Hi Hancel,

I seem to have a difference in opinion with a few things that were stated. Firstly, you differentiated medical and mental illness purely on the presence or absence of physiological distress, which I believe is inaccurate. Mental illnesses do have physical manifestations ( Called Psychosomatic ), in addition to behavioural and and psychological effects. Secondly, while you have painted a pretty accurate picture about the causes or contributing factors of mental illnesses, you have left out genetics, which is a huge area of research with respect to mental illnesses.

Lastly, mental illnesses do most certainly exist. They are far more diverse, are multifaceted, vary with respect to the levels of impairment, distress, among other things. Mental health communities world wide have been trying to psycho-educate the general population to seek help and to sensitize them about the stereotypes and stigmas attached to mental illnesses. I do advice caution while writing this reflective essay as it can influence the opinion of people who read it.

Thomas Szasz's 1961 book, "The Myth of Mental Illness," is probably the most well-known critique of,"mental illness," as a theoretical construct and its juxtaposition with "(physical) illness." The present-day fields of Clinical Psychology and Psychiatry tend to dismiss his ideas. The 4 D's - dysfunction, deviance, distress, and danger - are central to mental health field debates about what constitutes a mental illness. In this sense, mental illness is meant to resemble physical illness. Simultaneously, it's acknowledged that mental illness is multi-faceted; you can't simply treat the physical body and cure a mental illness. Mental illness includes the body, but it also includes thoughts and the social context (called the Biopsychosocial Model of Mental Illness). Best wishes with your critique, Hancel. ~ Kevin

Thanks Kevin, for share your ideas and the information.

Att.

Hancel

As Kevin has noted, "illness" is a multi-faceted construct. I agree with Kevin that it is important to employ a biopsychosocial approach. I would argue that such an approach is important both in the work of assessment and treatment. Unfortunately, all too often the biological receives more attention than other factors; i.e., search for biological causes and use of treatments that focus on the biological.

Hi Hancel,

You should take a look at:

• Chapter V of the International Classification of Diseases(ICD-10) produced by the World Health Organization(WHO)
• The Diagnostic and Statistical Manual of Mental Disorders(DSM-5) produced by the American Psychiatric Association(APA).

Taken from the Wikipedia entry for the 'classification of mental disorders.'

George

Hi Hancel,

I seem to have a difference in opinion with a few things that were stated. Firstly, you differentiated medical and mental illness purely on the presence or absence of physiological distress, which I believe is inaccurate. Mental illnesses do have physical manifestations ( Called Psychosomatic ), in addition to behavioural and and psychological effects. Secondly, while you have painted a pretty accurate picture about the causes or contributing factors of mental illnesses, you have left out genetics, which is a huge area of research with respect to mental illnesses.

Lastly, mental illnesses do most certainly exist. They are far more diverse, are multifaceted, vary with respect to the levels of impairment, distress, among other things. Mental health communities world wide have been trying to psycho-educate the general population to seek help and to sensitize them about the stereotypes and stigmas attached to mental illnesses. I do advice caution while writing this reflective essay as it can influence the opinion of people who read it.

If you haven't yet, be sure to review the Adverse Childhood Experiences (ACES) Study... https://scholar.google.com/scholar?q=ace+study+felitti&hl=en&as_sdt=0&as_vis=1&oi=scholart

http://www.paulverhaeghe.com/books.html#

On Being Normal and Other Disorders: A Manual for Clinical Psychodiagnostics

📷

Other Press | Paperback | 2004 ISBN10: 1590510895 | ISBN13: 9781590510896

Hello,

Really important conversation:)

There are three types of norms in psychology:

¨Quantitative – the result of the assessment, represents the distribution of a given trait in population, e.g. memory storage, level of anxiety

¨Socio-cultural - ambiguous; an aberration from social standards is often referred to as deviation

¨Theoretic norm- „normal state” is assessed on the basis of comparison between the observable indicators and the theoretical ones .

But it is true that none of these norms explains all the issues related to the definition of norm and pathology: )

Thanks to everyone for be interesting in this discussion, I think It's really pertinent .

I will reply some of your contributions , bit it will be later because I'm a little busy now.

All ideas you're expressed are useful and value to help me plan the article , his structure, the authors that I have to read, etc.

Best wishes. Kevin Grobman Kelvin Mutter George Schiro Sonali Siragowni Sriranga Bonita Roberts Urszula Lopuszanska Jorrit Teuwen

When you are researching illness, do not forget health and the new positive perspective on it. See https://www.bmj.com/content/343/bmj.d4163

I would add to Hans van lersel's comment and also suggest you can include reflection on the social determinants of health.

Dear Hancel,

When you wrote 'I am convinced that mental illness does not exist' , you surprised many people or researchers or clinicians.

But I wonder if you have read adequate and have honned your expertise in authentic schools of medicine, and have learned how not to think subjectively and execute only objective perspective. (Read about functional MRI, biological neuropsychiatry, etc. which prove biological aspect of mental illness).

Any body who has not achieved experitize in medical science, especially in psychiatry and in psychology especially in clinical psychology in association with philosophical psychology may NOT dare to keep target like that of yours.

My advise, first explore and then analyse your own self , own subconscious mind to find out why would you take up or choose such a research topic from vast ocean of topics.

Every one before my reply have suggested you the same advise but in a very subtle way.

I hope you don't take my comments personally, keep no hard feelings at all. I have No intention to hurt you. But I don't think I am playing role of a 'parent' of PAC theory of Erick Burne as well.

But if I evaluate my stand from Erick Burns's eyes then I may name it 'Parent adulterated Adult'. Hope, you have learned legendary Erick Burne's Transactional Analysis.

Please, please forgive me dear Hancel.

God bless you.

Hello dear Madhav.

I am very grateful for the time you have spent contributing ideas based on the question posed, although I admit some discomfort, because I would like to have this discussion in my native language, despite this, I will try to answer the arguments one by one.

The first idea that you expose, puts into question my experience to talk about it, stating that, if I have not been trained in an authentic medical school, then I can not talk about it. Regarding this, I want to express that all my training has been clinical, due to my strong interest in "Schizophrenia" I have had the opportunity to work in a multidisciplinary way with doctors, psychiatrists and other professionals in psychiatric clinics, and it is precisely not only based on my experience, but also on my studies, serious and dedicated, which formulated ideas like the one presented.

On the other hand, you suggest that I review the studies on functional magnetic resonance, neuropsychiatry, etc. I am not surprised that you base your thinking on this idea of ​​objectivity, after all, you have been trained as a doctor (I suppose), your idea of o​bjectivity is based on the observable, on the measurable, for you doctors and psychiatrists, the only thing that has Validity is what can be expressed by the body, and this has been precisely the reason why many doctors and psychiatrists, including Dr. Juan Mezzich, current president of the World Association of Psychiatry, has questioned the great dehumanization of medicine , by focusing on the body, the brain and genetics, they ended up forgetting the person, from whom they experience discomfort and suffering. Despite this, functional magnetic resonances, and other technologies, have not even been able to demonstrate objectively the basis of diagnoses or so-called "mental illnesses". You question subjectivity, but you forget that psychiatric diagnoses, the basis of pharmacotherapy, is based precisely on the subjectivity, on the reports of the patients, and how you will probably question my experience or my criteria (for not being a doctor or having been trained in an "authentic" university for medical studies ), you can review some ideas exposed among others, by Dr. Allen Frances, a leading figure of North American psychiatry, someone who played a leading role in the revision and publication of the DSM IV. Other sub-areas or sub-disciplines of medicine have objective support, can objectively support their diagnoses, psychiatry does not, and simply because we are talking about something very different, complex, which, in the case of people like you, want to reduce an image, a mere correlational phenomenon, and it is clear, the correlation does not imply causality. Do not be proud of objectivity, in psychiatry it does not exist. Just out of curiosity, check out Rosenhan's study about "On Being Sane in Insane Places."

Now, based on your disciplinary dogmatism, considering that medicine is completely objective, and I man to psychiatry, a fact that I strongly question, you intend to delegitimize the validity of the question, as if it were clear to everyone; I am glad if it is for you, I suppose it has been the product of your intellectual efforts, for me, as well as for many psychiatrists, doctors, clinical psychologists, etc, it is not. This has been an idea that for some time has been in question, and it has been precisely because they have not been able to provide sufficiently convincing arguments to believe that something like this exists. It is not possible that a fact, from your point of view, so obvious, generates so much doubt in several disciplines "philosophy, psychiatry, psychology, etc". Worldwide, there are not only authors, clinicians and researchers, but also internationally recognized organizations (The International Society for Psychological and social Approaches to psychosis or dthe Commission of Citizens for Human Rights ), Of which many researchers are part, for example Richard Bentall, John Read, etc., who discuss these ideas (Bentall, R. P. (2013). Reconstructing schizophrenia. Routledge ), Even dare to affirm that entities such as schizophrenia, are a scientific delusion ( Boyle, M. (2014). Schizophrenia: A scientific delusion ?. Routledge) And going further, not only the scientific nature of mental illness is questioned, but also the validity of psychiatry as a discipline (Read, J. (2005). The bio-bio-bio model of madness. Psychologist-leicester-, 18 (10), 596; Read, J., & Dillon, J. (Eds.). (2013). Models of madness: Psychological, social and biological approaches to psychosis. Routledge, Bentall, R. P. (2004) . Madness explained: Psychosis and human nature. Penguin UK ) they even discuss and debate ideas about the effectiveness of their medical treatments, of the psychopharmacological model ( Moncrieff, J. (2009). A Straight Talking Introduction to Psychiatric Drugs (Straight Talking Introductions) (Vol. 25). Pcs Books; Gøtzsche, P. C. (2015). Deadly psychiatry and organized denial. Art People; Bentall, R. P. (2009). Doctoring the mind: Why psychiatric treatments fail. Penguin UK ).

In the same way you disqualify my criteria and my foundations, I suggest you look beyond MAGNETIC RESONANCE, genetics and psychiatric drugs, and focus more on the study of people, review, read and know other perspectives , we are not only biology, it is the base, but it is not everything, and no matter how hard they try, human nature, what it means to be a person, can never be explained only from purely biological concepts.

What many psychiatrists consider to be mental illnesses, for me they are human problems, The fact that I desists from the term mental illness, does not imply that I think that people do not need help, of course, yes, there is a big difference between thinking about problems From diagnoses, symptoms, diseases, neurotransmitters, genetics, neurodevelopment, I also believe that there will be occasions where the psychological problem undoubtedly has an evident medical correlation, however in the majority of cases it does not. I prefer to think, as have been done by so many psychiatrists of psychosocial current, psychologists, among others, that human problems can be understood within the context and life history of people, it is the people who suffer, to them we must refer, listening to them, from the personal context of life, everything makes sense, people develop psychological problems not simply by neurotransmitters or genetics, also by suffering, by the circumstances and events of life, the trauma ( Read, J., van Os, J., Morrison, AP, & Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112 (5), 330-350.)

I hope you do not take personal my words, I do not discuss you, but your ideas.

And sorry if some sentences don´t look good, it´s a direct translation from spanish and for the way I have cited the references into the paragraphs.

Regards

Att.

Hansel

Madhav, Eric Berne's Transactional Analysis model differentiates between the nurturing parent which aims to support the child's move toward's differentiated adulthood and and the critical parent whose interactions are destructive. I detect the former in your response.

😊 Kelvin.

Dear Hancel/Hansel,

Good that you responded in some details.

Your response ascertains your conviction, your strong effort to convert one's own subjectivity to maximum objectivity. Your response convinces readers that yes, you are an expert in psychology. But simultaneously it also indicates that there is still ground for you (for me too) to nuture, develop. Neither you nor me are yet fully knowledgeable.

Allow me some time to reply all your points one by one. To do so, I intend to read your suggestions. Allow my brain to comprehend , process the information, from the references you have cited above.

Than for the sake of contribution to the field I would like to place my understanding about the topic of discussion , and would very much like to refute many of your points as well.

Before completing this reply let me tell everybody who is reading that I am not a die hard biological psychiatrist. In fact my skills, qualifications too would reveal this fact that I adopt very much holistic view to execute my expertise. And that's why I have trained myself in psychology, philosophy, psychotherapy, family medicine along with psychiatry.

It is getting interesting, isn't it my friends.

I invite readers too to contribute to this discussion more of objectively and much less of subjectively.

😊👍

Hi, Madhav.

I am very happy to be able to deepen this discussion with you.

As a young researcher, I am deepening in the knowledge of theories and studies on schizophrenia. Particularly I have been oriented more towards integral perspectives, those that consider psychological, social and cultural aspects to understand schizophrenia. I understand the idea that the basis is biology, however not everything can be explained from there. There is enough evidence in favor to consider schizophrenia as a product of psychological and social factors, as well as to take into account the aspects associated with the subjective experience of these people. What I propose is to contribute to a more human clinical practice, to think that everything is a product of neurotransmitters, many psychiatrists are not even interested in knowing and conversing with their patients,they are not interested in the experiential aspects, personal history, and Research has shown that they are important elements.

The authors who have allowed me to deepen these perspectives and especially in the studies, research, data, etc, are Jhon Read, Rochard Bental, among others. A text that I suggest if you want to know a little more my frame of reference is the book Models of Madness: Psychological, Social and Biological Approaches to Schizophrenia (The International Society for Psychological and Social Approaches to Psychosis Book Series), this book in an edition updated, collects all these ideas and research, which even put into question the medical and pharmacological paradigm on schizophrenia. You can also read the book Making Sense of Madness: Contesting the Meaning of Schizophrenia (The International Society for Psychological and Social Approaches to Psychosis Book Series)

I would love if you could read these texts, so we could talk more easily.

Personally I am also deepening and knowing all the vast knowledge that there is regarding this materia, with special emphasis on the perspectives raised before.

In the same way, I find it enriching to be creating these international work networks.

And about what you said about " convert one's own subjectivity to maximum objectivity " One of the principles contributions cited in the text that I suggested to you are based in subjectives studies of schizophrenia, and not for that they lack value, I prefer to study persons more than variables. What you call subjectivity for my is convictión in the Knowledge and ideas that I´m trying to understand. likewise, remember that objectivity is a serious epistemological problem in science, especially in the human and social sciences, including psychiatry, even if it is a subdiscipline of medicine. psychiatrists do have to worry, they do not have how to sustain objectively their diagnoses, something that other areas of medicine do.

Greetings.

Dear Sir,

I am yet to answer and refute your points. However, last lines of your recent post compares other areas of medicine with that of psychiatry.

Let me draw your attention to meaning of objectivity in medicine and that of psychiatry.

Objectivity in medicine does NOT mean identification of exact cause -effect relation. For exam. There is no exact cause of Bronchial Asthama other than genetic disposition. It can not be illustrated exactly how symptoms of asthama are produced by tangible cause. In fact pathophysioligy of asthama can be directly and convincingly connected to symptoms. Asthama is especially a disease of phenomenology.

Now compare asthama with schizophrenia with above explanation.

Schizophrenia is also a phenomenological disease where pathophysiology is clearly identified but exact cause other than genetic disposition is yet to be clarified.

But in this case you don't declare that you are fully convinced that Asthama is not a disease or does not exists !!.

So finally as for this post I would reassert , medicine and psychiatry both need endeavor of clinician and related experts to maximize objectivity by adhering to guidelines of text books and minimizing personal views or beliefs borrowed from disputed sources regarding everything about the disease.

💐💐💐

Based on my 40+ yrs. as a BHC clinician and an AF medic X 4 yrs. I take a biopsychosocial approach. When I train and teach I slightly differentiate disease from dis-ease.

Rich

I take a somewhat Darwinian view that something isn't a true illness unless it negatively impacts an organism's ability to thrive and pass on its genetic inheritance, its skills, knowledge, and nurturing to the next generation. If something can be rigorously defined and measured and it inhibits an person from thriving and passing on the things mentioned above (even in principle), then I am prepared to call it an illness. That includes so-called imagined illnesses which are still illnesses if they negatively impact the person. The issue of harm to society is a little more complicated. If a psychological condition means a person is likely to physically harm another (or themselves), then I am prepared to see the potential perpetrator restrained or segregated and possibly treated. However, it is well documented that society has on occasion used psychiatry to victimize and punish persons that the society or power elite see as dangerous. I think the only real protection in cases such as those is transparency.

George

Hi Hancel. Seriously interesting question. Hugely complex. It completetly challenges our conceptualisation of illness. The most promising ideas which may help to shed some light seem to be emerging in the field of narrative psychotherapy: perhaps Michael White's writing may be a good area to start checking this out. I suspect though that there is very little of the kind of substance yuo are looking for. I will be really interested to read your paper! Good luck. Bill

Some think like you do and then use disturbance or the like:

Merriam Webster: illness

noun ill·​ness | \ ˈil-nəs \

Definition of illness

1a : sickness sense 2 b : an unhealthy condition of body or mind

2 obsolete

a : wickedness b : unpleasantness

Synonyms & Antonyms for illness

Synonyms

affection, ail, ailment, bug, complaint, complication, condition, disease, disorder, distemper, distemperature, fever, ill, infirmity, malady, sickness, trouble

Antonyms

health, wellness