
Scientific wasteland: recent problems with psychiatry - hoffmannesque
https://www.the-tls.co.uk/articles/private/scientific-wasteland-problems-psychiatry-harrington/
======
SolaceQuantum
_" Advances in genetics, neuroscience and psychopharmacology all at once
reminded psychiatrists that biology ruled, that talk could be dispensed with,
and a truly medical psychiatry could finally emerge"_

I don't know if this is true for a good chunk of mental illnesses, tbh. How
does one use a purely biological model and treatment for PTSD, BPD, ASPD, etc?

~~~
yomly
We struggle to model individual proteins in full, and we think we can apply a
comprehensive biological model to the mind?

I can say with confidence that the abstraction of chemistry in physiology is
not watertight (is that a pun...?) and we still barely understand
physiological chemistry in any kind of way that any self-respecting scientist
could describe as rigorous.

The hubris of some people in their fields...

~~~
dmix
People build abstractions all the time on top of things they don’t think
biochemistry is going to teach us much about IRL psychological issues.

Humans have excellent pattern matching, reasoning, and lots of research into
the subject. I do believe there is value in doing it.

That said, I’m highly skeptical of a lot of talk therapy, beyond the simple
gains of saying things out loud to a 3rd party and challenging your mind and
assumptions.

------
bitwize
Freud dealt with the realm of ideas. As much as he got wrong, his approach of
dealing with the ideas in one's mind on their own terms, and finding and
sussing out the bad ideas to be replaced with good ideas _did_ , eventually,
yield beneficial results -- like the big wins of cognitive behavioral therapy.

~~~
gerbilly
I don't agree that it was mostly about ideas, Freud's main insight was to
deduce the existence of the subconscious mind: i.e. the idea that we don't
have direct access to our entire inner world.

It was a big departure from the way the mind was conceived till then.

~~~
droithomme
Is current consensus that this "subconscious mind" is an actual thing that
exists?

~~~
nabdab
No. Nothing of Freuds is actually testable. He asserts that there is a
“conscious mind” and “subconscious mind” but only in concept.

You might as well try to build an alternative theory of mechanics based on an
assertion that all objects have a conscious and subconscious mass, and that
gravity actually act on the subconcious mass and only moves the whole because
the two are interconnected.

~~~
didericis
This seems to be the crux of all of the scientific issues with psychiatry and
studies of personal and social behavior more broadly. Strict definitions of
what is being measured and ways to go about measuring those things without
administrator or self reporting bias don’t seem to exist, or at least they
don’t seem to be employed that often.

There are clever ways to get around those issues and tie theories about
behavior to observed action in the real world, and there are a number of
psychological theories that come up with a plausible sounding evolutionary
history to certain thoughts and behavior that _seem_ correct, but a lack of
good measurement instruments seems to be a very big problem preventing more
concrete answers to a lot of different questions about the mind. When talking
about things other than motor or perceptual related studies of the mind
(bionics related stuff), the most common measurement tool seems to be self
reported surveys, and although I think there are tricks you can do when
wording questions and statistically analyzing results to try to account for
patients trying to answer in ways they feel like they should that aren’t
necessarily accurate/make sure people don’t misinterpret questions, that whole
way of investigating claims seems to be very very shaky.

It’s a common complaint about the field, and I’m sure a lot of psychologists
and psychiatrists are sick of hearing it, but I haven’t felt like I’ve ever
gotten an adequate response about why it’s not a valid complaint.

------
AlexCoventry
Pay-walled, for me.

------
Mathnerd314
I didn't get much past the paywall, but it looks like a book review of this
book: [https://www.amazon.com/Mind-Fixers-Psychiatrys-Troubled-
Biol...](https://www.amazon.com/Mind-Fixers-Psychiatrys-Troubled-
Biology/dp/0393071227)

There are other reviews like
[https://www.theatlantic.com/magazine/archive/2019/04/mind-
fi...](https://www.theatlantic.com/magazine/archive/2019/04/mind-fixers-anne-
harrington/583228/) (discussed previously at
[https://news.ycombinator.com/item?id=19435815](https://news.ycombinator.com/item?id=19435815))

------
pmichaud
I didn't pay the $27.95 to read this, but the abstract is alarmingly wrong.

The analogous thinking is that software bugs, in particular data storage
errors[1], are best understood as hardware malfunctions, and that precise
interventions at the hardware level can solve them. It's not exactly wrong--
for any given software issue, you might be able to devise hardware changes
that correct it. But. I feel like I don't need to continue to make my point.

[1] In reality the lines blur between software and data, so the analogy might
be better more solid between trained ML models and hardware, where trained ML
models are both software and data in a way that can't be meaningfully
distinguished. So we're talking about correcting a trained ML model via a
precise hardware edit.

It's not wrong per se, not even insane in some cases. But the dismissive tone
in the abstract of taking the trained model of the human mind on its own
terms, versus as a purely biological object boggles my mind with how wrong-
headed it is.

~~~
SubiculumCode
I've never been convinced that the software-hardware analogy is especially
enlightening when it comes to the brain and the mind, in my informed opinion.

~~~
naringas
at one point I decided to disagree with the idea that the mind is just the
brain.

~~~
didericis
What else so you think there is? It seems patently obvious at this point that
our brains house our minds, given how manipulating someone’s brain causes them
to act much differently and report perceptual and behavioral changes.

Your post sounds suspiciously new age to me. I’m aware that our bodies feed
into our minds, and that things like hormonal levels, nutrition, gut flora and
fauna, etc all have a fairly profound impact on things like mood, but that’s
different that saying the mind is not the brain. Social isolation and long
periods of darkness also have profound impact on the mind. That doesn’t mean
that the night sky or society somehow “is” our mind, or that our minds are
somehow housed outside as well as in our brains.

There’s a tendency to belittle things that we understand mechanically, which
is why I believe people tend to believe the mind is somehow “beyond” the
brain. But we can still have deep respect for the sovereign, spiritual like
divinity associated with consciousness while recognizing that it’s all
happening within the confined, physical space that constitutes a person’s
brain, and that there’s a physical basis for it.

~~~
naringas
> I’m aware that our bodies feed into our minds, and that things like hormonal
> levels, nutrition, gut flora and fauna, etc all have a fairly profound
> impact on things like mood

it's pretty much that. the mind is the entire body. although it's mostly the
brain it is NOT entirely the brain.

> That doesn’t mean that the night sky or society somehow “is” our mind,

but our mind is formed by what we learn from society (culture) with our brains
(the software gets installed hahah)

> while recognizing that it’s all happening within the confined, physical
> space that constitutes a person’s brain

maybe all the language and the words form within the physical bound of the
brain, sure, but the mind more than just what we do with our brains.

In the end, thinking this way has led me to take better care of myself, not
just my "brain" (i.e. eating better and exercising the rest of the body a
little more)

~~~
didericis
While I think I agree with the spirit of what you’re saying, I take issue with
some of the semantics. What you are describing as “Mind” seems closer to
“Self” than what I would call “Mind”. I consider the mind to be the abstract
entity we use to experience the world. In my view, the mind is very much
coupled to the brain.

Tying all of our experiential world to a single organ in the body doesn’t
really do justice to the magnitude/scope of that experience, sure. But I think
it’s wrong to call that experience “Mind”.

Obviously I don’t want to interfere with your self care, and think it’s very
important to have a holistic view of self and your relationship to those
around you when trying to be healthy, I just don’t think “Mind” is the right
word to use for what you’re talking about.

------
droithomme
OP, please conform with HN rules by providing a workaround to the paywall. If
there is no workaround, the pay-walled article is not permitted here, per the
rules. Thank you.

edit: I see this was downvoted. Interesting.

October 3 2019 HN rules:
[https://webcache.googleusercontent.com/search?q=cache:40QUas...](https://webcache.googleusercontent.com/search?q=cache:40QUastnyuMJ:https://news.ycombinator.com/newsfaq.html)

 _> Are paywalls ok?_

 _> It's ok to post stories from sites with paywalls that have workarounds._

 _> In comments, it's ok to ask how to read an article and to help other users
do so. But please don't post complaints about paywalls. Those are off topic._

October 10 2019 HN rules:

Paywall rule has been removed. Paywalled articles with no workarounds are now
OK. Pay up or get out.

Thank you for the correction and the tip about the new rules changes
implemented this week.

~~~
Mathnerd314
This works for me in Firefox's console:

    
    
      $('.body-copy')[0].innerHTML = JSON.parse($$('script[type="application/ld+json"]')[0].firstChild.data).description
    

And I still see the paywall rule in the FAQ.

~~~
AlexCoventry
How did you come up with that snippet?

~~~
Mathnerd314
I did a search in the page source and there was the script tag with the
article content, then I just built it out. A lot of small sites seem to be
trying to obfuscate their content so they get SEO rather than really
paywalling it.

