[HN Gopher] Turning psychiatric labels into identities
___________________________________________________________________
Turning psychiatric labels into identities
Author : thunderbong
Score : 76 points
Date : 2024-05-27 07:06 UTC (15 hours ago)
(HTM) web link (www.newyorker.com)
(TXT) w3m dump (www.newyorker.com)
| thunderbong wrote:
| https://archive.ph/RfTgj
| bitmasher9 wrote:
| This is a classic mapping problem
| dyauspitr wrote:
| HITOP sounds even worse with a spectrum for everything. It sounds
| less like a system for diagnoses and more a subjective, self
| reported way of classifying all humans.
| Mathnerd314 wrote:
| If you look at the suggested measures, you will see that for
| example, the Big-5 personality traits are on there. https://ren
| aissance.stonybrookmedicine.edu/sites/default/fil.... Although
| self-reported, I wouldn't say Big-5 is "subjective". The
| measures have good test-retest validity and many independent
| scales have been developed and found to be strongly correlated.
| I would argue this means Big-5 is not just "you answered this
| question on this scale" - it is measuring something deeper,
| maybe not personality per se but at least a mental attitude. I
| could easily see extending this sort of measurement process to
| all of the traits in DSM, and I think it is a worthwhile goal.
|
| There are two issues I have with HiTOP though. First, they
| haven't actually developed and published the scales, or even a
| concise and reliable description of them. For example, if you
| look for Big-5 scales, you will find that only extraversion and
| neuroticism are well-defined. The other dimensions aren't
| replicable. Just by listing Big-5 and not adding any caveats,
| it is clear that HiTOP isn't taking a critical view of these
| measures. In terms of actual, usable scales, there are just the
| ICD-11 and DSM-5 AMPD personality models, and combining these
| into a concise scale is active research. In this area, the
| HiTOP project has accomplished little so far besides drawing
| attention to these and other models. There is a 405-question
| battery https://hitop.unt.edu/clinical-tools/hitop-digital-
| assessmen..., but it hasn't been validated.
|
| Second, I find the goals somewhat confused and the distinction
| between categorical and dimensional somewhat artificial. For
| example in
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5811364/, the
| proposal is to have a number of traits and to rate their
| severity. This model isn't particularly different from the
| current DSM - it is just that now rather than a "diagnosis of
| autism" one is rated as having a "severe autism trait". It is
| possible to have multiple diagnoses in the DSM and similarly in
| the proposed model it is possible to have multiple traits.
| About the only real difference is that diagnoses are going to
| be redefined to be one level above, what could be termed a
| meta-diagnosis in the current DSM. This is presumably going to
| be more strictly trait-based, and the traits are going to be
| de-duplicated, so that there are fewer differential diagnoses
| to deal with. You can see the proposed grouping here:
| https://renaissance.stonybrookmedicine.edu/HITOP/AboutHiTOP. I
| don't see much issue with such groupings, but I also don't see
| it as a big change. Despite them saying it's a new framework
| that bears no relationship to the current one, I think all the
| current labels will still be around for a while, and it doesn't
| seem hard to fit all the DSM-5 labels into the new framework
| either as traits or as diagnoses (syndromes).
| BLKNSLVR wrote:
| Sometimes the 'label' seems to be an excuse to continue
| behaviours that, were they not-yet-labeled, an individual would
| be encouraged to change.
|
| The label can be a shield against change or a weapon used to slay
| any accusation of weakness of discipline or laziness. It can be
| used as a security blanket to maintain the lifestyle to which one
| has become accustomed, justify all the bad habits involuntarily
| picked up from bad parenting and the ubiquity of entertainment
| and communication with friends and the complete lack of
| familiarity with being alone with only ones thoughts for company
| for any period of time.
|
| I know, for myself, there are easy and hard choices. I'm sure
| there are impossible choices for some states of mind, but they're
| a long way from my experience, and so all of the above may sound
| incredibly insensitive to those to whom I cannot even fake to
| relate with. I mean no offense, I'd like to have it explained.
|
| Is mental illness ever a learnt behaviour?
|
| Is mental illness a crystallisation of habits we unknowingly
| locked ourselves into?
|
| What is mental illness and what is just unfamiliar, not yet
| modelled behaviour and reactions to behaviour?
|
| Can any of the spectrums be navigated downwards through the
| smallest of steps over a long enough time period?
|
| What if "domestic violence" was actually a mental illness?
|
| (I ask the above to invoke thoughtfulness about our definitions
| and limitations and reactions to labels. I do not justify
| domestic violence, but that's because I believe there is always
| some amount of choice in how a human can react to a situation).
| suroot wrote:
| > complete lack of familiarity with being alone with only ones
| thoughts for company for any period of time.
|
| Riiiight...
| Apocryphon wrote:
| We're all hanging out in the comments, none of us should be
| casting that stone.
| grugagag wrote:
| > The label is a shield against change
|
| Surely it could be used for that. But it could also be used to
| get people who seem to fit the label to connect and discuss
| their own puzzling patterns of behavior, perhaps better
| understand why they never fit in no matter how hard they tried
| and so on. What is absolutely clear to me is that we as a
| population aren't uniform at all in thinking and operating;
| being a minority could be a painful experience as you're
| expected to conform to the norm. I think most discussion that
| expands this understanding is useful.
| zaphar wrote:
| For official diagnoses I think labels can be a useful way to
| begin conversations about improvement. However what looks
| like a growing trend is self-diagnoses. In those cases what
| seems to be happening more often is the label becomes an
| excuse and an identity to try to live up to.
|
| I don't think self-diagnosis is something that should be
| encouraged or lauded in any way. It seems more harmful than
| good so far.
| amanaplanacanal wrote:
| Self diagnosis seems completely natural when mental health
| care is unavailable because of a shortage of providers, or
| expense. What else are people going to do?
| zaphar wrote:
| I didn't say it wasn't understandable. I just don't think
| it's a good idea or something to encourage. If it
| actually makes things worse, even if it sounds like a
| good idea, it's not something that should be encouraged.
| And I do think it has a tendency to make things worse.
| TeMPOraL wrote:
| Worse, in mental care you're better off doing g some
| self-diagnosis to narrow down the possibilities and know
| which specialist to go first. If you just go to the first
| general psychiatrist you can find, it's likely they'll
| first want you explore depression.
|
| The problem with the above is, treating depression is a
| long process that can take years to yield perceptible
| results. If you try to explore it first, chances are
| you'll never explore anything else. Many of the other
| diagnoses can be tested and ruled out much faster,
| possibly in days to weeks (e.g. ADHD), so this is what
| you'd be better off starting with - but you have to
| suspect it first to know to seek out a psychiatrist
| specializing in that particular condition and ask them
| for an evaluation specifically.
| bluescrn wrote:
| Growing up in the 80s, kids usually weren't diagnosed with
| autism unless it was severe. There's no cure/medication, so
| seeking an official diagnosis is of no real benefit. But
| many people eventually connect the dots as adults, maybe do
| some reading, and suddenly make sense of their struggles
| and behaviors. Are they really less 'valid' than those with
| an 'official' diagnosis?
| zaphar wrote:
| I need to do _something_ and this is something is not
| usually a good justification for anything.
|
| It takes literally years of experience to properly
| diagnose someone, so yes, I do think it is potentially
| less valid than an official diagnosis. Self diagnosis has
| an effect of becoming a self fulfilling prophecy many
| times. Therapists have to get training in avoiding
| leading a patient into a wrong diagnosis because it leads
| to some terrible outcomes. It's called "iatrogenic
| illness" in the literature. Self diagnosing patients have
| none of that training and are at significantly higher
| risk of causing it to themselves.
| demondemidi wrote:
| There's no question kids (and immature young adults) identity
| shop, they always have, and DSM diagnosis is a nifty badge. And
| there's always profit in this desire to be unique just like
| everyone else. Whether it is a mall store that sells specific
| identity adornments, or today, doctors who will sign a
| prescription, both are ways to profit off kids anxiety at being
| individuals.
|
| But today's social media (even HN) is dominated by this
| generation so it is hard to discuss it without being downvoted
| into oblivion.
| cogman10 wrote:
| Perhaps the pendulum has swung too far, but for me as a kid
| psychiatric treatment and diagnosis was shameful. Before my
| time, it was grounds to send people to be locked away forever
| (which is probably why it was shameful in my childhood).
|
| The new era where everyone has a disorder is, in my opinion,
| preferable to the one where any disorder was viewed as
| inherent weakness that needs to be toughed through, even if
| that means some are diagnosed (or claiming diagnosis)
| undeservedly.
|
| It means that those that actually need these services (and
| yes, it's more than just make believe) have an easier and
| more socially acceptable route.
|
| I view it much the same way I view allergies. Sure, some
| people are "faking it" to be special, but enough aren't and
| allergens are a major problem for them. I have a family
| member that has been hospitalized multiple times because
| someone decided to test if they really had their allergy.
| dingnuts wrote:
| > Is mental illness a crystallisation of habits we unknowingly
| locked ourselves into?
|
| This has to be trolling. You have to deny even the most extreme
| forms of mental illness, like schizophrenia with persistent
| hallucinations, to be so completely obtuse in the current era
| as to blame mental illness on the patients.
|
| > What if "domestic violence" was actually a mental illness?
|
| If you plead insanity and are a danger to others, you go to an
| institution. This isn't an edgy thought experiment, bud. This
| is the sad reality of peoples' lives that you're dismissing.
| Fuck you with this flame bait, seriously. You aren't "just
| asking questions", you're an asshole.
| BLKNSLVR wrote:
| I was not intending to offend or troll and my apologies for
| coming across to you like that.
|
| It's a sensitive topic that covers myriad issues both mild
| and extreme and I guess my questions were around the milder
| side and therefore could be taken as offensive if looking at
| it from the more extreme side.
|
| The article focuses heavily on autism and only mentions
| schizophrenia once, so my commentary was based mostly on
| autism. The article also mentions sociopathy / antisocial
| personality disorder, which feels to me fairly distant from
| autism, or at least the lower ends of that spectrum.
| ChrisMarshallNY wrote:
| There are "causes," and "effects."
|
| A lot of "effects" are actually expressions of coping
| mechanisms. Things like drug use, spousal abuse, excessive
| sexual promiscuity, hoarding, having three hundred cats, etc.,
| are, quite possibly, self-prescribed ways to deal with the pain
| created by inner "causes."
|
| Very often, these coping mechanisms cause more problems, that
| also need to be coped/fixed.
|
| Say we steal a hat.
|
| We're a "thief." Simple, straightforward, and solves society's
| problem.
|
| But _why_ did we steal the hat?
|
| Did we steal it to keep the sun off our head? That means we
| wanted it for personal security.
|
| Did we steal it because it's a cool hat, with a cool logo, and
| will impress our companions? That means we stole it to improve
| our social standing.
|
| Did we steal it, because we think that it will impress
| $MEMBER_OF_SEX_WE_LIKE? That means we stole it, because we
| wanted to have more sex.
|
| We could also have stolen it, because we are compulsive
| thieves, and just _had_ to steal it; for no other reason, than
| we could. Stealing the hat was a coping mechanism for the inner
| pain, created by not stealing it.
|
| The first three causes are _motivations_ , and aren't
| necessarily any indication of a particular psychiatric disorder
| (but there's still stuff needs to be dealt with). There's a
| pretty good chance that consequences can be factored into the
| decision to steal, mitigating the problem.
|
| The last one, though, is straight from the DSM, and jail isn't
| really going to do anything to solve the problem. It will still
| be there, when we get out. Same goes for many people that are
| lifelong predators/offenders.
|
| I'm a big believer in addressing _root causes_ , and not just
| playing Whack-A-Mole with effects. This applies for finding and
| fixing software bugs, as well as my own pathologies. I like to
| fix the bug at its deepest level. When I was younger, I tended
| to apply the fix at the shallowest possible point.
|
| That means that I need to be _excruciatingly self-honest_. We
| look at diagnoses of mental illness or personal pathology as
| "investments," and tend to deliberately deny any data that may
| indicate that our diagnosis is wrong, or incomplete. Basic
| human nature. I have close family with extremely serious mental
| illness, and have been watching this play out, with highly
| educated therapists.
|
| Reality really doesn't give a crap about what we _think_. It
| just is. There 's no "moral" component. There's no need for
| accolades or approval. There's no money to be made.
|
| It. Just. Is., no matter what we do to bend it into our own
| worldview.
|
| If we're good with the shallow fix (and, in many cases, that's
| fine), then we can go for the easy fix, and we don't need to
| disturb our carefully-cultivated theories.
|
| If we really want to understand the _cause_ , though, and apply
| the fix at a deep level that will ensure a robust and lasting
| solution, we need to be absolutely _brutal_ about cleaning
| house, inventorying our own points of view, and avoiding sacred
| cows and third rails[0].
|
| [0] https://littlegreenviper.com/miscellany/sacred-cows-and-
| thir...
| dleink wrote:
| Your first two questions I'd answer with, "Yes, trauma."
|
| Additionally, I suspect an expert would say, "Domestic Violence
| is a crime caused by mental illness."
| rachofsunshine wrote:
| I don't think most mental health professionals would say that
| mental illness is a reason to maintain a damaging lifestyle.
| Quite the opposite - damaging normal healthy function is one of
| the defining traits of a mental illness, and one of the ways
| that mental illness is distinguished from normal variance in
| human cognition and emotion.
|
| But mental illness, as a framing, suggests a different course
| of action.
|
| When I was severely depressed many years ago, I was constantly
| trying to force myself to take more actions, to do more to
| change my life circumstances. I was nearly always screaming at
| myself inside my head to JUST DO SOMETHING AHHHHH. But that
| didn't work.
|
| It wasn't that I didn't want to do things. It was that I was,
| in a local sense, incapable of doing them. Not in the sense
| that I physically could not, say, move my muscles to go clean
| up my kitchen, but in the sense that I could not trigger the
| series of brain processes required to do that. The analogy I
| used a lot at the time was that it felt like being one of those
| old cord-pull lawn mowers. I could pull and pull and pull and
| pull and all I'd ever hear was the engine sputtering, and it
| was the most frustrating thing in the world.
|
| But today, here's how I'd frame the state I was in:
|
| * I was under significant stress from my living situation and
| self-criticism.
|
| * I was under _too much_ stress to emotionally cope with, so
|
| * I disengaged from feeling anything too strongly about my life
| or the world around me,
|
| * Which drained the positive and negative reward structures
| that feed into motivation, and
|
| * I spent so much energy trying to fend off those thoughts that
|
| * I didn't have sufficient mental energy for anything else, so
|
| * I couldn't do the daily maintenance tasks needed to avoid
| further deterioration
|
| Put another way, ability to overcome one's natural tendencies
| is a finite resource, and I was exhausting mine completely just
| getting through the day without losing it, which was disabling
| my ability to fix my situation.
|
| I didn't need to yell at myself more. What I needed was an
| environment that wasn't constantly stressing me out, and to
| train myself not to burn all my mental energy hating myself.
| Once I got that environment, once I understood that motivation
| is only very weakly under my direct control, and once I trained
| myself to maintain an environment that didn't add stress to my
| life, my mental health struggles abated.
|
| -----
|
| To put this in more HN-y terms, mental illness has a lot of
| similarities to working with a crappy external API (that's the
| mental illness bit) and to technical debt (that's the life-
| state bit).
|
| You can't go fix someone else's API. It's going to feed you
| crappy poorly-structured unreliable data all day long and
| there's nothing you can do about it. But you _can_ build a
| wrapper around it. You can validate it. You can learn to view
| what it tells you with a critical eye, and to correct for its
| common errors.
|
| And you can't fix technical debt today. Today you just have to
| engineer around it. But if that's all you ever do, the debt
| keeps accumulating and the problem gets worse. But if you can
| free up some time to go fix things, that frees up even more
| time to fix even more things, and you can find yourself on a
| more positive feedback loop that brings you back into a healthy
| place.
|
| The way you're framing this, BLKNSLVR, is like saying "it's
| possible to build software on top of this foundation, so just
| do it". And it is _possible_. But it isn 't easy, it burns far
| more resources than it should, and it doesn't fix the problem.
| The proper solution is to figure out a way to not be on fire
| today, then fix the underlying problem so you're not on fire
| tomorrow.
| BLKNSLVR wrote:
| Thank you for the detailed reply. I have very shallow
| experience with some of what you said above, and the way you
| explained it makes the 'stuck' feeling make more sense.
|
| I've treated it, in the past, as "you've gotten over it
| before, you'll get over it again, try not to take it out on
| other people in the meantime", which is treating the symptoms
| not the cause.
|
| I'll re-read this a few times.
|
| Thank you.
| mjfl wrote:
| iatrogenesis - when a therapist gives a possible explanation for
| your problem, they actually harm you because you begin to see it
| and start acting it out. The world becomes a theater, and you are
| on stage, playing your part in your mental illness. But these
| problems have such a low bar for diagnosis, that the majority of
| people qualify for at least one. But if the majority of people
| have some trait, is it really illness?
| readthenotes1 wrote:
| My understanding is that the DSM type labels are only
| appropriate if the character trait is having a catastrophic
| effect on someone's life.
| pseudalopex wrote:
| Significant. Not catastrophic.
| pseudalopex wrote:
| > But these problems have such a low bar for diagnosis, that
| the majority of people qualify for at least one.
|
| What is your evidence?
|
| > But if the majority of people have some trait, is it really
| illness?
|
| Lifetime cancer rates in some countries is 1 in 2. Can we say
| cancer is really illness?
| throw383y8 wrote:
| Priviliges?
|
| Mental illness is quite common. Imagine you could not label
| people as "creepy" or "invel", because they are most likely on
| some sort of spectrum. With mental illness they would be
| protected group. If it's personality trait, they are just creepy
| loosers.
| TeMPOraL wrote:
| Well, at least it would stop people from calling them names and
| feeling smugly superior about being on the lucky side of
| circumstances they likely had zero control over. At the same
| time, those "creeps" would have more therapy options available,
| helping at least some of them fit in better with the society at
| large.
|
| I understand that some types of people are inherently a problem
| for the majority of the population; I still feel that calling
| them "creepy losers" is a douchebag behavior that shows lack of
| empathy.
| throw383y8 wrote:
| > some types of people are inherently a problem for the
| majority of the population
|
| Dog owners? Getting a dog is 100% voluntary. Public
| defecation is all their choice. They can do it everywhere, if
| they get consent from all parties involved! Even licking and
| sniffing strangers crotch is ok, if it is consensual. Maybe
| even "suicide by pitbull" can be somehow voluntary.
|
| But it is totally fine to call them out. Creepy losers who
| can only have relationship with beast, that runs away on very
| first opportunity!!!
| mrangle wrote:
| Trained, high functioning people with the same condition are
| likely the best diagnosticians for that condition. At least for
| The Spectrum. As they would theoretically be better able to
| identify malingerers. The other side of the coin is that they
| could be more likely to flesh out a diagnoses in people whose
| symptoms are subtler or otherwise better covered.
| complaintdept wrote:
| Why are people so desperate to cling to labels? As I get older
| the notion of identity just seems increasingly absurd. Identities
| and labels have just become their own end. People seem like they
| don't exist anymore except on the terms and expectations already
| laid out by other people. It's no way to live.
| Teever wrote:
| They're filling a god shaped hole in their heart. They like
| most (all?) people don't understand the world or their role in
| it, or even worse they know they have no role in this world so
| they reach for what ever can give them fulfilment, belonging
| and direction, just like religious people do.
|
| I agree that it's no way to live.
| idontknowifican wrote:
| it always felt a bit more reactionary to me. a lot of people
| feel like they were unjustly treated, and the label helps
| them feel better about that stuff. normally i have seen an
| adult with a fresh diagnosis go really hard in to that
| identity, only to realize they over did it and land in a more
| neutral space.
|
| as someone who has a bunch of adult friends getting autism or
| add/adhd diagnosed, there is an immediate phase of "all of my
| problems are caused by this", followed by "how do i cope with
| this", and finally "this is just helpful context for me".
|
| there are quite a few that get stuck on one of those phases,
| but largely most people loop back around to a more reasonable
| view.
| pxc wrote:
| > god-shaped hole
|
| This cliche phrase definitely takes me back!
|
| The problem here is of course that gods aren't capable of
| solving this kind of problem anyway; an external,
| instrumental purpose ('God made me to do X', or 'God created
| me to have Y effect on the world') isn't _meaningful_ in the
| way people want intrinsic or subjective purposes to be
| anyway.
|
| In that sense religious institutions provide the same kind of
| earthly, banal, limited meaning that hackerspaces or secular
| charities or sports clubs or families do. But they're not any
| better at making existentialist yearnings well-formed than
| anything else is.
|
| I also don't think all that is necessary to explain the
| phenomenon at hand. That account is way too broad.
|
| Imo the drive here is more narrative; it's about making the
| stories of our lives make sense-- often in the simple sense
| of making them unsurprising. Discovering a diagnosis can be
| very cathartic, and can (partially) explain lots of patterns
| and events from one's past. It also brings some relief
| because it tells us that we are not uniquely defective in our
| failings and points us towards examples of others who have
| managed to succeed or survive despite the same ailment. And
| it gives us a vocabulary for identifying similar people from
| whom we can learn and in whom we can find solidarity. All of
| those things being are rewarding and/or useful.
| thrance wrote:
| If some find solace in religion, then good for them! But some
| (most?) are able to lead fulfilled lives without religion,
| and some lead outright miserable lives even with
| Jesus/YHWH/Allah/Quetzalcoatl in their hearts.
| mcphage wrote:
| Religious people have all the same identity issues as non
| religious people. I've been around too many religious people
| to think otherwise.
| Teever wrote:
| That's what I'm saying. We all have these problems, people
| cope with them differently. Some people fill that hole with
| religion "hurr durr, I'm a Catholic, others fill it withs
| "hurr durr, I'm an Oilers fan" and others fill it with
| psychiatric labels "Hurr durr I'm an autistic bipolar type
| II"
|
| Different sides of the same coin.
| thinkingemote wrote:
| At root it's kind of like this, you were right about God but
| it's not really about religion or religious people in the
| West. It's about looking for identity within and choosing
| something versus having something chosen for you. We name
| ourselves. Now we can choose our identity to be anything and
| even physical and biological reality is less important than
| our choices. We are told to find ourselves, fulfilment,
| belonging and direction within ourselves.
|
| A person can choose their religion now, they can label
| themselves according to what they believe in. For many in the
| West religion is a kind of loose political or ideological
| club. For many, religion and identity is found and chosen
| from within. "it's the real me", "I have found the meaning in
| my life by this chosen identity".
|
| But it has not been this way forever, and in other (non-
| Western) parts of the world it's still another way.
|
| The other way is to have your identity defined from above or
| outside you. For most people who we were, our identities were
| defined according to our position, where we lived, what our
| father did, what the culture was. Your father named you. To
| be "real" you would behave according to what identity had
| been given to you. Ultimately God is above everything and
| with regard to identities, symbolically represents this top
| down giving of a meaning of life.
|
| I guess it's making the hole bigger than trying to fill it
| with something else.
|
| Edits:
|
| a) I suppose that some older religious people who were "born
| into it" might be more towards identity-from-outside.
|
| b) It would work with non religious people in identity-from-
| outside cultures. Stereotypical examples: a farmer in rural
| China, a salaryman in Japan or a peasant in 17th Century
| Germany. Or a culture where children are encouraged to "do
| their best" with what they have at hand vs "find themselves"
| with things they might discover.
| talldayo wrote:
| A god-shaped hole, or a gap where god once was?
| https://en.wikipedia.org/wiki/God_of_the_gaps
| rmholt wrote:
| Because of social groups. A single person with $ILLNESS may
| want to connect with other people with $ILLNESS. Ergo making a
| group around $ILLNESS and thus identity is born.
|
| Labels are a tool, of communication with the rest of society,
| of expression.
| mxmilkiib wrote:
| Communication, finding things, solidarity, community,
| organisation.
|
| If you're part of any group (or set of groups), you're either
| less or more of an individual, depending on how you look at it,
| both of which can be viewed normatively as good or bad.
| temp0826 wrote:
| Paradoxical, but I feel part of the process of individuation is
| coming to terms with just how extraordinarily ordinary we
| actually are. For many that naturally comes with age, we simply
| care less about what others think. And it's very freeing. For
| those that can't get there, I think there is more often than
| not some kind of arrested development or trauma holding them to
| that pattern. It absolutely can be overcome; best not judge (it
| shouldn't really affect you in any case) and see that everyone
| is on their own path and some are further along than others.
| rebeccaskinner wrote:
| People find others who have things in common with them. Those
| things people have in common get names. Those named things
| become a big part of a persons life and so become an identity.
|
| Sometimes, identities are something that we choose- the article
| is focused on people choosing a psychiatric diagnosis as an
| identity but there are a lot of other identities people choose,
| based on their work, hobbies, where they live, etc.
|
| For example, I am a programmer. It's an identity I have, based
| on both my work and hobbies. It's a useful shorthand for me to
| share some information about myself and find other likeminded
| people.
|
| People don't always choose their identities either. A lot of
| people have an identity imposed on them. When society creates
| an identity around something that applies to you, it might be
| impossible to avoid it even if you want to, and embracing it
| may be a necessary survival strategy.
|
| I don't think it's a matter of desperation that people cling to
| them. In some cases it's a matter of pride, people want a way
| to claim their membership in a group and show their values and
| things they care about. I think we all do it, but some people
| are aware of it or do it intentionally more than others. In
| other cases, like I said, it's not a choice. People may
| desperately want to not have a label imposed on them but they
| can do little to avoid it.
| SoftTalker wrote:
| Identities can backfire though because people who don't
| identify as your identity have different ideas about that
| identity than you might.
|
| For example I'll never say "I'm a programmer" in a mixed
| social gathering of people I don't already know. It's a total
| conversation killer for anyone who isn't a programmer (i.e.
| most other people) and I really try to avoid bringing it up
| at least until I have found something else in common with the
| person I'm talking to.
|
| And in general, I think people who make $IDENTITY the main
| feature of their personality will have difficulty outside of
| that one social group.
| rebeccaskinner wrote:
| > Identities can backfire though because people who don't
| identify as your identity have different ideas about that
| identity than you might.
|
| That can be true, and I think it's particularly common with
| imposed, rather than adopted identities. In fact, people
| having particular ideas about you that aren't necessarily
| true is the reason a lot of imposed identities exist in the
| first place. There's not a lot you can really do about it.
| I suppose you can try very hard to not identify with
| anything, but that's not always an option, and even when it
| is it would be a very lonely existence.
|
| > And in general, I think people who make $IDENTITY the
| main feature of their personality will have difficulty
| outside of that one social group.
|
| Another way of saying that is that people who aren't well
| rounded will have trouble in a lot of social situations. I
| agree with that, but I don't think it's a problem related
| to having identities so much as it is someone restricting
| themselves to a single focal identity.
| Mathnerd314 wrote:
| I've tried introducing myself as "I'm a human", you'd think
| everyone would agree with this label but it gets
| unenthusiastic reactions. The followup "You're human too,
| right?" is even worse.
| mrangle wrote:
| Do you not understand the lack of enthusiasm? The logic
| will end with why its lack is not disagreement. Whereas
| the opposite is implied in your post.
| Mathnerd314 wrote:
| Well, there are some labels that get enthusiasm, and some
| that don't. Like, of the ones mentioned in the article,
| "I'm an introvert", "I'm a Libra", "I'm Gen Z", I've
| actually had some good conversations about conversation
| styles, astrological sign personalities, and different
| generations. But when I bring up being human, nobody is
| willing to get into cognitive biases or the daily mishaps
| of living. I understand that people have different
| reactions, but I don't really understand why they react
| the way they do - it seems like a culture issue.
| TeMPOraL wrote:
| "I'm an introvert", "I'm a Libra", "I'm Gen Z" - people
| mention these to separate themselves out of the group, or
| general population. "I'm a Libra, which is unlike most of
| you here, therefore my failings are unique and my
| successes are what makes me special".
|
| When you bring up "being human", you're _including
| everyone else_ in the good and bad things you attribute
| to being a human - which is likely to create awkwardness
| and generate a lot of feelings, most of them not very
| nice.
| delecti wrote:
| If you spend a long time feeling like nobody understands an
| aspect of yourself, learning that there's a name for that is a
| powerful feeling. People naturally gravitate towards people who
| make them feel understood.
| archsurface wrote:
| A shortcut to identity - it used to be music t-shirts.
| sircastor wrote:
| Having a label (and more specifically a mode of treatment) can
| be the difference between being treated like a human with
| health issues and just being "the guy who's weird"
| StefanBatory wrote:
| Like with autism. People are going to look at you differently
| anyway, but if hey know you're autistic, they might be
| willing to overlook some things that otherwise would label
| you as weird.
| Log_out_ wrote:
| Cause society leaves you hanging and alone with genetic curses
| best yiu get is chemical pacifiers and endless wallowing in the
| psychological diggestive tract to reform you into a productive
| sociopath. Labels help to for groups of people suffering a
| similar fate ignored by the out group, which does not get what
| labels are for.
| mrangle wrote:
| Because people need accommodations, either formal or informal.
| At its base, the logic is no more complicated. Other reasons
| for adopting a categorical identity will vary and often be
| nonexistent.
| azinman2 wrote:
| It's not surprising. People seek identities to confirm who they
| are, find companionship and community, and attach themselves to
| something bigger than one can figure out for one's self. We see
| it in people who are "healthy" as an identity, now in "nerds"...
| so for mental issues it makes you feel bigger than just yourself.
| I think less-clear identities are part of the big culture war
| struggle in the US... the inability to handle a plurality.
| kthejoker2 wrote:
| "Are turning" implies some sort of novelty.
|
| But it is the same as it ever was.
|
| We've had the xue-qi, humors, hysteria, the zodiac signs, witch
| hunts, the "sensitive" type, type A, temperaments, IQ tests,
| Freud, Rorschach, Jung, Myers-Briggs ...
|
| People will always try to "fix" themselves and others to a
| particular set of traits and then predict and analyze their
| future behavior through that "fixed" lens.
|
| We're barely a century removed from phrenology being an accepted
| criminal forensic tool.
|
| We have always been susceptible to the simplicity of psychiatric
| labels.
| samatman wrote:
| > _We 're barely a century removed from phrenology being an
| accepted criminal forensic tool._
|
| This, specifically, is a bad argument.
|
| Medicine is barely a century removed from using mercury salts
| to treat syphilis, but as it stands, can completely cure it
| with modern treatments, the rise of drug-resistant strains
| notwithstanding.
|
| If modern psychopathology is still largely prescientific, which
| one can make a strong case for, this is because of
| psychopathology now, not psychopathology a century ago.
| thefaux wrote:
| I'm not sure what point is being made here. I agree that many
| people will mindlessly and uncritically accept labels. But this
| comment feels cynically critical of any attempt to study
| psychology. Psychology is hardly the only science with an
| embarrassing history and many mistakes.
| kthejoker2 wrote:
| My point wasn't to slam on psychology; just the article seems
| to imply identity through shallow psychological labels is a
| new phenomenon, when it is as old as civilization itself.
| Apocryphon wrote:
| And it's not even just psychological labels, either. In
| East Asia, mostly Japan, blood types are used as a form of
| astrology (literally type A personalities). And in other
| contexts modern people sometimes self-identify based on
| their supposed chronotype or whether they're an endomorph
| or an exomorph in order to retroactively explain their
| nature or behaviors. Self-identity is often used for self-
| justification.
| bjornsing wrote:
| I sometimes wonder how much of the incurability of some of these
| illnesses or mental states is a product of people making them a
| part of their identity, or having that identity forced upon them
| by others. Because as pg quipped on Twitter the other day: "Never
| make a fixable problem a part of your identity, because then
| you'll never fix it!"
| thefaux wrote:
| Yeah, that's why I always raise an eyebrow when people self
| describe as say a java dev or a rubyist.
| TeMPOraL wrote:
| I feel this is something you do early on, as it generates
| drive and gives some sense of belonging (and faux us-vs-them
| conflicts that can pump a lot of motivation). Eventually, you
| learn and experience enough to transcend identifying yourself
| with a single set of tools.
| mrangle wrote:
| A problem with the article is the lack of differentiation, for
| stated or implied diagnoses, between potentially curable
| conditions and those that are developmental.
| rachofsunshine wrote:
| Having an understanding of what was wrong with me was an
| important part of understanding how to fix it, or more
| properly, how to work around it.
|
| I struggle plenty with depression and anxiety in the mental-
| illness sense of those words (as opposed to the current-
| emotional-state sense). What that means is that my brain is
| always over-sensitive to negatives and assumes bad outcomes in
| cases of ambiguity, to a degree that isn't rationally
| justifiable. I can't control that fact; it doesn't occur on a
| conscious level and those are inputs to my cognition, not
| outputs of it.
|
| But what I _can_ do is recognize that _because_ I am helpless
| to change those inputs, I need to know that they 're warped and
| know how to compensate for them. I know that my brain will
| serve me aggressively negative examples and downplay positive
| ones, so I needed to practice both (a) not listening to it and
| (b) consciously recalling positive examples to counterbalance
| it. I know my brain will make me nervous and jittery, so I
| needed to consciously train myself to think "okay, even if I
| totally screw this up, it isn't the end of the world". I know I
| tend to avoid things that scare or stress me, so I needed to
| train myself to confront or remove them.
|
| What my brain tells me still "feels" right to me, and it
| probably always will, and in that sense I cannot not have the
| mental health struggles I do. They are, in that sense,
| cognitively incurable (and so far I have not found a medication
| that lastingly cures them either). But understanding the fact
| that that is a fundamental part of the mental world in which I
| live has given me a lot of tools to do better than I could in
| the past.
| pseudalopex wrote:
| > People's symptoms frequently evolve according to the labels
| they've been given.
|
| This could be true. But the anecdotes and claims in the article
| are weak evidence.
|
| > Following Layle's visit to the psychiatrist, her mother
| observed, "You've been acting more and more autistic since we got
| the diagnosis."
|
| Reduced masking after diagnosis is common. Or her mother could
| have noticed and related behaviors she didn't before.
|
| > In 2006, a student at a Mexican boarding school developed
| devastating leg pain and had trouble walking; soon hundreds of
| classmates were afflicted. A fifteenth-century German nun started
| biting her companions; eventually, the strange hysteria infected
| convents from Holland to Italy.
|
| This is argument from analogy. Mass hysteria spreads without
| labels. And it is rare.
|
| > Ian Hacking, the philosopher, argued that such a dynamic
| fuelled the epidemic of multiple personality disorder in the late
| twentieth century, and something similar seems to be playing out
| now with the growing portrayal of dissociative identity disorder,
| the current name for M.P.D., on social media.
|
| This is begging the question. People more qualified than a
| philosopher have argued many perspectives about DID diagnosis.
|
| > One of Kriss's patients, a student who went by Haku, developed
| a multiplicity of selves after being introduced to the concept of
| dissociative identity disorder. "It's not that I thought he was
| faking it," Kriss recalls. "It seemed more that Haku wanted to
| have multiple personalities, even if that meant he had to force
| himself and others to believe in it."
|
| But does it occur frequently?
| pxc wrote:
| > People more qualified than a philosopher have argued many
| perspectives about DID diagnosis.
|
| Idk why you'd think a medical practitioner would be more
| qualified than a philosopher of science about when it comes to
| methodological issues, but you're wrong.
| TeMPOraL wrote:
| Perhaps because without having their theories reality-checked
| on a regular basis, a philosopher of science effectively
| turns into a protein-based LLM: saying convincing things, but
| unable to realize when some of it is wrong and invalidates
| everything said from that point on.
|
| Medical practitioners live and breathe methodology; they
| experience both the process and its output. They _are_ the
| reality test.
| kristianp wrote:
| One mental health problem not mentioned here is schizophrenia.
| Having a family member afflicted, I don't think having a label
| makes things much better. The schizophrenia treatments available
| just make me feel that we understand so little about it. The
| drugs used are such blunt weapons that can be debilitating in
| themselves.
| 1vuio0pswjnm7 wrote:
| HN editorialised title: "Turning psychiatric labels into
| identities"
|
| Author's title: "Why We're Turning Psychiatric Labels Into
| Identities"
|
| Print edition title: "Read the label"
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