>Labels determine what mental models we use when trying to intercede in a problem. Different labels get very different reactions and treatment modes.
I think he ever-so-briefly touched on a different angle of that problem: "The psychoanalysts don’t like it because it ignores the “unique milieu of individuality.” The more biologically-oriented clinicians don’t like it because it ignores biology. The DSM lacks “validity,” they say. A diagnosis based on a combination of symptoms is, they might argue, like a constellation of stars — sure, you could reliably identify the Big Dipper, but no one would argue that the Big Dipper is a valid interstellar system. It’s just a name."
The problem is that the label matches no defined model; which is why I think that everyone dislikes it.
>I hate labels, but they are a useful communication tool.
Agreed but without the matching underlying models, they're just added toil; especially, if they're only "valid" in niche use-cases (such as clinical settings).
For example, we have a general idea of what Schizophrenia is but when it comes to the classification, diagnosis, and/or treatment, that's when we lose context. Schizophrenia isn't - implicitly - the same classification, diagnosis, and treatments across the board for every patient. So, effectively, you're coupling a large group of individuals under a very generic label, which has no effective model applied to it.
I understand that cancer may have similar characteristics. All cancers are similar in that they are uncontrolled cell division, but the causes, symptoms, treatments, and characteristics of every cancer can be very different.
Exactly. It's often useful to have a label to describe a set of symptoms that you see occurring together over and over again, even if they don't always have the same root cause. The problem is when doctors mistake the existence of a label for understanding.
But we don't have that level of knowledge yet when it comes to schizophrenia. The closest I can get to such an absolute is "all schizophrenia cases are similar in that they manifest as sensory inputs uncorrelated to the outside world", but that isn't really a useful classification -- that description is based on symptoms, not on causes.
I was a homeschooling parent and had a role in a TAG/parenting/education organization to support that role. My feedback on very difficult kids, some of whom had been failed by multiple experts, was pretty popular, enough so that I de facto got "referrals," though I had no real formal credentials and charged no money. Parents would just talk to friends and say "Go talk to her" basically.
In many cases, these were Twice Exceptional kids who had started doing really strange things around the time they were toddlers or preschoolers. The strong negative reactions of adults around them then compounded the problem and made it an intractable issue.
I'm a former military wife and homeschooling parent. People are quick to be dismissive and tell me I don't know anything about x, y or z, etc.
But my experiences suggest to me that a lot of mental health issues are rooted in relatively prosaic cases of "kids do weird and stupid things because they are kids, some kids do very weird and stupid things for various reasons, and parents often don't have effective tools for handling the situation, thereby compounding the problem." My experiences also suggest that a lot of this is fixable, without drugs or therapy, if you can help the family disengage from long-standing patterns of interaction and help the child in question understand where their dysfunctional behaviors came from in a non-blaming manner and give them some better answers and/or just breathing room to change on their own without interference.
I spent about two weeks writing the above piece and it's based on many years of education and experience. It got more than 60k page views and people are republishing it, some with my permission and giving me credit.
I would like to do more of that kind of writing, but it made me zero money. I am routinely told my writing has zero value and I should go get a real job. I'm not good at the self promotion thing etc.
I think I know some useful things that could help parents avoid becoming mired in the kinds of problems this man in the article has. But I have no audience and people who know what I used to do mostly are in my past or simply unwilling to vouch for me, including some prominent people on HN who knew of my work in that area at the time, to some degree or another.
I've largely made my peace with the fact that I can't afford to write for free and lots of people on the internet expect excellent content for free. They don't want ads and they don't want to pay anything for it either. No, they don't want to be a Patreon supporter.
So I content myself as best I can with leaving comments on the internet and generally being percieved as a blowhard and arm chair politician type who has an opinion on everything and zero credibility.
> My experiences also suggest that a lot of this is fixable, without drugs or therapy, if you can help the family disengage from long-standing patterns of interaction and help the child in question understand where their dysfunctional behaviors came from in a non-blaming manner and give them some better answers and/or just breathing room to change on their own without interference.
Helping the family change how they interact with their children is therapy!
But it was often accomplished in one or a few emails, not months or years of intensive effort.
Someone would join the list and complain about the intractable, crazy making behavior of their impossible child. I would write a reply and say something like "That's a common issue with gifted kids. It's due to boredom and is easily solved by keeping them adequately occupied." They would go "Oh. My. God. That makes so much sense! Just before the last incident, he did actually say out loud 'I'm bored.'" and a long-standing, intractable pattern of problem behavior that had stubbornly resisted all prior intervention would largely disappear overnight once the parent made sure to keep their kid adequately occupied.
Or a parent of a particularly hard case would exchange a few emails with me for a week or two and then report back to me months later that all these terrible, intractable issues had magically changed and it had involved almost zero effort on the part of the parent who had spent years sinking enormous time, money and effort into resolving these problems, all to no avail until they spent a little time talking to me.
If it was therapy, it was like an *easy button" version of it, very unlike the roughly 3.5 years of intensive therapy I pursued in my youth to get my personal issues to simmer down to a dull roar before really resolving things around the age of forty when I got divorced and yadda.
I think he ever-so-briefly touched on a different angle of that problem: "The psychoanalysts don’t like it because it ignores the “unique milieu of individuality.” The more biologically-oriented clinicians don’t like it because it ignores biology. The DSM lacks “validity,” they say. A diagnosis based on a combination of symptoms is, they might argue, like a constellation of stars — sure, you could reliably identify the Big Dipper, but no one would argue that the Big Dipper is a valid interstellar system. It’s just a name."
The problem is that the label matches no defined model; which is why I think that everyone dislikes it.
>I hate labels, but they are a useful communication tool.
Agreed but without the matching underlying models, they're just added toil; especially, if they're only "valid" in niche use-cases (such as clinical settings).
For example, we have a general idea of what Schizophrenia is but when it comes to the classification, diagnosis, and/or treatment, that's when we lose context. Schizophrenia isn't - implicitly - the same classification, diagnosis, and treatments across the board for every patient. So, effectively, you're coupling a large group of individuals under a very generic label, which has no effective model applied to it.