Rectifying names in psychiatry

I know Scott Alexander is the psychiatrist with the diploma, but really, who takes diplomas seriously these days.

Psychiatry is not as bad as L. Ron Hubbard would lead you to believe, although it is pretty bad. The study of human behavior at its fringes is interesting and much of psychiatric findings makes sense. But of course, psychiatry is downwards from power, and thus pozzed and blinded in many very obvious and very stupid ways.

Psychiatry deals with the intersection between biology and religion at the fringes. This means it is downwards from the state religion; it follows instructions from the state religion in its dealings with the poor, the lost, the loons. In the absence of an official state religion, psychiatry has become a tool of the unofficial state religion to give meaning to it’s patients, with predictable consequences.

The most important consequence being that psychiatry takes itself too serious, that it imagines it should find a panacea for the bane of human existence, much like how the majority of healthcare imagines it should find a panacea for human sickness, while the truth is that both doctors and psychiatrists are, in the overwhelming majority of cases, pretty limited in their options. We see over and over again that psychiatrists invent disorders and theories that are too clever by half, which in the end turn out to be convoluted reinventions of wheels that have been known long ago.

The majority of psychiatry violates Hippocrates’ rule: it does more harm than good.

What should good psychiatry look like?

The overwhelming majority of psychiatric patients are not responding abnormally to a normal system. They are responding normally to an abnormal system. The cases where a disorder is caused by abnormal brain structure, such as fetal alcoholic syndrome, or, later in life, a very hard hit to the head, are outshone 95 to 100 cases where the disorder is caused by normal brain structure responding to abnormal stimuli.

In these 95 cases, psychiatry has little reason to meddle and stick their fingers in open wounds. Thus the role of a good psychiatrist is much much smaller than it is at present.

As for the remaining 5 cases; used to be so that the village idiot was taken care of by the family and community. Lunatic asylums are a byproduct of delegation (or confiscation) of this responsibility by the state. Much like I’d rather see prisons closed and criminals given public whippings or sentenced to death, I’d also like to see lunatic asylums closed. But since we have big cities, not just small villages, I feel that a compromise need be reached. I support Jim’s proposal of 2 healthcare systems: one private, which law-abiding citizens pay for and receive good healthcare in. The other is state-owned and free, reserved for the poor, the outcasts, the loons. To be patient in the latter system is low-status, works on a revolving door basis. Closed psychiatric institutions should be part of the latter system.

Anyway, let’s get down to brass tax and rectify some names.

I’ll show and tell. My show and tell will be crude, which is not to make things simpler than they are. Sometimes they are simple, sometimes they are complex, but in either case a crude answer suffices. I will not engage in the typical modernist approach of disclaiming lack of expertise beforehand; I find this weak and demonstrating lack of confidence. As far as you may be concerned, I am an ultimate expert on all these matters.

Borderline personality disorder
Is pretty much exclusively a female thing, and if not just normal female behavior, a consequence of bad ownership by the father. A borderline women has never felt securely owned, but feeling the instinctive need to be owned, seeks out abusive relationships that mirror the abusive relationship she had with her father. She sabotages all relations she has, in part because that’s what women do, in part because her father did so to her. The cure for this is good ownership — a man who does not take her shit, who teaches her that being well behaved will give her fulfillment and love. Shakespeare’s ‘the taming of the shrew’, so to say. Which is the opposite of what psychiatry does, namely to teach the woman that she is strong and independent, which she knows in her bones she is not.

Self-mutilation falls into the same category. The cuts are a cry for help: ‘stop me from hurting myself, take proper ownership!’ Self-mutilation is a sign that she is not being owned properly.

Anorexia, bulimia; the same.

Sociopaths and psychopaths
Are among the most mythified creatures of psychiatry. ‘Is YOUR neighbor a sociopath?’ Who knows!

Supposedly there is some academic difference between a sociopath and psychopath, but they are pretty much the same. I’ll stick to the word sociopath.

Sociopath is really just a new word for liar. That’s all there is to it. A sociopath is someone who lies, often and without remorse. An entire mythology is built around sociopaths; it is nonsense. Supposedly, sociopaths lack empathy, but most people lack empathy. Supposedly, sociopaths treat other people like pawns, but most people treat other people like pawns. Supposedly, sociopaths do not care about anything, but I know for a fact sociopaths care about things, just like anyone else. No one does not care about anything, it goes against our survival instinct.

In my personal life I have been friends with several men who’d been stamped obvious sociopaths by psychiatrists, and it was always obvious to me that they’re really just like anyone else, the only difference being that they lie with remarkable ease and conviction.

The mythology around sociopaths is mostly build up by females who fantasize about not-giving-a-fuck badboys, and males who pretend to be not-giving-a-fuck-badboys.

Sociopathy is solved in exactly the way the problem with liars is solved: out-group them as liars.

Is a logical response towards a dysfunctional role within a dysfunctional system. Most of the people who pretend to care about you don’t care about you, the people in power don’t care about you. To be depressed about this is not a disorder, it is entirely logical. Depression is your body telling you that something about the way you are living is not right.

Depression is solved by treating it as a functional response towards a dysfunctional system, as opposed to treating it as a dysfunctional response towards a functional system as psychiatry does. The solution for the depressed person is to find a more natural role in society, which of course is easier said than done, although not impossibly so. For men, owning territory, having a nice job, owning a nice woman, being the patriarch of a family, are the easiest fixes psychiatrists will not tell you about. For women, being owned by a man, having children, not working a job you hate, are the easiest fixes psychiatrists will not tell you about.

In the same vein of depression: a functional response to a dysfunctional situation. Women are more prone to anxiety disorders, because women are more dependent upon their surroundings. Since modern surroundings, especially big cities, are hostile, anxiety is a normal, not an abnormal response. When my girl lived by herself in the big city, studying at a university that hated her, she become socially anxious, developed obsessive compulsive ticks and had to force herself to leave the house. Pretty sure that if left to her own devices, a psychiatrist would’ve wrote long reports about her anxieties, prescribed her medicine and endless therapy, and after a few years she’d have internalized that she was an abnormal person.

Luckily she was not left to her own devices — She met me, quit her studies, moved in with me. All her anxieties disappeared. No more social anxiety, no more ticks, no more trouble leaving the house. Like snow before the sun.

Attention-Deficit (Compulsive) Disorder
A particularly nasty one. ADHD, or ADD, is defined as the inability to sit still for 8 hours and listen to boring men talking, or the inability to, for hours on end, read books that are not interesting. To in response become restless and agitated is normal, not abnormal.

ADD medication is the frontline of subduing men, of telling them something is wrong with them as opposed to something being wrong with the education system. Simple truth is not everyone is cut out for sitting still for 8 hours on end, or for reading for hours on end. Different people, different talents.

ADD is like forcing a fish to climb a tree for years on end, and when it inexplicably fails to do so, diagnose it with Tree Climbing Disorder and force-feed it tree climbing pills.

Anti-Social Personality Disorder, Narcissistic personality disorder
Is merely the reinventing the existence of assholes. Assholes have been in this world for a long time, the name asshole has been perfectly adequate. Like with sociopaths, a lot of nonsensical mythology has been built around these disorders. Supposedly, narcissists view themselves as the main protagonist in their own movie. Spoiler: everyone views themselves as the main protagonist in their own movie.

The only distinctive feature of ASPD and NPD is being an asshole. There are many assholes in this world, and the solution for assholes is the same it has always been: let them be, and if they violate law, a few public whippings. That is all.

Post Traumatic Stress Disorder
PTSD is a funny one, because it is mostly fiction. Men don’t mind killing; we are descended from killer apes, it is in our DNA to kill. In the minor sense that PTSD is real, it is a response not to actual war, but the feeling that it was futile for you to participate in the frontline of said war, that you were being used as a useful idiot by others, and were not allowed by your superiors to win said war. Once again, an entirely logical response.

Of course, most PTSD cases are merely attention seeking cases. Observe studies in the Washington Post suggesting that 25% of college students could develop PTSD because of Trump, as compared to the 2-3% of WWI veterans suffering from shell shock or combat fatigue. Nothing better illustrates the fact that the common conception of PTSD is a convenient fiction.

Schizophrenia is one of the few ‘honest’ disorders. Schizophrenia is, for whatever reason, the inability to cope with reality and a cognitive breakdown in response to it. Since reality can be pretty daunting, often an entirely logical response. In its prolonged state, schizophrenia is what we used to call crazies and loons, and rightly so. The homeless person garbling nonsense is what we label the schizophrenic. Used to be the village idiot, who was taken care of by family and community, now we delegate the responsibility to the state, with all predictable consequences.

19 thoughts on “Rectifying names in psychiatry

  1. This is fabulous. Thank you. As I happen to be dating a psychologist, it was particularly interesting. My view would be that shrinks caN be useful. For instance, lots of problems develop in life if one feels that one was abandoned by one’s mother. Or abused by one’s father. Neural pathways are set up. Once one becomes conscious of them, they can be changed. That is a legit usage of psychology. But your classifications are entirely sound.

    1. Yeah, but currently the impetus is to link mental anguish with physical trauma so as to allow for thought policing and censorship. So PTSD is no longer a useful concept. Has to be abandoned.

  2. I have to argue with this because of personal experience. First, ADHD. Go and look at the questionnaire for diagnosing adult ADHD:

    You will find it is far more specific. For example:

    – Often changing the subject of the conversation
    – Mislays wallet, keys, or agenda and Loses a lot of time searching for things
    – Fidgets with the legs or Tapping with a pen or playing with something

    Furthermore, an evidence for it being real is that people with ADHD react differently to stimulants: they are actually calmed by something like amphetamines.

    I call it “absent minded professor syndrome”.

    Furthermore it has advantages as well. I am very good at seeing the big picture of things, making connections, associations between different things, because I am less lost in boring details than others.

    Another thing I am good at is dealing with stress. When others get panicky in a situation, that is, for me, just when the situation actually got interesting enough to pay attention to it! I like crises. Crisis situations calm me. They really do. I suppose this is also why adrenaline junkies exist. One prominent medication for treating ADHD, Strattera is all about blocking noradrenaline uptake. The adrenaline rush of a crisis situation makes an ADHD person actually calm, focused and very efficient. If I could start over, I would be a fireman. But I tend to gravitate towards jobs anyway where I put out unexpected “fires” in software.

    Furthermore I once went to an ADHD support group. Not anymore, support groups are not my thing, too whiny. At any rate the people there were very diverse: some so autistic they could hardly communicate, some vibrant, talkative extroverts, some rail-thin due to plain simply forgetting to eat, some very fat, clearly abusing comfort foods. And yet there was a clear common thread. The subject of the conversation was all over the place as people associated rather wildly, someone would say something which would remind something of an entirely different topic which would remind someone of yet another topic. The other two things I mentioned above were also quite widespread.

    Finally, some research suggests a genetic cause:

    ” with this genetic mutation, “You probably do better in a context of aggressive competition.”

    1. Not seeing us disagree.

      My contention with ADHD is not that it not exists, but that it is used as a stick to beat young men into submission.

    2. The idea that we should give kids brain altering drugs because of how they answered a QUESTIONAIRE doesnt seem a little bit extreme to you?

      1. Of course it does, except that I never talked about that aspect.

        1. The DIVA is a test for diagnosing adults.

        2. The very fact that, at least here, amphetamine type stuff is not allowed for adult patients but for kids yes, makes it obviously extremely dodgy to give to kids.

        3. A special case of ADHD treatment – drugging the fuck out of kids without even proper diagnostics – should not invalidate the whole thing.

        I think I have some ideas about how to educate ADHD kids without drugs. If anyone is interested, I will write an essay on my own blog, not here. Summary: every bookish learning should take place only after exhaustive physical exercise, make it risky: big rewards, big punishments, hence exciting, and be strict but allow them new chances to make up for past laziness, that is, if they got fail grades all through the semester, but are willing to put in a hyperfocus burst during the last week and learn everything that was taught during the semester and retake all the failed tests, allow them to.

  3. Then, depression. Depression is a murky topic because it is just fashionable. Too many people claim they are depressed without any diagnosis. I think many lazy docs just accept such a self-diagnosis and hand out them pills. It is just the fashionable thing du jour.

    My situation was different, as I was talking with a shrink about an unrelated subject and he just said wait you look very joyless. Well of course. My life is basically like playing orchestra on a sinking Titanic. You, too, feel like that, right? In this sense you are right that it is adaptation to a dysfunctional society. So I have a joyless, just doing my duty without much passion or fun view of life. “shut up and soldier” expresses it well, the German version, Maul halten und weiter dienen even better.

    Looking at it through the lenses of the classics, the central example of a depressed character was Shakespeare’s Hamlet. Basically, an unresolvable internal dilemma type of situation.

    Biologically, depression seems to have a lot to do with status. Monkeys who lose dominance contests get depressed. Apparently, it helps them to display those kinds of passive, submissive behaviors that help them not get killed by the winners. Another theory explains the link between inflammation and depression that basically it is a behavior evolved for times of being sick, basically staying in the ancestral equivalent of a sickbed and not jumping around, helps with healing.

    My hunch is what people call depression these days is probably multiple different things with different causes sort of mixed together.

    My other hunch is what is called depression these days is overly influenced by American cultural norms, namely that everybody is supposed to pursue happiness in life and be very optimistic and when asked how are you reply great! with a big white-toothed grin. This is not how a lot of cultures roll. While e.g. Italians are similarly positive, from Germany up Scandinavia and east to Russia the cultures are a whole lot grumpier. Vienna here is kind of infamous for having a culture of complaining all the fucking time.

    I haven’t looked into it but people are saying Jordan Peterson is saying people are adapted to very gradual and local status ladders. I sort of think in similar terms. We have top elites and then everybody else is a regular guy. For example, our clothes say nothing about our class or status and that is very novel thing in history. Now everybody is wearing jeans and shirts, and putting on a suit in situations where the work requires it with the same mindset one puts on a uniform. Nobody dresses up for breakfast like the aristoi in You Rang Milord? did. You can hardly tell the bricklayer and the top project manager apart on a Sunday afternoon by their clothes or jewelry. We longer have special greetings up or down the ladder. We are not calling the boss Mr. Director anymore, it is mostly “Hi, Jack!”

    My hunch is that it is not as much low status as this ambiguous status that is related to depression. Back in old Roman times Christianity was popular not among low status people but people of ambiguous status: rich widowed women, highly skilled freedmen, who were high on one ladder and low on another. Perhaps this is what makes the Prog religion go strong.

  4. >Men don’t mind killing; we are descended from killer apes

    Careful. We have plenty of evidence of soldiers not firing their weapons in battle or not aiming at the enemy in the world wars. This was real enough that new training methods had to be developed that addressed this, by the Vietnam era, it was solved. How this evidence is to be interpreted is a big question.

    I tend to agree with you, that it is likely not disliking killing that caused this behavior, but mostly being scared out of their pants and frozen solid or panicky unloading in the general direction of the enemy. But the evidence can be interpreted in other ways as well.

    I think we are not well adapted to the kind of war where survival is about luck, not skills. If another dude is coming at us with a sword, OK, we feel confident we can defeat him and survive. If there are two big teams putting a lot of lead in the air and it is pretty much random who gets hit, that is really scary and can shock one. A kind of learned helplessness, that you cannot be fast, strong or skilled enough to survive if a shell or bullet is coming your way.

    1. > Careful. We have plenty of evidence of soldiers not firing their weapons in battle or not aiming at the enemy in the world wars.

      Killer apes have no trouble killing the out-group, likely have trouble killing the in-group. Mixing up in-group and out-group, as leftists are apt to do, is what causes confusion, killing in itself is wholly natural.

  5. Facial bifurcation is very telling. Isolate someone’s eyes from the rest of their face and you can tell what’s going on ‘behind the scenes’. Suppressed fear, anger, etc.

    Without male ownership and childbirth, women slowly and near-universally go insane as they age through their late teens and 20’s. Her brain is designed for worrying about her little kids, and if it does not get that, it begins engaging in risk-taking behavior intended to get her raped and impregnated against her rational wishes.

    PTSD: in human warfare ‘as evolved’, you fought a battle, then fucked and drank yourself silly, and lived in safety until the next one. You didn’t live under the constant threat of being blown up at any moment for the two years you were deployed. Most men can take that, some can’t. No PTSD until soldiers were under the constant threat of sudden death.

  6. I sincerely think you don’t get the nature of PTSD. It’s not a result of logically thinking about a combat situation and deciding it’s futile in some abstract sense. It’s the visceral result of a deadlocked or incomplete response of the body – somatically, physiologically, psychologically – to perceived acute survival threats. Animals in the wild don’t get PTSD-like symptoms, but they can be induced in controlled environments. Peter Levine’s In an Unspoken Voice covers all this information if you’re interested in learning. With regard to college students vs WW1 soldiers, I’m sure there is a lot of misdiagnosis of hysteria as PTSD; but I also know that modern people have far less resilience to stress than earlier generations, probably because of the increasingly abnormal social conditions and the prevalence of pollution and worse nutrition.

    1. Not only is PTSD misdiagnosed, it is purposefully misused in order to attack, because our culture of victims encourages people to become victims in order to attack.

      Thus you’ll find that you give a certain kind of woman as much as a wrong glance, and she’ll claim permanent traumatic damage because of the experience. It’s not so much that we’ve become less resilient to stress, it’s that we are rewarded for acting butthurt.

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