Dear colleagues,
For over a century, the field of psychiatry has operated on a basis of subjective narrative, not objective science. It has constructed a "false map" of human coldness, where diagnosis is not a discovery, but a judgment rendered by an "expert" whose only instrument is his own opinion and general personal perspective.
I therefore propose abandoning this "rhetorical framework" and replacing it with a physical and falsifiable model from Physicobioneurodynamics. The hypothesis is that psychopathy is not a chaotic disorder, but a state of extreme neurodynamic order, characterized by low network entropy. This "operating system," lacking affective "noise," is perfectly optimized for logic and strategy.
This leads us to an unavoidable conclusion and a direct challenge:
The current model, where a psychiatrist diagnoses based on a conversation and teaches the patient to self-diagnose based on what the patient says and affirms as a psychiatrist, no longer holds water.
If the same low-entropy architecture can produce a functioning genius or a predatory criminal, what legitimacy does a specialist have to issue a definitive judgment or diagnosis about "pathology" as if it were a static stereotype of an individual that must be assumed, represented, or interpreted, based solely on their observable behavior and subjective interpretation?
My argument is none. Psychiatry can no longer hide diagnostic systematization as if it were a God deciding with his finger who is admitted and who is not.
This is not a debate to excuse harmful behavior. It is a direct challenge to psychiatry's monopoly on the definition of normality and pathology, which teaches us to know nothing about ourselves, to collaborate, and to adopt a persona that destroys the identity of every human being from within.
I challenge the community to confront this "Paradox of Order." Will we continue to rely on a diagnostic system based on opinion, or are we ready to demand a science of the mind based on physical, objective measurements that returns the power of understanding to the individual? How is it possible that after so many years, something that cannot be measured is still called science?
It's as if it were a combination of psychoanalysis and psychopharmacology. Useless to a certain extent.
Most, if not all, psychiatric diagnoses are mere worksheets that need to be studied and analyzed from various angles to rigorously corroborate that "That's it!" and that it doesn't remain a simple diagnostic hypothesis. But it seems that psychiatry hasn't had a problem with this little detail for a long time, but that's over. The standards of science don't, or wouldn't, allow something like this to continue operating. This also applies to psychology, medicine, oncology, and many other disciplines that still ignore true systems dynamics.
For a full development of this hypothesis and its experimental proposal, I attach my work.
Psychiatry is not based on an accurate diagnosis, since consensus psychiatry does not know the cause of the main mental disorder - depression. Psychiatry probably does not even ask the question of finding the cause of depression, but only asserts the presence of the disorder. The mechanism of depression is conceptually complex for a person, but at the same time very simple. For example, for a fly to fly out of a nearby open window is a very difficult task, so it stubbornly and carefully hits its head against the glass, doing its job of flying out of the room into the street. Psychiatry also stubbornly does its job, although the exit is very close, but this requires conceptual changes. Psychiatry now knows nothing about depression and does not know the real scale and importance of depression. Now 99.999999% of people essentially constantly live with a heavy metal weight tied to their neck. Yes, it is inconvenient. A person does not know about this weight, but feels some discomfort and suspects something. This weight is invisible. That is why psychiatry seems subjective. The psychiatrist does not see this metal weight, but suspects that it exists and tries to form some opinion about something that he does not know, but suspects that it exists. The transfer of psychiatry to an accurate diagnosis will occur when psychiatry gains access to the formula of depression and to the tools for its management. On my RG page there is a general description of the real mechanism of depression.
Science evolves where measurement is possible, but complex systems like the mind often resist simple metrics. Diagnostic categories persist due to clinical utility despite their limitations. True progress demands developing objective, quantifiable tools without disregarding subjective experience.
https://en.m.wikipedia.org/wiki/One_Flew_Over_the_Cuckoo%27s_Nest_(film)
Watch/read above. It is a state of conflicting energies joining. Read Carlos Castenada(more liberal? Timothy Leary, Mckenna, RAWilson).
"The sick are compassionate" Putin after epidemic.
Do not blame doctors. That is consensus.
"With all due respect, I disagree with your position, since psychiatry has historically served as a universal system responding to adverse social realities. The perception of psychiatry cannot be reduced exclusively to medical practice - or even to anti-psychiatric criticism - but must be understood through the prism of the position and actions of psychiatrists and psychologists working with human suffering." Currently, psychiatry is not fulfilling its function in managing depression - the most common disorder that affects 99.99% of the population. If psychiatry is the coordinator for managing depression, then it is necessary to inform society about the existing problems in understanding depression. Currently, psychiatry has zero understanding of the true causes of depression, but it is necessary to inform everyone about this and ask for help from a wide range of researchers, since the current percentage of understanding of the processes of depression in psychiatry is zero. So that society and researchers understand the current understanding of depression in psychiatry. Depression is melancholy, it is the inability to experience pleasure. In managing depression, the goal is to restore the patient's ability to enjoy and eliminate melancholy and anxiety, not to work with suffering. When you tell a patient that you will work with his suffering, you further aggravate the process of depression. It is the same as if a person broke his arm and the doctor would teach the patient how to live with a broken arm and would not perform an operation to fuse the bone of the broken arm. Regarding depression, psychiatry now tries to persuade a person to live with a broken psyche and does not take measures to eliminate the cause of depression. When there is no understanding of the causes of the disease, then you cannot apply effective treatment and therefore you will have to work with the patient's suffering. If you know the cause of the disease, then you apply effective treatment and eliminate the disease.
"Psychological or psychiatric diagnosis is not simply a labeling exercise, but an objectification of subjective suffering designed to guide inclusive and socially responsible health care. Both disciplines must be situated in their sociocultural and historical contexts, where conditions like depression were once viewed as existential or social alienation rather than as illness. Our understanding of mental illness has changed as society has changed." If you imagine the process of depression as a large building, then psychiatry now has only one room in that building. Changes in the understanding of depression in psychiatry have occurred, but they have not changed the percentage of understanding of the processes of depression - psychiatry understands zero percent of the processes of depression. Psychiatry sees only the result in the form of a symptom. And what happens before you tell a patient that he is depressed?
"This evolution is reflected not only in the DSM-5 but also in systems such as the ICF, which expand our perception beyond symptoms to include functioning, participation, and the environment. While psychiatry has developed pharmacological approaches, psychology has introduced therapeutic methods based on narrative, behaviorism, psychodynamics, and humanism - all of which help people reconnect with their lived reality." When there is no understanding of the disease process, it is common to prescribe such a disease as multifactorial. Then it is convenient to tell the patient that he has many causal factors and to remove responsibility from the doctor. All methods of depression management currently used in psychiatry are aimed either at distracting the patient from depression, or replacing depression with another stimulus, or partially disconnecting him from reality. These methods do not aim to return the patient to the ability to experience pleasure and eliminate anxiety.
"Psychologists also use tools such as projective techniques to reveal the structure of trauma and symptoms in the personal narrative. Symptoms are not just behavior, they are manifestations of disturbed ways of being, shaped by the unique relationship between thought and action (pensée et action) of a person. Understanding these patterns gives suffering a deeper meaning." Suffering in depression has a deep meaning if you do not know the causes of depression and have to mythologize depression. Depression is a clear signal of a disorder, which must be answered clearly. There is no deep meaning in depression - it is an ordinary signal of the body, which turns into depression if you give an inadequate response to this simple signal. An inadequate response to a simple signal of the body leads to suffering and dissatisfaction of the body.
"Psychology thus does not diminish human experience but expands it by offering a multidimensional framework that takes into account the complexity of human existence in a world where suffering is not simply biological but deeply relational and existential." Suffering is not the engine of civilization. Appreciation, positivity, and joy are the engines. Depression is a highly complex, multidisciplinary disease, and monopolizing the management of depression by a limited number of disciplines is a mistake.
When an oncology surgeon mandates chemotherapy as a non-negotiable precondition for surgery, especially against a patient's wishes or when it is clinically contraindicated, they engage in a form of medical paternalism that profoundly violates patient autonomy. This practice effectively holds a potentially life-saving operation hostage to a rigid treatment protocol, subverting the ethical cornerstones of beneficence and informed consent.
Dear colleagues,
First, I apologize for my recent silence and my deepest gratitude for the extraordinary quality of this debate. I have followed each intervention with immense interest. My absence from the comments was not due to disinterest, but precisely the opposite: the depth of your criticisms and contributions forced me to withdraw and work on the most honest and rigorous response I could offer, even though it was not requested, from the heart.
This discussion has crystallized the fundamental crossroads of our science. On the one hand, the need for a science that honors subjective experience, narrative, and the relational complexity of suffering has been eloquently argued. On the other, the end of "rhetorical frames" and the need for a science based on physical, objective, and measurable properties have been demanded with implacable logic.
How do we close this gap? How do we build a bridge between the phenomenological "legend" and the neurodynamic "map" without betraying either?
My answer to this question is the work I've been immersed in these past few days, one of the most significant and complex I've ever undertaken, not only technically but personally, as many will understand. I am pleased to announce that I am completing a new manuscript devoted entirely to depression, which I hope will be the most important contribution of my Physicobioneurodynamics to date and a demonstration of my commitment not only to treating depression but also to properly understanding and educating about it for what it is.
This will be the first work to offer a detailed conceptualization of depression as a state of rigid systemic metastasis, a topological rupture of the individual's "self," proposing a set of neurotopological biomarkers (the "entropic signature") to objectively measure the "experienced form" of suffering with neurotopological psychometry and, most crucially, a protocol to catalyze the transition to isostasis and recovery from phenomenology.
It is my attempt to demonstrate that we do not have to choose between opinion and measurement. We can, and must, build a science that measures subjective experience with the same precision with which a physicist measures an energy field.
This is my mission, the same mission that everyone has experienced at some point with great ambition, commitment, and love for their disciplines. I hope this next work will live up to the debate that you have so brilliantly enriched with your more than necessary years of experience.
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