The Psychiatry Museum vs. the Reasonable Radical
During my last visit to LA, I visited the Psychiatry: An Industry of Death Museum. Though I knew the Church of Scientology was heavily involved, I was still favorably predisposed. I reject the philosophy of mind that underlies modern psychiatry, and I’m very skeptical about the net long-run benefits of psychiatric treatment. I’m not just an explicit Szaszian; I won the 2005 Szasz Prize. If I wouldn’t appreciate this aggressively-named museum, who would?
Unfortunately, Psychiatry: An Industry of Death was a big disappointment. I was pleased to see multiple video clips of the great Thomas Szasz. I was fascinated by the gruesome tools of early psychiatry. But I can’t imagine any normal American finding the museum remotely persuasive.
Why not? First and foremost, because the museum defends a radical position without admitting that it’s radical! This is a bad strategy even when your audience is a blank slate; if you manage to pique their curiosity, they’ll still quickly discover that you were misrepresenting controversy as consensus. But if your audience is already familiar with the standard story, defending a radical position without admitting it’s radical is rhetorically disastrous. You instantly sound like a brainwashed cultist, too caught up in your own weirdness to even comprehend the standard view. And that’s precisely how Psychiatry: An Industry of Death sounds. Since almost every American adult takes the disease model of mental illness for granted, you can’t credibly start with the flat-out denial of that premise.
Instead, the reasonable radical must take a circuitous path.
Step 1: Fairly describe the conventional view – and grant that it is the conventional view.
Step 2: Make many common-sense observations inconsistent with the conventional view.
Step 3: Show that your radical view explains these anomalous observations.
Step 4: Now, double back and start pointing out deeper flaws in the conventional view.
Step 5: Consider and address counter-arguments.
Step 6: Tirelessly but calmly return to Step 2.
Take my writings on mental illness.
Step 1: I unambiguously acknowledge that I’m criticizing the standard view that most people take for granted.
Step 2: I make common-sense observations such as (a) alleged symptoms of mental illness are usually responsive to incentives, (b) delusions and even hallucinations aren’t generally considered symptoms of mental illness as long as they’re part of an established religion, (c) many strange lifestyles (e.g. extreme mountain climbing) aren’t classified as mental illnesses, even when they’re more self-destructive than other strange lifestyles (e.g. heroin addiction) that are classified as mental illnesses.
Step 3: Present my alternative view that mental illness largely (though perhaps not exclusively) amounts to extreme, socially stigmatized preferences; in other words, that the label is a moral judgment masquerading as a medical judgment.
Step 4: Cover topics like how psychiatrists “discovered” that homosexuality wasn’t really a mental illness.
Step 5: Consider hard cases like visual hallucinations.
Step 6: Keep arguing – and keep listening.
You could object that I fail to live up to my own standards; I’m not the “reasonable radical” I claim to be. But either way, my larger point holds. If you want to sell a radical position to normal people, you have to meet them where they stand. You have to admit that their incredulity is understandable. And you, the radical, must assume the burden of proof. Otherwise, you just sound crazy.
The post appeared first on Econlib.
The link for "reject the philosophy of mind that underlies modern psychiatry" is a 404
Most mental illnesses don't respond to incentives though: For example, autistic people. Consider Scott Alexander's discussion on autism: https://slatestarcodex.com/2015/10/12/against-against-autism-cures/
"And yes, institutionalization adds a whole lot of extra suffering to the mix. But even here, I find Matthews’ narrative overly simplistic. He talks of a world where random doctors swoop in and trick parents into sending their children to institutions out of pure prejudice and stigma. Anyone who’s ever worked with these families has seen something very different. These parents aren’t poor deluded rubes who have been tricked by stigmatizing doctors. They’re well-educated, deeply committed to their children – and desperate. They’ve spent years trying to raise kids who were violent, self-injurious, locked in a sensory hell without the ability to explain their problems verbally, and maybe having seizures all the time to boot. Their decision to institutionalize is a reluctant concession to this reality. I do not feel the slightest bit of qualification to pass judgment upon these parents and I invite anybody who does to spend a few moments talking to them. Unless you can give these parents a better option – and trust me, they’ve looked – institutionalization isn’t a moralistic tale of prejudice and stigma in the medical system. It’s just a few more drops of misery added to the vast morass of suffering that is severe autism."
Also: religion. Suicide bombers still blow themselves up, even though this has an extremely obvious effect of death. More often, people refuse medical treatments for senseless reasons.
I'm still Libertarian because society is totally wrong about what to do about these things, and bio"ethicists" are more likely to ban curing my autism than cure it. Also, although I'm getting some disability payments, I would still be much better off it I was allowed to leave the hellish school system for a job back when my symptoms were less advanced, and I'm having a hard time supporting myself with a job mainly because regulation is an insurmountable morass for me; otherwise I would support myself with my own projects. But still, Caplan's argument that the mentally ill can be threatened with bodily harm into not having their conditions doesn't apply, because for a while really was considering suicide.