Posted by alexandra_k on September 14, 2006, at 21:25:41
In reply to Re: internet and the manufacture of madness... » alexandra_k, posted by Dinah on September 14, 2006, at 9:52:10
> "an excessive dependence on and a demanding attitude towards others"
Okay :-)> I think that the issue about rather pscyh diagnoses are value laden is a most important one.
Yeah, there is a lot of debate...
> Clearly the mental health community itself has decided they *can* be, since they have removed various "illnesses" from the DSM.
Yeah, that is true. I guess the debate is fairly much around the issue of whether mental illnesses are *essentially* value laden or whether psychiatric classification can approximate the objectivity of... classification of clades in biology (for example).
According to the folk theory of biology whales are fish. Then the biologists come along and tell us that whales aren't fish they are mammals. According to folk theory of biology trees are a natural kind. Then the biologists come along and tell us that trees aren't a natural kind. There aren't any interesting generalisations that you can make about trees in general and whether something is a tree or a shrub can depend on climate and other environmental conditions.
The DSM has been critiqued for being something like a systematisation of folk theory of mental illness. A lot of the categories in the DSM haven't been validated and it is very unclear that you can make interesting generalisations on the basis of the current dx categories. Psychiatry isn't as well developed as a science as biology is. One of the hopes is that pscyhiatric nosology should improve so that it captures real kinds of mental illness.
There would be a problem with this approach if psychiatry was essentially value laden in a way that biology (as an example) is not.
Wakefield has been influential for his 'harmful dysfunction' analysis of mental disorder. He thinks that there are two components to mental disorder.
1) An (objective) dysfunction / disorder / disease within the individual.
2) A value judgement that that dysfunction / disorder / disease is bad.
He thinks that both conditions are necessary and that they are together jointly sufficient for mental illness.He has been critiqued on a number of grounds. With respect to his first condition, some have argued that the notion of disorder / dysfunction / disease is essentially value laden and hence the notion is not objective.
Medicine and some aspects of biology also make use of the notion of disorder / dysfunction / disease, however. If those notions are essentially value laden then psychiatry, medicine, and those aspects of biology would be in trouble with respect to being a proper (objective) science. Perhaps...
> An ideal of "healthy" that is tied into what the community values.
Perhaps... Though... If I break my leg then there wouldn't seem to be any problem in saying that my leg is objectively malfunctioning, disordered, or diseased. How I feel about my leg being broken, whether I think it is a 'good' or a 'bad' thing, however, would seem to be a seperate matter.
> Clearly if someone could go to a different society with the same set of "symptoms" and be judged fine there, and ill here, then the judgement of illness is based on a lack of adherence to customary cultural norms rather than a true illness?
The judgement is. But is there a fact of the matter about whether the person is ill or not? If you think dysfunction / disorder / disease is objective then it follows that people can be wrong with their judgements.
If mental illness is a neurological dysfunction / disorder in the sense that there are neural mechanisms that are malfunctioning then psychiatry (once we have hit upon the true natural kinds of nature) would seem to be similarly objective.
Some people argue that psychiatry, medicine, and biology more generally requires value judgement because you can't cash out function / malfunction (dysfunction or disorder) in a way that doesn't require value.
Ruth Millikan has done a lot of work (in philosophy) on how function / dysfunction can be cashed out in a way that doesn't require values (it is determined by physical facts and a historical notion of 'proper function').
e.g., the proper function of the heart is to pump blood. the heart does a lot of things besides pumping blood, however, it makes thumpity thump noises, for example. If the heart made thumpity thump noises rather than pumping blood then the organism would die, however. If the heart pumped blood but didn't make thumpity thump noises then the organism could be just as well off as a heart that pumped blood and did make thumpity thump noises. The heart was selected (by natural selection) in virtue of its pumping blood. Hence, the proper function of the heart is to pump blood.
You could say that treating survival as the organisms 'good' is to introduce values. But... seems to be a pan-cultural 'good' so thats okay. Maybe psychiatry can similarly cash out the notion of disorder, dysfunction or whatever in a naturalistic way that isn't interestingly value laden... Or maybe not. Even the biology case is controversial. Still, if psychiatry only requires values in the way that biology requires values then that isn't terribly interesting... Most people agree that biology is a proper objective science so there isn't such a problem.
Just some ravings (sorry I didn't have time to edit...)
I'm not sure what I think...
Whether it is possible for psychiatric taxonomy to be objective (similarly to biological classification of clades) or whether that will never work because classification essentially requires value judgements where the value judgements that are required vary across cultures...
I'm not sure what I think...
Is the term 'excessive' something that can be cashed out objectively or is it essentially value laden? (going back to the terminology you thought required value judgement). Is the term 'demanding attitude' something that can be objectively assessed or is that essentially a value judgement too? Hard to say... I agree such language should be curbed / eliminated if possible.
poster:alexandra_k
thread:684913
URL: http://www.dr-bob.org/babble/social/20060911/msgs/686061.html