Comment by quanticle | Hacker News Reader

Comment by quanticle | Hacker News Reader

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    It threw into perspective for me how psychosis must have been viewed in
    those times, before medicalization: a potentially valuable journey of growth
    and transformation, rather than just like, “well that sucks”.

It was viewed like that for a small proportion of people, who ended being crazy enough to be interesting, but not so crazy as to be dangerous. A much larger fraction were exiled and left to fend for themselves, resulting in their eventual death. It's important to not over-romanticize "ancient" or "traditional" societies. They were groups of people, trying to survive in a world just as harsh as ours (or even harsher, in many cases) with far fewer resources. They had to make difficult choices about who to give food, clothing and medicine to, because they did not live in some kind of utopia, they lived in nature, with all its harshness and brutality.

Yes, if the shaman candidate went out on their vision quest, and returned cured, they were accoladed and held in high esteem. But for all the ones that ventured forth, how many never returned?

What tribes did with people who couldn’t pull their weight is an empirical question that varies per tribe per time. But, I think you’re essentially correct, and far from being a gotcha, your observation that going out on the vision quest didn’t necessarily mean you were coming home, I think is exactly where a lot of power of the role came from. You go out to fight dragons, and most people die fighting dragons.

There's some historical burden of this analysis to that you could be ready to back up. Most people who experience psychosis don't experience it as a perpetual state, and they aren't particularly more dangerous while experiencing or any more dangerous while not.

It's certainly feasible that in many cases it would be chronic and severe enough to interfere with necessary responsibilities but that doesn't take us straight to "everyone who showed psychosis was exiled or executed." We know that some cultures did have explicit roles and accommodations for people who were way out there.

One of the graphics the author showed mentioned this but it didn't otherwise come up: look at the tradition of the holy fools in some slavic cultures. This got rolled into christianity but it appears to predate it in those cultures and straightforwardly includes people without obvious productive benefit for their society.

    Most people who experience psychosis don't experience it as a perpetual
    state,

Agreed.

    and they aren't particularly more dangerous while experiencing or any more
    dangerous while not.

Hard disagree. I have been in a mental ward. I have been in close proximity to people who have been undergoing psychotic breaks. Never have I felt in more danger for my safety, even though, ostensibly, nurses and other trained medical professionals were right there to deal with the issue. Being in close proximity to someone undergoing psychosis is a terrifying thing, and it's no surprise that traditional societies, in the absence of other mechanisms, would choose to exile people undergoing psychosis. And if the people never returned from their exile, well, that's a hard thing, but the great spirit must have had a different purpose for them.

Yes these aren't privileged experiences I have had them too. It is extremely frightening and is riskier than a lot of other activities. That's not itself evidence of how any particular culture treated people experiencing it or what they thought or expected of the experience.

This particular subject is one that has interested a lot of people, including historians and anthropologists, and there is a lot of history and anthropology on it. I'm neither, but from what I've read people who have professionally studied it mostly refrain from making generalizations of how it has been experienced through time and across cultures.

If you're going to say or imply that surviving these experiences, or being tolerated for experiencing them, was only "a small proportion" then you're making broad assertions. I'm curious what that is based on other than extrapolation from your own frightening experiences.

    If you're going to say or imply that surviving these experiences, or being
    tolerated for experiencing them, was only "a small proportion" then you're
    making broad assertions.

It's a broad assertion I feel safe making from what I've read, and from what I know of human nature, and the often toxic dynamics of small communities. Being different in a small tribe sucks. Yeah, if you're different in just the right way, you're venerated as a shaman or religious figure. But I feel absolutely safe in asserting that for the average mentally ill person, being mentally ill in a pre-modern society would have been worse, both in quantity and quality of life.

Maybe you wouldn't have been exiled, as such. But you would have been a marginalized outsider in an environment that was far more resource constrained than the environment in which we live today, and which rewarded conformity to a far greater degree.

You assume death is better than life for the "mad".

This is non-obvious, as one of them.

I assume no such thing. Quite the opposite, actually. I'm pointing out that the author makes this assumption, implicitly, by suggesting that vision quests and other traditional shamanic interpretations of psychosis are a better, more holistic way of dealing with "mad" people than modern medicine.

Yes, going out into the desert without supplies to perform a vision quest is certainly more romantic than a stint in a mental hospital. But it's certainly not safer.

It's not about safe.

It's about:

utility_positive_outcome * probability_postitive_outcome + utility_negative_outcome * probability_negative_outcome

You've made these two smaller in absolute magnitude, but also biased things toward negative (look up the side effects of neuroleptics).

You've also conveniently deprived those affected of their agency to have an opinion about this.

Speaking as someone whose survival to $CURRENT_AGE was once so poor a bet that a couple of life insurance underwriters you've heard of refused to take it at any price, I feel okay about saying that, if life were otherwise reliably safe, your argument here would weigh more than it does.

How many of your relatives have died from bacterial infections? From getting kicked in the head by a horse? From being stabbed in a dispute? From drowning? From war? How often have you faced starvation?

If you're arguing that the modern world is anywhere close to the same level of danger as the ancient world, then you're sadly mistaken.

All of those things continue to be very relevant dangers in the modern world, too (well, except for the part about horses, but cars have certainly surpassed them as a substitute).

You can still die from those, but the odds of dying from bacterial infection have gone down dramatically.

Depends on what part of the world you're in.

It's interesting that you seem to assume I could honestly answer "none" or "never" to all of those questions, but also beside the point, because the argument you're answering is not the one I made.

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