What goes and what doesn’t

We need to be clearer on the nonsense that science really did cast out: ringing bells to ward off lightning strikes, centuries of bleeding and quack cures that no one ever thought to test, the confused ways of confronting mental illness, the fanciful ways of mixing fact and idealization in hagiography and other attempts at history, the often unreflective teleology, etc. Good riddance to the whole bewildering embarrassment, and God bless science for driving it out. It’s hard to look back on it without feelings of condescension or anger.

But then, no one is fighting to bring back bloodletting or fanciful hagiographic legends. What science drove out is something we’re all happy to part with. Even the most die-hard traditionalist doesn’t want his doctor to tie radishes to his feet to ward off the ague. So it’s hard to see what we can do with this stuff that no one wants to return to – presumably some want to bring it up to cast aspersions on the religion, philosophy, and politics of the time. The critique might have some merit, but the categories one has to jump across to make it are so far apart make it hard to push the it very far – it’s something like an argument that questioned how the Mayo clinic could be of any value since it belonged to a society that dropped the atomic bomb, terrorized nations by murdering their citizens with drones, and was on track to incarcerate a third of the black male population. This isn’t giving context, it’s just poisoning the well.

There are areas where ancient thought could do with a good dollop of experimentation – Aristotle always insisted that the only point of ethics was practice and not theory but the resulting ethics is nowhere as close to the practical as contemporary cognitive science. But it is lunacy to think we can just pitch the ethics and do cog. sci.

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11 Comments

  1. Zippy said,

    August 20, 2016 at 9:14 pm

    “… the confused ways of confronting mental illness …”

    I don’t think today’s psychic witch doctors are especially more legitimately scientific or less harmful than those of yesteryear; though admittedly the marketing sounds more sciency.

    • David said,

      August 20, 2016 at 9:52 pm

      There is still a lot of confusion. There might always be. In the past, the tendency might be to neglect the real chemical/physical aspect of mental health. Today, we’re more likely to error by assuming that the chemical/physical is all there is to it.

    • August 20, 2016 at 10:50 pm

      This post started as a meditation on the strange status of what we now call mental health. On the one hand, reason was thought to be wholly spiritual and so any corruption of reason had to be some sort of spiritual corruption: sin, possession, divine punishment, etc. That said, there has always been a tradition seeing it as a physical or psychological corruption, i.e. arising from the power of suggestion, fakery, physical ailments, and of course humors/hormones (from the black bile of melancholy to the serotonin of… melancholy.)

      The narrative of scientific success should mark a clear arc from spiritual/ magical explanations and cures to physical ones, and to a large extent it is there. The medicalization/de-spiritualization of disease is in large measure a move toward reality. Nevertheless psychiatry has established pretty definitively that drug therapy is no more effective than talk therapy, meaning that, if one takes the mind as purely natural, it appears to be a natural phenomenon that responds to the speech of those our tribe has anointed to heal with words. Good luck telling that apart from the sort of thing science was supposed to save us from.

      • Zippy said,

        August 21, 2016 at 1:47 pm

        The “pretty definitively” claim is probably based on the clinical trial system, the meat and potatoes “science” of psychiatric and other medical practice underlying the positively Orwellian term “evidence based medicine.”

        David Healy’s books – especially his recent book Pharmageddon – are canonical background about the state of modern medicine in general and psychiatry in particular.

        Some of modern medicine is a technological wonder and scientific triumph. Other parts of it are superstitious witchcraft — deadly superstitious witchcraft. The leading causes of death in America today, in order, are heart disease, cancer, and doctors.

  2. Curio said,

    August 22, 2016 at 12:04 pm

    I work in mental health and from where I stand I don’t see anyone claiming that psychiatry is going to solve all our problems. Everyone knows that most pharmacological treatments work better when coupled with therapy.

    One of the most common goals we work on with clients is “emotional regulation”. Interestingly, Chastek recently wrote in a post on love

    “Virtue just is a correct emotional response to the world, where “correct” means one that is purified of its dark shadow and where some emotional responses have been grown more or less from scratch from the habitual repetition of some behaviors”

    https://thomism.wordpress.com/2016/07/15/love-as-primarily-willed-or-emotional/

    So, in a way, contemporary mental health practice approaches virtue ethics. Consider also the connection between CBT and Stoic philosophy.

    • Zippy said,

      August 22, 2016 at 2:07 pm

      I don’t see anyone claiming that anyone is claiming that psychiatry is going to solve all our problems.

      • Curio said,

        August 22, 2016 at 4:26 pm

        Isn’t that more or less the narrative that David Healy assumes in his critique of psychopharmacology?

      • Zippy said,

        August 22, 2016 at 4:26 pm

        No.

  3. Curio said,

    August 22, 2016 at 8:45 pm

    Well then. My point was just that most psychiatrists and most therapists who work with psychiatrists are aware of the limitations of psychiatry.

    This is proposition not held by the anti-psychiatry movement (The Mad in America crew, of which Healy is a part)

    • Zippy said,

      August 22, 2016 at 10:40 pm

      Not really. Most doctors (let alone psychiatrists) are not aware that “evidence based medicine” in particular, as a marketing term for certain kinds of medical treatments based on the clinical trial system, is an Orwellian fraud. And being against Orwellian frauds is not “anti-psychiatry” unless psychiatry is simply an Orwellian fraud as such. But Healy would disagree with that, as anyone who has actually read his books would know.

      • Curio said,

        August 23, 2016 at 1:34 am

        Agreed that EBM is an empty slogan at best, and a deceptive fraud at worst. I don’t mean to poison the well here, but it’s unfortunate that many critics of EBM advocate something much less rigorous and systematic. The last treatise I read on this subject was volume IV of the Divided Legacy series by Harris Coulter. He was also a note critic of the randomized controlled trial, but his proposed alternative – homeopathy as the medical norm – is hardly satisfying.

        As for Healy, I’ve only read blog posts. So mea culpa. It was a knee jerk reaction.

        At my facility, we operate under the neurosequential model of therapeutics developed by Bruce Perry (a psychiatrist) for work with traumatized children. It’s heavy on providing healthy relational experiences and light on the hasty prescribing of pharmaceuticals.


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