You are being fooled about mental illness
It's not illness
It's not dysfunction
It's not biological
It's not medical
It's not chemical
It. Is. Meaningful.
At the risk of sounding overly insulting, I'm appropriating James Carville's popular 1992 phrase to emphasize that mental disorder is about the mind, not the brain or body. Carville's "it's the economy, stupid" emphasized that the economic situation during a presidential election is paramount, and far surpasses other campaign issues.
By borrowing his phrase, I'm emphasizing that the mind is paramount for understanding mental disorder. Further, not only does mind far surpass the brain and body in this understanding, the brain/body is irrelevant. The brain is not the mind and the mind is not the brain. Looking at one in order to understand the other is foolish.
Let's do a thought experiment. Take all mental and behavioral problems and identify the ones caused by defective bodily functioning: confusion brought on by drug use, uncharacteristic behaviors caused by a brain tumor, fatigue due to a vitamin B12 deficiency, mania as a result of cocaine intoxication, hallucinations because of Parkinson's disease. Those mental and behavioral problems are not examples of mental disorder. They are straightforward physiological disorders. As I explained earlier, merely having a mental or behavioral symptom does not make a problem a mental disorder.
Once those examples are thrown out, what is left? These: desiring to shut down int he face of extreme apathy and disappointment about life, a keen interest in being prepared and hypervigilant, a desire to numb painful feelings with drugs, entertaining alternative realities that better explain strange personal experiences, an unwillingness to live within social and biological limitations. These are, respectively, diagnosed as depression, anxiety, substance use, schizophrenia, and bipolar disorder. But they have no pathophysiological basis. They have a meaningful basis. They are about mind, not brain or body.
Certainly, while those "mental disorders" are occurring, the brain is undergoing physiological activity. But that brain activity is not pathological or otherwise a matter of dysfunction. It is working quite well. Instead, the problems are about how the person responds to those meaningful things and how that response works or doesn't work in their social contexts. That is the essence of mind - it is the experiential foundation upon which all meaning and choices are based. Physiologically tinkering with a person who doesn't have a physiological problem is dangerous.
In Sunday's MSNBC "Yasmin Vossoughian Reports," Ms. Vossoughian interviewed Dr. Ira Glick about mass shooters. In the interview, Dr. Glick presented blatant falsehoods about mental disorder. He dangerously perpetuated a myth that unmedicated mental patients are prone to violence. This does nothing but provide a scapegoat, not a solution.
Although Dr. Glick admitted that "people with mental illness" have less risk of being violent than others, he nonetheless went on to say that "...the public should be made aware that some [my emphasis] unmedicated mental patients do pose an increased risk of violence." If those "with mental illness" have less of a chance of being violent to start with, how could not taking medication raise that risk?
It is also important to note what Dr. Glick didn't say. He failed to mention that some unmedicated mental patients pose no risk. Further, he failed to point out that some non-patients still pose an increased risk of violent behavior. Therefore, his statement that some unmedicated mental patients pose an increased risk of violence is meaningless and tantamount to saying some Golden Retrievers bite people, while failing to point out that some of them don't bite, and some other breeds do bite. This is useless information for someone wanting to obtain a family pet, just as it is useless information to tell the pubic and policy makers that some unmedicated mental patients pose an increased risk of violence.
It isn't the patient status that increases one's risk for violence. In my previous blog post, I explained the empirically-derived factors known to increase one's risk, and being diagnosed with a mental disorder is not one of them. Moreover, I emphasized that science tells us that medication actually increases the risk of violence - the science involved includes the drug companies' own pre-marketing clinical trials. Sadly, despite knowing these risk factors, our leaders lack the political will to address them seriously - money and self interest stands in the way.
Perhaps the most troublesome flaw in Dr. Glick's reasoning is his study. He claims it is the first of its kind. This is a dubious claim as many studies have been conducted on the same topic for several years, even if not with exactly the same method and focus. The study is based on a very select sample of 35 shooters (those who lived) between 1982 and 2019 and obtained from one popular news magazine's database.
The research is based solely on after-the-fact information gleaned from documents and individuals who were involved in the prosecution of the shooters. This means that all shooters would have been diagnosed with a serious mental disorder, skewing the picture. What mass shooter would be clinically cleared by a forensic psychiatrist after the fact, especially while being detained for prosecution? Ans. None.
The researchers attempted to determine if those who died in their shooting were different in terms of mental disorder from those who lived, but that was done by reviewing the available information on the deceased shooters, but only after the shooting. This would ensure that most of them also would have been diagnosed mentally ill, which was then conveniently presented as evidence that the ones who lived were no different than those who died, and designated mentally ill.
The main thrust of Dr. Glick's message is a reinforcement of the long-since-debunked falsehood that people identified as mentally ill have a brain "illness" or their brains are "sick" and "damaged" in some way, and that the alleged illness is what drives them to kill. There is no such illness, as there is no scientific evidence of brain defect or dysfunction in those labeled mentally ill, despite more than a century of looking for it. Still, orthodox practitioners, academicians, and researchers among the mental health professions continue to peddle such gibberish.
The icing on Dr. Glick's cake is that he encourages us to identify these potential shooters and give them the treatment "they need" in order to prevent the violence. Welcome to Bizarro World!