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"Not by coincidence the history of psychiatric interventions forcibly imposed on patients is long and depressing....

I'm not familiar with the history of medicine, but as one example medical doctors used to treat nearly every problem by bleeding the patient. Doctors don't do that anymore because medicine is now on a scientific basis and not a folklore basis. Is medicine therefore forever tainted by these past practices and invalid as a field? No. Apply the same logic mutis mutandis to psychiatry. Putting psychiatry on a scientific basis by understanding brain chemistry and functional MRI brain scans will lead to (has already in some cases) effective and humane psychiatric interventions.

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I kind of see the point he is making here, but the simple point of the matter is that psychology is not advanced enough yet to be able to "I kind of see the point he is making here, but the simple point of the matter is that psychology is not advanced enough yet to be able to clearly tell what the cause is of a mental dysfunction. Sometimes it is caused by a brain disorder, sometimes caused by problems in the subconscious."

"But if one has not clearly identified the cause, then one cannot call the illness or the malfunction by the causal root. I mean, it would be great if they could do this, but right now they cannot. It's still an early science."

I agree with the second point...but I'm confused as well given the first.

Are you saying that in all cases of any and every particular mental dysfunction the cause may be a brain disorder or may be a subconscious problem (or even something else), but it's not known whether one or the other, or both, or even other things, are the actual cause?

Or, are you simply saying that it is not known what the cause of all mental dysfunctions are, that although the cause for some specific mental dysfunctions is known to be a brain disorder, and the cause for some other specific mental dysfunctions is known to be caused by subconscious problems, for yet others it is not yet known, and those therefore may be caused by either brain disorders or subconscious problems (or perhaps have some other causes, you mentioned "psychological association" as one possibility)?

Isn't it known that Alzheimer's disease, for instance, is a degenerative brain disease that causes mental dysfunction? Is Alzheimer's a "mental illness" as well as a brain disease?

Is brain damage or injury (from head trauma for instance) which causes the loss of mental function a "mental illness" as well as brain damage?

Isn't it known that subconsciously held ideas cause, as the sole cause, specific psychological problems, such as your friend's problem with abandonment?

If you are not saying that there are no known causes for any and every mental dysfunction, do you still insist on calling brain or neurological disorders (or other physical disorders) which are known to cause mental dysfunctions, "mental illnesses"?

If so, why?

You said: "I hold, as does Objectivism (see "The Psychology of Psychologizing") that a man is responsible for his actions, even if he has a mental illness, so long as he is not psychotic."

I reread that article. It is a good article -- mostly it is about the misuse of psychology or "psychologizing," but she does have a few important things to say that are relevant here.

However, from the line you quoted, it seems as though you do hold that there's an exception to the idea that "mental illnesses" do not cause crime. Perhaps I misunderstand you.

If a man is not responsible, at least in some instances, for his actions if he's "psychotic," then if he commits a crime (an action) while "psychotic," then he's not responsible or guilty of committing a crime; his "psychosis" is responsible; it caused the crime. That is the conundrum that Szasz pointed out, the idea of disease as having agency or causing an individual's actions.

Other than that, in general, I think we mostly agree in as much as holding that psychological problems do not warrant involuntary commitment.

However, although you use the standard, a "danger to others," that is not the current standard for involuntary commitments. It's broader, it is "danger to self or danger to others." Individuals who have psychological problems, yet who have not committed any crime, are involuntarily committed still today, and they are "treated" against their will, even without being committed.

The idea of "psychological problems" implies, in my view at least, something distinct from mental dysfunctions caused by brain or neurological or other bodily disorders or diseases. Alzheimer's disease is a brain disease, not a "mental illness." A cure or treatment for Alzheimer's would require treating the cause, not the effects. Treating or resolving psychological problems requires treating their cause which I'm presuming to be psychological in nature, not physical.

I'm not familiar with the history of medicine, but as one example medical doctors used to treat nearly every problem by bleeding the patient. Doctors don't do that anymore because medicine is now on a scientific basis and not a folklore basis. Is medicine therefore forever tainted by these past practices and invalid as a field? No. Apply the same logic mutis mutandis to psychiatry. Putting psychiatry on a scientific basis by understanding brain chemistry and functional MRI brain scans will lead to (has already in some cases) effective and humane psychiatric interventions.

I'm not certain what "mutis mutandis" means. However I did look up and find a definition of the phrase, "Mutatis mutandis":

"A direct translation from Latin of mutatis mutandis would read, 'with those things having been changed which need to be changed'. More colloquially, it can be interpreted as 'the necessary changes having been made,' where "the necessary changes" are usually implied by a prior statement assumed to be understood by the reader." http://encyclopedia.thefreedictionary.com/mutatis+mutandis

If that's your point, I agree. Certainly, with respect to blood letting, that history doesn't forever taint medicine.

But, with respect to "mental illnesses," specifically with respect to involuntary commitments and "treatments," I do not think all the necessary changes have been made. Doctor-patient relationships should be voluntary.

Edited by Trebor
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If that's your point, I agree. Certainly, with respect to blood letting, that history doesn't forever taint medicine.

But, with respect to "mental illnesses," specifically with respect to involuntary commitments and "treatments," I do not think all the necessary changes have been made. Doctor-patient relationships should be voluntary.

Yes, that is what I meant. Apparently I am part of the horde of people using latin incorrectly. Google returns pages of people using "mutis mutandis" in context but not a single definition.

Doctor-patient relationships should be voluntary, except when they cannot be because the patient is incapacitated or under the age of consent. Even in that circumstance someone acting in the role of parent, guardian or next of kin will provide consent on behalf of the patient. The definitions of "capacity" and "incapacitated" ought to be in legal terms and not dependent on the state of a specific science. The power of the legal proxy appointment can be abused but that issue is legal not scientific.

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Or, are you simply saying that it is not known what the cause of all mental dysfunctions are, that although the cause for some specific mental dysfunctions is known to be a brain disorder, and the cause for some other specific mental dysfunctions is known to be caused by subconscious problems, for yet others it is not yet known, and those therefore may be caused by either brain disorders or subconscious problems (or perhaps have some other causes, you mentioned "psychological association" as one possibility)?

I'm not an expert on mental illnesses, but from what I have read, there is a lot of disagreement within the mental health profession as to which mental illnesses are due to brain malfunction and which are due to psychological problems. The jury is still out even for disorders like schizophrenia, for which the cause is not yet known, which makes it difficult to come up with an effective treatment. There are effective treatments out there for a wide variety of mental illnesses, but it is unclear at this point if one could resolve or at least subdue psychological problems with medication. There are people out there, both in the profession and intelligent observers, that hold that the subconscious is the functioning brain; or at least in the sense that memory retrieval and cognitive functioning can be tied to brain function. As Ayn Rand noted, the subconscious is like a computer that we can program, and the brain acts like a biological computer. So, one day, if one has a mental blockage due to say a trauma, which is now known as repression, it might be treatable via some sort of medication. My point is that as we learn more and more about how the brain operates, more and more medications are being made for ailments such as bipolar disorder, depression, schizophrenia, and yes even Alzheimer's, which was once thought to be more of a psychological problem.

So, as amateurs, we can keep up with the news, but we are not there first hand to make the assessment as to whether or not someone has a psychological problem or a brain malfunction. That is one reason these two sets of mental malfunction problems are categorized as mental illnesses; because they definitely disrupt mental or cognitive functioning.

As to a mental illness causing a crime, no not in the sense of putting an idea in his head, to say rob a bank or to kill his neighbor, but some mental illnesses renders their cognitive judgment very dubious, and if they act on that dubiousness, they could very well commit a crime and not think anything about having done it, because their rational judgment is off kilter. I think they still have to be held responsible for what they do, insofar as they are still able to reason; in other words, so long as one can reason, then he ought to stop and think before committing an action such as an objective crime. In some cases, the mental illness will lead someone to only be able to function short-range, and if they find themselves on the streets because they can't hold a job, some take to robbing and begging to make ends meet such as they are. In those cases, they can be told they have the option of going to jail or getting mental health treatments. Now in the past, when lobotomies were in vogue, that might be a tough choice to make -- don't think I would voluntarily submit to any kind of lobotomy, even these days!

But some mental health professional claim that modern brain medication does the same thing as a lobotomy -- it's part of the controversy of treating the mentally ill. So, the sufferer needs to rationally assess if his treatment is working or not, using his best judgment while getting treatment. But I don't think it should be forced on him, unless he actually become a criminal, and even then he'd have to be given the choice of treatment or jail.

If the subconscious is like a computer, and the brain is that physical computer, then who knows what treatments might arise in the future to re-configure the computer, the biological brain? They are already at the point where disturbing memories can be erased bio-chemically, and then one wouldn't have the psychological problem activated by those memories. I don't think I would ever want to go this, because I don't know how well they can control what is and is not erased; and also, even bad memories might be important for integration.

The more we learn the better the treatments will become, so I don't have a problem calling them all mental illnesses because they all effect cognitive abilities.

Edited by Thomas M. Miovas Jr.
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Yes, that is what I meant. Apparently I am part of the horde of people using latin incorrectly. Google returns pages of people using "mutis mutandis" in context but not a single definition.

Doctor-patient relationships should be voluntary, except when they cannot be because the patient is incapacitated or under the age of consent. Even in that circumstance someone acting in the role of parent, guardian or next of kin will provide consent on behalf of the patient. The definitions of "capacity" and "incapacitated" ought to be in legal terms and not dependent on the state of a specific science. The power of the legal proxy appointment can be abused but that issue is legal not scientific.

In principle, I agree with what you say, Grames. Plus, I'd add, having not mentioned it previously, that I certainly recognize that individuals with highly contagious, serious or deadly, bodily diseases should be quarantined involuntarily (a redundancy); so, even with respect to physical diseases, doctor-patient relationships are not always voluntary. A quarantine does not violate individual rights. So, perhaps instead of saying that doctor-patient relationships should be voluntary, I should have said that doctor-patient relationships should be in accord with the principle of individual rights.

And I agree with your points with respect to minor children.

I think that the concept is "competency," not capacity (or incapacitated), but perhaps I'm wrong, and I would think that being incapacitated, such as being in a coma, is a default case of being incompetent.

I agree, "capacity" (or "incapacity") or "competency" (or "incompetency") is, as it relates to this topic, a legal issue. It must be objective in order to avoid any breach in the recognition of and protection of individual rights. Although it is a legal issue, I'm not sure how it can be divorced from the state of a specific science, psychology or psychiatry in this case. How else is it to be decided? Isn't it a legal determination based upon the availlble scientific evidence? If not, what is it based upon?

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I think that the concept is "competency," not capacity (or incapacitated)...
Which must be further qualified: competent to stand trial, competent to testify (not sufficiently expert or offering nothing of legal value). One can have diminished capacity, which may be a defense against conviction.
I agree, "capacity" (or "incapacity") or "competency" (or "incompetency") is, as it relates to this topic, a legal issue. It must be objective in order to avoid any breach in the recognition of and protection of individual rights. Although it is a legal issue, I'm not sure how it can be divorced from the state of a specific science, psychology or psychiatry in this case. How else is it to be decided? Isn't it a legal determination based upon the availlble scientific evidence?
The law is pretty much subjective. In Dusky v. US (which is about "fit to be tried") it was held that "it is not enough for the district judge to find that 'the defendant [is] oriented to time and place and [has] some recollection of events,' but that the 'test must be whether he has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding—and whether he has a rational as well as factual understanding of the proceedings against him'. But the substance of the questions is still not yet crisply defined anywhere in the law: how does one determine a sufficient present ability, what is the test or measure of 'reasonable degree of rational understanding'.

In Ohio, the law describes procedures. Many many words: the bottom line is ORC 5122.15 ( B ) "Unless, upon completion of the hearing the court finds by clear and convincing evidence that the respondent is a mentally ill person subject to hospitalization by court order, it shall order the respondent’s discharge immediately." Fortunately there is a definition of "mentally ill person subject to hospitalization": the person must have a "mental illness" which means a

substantial disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality, or ability to meet the ordinary demands of life

and then because of the mental illness, the person

(1) Represents a
substantial risk of physical harm to self
as manifested by evidence of threats of, or attempts at, suicide or serious self-inflicted bodily harm;

(2) Represents a
substantial risk of physical harm to others
as manifested by evidence of recent homicidal or other violent behavior, evidence of recent threats that place another in reasonable fear of violent behavior and serious physical harm, or other evidence of present dangerousness;

(3) Represents a
substantial and immediate risk of serious physical impairment or injury to self
as manifested by evidence that the person is unable to provide for and is not providing for the person’s basic physical needs because of the person’s mental illness and that appropriate provision for those needs cannot be made immediately available in the community; or

(4) Would benefit from treatment in a hospital for the person’s mental illness and is in need of such treatment as manifested by
evidence of behavior that creates a grave and imminent risk to substantial rights of others or the person
.

Of course a judge could just go off the rails, but barring that, they would have to convinced that the person has a mental illness, and that the illness caused certain specific problems. The way you find out if a person is acting self-destructive because of mistaken premises and lousy philosophy versus actual mental illness is to listen to paid shrinks give their trained opinions. The law does not dig any deeper into the matter.

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I'm not an expert on mental illnesses, but from what I have read, there is a lot of disagreement within the mental health profession as to which mental illnesses are due to brain malfunction and which are due to psychological problems.

I'm no expert either; I simply have a difficulty grasping just what are so-called "mental illnesses." What concerns me is whether they are objectively valid as well as the potential for violations of rights in the name of "treating" them on the grounds that the "mentally ill" are a "danger to others."

There are people out there, both in the profession and intelligent observers, that hold that the subconscious is the functioning brain; or at least in the sense that memory retrieval and cognitive functioning can be tied to brain function. As Ayn Rand noted, the subconscious is like a computer that we can program, and the brain acts like a biological computer.

Makes sense to me. I don't see how it could be otherwise. We, our consciousness, our minds, are not ghosts in the machine.

As to a mental illness causing a crime, no not in the sense of putting an idea in his head, to say rob a bank or to kill his neighbor, but some mental illnesses renders their cognitive judgment very dubious, and if they act on that dubiousness, they could very well commit a crime and not think anything about having done it, because their rational judgment is off kilter. I think they still have to be held responsible for what they do, insofar as they are still able to reason; in other words, so long as one can reason, then he ought to stop and think before committing an action such as an objective crime. In some cases, the mental illness will lead someone to only be able to function short-range, and if they find themselves on the streets because they can't hold a job, some take to robbing and begging to make ends meet such as they are. In those cases, they can be told they have the option of going to jail or getting mental health treatments. Now in the past, when lobotomies were in vogue, that might be a tough choice to make -- don't think I would voluntarily submit to any kind of lobotomy, even these days!

I don't understand, "...some take to robbing and begging...they can be told they have the option of going to jail or getting mental health treatments."

Do you think that begging is or ought to be a crime? Begging as such in the same way that robbing is always a crime, or should be.

It seems that although you say that "mental illnesses" do not cause crime, you nevertheless hold that they make it more likely that an individual will act criminally, that they sort of cause crime.

I don't see a difference between that claim and the claim that poverty makes it more likely that an individual will act criminally. It may be true that poor individuals are more likely to commit crimes, true statistically in the sense that more crimes are committed by the poor, but poverty doesn't cause crime.

If a poor person commits a crime would you offer him the same deal you'd offer to the "mentally ill" who commits a crime: jail or "treatment" for his poverty -- which these days perhaps would be an "injection of capital" from the government?

Either "mental illnesses" (some or all) cause crime, or they do not. If psychological determinism is not valid, is partial psychological determinism valid?

If the subconscious is like a computer, and the brain is that physical computer, then who knows what treatments might arise in the future to re-configure the computer, the biological brain? They are already at the point where disturbing memories can be erased bio-chemically, and then one wouldn't have the psychological problem activated by those memories. I don't think I would ever want to go this, because I don't know how well they can control what is and is not erased; and also, even bad memories might be important for integration.

I don't think I would either. Interesting to think that one might have the option though. Just knowing it would be possible, yet choosing not to do so, would perhaps make such memories less disturbing, easier to deal with. Perhaps, for example, a rape victim who knew she had the choice would find it easier to deal with the horrible memory just knowing that were it to be too much, she cold always have them erased.

The more we learn the better the treatments will become, so I don't have a problem calling them all mental illnesses because they all effect cognitive abilities.

I guess we have a basic disagreement on that.

Regardless, I appreciate your willingness to discuss this issue.

(I don't spend a lot of time online or in online discussions, so I hope you don't consider it rude of me to not be engaged in this discussion more often or more regularly.)

Edited by Trebor
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I guess I need to restate something, because I did not say that being mentally ill, having a psychological problem, or having a brain problem caused someone to commit a crime. As an analogy, just as being drunk does not cause crime, so too, having a cognitive problem does not cause crime. Statistically, the percentage of those with a mental illness are no more likely to commit a crime than those who do not have a mental illness -- even for major disorders like schizophrenia (which tends to make the news more often than other mental disorders, especially when a crime is committed by one of them).

As to the relationship between brain and mind, that's an ongoing debate, but one cannot say that one's awareness of either reality or oneself is the brain, since we are not directly aware that we even have a brain. In a certain sense, one can say that having consciousness is possible because we have a brain, but the awareness is not a physical thing. What I am getting at is that until we can tie the mis-functioning of the brain to a cognitive malfunction, then we have to say it is an illness of the mind and not of the brain.

In the example I gave earlier of repression, a person no longer has access to certain memories because he blocked them at some point -- usually from a trauma "reflex" or an unwillingness to "go there" once the trauma is over. One can even go into shock due to a trauma, which is not a voluntary turning away from the horror before oneself. At this time, there is no real treatment for these ailments, though some good psychologist can bring them out so they can be dealt with rationally; but as far as I know, there is no medication one can take to open up a painful memory. And so long as the memory is not accessible, one cannot move on rationally from that trauma. This may or may not effect the sufferer the rest of his life, but it depends on what values he is trying to pursue. If the value is strongly associated with the trauma, and he has blockage of the trauma, his subconscious will not operate correctly with regard to that value -- he might even have a negative psychological reaction to it, like a cognitive allergy.

Say one has gotten a cute little kitten for Christmas, and one day that cute little kitten knocks over a Christmas candle and the house burns down and one's parents are killed. Due to those events, one could develop a negative psychological reaction to cute kittens, which might only occur on the emotional level (i.e. not in words). If translated into words, it might be something like: Kittens are dangerous! But this is part of the controversy of handling those types of ailments. If it is not explicit words in there programming the computer (the subconscious), then how can that incident be dealt with effectively so that the person with this ailment can go back to enjoying cute little kittens? That's one reason they are called mental illnesses, though I know many people would not want to call it that because it sounds like "he has gone mental!"

Regarding being a danger to others, if there is objective evidence that someone is about to violate or has violated the individual rights of another, then it is the job of the government to step in; whether he has a mental illness or not. The only difference is that if someone has a mental illness, the court might decide that treatment is better than jail. They even decide this for beginning criminals, either go to some sort of personal training not to be violent, or go to jail.

As David Odden pointed out, however, the law isn't crystal clear on these issues, so it is often up to the discretion of the judge. But under objective law, the court could not decide to do something physical to the defendant, such as order a lobotomy, against the defendant's will -- no more than the court could decide to cut off the offending arm of the defendant accused of pointing a gun at someone.

Besides, I am talking about the law as it should be, not as it is now. I fully realize that when it comes to treating the mentally ill, that many wrongs have been done in the past and probably continue to this day.

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Which must be further qualified: competent to stand trial, competent to testify (not sufficiently expert or offering nothing of legal value). One can have diminished capacity, which may be a defense against conviction.The law is pretty much subjective.

Here's something interesting as well, from Szasz:

"The Insanity Defense: From Solution to Problem

The insanity defense, as we know it, is a relatively new cultural invention. I believe it is not possible to understand the problems it causes unless we understand the problems it solved in the past and solves today.

The "crime" that led to the creation of the insanity defense was not murder, but a deed long considered even more heinous, namely, self-murder or suicide, punished by both ecclesiastic and secular penalties: the suicide was denied religious burial and his estate was forfeited to the Crown's Almoner.

Because punishing suicide required doing grave harm to innocent parties -- that is, to the suicide's children and spouse -- men sitting on coroner's juries eventually found the task to be a burden they were unwilling to bear. However, prevailing religious beliefs precluded repealing the laws punishing the crime. The law now came to the rescue of the would-be punishers, offering them the option of finding the self-killer non compos mentis and hence not responsible for his deed. In the eighteenth century, it became a matter of routine for juries to arrive at the posthumous diagnosis that the suicide was insane at the moment he killed himself. (The criminal law against suicide was repealed only in the nineteenth century, by which time it had been replaced by mental health laws.)

The celebrated English jurist William Blackstone (1723-1780) recognized the subterfuge and warned against it: "But this excuse [of finding the offender to be non compos mentis] ought not to be strained to the length to which our coroner's juries are apt to carry it, viz., that every act of suicide is an evidence of insanity; as if every man who acts contrary to reason had no reason at all; for the same argument would prove every other criminal non compos, as well as the self-murderer." It was too late. By validating the fiction that suicides could, post facto, be found to have been non compos mentis, the law had crafted a mechanism for rejecting responsibility -- the criminal's for his deed, the jury's for its duty -- and, aided by the medical profession, wrapped the deception and self-deception in the mantle of healing and science.

We must keep in mind that the impetus for excusing self-murder did not come from its ostensible beneficiaries, the victims of the law against suicide. Clearly, it could not have come from them: the self-killer was dead; his family, bereft of means and reputation, was powerless. Instead, the impetus for the insanity defense came from those who needed it and had the political clout to make law and medicine embrace it -- that is, judges and lawyers, coroners and mad-doctors. Coroner's juries and judges could thus evade the burden of having to impose harsh penalties on the corpses of suicides and the widows and orphans they left behind; and physician's could pride themselves for saving innocent persons from suffering for the sin-crimes of "insane" self-killers.

The result of the practice of routinely excusing suicides of their sin-crimes by viewing them as insane was that persons suspected of being suicidal began to be incarcerated in insane asylums. Soon that, too, became a routine practice and reinforced the belief that persons who kill themselves or others are insane, and that the insane are likely to kill themselves or others."

*** Szasz, T. Does insanity "cause" crime?. Ideas on Liberty, 50: 31-32 (March), 2000. Reproduced from www.szasz.com by permission of J.A. Schaler.***

Link: "Does Insanity Cause Crime?" -- Thomas Szasz

Edited by softwareNerd
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In the example I gave earlier of repression, a person no longer has access to certain memories because he blocked them at some point -- usually from a trauma "reflex" or an unwillingness to "go there" once the trauma is over. ..... -- he might even have a negative psychological reaction to it, like a cognitive allergy.

Say one has gotten a cute little kitten for Christmas, and one day that cute little kitten knocks over a Christmas candle and the house burns down and one's parents are killed. Due to those events, one could develop a negative psychological reaction to cute kittens, which might only occur on the emotional level (i.e. not in words).....

In my opinion, because these kind of predicaments are created by the normal functioning of the mind they shouldn't be classified as illnesses. Illness in any other context is about physical malfunctioning and can have a physical remedy. If no physical cure is even possible, why lump it together with clinical depressions and make analogies to allergies? This is bad concept formation. "Mental dysfunction" can work as a genus for all mental problems, but actual mental illnesses have nothing in common with psychological problems beyond both being mental so it doesn't help to use the term unless in the context of differentiating from medical problems that medical doctors address.

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In my opinion, because these kind of predicaments are created by the normal functioning of the mind they shouldn't be classified as illnesses. Illness in any other context is about physical malfunctioning and can have a physical remedy.

Well, it might be possible for her to take anti-anxiety medication, which would be physical. In my understanding, anxiety comes about when there are two conflicting subconscious evaluations -- the cuteness of the kitten versus having lost her parents due to a kitten. However, anti-anxiety pills are not the real solution, because they don't get to the root of the problem. It would actually take a competent psycho-therapist to unravel her problem and to help her find a solution. Otherwise, she might go around avoiding cute kittens, avoiding Christmas trees, avoiding family reunions, avoiding the whole Christmas celebration, avoiding anyone who likes kittens, etc. So, it can get to the point where she avoids so much at Christmas time that she can no longer live her life effectively. And that's why I would classify it as an illness.

Yes, in a sense, one can say her reaction is normal -- i.e. to be expected given the events -- but these types of problems tend not to just stay localized. She might even get to the point where she avoids anything that would otherwise lead her to be happy. If man's life is the standard and one's own happiness is the goal, then she definitely has a problem.

The thing for her to realize is that the kitten didn't murder her parents -- it was an accident. What would really give her problems is if she really liked the kitten and took for granted that it was her fault that the house burned down because she liked the kitten so much and liked to play with it.

So, you see, it is not an issue of merely avoiding kittens -- it becomes more globalized. I would say that she has a problem with her subconscious mind automatically integrating everything associated with the kitten and the accident and feeling anxiety regarding those things.

Let's say much later in her life she falls in love with a wonderful man. He loves kittens and loves Christmas, so he buys her a kitten for Christmas. Her past associations will lead her to rejecting him out of hand even though he didn't do anything wrong.

According to Dr. Szasz and some others, this is just her way of coping with the past disaster, and there is no cure to be sought. I disagree. Having a terrifying reaction to kittens is not a normal reaction to something so cute and cuddly. She does have a problem, and the only way she can effectively go on to live a happy life is to resolve it. No, it is not a physical ailment, but it is an ailment. And it would take a competent psychologist to help her to overcome the ailment so she can enjoy her life.

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I like to elaborate on this a little further because I was having a conversation with someone and she said (or implied) that having a psychological problem is a sign of irrationality -- it isn't. By analogy, the subconscious is like a personal computer that you have and can program over time -- all of your automatized ways of doing things comes from this personal computer. And just like a program on a personal computer can crash or freeze up under certain conditions, so too can your personal mental computer freeze up and crash. If your computer crashes, you don't say the computer is irrational. You can't even necessarily say that the programmer was irrational -- maybe he never thought that particular combination would come up that leads to the crash, and so he didn't try to work the bug out ahead of time.

Going back to the story about the little girl and the Christmas disaster, she had no way of knowing that by programming her subconscious to avoid kittens that someday that love of her life would show up 20 or so years later and give her a kitten for Christmas. We are not omniscient, and it is difficult enough to root out disintegrated material in our conscious minds that we are directly aware of. We cannot get directly into our subconscious and change the programming -- there are ways of reprogramming the subconscious, but if you are not even aware of the bug then you are not going to try to do anything about it; hence one is not irrational to have a bug in the programming of one's own mental personal computer.

The irrationality or the rationality comes into play once someone is aware they have a bug in their programming. If it is not effecting their lives in a significant manner, then one can work around it, just as one has to occasionally reboot one's personal computer. The irrationality comes into play if the person having the problem doesn't want to face up to the fact that the psychological problem is interfering with an otherwise happy life -- i.e. one cannot pursue some values that trigger the bug. The rational person would identify the fact that he has a problem and that he must fix it if he is to pursue those values -- and sometimes pursuing those values is the fix for the bug.

I cannot go into all of the ways that can be done, but it can be done. I'm not a professional but generally feeling a great deal of anxiety over some things without a good reason is indication of such a bug in your subconscious. That's not always the case, as one can feel anxiety about, say, getting up on stage for the first time. But that is what makes diagnosing such problems so difficult. Is it normal anxiety (due to being in a new situation) or is it due to a bug and your programming is about to crash?

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I like to elaborate on this a little further because I was having a conversation with someone and she said (or implied) that having a psychological problem is a sign of irrationality -- it isn't.

I agree that gaining a psychological problem is not necessarily irrational, but preferring to keep one is.

The psychological problems you have described in your last two posts are examples of the general problem of learning. One should unlearn the wrong lessons and learn the right lessons. It doesn't matter if the context is studying Objectivism or engineering or kung fu or happiness understood as mental health. The applicable methods are the same.

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The psychological problems you have described in your last two posts are examples of the general problem of learning. One should unlearn the wrong lessons and learn the right lessons. It doesn't matter if the context is studying Objectivism or engineering or kung fu or happiness understood as mental health. The applicable methods are the same.

Perhaps. I certainly agree that one ought to strive for no contradictions on the conscious level and strive for a smoothly operating subconscious (i.e. no clashes in the automatized programs).

How one eradicates inconsistencies in the conscious mind (your explicit thinking) requires thinking an issue through and integration; and this will eventually lead to a smoothly functioning subconscious for the most part. For example, since I was raised Catholic, which has contradictions due to the influence of two different philosophers -- Augustine and Aquinas -- I was often torn as to which action to take in a particular circumstance. Since Objectivism is more integrated fully, that indecisiveness became less severe the more I became integrated towards Objectivism. But that transition took quite a number of years, and I had to think it through thoroughly to become more integrated.

A psychological problem, on the other hand, is often not held as an explicit idea. There can be an association with some terrible event of the past that is held wordlessly. For example, in the case of the little girl and the kitten, it may not be the case that she consciously held the premise that all kittens are dangerous. A real disaster did occur because of a kitten, and her subconscious would then warn her every time a kitten came into her life -- probably as a very negative emotional reaction to kittens. So, it is not as if she read a book on kittens and consciously held in her mind that kittens are dangerous, but rather that the one episode of the kitten burning down the house and killing her parents became rather indelible in her subconscious. I wouldn't count this as irrational merely because the disaster did actually occur and kittens can be dangerous if not watched when around candles. And I think reading about kittens -- the way one can read about Objectivism -- would probably be insufficient in changing the emotional reaction to kittens. In other words, she would have to have the experience of holding a kitten and enjoying it cuddliness and playfulness in order for her emotional reaction to change.

However, in order not to be rationalistic about one's learning (about Objectivism or anything else one learns) one cannot just do the book learning anyhow, one must be interactive with the world (with reality) and learn to integrate facts, rather than just reading and thinking.

So, I guess I agree there is a connection with resolving consciously held premises and correcting psychological ailments, but I don't know that anyone (or not many people, including professionals) understand how to resolve psychological ailments through re-teaching. Cognitive therapy comes the closest, but I don't think it is there quite yet. Some things I have read and tried occasionally is that doing something against a psychological ailment can correct it -- i.e. going by the facts instead of going by emotional reactions via a cognitive re-evaluation (based on the facts), but I don't think it has been refined down to a science at this point in time.

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  • 1 month later...

Here is an interesting study based upon school kids who have gone on a killing spree. Apparently, having mental problems is insufficient for saying that someone will go Columbine and try to kill a bunch of their peers in high school or college. It also says the motivation can't be pinned onto violent video games. While quite a few people suffer from psychosis, paranoia, and more neurological ailments, these alone do not account for the killing sprees. Evidently, it still takes a kind of special irrational revenge attitude that comes from the personal psychology aside from mental problems in and of themselves.

I do think that if someone is showing signs of preparing to go out and attack a group of people, then he ought to be stopped as a potential mass murderer, but not just because he has a mental illness since it doesn't lead to these types of irrational revenge sprees having no basis in rational justice.

"In "Why Kids Kill: Inside the Minds of School Shooters," released by Palgrave Macmillan just before the 10th anniversary of the slayings in Littleton, Colo., Langman writes that most of the shooters were severely mentally ill, their defective personalities and disordered minds causing existential rage that found its expression in mass murder."

"The most prevalent misconception about school shootings, Langman contends, is that they are perpetrated by loners or outcasts striking out against classmates who bullied them. In reality, most shooters were teased no more or no less than their peers, most had friends, and most of the victims were targeted at random."

"Langman agrees: Mental illness alone is not the answer, if only because the overwhelming majority of troubled kids are not homicidal. Rather, rampage attacks are caused by "complex combinations of environmental, family, and individual factors" that vary from perpetrator to perpetrator, he writes."

All in all, the study, in my opinion, doesn't reach a solid conclusion about why they did what they did, and it's interesting that philosophy isn't involved in the study, such as extreme nihilism and lack of rationality. But it does shown that a mental illness per se is not going to lead to mass shootings; however, it doesn't try to lay any claim as to why they were mentally disturbed in the first place.

I think psychology still has a way to go in coming up with legitimate causes for some actions that can be difficult to understand from a simple common sense approach. The science of psychology is making inroads, and it is interesting that one of the shooter's journals showed what he was thinking and about to do, though this wasn't mentioned in earlier reports.

In other words, what led to their mental illness and why did it express itself as a mass murder spree?

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Just for perspective on the issue of forcibly detaining those who have a mental illness, here is a story about the mentally ill and medication. Evidently, at least 93% of those who have a serious mental illness manage not to wind up in jail, which shows that they may not be as prone to violence as some suspect just because they have a mental illness.

I also saw a special on PBS (I think) about mental illness and those who rotate in and out of prison. Usually this occurs because the person got off his medication and then became either a public nuisance or committed real crimes in the search for food or shelter; a few got into legal trouble because they thought they were fighting the devil or Osama bin Laden while they threw rocks and stuff at passerbys or people's homes.

But basically, both the article and the special showed that so long as one on the proper medication, they are no harm to anyone more so than one normally finds involved in crimes without a mental illness.

I still don't think one can be forced to take medication, but the alternative for most who don't is probably jail, unless they get some other sort of help (the controversy being medication versus therapy).

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Just for perspective on the issue of forcibly detaining those who have a mental illness,...

So, there are mental illnesses that do in fact cause people to become criminals, but when they're medicated, their mental illnesses no longer cause them to become criminals, at least no more than the population at large who presumably are not mentally ill.

Why in the world do you question forcing such individuals to take medication, but have no problem forcing them to go to jail or undergo forced therapy?

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So, there are mental illnesses that do in fact cause people to become criminals, but when they're medicated, their mental illnesses no longer cause them to become criminals, at least no more than the population at large who presumably are not mentally ill.

Well, no, I wouldn't say that the mental illness caused them to become criminals, certainly not when 93% of people with serious mental health problems do not become criminals. Even when one is destitute, one can retain enough self-respect not to commit crimes. Part of that special I saw on TV claimed this was happening because government run mental asylums have been shut down, effectively leaving those with mental health problems no other options. But I disagree with this assessment. There are free mental health facilities out there. I don't think they ought to exist at the expense of the tax payer, but it is not as if there are no options out there.

Why in the world do you question forcing such individuals to take medication, but have no problem forcing them to go to jail or undergo forced therapy?

For one thing, forcing them to take medication would be at the expense of someone else -- i.e. the tax payer -- but I don't think the government ought to get involved in dispensing medications by force. Yes, they can be arrested if they commit a crime, and while in jail they can be offered medication; but I think the government forcing medications on people just opens up way too many avenues of abuse. I mean, what if the government decided that you, as an Objectivist and individualist, are just flat our crazy to be taking that stance -- should they be permitted to force you onto ego subduing medications? I don't think so; and yet such measures were taken by the former Soviet Union. The government ought not to be involved in deciding if someone has a mental illness or not; except, perhaps, in such cases where someone is not mentally fit enough to stand trial. What if your child acts up at school -- should the government force him to take Ritalin, even against his or your wishes? I don't think so. And yet, that is what you are condoning if you say the government can force feed someone medications.

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Why in the world do you question forcing such individuals to take medication, but have no problem forcing them to go to jail or undergo forced therapy?

Because once the sick person has violated someone's rights, then the government has the right to use force. You can't just have the government kicking in doors and forcing pills down the throats of mentally ill people.

Edited by K-Mac
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Well, no, I wouldn't say that the mental illness caused them to become criminals, certainly not when 93% of people with serious mental health problems do not become criminals.

However, you said previously:

But basically, both the article and the special showed that so long as one on the proper medication, they are no harm to anyone more so than one normally finds involved in crimes without a mental illness.

I still don't think one can be forced to take medication, but the alternative for most who don't is probably jail, unless they get some other sort of help (the controversy being medication versus therapy).

Saying that as long as someone is "on the proper medication, they are no harm to anyone..." certainly implies that without the medication they are in fact a harm, or threat, to others, and therefore criminal (Threats are criminal.) due to their mental illness. Else, how can medications, taken to treat their mental illness, have any impact on their harm or threat to others, their criminal conduct?

Without medications such individuals are more harm or threat to others than with medication. If they can't be forced to take medications, then the alternative is jail (force) or forced therapy, in your stated view, with your approval. (By the way, the forced jail and therapy would be just as much an expense to someone else, the taxpayers, as would forced medication, so that argument seems moot.)

You didn't specify whether or not such persons, for whom jail or forced therapy are a proper alternative to forced medication (which you're against), have to have already committed a crime or if they are inherently criminal due to their having crime-causing mental illnesses (which certainly seems implied). Even if you only meant mentally ill individuals, with or without crime-causing mental illnesses, who have committed crimes, you are all for putting them in jail and/or forcing them to undergo therapy.

Why you wouldn't force them to take medications that treat their crime-causing, or even non-crime-causing, mental illnesses baffles me. If you regard forced therapy as perhaps appropriate, then it's because you view their mental illness as relevant to their criminality and of significance to the government (in spite of later saying that you don't want the government to decide who is or isn't mentally ill), and you don't have any problem forcing therapy on such persons. But forced medication shouldn't be part of forced therapy?

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Because once the sick person has violated someone's rights, then the government has the right to use force. You can't just have the government kicking in doors and forcing pills down the throats of mentally ill people.

If the (or at least some) mentally ill are inherently a threat to others unless they are medicated, then it seems appropriate to have the government "kicking in doors and forcing pills down the throats of [such] mentally ill people."

It's proper for the government to quarantine individuals who have serious and contagious diseases regardless of their intent to harm or threaten others, so if some mental illnesses do cause individuals to be a harm or threat to others, then I can't see why it's not proper for the government to use force to address such violations of rights even to the point of forcing such individuals to take medications.

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Why you wouldn't force them to take medications that treat their crime-causing, or even non-crime-causing, mental illnesses baffles me. If you regard forced therapy as perhaps appropriate, then it's because you view their mental illness as relevant to their criminality and of significance to the government (in spite of later saying that you don't want the government to decide who is or isn't mentally ill), and you don't have any problem forcing therapy on such persons. But forced medication shouldn't be part of forced therapy?

I guess you didn't read what I wrote -- 93% of all of the people with serious mental disorders are no threat to anyone; so setting a standard based on those few 7% who may or may not be arrested for rights violations is confining 97% of the mentally ill under the provinces of the State, which shouldn't be done. Besides, many, if not most, who wind up in jail are there for taking drugs, which shouldn't be a crime anyhow. And I never said they would be forced into therapy, which couldn't be done anyhow. One cannot force a mind to think or to resolve internal problems or confusions.

What I said was that if a person violates rights, then he can be confronted by the State; who's sole purpose is to defend individual rights. He can be given the option of going to jail, or seeking therapy (medication or psychology). But only if he is violating individual rights. Just being mentally ill is not violating anyone's rights, and so their rights cannot be violated. One cannot say that just because someone has, say schizophrenia or bipolar disorder or severe depression that they will become violent of necessity because of the mental illness -- and the facts clearly show this.

If you have an inordinate fear of the mentally ill, then that is a problem you are having, but it is no excuse to force medicate them all.

And you didn't even contend with my presentation of the abuses of the Soviet Union, who thought all "defectors" were mentally ill; or many school administrators who thinks a child acting up has Attention Deficit Disorder and needs to be medicated for it.

No, the State should not have the authority to medicate people at the State's discretion, using force against those deemed to be mentally ill. It would be a violation of the individual rights of those who are mentally ill. In other words, being mentally ill does not make one a criminal. They are only criminal to the extend of violating the individual rights of others in that society. If they do not violate anyone's rights, then they need to be left alone by the force of the State.

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I guess you didn't read what I wrote -- 93% of all of the people with serious mental disorders are no threat to anyone; so setting a standard based on those few 7% who may or may not be arrested for rights violations is confining 97% of the mentally ill under the provinces of the State, which shouldn't be done. Besides, many, if not most, who wind up in jail are there for taking drugs, which shouldn't be a crime anyhow. And I never said they would be forced into therapy, which couldn't be done anyhow. One cannot force a mind to think or to resolve internal problems or confusions.

Excuse me, but I did read what you wrote. (Or are you just trying to be insulting?) What you wrote was confusing, so I asked for clarification. Perhaps you should reread what you wrote yourself, and see if perhaps it is confusing.

Regardless of the 93 or 97 percent, you summed up the two sources, the article and show, by saying that as long as the mentally ill are taking their medications, they're no more threat than anyone else. The implication is that some mental illnesses do cause criminal behavior. That's not insignificant even if it's a small percentile. That's the issue I asked about. (If a small minority had a deadly, contagious disease, is it proper to quarantine them? Is malicious intent relevant?)

What I said was that if a person violates rights, then he can be confronted by the State; who's sole purpose is to defend individual rights. He can be given the option of going to jail, or seeking therapy (medication or psychology). But only if he is violating individual rights. Just being mentally ill is not violating anyone's rights, and so their rights cannot be violated. One cannot say that just because someone has, say schizophrenia or bipolar disorder or severe depression that they will become violent of necessity because of the mental illness -- and the facts clearly show this.

I agree that the sole function of the government should be the protection of individual rights.

For what crimes would you advocate such an option, jail or treatment? (When the government offers the option, jail or treatment, does that mean that if one choses the treatment instead of the jail time, it's voluntary?)

If you have an inordinate fear of the mentally ill, then that is a problem you are having, but it is no excuse to force medicate them all.

What makes you think that I might have an inordinate fear of the mentally ill?

And you didn't even contend with my presentation of the abuses of the Soviet Union, who thought all "defectors" were mentally ill; or many school administrators who thinks a child acting up has Attention Deficit Disorder and needs to be medicated for it.

I'm not the one advocating that the government treat mental illness, even as an option to jail. My concern, at least one of them, is that what you're suggesting will and does lead to the Soviet style abuses.

No, the State should not have the authority to medicate people at the State's discretion, using force against those deemed to be mentally ill. It would be a violation of the individual rights of those who are mentally ill. In other words, being mentally ill does not make one a criminal. They are only criminal to the extend of violating the individual rights of others in that society. If they do not violate anyone's rights, then they need to be left alone by the force of the State.

So, if there are some mental illnesses that do in fact cause crime, the State has no interest? And if medications do stop those people from acting criminally, the state has no interest?

I agree with the gist of what you say with respect to individuals rights and the mentally ill. I just don't think you're consistent -- you seem to hold conflicting views as to whether or not some mental illnesses cause criminal behavior. I'm trying to understand which it is.

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I wasn't trying to insult anyone in this thread, but I don't understand why I'm not being understood; so, let me start at the beginning.

There is no evidence that having a mental illness will lead one to becoming a criminal (in the individual rights sense). At least statistically, the percentage of those who have a mental illness and commit crimes are roughly the same percentage of those who do not have a mental illness and commit crimes. In other words, there is no statistical correlation between having a mental illness and violating someone else's rights. As far as the law is concerned, it doesn't make a difference if you commit a crime while not having a mental illness versus committing a crime while having a mental illness. According to what I have read, character and personality comes before any supposed criminal activity; that is, if one was prone to violence before getting a mental illness then one is just as prone to violence after getting a mental illness, and if one was not prone to violence before getting a mental illness one is not prone to doing violence after getting a mental illness. The mental illness does not cause the violence or the breakage of the individual rights of others.

In some cases, someone with a mental illness may conclude that his neighbor is Osama bin Laden or the devil and take preemptive action against him -- such as throwing rocks through his windows or trying to shoot him. But there are plenty of other such scuffles going on between people who do not have a mental illness, so the statistics cancel out. In other words, it doesn't matter if your neighbor thinks you are the devil, an arrogant SOB, or a druggie, or a greedy capitalist, or a socialist, or whatever; he doesn't have the right to take the law into his own hands and try to do violence to you.

What I'm saying regarding the medication part is that if a particular individual is up for probation of some sort, and it can be shown that so long as he stays on his medication he won't violate rights afterwards, then the probation officer can make that very clear to the offender -- that it is either further jail time or stay on the medication and be a free man. However, I don't think those with mental disorders ought to be treated differently strictly based upon the fact that he had a mental illness. If he committed a rights violation crime, then he needs to be treated like a criminal. The only difference is when it comes to probation, similar to stipulations put on all criminals who are put on probation -- its just that the mentally ill person needs to show that he understands that part of his probation is that he needs to stay mentally healthy for a certain time period as he gets back on his feet.

Now, is this the same thing as forcing someone to take medications when they have not violated rights. No, it isn't. Under probation, the State can rightly impose restrictions and necessities of remaining on probation -- i.e. they have to hold a job, they have to check in with the probation officer periodically, etc. otherwise, they go back to jail. The criminal violated someone's rights, and if he gets the chance for a reduced sentence due to good behavior or he makes restitution somehow and gets probation, then he needs to follow the procedure or he is back in jail. That's all I'm saying.

But even in jail, I'm not sure one could rightfully force an inmate to take medications against his will; primarily because of the known side effects that can be debilitating. Just because someone is locked up in jail doesn't mean that the State can do with him whatever it pleases.

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