Fix What’s Really Broken

by SandWyrm


Not too long ago, SinSynn posted an article over on House of Paincakes where he told the story of his struggle with drug addiction. Because he wanted to cut through the bullshit and tell people the truth about what it's really like to go through that experience. Well now, because of a comment on my last post, I've got my own real-life story to share. Not about drug addiction, but about how the confusion of psychology with science skews our perceptions of health. Which, for reasons you'll see, is one of my major pet peeves. Because it has affected me personally time and again.


My last post speculated on some addiction-like patterns that I see as common to both drugs and hard-core game playing. With the stated assumption that advances in Neuroscience (particularly in real-time imaging of brain activity) would eventually allow us to quantify these effects.

This led to some disparaging comments about neuroscience from someone hiding behind an OpenID serial number. For the sake of this article, I'll assume that he's male and call him '000B'. Hi 000B!

Now according to 000B, neuroscience is next to useless, and both biology and psychology are far superior as scientific tools.
Biology is, of course, a long-established and respected science. One whose sub-branches includes the work of those studying the functioning of the human nervous system. So calling biology superior to neuroscience is like say that cars are superior to Fords. Or that Fords are superior to Mustangs. Uh... OK. Whatever.

But then I twisted 000B's panties and pointed out that psychology was not a science, and this is where he went full-scoff on me. Because he doesn't understand the difference between a scientific discipline, and a philosophical one.

Observe:

"Your contempt for psychology is surprising, and your faith in fancy machines endearing. Your explanation for what you believe psychology to be, helps explain both. Do you believe "descriptive disciplines" to be non-scientific? Do you share similar contempt for geology, or understand that biology is very similar? Regardless, this is far afield, and an on-going theme -- expressed interest in science, but contempt for the actual sciences that might be able to answer the specific questions you pose.

Best of luck waiting for neuroscience to get around to confirming what sociology, psychology, psychiatry, and biology have already "described". I anticipate they'll have fairly conclusive answers for you in the next two or three decades, assuming they actually embrace science (and not just the trappings). Or you could ask a scientist in a different field, who might have several decades of both descriptive and experimental evidence and a fairly well-supported set of answers."

And here is my overly-detailed reply...

000B, I’m counter-amused by your lack of respect for those who develop and use scientific measurement tools. Do you hold the same scorn for blood pressure cuffs and microscopes? Probably. Since you are fundamentally confused as to the differences between science and philosophy.

Science is not a thing, but a process. One where knowledge is built and organized in the form of *testable* explanations about nature. If a theory cannot be proven or disproven, then it is not scientific. Nor is the validity of a scientific finding dependent on how many people, even if they call themselves scientists, believe in it.

Philosophy, on the other hand, is the study of general and fundamental problems. Philosophers can follow a systemic and disciplined approach in their work, and even hold rational arguments that incorporate scientific evidence. But a philosophical theory cannot be objectively proven or disproven. Hence, the only possible measure of its success is how many people come to believe in it.

Psychology, as a study of the general and fundamental problems of the mind, is thus a branch of philosophy, not science. Because even 75 years after Freud, the disorders it seeks to treat still have no objective test for their diagnosis. Nor are they even clearly defined in the DSM, it’s primary manual. Where the inclusion and description of each ‘disorder’ are primarily decided upon by culture and politics, not objective biological measurements.


Now… I have a great deal of respect for both science and philosophy, properly applied. Both are essential to society, and science cannot pave a road without philosophy first blazing the trail. Establishing the conceptual framework within which the objective observations of science, and their resulting theories, can be made. In this way, the insights produced by philosophy are vital to good science.

But when people confuse the two disciplines, all sorts of bad things happen, and nowhere does this confusion do more damage to everyday people than in psychology. Which has become an easy substitute for the words “I don’t know” across the entire medical profession. Encouraging  psychoactive drugs to be thrown at problems which are usually better addressed by other medical disciplines.

Want a personal example? Because I have one. Actually I have three or four, but I'll keep it simple and just relate the latest.

Last fall I went into the ER with complete paralysis of the lower half of my face. I couldn’t talk, I couldn’t even smile. But I could write just fine. This was my third visit to that ER in 2 months, as I increasingly suffered from muscle spasms, all-over pains, uncontrolled sweating, insomnia, and ‘crashes’ where I’d go into a half-sleep state multiple times a day. Even as my heart felt like it would pound its way out of my chest. I worried about this… A LOT. So did my wife.

The doctors scratched their heads, because it obviously wasn't a stroke (duh). Yet I couldn't make a sound. The signals from my brain simply weren't making their way to my face and throat. As they ran the blood work, finding nothing obvious, I slowly regained the ability to move my lips and mouth. Until, an hour later, I could talk well enough to be understood. After an hour and a half, I could talk normally.

That's when the ER doctor sat down and patiently told me that I was crazy.

He was very nice about it, as were the previous 2 ER docs. My GP... not so much. But the message was clear. It's all in your head. Go see a psychiatrist. You're suffering from anxiety.

I went home, slept badly, and the next morning the muscle spasms started again. Then, quite by accident, I took a magnesium supplement. Within half an hour the spasms, tingling, and numbness  were completely gone. You can imagine how pissed off I felt at all those docs. But the best was yet to come.

The rest of the anxiety symptoms were still there. It's not like I had placebo-ed my problems away. But my facial paralysis had quite obviously been caused by a severe lack of a key electrolyte (the minerals you need to transmit nerve impulses around), and the only time I get muscle spasms or tingling anymore is when I forget to take my daily magnesium.

Continuing the story... I ended up back in the ER again a few months later, after my heart pounded so hard that my chest ached for hours afterward, and suffered through yet another lecture by a doctor who couldn't bring himself to say "I don't know". So he told me as authoritatively as he could that he's been doing this for 20 years, and it was all in my head. Then he asked me if I'd ever been diagnosed with bipolar disorder (nope), wrote me a scrip for Xanex (which I tore up), and sent me on my way.

This is supposed to be where I decided to be a good little patient and did as I was told. Problem is, I knew better. Not only does my family have actual bipolar people in it, but I went to art school. So trust me when I say that I know what real mental illness looks like first hand. I also know very well how psychiatry works. Because I was run through that mill (uselessly) as a kid. Nor was this the first time a doctor told me a problem was in my head, which later turned out to have a physical cause.

So here's what would have happened if I had taken their advice: A very nice psychiatric professional would have listened to me describe my problems, asked me some questions, considered them at some length, and then diagnosed me with General Anxiety Disorder. Putting me on either an SSRI, or a Benzodiazepine (or both) to calm me down. After a few months of tweaking the dosages, I would have reached a somewhat less anxious steady-state. Though I would still have felt miserable, with a complete lack of energy.

Now pay attention 000B, because this is the part that you may not grok in your confusion of science with philosophy.

This diagnosis of general anxiety would have been spot on. I WAS suffering from general anxiousness, and those drugs would have helped calm me. If not to a ‘happy’ state, then at least into a state where I could go about my daily life more easily. From a psychological standpoint, this course of action would have been both reasonable and correct. By any established psychological measure, I would have been successfully treated.

But that is the trap 000B. Because psychology, due to its being a philosophy instead of a science, assumes that the 'mind', a purely conceptual construction, is somehow separate from the bodily processes that support the brain and nervous system. Leading those in the psychological disciplines to believe that they are treating 'the mind', when what they're really doing is addressing a complex system of interconnected biological processes.

In short, they only notice and modify the most obvious aspects of a person's behavior. Without considering what the underlying causes of that behavior might be. Which is the equivalent of trying to remove the rust from a car by painting over it.

So I persisted in looking for what was really wrong. Which, as it finally turned out, was my sinuses.



In total, I had something like 25% of the airflow that I was supposed to have normally, and none at all when I was sick. That plus the long-term chronic infection were the source of most of the anxiety that had appeared in the months previous. That is, the majority of the added stress I was under wasn't mental. It was physical in nature, and no amount of positive thinking or verbal therapy was going to make it go away.

So I had the surgery done, and now I'm breathing as easily as most people do. As I've recovered from the procedure these last couple of months, the anxiety has gone way, way down. Along with it, the aches and crashes have disappeared. Even as the real mental stresses in my life have increased due to family troubles.

As a measure of how hyperactive my immune system had become battling that infection for months or years, consider that my kids have brought home colds, stomach flu, and strep throat since Christmas. Normally, I would catch everything. Yet I'm the only one in the family that didn't catch any of these. I got a little sniffy for a couple of days, and snored a bit more. But that was it.


If this had all happened in the 1950's, then there would have been no MRI to tell my ENT that what seemed like a minor routine sinus issue was actually quite severe. Because there would have been no good way, short of cutting into my face, to know what was happening inside the center of my head. In that case, the only logical recourse would have been psychological or psychiatric treatment for the behavioral symptoms of my anxiety. In an attempt to paint over the rust of my condition.

But this isn't the 1950's, and thanks to a "fancy" technology whose clinical use only goes back 34 years, and which only really matured in the last 10 or so, I was able to get the physical cause of my anxiety properly diagnosed and treated. Rather than just throwing drugs at my behavioral symptoms, as 2/3rds of the doctors that I talked to over the course of this journey urged me to do. Which would have resulted in my overall physical and mental condition deteriorating from the ongoing infection plus drug side-effects.

So that is why I'm contemptuous of psychology. Not because the people that practice it are evil, don't work hard, aren't disciplined, or don't honestly want to help people. Not because psychology hasn't amassed a great deal of useful information about human behavior. But because the underlying assumptions of psychology are flawed, and these flawed assumptions infect the entire medical profession, due to psychology's confusion with real science. Polluting the attitudes of physicians towards patients with conditions that aren't easily diagnosed in a 10-minute office visit.

Which, if you're not a stubborn, opinionated, a-hole like me, can destroy you both mentally and physically. I've seen way too many of my friends and family struggle with this crap not to care.


Now there are certainly some conditions, such as Bipolar, that only psychology and/or psychiatry can currently be used diagnose and treat. But this is only because, until very recently, we had no other decent diagnostic tools beyond "Tell me how you feel...". And we still have no good guide to treatment beyond "This drug usually works for what I think you have...".  As someone whose loved ones deal with Bipolar, I know that there is no steady-state in the long term. The drug that works today may not work next month, and nobody knows the underlying reasons why. So treatment is a currently a guessing game with no end.

But... As these new technological tools (imaging, genetic testing, biochemistry) improve over the coming decades, we'll not only be able to diagnose these conditions more accurately. But we'll also be able to make better guesses about what treatment paths to follow. Based on the specific brain regions that need to be dulled or enhanced in function. Along the way, we'll discover that what seemed like 3-4 separate conditions are actually just minor variations on one. While what seemed like one condition actually has multiple distinct causes. Because that's what happens when a philosophy is displaced by scientific observation. But when a philosophy instead pretends to be science, people mistake the path for a paved road.

End of rant. :)