When Do We Have Empathy for the Mentally Ill?
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daily.jstor.org
As long as we do not conceive that mental illness is a thing, we won't tolerate it and the mentally ill will never be able to accept they have a condition, so they will just be a burden to themselves and others.
I always relate with human beings knowing they can make errors because of their mental process or even their mental issues, even mild. Lurking on certain subreddits like JusticeServed, I can often see how some people in the US believe in capital punishment and have literally no mercy towards faulty but natural human behavior. I don't live in the US, so I might be biased, but I'm surprised how people can have such hard belief in free will ("you can make it if you want" etc).
Experiments in quantum physics show that usually you can't know exact outcome of a quantum measurement. I don't think that has something to do with free will problem, but your belief in determinism seems irrational too.
Yes, there are theories which try to mitigate this inconsistency, but they require quite a bit of mental acrobacy and aren't generally accepted.
As a naive young person, I hoped that a metal illness was just that, an illness that can be cured.
After discovering mine, the curtain was pulled back, revealing the 'trick' all along behind the illusion of cure, was just suppression. Bacteria are killed, sometimes Viruses too. But thoughts, and feelings cannot be cured or killed, they must be suppressed.
For 'Free Will', one should be free to control one's will.
I can't pass through doors in the first try, or the 20th, sometimes when I'm by myself.
Some people cower right before a fight they've prepared for, for months, they knew fight day was coming.
Anger kills people, people 'see red'.
If these thoughts and feelings are your will, hopefully we find out that they're free, not you.
the Free Will (TM) state machine uses this constantly updated training data to bias its decisions throughout its shelf life. so there are rules (like you stated) but there is also a huge set of data that alters the rule's parameters, to such extent that some times, new rules are created and old ones get discarded.
free will in itself will never be provable.
You are you after all. But you are also still just a human being, subject to their quirks, foibles and limitations too.
> We just don't have enough knowledge to fast forward the simulation?
Well we could simulate a trillion possible outcomes because we're talking a simulation that involves a trillion variables. Which one would definitely occur we could only be sure in hindsight.
Maybe just like how computers can't truly generate a random number, we can make it appear virtually random. Maybe freewill is somewhat similar in that regard, that there's quite a bit of freedom in a lot of choices, but overall it's not absolutely free will that we're operating on.
(My Struggle, Book 6)
Some people arent capable of acknowledging they have a condition precicley because of their condition..
It is hard when someone is developing mental illness or has hit some tipping point. Once upon a time your friend or loved one was pretty normal, and they've gradually become more erratic, hard to deal with, potentially dangerous even. And most people aren't experienced with how to deal with those issues and they're tough issues. And there's no line when friends, family, society can just take over for a mentally ill person.
>we won't tolerate it and the mentally ill will never be able to accept they have a condition
There's some caveats to that. Mainly being that mental illness covers a huge spectrum and people at the deeper end may not be capable of acknowledging they have an issue, or even if they can, that admission isn't the thing that will change their circumstances.
The identity of self-determination in the U.S. is interesting. There is a lot of truth to how many Americans are just down on their luck millionaires. And how consistently they will work against their own self-interests, because someday they might be wealthy or powerful and they want to enjoy that maximally.
And you can see some of these attitudes among many successful people who want to believe it was their effort, their hard work, their genius that made them successful, solely. Or at least those are the biggest factors, while luck, circumstance and opportunity are minimized or completely dismissed. They want to believe if they had to start over they could do it all again and the admission that that might not be the case is not what a lot of people's egos want to hear.
So perpetuating that myth of the self being all. That very successful people did it all on their own. That we're all completely totally responsible for ourselves and our circumstances can enable us to feel good about ourselves, and make it easier to blame those who are beneath us on the socia-economic ladder for their own circumstances and not acknowledge that the system is broken, or stacked against some people, that some of us had significant advantages. It makes it very difficult for a lot of people to walk a foot, let alone a mile, in another man's shoes. And that permeates everything in our society, even views of mental illness.
> I don't live in the US
This strikes me as a really weird thing to casually drop in the middle of your argument. I would assert that if people from the US are over-represented on /r/justiceserved, it's for the same reason they're over-represented on /r/aww: It's an English language forum and 80% of the native English speakers in the world are from the US.
>...respondents felt less empathy for the fictional patients when they read the biological explanation.
Am I missing something here? Of course people would empathize more with a person who has relatable experiences. Nobody is going to relate to "an MRI scan revealed that she had an unusually small hippocampus" but almost everyone has experienced relationship troubles and problems at work.
It seems clear to me that it's not right since in both cases the causes are outside the control of the afflicted person—even more so in the case of a brain structure anomaly; and a common ethical heuristic is to not blame someone in such a situation—but practically speaking, because people can't relate to the brain structure issue, they won't empathize as much.
Another ambiguity here is what's meant by 'empathy'. If you take it to mean 'relate to' (which is one meaning of course), then it's vacuous to say people have more empathy for those they can relate too. But there's another usage referring essentially to a cognitive mode wherein the empathetic person acts with understanding toward someone they're engaging with. It's surely easier to enter that mode when it's something you can personally relate to—but that isn't necessary: we can become empathetic in this way just through an abstract understanding of someone's situation.
Is it?
In the second scenario, I empathize with the painful experience, not just with the outcome (depression). Even if both fictional characters are described as having the same state now, how they got there matters to us. We feel empathy for what they went through.
I don't think there's anything wrong to have different emotions towards a person who has just been robbed, compared to someone who hasn't been (but doesn't have more money in the bank account).
We have codified this in our laws. We give different punishments for the same crime depending on the criminal's path and emotional state. We literally judge people based on what they went through. Why is it wrong or unfair to feel differently towards the two fictional characters in this case?
> We feel empathy for what they went through.
(which I mostly agree with) —then yes, the relatively higher portion of empathy should go for the character in the latter scenario (which matches the results of the study).
That said, if we generalize the study and apply it to the setting it's concerned with (medical practitioners empathizing with patients)—it's not a matter of relative measures between multiple patients; it's a question of whether the empathy a patient may (or may not) inspire is sufficient to cross some threshold for a medical practitioner.
If the fact that the cause is of biological origin is sufficient to drop the empathy response beneath that threshold —then it's problematic (the paper points out supporting research for just how problematic it is). After all, the person who has suffered a lifetime of depression does deserve empathy from a doctor/therapist, even if not as much (I guess) for somebody who suffers additional afflictions on top.
Actually that makes me wonder how much dealing with many patients who are very badly off (and deserving much empathy) moves the threshold for the doctor, so that maybe they can't empathize so much for patients with situations which are legitimately bad—but not as bad as what they've seen a lot of...
That's a good suggestion I hadn't thought of. Really not sure aside from that—I've got some vague ideas about certain 'empathy trainings' that could be done, but I'd be concerned about throwing a random factor into how the rest of their work is done...
If you take a look at the original research (linked to from the posted article), then you can skip to the discussion section to see the authors wording of what you are taking about. They are saying the same thing as you, essentially, in a more specific and sophisticated way (page 4 of 5)
Is there something that can be "done about it"? Well someone will probably build an app for it because that's just how people in tech like to solve problems but these kinds of bias just seem to be a naturally built in part of the operating system as I see it.
The part of the “operating system” that they are talking about is a part that isn’t firmware, but rather software (or FPGA, more accurately metaphorically speaking) - meaning thought process, not instinct or gut feeling.
The way it works is this: You need to have a construction of someone (or something) to have empathy for it. The way you generate that construction is by shared experience. The experiences that you have are what you use, the building blocks, to construct that abstract person.
Biological Terry has no building blocks by which the empathizer generates empathy; only super diffuse academic terms. Psychosocial Terry, on the other hand, is an abstraction filled with facts which the empathizer (in almost all cases) shares. The extent to which the empathizer has loss of a close family member, a critical parent, a breakup, and issues at work will be the extent to which they can generate abstract Terry and thus the extent to which they can empathize.
That's the mechanism they are running into in this study, I think.
Either could just be sufficient though and likelihood of sufficiency for empathy is the thing, subject to the whim and winds of society, being studied.
So "of course" I expected those clinicians to emphathize more with patients with biological problems.
Also, sometimes you can have empathy, but can't personally handle someone. You have to do what's best for yourself, also.
Shitty people sometimes become quite pleasant as dementia progresses. Some really nice people become completely nasty. Sometimes there is no change.
The shitty person pushes you overboard.
I raised two special needs sons. They are okay in part because I wondered why they did things. I was curious about the first person perspective. I was interested in finding out "What's their motivation?"
So I think this is a much more complicated thing than you are making it out to be. People have a relationship to themselves. They have a relationship to their environment. They have a relationship to other specific individuals and to a larger society.
Mental health discussions often posit that you are mentally healthy if and only if you get along smoothly with other people. They often don't wonder at those other elements and they don't question the possibility that maybe it is the other people who are all messed up, not you.
I think this is a vastly complicated topic. It is both broad and deep. It touches on psychology, sociology and philosophy.
And I don't know that HN is really a suitable place to try to dig into it in a meaty way, frankly.
Who gets to decide what is a "negative" behavioral issue?
I assure you that the computer types will be among the first to be medicated to to take the edge off their "negative" behavioral issues.
Occam's razor prefers the first, right? You're introducing an additional explanation.
Tautology has no explanatory power.
mental_illness -> shittiness
being_a_naturally_shitty_person -> shittiness
mental_illness = true
shittiness = true
So, from that starting point, we already have an account for the shittiness being exhibited since:
mental_illness -> shittiness
and
mental_ilness = true
In judging a harmful person's character, all that matters is whether that person has definite potential to become a net-good person given spiritual instruction, social support, medication, or whatever. But if such a process is infeasible, then the person needs to be written off. Some people are irredeemably lost, and the only thing you can do is love them and pray for them, at a great distance.
At the same time, I implore you not to give up. For people with mental illnesses like you describe, access to reliable Healthcare is everything. A good doctor who monitors their medications is everything. If I were to describe the situation in engineering terms, I'd say that every single support such a person receives is load bearing. Which is why it can be just so difficult, when only one failing can lead to collapse.
I hope you are able to help her, provide her with something. If nothing else, try to put a roof over her head. Being homeless makes all of those other problems of access worse.
It does suck. I hope you try again. If you need someone to chat with feel free to reach out to me. My email is mayreply at my name dot com.
Even if you have good healthcare most doctors and even most specialists are terrible at dealing with anything that they don't see on a daily basis. Having a spouse with multiple rare chronic ailments has been eye opening.
It's like a double whammy. Not only is your childhood destroyed, you now are somehow considered by society responsible for her just because she is your biological mother.
They should expect to have their efforts to "help" be sabotaged for seemingly no reason, be betrayed as a means to get self esteem, constant testing of boundaries, etc. Then they should make the decision of whether to take the project before ever needing to interact with the person.
I'm quite confident that's part of why therapy did me so much good. He wasn't going to make less money by actually being effective.
Its actually pretty disturbing to me that multiple people felt necessary to share their opinion about that here.
Sometimes when mental illness turns a person into a malicious abuser, we have to protect ourselves regardless of whether we blame them fully for their actions or not. Nature turns the person into a disaster (sometimes, it’s not like EVERY case is like this), and when it does that, we’re justified in doing want it takes protect ourselves, to keep from being abused or harmed - not blaming them doesn’t mean we have to go out and stand in the storm, so to speak.
Here’s wishing you peace and happiness. :)
eg, this study:
https://jamanetwork.com/journals/jama/fullarticle/183929
> In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; P<.001 for interaction). The risk increase among those with substance abuse comorbidity was significantly less pronounced when unaffected siblings were used as controls (28.3% of those with schizophrenia had a violent offense compared with 17.9% of their unaffected siblings; adjusted OR, 1.8; 95% CI, 1.4-2.4; P<.001 for interaction), suggesting significant familial (genetic or early environmental) confounding of the association between schizophrenia and violence.
There also does not appear to be a definition for what they define as a 'substance abuse comorbidity' Looking it up: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669586/
"Schizophrenia Patients Report Consistently Higher Rates of Substance Abuse Than the General Population, Notably With Respect to 4 Licit (Nicotine and Alcohol) and Illicit (Cannabis and Cocaine) Substances"
it also says this is not to be used as a baseline for studies but if Schizophrenia is commonly co-morbid with substance abuse then pointing out that mental illness doesn't increase violence by much seems like a red-herring.
No.
It tells us that people who are mentally ill are about as violent as the general population unless they also have substance abuse.
> it also says this is not to be used as a baseline for studies but if Schizophrenia is commonly co-morbid with substance abuse then pointing out that mental illness doesn't increase violence by much seems like a red-herring
When trying to predict risk of violence knowing that someone has schizophrenia tells you almost nothing. Knowing they have substance misuse tells you a bit more.
And knowing that people with schizophrenia are not more violent than the general population means community treatment is easier to provide.
thats a 2.5 difference in patients with schizophrenia compared to the general population
> When trying to predict risk of violence knowing that someone has schizophrenia tells you almost nothing. Knowing they have substance misuse tells you a bit more.
That is simply not true though. Substance abuse changes the rate at which it happens but Substance abuse seems to have a high comorbidity with Schizophrenia and while the rate is significantly lower when there are no substance issues it is still higher. Substance abuse, per the link you provided, creates a 3rd and fourth population subset (1: schizophrenics 2: neurotypical 3:Schizophrenics with Substance abuse 4: NT with Substance abuse) Which after your response, seems like you're being intentionally misleading in order prove your point.
I share the same feeling with you, although I'm still struggling if I should help her.
Two years working in support trying to perform RCAs on arcane issues and I can't find an answer to why my girlfriend is angry sometimes. It's disheartening to say the least but I haven't given up yet.
Learning DBT skills (The Dialectical Behavior Therapy Handbook) helped me a lot too especially emotional regulation.
Having an amazing therapist who was supportive as well as a professional and personal support network helped too.
I have borderline and I think working on myself has ironically made me a much better communicator. So there's hope.
I don't know if this is the right explanation but I think someone with BPD is essentially a burn victim except with feelings. I am super sensitive and extreme. You're either amazing or the worst person in the world. When things get bad, I don't have any memory of good times. I can only see black or white- no grey.
This comes from my childhood. My parents were extremely abusive. My dad told me to kill myself when I was suicidal. That's how I survived my childhood. I needed a clean slate and forget all the bad things. Today it hurts me more than it helped me then.
In the past when I got upset, it was instantly I think we should break up. The pain whatever it was, was intolerable. And all those break up pains add up. Not only do they hurt me, but it hurt my partners. And I didn't feel like I could survive the feeling of being broken up with, so I was always trying to protect myself by breaking up first. It's still my first instinct whenever I get a whiff of something going bad - shit, do I need to end this? But now I keep it to myself. I wait. I put my crazy emotions together. Talk calmly. Use a lot of I statements. When you did this, it made me feel this. I'm lucky to have a ridiculously supportive partner. I think he's an alien or at least superhuman. We've never raised our voices at each other once since we've been together except to say I can't hear you from the bathroom haha.
I've gotten a lot better. I'm still working on myself. I hope this helps a little and I wish you and your girlfriend the best.
https://www.verywellmind.com/support-empathy-truth-set-for-b...
That said, the state in a truly civilized society could take better care of people who aren't neurotypical. Something I believe is lacking in the US.
Out of sadness and anger, I cut off all of our contacts. A month later, she emailed me saying her psychiatrist said she had suicidal thoughts, and she wanted to see me. I went to see her immediately out of worries. That's the first time for the past 3 years I felt that she was not normal. For example, she was extremely talkative and she jumped between different topics that don't even have any connections. I knew that she had a history of depression for 10 years. But I don't know if it was a mis-diagnosis or her depression had developed into bipolar. She said her marriage decision was made during her maniac episode. She only loved me. But she decided to stay in the wrong marriage, because she couldn't punish her husband for her wrong decision. After making sure she didn't have the suicidal thoughts, I left.
I started to read about bipolar and learnt that during its maniac episode, a patient trends to make high risky decisions that he/she would regret afterwards, including spending lots of money, and having affairs.
And then after a month, she wanted to see me again, for a farewell, because she had to leave the country. She told me she had an affair with another guy and got pregnant. Again, she said she only had loved me, but she made wrong decisions during her maniac episodes. She said I could forget about her because she had turned into a different person, not the same girlfriend I ever had. Even I had read wikipedia and even a website about bipolar infidelity, it was really hard for me to accept everything. Again, out of anger, I told her I despised her and would never trust her. This time she blocked my contacts.
I don't know how I should accept and understand her, forgive her and help her. She mentioned that she wanted to leave me, because she knew I loved her, so she can't become my burden. That deeply saddened me.
For the past a few months, I have trapped myself in a loop of thinking about everything happened and feeling being used and then all the nice time we had together. I struggled a lot, not knowing if I should pick up the phone.
This is just one sentence, you can re-read it many times. Yet, the guy would not really appreciate the depth of its meaning - since he doesnt know what it means to live with a bipolar or close to a bipolar person. Its a circle of hell of its own, he was only slightly touched by the sickness and is still shaken, compared what it can be after longer time. Words just cannot describe how awful mental illnesses are.
With some mental illnesses, you can't really have an effective relationship. The ill person is literally incapable of it, even if they really want to be capable of it. It is not a kindness to try to have such a relationship -- for either party (imagine the hell of guilt the other person must have towards the OP!). I've had good friends who were mentally ill and even that is quite taxing, but you need to know your limits. Again, it does no good at all to offer something to someone when you have no realistic ability to make it work.
I don't think you need to be nasty about it (usually... sometimes it might come down to that). Even if the person has done incredibly bad things, perhaps having sympathy for both parties (yours and theirs) is appropriate. But as the healthy person, you have to be firm and clear about what is possible -- and incredibly often that is nothing.
I really wish there was another way, but you don't dive into the water to save a drowning person, when you don't know how to swim. Instead of 1 person drowning, there will be 2.
True and true.
It sounds like she has a mental illness, like you suspect. The sad thing about many of those is you just can't do anything about some of them. If a person's disease is so advanced that for example (say Alzheimer's) they don't recognize you / hate you, that's unfortunately the reality of their world and outside of committing them you can't do much but simply be there if you need to.
You've got your own life to manage. trying to manage someone else's, when they're sick to boot, is a monumental effort. Ask anybody with a mentally disabled kid. It's gargantuan. There's no shame at all in deciding you aren't up to the task (in your situation at least).
You've probably heard it, but you shouldn't feel guilty. You've done nothing cruel, you sound like you're being as good a friend / ex lover as you can given the circumstances.
When my friend called me asking me my opinions on the least painful ways to die, I thought it was just another cry for help in 3 years of similar ones. I waited to say something and then they found her body later. Obviously dealt with years of guilt etc over that but I bring it up because I think what the psychs told me can be useful advice for you. They said mental illness is a disease, and just like when your friend gets pneumonia you be there for them, but you let the doctors, the professionals treat them. If they're sick and not going to the doctor you tell them "hey, you should go to the doctor." If you find them laying in the tub unresponsive from pneumonia, you call 911. That's the extent of your responsibility. You aren't a doctor, so don't feel guilty about not being able to somehow treat the disease.
Anyway I'm a person on the internet, if you can afford therapy I say do that, similar to above this is stuff for the professionals and they have good advice.
I just want to spell this out explicitly because I think it's a very important point, you do not need to have a mental illness to get help from a therapist. Feelings of guilt or shame are perfectly valid reasons to see a therapist, even if they're not caused by a mental illness.
My girlfriend was an old friend from high school that I reconnected with after many years. We clicked instantly and started dating shortly thereafter. Slowly she let me in on her struggles with depression and bipolar disorder. I was openly supportive but I never paid it any mind since she seemed the same as anyone else whenever we were together.
Fast forward a number of months and things quickly unravel. Out of nowhere she starts shutting me out and acting erratic. Then she breaks up with me. A week or so passes and she reaches out asking for some of her stuff back. I oblige and we meet up. Afterwards, she starts telling me about how she misses me and how she made a rash decision. We start sleeping together again but she's still being distant.
Fast forward another month or so and I finally learn the truth. She broke up with me because her ex reached out to her and she didn't know how to handle it. Then she got back together with me out of impulse, but she didn't know what to do since her ex had already moved back in at that point.
Where our stories differ is that I kept on seeing her after finding out about the boyfriend because I didn't want to abandon her. One day she'd tell me that she was only with him because she needed the financial support that he was able to provide her, then on another she'd talk about him like he was the greatest thing to ever happen to her.
Eventually things came to a head and she blocked me out of the blue. Later on I found out that she was actually pregnant and had an abortion. At the time I was so angry at her for everything but in hindsight I think she did me a great favor. Mental illness is nothing to scoff at and being with a person burdened by it is a struggle regardless of how much love you have for them. I don't think she's a bad person and I'm greatly indebted to her for forcibly removing me from her life.
As someone who struggled with a bipolar diagnosis and now a borderline personality disorder diagnosis, you do not have to accept, understand, forgive, or help her.
In order to accept her you need to accept that she has hurt you and will continue to hurt you unless she decides to make a change. Mental health issues can make a person do bad things but it should never be an excuse. It's possible to get better but it requires work. I think when you separated you realized that you deserved to not be hurt, no matter what, and maybe she felt that way too. In order to forgive and help her, you will have to sacrifice yourself, because you cannot help her until she wants to help herself. I was diagnosed in high school and it took me almost 7 years to get to where I am today.
> For the past a few months, I have trapped myself in a loop of thinking about everything happened and feeling being used and then all the nice time we had together. I struggled a lot, not knowing if I should pick up the phone.
The bad doesn't take away the good times. I'd recommend going no contact to help recover. Do you have anyone you can reach out to? If you have someone you can talk to, catch up with, get a drink/coffee/shoot the shit with, they should be able to help you break you out of your loops and see the bad and good things better. And as someone commented below, therapists are the best. Wish you the best.
This an error in thinking about how the brain works, and unfortunate if true, regardless of what level of "clinician" it refers to.
Perhaps both frameworks for understanding are equally valid, but the "psychosocial" explanation is several layers of abstraction above the "biological" one.
As I've said before on the same topic [1]: 1) the brain is an organ that obeys physical laws 2) behavior and perception depend entirely on the brain 3) of course environment is important, but how is that represented in the brain? It's still physiological, which inevitably includes chemicals/biology/whatever you prefer to call it.
Also, with the psychosocial explanations, there is an element of blaming someone or something else. Most people will feel they are the victim of something unjust and that resonates with many people.
Mental illness typically has both components. Family is known to compound mental health issues that have a biological component.
My sister minored in psychology in college and took some graduate courses in it later. She once told me "We must not have the genes for schizophrenia or someone in the family would surely have it given how the family operates" and then talked about how schizophrenics go do inpatient therapy, get better, go home to the nutso family and get worse again.
I think we need better parenting resources for families dealing with neurodivergent offspring. I've seen time and again that parents don't know effective means for dealing with such kids and it actively creates problems which then become very intractable.
I'm good at that and did some work for a time with a related organization and spent a few years trying to figure out how to blog about such subjects. That never really got traction. Articles like this give me a twinge of regret and guilt that I never figured out how to more effectively share what I know. I'm convinced that better parenting resources for difficult kids would really make a difference in the world.
But, I just don't have a path forward. You need fertile ground for such seeds to take root and I've never found that, basically. Then I got badly burned by someone who used information in my parenting blog to manipulate me and it's a case of... Whatever. Not my problem.
It is said that if C-PTSD was correctly diagnosed, the DSM manual would shrink to a small booklet. At lest 85% of the mentally ill suffered some kind of abuse according to a recent study, and since the parents know they can't do anything that leaves physical marks, many smarter people get more creative - teaching them things wrong, or not at all; ordering them to do something, then punishing them for doing it; (or a semi famous case of a man who was among other things deathly afraid of water, because his father's punishment of choice was spraying him with a hose) etc. All that while maintaining the image of a sweet person outside home, so that nobody trusts the victim, because it's "impossible" that such a nice man/woman would do something like that to their child...
It's doubtful there is a biological component at all, since the Nazis killed off most of the mentally ill in some parts of Europe, but the prevalence rates remained unchanged.
I'm all for freedom, but there should be ways to remove the child from their parents when it's being raised in some nonstandard, and clearly dysfunctional way. There should also be some equivalent of witness protection that would give the people a new identity. Once it gets known the person is "mentally ill" people will harras them, try to convince them of nonsense (or that some common knowledge is actually false) for the kicks, or otherwise "gaslight" them, (well knowing that nobody will trust the person) so there is no way they could get better with such a label at home.
A common theme is that bright toddlers can wind up with screwy ideas because of being bright toddlers. They are just smart enough to leap to ridiculous conclusions based on partial information and incomplete mental models.
For a time, my oldest was deathly afraid of ladybugs. We lived on the third floor and there was a tall tree just outside his window. He ended up with yellow and black ladybugs in his bedroom.
He was terrified. I laughed about it, but shut the door and let him sleep in my room. I couldn't understand why he was so afraid of these harmless insects, but I respected the fact that he was.
Years later, he was able to tell me what he couldn't articulate at the time of the incident: because they were yellow and black and he knew bees were yellow and black, he was convinced they were bees. He couldn't explain how he knew the color while having no idea they looked nothing like bees.
When he was about seven, he similarly reacted with terror to rolly pollies. They are completely harmless.
So I collected a few up and put them in a dish with lettuce. I figured he was mistaking their antennae for mandibles, and he was. He thought they would bit him.
I told him they eat plants and showed him the chewed lettuce. I explained the antennae were how they smelled. They were not for biting. I held them in my hand and showed my son "See, they are smelling me."
He got over his fear of these harmless bugs. His fear was based on incorrect conclusions due to partial info and the ability to make inferences.
After providing the right mental models to some parents, they were able to help their children also let go of phobias based on similar circumstances.
But most parents don't have access to those mental models. Instead, they are given models that make the problem worse.
Humans are not going to stop having a childhood phase. We aren't going to start springing fully formed from incubators or something like that. There will always be a long period of growth in which they are taking in a lot of knowledge.
Furthermore, parents in the US are going thrown to the wolves. There are studies and articles out there showing that American parents are incredibly stressed out in ways and to degrees you don't see in most developed countries.
If we want parents to do a better job with their kids, we need to design a supportive system that helps them raise their children. One of the consequences of our current model is that the societal message to parents is that authority is inherently abusive and cannot be trusted. This tends to poison their relationship to their children. If society were more of a "good steward" for the people, parents would have an easier time being good stewards to their kids.
If you don't put those pieces in place, adding aggressive measures to take kids from parents just deepens the problem.
Positing that parents are merely intentionally abusive for no real reason and there isn't a biological basis and then seeking to add more punishment to the system is broken on the face of it. A lot of abusive parents are trying to control a child and simply don't know how to get good results. A punishment model isn't very effective.
I was a homemaker and full-time mom for years. I am frequently pissed all over by career women who think what I did has no value. I have been told he people on Hacker News that college education is wasted on a mom and homemaker.
But the reality is that raising healthy people is a serious challenge and requires a lot of knowledge and skill, especially if there are any special needs, including a high IQ. Very smart children are endlessly curious and "curiosity killed the cat." Patents of gifted kids are often tearing their hair out.
And we aren't providing them the support they need. Then we wonder why so many people are dysfunctional.
I hate living in the world where I have to ask that question -- and it does seem that there has been an improvement, such that modern research is less likely to be based on faulty analysis. 2014 seems like it could be on the borderline, though.
A comment from someone with more knowledge of statistics and experimental methods would be helpful.
You can find the full article, free at https://www.jstor.org/stable/43278786?mag=when-do-we-have-em.... The article contains a full materials and methods section to aid with replication. The study design was simple enough to allow for relative ease of a repeat study. The authors applied relatively simple and traditional statistical methods (a more complex ANOVA) along with a mechanism to ensure that they were measuring empathy correctly by correlating measure of empathy with a separate measure of personal distress. You can dig into the details in the article, but it all seems to line up well.
In summary, you could probably replicate this yourself using Survey Monkey and Wolfram Alpha.
2) You're right, its been published for four years, seems to have had some sort of impact (since the news has mentioned it), and doesn't seem that complicated or expensive to do in principle. So, is there a direct replication?
2) I can look into your question, later, but you can answer it by searching for citations of the original research.
I think we both know that direct replications remain rare for this type of research and it is highly unlikely that one exists.
I did a brief search, though, and the paper appears to have made some rounds in the NIH.
The fact that it could be replicated from details in the paper without excessive expense or difficulty is also reassuring, even before knowing if such a replication has taken place.
To give you a better mental model: they essentially came up with two sets of 6 words where one set was paired to representing empathy and the other to personal distress. The authors then grouped doctors to receive either biological or psychosocial stimuli and asked them to rate themselves on each word after being presented the stimuli. Statistical analysis was simply comparing the results.
Another noteworthy item is that they also included another set of six words to be rated, which they did not use in the statistical analysis, but which they claimed were used as fillers (words like angry, resentful, joyous, etc. - implying that they took care to not make it readily apparent what specific variable they were measuring).
Study integrity aside, they found that schizophrenia vignettes elicited almost the same magnitude of empathy for either bio or psychosocial explanations and depression showed the widest gap.
There is a deeply insightful book called "Against Empathy : The Case for Rational Compassion" by a Paul Bloom. I hadn't thought too much about it until I read the above quote assuming empathy to be a Good Thing and that researchers and doctors et al should strive for greater levels of it. I think practitioners should at the very least make the distinction between empathy and compassion. We need more compassionate doctors, not empathetic ones. And disambiguating language opens up all sorts of incredible and sophisticated interactions.
Something about it bothered me - I think that it felt like a straw man arguing a position nobody really has just to be very pedantic about his specific usage of the word empathy.
[1] https://www.lesswrong.com/posts/7X2j8HAkWdmMoS8PE/disputing-...
The most interesting definition (partly just IMO, but also because it's the one whose derivative of 'being talked about' is also large right now), which is also an important concept in certain Eastern philosophies for instance, has to do with a cognitive mode perhaps best characterized by 'openness'—but since that term is fraught, let me try something from scratch.
There is something in our brains that works in a very sphincter-like way—similar to the pupil, for example. Rather than letting in more or less light, however, it determines how much you will be affected by present percepts. If it is closed, you can see all sorts of horrendous or magnificent stuff and have little to no reaction; if wide open, you may genuinely weep while hearing a beautiful song or something. (I don't want make strong claims on this next point, but I think it's useful to say something on the matter: what determines the openness here has a number of factors, but how safe you feel at the moment [e.g. anxiety can block it] and how 'internally pre-occupied' you are, are probably two big ones.)
The empathetic 'cognitive mode' I was describing earlier is essentially just being in the 'open' state. It allows you to be affected by someone else's present suffering in a very direct/immediate way, without contemplation—which is why the author's alternative of 'rational compassion' is so controversial: the claim of modern proponents of the sort of empathy I've been describing stresses the importance of this direct connection and immediacy, claiming that being in this cognitive mode is the only way to genuinely act in the interest of another person—whereas when you approach altruism purely rationally, other motivations will typically be involved.
But, the picture I got is that the book doesn't actually talk about that sort of empathy at all.
Modern society categorizes people. When a citizen fails to adapt to society (for better or worse) and they feel a certain pressure to submit to the opinions of an "expert", they become part of a revenue stream. The DSM-V has them figured out.
Many types of mental illnesses are symptoms of the environment. We are spending too much time looking at MRIs, that is, looking inward - the brain structure must hold the clues to the "cure".
But the brain molds to interface the user with its surroundings. It is the effect, not the cause.
Perhaps show empathy for the mentally ill once they've spent years being drugged out by attempted "cures".
I never once saw one more excited than the times they’d describe what it was like to find out a patient was a candidate for a targeted therapy and bring them back from death’s door.
Most of them do this to treat, and I believe they’d be very happy to be out of a job if it meant fewer children, parents, or simply humans, had to die.
As a society we are much too afraid to call shitty doctors shitty doctors. Having parents in medicine, I grew up hearing about them all the time.
I do believe that most doctors would not consciously and maliciously decide to sacrifice people's health for money. I also believe that most doctors aren't particularly diligent about keeping up to date on medical information throughout their careers; for every developer with 30+ years of experience who has treated a job as a job and worked with the same tech staff for all his life without bothering to learn new ones, there's a doctor doing the same with medicine.
The ones I mention, being involved in clinical trials and new treatments/diagnostics makes them particularly appropriate for this discussion because they are at the intersection of translational treatment and patients. (Cures vs patients) You’re right that many doctors aren’t called out like they should be out of some misguided deference, and I’m disappointed to hear how many of them are in cases which matter so, so very much to you, if not to them.
With regard to your personal experience, remember that no professional will care as much about your or your loved one’s condition as you will. You (or your loved one) are the only patient you’re treating, and I encourage you to advocate as necessary.
But my comment is directed at the belief that a medical professional always knows best. The doctor that actually interfaces with the patient is equipped with tools and techniques that originate from other divisions of expertise that develop pharmaceuticals, testing equipment, or coordinate large-scale case-studies.
These numerous cohorts that sift through the data (and are now faced with ever-increasing administrative costs) seem disconnected with recurring patterns in the life of a citizen that end up causing these brain anomalies.
Again, they are chasing down the effect, not the cause.
I suspect you don't know many doctor personally. If you have the intelligence, patience, grit, money, etc. to go through the many years of school and training to be a doctor, you're not doing it primarily for the money. There are other professions that offer similar levels of pay and prestige with much less trouble. Doctors want to help patients.
He would smoke through a pack every night. Needless to say, his base-line health was compromised because of these habits.
One night he tells me the doctor has discovered a tumor on his lung. He continued to smoke at the same rate, against my (and I'm sure his doctors) advice.
At some point he started chemo, and still came to work. Looked like a dead man walking. I'm no medical expert, but it seems to me that chemotherapy irritates the wound.
Fast forward a couple months after I had quit that job, I hear that he has died of lung cancer. But I also here that his wife had resorted to putting donation jars at cash registers at nearby gas stations, in order to keep funding this "treatment".
So this man died of a habit he refused to give up, but not before trusting the doctor(s) involved and draining the resources his family would have after he was gone.
I know this is not a story of mental illness, which seems to be a more elusive affliction that something like cancer that directly affects the bodies hardware.
The theme of my input on this empathy matter is not directed at the disposition of the doctor, but rather the assumption of the patient that the doctor always knows best.
It is more of a trust issue, now that administrative costs make up 30% of healthcare cash flow.
When we ask people about stigma we see those with an illness usually described by a medical model (schizophrenia, bipolar) experience less stigma than people with an illness usually described by a psycho-social model (especially the personality disorders, where levels of stigma are remarkably high, even from mental health professionals).
> The authors note that their findings can’t be extended to all situations. For example, other research has found that trial judges tend to impose less severe sentences on people with mental illnesses when given a biological explanation for the disorder.
- http://econfaculty.gmu.edu/bcaplan/pdfs/szasz.pdf
- http://slatestarcodex.com/2015/10/07/contra-caplan-on-mental...
Science will reduce and dehumanize all that makes that human to a nameless patient file while trying to fix the issues.
Religion might demonize and ostracize.
I feel that before all of this because there was no explanation, the mentally ill were just treated as having a different mindset. I mean.. if we tried to "fix" all the artists that have lived, the world would be a much bleaker and empty place without their art.