Do you believe that psychiatry provides us valid knowledge that allows us to identify, study, and treat individuals who have mental influences that cause them to be a danger to themselves or society? If not, by what means to propose that we do so?
> Do you believe that psychiatry provides us valid knowledge that allows us to
No, it really doesn't.
If someone comes into a clinic and ask psychiatrist for a help, he is gonna be diagnosed with some kind of a disorder 100% the time.
But if you think about it, it's not psychiatrist who determines if the person is healthy, it's the person himself. If you meet with a psychiatrist, you have a disorder. Period.
> treat individuals who have mental influences that cause them to be a danger to themselves or society?
It reminds me of an old Soviet practice to treat people who were under influence from Western countries. Quite obviously, it was considered a mental disorder which was dangerous to themselves and for the (Communist) society. So those were usually locked up in a psychiatric clinic and never heard from ever since.
The methods to determine if a person is "ill" never changed. "I think that person has disorder, so let's come up with a disorder that fits more or less." As mentioned in the article above, the response should be: where is your blood test?
> If not, by what means to propose that we do so?
Quite easy really. Whether a person is a danger to society or not, should be determined by a court jury based on his previous actions.
> If you meet with a psychiatrist, you have a disorder. Period.
Whether or not that's true, it's irrelevant to the statement about providing valid knowledge. If a person goes to a family doctor, they have a health issue. If a person goes to a lawyer, they have a legal issue. To an accountant, they have a fiscal issue. Merely 'going to [professional]' does not mean that they have invalid knowledge.
> Whether a person is a danger to society or not, should be determined by a court jury based on his previous actions.
Not only is this is a huge waste of time and money (court officials, jury, legal teams...), but it's even more subjective that the system you want it to replace. And it's already well-known that courts deal with mentally ill people far worse than mental health services do.
>> Quite easy really. Whether a person is a danger to society or not, should be determined by a court jury based on his previous actions.
A couple of problems with this solution come to mind. You say that the knowledge that psychiatry produces is invalid because it is non-scientific. The process by which the justice system produces knowledge is decidedly non-scientific and inherently subjective. Why do you hold the knowledge produced by the non-scientific process of justice above the non-scientifically produced knowledge of psychiatry?
Additionally, by the time the justice system gets involved, a crime against society has already occurred. Surely we can do better than waiting for tragedy before intervening?
Homosexuality was once considered a psychiatric disorder. That alone tells you that it is a reflection of social norms, not objective truth, and therefore, inherently unscientific.
This is different from medicine (which also had an interesting past as it evolved) in that there's broad, objective consensus as to what's harmful and what's not, and its work is detailed and reproducible and there's few questions how the mechanisms of action work - infectious particles harm the body and cause disease, and there's no debate on that matter.
Whether or not psychiatry can help those who are a danger to themselves or others (answer: of course it can.. one way or another) is orthogonal to whether it's scientific or not.
The idea of evidence-based medicine and using the scientific method in medicine came up in the 1960s. It took longer still for it to become widely used and there are still massive problems in that area today, take a look at drug testing as an example. You can't reasonably claim psychiatry to be significantly more or less scientific than medicine.
You're idea that there is an objective consensus on what's harmful and what's not is simply ridiculously wrong. Just look at discussions about making insecticides or pesticides illegal that come up quite regularly.
You're idea that there is an objective consensus on what's harmful and what's not is simply ridiculously wrong.
I didn't say for all things, but I did say broad. And most importantly, the results of the studies have nothing to do with what people think is harmful or wrong, only what actually can be measured and reproduced.
People argue over climate science too (and for the same reason as your counterexample). There's still broad consensus at the end of the day.
Meanwhile, the psych "science" is inherently anchored to whatever the social norms of the day are. Medical science and biology can define a healthy body with much more certainty and detail than psychiatry can define a healthy set of thoughts.
We know very little about how the brain and the mind actually work. Nevertheless we need to somehow people who have problems with these things. It makes sense to try things that might not be fully supported by science as has been done successfully in medicine. Of course mistakes happen when you do that but it doesn't make sense to abandon psychiatry as worthless because of that.
Nobody suggested abandoning it, merely that as a "science", it's woefully deficient. I have no doubts that we'll begin figuring it out soon enough.
In the meantime, I suggest treating all psychology with a few more grains of salt than usual, keeping in mind that the science is often based on opinion rather than fact.
..especially when a nontrivial amount of peer reviewed papers can't be reproduced.
Yeah, I agree that psychiatry's value rests less on its categorization as science or not but rather its ability to reliably reproduce valid and accurate knowledge of use to society and individuals.
I have began to push back against the position that the scientific method is the exclusive measure of valid and valuable knowledge, and I detected a bit of that in your assertion.
Personally I believe that psychiatry can be both a science and not a science, depending on how one practices it. And that some highly valid and valuable knowledge remains outside the reach of science, and always will. And other highly valid and valuable knowledge can only be produced by the scientific method and will remain outside the reach of subjective methods.
> Personally I believe that psychiatry can be both a science and not a science
Like alchemy, astrology or theology? Or medical sciences in middle ages?
Like all those "sciences", psychiatry lacks a solid base, a set of verifiable facts which entire science is based upon. Why those disorders happen? Which substance causes them? Anybody can answer that?
Medicine as practiced now has both scientific and non-scientific parts. Original research, as in bioinformatics, drug discovery, etc. constitutes the scientific part as it uses systematic experimentation, logic, statistics, etc. to deduce universal laws that can be independently verified.
However, the application of this knowledge to actual individuals in an doctor's office or hospital is an inherently subjective and non-scientific process, involving subjective inputs such as 'Rate your pain on a scale of 1-10.', 'How are you feeling after we upped your dose?', 'Is this treatment plan allowing you to get back on the job?' etc. The value a doctor provides is taking the vast corpus of medical knowledge (both scientific and not) and applying it to a single individual. This is not science, but is critical for the medical treatment process.
So what's the argument, that we should just wait a few centuries to help anyone who is mentally ill because we don't know enough about the underlying mechanisms?
