Thursday, March 25, 2010

GUEST BLOG: Why the Happy are Nuts*

Today's blog post is from guest contributor, and sometime commenter, Thomas Rivers.

Sophist_Monster concludes:
The historian thus argues that these are not simply questions of science but are also and always moral questions as well. I would sum this up by arguing that the question is not simply/only "Is homosexuality a mental illness?" The questions is/should be "What are the consequences of asking whether homosexuality is or is not a mental illness?" "Should we ask such a question at all?" That is (what) the debate (should be) about because the rest, the science, is entelechy, so to speak. We should not use, in the words of the interviewed historian, "the rod of science to beat back those we don't agree with." Because it is about agreement, an admission few seem willing to make, we have to be able to confront sources of disagreement and do so "honestly." Science alone cannot claim to settle questions of the good life because science itself already takes place in context made possible by previous decisions, previous values. If we stop at the "scientific" we miss the complexity of any and all other debates.

Spare the rod: save the argument.
To this focus and conclusion I would add in support the following (liberally borrowed from “A Proposal to Classify Happiness as a Psychiatric Disorder,” by Richard P. Bentall, in the June 1992 issue of the Journal of Medical Ethics, published in London. Bentall then was a senior lecturer in clinical psychology at Liverpool University):

Bentall first claims that, though counter-intuitive, happiness should be classified as a disease and so included in diagnostic manuals. Using the language of diagnosis he notes the behavioral components of this “disease” including joy, smiling, and being carefree. What is noteworthy in diagnosing for the disease of happiness is that one of the most reliable ways to diagnose is to ask the “patient,” just as one does in diagnosing a person who is depressed—a good indicator or at least one in current use is the patient says they are “happy” or “sad.” It would be hard to diagnose someone as sad or depressed if they self-reported that they were not.

As expected Bentall’s proposal goes through the usual criteria including epidemiological studies (rich score higher on being happy then the poor,) and genetic studies. Philosophers distinguish between behavior that might be worthy of psychiatric attention and behavior that is not by determining whether the behavior is rational. “There is consistent evidence that happy people overestimate their control over environmental event.” In sum, Bentall notes, “that happiness meets all reasonable criteria for a psychiatric disorder. It is statistically abnormal and consists of a discrete cluster of symptoms; there is at least some evidence that it reflects abnormal functioning of the central nervous system; and it is associated with various cognitive abnormalities—in particular a lack of contact with reality.” Bentall then recommends inclusion in the DSM the name “Major Affective Disorder, Pleasant Type.”

Where it gets interesting apropos of sophist_monster posting is when Bentall notes the objections to this. One of them of course would be that happiness doesn’t normally come under “therapeutic concern”—but this objection would then rest on the fact that the naming of diseases (which is to do something) are culturally and historically relative phenomena. “On this account, sickle-cell anemia, anorexia nervosa, and psychopathy were not diseases before their discovery.”

The second objection is that happiness is not normally negatively valued; but implicit in this objection is that value judgments (persuasion) “should determine our approach to psychiatric classification.” In sum Bentall is making the claim of rhetoric and the strong defense—that subjective values are the basis of such scientific systems of classification.

*The title of the post comes directly from a Harper's Magazine story on the Bentall article.

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