Actually I do not a priori exclude other approaches. But before considering them I would like to hear why they should be superior to science. So far I haven't seen any convincing arguments why they should be prefered for mental illness in general, depersonalization disorder in particular or much of anything else, especially since science apparently outperformed them all. The step from the middle ages to our modern life was achieved by science. Of course this sets the bar for alternative approaches very high.
I apologize that this response isn’t going to be as well structured as yours was. I haven’t figured out how to do the whole multi-quote thing. And I might also just be too lazy.
I’m not sure what you mean by “high level functions,” or that I was referring to those when talking about negative symptoms. My example with the saxophone player was a bit tongue-and-cheek that was trying to accentuate the point I was trying to make.
You say that hallucinations and delusions are difficult to define. Well, they might be if we insist on interpreting them psychiatrically. But is there any other way to understand them?
What is a delusion? Well, Richard Dawkins wrote one book about a delusion. Of course, a lot of religious people might have a word about Dawkins’ idea of what truly is a delusion; many of them probably think Dawkins is the deluded one. Which is an important thing to remember when we use the term “delusion;” what counts as a delusion depends on whatever the speaker considers to be true, not necessarily what is actually true.
a delusion is not just any old false belief, but a stubbornly held false belief that the person is not interested in correcting, usually because it is valuable or meaningful to the person. Schizophrenic delusions differ from the delusions that everyone has in that they are idiosyncratic and often have a more subjectively bizarre or disturbing quality to them. I don’t see any reason why we should be positing a materialist explanation for a false belief. Why might a person develop such a crazy idea? Well, why are there conspiracy theories? Why are there flat earth believers in the modern world? Why does this forum contain thousands of “theories” as to the cause of DPDR? We are all seeking answers, trying to find meaning, and often construct alternative realities to resolve an internal conflict or to boost a damaged ego.
And what about hallucinations? By far the most common type of hallucination is the auditory hallucination: “hearing voices.” But do you think that language accurately describes what is actually happening? Do some people “hear voices?”
When we first developed some of our modern neuroimaging technology, psych researchers used that technology to see what was happening in the brains of people who “heard voices.” But they were shocked to discover that the part of the brain that was highly active was not Wernicke’s Area (associated with hearing) but Broca’s Area (associated with speaking). “Broca’s Area was a surprise” they said. Except, it should not have been a surprise, and it would not have been a surprise if they had not been deceived by their own misleading language. Because if Wernicke’s Area had significant activity, that would have been a monumental discovery; it would have strongly suggested that the psychotic was actually hearing something! But if course, he is not hearing anything, he is talking to himself (which was essentially Socrates’ definition of “thinking”). What do you think is the best explanation for Norman Bates’ behavior in the movie “Psycho?” Did he suffer from a brain abnormality that we have not yet discovered despite billions and billions of dollars of highly-motivated research (but nevertheless, definitely exists!) that was causing him to hear voices—voices that contained semantic content that was meaningful to Mr. Bates—telling him that the women he was seeing were skanky sluts? Or do you think that he was experiencing a conflict between his own romantic and sexual feelings for these women and some of the ideas that he had learned about what women are like, and disowned one of those voices of us self-conversation, “hearing” one of them in the voice of his dead mother, a figure to whom he had attributed a great deal of authority? (Yes, I know it’s fiction, lol, but I just wanted to give a well-known example).
Hallucinations are a form of self-conversation by a person who is particularly focused on his own internal experiences. Some psychotically depressed persons “hear” the voices of their dead loved ones to keep them company, a form of remembering. Other people disown their own thinking when they find it’s contents to be particularly disturbing. People generally don’t need encouragement to evade responsibility. Of course, psychiatrists make it easy when they insist on interpreting some experiences as “hearing voices” too. These interpretations receive further confirmation from the more common observations that these “voices” are reduced in intensity or go away entirely when the person is engaged in oral activity, such as eating or speaking.
Why do some people experience their own thinking with such extreme intensity? Brain damage could be a partial explanation for some, but that doesn’t necessarily have to be the case. The intensity (“loudness”) of our internal monologue depends greatly on the direction of our attention. When I’m having fun with friends, my thinking is quieter, when I’m trying to solve a challenging math problem, my thinking becomes quite a bit louder, and sometimes it gets to the point where I feel I might be going insane, so I take a break and focus on more worldly things, and return to the problem with a “refreshed” mind. That often worked for me when I was in school
You ask me why some alternative approach should be superior for mental illness in general? Let me ask you: is there a difference between a wink and a blink? And if so, what is that difference? Ancient/medieval man might have acknowledged that the difference is that different agents are responsible: I am responsible for winking, and spirits/demons/God, etc, is responsible for the blink. Modern scientific man would conclude that the difference is in the precise muscles and regions of the brain responsible for each event. I believe that the difference is more fundamental: the blink requires a materialist-mechanistic explanation, and the wink requires a semantic-teleological one. A wink is a performance that is meaningful; it contains semantic content. And so, in my view, is the difference between physical and mental illnesses. Our science has done remarkable things when it comes to the understanding, diagnosis, and treatment of organic (physical) illnesses. How well have our positive mental sciences been working for us though? How many mental diseases have we cured? Can we reliably treat any of them with our medicines? Can we actually use this knowledge to explain how and why these meds work or don’t work? Genetic/neuroscientific research might have yielded some statistically significant results here and there, but nothing pathognomonic, and they struggle to actually link those correlations (let alone make any causal determinations) to these mental problems. But the model of mind that I am proposing can explain addiction, eating disorders, depression/anxiety/PTSD, ADHD…it can even explain psychosis, as I tried to do earlier in this post.
Why should we adopt a non-scientific approach to mental illness? Because it explains more and it works better, in my view. These issues are not unitary phenomena, they don’t occur in people the same way like many physical illnesses do. I keep hearing about there being many types of depression, and that more types keep being identified. I agree. There are as many types of depression as there are depressed persons in the world. Grouping them all together and trying to discover the source of their problem in the body is rather absurd in my view.
So where does that leave us with DPDR? Is this experience more like a wink or a blink? That’s the question I’ve been asking and trying to answer for the last two decades, and I still don’t know, though I suspect it’s probably a lot of both.
