Wednesday, July 8, 2020

Comments by michael_mascolo

Showing 2 of 2 comments.

  • Here is an important thought experiment. So, let’s say that neuro-scientists find evidence that some pattern of psychological activity (assuming it could be pinned down to a single pattern) that can be called “depression” correlates with or can be mapped onto brain pattern xyz. The question becomes: If I detect xyz in you, and you do not exhibit the “depressive” psychological pattern in question, are you still depressed? How could the answer to this question possibly be yes? (Unless you want to be bizarre and say, “the person is depressed but asymptomatic.) This is an important question because it doesn’t matter what psychological profile a person exhibits when he or she has diabetes, cancer or heart disease. The disease is defined by the level of insulin, the aberrant growth of the cells, or the clogging of the arteries, regardless of the person’s psychological profile. This suggests that, conceptually (and even if they have biological roots — which ALL psychological processes have), psychological problems are not brain illnesses. Conceptually, psychological problems must be defined psychologically, and with reference to standards and values that define normative forms of psychological activity. This does not rule out the participation of biological processes in aberrant psychological patterns. Biological processes do not operate independent from psychological and socio-cultural processes.

  • Jonathan: In my view, your remarks are right on. Yes, Insel’s critique is of the validity of the DSM is much like Szasz’s. But his solution is very different — he sees aberrant behavior as a series of symptoms of biological (brain) illness. The British Psychological Society (?) I think, is similarly critical of the DSM, but adopts a very different solution — preferring to maintain the focus on the psychological level of functioning, and not to reduce it to brain. They may err, however, on an over-emphasis on environmentalist-leaning interpretations of the origins of norm-violating psychological patterns.

    In my view, Szasz’ notion that the concept of “mental illness” is conceptually incoherent is correct. However, Szasz’s position WAS too extreme. He advocated a rather rigorous libertarianism — a view in which individuals with psychological problems were seen as primarily responsible for their actions and able to make their own decisions regardless of their degree of impairment. This actually brings back a Cartesian notion of mind and therefore cannot become ill. However, in saying this, Szasz treats the “mind” as some rational and encased process that exists independent from the brain. That’s the only way that he can say, it seems to me, that the person with psychological difficulties necessarily can behave “rationally” and have full responsibility for his or her actions. This goes too far. We need new ideas for understanding the nature of the psychological–ideas that neither reduce conscious agency to brain activity nor define “mind” as something that stands outside of the context of brain activity and the physical body.

    Bravo, Jonathan!