Judging and labelling disorders

Question of the Day, Oct 15-16. 2015. Judging and Labeling with disorders…

Question submitted by Andrew:
(Inspired by this video which Kathy posted in reference to another QOTD.)

Why has societies propensity for judging certain individual personality traits as ‘mental disorders’, especially in children, become so popular?

Agree that it is a really complex situation.
Align with most aspects of what others have written.

It seems to me that to be human is to have different probabilities of different strategies in different contexts. There is a vast range of responses that are possible in most situations.

One of the key drivers of this is the dominant paradigm in education, that there is a right way of being, rather than accepting that diversity is normal, and that a “normal” distribution has some outliers by definition.

Another key driver is a poor understanding of the sorts of complexity that exist, and the sorts of responses that are appropriate to different sorts of complexity.
I like David Snowden’s Cynefin framework for the management of complexity. It is necessarily an over simplification, and it does convey many of the key aspects involved.
The framework has 4 classes of complexity – simple, complicated, complex and chaotic.
In simple systems the constraints on the system are well defined, and we can develop categories of response that are most appropriate, and deliver “best practice” guidelines to be followed. An appropriate action in such systems is sense, categorise, respond (follow the rules, they work).
In complicated systems, the boundaries are less well defined. Experts in such systems develop knowledge that often they are not even conscious of until the context arises. Diagnosis by doctors are a good example. The constraints we impose on behaviour need to be relaxed, so that there is room for the experts to use their knowledge, so “good practice” guidelines are appropriate. The appropriate behaviour is sense, analyse respond.
In complex systems, the constraints on the system are weak. Complex systems can respond in any way, and some outcomes are more probable than others. These systems are dispositional, more likely to respond in some ways than others. All one can do in such systems is to push them a little and see how they respond. The appropriate sequence of action is probe, sense, respond.
Chaotic systems come in two major flavours, deterministic and non-deterministic, but the outcomes are identical in the sense that they defy prediction. There is no logical predictable pattern to chaos, however much our brains want to convince us that there is actually a pattern there. All one can do when in the grips of a chaotic system is act, sense, respond. Try and get out to some-place more predictable and safe. The actions of the system and the people within it are often novel.

Unfortunately for us, reality (including people) has a vast spectrum of examples of all types of systems, and all combinations of systems in various contexts.
There is no “one size fits all” response, even in the best of theories.

Then there is the whole class of influence of our market based monetary system, and our bureaucratic educational system.

Once one reaches doctoral level, it is essentially “publish or perish”. This leads people to search for ever finer distinctions, so that they can lay claim to academic merit and advance through the system.

Overlay on that system the incentives of the drug industry. If one doesn’t want to make a career in academic circles, then one usually has an eye on a high paying private sector role. To land one of those jobs usually requires finding something that can be sold at a profit. There is no incentive in that system to promote cheap cures. The incentive is always to find a new class of drug to treat some newly defined condition, and to find plausible ways of outlawing any cheap alternatives.
Sometimes the conditions really do exist, and treatment is really a reasonable idea in most situations, and often not.
Remaining profitable requires lobbying to get certain conditions listed as being suitable for treatment by certain classes of drugs, and the incentives within that system are definitely not to find or publicise any cheap and readily available cures.
The more classes of disease, the more drug treatments approved, the more profit to be made.
The incentive structure is definitely not one of delivering health.

Looking at a more philosophical context.
The classical notion that there is a “right” way of being, is disproven beyond any shadow of reasonable doubt.

It seems clear in logic that we need to be prepared to accept an exponentially growing diversity on all measurement scales.

It seems clear in logic that we need to value individual life and individual liberty as our prime values (in that order).
And having liberty actually comes with a responsibility to take all reasonable action to preserve the life of self and others, and to take all reasonable steps to avoid undue restriction on the freedom of others. Freedom in this sense is not a freedom from consequence, or a freedom to unreservedly engage in whim or fancy. Responsibility is very much a part of freedom.

Add in the added layer of complexity, that any distinction that is truly new, will be consider wrong by the majority thinking the old way. It usually takes time and repeated exposure to new ideas before they become accepted. It was about 6 years between Einstein publishing his most famous works and any sort of general recognition for what he had done, and that in a very small community of experts. Alfred Wegener died in 1930 still being ridiculed for his 1912 theory of plate tectonics. I actually was a student in 1974 in the first undergraduate course on the planet to teach plate tectonics as a legitimate theory. Sometimes it takes a long time for new ideas to become accepted. I got the reality of that 41 years ago.

So in this understanding, having hard rules is only appropriate to simple situations. In any situation that is complicated, complex or chaotic, individuals require greater degrees of freedom than simply following rules (and I get the legal system doesn’t always see it that way yet, and it is where it needs to evolve to).

What is needed in our future is acceptance of diversity, provided such diversity stays within the confines of respect for life and liberty generally.

About Ted Howard NZ

Seems like I might be a cancer survivor. Thinking about the systemic incentives within the world we find ourselves in, and how we might adjust them to provide an environment that supports everyone (no exceptions) - see www.tedhowardnz.com/money
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