PSYC 372 Unit 3

Recently in class, Dr. Pashak claimed that mental disorders are not real. Why would a clinical psychologist have such a radical perspective?

He is being nuanced with the word “real,” and has a scientific (not radical) perspective. Mental disorders are important concepts, but do not physically exist tangibly.

Which of the following quotes appears to reify the idea of happiness?

“My condition has left me unable to possess happiness.”

Imagine that a patient says this to her doctor: “Lately I’ve been crying a lot and I’m always exhausted. My mom said I have depression, which is a mental disease existing in my brain and causing all my problems.” Which option below best identifies the logic problem which has occurred?

reification fallacy

Which of the following is NOT a good example of a tautology?

a. sometimes good luck isn’t good enough
b. the best you can do is to try your best
c. whatever happens, happens
d. a win is a win

How would Dr. Miller likely argue that psychology and values relate?

Applying the science of abnormal psychology to real-life absolutely requires strong pro-social humanitarian values, as one without the other is dangerous.

The woman in the case study at the end of chapter 2 was dealing with severe abdominal pain—what was actually causing it?

sponge left in her surgical site

Imagine that a research study using a sample of adolescents finds a strong positive
correlation between severity of depressive symptoms and frequency of dressing in a
“goth”/“emo” appearance (i.e., wearing lots of black fabrics, dark eye shadow, nails painted black, long hair with diagonal bangs, showing interest in aggressive music). If the headlines below are from online news sources which found this study fascinating and wrote articles covering it, which one DOES NOT confuse correlation with causation?

a. “High school principals: Want to cure your students’ depression? Enforce school
uniforms.”
b. “Stereotype confirmed: Study finds that ‘goth’ kids really are more depressed
than their ‘preppy’ peers.”
c. “Worried about your teenager? Throw out their black band tee shirts and invest in
some colorful polos for summertime.”
d. “Why you should protest Hot Topic for selling products dangerous to high schoolers’ mental health.”

Which of the following is NOT one of the illusions or critical thinking problems discussed in this unit?

a. that mental disorders are specifically a bodily / brain-based problem
b. that mental disorders are unique from one another and specifically identifiable
c. that mental disorders have no cures and are generally untreatable
d. that mental disorders are static, the exact same across time and cultures

A commercial on tv advertises a brand new drug used to treat symptoms specifically of Social Anxiety Disorder, which is offering “more relief than ever before with less side effects!” Which of the problems/illusions from this unit is NOT the most relevant here?

a. the problem of the nominal fallacy
b. the illusion of thinking mental disorders can be objectively defined
c. the problem of mind vs. body
d. the illusion of thinking that mental health care is always improving

Why is it important to be aware of the common problems in abnormal psychology and to avoid believing in the common illusions?

a. Complacency regarding the combination of labeling and social control has led to
disastrous policies throughout history (e.g., forced sterilization).
b. The medicalization of mental health problems has decreased individuals’ ability to see themselves as responsible for their own behavior and hopeful for improvement.
c. When we don’t work against it, our tendency is to oversimplify things and when this
happens to mental health topics, we lose sight of the truth and people are harmed

ALL

Miller’s 5 Illusions in Abnormal Psychology

llusion #1: “mental disorders” can be objectively defined
Illusion #2: measurement is the key to problem solving
Illusion #3: the general quality of mental health care is always improving
Illusion #4: the way to improve mental health care is through more and better scientific research
Illusion #5: moral values have no place in mental health diagnosis, treatment, or research

“Objectivity” Doesn’t save us:

• Despite our desire to believe in the objectivity of mental health diagnostics, this is
simply unrealistic.
• Always envious of the “hard sciences,” psychology/psychiatry used the DSM
system as essentially an attempt to create a true taxonomy or nomenclature
- the periodic table of the elements in chemistry
- the order of taxa (domain, kingdom, phylum, class, order, genus, species) in biology
- the social sciences simply do not have this!

“Measurement” Doesn’t Save Us

• Thorndike famously said in 1918: “Whatever exists at all exists in some amount.
To know it thoroughly involves knowing its quantity as well as its quality.”
- this is frequently a cornerstone of psychometric logic (i.e., we must objectively assess)
- Miller disagrees and argues that much of the human experience is outside measurability

• Mental suffering is chaos
- involved are cognitive, affective, physiological, interpersonal, behavioral, and other issues
- Miller argues that this interwoven complexity undermines most psychometric efforts

New Stuff Doesn’t Save us

• Receiving a diagnosis from a mental health provider sometimes gives patients a short-term sense of relief, validation, that they’re “not alone” in that suffering, but can also prompt helplessness and a belief in oneself as “broken” or “defective”
• As time progresses and new versions of psychoactive/pharmaceutical treatments are released, we are actually not seeing drastic improvements in patient functioning as one may be led to believe based on tv/radio ads.
• The various subfields often attack one another (e.g., clinical vs. counseling psychologists, social workers vs. psychiatrists) and give the public a confusing array of seemingly battling care options—all of which prevents real growth.

Research Doesn’t Save Us

• Most well-designed studies have dreadfully poor external validity
- (i.e., the findings don’t translate meaningfully to real-life outside the lab)
• Clinical trials have such stringent control that they don’t represent what happens
in real treatment settings (i.e, everyday clinics across the country)
• The scientific method is a necessary framework for understanding abnormal
psychology, but it is not unitary, nor the only important lens, nor immune to bias.
- people conducting scientific research are still human, and thus vulnerable to close-
mindedness, bias, and clinging to beliefs.
- “science without a moral perspective—without basic human decency—is fraught with danger” (Miller, 2015, p.52).

Stripping Value Doesn’t Save Us

• As argued by Africana social psychologist Dr. Halford Fairchild:
- “anything that is value-free is value-less”
• Dr. Miller would agree:
- while the “hard” sciences sometimes attempt to describe nature as-is, the social sciences are inherently drawn toward making nature into what they desire it be
- for abnormal psychology, this of course means that we desire a society which is less
disturbed, less dysfunctional, less suicidal, and experiencing less suffering
• Thus, an honest application of abnormal psychological science may involve value:
- if we know that war traumatizes those involved, then how shall we work toward peace?
- if we know that prejudice stresses those involved, then how shall we seek inclusivity?
- if we know that poverty depresses those involved, then how shall we seek equality?

How do we attain an Illusion-Free Abnormal Psychology?

Biological, psychological, social, political, economic, and spiritual factors all affect the human beings who seek treatment in the mental health system. Abnormal psychology would be foolish to ignore the importance of any of these forces in our lives.”

Pashak’s 5 common problems in mental health

Problem#1: Dismissal of Mental Health
Problem#2: Mind vs. Body
Problem#3: Correlation vs. Causation
Problem#4: Ignorance of Culture/History
Problem#5: Logical Fallacies:
#5a: Tautological Fallacy
#5b: Nominal Fallacy
#5c: Reification Fallacy

Problem #1: Blatant Denial/Dismissal

• Simple and blatant disregard for understanding the mental health of others. For example:
- “There’s no excuse for being that way.”
- “Just pull it together.”
- “Stop acting crazy.”
- “You don’t have it worse than anyone else; get over it.”
• For the most part, these thoughts involve a lack of empathy and psychological insight
• Also may employ anecdotal thinking:
- “My life isn’t like that, so their lives shouldn’t be like that.”
- Anecdote = one single event/example/ocurrence, a narrative
- Unscientific because we can’t generalize from 1 data point

Problem #2: Mind vs. Body

• Can the mind really be reduced to solely the body?
• We’ve tried continuously throughout history:
-Lobotomies
- Electroshock therapy
- Psychotropic medications
- Clinical neuroscience
• While these have led to major gains in understanding, picture remains incomplete
-Addresses only one level of analysis
- Aka “biological reductionism”

Biogenetic Essentialism

• Saying “it’s a chemical imbalance” is popular... But is that helpful? Is it fully accurate?
- It does reduce blame for the mentally unhealthy, but...
- It is essentialist thinking, which is unrealistic
> (i.e., endorsing an inner explanatory factor which is invisible, deterministic, rigid, understood by “essence experts”)
- It increases avoidance, hopelessness, fear

Problem#3: Correlation vs. Causation

• Continuing from Problem #2... Does the presence of brain differences between known groups
  indicate that the brain was the sole cause, or might this be correlational?
  - Can mental health truly be seen as a biologically-bound static trait (like genes and eye color) or might there be
  some flexibility in manifestations with other causal factors to consider (like muscles)?
  - People love seeing fMRI data, but let’s not assume it’s infallible or inarguable

  • Setting mind/body issues aside, correlation vs. causation is still a major problem in mental health conceptualization in the general public, and sometimes among professionals. Ever heard these?
    - Laziness/irresponsibility/immaturity causes...
    - Violent video games cause...
    - Spanking causes...

Problem #4: Ignorance of Context

• Lacking insight to cultural differences or historical trends involved in mental health
science can leave one very myopic (near-sighted!)
- Many worship-related or religious activities could seem delusional or obsessive-compulsive to an
outsider of that religious culture (e.g,. chants, singing, counting beads, cognitive restrictions)
- What might look like “paranoia” out of context may make lots of sense in a war-torn country or for oppressed groups facing persecution
• Another manifestation of Problem #4 could include talk of a mental health problem as being “a thing” or not, or as being “a discovery.”
- Binge-Eating Disorder, “new thing” as of 2013
> The behavior/problem isn’t necessarily new, just the label
- No more Asperger’s Disorder as of 2013, “not a thing anymore”
> Did this phenomena really cease to occur? Nope, just its label

Problem #5a: Tautological Fallacy

• This is the fallacy of saying the same thing twice, in slightly different
language, and acting as though something was novel or additive.
• Boils down to nothing more than X=X
“Boys will be boys.” “Stupid is as stupid does.”
::sigh:: “It is what it is.” “Haters gunna hate.”
“You do you.” “Crazy people are crazy.”

Problem #5b: Nominal Fallacy

• This is the fallacy of assuming that because something has been named/labeled, it has been explained and its cause identified.
- May seem similar to tautology, but also mistakenly assumes causation has been addressed

• “GAD is not the cause of her anxiety. That is the term we use to describe her anxiety.”
• Key thing to remember is that disorders are
constructs, they are names/labels, they are ideas.
- they are NOT causes, explanations, or entities...

Problem #5c: The Reification Fallacy

• A form of logic, argument, or belief wherein an abstract concept is identified,
named, and then mistreated as concrete (i.e., existent in the tangible world).
- May seem similar to nominal and tautological fallacy, but also implies existence.

Disease and Disorer…Abstract or Tangible?

Disorder (Concept): Hyperactivity, Anxiety

• Used to describe a abnormality in which the etiology or pathologic processes are unknown

Disease (Concrete): Brain tumors, Chicken Pox

• Used to describe an abnormality where the etiology or pathologic processes are known

How does the reification fallacy happen?

We identify the concept/idea/phenomenon, name it, but then we mistreat the construct and it shifts from an adjective (introverted) to a noun as though it truly existed concretely in nature, and we begin to act like it has causal powers.

• Example: "he has introversion which caused him to stay home”

What is the truth about disorders?

We cant have a disorder any more than we can have love, they’re constructs, aka not real physically.

Mental disorders are…

Are:

• Constructs, labels, to be taken seriously, worthy of empathy, somewhat understood and mostly treatable, complicated, best understood thoruhg multi-systems thinking of the biopsychosocial model

Are not:

• Real/existent, tangible/concrete, causal explanations, exempt from changes in history and culture, to be confused with diseases, understood solely through biology

Allen Frances on Diagnosis

Umpire #1: “There are balls and there are strikes and I call them as they are.”
• i.e., “Disorders are real, and diagnosis just identifies what someone has.”
• Naïve to the impact of culture and arbitrary cut-offs; can lead to over-medicalization or biological reductionism
• May involve Problem #2, Problem #4, and maybe Problem #5
Umpire #2: “There are balls and there are strikes and I call them as I see them.”
• i.e., “Mental health conditions have some legitimacy, but diagnosis is an estimate.”
• Acknowledges both the arbitrary aspects but also the real experiential aspects
• Although uncomfortable, this is the sweet spot
Umpire #3: “There are no balls and no strikes until I call them.”
• i.e., “I’m totally making this up.”
• Dangerously invalidates all mental health issues as myth (i.e., no such thing)
• May involve Problem #1