The Myth of Mental Illness
By: Dr. Sam Vaknin
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"You can know the name of a bird in all the languages of the world, but when you're finished, you'll know absolutely nothing whatever about the bird… So let's look at the bird and see what it's doing – that's what counts. I learned very early the difference between knowing the name of something and knowing something."
Richard Feynman, Physicist and 1965 Nobel Prize laureate (1918-1988)
"You have all I dare say heard of the animal spirits and how they are transfused from father to son etcetera etcetera – well you may take my word that nine parts in ten of a man's sense or his nonsense, his successes and miscarriages in this world depend on their motions and activities, and the different tracks and trains you put them into, so that when they are once set a-going, whether right or wrong, away they go cluttering like hey-go-mad."
Lawrence Sterne (1713-1758), "The Life and Opinions of Tristram Shandy, Gentleman" (1759)
III. The Biochemistry and Genetics of Mental Health
IV. The Variance of Mental Disease
V. Mental Disorders and the Social Order
VI. Mental Ailment as a Useful Metaphor
I. Overview
Someone is considered mentally "ill" if:
1. His conduct rigidly and consistently deviates from the typical, average behaviour of all other people in his culture and society that fit his profile (whether this conventional behaviour is moral or rational is immaterial), or
2. His judgment and grasp of objective, physical reality is impaired, and
3. His conduct is not a matter of choice but is innate and irresistible, and
4. His behavior causes him or others discomfort, and is
5. Dysfunctional, self-defeating, and self-destructive even by his own yardsticks.
Descriptive criteria aside, what is the essence of mental disorders? Are they merely physiological disorders of the brain, or, more precisely of its chemistry? If so, can they be cured by restoring the balance of substances and secretions in that mysterious organ? And, once equilibrium is reinstated – is the illness "gone" or is it still lurking there, "under wraps", waiting to erupt? Are psychiatric problems inherited, rooted in faulty genes (though amplified by environmental factors) – or brought on by abusive or wrong nurturance?
These questions are the domain of the "medical" school of mental health.
Others cling to the spiritual view of the human psyche. They believe that mental ailments amount to the metaphysical discomposure of an unknown medium – the soul. Theirs is a holistic approach, taking in the patient in his or her entirety, as well as his milieu.
This article appears in my book "Malignant Self-love: Narcissism Revisited"
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In a way, the three schools are akin to the trio of blind men who render disparate descriptions of the very same elephant. Still, they share not only their subject matter – but, to a counter intuitively large degree, a faulty methodology.
As the renowned anti-psychiatrist, Thomas Szasz, of the State University of New York, notes in his article "The Lying Truths of Psychiatry", mental health scholars, regardless of academic predilection, infer the etiology of mental disorders from the success or failure of treatment modalities.
This form of "reverse engineering" of scientific models is not unknown in other fields of science, nor is it unacceptable if the experiments meet the criteria of the scientific method. The theory must be all-inclusive (anamnetic), consistent, falsifiable, logically compatible, monovalent, and parsimonious. Psychological "theories" – even the "medical" ones (the role of serotonin and dopamine in mood disorders, for instance) – are usually none of these things.
The outcome is a bewildering array of ever-shifting mental health "diagnoses" expressly centred around Western civilisation and its standards (example: the ethical objection to suicide). Neurosis, a historically fundamental "condition" vanished after 1980. Homosexuality, according to the American Psychiatric Association, was a pathology prior to 1973. Seven years later, narcissism was declared a "personality disorder", almost seven decades after it was first described by Freud. Prominent psychiatrists have taken to accusing the committee that is busy writing the next, fifth edition of the DSM (to be published in 2013) of pathologizing large swathes of the population:
“Two eminent retired psychiatrists are warning that the revision process is fatally flawed. They say the new manual, to be known as DSM-V, will extend definitions of mental illnesses so broadly that tens of millions of people will be given unnecessary and risky drugs. Leaders of the American Psychiatric Association (APA), which publishes the manual, have shot back, accusing the pair of being motivated by their own financial interests - a charge they deny.” (New Scientist, “Psychiatry’s Civil War”, December 2009).
Perhaps the two tests of whether a set of cognitions, emotions, and behaviors constitutes a clinical entity should be:
1. Invariance: is it considered a mental illness across all cultures, periods in history, and societies? If it is, chances are that we are dealing with an objective, ontological, immutable diagnosis.
2. Is it the outcome of an ego-syntonic personal philosophy or ideology? If it is, chances are that this is a culture-bound syndrome, not a mental illness.
II. Personality Disorders
Indeed, personality disorders are an excellent example of the kaleidoscopic landscape of "objective" psychiatry.
The classification of Axis II personality disorders – deeply ingrained, maladaptive, lifelong behavior patterns – in the Diagnostic and Statistical Manual, fourth edition, text revision [American Psychiatric Association. DSM-IV-TR, Washington, 2000] – or the DSM-IV-TR for short – has come under sustained and serious criticism from its inception in 1952, in the first edition of the DSM.
The DSM IV-TR adopts a categorical approach, postulating that personality disorders are "qualitatively distinct clinical syndromes" (p. 689). This is widely doubted. Even the distinction made between "normal" and "disordered" personalities is increasingly being rejected. The "diagnostic thresholds" between normal and abnormal are either absent or weakly supported.
The polythetic form of the DSM's Diagnostic Criteria – only a subset of the criteria is adequate grounds for a diagnosis – generates unacceptable diagnostic heterogeneity. In other words, people diagnosed with the same personality disorder may share only one criterion or none.
The DSM fails to clarify the exact relationship between Axis II and Axis I disorders and the way chronic childhood and developmental problems interact with personality disorders.
The differential diagnoses are vague and the personality disorders are insufficiently demarcated. The result is excessive co-morbidity (multiple Axis II diagnoses).
The DSM contains little discussion of what distinguishes normal character (personality), personality traits, or personality style (Millon) – from personality disorders.
A dearth of documented clinical experience regarding both the disorders themselves and the utility of various treatment modalities.
This article appears in my book "Malignant Self-love: Narcissism Revisited"
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Numerous personality disorders are "not otherwise specified" – a catchall, basket "category".
Cultural bias is evident in certain disorders (such as the Antisocial and the Schizotypal).
The emergence of dimensional alternatives to the categorical approach is acknowledged in the DSM-IV-TR itself:
“An alternative to the categorical approach is the dimensional perspective that Personality Disorders represent maladaptive variants of personality traits that merge imperceptibly into normality and into one another” (p.689)
The following issues – long neglected in the DSM – are likely to be tackled in future editions as well as in current research. But their omission from official discourse hitherto is both startling and telling:
· The longitudinal course of the disorder(s) and their temporal stability from early childhood onwards;
· The genetic and biological underpinnings of personality disorder(s);
· The development of personality psychopathology during childhood and its emergence in adolescence;
· The interactions between physical health and disease and personality disorders;
· The effectiveness of various treatments – talk therapies as well as psychopharmacology.
III. The Biochemistry and Genetics of Mental Health
Certain mental health afflictions are either correlated with a statistically abnormal biochemical activity in the brain – or are ameliorated with medication. Yet the two facts are not ineludibly facets of the same underlying phenomenon. In other words, that a given medicine reduces or abolishes certain symptoms does not necessarily mean they were caused by the processes or substances affected by the drug administered. Causation is only one of many possible connections and chains of events.
To designate a pattern of behaviour as a mental health disorder is a value judgment, or at best a statistical observation. Such designation is effected regardless of the facts of brain science. Moreover, correlation is not causation. Deviant brain or body biochemistry (once called "polluted animal spirits") do exist – but are they truly the roots of mental perversion? Nor is it clear which triggers what: do the aberrant neurochemistry or biochemistry cause mental illness – or the other way around?
That psychoactive medication alters behaviour and mood is indisputable. So do illicit and legal drugs, certain foods, and all interpersonal interactions. That the changes brought about by prescription are desirable – is debatable and involves tautological thinking. If a certain pattern of behaviour is described as (socially) "dysfunctional" or (psychologically) "sick" – clearly, every change would be welcomed as "healing" and every agent of transformation would be called a "cure".
The same applies to the alleged heredity of mental illness. Single genes or gene complexes are frequently "associated" with mental health diagnoses, personality traits, or behaviour patterns. But too little is known to establish irrefutable sequences of causes-and-effects. Even less is proven about the interaction of nature and nurture, genotype and phenotype, the plasticity of the brain and the psychological impact of trauma, abuse, upbringing, role models, peers, and other environmental elements.
Nor is the distinction between psychotropic substances and talk therapy that clear-cut. Words and the interaction with the therapist also affect the brain, its processes and chemistry - albeit more slowly and, perhaps, more profoundly and irreversibly. Medicines – as David Kaiser reminds us in "Against Biologic Psychiatry" (Psychiatric Times, Volume XIII, Issue 12, December 1996) – treat symptoms, not the underlying processes that yield them.
IV. The Variance of Mental Disease
If mental illnesses are bodily and empirical, they should be invariant both temporally and spatially, across cultures and societies. This, to some degree, is, indeed, the case. Psychological diseases are not context dependent – but the pathologizing of certain behaviours is. Suicide, substance abuse, narcissism, eating disorders, antisocial ways, schizotypal symptoms, depression, even psychosis are considered sick by some cultures – and utterly normative or advantageous in others.
This was to be expected. The human mind and its dysfunctions are alike around the world. But values differ from time to time and from one place to another. Hence, disagreements about the propriety and desirability of human actions and inaction are bound to arise in a symptom-based diagnostic system.
As long as the pseudo-medical definitions of mental health disorders continue to rely exclusively on signs and symptoms – i.e., mostly on observed or reported behaviours – they remain vulnerable to such discord and devoid of much-sought universality and rigor.
V. Mental Disorders and the Social Order
The mentally sick receive the same treatment as carriers of AIDS or SARS or the Ebola virus or smallpox. They are sometimes quarantined against their will and coerced into involuntary treatment by medication, psychosurgery, or electroconvulsive therapy. This is done in the name of the greater good, largely as a preventive policy.
Conspiracy theories notwithstanding, it is impossible to ignore the enormous interests vested in psychiatry and psychopharmacology. The multibillion dollar industries involving drug companies, hospitals, managed healthcare, private clinics, academic departments, and law enforcement agencies rely, for their continued and exponential growth, on the propagation of the concept of "mental illness" and its corollaries: treatment and research.
“The wording used in the DSM has a significance that goes far beyond questions of semantics. The diagnoses it enshrines affect what treatments people receive, and whether health insurers will fund them. They can also exacerbate social stigmas and may even be used to deem an individual such a grave danger to society that they are locked up ... Some of the most acrimonious arguments stem from worries about the pharmaceutical industry's influence over psychiatry. This has led to the spotlight being turned on the financial ties of those in charge of revising the manual, and has made any diagnostic changes that could expand the use of drugs especially controversial.” (New Scientist, “Psychiatry’s Civil War”, December 2009).
VI. Mental Ailment as a Useful Metaphor
Abstract concepts form the core of all branches of human knowledge. No one has ever seen a quark, or untangled a chemical bond, or surfed an electromagnetic wave, or visited the unconscious. These are useful metaphors, theoretical entities with explanatory or descriptive power.
"Mental health disorders" are no different. They are shorthand for capturing the unsettling quiddity of "the Other". Useful as taxonomies, they are also tools of social coercion and conformity, as Michel Foucault and Louis Althusser observed. Relegating both the dangerous and the idiosyncratic to the collective fringes is a vital technique of social engineering.
The aim is progress through social cohesion and the regulation of innovation and creative destruction. Psychiatry, therefore, is reifies society's preference of evolution to revolution, or, worse still, to mayhem. As is often the case with human endeavour, it is a noble cause, unscrupulously and dogmatically pursued.
Another useful metaphor is to consider mental illness as a kind of self-perpetuating viral organism, which injects negative statements into the mind of the patient (nod to Cognitive-Behavioral Therapy, or CBT). Like every organism, it strives to perpetuate its existence, transfer its genes (its life-negating, dysfunctional, and self-defeating theorems), and fend off its enemies. Often, the patient reports feeling “invaded” or “body-snatched” by his disorders, which he experiences as “alien” to his core or essence.
VII. The Insanity Defense
"It is an ill thing to knock against a deaf-mute, an imbecile, or a minor. He that wounds them is culpable, but if they wound him they are not culpable." (Mishna, Babylonian Talmud)
If mental illness is culture-dependent and mostly serves as an organizing social principle - what should we make of the insanity defense (NGRI- Not Guilty by Reason of Insanity)?
A person is held not responsible for his criminal actions if s/he cannot tell right from wrong ("lacks substantial capacity either to appreciate the criminality (wrongfulness) of his conduct" - diminished capacity), did not intend to act the way he did (absent "mens rea") and/or could not control his behavior ("irresistible impulse"). These handicaps are often associated with "mental disease or defect" or "mental retardation".
Mental health professionals prefer to talk about an impairment of a "person's perception or understanding of reality". They hold a "guilty but mentally ill" verdict to be contradiction in terms. All "mentally-ill" people operate within a (usually coherent) worldview, with consistent internal logic, and rules of right and wrong (ethics). Yet, these rarely conform to the way most people perceive the world. The mentally-ill, therefore, cannot be guilty because s/he has a tenuous grasp on reality.
Yet, experience teaches us that a criminal maybe mentally ill even as s/he maintains a perfect reality test and thus is held criminally responsible (Jeffrey Dahmer comes to mind). The "perception and understanding of reality", in other words, can and does co-exist even with the severest forms of mental illness.
This article appears in my book "Malignant Self-love: Narcissism Revisited"
Click HERE to buy the print edition from Amazon (click HERE to buy a copy dedicated by the author)
Click HERE to buy electronic books (e-books) and video lectures (DVDs) about narcissists, psychopaths, and abuse in relationships
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This makes it even more difficult to comprehend what is meant by "mental disease". If some mentally ill maintain a grasp on reality, know right from wrong, can anticipate the outcomes of their actions, are not subject to irresistible impulses (the official position of the American Psychiatric Association) - in what way do they differ from us, "normal" folks?
This is why the insanity defense often sits ill with mental health pathologies deemed socially "acceptable" and "normal" - such as religion or love.
Consider the following case:
A mother bashes the skulls of her three sons. Two of them die. She claims to have acted on instructions she had received from God. She is found not guilty by reason of insanity. The jury determined that she "did not know right from wrong during the killings."
But why exactly was she judged insane?
Her belief in the existence of God - a being with inordinate and inhuman attributes - may be irrational.
But it does not constitute insanity in the strictest sense because it conforms to social and cultural creeds and codes of conduct in her milieu. Billions of people faithfully subscribe to the same ideas, adhere to the same transcendental rules, observe the same mystical rituals, and claim to go through the same experiences. This shared psychosis is so widespread that it can no longer be deemed pathological, statistically speaking.
She claimed that God has spoken to her.
As do numerous other people. Behavior that is considered psychotic (paranoid-schizophrenic) in other contexts is lauded and admired in religious circles. Hearing voices and seeing visions - auditory and visual delusions - are considered rank manifestations of righteousness and sanctity.
Perhaps it was the content of her hallucinations that proved her insane?
She claimed that God had instructed her to kill her boys. Surely, God would not ordain such evil?
Alas, the Old and New Testaments both contain examples of God's appetite for human sacrifice. Abraham was ordered by God to sacrifice Isaac, his beloved son (though this savage command was rescinded at the last moment). Jesus, the son of God himself, was crucified to atone for the sins of humanity.
A divine injunction to slay one's offspring would sit well with the Holy Scriptures and the Apocrypha as well as with millennia-old Judeo-Christian traditions of martyrdom and sacrifice.
Her actions were wrong and incommensurate with both human and divine (or natural) laws.
Yes, but they were perfectly in accord with a literal interpretation of certain divinely-inspired texts, millennial scriptures, apocalyptic thought systems, and fundamentalist religious ideologies (such as the ones espousing the imminence of "rapture"). Unless one declares these doctrines and writings insane, her actions are not.
We are forced to the conclusion that the murderous mother is perfectly sane. Her frame of reference is different to ours. Hence, her definitions of right and wrong are idiosyncratic. To her, killing her babies was the right thing to do and in conformity with valued teachings and her own epiphany. Her grasp of reality - the immediate and later consequences of her actions - was never impaired.
It would seem that sanity and insanity are relative terms, dependent on frames of cultural and social reference, and statistically defined. There isn't - and, in principle, can never emerge - an "objective", medical, scientific test to determine mental health or disease unequivocally.
VIII. Adaptation and Insanity - (correspondence with Paul Shirley, MSW)
"Normal" people adapt to their environment - both human and natural.
"Abnormal" ones try to adapt their environment - both human and natural - to their idiosyncratic needs/profile.
If they succeed, their environment, both human (society) and natural is pathologized.
Note on the Medicalization of Sin and Wrongdoing
With Freud and his disciples started the medicalization of what was hitherto known as "sin", or wrongdoing. As the vocabulary of public discourse shifted from religious terms to scientific ones, offensive behaviors that constituted transgressions against the divine or social orders have been relabelled. Self-centredness and dysempathic egocentricity have now come to be known as "pathological narcissism"; criminals have been transformed into psychopaths, their behavior, though still described as anti-social, the almost deterministic outcome of a deprived childhood or a genetic predisposition to a brain biochemistry gone awry - casting in doubt the very existence of free will and free choice between good and evil. The contemporary "science" of psychopathology now amounts to a godless variant of Calvinism, a kind of predestination by nature or by nurture.
The Conspiracy of Symptoms: Mental Illness as a Network – Metaphor or Reality?
Network methodology and concepts are recently being applied to mental health
disorders (psychopathology): symptoms are treated as nodes, causally
interconnected via biological, psychological, and societal mechanisms.
Symptoms can become self-sustaining and self-reinforcing as they get integrated
in robust feedback loops. The entire network than becomes chaotic (disordered).
Stable states of networked symptoms amount to discreet mental health diagnoses
(Borsboom, D.(2017) A Network Theory of Mental Disorders, World Psychiatry,
16(1): 5–13, https://doi.org/10.1002/wps.20375).
This reconception of mental illness as a network of directly and dynamically
interacting symptoms is a reversal of the medicalized, static common cause and
latent variable model where symptoms are brought on by a single mental health
syndrome or disorder (Bringmann, L. F., & Eronen, M. I. (2018). Don't blame
the model: Reconsidering the network approach to psychopathology. Psychological
Review, 125 (4), 606-615. https://doi.org/10.1037/rev0000108).
In these nascent models, the emphasis is on internal psychodynamic etiology.
They neglect social and interpersonal interactions as major drivers of mental
dysfunction. Indeed, incorporating other people in such diagrammatics will
serve the flesh out the network, materialize it, put on a human face on it, and
connect the internal to the external, as is the case in real life. Interactions
with significant others or strangers, intimate partners, or colleagues, family,
and friends are as symptom-inducing as any neurotransmitter. Indeed, they are
often the direct cause for such secretions and for most crucial and relevant
network effects and cascades in the first place.
Networks are not a new concept. As Douglas Hofstadter noted in “Godel, Escher,
Bach”, Indra’s bejewelled Net is 3000 years old. The most modern incarnations
of this organizational principle have to do with computing and business.
National economies and the global arena are set up as networks of producers,
suppliers, and consumers or users. Indeed, the network is one of two organizing
principles in business, the other being hierarchy. Business units process flows
of information, power, and economic benefits and distribute them among the
various stakeholders (management, shareholders, workers, consumers, government,
communities, etc.)
Similarly, neural networks are used to process information (both endogenous and
exogenous), convey instructions and programming, allocate energy, and monitor
and distribute outcomes among its corporeal clients. They bring together
producers of signalling and catalyzing molecules and their consumers and
end-users: various tissues and body systems.
In mental health networks, it is possible that symptoms act like thermodynamic
sinks, draining data generated from within and from without and filtered via
psychological constructs, defense mechanisms, memories, core identity,
socialized roles, inhibitions, and internal and external objects.
Within networks, timing determines priority and privileged access. First movers
(pioneers, early adopters, or processes which immediately follow stimuli such
as triggers) benefit the most from network effects. In hierarchies, positioning
is spatial, not temporal: one’s slot in the pyramid determines one’s outcomes.
But this picture is completely reversed when we consider interactions with the
environment: The spatial scope and structure of the network (e.g., the number
of nodes, the geographic coverage) determine its success while the storied
history of the hierarchy (its longevity, in other words: its temporal aspect)
is the best predictor of its reputational capital and its capacity for wealth
or signal generation.
Counterintuitively, access to information and the power it affords are not
strongly correlated with accrued benefits. In networks, information and power
flow horizontally: everyone (or everything, every node) is equipotent and
isomorphic. Like a fractal or a crystal, every segment of the network is
identical to the other both structurally and functionally (isomorphism). But
benefits accrue vertically to the initiators of the network and are heavily
dependent on tenure and mass: the number of nodes “under” the actor. Thus, the
earlier participants or members enjoy an exponentially larger share of the
benefits than latecomers (MLM commissions, ad revenues in business – or access to
mental resources and processing power in psychology).
In hierarchies, benefit accrual is also closely correlated with one’s position
in the organization and, less often, with one’s tenure. Power, information, and
benefits are skewed and flow vertically and asymmetrically: the hierarchical
organization is based on diminishing potency and heteromorphism (no functional
cross-section of the structure resembles another). Members of the hierarchy
experience an external locus of control and often develop alloplastic defenses
(they blame the world for their failures and errors) and passive-aggressive
reactive patterns.
As usual, evolution borrowed the best of all possible worlds, models, structural
engineering approaches, and action principles. In living organisms and even
moreso in human psychology, hierarchies combine with networks seamlessly to
yield optimal favourable outcomes.
Consider this apex and culmination of creation: the brain.
Neural activity in the brain is subject to thresholds of activation and
excitation which accrue in multiple populations or units. This structure is
midway between a network and a hierarchy and resembles the stock exchange with
its trading curbs or circuit breakers (where every equidistant participant is
equipotent, at least ideally).
Networks evolve from informal, diffuse structures to increasingly formal ones.
Hierarchies go the other way: from formal to informal. The formal hierarchy
ends up playing host to numerous informal networks (e.g. in the boardroom or in
the neuroplastic brain as it re-wires its pathways).
In business, over time and as size increases, informal networks tend to
introduce terms of service, regulations, and etiquette that render them less
nimble and more focused. In the brain, they generate proteins that code for
memories and are stable structures within otherwise plastic neural pathways.
Finally, hierarchies tend to concentrate their concerted efforts on
problem-solving and on fending off challenges. They seek equilibrium and
homeostasis and avoid creative destruction, disruptive technologies, and
paradigm-altering innovation.
In the business world, networks thrive on challenges and novelty. They benefit
from disequilibrium and disruption. They foster technological instability as
well as other forms of chaotic interaction such as creative disruption and
creative destruction. Consequently, they tend to attract mavericks and
entrepreneurs, not managers and academics, for instance.
Again, the brain is a delicate balancing act between these two models with
interspersed and interacting stable and stochastic structures. Exactly like in
the twin cases of cancer and viruses - lethal mutative pathologies which serve
also as evolutionary agents – mental illness may be a way to experiment with
variations on the themes of mental health in order to yield or discover higher,
more efficient organizational structures, principles, and processes.
Both hierarchies and networks are homophilic (attract same-minded people, and
similar stimuli, information, constituents, or elements) and, therefore, acts
as “sinks”. Both are threatened by confirmation bias and by the emergence of
in-house monocultures which are susceptible to external shocks (“silos”).
But networks are far better suited to leverage synergies: they are less rigid
than hierarchies and, as a result, have the upper hand as far as coordinated
emergent response times and dissemination of new information go. Networks are
also far better suited to optimize their social or peer capital (same tissue
biological cells or neurones are such “peers”) because they emphasize social,
peer-to-peer interactions over top-down flows.
Networks go through a life cycle which can be divided to three phases: 1.
Memetic Phase; 2. Network Effects Phase; and 3. Collapse Phase.
The Memetic Phase is autonomous and based on the distributed replication of memes. It is characterized by fecundity (replication) but not by fidelity (authenticity of replicated memes), or longevity.
We use emotions and cognitions to fixate memories and contextualize them
precisely for this reason. In many mental health conditions, this process is
interrupted by various forms of dissociation, by infantile and regressive
defense mechanisms, by cognitive deficits and biases, or via emotional
dysregulation.
The transition to the phase of network effects (network externality) is based
on a bandwagon effect: a positive feedback loop enhances the value of the
network for its members and users the greater their number is.
The more insulated the network is, the more of a self-sufficient and
self-sustaining ecosystem it is, the greater its value to its members. But a
degree of openness to the environment is critical to ensure proper regulation,
validation, calibration, and verification within a regime of non-impaired,
functional testing of reality.
Various psychotherapies emphasize the former self-reinforcing aspects of
networks (CBT) – or the latter, homeostatic functions (mindfulness).
The orthodox prevailing wisdom is that as some critical mass or threshold are
transcended, the network goes viral. But this is not necessarily good news. In
nature, viral pandemics self-limit and peter out. Ageing-related mental health
disorders can be thought of the unfortunate by-products of the inexorable
process of winding down of an organism once “herd immunity” had been
established in its natural, now immune, hosts.
Similarly, all networks decline, decay and collapse if they fail to activate
their members: monopolize or consume their time, monetize their eyeballs,
reward them for time spent within the network, or otherwise create value added
intrinsically or extrinsically. Similarly, incipient networks decay in the
brain if they fail to excite or activate a neural pathway or if they lack
feedback from the body.
Various reinforcement techniques leverage this principle to inculcate in the target some pathology or to eradicate it (healing) by flooding the mind (brain) with the relevant, behavior-triggering, signals and messages – or by starving the unhealthy mind of the cues that provoke the illness. Social media make abundant use of these psychological insights and revelations to foster operant conditioning and long-term addiction in their unfortunate users.
Also, if the network is totally sealed off and homophilic – is biased as far as information and membership flows are concerned, is subject to solipsistic confirmation bias – it is doomed to collapse.
Following the collapse, the network can survive as a remnant, as a residual network (“neutron star network”), or as an archive (“memory” or “identity” which is a set of memories organized into reframed narratives).
Certain mental health conditions, such as psychotic disorders, mimic such
solipsism by confusing and conflating internal objects with external ones.
Consequently, no information is granted a privileged position, no data are
deemed “objective”. This hyperflexive confusion makes it impossible for the
patient to generate self-efficacious feedback loops based on proper reality
testing.
All told, networks thrive when two conditions are met rigorously:
(1) When they generate meaning intrinsically, no matter how outlandish it is
(consider religions, scientology, and inane or eccentric cults such as flat
Earthers, birthers, or believers in reptilian aliens as the true rulers of
humanity).
Such self-generated meaning bonds the members and affords them a feeling of “home”, of affiliated exclusivity, of belonging to a brotherhood. It also provides them with a narcissistic boost due to their access to arcane or occult knowledge.
Networks decay when meaning is exclusively imported (extrinsic) or even when it
arises only as a result of the network’s interactions with other exegetic,
nomological, or hermeneutic systems.
Mental illness may be exactly this: an exclusively internal generation of
meaning which is not subjected to unimpaired or rigorous friction with reality.
(2) Networks thrive when they generate value endogenously, by empowering and
gratifying their members as they leverage the total resources of the network.
Political parties, social media, institutional religions, and the Freemasons
are examples of such networks.
Networks decay when they depend on the outside for value creation (exogenous
value proposition). Even hybrid networks – such as MLMs (Multi-Level Marketing)
- are doomed to fail ultimately owing to this dependence.
Again, mental illness is largely solipsistic (for example, in the cases of
delusions or hallucinations). It serves to restore both ego-syntony and
self-efficacy. It is therefore of critical value to the mentally ill patient.
This might explain why curing mental illness and healing are so difficult to
accomplish: mental disorders, in most cases, are positive adaptations which
allow for the optimization of scarce resources under the constraints of the
individual’s idiosyncratic personality and chaotic life circumstances.
Thus, the more insulated, self-contained, and self-sufficient the network and
its memeplex are as far as generating meaning (goals) and value (benefits, both
emotional and economic) – the longer it survives and the more it prospers.
Facebook and Apple are prime examples of such insular, closed, exclusive
ecosystems. Mental illness is another such instance.
BIBLIOGRAPHY
Alt, R. and Fleisch, E. (2001). Business Networking Systems: Characteristics
and Lessons Learned. 5(2), pp.7-27.
Dubois, L. (2007). How Leaders Create and Use Networks. [online] Harvard
Business Review. Available at: https://hbr.org/2007/01/how-leaders-create-and-use-networks
[Accessed 11 Dec. 2019].
Ibarra, H. and Hunter, L. (2007). How to Network Effectively. [online] Inc.com.
Available at: http://www.inc.com/guides/2010/08/how-to-network-effectively.html
[Accessed 11 Dec. 2019].
Trosson, D. and Kostopoulos, A. (2012). Techno-Economic Aspects of
Information-Centric Networking. Journal of Information Policy, 2, pp.26-50.
Uzzi, B. and Dunlap, S. (2005). How to Build Your Network. [online] Harvard
Business Review. Available at: https://hbr.org/2005/12/how-to-build-your-network
[Accessed 11 Dec. 2019].
Perkin, Emily. Networks: An Annotated Bibliography [online] Research and Policy
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Postscript about the Shortcomings
of Psychology
From
protoscience to proper science: The path ahead for reforming psychology by
Chris Chambers, The Guardian, May 9, 2017
“My aim with this book was to document the fundamental problems I see with
research practices in psychology and how we can fix them. The seven sins, in
turn, are bias, hidden flexibility, unreliability, data hoarding,
corruptibility, internment and bean counting. They cover the full spectrum of
academic practice, from the way we design and report experiments, to the way we
handle fraud cases, to the bizarre ways we attempt to measure the quality of
science and scientists.
Let’s take the first sin as an example. One major form of bias is publication
bias: a well-known form of malpractice in which journals selectively publish
results that are clear and novel, rejecting studies of equivalent quality that
happened to produce negative or less conclusive findings. Because researchers
must publish or perish, publication bias in turn drives researchers to engage
in biased research practices to produce publishable results, regardless of
whether those results are credible. One such routine practice is a form of
hindsight bias in which an unexpected result (usually cherry picked out of a
dataset) is written up as though the author predicted it from the beginning.
Reinventing history helps authors create more compelling narratives, but such
inferences are no different to randomly spraying a wall with a machine gun and
then drawing a bullseye around whereever the bullets happened to land.
One of the best ways to guard against bias is study pre-registration: writing
down in advance our study predictions, how we plan to acquire data, and how we
plan to analyse it once we get it. In science it makes sense to treat our
future self as a different person to our past self, and indeed to treat that
person as a hostile entity. Past me may be genuinely interested in the answer
to a question, but future me knows that I need to play the academic game to
advance my career, and so will tempt me toward bias. Past me can help keep
future me honest by pre-registering his intentions.
In turn, journals have the power to eliminate bias by deciding what gets
published based on detailed study protocols, before results even exist. This
new format of publication, called a Registered Report, breaks the cycle of bias
and holds great promise for improving the reliability of published research.
Even though Registered Reports began in psychology, they have now been adopted
by journals in psychiatry, nutrition, computer science, political science, and
many other fields. The 50th journal to launch them was BMC Biology, showing the
potential for psychology to help formulate solutions in neighbouring
disciplines ...
So much has been said now about the reproducibility crisis, both in psychology
and science in general, that none can honestly profess ignorance. And yet so
many remain silent. I see these people much as I see my former self: experts at
winning, lawyering their way through their academic careers; otherwise
intelligent people cranking the handle in a broken machine. They don’t care if
the system is broken because it seems to work for them. They don’t see how psychology
is failing its public mission because their careers succeeded.
On the other hand I have a deep and abiding respect for senior psychologists
who are facing up to the reality that we need to change the way we work, and I
admire even more the growing ranks of younger scientists who are championing
reform. They are chafing against an academic establishment that, far from
rewarding their efforts, at times labels them as trouble-makers and terrorists.
If reform succeeds it will, in large part, be a victory owed to those
scientists who refused to be silenced and forced the powerful to pay attention.
The overarching message of my book to them, as to all psychologists, is: stay
inspired and keep shouting. Some of us, at least, are listening.”
The Seven Deadly Sins of Psychology: A Manifesto for Reforming the
Culture of Scientific Practice, Chris Chambers, Princeton University Press:
2017.
Whenever a mental health diagnosis
gets a profoundly, awfully bad rep and is stigmatizes and demonized,
unscrupulous, third rate "scholars", bordering on con artists, rush
to enrich themselves by catering to the grievances of the diagnosed clients.
They conjure up, out of whole cloth, flattering "diagnoses" and offer
them as aggrandizing consolations to the aggrieved patients.
Three recent examples: shy or quiet borderline (as distinct from the pernicious
and destructive disorder), empath (read: glorified, angelic covert narcissist),
and high-functioning, “recovered”, or productive narcissist and psychopath (not
the devastating actual dysfunctions).
Let it be crystal clear: there are no such things as shy borderline, empath, or
high-functioning narcissist. These are not clinical entities, you cannot find
them in any college or university textbook, and they do not form a part of any
academic curriculum or syllabus. There are no studies which support any of
these much hyped, exclusively YouTube constructs.
These faux "diagnoses" are proffered to the gullible and to the
grandiose by callous, self-styled, avaricious "experts" and
"coaches": snake oil salesmen and women with zero real world
credentials or track records.
People with debilitating mental illnesses lap these fig leaves up - and pay
hand over foot for the privilege - in order to convert themselves from
perpetrators to victims and from antisocial to prosocial. It makes them feel
good and the purveyors of these shoddy counterfeit wares are laughing all the
way to the bank.
Just try to contest or even question these "diagnoses" where they
congregate in cyberspace and witness the vicious sniping and backlash by
"empaths", the shrill and violent defiance by "shy" and
"quiet" borderlines, and the destructive orgies of decompensation and
acting out by "productive" and "high-functioning" narcissists.
Also Read
The Metaphors of the Mind - Part I (The Brain)
The Metaphors of the Mind - Part II (Psychotherapy)
The Metaphors of the Mind - Part III (Dreams)
The Use and Abuse of Differential Diagnoses
Althusser, Competing Interpellations and the Third Text
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Frequently Asked Questions about Pathological Narcissism
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Internet: A Medium or a Message?
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