
When Do We Have Empathy for the Mentally Ill? - UpshotKnothole
https://daily.jstor.org/when-do-we-have-empathy-for-the-mentally-ill/
======
jokoon
I think that deep down, mental illness is not really accepted as something
real. We tend to believe in free will and how people are responsible for their
own actions, and we tend to apply this to the mentally ill too, and this is
exactly why free will is a flawed concept.

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).

~~~
reallymental
That's a deep rabbit hole. What about the will of those on JusticeServed? Were
they free to decide to be on that?

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.

~~~
intralizee
The reality is you don't have a will, just variables & events creating the
person you are in the current moment.

~~~
tudelo
Given that you would say that everything in our life is determined at birth?
We just don't have enough knowledge to fast forward the simulation?

~~~
odnes
The opposite of free will is not necessarily pre-determination. It's probably
the case that events proceed randomly at atomic levels and this randomness
snowballs into more macro events (e.g. neurons discharging).

~~~
intralizee
Still pre-determination if you have a system that is deterministic but
influenced from an outside force and the outside force executing the
alterations is not in the system being influenced.

------
swebs
>For example, one vignette described “Terry,” a 28-year-old woman who felt
deeply sad for the past four weeks and lost interest in activities she usually
enjoys. In the “biological” version presented to the study participants,
Terry’s father also suffered from symptoms of depression, a doctor told her as
a teenager that she might have an imbalance of neurotransmitters, and an MRI
scan revealed that she had an unusually small hippocampus, which could affect
her reaction to stress. In the “psychosocial” version, Terry’s father died
when she was five, her mother has always been highly critical and not very
nurturing, and Terry suffered from a recent breakup and problems at work.

>...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.

~~~
westoncb
My read is that, if you think about it, yes, it's somewhat obvious that would
happen—but the question is, since that's clearly not fair behavior/right, what
do we do about it?

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.

~~~
romwell
>but the question is, since that's clearly not fair behavior/right

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?

~~~
westoncb
I do have to agree with you insofar as the studies' particular results go: in
both scenarios, the patient suffered: in the first scenario because of a
lifetime of depression, in the second because of the same + the trauma of the
early life experiences. So, if we follow your dictum:

> 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...

~~~
romwell
OK, I think I see your point. Maybe we can train the professionals to act out
of reasons other than empathy? Or be more attuned to the current state and not
the history. (Don't know if that is possible, or what specifically needs to be
done).

~~~
9wzYQbTYsAIc
The real issues at hand with this research are 1) prescribing medicine too
often and 2) interacting with patients too little.

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)

------
thowaway655321x
Using a throwaway for potentially obvious reasons. I have a very hard time
having empathy for my mom. She is diagnosed manic depressive, bipolar,
schizophrenic. I've witnessed her deteriorate over my entire life. You can
tell me all day that it biological. I can utterly accept that. I can't accept
that a bright woman has fucked up her life to the point where she is homeless.
That she has alienated all those who would help her. That she would destroy
her own environment and blame the imaginary. We've had to decide to leave her
to herself and not help due to the manipulation that comes with it. Her phone
is blocked. We've moved addresses. I don't know if empathy is the right
answer. It sucks. The whole thing sucks.

~~~
AaronFriel
I have nothing but sympathy for you. You no doubt wrote this knowing some,
perhaps most people would not understand your decisions and chastise you for
them. They don't understand, maybe never will.

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.

~~~
topmonk
I have to ask, why is it his responsibility? If his childhood is so bad that
he has no connection to her why should he work to improve her life rather than
the life of any other homeless or mentally ill people?

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.

~~~
tremon
Responsibility is a loaded word, especially in these cases. I'm not sure it's
what you intended, but your simple question has a much more judgemental and
condemning tone than the entire post you're replying to -- even though you are
defending the OP.

------
evervevdww221
My ex-grilfriend married herself in one day, after I accompanied her to a
hospital for her "severe insomnia" problem, without even telling me.

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.

~~~
tartoran
You're lucky to not have entered more deeply into this relationship. Maybe she
sensed you're a nice person and gave you a break. Better suffer a bit now than
a whole lot later on.

~~~
antocv
> Better suffer a bit now than a whole lot later on.

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.

~~~
mikekchar
Yeah, a friend of mine had a similar situation, but understood his
girlfriend's condition. He stuck with her for a _long_ time (even when she
suddenly got married to a different guy). I don't want to speak for him, but
despite the incredibly calm way he handled the _many_ difficult situations he
was put into, I know it had a pretty big toll on him. Now he's out of the
situation completely and I think he is much happier.

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.

------
lamename
> It’s possible that biological explanations lead clinicians to see the
> conditions as immutable.

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.

[1]:
[https://news.ycombinator.com/item?id=16445950](https://news.ycombinator.com/item?id=16445950)

~~~
9wzYQbTYsAIc
I’m not sure that I understand the first sentence of your comment - are you
saying that you think it is an error for the authors to make that specific
conclusion? Or are you saying that clinicians should never see mental illness
as immutable?

~~~
lamename
It's an error for the clinicians to think that biological = immutable

------
DoreenMichele
We find medical conditions hard to really solve. Most people just can't begin
to cope with a medical explanation of mental issues in terms of seeing it as
treatable. That's a concept not even in its infancy. We've barely conceived
it. It is still gestating.

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.

~~~
PavlikPaja
>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.

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.

~~~
DoreenMichele
I used to participate in the online gifted community and was somewhat
respected as a knowledgeable person with good ideas. As such, people would
email me and talk to me about their parenting challenges. So I got to talk to
a fair number of parents who were at wit's end. In many cases, I was able to
help them untangle their mess.

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.

------
currymj
Given the journal and the time it was published, are we sure this is research
that would replicate? I looked at it and I don't see anything egregiously bad-
looking, but I don't know much of anything about experimental design.

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.

~~~
9wzYQbTYsAIc
This study was submitted to Track II for review by the Editorial aboard at
PNAS (Proceedings of the National Academy of Sciences of the United States of
America) 4 years ago. The study was conducted by psychologists at Yale and
editing by a professional at University of Melbourne, AU.

You can find the full article, free at
[https://www.jstor.org/stable/43278786?mag=when-do-we-have-
em...](https://www.jstor.org/stable/43278786?mag=when-do-we-have-empathy-for-
the-mentally-ill&seq=2#metadata_info_tab_contents). 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.

~~~
currymj
So am I right in concluding that the design was simple enough to be mostly
forking-paths-free, and there weren't any oddly specific choices made in the
analysis (to dig a "significant" result out of the data)?

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.

~~~
9wzYQbTYsAIc
Absolutely, this was a straightforward research design with a straightforward
statistical analysis. The statistical significance was strong.

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.

~~~
9wzYQbTYsAIc
In all honesty, I’d recommend that you spend an evening perusing the actual
research article as it is a good example of academic social science research,
in my opinion.

------
lsh
> "That’s one reason why efforts to encourage empathy for people with
> depression, anxiety, or other mental disorders often focus on the biological
> basis of the conditions."

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.

~~~
fossuser
I found the premise of that book to largely just be disputing definitions [1]
with a very particular definition of empathy that isn’t actually how people
use the word.

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-...](https://www.lesswrong.com/posts/7X2j8HAkWdmMoS8PE/disputing-
definitions)

~~~
dkarl
I don't see it as disputing definitions at all. Paul Bloom is clear what he
means by "empathy" and doesn't carelessly apply his argument when the word
"empathy" means something else. In fact at the same time he argues that
empathy by his meaning isn't good practice for doctors he says the "empathy
training" for doctors that he is aware of is a good thing, precisely because
the word is used in a different way. He defines certain terms in certain ways
for the sake of making his argument while acknowledging that the same words
are commonly used in ways that his argument doesn't apply to.

------
moneytide1
I saw someone post to HN once in an article about a cancer vaccine - "Doctors
want patients, not cures". Really stuck with me.

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".

~~~
stochastic_monk
I’ve had the pleasure of working with a number of doctors who are well-
respected in their field.

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.

~~~
opportune
Even "very good" doctors often don't know the state of the art procedures and
treatments for their craft, as I have personally discovered since a close
family member began receiving cancer treatment. From my experience, the vast
majority of doctors' response to bringing up experimental treatments or care -
or even recently approved, well-researched treatments - is a mindless
affirmation of "that's the future", meaning they don't know anything about it.
If you press them, most will say that they prefer to start patients with XYZ,
which means "I want your business but don't know about that treatment". This
happened to my own sick relative, a pharmacogenomics researcher, who said it
reminded him almost exactly of trying to get clinicians to incorporate _basic_
gene panels into their practice (e.g. don't give this patient warfarin because
they have this gene which will make them bleed to death).

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.

~~~
stochastic_monk
It’s true that there are such doctors. My experience is not necessarily
typical, as these were faculty at a well-regarded cancer hospital and always
very close to new developments.

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.

------
DanBC
This is mildly interesting because people who are mentally ill and who get
treatment will report a contrasting experience.

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).

~~~
Sean1708
The article did touch on that briefly:

> 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.

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peter303
I refrain from making crazy people jokes when I realized that as many as a
quarter of certain subpopolutions, e.g. middle age US women, may be on
psychoactive drugs for one condition or another. Pretty good chance of hurting
soneones feelings then without knowing it.

------
Invictus0
The literal definition of empathy is rooted in the ability to understand and
relate to someone else. Doctors can't empathize with most patients, nor do
they need to. I think sympathy is the word this article is looking for.

~~~
Fricken
I went through a couple phases of clinical depression as a young man, and now
that more than a decade has passed, I can't relate to that person who didn't
have the willpower to get out of bed for 6 months. Even though that person was
me, it's hard to imagine now what that is like. But I can certainly
sympathize.

------
qwerty456127
Almost always. And almost everybody is more or less mentally ill in a way or
another, me included.

~~~
1000units
You're probably just fine aside from a slight self-deprecating tendency or so.

------
mlthoughts2018
Two somewhat related ideas,

\-
[http://econfaculty.gmu.edu/bcaplan/pdfs/szasz.pdf](http://econfaculty.gmu.edu/bcaplan/pdfs/szasz.pdf)

\- [http://slatestarcodex.com/2015/10/07/contra-caplan-on-
mental...](http://slatestarcodex.com/2015/10/07/contra-caplan-on-mental-
illness/)

------
mgarfias
Not when she’s my ex and is psychologically abusing our son. No sympathy for
the devil

------
fuscy
I think people had more empathy for the mentally ill before the advent of
science or religion.

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.

~~~
pragmatick
Sure... [https://about-history.com/the-cruel-way-people-with-
mental-h...](https://about-history.com/the-cruel-way-people-with-mental-
handicaps-were-treated-in-the-middle-ages-will-make-your-stomach-turn/)

