I think I am very confused about the idea of mental illnesses.
First of all to understand an illness, we need a ideal of health to compare to. Where does this ideal come from and what it is? When I come to LW (or even Reddit) I feel like i am depressed compared to you because I never really had much of a goals or passions or interests in life, so generally being anhedonic and alway have to keep fighting boredom. On the other hand, as far as I can tell, my attitude is not different from that of my parents and family members, I was raised so that they told me life is hard and it is about survival, not fun, and indeed my parents had their two hands full and more with just securing a comfortable middle class existence, they did not really have any energy for personal goals. If my father was alive and I would complain about boredom, he would say “you have it too good, when I was 37 I was standing 12 hours on top of a ladder painting houses so that we can pay off our flat” and things like that. So compared to LW, I am depressed, compared to my family norm, I am normal (except having it too good, obviously). The point is, there is no cast in stone definition of what is healthy. It may depend on culture, on age, on time, on a lot of things how we define the healthy.
A decade or two ago I had a strong interest in Buddhism. And my teachers were of the opinion that what most people consider healthy, in the sense of happiness / non-depression, is still a very low level and we can improve on that. They kept quoting Freud, saying the goal of psychotherapy is to turn abnormally unhappy people into normally happy people. And they claimed to take over from there, to try to turn people into being radiantly happy, through meditation. Their philosophy was that only complete happiness can be defined as healthy.
So, the point is, we do not have a “cast in stone” level of mental functioning that we could call unanimously “healthy”, so we cannot really objectively define mental illness as a comparison to that. Pretty much it seems like the question of whether people like me or my parents / family members are depressed or not just depends on whether they want to change their mood or not , seek therapy or not. They can be seen as pretty normal, in a society that not too “dreamy” (i.e. not US-type “follow your dreams” type of society, but a more grim one).
Another weird issue is blame, stigma etc. In my childhood it was very confusing. It is the natural instict of children to be cruel assholes to people who seem to have some deficiency or problem. And then they tried to teach us e.g. “do not make fun of this man who sits in a wheelchair, he cannot help being disabled” so we tried to learn the distinction that sometimes you can be an ass to people, if it is about something they can help, but sometimes not, when it is about something they cannot help. As children we developed roughly this model, a milder defect is usually something that “can be helped” and thus you can be an ass to people who have it, and a harder defect is something “cannot be helped” and thus to be met with compassion. So for example we could make fun of a child for being clumsy, but not if a neurological disorder made him very clumsy. We could call a child stupid as long as he was only little stupid, but someone with serious mental retardation, very low IQ not. Our model of illness was largely a more severe version of normal defects, the kind of normal defects we made each other fun of for. Or bullied each other for verbally. When we grew up, of course we stopped behaving like little pricks about it. Still the essential distinction stayed there: if, for example, a man is only somewhat stupid, you can think “haha what an idiot” and consider this an insult or censure. If a man is very ,very stupid, clearly mentally retarded, then not, then your appropriate atttude is compassion, not censure. Later on I learned that there is no reason why not think that moderate versions of the same problem do not work through the same pathways as illness. So this distinction is not tenable. Since then, I cannot tell the difference if a person is simply an ass or has antisocial personality disorder, is a fucking coward or suffers from anxiety disorders and panic attacks, and so on. I can no longer tell the difference what could rightfully drawn criticism, scorn, censure, and what should be met with compassion. The only consistent solution would be to consider virtually everything an illness, and think “he cannot help being what he is” and meet everything with compassion, but that is an entirely unusual and weird human norm. It is not how people normally feel. If for example a soldier runs away from battle leaving his comrades in the shit, they will not think “poor fellow has anxiety disorder and panic attacks”. They will think “fucking coward”. This is the normal human attitude. And we are trying to wall it off into illnesses that “he cannot help being what he is” in which cases we do not use this normal attitude but more like think with compassion and understanding. But this distinction is not really tenable. Ultimately the illness and non-illness are very much the same thing. So what is the truly proper attitude? Give up all kinds of censure and criticism? I am really confused by this.
“But this distinction is not really tenable. Ultimately the illness and non-illness are very much the same thing”, Sure, if you consider having not having use of both of your legs to be ‘very much the same thing’ as having two perfectly working legs.
That is a bit extreme. My point is more like, if unable to walk is 0 and being Michael Flatley is 100, there is a 20 or 40 level of leg clumsiness which you can see either as “normal” clumsiness or a neurological disability, neuromotoric illness, and my point is that humans tend to react radically differently to which interpretation is being used. A normally clumsy guy gets laughed out of the dancing course, the guy with the disability gets sympathy, pity and points for just trying. My struggle is trying to figure out a consistent and logical approach.
From a Buddhist perspective it doesn’t make much sense to talk about mental illness.
Mental illnesses are narrow intellectual concepts that create a sense of identity and Buddhism is about not attaching yourself to labels.
The Buddhist ideal is simply to show compassion to everyone.
At the same time a concept like depression can have some use. Depression is more than just being unhappy. If you use it to simply mean the opposite of happy you devoid it from meaning. It’s a cluster of symptoms. Having the concept allows us to research that cluster and come up with things that aren’t obvious.
So what is the truly proper attitude? Give up all kinds of censure and criticism?
Give criticism based on the utility of the effect of giving criticism. If you give someone constructive feedback that allows him to improve, that criticism is good.
Censure is similar. If someone violates social norms punishing him was disapproval is useful to enforce those social norms.
Later on I learned that there is no reason why not think that moderate versions of the same problem do not work through the same pathways as illness.
Just because they work through the same pathways doesn’t mean that they are the same with respect to ability to overcome them.
Someone who is clumsy because of a neurological disorder cannot do anything which prevents himself from being clumsy. Someone who is “normally” clumsy can. The fact that they both have similar causes doesn’t change that.
Someone who is clumsy because of a neurological disorder cannot do anything which prevents himself from being clumsy. Someone who is “normally” clumsy can.
Given that placebo’s do seem to have an effect on mental illnesses, I don’t think there reasons to believe that people with mental illnesses can’t do anything affect their state. On the other hand the fact that change is possible doesn’t mean that a person can change simply by trying very hard.
But there’s a difference between being able to change their state, and being able to change their state far enough to achieve normality. Someone who is very clumsy because of severe neurological problems could, by effort, get somewhat better, but even with a lot of effort he will still be clumsy, just less clumsy. Someone who is clumsy in the way that most clumsy people are, on the other hand, can entirely alleviate the clumsiness by effort. Even if they have similar causes, in one case the gap is a size that can be made up for by effort, and in the other case it is not.
Someone who is very clumsy because of severe neurological problems could, by effort, get somewhat better, but even with a lot of effort he will still be clumsy, just less clumsy.
The fact that something isn’t changeable by investing effort doesn’t mean that it isn’t changeable by another strategy. Sometimes the key to change is investing less effort.
Biological issues and mental issue also also often interlinked. Making it part of your identity that you can’t do something for biological reason X can often make change more difficult.
But there’s a difference between being able to change their state, and being able to change their state far enough to achieve normality
Given someone in front of you, how do you tell? How can this difference be observed?
It is easy to imagine “someone who cannot change their state” and “someone who can change their state”, but if you erase the XML tags and that your imagination has attached to the two, what would you actually be seeing?
By just saying “most humans can compensate for X degree of clumsiness. This person has Y degree of clumsiness. Y is greater than X”.
Of course, your ability to determine those two factors isn’t perfect, so you will get it wrong sometimes, especially in borderline cases, but you can certainly do better than chance.
Better than chance is a low bar. If you have some problem in your life, how do you determine whether and to what extent it is solvable, when to carry on and when to give up? Where the problem is, for example, akrasia, clumsiness, social anxiety, despair at the magnitude of the ills of the world, being a refugee in a flimsy boat in the Mediterranean, or acne.
It is easy to invent examples in the imagination where it is clear that you can solve it or clear that you can’t. There are fewer easy answers for the problems that life throws at you, which are not selected for solvability or unsolvability.
Going back to an ancestor comment:
Someone who is clumsy because of a neurological disorder cannot do anything which prevents himself from being clumsy. Someone who is “normally” clumsy can.
Again, it’s not always easy to tell. I’ve seen people with severe cerebral palsy who it was clear were never going to walk or speak with a clear voice. I’ve also seen beginners in the taiko class who are competent at the ordinary movements of day to day life, but make a complete hash of what seem to me like the very simplest actions. I wonder if they are ever going to get it, and recognise that I don’t know. So I point them toward the correct movements, see them do the wrong thing again, and repeat. When I first took up tai chi, maybe the teacher thought the same thing about me. Eventually I learned, but I’ve seen other people go on for years without advancing. Could they, with different instruction? I can’t tell.
“Better than chance” is just another way to say “sometimes it actually works”. It doesn’t need to work every single time for it to be something useful.
And given the human tendency to generalize from one example, it has to be hard to take another look… My own learned response is ‘the person is clumsy and so has to be ignored if possible; it does not matter why s/he is so, since both a mentally ill or just careless can probably realize my rudeness if I stare.’ On the other hand, if someone at my workplace has a disability, I would be very wary of them having to do anything with volatile chemicals, and quietly but unceasingly influence things to make her/him stop. (I am in a plant physiology Dept.) Possibly I would be most rude to such a person, but exploding centrifuges just aren’t safe.
I think I am very confused about the idea of mental illnesses.
First of all to understand an illness, we need a ideal of health to compare to. Where does this ideal come from and what it is? When I come to LW (or even Reddit) I feel like i am depressed compared to you because I never really had much of a goals or passions or interests in life, so generally being anhedonic and alway have to keep fighting boredom. On the other hand, as far as I can tell, my attitude is not different from that of my parents and family members, I was raised so that they told me life is hard and it is about survival, not fun, and indeed my parents had their two hands full and more with just securing a comfortable middle class existence, they did not really have any energy for personal goals. If my father was alive and I would complain about boredom, he would say “you have it too good, when I was 37 I was standing 12 hours on top of a ladder painting houses so that we can pay off our flat” and things like that. So compared to LW, I am depressed, compared to my family norm, I am normal (except having it too good, obviously). The point is, there is no cast in stone definition of what is healthy. It may depend on culture, on age, on time, on a lot of things how we define the healthy.
A decade or two ago I had a strong interest in Buddhism. And my teachers were of the opinion that what most people consider healthy, in the sense of happiness / non-depression, is still a very low level and we can improve on that. They kept quoting Freud, saying the goal of psychotherapy is to turn abnormally unhappy people into normally happy people. And they claimed to take over from there, to try to turn people into being radiantly happy, through meditation. Their philosophy was that only complete happiness can be defined as healthy.
So, the point is, we do not have a “cast in stone” level of mental functioning that we could call unanimously “healthy”, so we cannot really objectively define mental illness as a comparison to that. Pretty much it seems like the question of whether people like me or my parents / family members are depressed or not just depends on whether they want to change their mood or not , seek therapy or not. They can be seen as pretty normal, in a society that not too “dreamy” (i.e. not US-type “follow your dreams” type of society, but a more grim one).
Another weird issue is blame, stigma etc. In my childhood it was very confusing. It is the natural instict of children to be cruel assholes to people who seem to have some deficiency or problem. And then they tried to teach us e.g. “do not make fun of this man who sits in a wheelchair, he cannot help being disabled” so we tried to learn the distinction that sometimes you can be an ass to people, if it is about something they can help, but sometimes not, when it is about something they cannot help. As children we developed roughly this model, a milder defect is usually something that “can be helped” and thus you can be an ass to people who have it, and a harder defect is something “cannot be helped” and thus to be met with compassion. So for example we could make fun of a child for being clumsy, but not if a neurological disorder made him very clumsy. We could call a child stupid as long as he was only little stupid, but someone with serious mental retardation, very low IQ not. Our model of illness was largely a more severe version of normal defects, the kind of normal defects we made each other fun of for. Or bullied each other for verbally. When we grew up, of course we stopped behaving like little pricks about it. Still the essential distinction stayed there: if, for example, a man is only somewhat stupid, you can think “haha what an idiot” and consider this an insult or censure. If a man is very ,very stupid, clearly mentally retarded, then not, then your appropriate atttude is compassion, not censure. Later on I learned that there is no reason why not think that moderate versions of the same problem do not work through the same pathways as illness. So this distinction is not tenable. Since then, I cannot tell the difference if a person is simply an ass or has antisocial personality disorder, is a fucking coward or suffers from anxiety disorders and panic attacks, and so on. I can no longer tell the difference what could rightfully drawn criticism, scorn, censure, and what should be met with compassion. The only consistent solution would be to consider virtually everything an illness, and think “he cannot help being what he is” and meet everything with compassion, but that is an entirely unusual and weird human norm. It is not how people normally feel. If for example a soldier runs away from battle leaving his comrades in the shit, they will not think “poor fellow has anxiety disorder and panic attacks”. They will think “fucking coward”. This is the normal human attitude. And we are trying to wall it off into illnesses that “he cannot help being what he is” in which cases we do not use this normal attitude but more like think with compassion and understanding. But this distinction is not really tenable. Ultimately the illness and non-illness are very much the same thing. So what is the truly proper attitude? Give up all kinds of censure and criticism? I am really confused by this.
“But this distinction is not really tenable. Ultimately the illness and non-illness are very much the same thing”, Sure, if you consider having not having use of both of your legs to be ‘very much the same thing’ as having two perfectly working legs.
That is a bit extreme. My point is more like, if unable to walk is 0 and being Michael Flatley is 100, there is a 20 or 40 level of leg clumsiness which you can see either as “normal” clumsiness or a neurological disability, neuromotoric illness, and my point is that humans tend to react radically differently to which interpretation is being used. A normally clumsy guy gets laughed out of the dancing course, the guy with the disability gets sympathy, pity and points for just trying. My struggle is trying to figure out a consistent and logical approach.
From a Buddhist perspective it doesn’t make much sense to talk about mental illness. Mental illnesses are narrow intellectual concepts that create a sense of identity and Buddhism is about not attaching yourself to labels. The Buddhist ideal is simply to show compassion to everyone.
At the same time a concept like depression can have some use. Depression is more than just being unhappy. If you use it to simply mean the opposite of happy you devoid it from meaning. It’s a cluster of symptoms. Having the concept allows us to research that cluster and come up with things that aren’t obvious.
Give criticism based on the utility of the effect of giving criticism. If you give someone constructive feedback that allows him to improve, that criticism is good. Censure is similar. If someone violates social norms punishing him was disapproval is useful to enforce those social norms.
But there is a long standing rule / norm that e.g. being officially insane (not having mens rea) exemps one from punishment.
Just because they work through the same pathways doesn’t mean that they are the same with respect to ability to overcome them.
Someone who is clumsy because of a neurological disorder cannot do anything which prevents himself from being clumsy. Someone who is “normally” clumsy can. The fact that they both have similar causes doesn’t change that.
Given that placebo’s do seem to have an effect on mental illnesses, I don’t think there reasons to believe that people with mental illnesses can’t do anything affect their state. On the other hand the fact that change is possible doesn’t mean that a person can change simply by trying very hard.
But there’s a difference between being able to change their state, and being able to change their state far enough to achieve normality. Someone who is very clumsy because of severe neurological problems could, by effort, get somewhat better, but even with a lot of effort he will still be clumsy, just less clumsy. Someone who is clumsy in the way that most clumsy people are, on the other hand, can entirely alleviate the clumsiness by effort. Even if they have similar causes, in one case the gap is a size that can be made up for by effort, and in the other case it is not.
The fact that something isn’t changeable by investing effort doesn’t mean that it isn’t changeable by another strategy. Sometimes the key to change is investing less effort.
Biological issues and mental issue also also often interlinked. Making it part of your identity that you can’t do something for biological reason X can often make change more difficult.
Given someone in front of you, how do you tell? How can this difference be observed?
It is easy to imagine “someone who cannot change their state” and “someone who can change their state”, but if you erase the XML tags and that your imagination has attached to the two, what would you actually be seeing?
By just saying “most humans can compensate for X degree of clumsiness. This person has Y degree of clumsiness. Y is greater than X”.
Of course, your ability to determine those two factors isn’t perfect, so you will get it wrong sometimes, especially in borderline cases, but you can certainly do better than chance.
Better than chance is a low bar. If you have some problem in your life, how do you determine whether and to what extent it is solvable, when to carry on and when to give up? Where the problem is, for example, akrasia, clumsiness, social anxiety, despair at the magnitude of the ills of the world, being a refugee in a flimsy boat in the Mediterranean, or acne.
It is easy to invent examples in the imagination where it is clear that you can solve it or clear that you can’t. There are fewer easy answers for the problems that life throws at you, which are not selected for solvability or unsolvability.
Going back to an ancestor comment:
Again, it’s not always easy to tell. I’ve seen people with severe cerebral palsy who it was clear were never going to walk or speak with a clear voice. I’ve also seen beginners in the taiko class who are competent at the ordinary movements of day to day life, but make a complete hash of what seem to me like the very simplest actions. I wonder if they are ever going to get it, and recognise that I don’t know. So I point them toward the correct movements, see them do the wrong thing again, and repeat. When I first took up tai chi, maybe the teacher thought the same thing about me. Eventually I learned, but I’ve seen other people go on for years without advancing. Could they, with different instruction? I can’t tell.
“Better than chance” is just another way to say “sometimes it actually works”. It doesn’t need to work every single time for it to be something useful.
And given the human tendency to generalize from one example, it has to be hard to take another look… My own learned response is ‘the person is clumsy and so has to be ignored if possible; it does not matter why s/he is so, since both a mentally ill or just careless can probably realize my rudeness if I stare.’ On the other hand, if someone at my workplace has a disability, I would be very wary of them having to do anything with volatile chemicals, and quietly but unceasingly influence things to make her/him stop. (I am in a plant physiology Dept.) Possibly I would be most rude to such a person, but exploding centrifuges just aren’t safe.