Seriously Caplan needs to go spend some time touring a psychiatric unit and meet these people. I think he just hasn't talked to enough people with severe mental illness, and most of this is his armchair theorizing.
The crucial element often missed is that any concept of "mental illness", just like any other concept of health or illness, requires a prior notion of the proper functioning of the organism. This means getting into teleology, which a lot of people are reluctant to do, even though I'd argue it isn't as problematic as we tend to believe these days.
The preferences and incentives talk can be very important in some cases, but it seems like everything gets reduced to "if you put a gun to someone's head..." But that just isn't how life and incentives actually work. Put a gun to someone's head and tell them to walk, and even if they have a broken leg, they'll still try to limp along.
The point in mental illness is often less a function of whether someone is simply making "bad decisions", but whether their neurocognitive machinery that is used for perceiving reality, regulating their impulses, managing memory, moods, etc etc is functioning in the way it is supposed to, or if it is systematically thrown off by, say, an infection, autoimmune disorder, metabolic disturbance, or what we call schizophrenia (which is almost certainly what we'd call a developmental synaptopathy and not some Szaszian thing where someone just has different preferences from the crazy society he finds himself in).
I think Caplan is wrong about the force of his "put a gun to the head" argument, due to various reasons discussed by Scott, nevertheless I have two points to note on the matter. The first is that there is a large disconnect between how lay people conceptualize mental illness and how people with more nuanced views such as Scott do, I think Szasz through various aphorisms can reveal the weird inconsistencies with the usual over medicalised account of mental illness and help gain a greater sense of awareness as to the fact that various demarcations are in large part a value judgement.
Secondly from what I can tell, Scott seems reluctant to give examples of how actual psychologists go about compiling the DSM, of interest here would be for example, Richard Green on how the APA went about removing homosexuality from the DSM, "Ludicrously, that decision led to a shotgun marriage between science and democracy." or the Blanchard Rind controversy on whether pedohebephilia should be considered a disorder (not to be confused with the other Rind controversy) interestingly the current stance in the DSM 5 is to demarcate between a paraphilia and paraphilic disorder. Even more broadly sex researchers use a great variety of terms such as Paraphilias, Paraphilic disorders, Fetishes, Kinks, Sexual Orientation etc. and have moved various conditions in and out of these categories, much in the style that Green has outlined, in fact even if a coherent definition of the above were to be established, given the limited amount of quantitative data, one couldn't even in principle justify putting something in one category as opposed to another, outside of doing so on the basis of not doing positive science. As such I think the Szaszian account has a lot greater explanatory power than people give it credit for.
If we can't really agree on what the terms mean, then aren't we just discussing which filter or heuristic to adopt? It seems to me that he is claiming that treating these things as preferences and leaving people alone unless they commit crimes is the best thing to do. This seems like bog standard libertarianism. It is possible to disagree that this would be a good move for a society to make, but arguing about what words to use doesn't seem helpful.
I think the involvement of normative aspects interferes with an attempt to analyze things in an objective scientific manner. Caplan believes in objective "common sense" morality, I think he's wrong about that. Greg Cochran's approach of looking at Darwinian fitness is objective/scientific, but basically everyone in psych prefers some other normative standard.
If preferences can be mental illnesses, then we must permit that mental illnesses are better than their absence, for they facilitate a greater variety of possible sources of value. Either illnesses rock because preferences rock, or preferences aren't illnesses, and I'd say the latter is more intuitive. Let me elaborate a bit more on preferences being awesome.
The technology to become almost-omnipotent is within humanity's reach; reality could be negotiable on the levels that matter most; we could live in a dreamlike world where everyone gets what they want and there are no trade-offs. Given that, it is strictly worse to destroy the preferences of others than to help them cope with the temporary pre-singularity trade-offs that their preferences involve.
> If you have an insatiable preference for ... having sex with small children ... those are all preferences, but if there was a way to cure them, they’d be very worth curing and would be mental illnesses.
Them's fightin' words! When I was 6 I wanted to have sex with pedophile women. The actual opinions of children on whether they can consent are unjustly dismissed and minimized. In a better future where we recover ever so slightly from our excessive ageism, I would have had the privilege of a scandalous forbidden romance with one of the many pedophile women such as those teachers who are presently thrown in prison for the actually-consensual but statutorily-disapproved intercourse they have with their male students.
There is some core of “mental illness” that people are referring to. While Ill-defined in the abstract, many people have put a lot of time into figuring out specific conditions that constitute mental illness.
This is a useful framework. Oftentimes recognizing the signs of illness and treating it can be very good for people.
Is it possible that most of the resistance to the terminology stems from an aversion to forcing people to change their beliefs on pain of imprisonment? I am also somewhat skeptical that a person capable of understanding the facts of their situation and who refuses treatment should be treated. If they’re a danger to others, locked up, but forcible treatment could be a step too far.
I don’t think that aversion is intrinsically tied to whether we have a strong definition of mental illness, or whether that includes “preferences”. It just requires a particular view of the rights of an individual.
Seriously Caplan needs to go spend some time touring a psychiatric unit and meet these people. I think he just hasn't talked to enough people with severe mental illness, and most of this is his armchair theorizing.
The crucial element often missed is that any concept of "mental illness", just like any other concept of health or illness, requires a prior notion of the proper functioning of the organism. This means getting into teleology, which a lot of people are reluctant to do, even though I'd argue it isn't as problematic as we tend to believe these days.
The preferences and incentives talk can be very important in some cases, but it seems like everything gets reduced to "if you put a gun to someone's head..." But that just isn't how life and incentives actually work. Put a gun to someone's head and tell them to walk, and even if they have a broken leg, they'll still try to limp along.
The point in mental illness is often less a function of whether someone is simply making "bad decisions", but whether their neurocognitive machinery that is used for perceiving reality, regulating their impulses, managing memory, moods, etc etc is functioning in the way it is supposed to, or if it is systematically thrown off by, say, an infection, autoimmune disorder, metabolic disturbance, or what we call schizophrenia (which is almost certainly what we'd call a developmental synaptopathy and not some Szaszian thing where someone just has different preferences from the crazy society he finds himself in).
I think Caplan is wrong about the force of his "put a gun to the head" argument, due to various reasons discussed by Scott, nevertheless I have two points to note on the matter. The first is that there is a large disconnect between how lay people conceptualize mental illness and how people with more nuanced views such as Scott do, I think Szasz through various aphorisms can reveal the weird inconsistencies with the usual over medicalised account of mental illness and help gain a greater sense of awareness as to the fact that various demarcations are in large part a value judgement.
Secondly from what I can tell, Scott seems reluctant to give examples of how actual psychologists go about compiling the DSM, of interest here would be for example, Richard Green on how the APA went about removing homosexuality from the DSM, "Ludicrously, that decision led to a shotgun marriage between science and democracy." or the Blanchard Rind controversy on whether pedohebephilia should be considered a disorder (not to be confused with the other Rind controversy) interestingly the current stance in the DSM 5 is to demarcate between a paraphilia and paraphilic disorder. Even more broadly sex researchers use a great variety of terms such as Paraphilias, Paraphilic disorders, Fetishes, Kinks, Sexual Orientation etc. and have moved various conditions in and out of these categories, much in the style that Green has outlined, in fact even if a coherent definition of the above were to be established, given the limited amount of quantitative data, one couldn't even in principle justify putting something in one category as opposed to another, outside of doing so on the basis of not doing positive science. As such I think the Szaszian account has a lot greater explanatory power than people give it credit for.
I like this article but dont think BC would be convinced by it
fun fact Thomas szaszsz was the original choice to play lord Voldemort but JK Rowling objected because he wasn’t British
If we can't really agree on what the terms mean, then aren't we just discussing which filter or heuristic to adopt? It seems to me that he is claiming that treating these things as preferences and leaving people alone unless they commit crimes is the best thing to do. This seems like bog standard libertarianism. It is possible to disagree that this would be a good move for a society to make, but arguing about what words to use doesn't seem helpful.
I think the involvement of normative aspects interferes with an attempt to analyze things in an objective scientific manner. Caplan believes in objective "common sense" morality, I think he's wrong about that. Greg Cochran's approach of looking at Darwinian fitness is objective/scientific, but basically everyone in psych prefers some other normative standard.
You're mistaken. Please change your mind.
If preferences can be mental illnesses, then we must permit that mental illnesses are better than their absence, for they facilitate a greater variety of possible sources of value. Either illnesses rock because preferences rock, or preferences aren't illnesses, and I'd say the latter is more intuitive. Let me elaborate a bit more on preferences being awesome.
The technology to become almost-omnipotent is within humanity's reach; reality could be negotiable on the levels that matter most; we could live in a dreamlike world where everyone gets what they want and there are no trade-offs. Given that, it is strictly worse to destroy the preferences of others than to help them cope with the temporary pre-singularity trade-offs that their preferences involve.
> If you have an insatiable preference for ... having sex with small children ... those are all preferences, but if there was a way to cure them, they’d be very worth curing and would be mental illnesses.
Them's fightin' words! When I was 6 I wanted to have sex with pedophile women. The actual opinions of children on whether they can consent are unjustly dismissed and minimized. In a better future where we recover ever so slightly from our excessive ageism, I would have had the privilege of a scandalous forbidden romance with one of the many pedophile women such as those teachers who are presently thrown in prison for the actually-consensual but statutorily-disapproved intercourse they have with their male students.
Thanks for the discussion on this! I was unfamiliar with these people and their arguments.
Suppose people who eat only vegan had health problems en masse. Would that change your opinion on animal products?
Zhanna Samsonova may be philosophically your ideal, but I think even you would agree she was mentally ill.
At the end of the day, there is no clear dividing line between health and illness of any sort.
There is some core of “mental illness” that people are referring to. While Ill-defined in the abstract, many people have put a lot of time into figuring out specific conditions that constitute mental illness.
This is a useful framework. Oftentimes recognizing the signs of illness and treating it can be very good for people.
Is it possible that most of the resistance to the terminology stems from an aversion to forcing people to change their beliefs on pain of imprisonment? I am also somewhat skeptical that a person capable of understanding the facts of their situation and who refuses treatment should be treated. If they’re a danger to others, locked up, but forcible treatment could be a step too far.
I don’t think that aversion is intrinsically tied to whether we have a strong definition of mental illness, or whether that includes “preferences”. It just requires a particular view of the rights of an individual.