Posted by Larry Hoover on February 19, 2007, at 16:33:46
In reply to Re: Everything I believe may be wrong » Larry Hoover, posted by munificentexegete on February 19, 2007, at 4:00:42
> >> Parkinson's disease is a Mental Illness, it has a pathophysiology being the decay of the dopaminergic system.
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> > Parkinson's Disease existed, both as a human experience and as a concept, long before we had any knowledge of the pathophysiology. Did it suddenly spring into existence when we discovered the decay in the subtantia negra?
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> Of course not, however, and this is the crucial part, because it had a physical component to its definition, the “shaky palsy” as it was first coined, it was always going to be possible to at some point discover the pathophysiology behind the disease.Well, that's how little you know about schizophrenia, then. There are distinct pathological changes associated with it (e.g. cortical shrinkage/enlargement of the ventricles), and neurological disturbances such as detriments in smooth pursuit/saccadic eye motions. Your original proposition was that Parkinson's is a mental illness because of pathophysiology. The same is true of schizophrenia, only the changes are more diffuse and delocalized. A prime difference is that Parkinson's affects motor neurons in a unique way, but one might argue a similar disturbance in the visual cortex of a schizophrenic. As you yourself said, it is always possible to discover the pathophysiology behind the disease. We may be slightly further back on the curve with schizophrenia, but the idea that it is purely subjective is quite absurd.
> The definition of schizophrenia is such that its pathophysiology can never be identified.
Not true.
> It is defined as a subjective not an objective concept on purpose. It is a fraud, a phoney, imaginary, delusional, unscientific, it is an insidious concept. It is a metaphoric term allowing anyone to be defined as seriously ill.
There's nothing on purpose about it. Your premise is implausible. You make it sound like a grand conspiracy.
> >> If we define schizophrenia as an overactivity in the dopaminergic system, then it too would be a Mental Illness. If we define bipolar as the overactivity followed by the under activity of the serotogenic system, then it too becomes a Mental Illness. However, without any pathophysiology schizophrenia and bipolar are meaningless, not mental illness at all, nothing more than metaphoric terms allowing doctors to define the well as diseased.
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> > I don't think a lay person needs to think "dopaminergic" to understand that a schizophrenic is having a different experience of the common reality than they themselves are having. Meanings of words have social components quite apart from their more technical definitions. It is true, most psychological diagnoses are behavioural. That does not invalidate the diagnoses themselves. The absence of evidence is not evidence of absence.
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> Schizophrenia is a useless subjective term, one can no more have schizophrenia than have squalemoertosaisa, its a scientific forgery nothing more.I think I heard you the first time, but I am no more convinced than I was before. "Petitio principii", you are begging the question.
> >> Redefine them as illnesses by all means, but don't insult our intelligence and expect us to admire the counterfeit.
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> > I am indeed concerned about redefinition going on.
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> Lol, i am merely pointing out where science has given way to permanent subjectivity. Illness is a physical, medical concept, medicine is a science, medical diagnoses need to be supported by physical facts not subjective judgment.Not so. We were vaccinating against viral illnesses before viruses (I prefer virii, but no one knows Latin any more) were even discovered. As I say, you need not have physical findings before treatment can begin.
> Otherwise doctors can go around willy nilly diagnosing everyone ill on a whim, and this is precisely the predicament we find ourselves in. It is not a very comforting thought.
Who is being diagnosed on a whim? Not me, sir.
> > I am always struck by one key element in the diagnostic assessment of psychological illness, such as defined in the DSM. It is the presence of phrasing such as "causing marked impairment/distress"....
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> hmmm, psychological illness, sounds like witchcraft, where's the scientific evidence for that?Sounds like a well-established term in modern medicine.
> I am not against psychological counselling for problems in living, but there is no proof that psychological problems are illnesses.
Here we have it. You call it "problems in living". I think it's clear who is inventing concepts.
Psychological counselling.....sounds like witchcraft, don't you think? ;-)
I would like to see you work with an acute paranoid schizophrenic with counselling alone.
> > I prefer to see the psych diagnoses as working hypotheses, rather than as constructs with perfect validation.
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> Lol, hypotheses, where did the science go?That is science, dude. Ever heard of the scientific method?
> You know as well as I that they are designed to be permanent hypotheses and never fact.
I know nothing of the sort. I totally disagree.
> Shouldn't one have to discover a disease, rather than invent one that can never be discovered?
Another logical fallacy. If A then B, not A not B, is fallacious reasoning.
> >As hypotheses, the existence of exceptions serves to suggest a boundary condition not yet understood very well.
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> Precisely. ; )That is the scientific method, once again.
> > I agree with you that we have only a weak and preliminary conceptualization of the relationship between brain tissue and biochemistry and the resultant cognition and behaviour. I also agree that it is unpleasant to be experimented on (a thesis that I infer from your arguments), yet that is all we have. It is all we have ever had.
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> I think we have an incredible understanding of how the brain works, the neurosciences are quite literally awe inspiring, just pick up any neurology or even psychiatric textbook to see the true depth of understanding we now have at our disposal. everything from blood tests to high resolution scans to genetic code analysis; medicine applied in a scientific manner is truly a blessing, extending and improving the quality of millions of lives.We know very little about the brain, dude. Very little. We understand the function of less than 0.001% of the genome. Blood tests for psych conditions other than infection are useless. Scans have only begun to be correlated to cognitive states and function, and are yet exceedingly crude instruments. We can barely image at 10's of magnification, and only on specific substrates. What is the meaning of the correlation between radiolabelled glucose uptake in the cingulate, and mood, precisely? We don't have a clue, dude.
> Unfortunately I am sad to say that medicine has also constructed concepts like schizophrenia and bipolar. We could wait 10 million years or more, the pathophysiology of schizophrenia will never be elucidated.
So, you at least admit there is a pathophysiology of schizophrenia. I would argue that we will know sooner than that. Want to wager $20 on it?
> Those concepts have been specifically designed to enable a doctor to classify anyone as seriously ill and have them held and tortured against their will.
Oh come on! Please be civil to, and about, doctors.
> They are not bona fide illnesses, they are complete forgeries and will remain so eternally regardless of the level of medical knowledge and expertise.
I thought we knew everything already? I'm really having trouble following when it is that we are supposed to know everything, and when it is that we are supposed to know nothing.
Lar
poster:Larry Hoover
thread:732492
URL: http://www.dr-bob.org/babble/20070219/msgs/734204.html