In the early 1970s, psychologist David Rosenhan set out to answer a simple question: Can psychiatrists tell the sane from the insane?

Rosenhan and seven other perfectly rational “pseudopatients” went to a dozen U.S. hospitals complaining that they were hearing voices. All but one were diagnosed with schizophrenia and sent to a psychiatric ward. Each had been warned by Rosenhan that, to get out, they would have to convince the psychiatric staff they weren’t insane. So, immediately after they were admitted, they stopped mimicking symptoms of “abnormality” and behaved as they normally would.

Still, they were kept in the hospital for periods ranging from seven to 52 days, each finally discharged with a diagnosis of schizophrenia, “in remission.”

The Rosenhan experiment sparked a crisis of confidence in psychiatric diagnosis — a crisis that appears to be playing out again today.

This time the catalyst is the newest and fifth edition of the official guidebook of psychiatry: the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. The encyclopedic tome has undergone its first major revision in nearly two decades and makes its official debut May 18 at the annual meeting of its publisher, the American Psychiatric Association.

The rewrite has been rocked by boycotts and the resignations of some of the very experts tapped to give advice — including the former head of the department of psychiatry at the University of British Columbia, John Livesley, who says he quit the DSM-5’s personality disorders work group over a “disregard for evidence.”

…

The public clash is making psychiatry look like “nonsense,” says Allen Frances, the man who led the task force that created the fourth edition of the DSM in 1994. “It’s bad for patients. This will discourage people who desperately need help from getting it.”

Frances has been the DSM-5’s most dogged and unapologetic critic. He says the book contains untested diagnoses on the “fuzzy boundary of normality” and that it recklessly lowers the thresholds for existing ones.

…

Psychotherapist Gary Greenberg is more blunt. “Even at its best … psychiatric diagnosis is fiction sold to the public as fact,” Greenberg writes in his new book, The Book of Woe: The DSM and the Unmaking of Psychiatry.

“There is a huge disconnect between what psychiatry claims for itself, and what it can actually do,” he says.

Canadian psychiatrist Joel Paris says that “no one really knows what a mental disorder is,” or how to clearly separate normal from abnormal. “It’s all very fuzzy.”

In other words, 200 years after psychiatry was recognized as a medical discipline, a stark question persists: Is psychiatry credible?

mistercray:

The father of one of my students was murdered last week. I can’t imagine going through that at such a young age. When he came back to school, it was as if nothing had ever happened. I heard him mention the upcoming funeral but with no more emotion than any other weekend plan. I don’t know if he is that much more emotionally stable than I am or if maybe his father wasn’t a big part of his life but I was shocked. For a couple days I couldn’t talk to him without actively trying to suppress the murder that was dominating my attention.

Just today I found out about another one of my student’s home lives. De’Andre was raised in New York until his mother and grandfather were gunned down in a robbery attempt. Grandma spent all of her money getting him out of New York and chose Orlando as a destination because of how Disney looked on TV.

Not surprisingly, these kids aren’t great students. It’s hard enough to convince a student that learning about the scientific method is worth while when they plan on having a long healthy life.

The current “Value Added Model” (used to determine wether a teacher is effective or not) uses all sorts of variables like past test scores, reading level, etc.. to predict how much a student is expected to learn, but one factor that is legally prohibited from being included in the algorithm is poverty. Can we as a state/country come together and recognize that poor people have different set of struggles in life that make learning incredibly harder? I hope so, especially because without doing so teachers are incentivized to go to the rich school districts and away from where the help is needed the most.

If this sounds depressing, it’s because it is.

“Foucault defines the event as something that has a beginning and an end. Every human experience, activity, idea and cultural form can be analysed as an event or as a series of events. Foucault uses this concept as a way of arguing against metaphysical essences in history. It is important to emphasise that his notion of the ‘event’ shares little in common with the event as it has been defined by other forms of philosophy which define it as the rare and earth shattering eruption of transcendence (or the eternal) into history.

If each event has a discrete beginning and end, it does not exist on its own, it can only exist in relation to other events and to other levels of events. An event when it begins, is already part of a history and a social and cultural structure. It both perpetuates and marks a break or difference – no matter how small – from those structures. It is both the Same and the Other.

Foucault also applies notions of the event, of difference, to his discussion of the formation of the self. The self is likewise an ‘event’. We are born into a language, culture and historical situation and we are trained by, and train ourselves, with the tools produced by our history and culture. At the same time, however, we have the capacity to modify how we belong, to make a unique contribution.

People are continually trying to tie things down and render them the Same so as to maintain social and other forms of order, but the Other, that which is different, keeps on dissolving these orders. One could argue, using worn out and questionable philosophical terms, that in Foucault’s work, this Other is ‘immanent’ rather than ‘transcendent’. Hence the Other is something that is constantly present and in dialogue with what is going on here and now and in ordinary lives. Continual difference pervades our existence, opening up the possibility for transgression at every moment, not just exceptionally. Of course, whether or not people take up the opportunities offered is another matter.”
-Foucault and the Event, from Claire O’Farrell’s blog, Refracted Input, June, 2012, http://inputs.wordpress.com/2012/06/11/foucault-the-event/

epistemes:

“In 1927, Werner Heisenberg showed that uncertainty is inherent in quantum mechanics. It is impossible to simultaneously measure certain properties of a particle—position and momentum. In the quantum world, matter can take the form of either particles or waves. Fundamental elements are neither particles nor waves but can behave as either and are merely different theoretical ways of picturing the quantum world. Inexactness marks an end to certainty. As we seek to measure one property more precisely, the ability to measure the other property is undermined. The act of measurement negates elements of our knowledge of the system. Inexactness undermines scientific determinism, implying that human knowledge about the world is always incomplete, uncertain, and highly contingent. Inexactness challenges causality. As Heisenberg observed: “Causality law has it that if we know the present, then we can predict the future. Be aware: In this formulation, it is not the consequence but the premise that is false. As a matter of principle, we cannot know all determining elements of the present.” Inexactness questions methodology. Experiments can prove only what they are designed to prove. Inexactness is a theory based on the practical constraints of measurement. Inexactness and quantum mechanics challenge faith as well as concepts of truth and order. They imply a probabilistic world of matter, where we cannot know anything with certainty but only as a possibility. It removes the Newtonian elements of space and time from any underlying reality. In the quantum world, mechanics are understood as a probability without any causal explanation. Albert Einstein refused to accept that positions in spacetime could never be completely known and quantum probabilities did not reflect any underlying causes. He did not reject the theory but the lack of reason for an event. Writing to Max Born, he famously stated, “I, at any rate, am convinced that He [God] does not throw dice.” But as Stephen Hawking later remarked, in terms that Heisenberg would have recognized, “Not only does God play dice, but … he sometimes throws them where they cannot be seen.” […] In his 1930 text The Principles of Quantum Mechanics, Paul Dirac contrasted the Newtonian world and the quantum one: “It has become increasingly evident … that nature works on a different plan. Her fundamental laws do not govern the world as it appears in our mental picture in any direct way, but instead they control a substratum of which we cannot form a mental picture without introducing irrelevancies.” There was a world before Heisenberg and his uncertainty principle. There is a world after Heisenberg. They are the same world, but they are different.”

— Satyajit Das, Impossible Inexactness (via ludimagister)