so completely obtuse in the current era as to blame mental illness on the patients.
> What if "domestic violence" was actually a mental illness?
If you plead insanity and are a danger to others, you go to an institution. This isn't an edgy thought experiment, bud. This is the sad reality of peoples' lives that you're dismissing. Fuck you with this flame bait, seriously. You aren't "just asking questions", you're an asshole.
This has to be trolling. You have to deny even the most extreme forms of mental illness, like schizophrenia with persistent hallucinations, to be so completely obtuse in the current era as to blame mental illness on the patients.
> What if "domestic violence" was actually a mental illness?
If you plead insanity and are a danger to others, you go to an institution. This isn't an edgy thought experiment, bud. This is the sad reality of peoples' lives that you're dismissing. Fuck you with this flame bait, seriously. You aren't "just asking questions", you're an asshole.
I was not intending to offend or troll and my apologies for coming across to you like that.
It's a sensitive topic that covers myriad issues both mild and extreme and I guess my questions were around the milder side and therefore could be taken as offensive if looking at it from the more extreme side.
The article focuses heavily on autism and only mentions schizophrenia once, so my commentary was based mostly on autism. The article also mentions sociopathy / antisocial personality disorder, which feels to me fairly distant from autism, or at least the lower ends of that spectrum.
It's a sensitive topic that covers myriad issues both mild and extreme and I guess my questions were around the milder side and therefore could be taken as offensive if looking at it from the more extreme side.
The article focuses heavily on autism and only mentions schizophrenia once, so my commentary was based mostly on autism. The article also mentions sociopathy / antisocial personality disorder, which feels to me fairly distant from autism, or at least the lower ends of that spectrum.
> complete lack of familiarity with being alone with only ones thoughts for company for any period of time.
Riiiight…
Riiiight…
We’re all hanging out in the comments, none of us should be casting that stone.
Why are people so desperate to cling to labels? As I get older the notion of identity just seems increasingly absurd. Identities and labels have just become their own end. People seem like they don't exist anymore except on the terms and expectations already laid out by other people. It's no way to live.
People find others who have things in common with them. Those things people have in common get names. Those named things become a big part of a persons life and so become an identity.
Sometimes, identities are something that we choose- the article is focused on people choosing a psychiatric diagnosis as an identity but there are a lot of other identities people choose, based on their work, hobbies, where they live, etc.
For example, I am a programmer. It’s an identity I have, based on both my work and hobbies. It’s a useful shorthand for me to share some information about myself and find other likeminded people.
People don’t always choose their identities either. A lot of people have an identity imposed on them. When society creates an identity around something that applies to you, it might be impossible to avoid it even if you want to, and embracing it may be a necessary survival strategy.
I don’t think it’s a matter of desperation that people cling to them. In some cases it’s a matter of pride, people want a way to claim their membership in a group and show their values and things they care about. I think we all do it, but some people are aware of it or do it intentionally more than others. In other cases, like I said, it’s not a choice. People may desperately want to not have a label imposed on them but they can do little to avoid it.
Sometimes, identities are something that we choose- the article is focused on people choosing a psychiatric diagnosis as an identity but there are a lot of other identities people choose, based on their work, hobbies, where they live, etc.
For example, I am a programmer. It’s an identity I have, based on both my work and hobbies. It’s a useful shorthand for me to share some information about myself and find other likeminded people.
People don’t always choose their identities either. A lot of people have an identity imposed on them. When society creates an identity around something that applies to you, it might be impossible to avoid it even if you want to, and embracing it may be a necessary survival strategy.
I don’t think it’s a matter of desperation that people cling to them. In some cases it’s a matter of pride, people want a way to claim their membership in a group and show their values and things they care about. I think we all do it, but some people are aware of it or do it intentionally more than others. In other cases, like I said, it’s not a choice. People may desperately want to not have a label imposed on them but they can do little to avoid it.
Identities can backfire though because people who don't identify as your identity have different ideas about that identity than you might.
For example I'll never say "I'm a programmer" in a mixed social gathering of people I don't already know. It's a total conversation killer for anyone who isn't a programmer (i.e. most other people) and I really try to avoid bringing it up at least until I have found something else in common with the person I'm talking to.
And in general, I think people who make $IDENTITY the main feature of their personality will have difficulty outside of that one social group.
For example I'll never say "I'm a programmer" in a mixed social gathering of people I don't already know. It's a total conversation killer for anyone who isn't a programmer (i.e. most other people) and I really try to avoid bringing it up at least until I have found something else in common with the person I'm talking to.
And in general, I think people who make $IDENTITY the main feature of their personality will have difficulty outside of that one social group.
> Identities can backfire though because people who don't identify as your identity have different ideas about that identity than you might.
That can be true, and I think it's particularly common with imposed, rather than adopted identities. In fact, people having particular ideas about you that aren't necessarily true is the reason a lot of imposed identities exist in the first place. There's not a lot you can really do about it. I suppose you can try very hard to not identify with anything, but that's not always an option, and even when it is it would be a very lonely existence.
> And in general, I think people who make $IDENTITY the main feature of their personality will have difficulty outside of that one social group.
Another way of saying that is that people who aren't well rounded will have trouble in a lot of social situations. I agree with that, but I don't think it's a problem related to having identities so much as it is someone restricting themselves to a single focal identity.
That can be true, and I think it's particularly common with imposed, rather than adopted identities. In fact, people having particular ideas about you that aren't necessarily true is the reason a lot of imposed identities exist in the first place. There's not a lot you can really do about it. I suppose you can try very hard to not identify with anything, but that's not always an option, and even when it is it would be a very lonely existence.
> And in general, I think people who make $IDENTITY the main feature of their personality will have difficulty outside of that one social group.
Another way of saying that is that people who aren't well rounded will have trouble in a lot of social situations. I agree with that, but I don't think it's a problem related to having identities so much as it is someone restricting themselves to a single focal identity.
I've tried introducing myself as "I'm a human", you'd think everyone would agree with this label but it gets unenthusiastic reactions. The followup "You're human too, right?" is even worse.
It gets unenthusiastic reactions because for someone to effectively communicate they need to figure out broadly who you are. By pointing out the obvious you are refusing to give up any information about yourself. It's nearly as bad as saying "I don't want you talking to me".
>you'd think everyone would agree with this label
"We identify with the same label" isn't the important part. What is important is that the other person can place you somewhere.
>you'd think everyone would agree with this label
"We identify with the same label" isn't the important part. What is important is that the other person can place you somewhere.
Do you not understand the lack of enthusiasm? The logic will end with why its lack is not disagreement. Whereas the opposite is implied in your post.
Well, there are some labels that get enthusiasm, and some that don't. Like, of the ones mentioned in the article, "I’m an introvert", "I’m a Libra", "I’m Gen Z", I've actually had some good conversations about conversation styles, astrological sign personalities, and different generations. But when I bring up being human, nobody is willing to get into cognitive biases or the daily mishaps of living. I understand that people have different reactions, but I don't really understand why they react the way they do - it seems like a culture issue.
"I’m an introvert", "I’m a Libra", "I’m Gen Z" - people mention these to separate themselves out of the group, or general population. "I'm a Libra, which is unlike most of you here, therefore my failings are unique and my successes are what makes me special".
When you bring up "being human", you're including everyone else in the good and bad things you attribute to being a human - which is likely to create awkwardness and generate a lot of feelings, most of them not very nice.
When you bring up "being human", you're including everyone else in the good and bad things you attribute to being a human - which is likely to create awkwardness and generate a lot of feelings, most of them not very nice.
>I've tried introducing myself as "I'm a human", you'd think everyone would agree with this label but it gets unenthusiastic reactions. The followup "You're human too, right?" is even worse.
> I don't really understand why they react the way they do - it seems like a culture issue.
I'll dissect it with precision in order to assist you in escaping this particular social and mental trap.
Human social communication absolutely depends on fundamental shared assumptions.
Examples:
Murder is fundamentally bad
Literacy is fundamentally good
Even more fundamental than those:
Everyone literally has a head on their shoulders
Virtually everyone has a face on their head
Everyone is human
Whatever else your or anyone's unique thoughts or self-categorizations, those assumptions must exist or people won't want to engage with you.
Trying to bring them up as a point of discussion will place you in the range of "too weird" to "too crazy" to speak with.
In your specific case, I'd personally take the opener as a type of conversational manipulation. On top of being highly weird, because its an absolute assumption. Parallel to the type of thing that door to door salesmen say.
That is, they pose a question that they know 99% of people will feel compelled to agree with in order to force further conversation. That's you, with this opener.
Personally, I love not answering such questions from door to door sales people that are used to almost 100% compliance.
I give sales people the time of day who instead take a simple and sincere approach.
People are giving you a bad reaction because its a shared unspoken assumption, and because they are feeling manipulated. So, they feel manipulated by someone who is being very weird.
In contrast, introversion, age, and astrological signs are not shared assumptions. They are new information that therefore can be a socially acceptable substrate for further conversation.
Try talking to people about themselves, using simple questions and sincerity. It has a high success rate.
> I don't really understand why they react the way they do - it seems like a culture issue.
I'll dissect it with precision in order to assist you in escaping this particular social and mental trap.
Human social communication absolutely depends on fundamental shared assumptions.
Examples:
Murder is fundamentally bad
Literacy is fundamentally good
Even more fundamental than those:
Everyone literally has a head on their shoulders
Virtually everyone has a face on their head
Everyone is human
Whatever else your or anyone's unique thoughts or self-categorizations, those assumptions must exist or people won't want to engage with you.
Trying to bring them up as a point of discussion will place you in the range of "too weird" to "too crazy" to speak with.
In your specific case, I'd personally take the opener as a type of conversational manipulation. On top of being highly weird, because its an absolute assumption. Parallel to the type of thing that door to door salesmen say.
That is, they pose a question that they know 99% of people will feel compelled to agree with in order to force further conversation. That's you, with this opener.
Personally, I love not answering such questions from door to door sales people that are used to almost 100% compliance.
I give sales people the time of day who instead take a simple and sincere approach.
People are giving you a bad reaction because its a shared unspoken assumption, and because they are feeling manipulated. So, they feel manipulated by someone who is being very weird.
In contrast, introversion, age, and astrological signs are not shared assumptions. They are new information that therefore can be a socially acceptable substrate for further conversation.
Try talking to people about themselves, using simple questions and sincerity. It has a high success rate.
If you spend a long time feeling like nobody understands an aspect of yourself, learning that there's a name for that is a powerful feeling. People naturally gravitate towards people who make them feel understood.
Paradoxical, but I feel part of the process of individuation is coming to terms with just how extraordinarily ordinary we actually are. For many that naturally comes with age, we simply care less about what others think. And it's very freeing. For those that can't get there, I think there is more often than not some kind of arrested development or trauma holding them to that pattern. It absolutely can be overcome; best not judge (it shouldn't really affect you in any case) and see that everyone is on their own path and some are further along than others.
Because of social groups. A single person with $ILLNESS may want to connect with other people with $ILLNESS. Ergo making a group around $ILLNESS and thus identity is born.
Labels are a tool, of communication with the rest of society, of expression.
Labels are a tool, of communication with the rest of society, of expression.
Communication, finding things, solidarity, community, organisation.
If you're part of any group (or set of groups), you're either less or more of an individual, depending on how you look at it, both of which can be viewed normatively as good or bad.
If you're part of any group (or set of groups), you're either less or more of an individual, depending on how you look at it, both of which can be viewed normatively as good or bad.
Having a label (and more specifically a mode of treatment) can be the difference between being treated like a human with health issues and just being "the guy who's weird"
Like with autism. People are going to look at you differently anyway, but if hey know you're autistic, they might be willing to overlook some things that otherwise would label you as weird.
>Why are people so desperate to cling to labels?
Because to exist in any society you need to figure out what you are in relation to that society. If you can't answer "who am I", how could you figure out "what should I do with my life".
Identity itself is neither good or bad, but it is inevitable. The labels are just short hands to communicate an identity.
Because to exist in any society you need to figure out what you are in relation to that society. If you can't answer "who am I", how could you figure out "what should I do with my life".
Identity itself is neither good or bad, but it is inevitable. The labels are just short hands to communicate an identity.
Because people need accommodations, either formal or informal. At its base, the logic is no more complicated. Other reasons for adopting a categorical identity will vary and often be nonexistent.
> People seem like they don't exist anymore except on the terms and expectations already laid out by other people
Hasn't this always been true? think what's changed is the labels and identities being selected between, rather than the actual underlying dynamics. We are social animals, so it seems sort of natural that we'd devote a lot of mental effort to understanding ourselves in the context of other people.
Hasn't this always been true? think what's changed is the labels and identities being selected between, rather than the actual underlying dynamics. We are social animals, so it seems sort of natural that we'd devote a lot of mental effort to understanding ourselves in the context of other people.
A shortcut to identity - it used to be music t-shirts.
They're filling a god shaped hole in their heart. They like most (all?) people don't understand the world or their role in it, or even worse they know they have no role in this world so they reach for what ever can give them fulfilment, belonging and direction, just like religious people do.
I agree that it's no way to live.
I agree that it's no way to live.
> god-shaped hole
This cliche phrase definitely takes me back!
The problem here is of course that gods aren't capable of solving this kind of problem anyway; an external, instrumental purpose ('God made me to do X', or 'God created me to have Y effect on the world') isn't meaningful in the way people want intrinsic or subjective purposes to be anyway.
In that sense religious institutions provide the same kind of earthly, banal, limited meaning that hackerspaces or secular charities or sports clubs or families do. But they're not any better at making existentialist yearnings well-formed than anything else is.
I also don't think all that is necessary to explain the phenomenon at hand. That account is way too broad.
Imo the drive here is more narrative; it's about making the stories of our lives make sense— often in the simple sense of making them unsurprising. Discovering a diagnosis can be very cathartic, and can (partially) explain lots of patterns and events from one's past. It also brings some relief because it tells us that we are not uniquely defective in our failings and points us towards examples of others who have managed to succeed or survive despite the same ailment. And it gives us a vocabulary for identifying similar people from whom we can learn and in whom we can find solidarity. All of those things being are rewarding and/or useful.
This cliche phrase definitely takes me back!
The problem here is of course that gods aren't capable of solving this kind of problem anyway; an external, instrumental purpose ('God made me to do X', or 'God created me to have Y effect on the world') isn't meaningful in the way people want intrinsic or subjective purposes to be anyway.
In that sense religious institutions provide the same kind of earthly, banal, limited meaning that hackerspaces or secular charities or sports clubs or families do. But they're not any better at making existentialist yearnings well-formed than anything else is.
I also don't think all that is necessary to explain the phenomenon at hand. That account is way too broad.
Imo the drive here is more narrative; it's about making the stories of our lives make sense— often in the simple sense of making them unsurprising. Discovering a diagnosis can be very cathartic, and can (partially) explain lots of patterns and events from one's past. It also brings some relief because it tells us that we are not uniquely defective in our failings and points us towards examples of others who have managed to succeed or survive despite the same ailment. And it gives us a vocabulary for identifying similar people from whom we can learn and in whom we can find solidarity. All of those things being are rewarding and/or useful.
it always felt a bit more reactionary to me. a lot of people feel like they were unjustly treated, and the label helps them feel better about that stuff. normally i have seen an adult with a fresh diagnosis go really hard in to that identity, only to realize they over did it and land in a more neutral space.
as someone who has a bunch of adult friends getting autism or add/adhd diagnosed, there is an immediate phase of “all of my problems are caused by this”, followed by “how do i cope with this”, and finally “this is just helpful context for me”.
there are quite a few that get stuck on one of those phases, but largely most people loop back around to a more reasonable view.
as someone who has a bunch of adult friends getting autism or add/adhd diagnosed, there is an immediate phase of “all of my problems are caused by this”, followed by “how do i cope with this”, and finally “this is just helpful context for me”.
there are quite a few that get stuck on one of those phases, but largely most people loop back around to a more reasonable view.
If some find solace in religion, then good for them! But some (most?) are able to lead fulfilled lives without religion, and some lead outright miserable lives even with Jesus/YHWH/Allah/Quetzalcoatl in their hearts.
Religious people have all the same identity issues as non religious people. I’ve been around too many religious people to think otherwise.
That's what I'm saying. We all have these problems, people cope with them differently. Some people fill that hole with religion "hurr durr, I'm a Catholic, others fill it withs "hurr durr, I'm an Oilers fan" and others fill it with psychiatric labels "Hurr durr I'm an autistic bipolar type II"
Different sides of the same coin.
Different sides of the same coin.
I agree with this, but I wouldn’t call it a “god shaped hole” any more than I’d call it an “oilers shaped hole”.
I would, because the thing that used to primarily fill this hole was religion, and thats the hole people are trying to stuff.
I'm not religious btw, this is just what I see.
I'm not religious btw, this is just what I see.
> the thing that used to primarily fill this hole was religion, and thats the hole people are trying to stuff
Calling it "a hole" even, is stretching the metaphor too far. People have needs, and religion has often been used to fill that need, as has nationalism, and occupations, and any other thing. But there isn't a single "hole", and that hole doesn't have a "shape". There's just people who have needs, and ways people have tried to fulfill those needs.
Calling it "a hole" even, is stretching the metaphor too far. People have needs, and religion has often been used to fill that need, as has nationalism, and occupations, and any other thing. But there isn't a single "hole", and that hole doesn't have a "shape". There's just people who have needs, and ways people have tried to fulfill those needs.
At root it's kind of like this, you were right about God but it's not really about religion or religious people in the West. It's about looking for identity within and choosing something versus having something chosen for you. We name ourselves. Now we can choose our identity to be anything and even physical and biological reality is less important than our choices. We are told to find ourselves, fulfilment, belonging and direction within ourselves.
A person can choose their religion now, they can label themselves according to what they believe in. For many in the West religion is a kind of loose political or ideological club. For many, religion and identity is found and chosen from within. "it's the real me", "I have found the meaning in my life by this chosen identity".
But it has not been this way forever, and in other (non-Western) parts of the world it's still another way.
The other way is to have your identity defined from above or outside you. For most people who we were, our identities were defined according to our position, where we lived, what our father did, what the culture was. Your father named you. To be "real" you would behave according to what identity had been given to you. Ultimately God is above everything and with regard to identities, symbolically represents this top down giving of a meaning of life.
I guess it's making the hole bigger than trying to fill it with something else.
Edits:
a) I suppose that some older religious people who were "born into it" might be more towards identity-from-outside.
b) It would work with non religious people in identity-from-outside cultures. Stereotypical examples: a farmer in rural China, a salaryman in Japan or a peasant in 17th Century Germany. Or a culture where children are encouraged to "do their best" with what they have at hand vs "find themselves" with things they might discover.
A person can choose their religion now, they can label themselves according to what they believe in. For many in the West religion is a kind of loose political or ideological club. For many, religion and identity is found and chosen from within. "it's the real me", "I have found the meaning in my life by this chosen identity".
But it has not been this way forever, and in other (non-Western) parts of the world it's still another way.
The other way is to have your identity defined from above or outside you. For most people who we were, our identities were defined according to our position, where we lived, what our father did, what the culture was. Your father named you. To be "real" you would behave according to what identity had been given to you. Ultimately God is above everything and with regard to identities, symbolically represents this top down giving of a meaning of life.
I guess it's making the hole bigger than trying to fill it with something else.
Edits:
a) I suppose that some older religious people who were "born into it" might be more towards identity-from-outside.
b) It would work with non religious people in identity-from-outside cultures. Stereotypical examples: a farmer in rural China, a salaryman in Japan or a peasant in 17th Century Germany. Or a culture where children are encouraged to "do their best" with what they have at hand vs "find themselves" with things they might discover.
A god-shaped hole, or a gap where god once was? https://en.wikipedia.org/wiki/God_of_the_gaps
Cause society leaves you hanging and alone with genetic curses best yiu get is chemical pacifiers and endless wallowing in the psychological diggestive tract to reform you into a productive sociopath. Labels help to for groups of people suffering a similar fate ignored by the out group, which does not get what labels are for.
[deleted]
Priviliges?
Mental illness is quite common. Imagine you could not label people as "creepy" or "invel", because they are most likely on some sort of spectrum. With mental illness they would be protected group. If it's personality trait, they are just creepy loosers.
Mental illness is quite common. Imagine you could not label people as "creepy" or "invel", because they are most likely on some sort of spectrum. With mental illness they would be protected group. If it's personality trait, they are just creepy loosers.
Well, at least it would stop people from calling them names and feeling smugly superior about being on the lucky side of circumstances they likely had zero control over. At the same time, those "creeps" would have more therapy options available, helping at least some of them fit in better with the society at large.
I understand that some types of people are inherently a problem for the majority of the population; I still feel that calling them "creepy losers" is a douchebag behavior that shows lack of empathy.
I understand that some types of people are inherently a problem for the majority of the population; I still feel that calling them "creepy losers" is a douchebag behavior that shows lack of empathy.
Trained, high functioning people with the same condition are likely the best diagnosticians for that condition. At least for The Spectrum. As they would theoretically be better able to identify malingerers. The other side of the coin is that they could be more likely to flesh out a diagnoses in people whose symptoms are subtler or otherwise better covered.
HITOP sounds even worse with a spectrum for everything. It sounds less like a system for diagnoses and more a subjective, self reported way of classifying all humans.
If you look at the suggested measures, you will see that for example, the Big-5 personality traits are on there. https://renaissance.stonybrookmedicine.edu/sites/default/fil.... Although self-reported, I wouldn't say Big-5 is "subjective". The measures have good test-retest validity and many independent scales have been developed and found to be strongly correlated. I would argue this means Big-5 is not just "you answered this question on this scale" - it is measuring something deeper, maybe not personality per se but at least a mental attitude. I could easily see extending this sort of measurement process to all of the traits in DSM, and I think it is a worthwhile goal.
There are two issues I have with HiTOP though. First, they haven't actually developed and published the scales, or even a concise and reliable description of them. For example, if you look for Big-5 scales, you will find that only extraversion and neuroticism are well-defined. The other dimensions aren't replicable. Just by listing Big-5 and not adding any caveats, it is clear that HiTOP isn't taking a critical view of these measures. In terms of actual, usable scales, there are just the ICD-11 and DSM-5 AMPD personality models, and combining these into a concise scale is active research. In this area, the HiTOP project has accomplished little so far besides drawing attention to these and other models. There is a 405-question battery https://hitop.unt.edu/clinical-tools/hitop-digital-assessmen..., but it hasn't been validated.
Second, I find the goals somewhat confused and the distinction between categorical and dimensional somewhat artificial. For example in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/, the proposal is to have a number of traits and to rate their severity. This model isn't particularly different from the current DSM - it is just that now rather than a "diagnosis of autism" one is rated as having a "severe autism trait". It is possible to have multiple diagnoses in the DSM and similarly in the proposed model it is possible to have multiple traits. About the only real difference is that diagnoses are going to be redefined to be one level above, what could be termed a meta-diagnosis in the current DSM. This is presumably going to be more strictly trait-based, and the traits are going to be de-duplicated, so that there are fewer differential diagnoses to deal with. You can see the proposed grouping here: https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP. I don't see much issue with such groupings, but I also don't see it as a big change. Despite them saying it's a new framework that bears no relationship to the current one, I think all the current labels will still be around for a while, and it doesn't seem hard to fit all the DSM-5 labels into the new framework either as traits or as diagnoses (syndromes).
There are two issues I have with HiTOP though. First, they haven't actually developed and published the scales, or even a concise and reliable description of them. For example, if you look for Big-5 scales, you will find that only extraversion and neuroticism are well-defined. The other dimensions aren't replicable. Just by listing Big-5 and not adding any caveats, it is clear that HiTOP isn't taking a critical view of these measures. In terms of actual, usable scales, there are just the ICD-11 and DSM-5 AMPD personality models, and combining these into a concise scale is active research. In this area, the HiTOP project has accomplished little so far besides drawing attention to these and other models. There is a 405-question battery https://hitop.unt.edu/clinical-tools/hitop-digital-assessmen..., but it hasn't been validated.
Second, I find the goals somewhat confused and the distinction between categorical and dimensional somewhat artificial. For example in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/, the proposal is to have a number of traits and to rate their severity. This model isn't particularly different from the current DSM - it is just that now rather than a "diagnosis of autism" one is rated as having a "severe autism trait". It is possible to have multiple diagnoses in the DSM and similarly in the proposed model it is possible to have multiple traits. About the only real difference is that diagnoses are going to be redefined to be one level above, what could be termed a meta-diagnosis in the current DSM. This is presumably going to be more strictly trait-based, and the traits are going to be de-duplicated, so that there are fewer differential diagnoses to deal with. You can see the proposed grouping here: https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP. I don't see much issue with such groupings, but I also don't see it as a big change. Despite them saying it's a new framework that bears no relationship to the current one, I think all the current labels will still be around for a while, and it doesn't seem hard to fit all the DSM-5 labels into the new framework either as traits or as diagnoses (syndromes).
iatrogenesis - when a therapist gives a possible explanation for your problem, they actually harm you because you begin to see it and start acting it out. The world becomes a theater, and you are on stage, playing your part in your mental illness. But these problems have such a low bar for diagnosis, that the majority of people qualify for at least one. But if the majority of people have some trait, is it really illness?
My understanding is that the DSM type labels are only appropriate if the character trait is having a catastrophic effect on someone's life.
Significant. Not catastrophic.
> But these problems have such a low bar for diagnosis, that the majority of people qualify for at least one.
What is your evidence?
> But if the majority of people have some trait, is it really illness?
Lifetime cancer rates in some countries is 1 in 2. Can we say cancer is really illness?
What is your evidence?
> But if the majority of people have some trait, is it really illness?
Lifetime cancer rates in some countries is 1 in 2. Can we say cancer is really illness?
HN editorialised title: "Turning psychiatric labels into identities"
Author's title: "Why We're Turning Psychiatric Labels Into Identities"
Print edition title: "Read the label"
Author's title: "Why We're Turning Psychiatric Labels Into Identities"
Print edition title: "Read the label"
"editorialise = express opinions rather than just report the news"
It is a anti-clickbait practice to remove "you" or "we" (implying reader) from titles on HN, not editorialization.
It is a anti-clickbait practice to remove "you" or "we" (implying reader) from titles on HN, not editorialization.
Correction:
HN edited title: "Why We're Turning Psychiatric Labels Into Identities"
HN edited title: "Why We're Turning Psychiatric Labels Into Identities"
This is a classic mapping problem
This could be true. But the anecdotes and claims in the article are weak evidence.
> Following Layle’s visit to the psychiatrist, her mother observed, “You’ve been acting more and more autistic since we got the diagnosis.”
Reduced masking after diagnosis is common. Or her mother could have noticed and related behaviors she didn't before.
> In 2006, a student at a Mexican boarding school developed devastating leg pain and had trouble walking; soon hundreds of classmates were afflicted. A fifteenth-century German nun started biting her companions; eventually, the strange hysteria infected convents from Holland to Italy.
This is argument from analogy. Mass hysteria spreads without labels. And it is rare.
> Ian Hacking, the philosopher, argued that such a dynamic fuelled the epidemic of multiple personality disorder in the late twentieth century, and something similar seems to be playing out now with the growing portrayal of dissociative identity disorder, the current name for M.P.D., on social media.
This is begging the question. People more qualified than a philosopher have argued many perspectives about DID diagnosis.
> One of Kriss’s patients, a student who went by Haku, developed a multiplicity of selves after being introduced to the concept of dissociative identity disorder. “It’s not that I thought he was faking it,” Kriss recalls. “It seemed more that Haku wanted to have multiple personalities, even if that meant he had to force himself and others to believe in it.”
But does it occur frequently?