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Comment by jeffreyrogers | Hacker News Reader

There's a book called The Myth of Mental Illness[0] that deals with this issue at length. The author argues that many forms of what we call "mental illness" are not real illnesses at all, but extreme preferences that prevent people from successfully integrating in society. He's not saying that these behaviors are healthy or natural, but he makes the argument that because these behaviors arise from differences in preferences we shouldn't make treatment compulsory, in part because doing so abridges a person's rights to liberty and also because it's hard to "cure" someone who doesn't see their behavior as problematic.

If you're going to disagree with these arguments please realize that they are not my own. While I agree with much of what's in The Myth of Mental Illness, I don't agree with all of it. The above is obviously a very brief summary and leaves a lot unaddressed.

[0]: https://en.wikipedia.org/wiki/The_Myth_of_Mental_Illness

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You agree with his splitting of the body into distinct mental and physical spheres? It seems his contention, based on the wiki, would be reliant on the mind-body duality. This conjecture of his came before numerous neurological discoveries, I highly doubt it'd pass muster as a scientific argument today.

Further, as a researcher of mental health, I found the stigma associated with mental health treatment leads to a loss of seeking treatment, which may contribute to suicide or highly reduced quality of life in those whom treatment may benefit. Such books as this one do far more damage than good by perpetuating this harmful stigma.

In some instances yes, I do. In others no. The book was written in the 60s and it seems fairly clear now that some mental illnesses have physiological roots. It also seems clear that many issues such as depression, eating disorders, anxiety, etc. are often the consequence of environmental or other non-physiological phenomena.

Have you read the book? He doesn't argue that people should not seek treatment. He argues that many mental illnesses don't originate in physiological problems but are instead problems with people reconciling conflicting desires (I'm simplifying a lot here). He argues against compulsory treatment, not voluntary treatment.

The author was a psychiatrist and psychoanalyst. He is definitely not advocating for people to avoid treatment. He is suggesting that the focus on physiological causes of mental health problems obscures the causes of many such problems and prevents people from resolving them appropriately.

Mind-body duality has nothing to do with the question of whether mental illness is a useful term. Every character trait, whether it's called an illness or not, has biological roots.

>The author argues that many forms of what we call "mental illness" are not real illnesses at all, but extreme preferences that prevent people from successfully integrating in society.

My understanding is the latter half of what you described is one of the main criteria for a mental illness. Not that some part of the body isn't functioning properly, but "Is this causing problems between him and the rest of society?"

(Not saying I agree with the criterion)

This has implications when you have a society of people with a lot of minorities from very different cultures.

Some people do not want to integrate.

I am one of those who will never work for the gov, regardless of the amount of money or consequences, or for companies like google and facebook.

It has caused problem in a previous job, where I just refused to work on something.

Do you think a belief shared by a tiny minority of the population, and that costs you a job, is a mental illness?

Is it a mental illness to fear big brother? Maybe. I could also say I have my preferences.

>Do you think a belief shared by a tiny minority of the population, and that costs you a job, is a mental illness?

No, and I don't think any mental health professional would. This isn't exactly causing problems for either you or society. It caused a problem in your previous job, but it wouldn't cause a problem for most jobs you could do.

What does the author mean by preferences? The use of the word, to me, would seem to imply that people with depression prefer to feel numb and lose interest in their hobbies; people with OCD prefer to wash their hands until they bleed; etc. I can definitely understand preferences playing a role in some things, like culture bound syndromes, but to say that someone with schizophrenia prefers to hallucinate malicious voices seems bizarre.

Sounds like you might like to read the book!

I think preferences is an interesting way to describe this, as it assumes a choice, which I don't think is true. But I do believe that the DSM-[x] is a description of deviations from social norms, and psychology/psychiatry is a way to help people adhere and integrate into society through therapy and drugs as their deviation makes it problematic to exist in society.

I can try to highlight a difference.

At least in terms of depression feeling numb and losing interest can feel involuntary; a feeling like nothing can penetrate this deep fog that you've nestle into. You sort of know you don't want to feel this way but the tricky bit is teasing away if it's "health" or "circumstance". But I think for the author this would fall under "actually unhealthy".

Contrast this with something like narcissism, psychopathy, or school shooters where the author might say: You just think they're ill because you think they're assholes, inconsiderate, or evil. They're not ill, they just don't play by your rules.

Disclaimer: Unfamiliar with the book. The preceding is speculation of the point of view as explained by the parent, but a view that I sorta resonate with.

With every school shooting or public massacre there are these long diatribes about it being a public mental health issue (or a gun issue?). Why can't they just be evil assholes who didn't have much to lose? or chose to act out in a vague revenge against society? I'm not saying I disagree but I suppose I'm skeptical it being painted as so cut and dry.

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