Note that Rosenhan was a social psychologist. The list of faulty or outright fraudulent experiments done by psychologists grows ever longer. The entire field seems bankrupt to me. Part of the problem are perverse incentives. Get one positive and interesting result (which you can tailor to the zeitgeist for maximum impact) and you can live off books, TED talks and lectures for your whole life. Recent examples include power posing and confidence [1] (poor experiment) or changing political bias regarding gay rights [2] (outright fraud).
If psychology wants the status and rewards of being considered a legitimate science, it needs to make dramatic changes. In the meantime any initial result psychological research produces must be considered not just preliminary, but suspect.
I can't seem to figure out the incentives behind [2], the idea that during door-to-door canvassing only gay people can be effective at changing non-gay people's minds about same-sex marriage seems like an odd narrative for someone to want to push.
Other than encouraging employment of gay individuals by political campaigns/canvassers or maybe a general superiority complex, by stating that only gay people are capable of changing people's minds on the subject.
I have noticed a general pattern on Twitter, from people who push this sort of social science stuff, that they believe only people who are in the in-group (ie, race, gender, class, etc) are allowed to have opinions or engage in research about the group itself. Which always seemed anti-intellectual and borderline dangerous, as it actively discourages the wider population not only from doing useful research but also helping overcome ignorance in their day-to-day conversations, writing books, political projects, etc and generally engaging in issues.
It just makes everyone even more scared, careful, and closed off to the subject(s). Which is the opposite incentive structure for 'producing a cascade of opinion change' (as the study claims).
This just seems to be a punitive approach to change/progress, where oppressed groups, or people representing the groups, are just in it to collect an endless amount of things to shame other people for "not getting it", which ties back into the superiority thing. Assuming the actual goal is ending oppression, this is taking a totally backwards approach by providing ever more ways to minimize and degrade the opinions and personhood of other groups. And when this (self-)destructive strategy is challenged it's met with a bunch of hand-wavy stuff about privilege to justify everything.
Meanwhile the average person on the outside is just trying to live there life and aren't heavily invested. This punitive approach, particularly via social media, would seem to me to make them more likely to just avoid, ignore, or even resent such talk of change.
If you are talking about the seeming 'wokeness' of this research well yes, that is probably a fair comment. But that would be fine if they actually did a proper experiment. I don't think it is a coincidence that particularly woke research may be of poor quality. I agree with you that a strong idealogical bias is a hazard to generating truth. This is most pertinent in preventing certain types of research from being performed or results from being released. This is mostly a problem for psychology and sociology, which among their other merits have limited impact on actual life.
> I can't seem to figure out the incentives behind [2]
If I recall from discussion at the time, the reason the false finding was so welcome (and therefore so rewarding to the con man who wrote it up) was that it purported to show that making a large change to public opinion was cheap and easy to do.
The list of faulty of outright fraudulent experiments done in any number of fields, especially the biomedical sciences, also grows ever longer, but it it seems this argument is hardly ever leveled here. It's well-established now that these problems exist in other fields, such as immunology, oncology, and other fields. Even closely related fields, such as the neurosciences, have been shown to be full of improbable and unreplicable findings, and many neuroimaging results are not interpretable in the way that claims are made of them.
Theranos anyone?
Every field should be looked at with caution until the perverse incentives that currently exist in academics are addressed.
What I see instead is a bias in certain physical sciences to think that somehow experiential phenomena are less rigorous because they don't fit the mold of those sciences as much. The systems are more complex and different metaphysically, so their legitimacy is questioned. This is somehow still happening even as developments in fields like quantum physics and AI are leading many very competent scholars to question basic assumptions about the nature of experience and consciousness vis-a-vis physically observable phenomena.
The irony of the Rosenhan study is that Rosenhan was putting forth exactly the same arguments as you, that psychiatry lacks rigor because it's too subject to the whims of subjectivity. So when this paper is shown to have been a fraud (even though it was dismissed in the field for many other reasons, but overall because it was unscientific) it is evidence that psychology is unrigorous? When it is not widely known to be a fraud per se, it is cited as evidence that psychology is unrigorous as well? It seems there's no way to win: the critics of the field cite this work as evidence of lack of rigor, and then when it's shown to be fraudulent, it's also shown as lack of rigor.
The even greater irony is that many of these fraudulent studies are being identified by... you guessed it, psychologists. I would go so far as to say no field has done more for the scientific study of science than psychology. Meta-analysis has its birthplace in psychology, and all these discussions of replicability ultimately flow from psychology as a field. If anything, psychology is among the only ones to be open about these issues and to take them seriously. In many other fields, they're swept under the rug, and questioners are attacked with arrogant hostility and accusations of incompetence.
The issue is that other sciences are not held back by these problems. We still have bridges, semiconductors, space flight and new cancer treatments. This is partly because it is much easier to measure and verify experimental phenomena (you call this a bias, but it is merely a fact?), but also because being correct matters. However many crappy experiments are done or results fabricated, at the end of the day you still have to put your rocket on the launch pad and fire the engines. The reproducibility issues in these sciences is a matter of efficiency.
Psychology is different in the sense that it doesn't seem to matter to the field very much whether they are correct. I say this because they keep doing experiments which lack a robust design, and then proceed to use complex statistical models to infer many unsupported claims which never seem to replicate. Then they meta-analyse these results to conclude that if there is an effect it is small or only applies to certain people. The 'power pose' study I linked is a case in point. All this is done in a very rigorous way by rigorous people using advanced equipment and statistics, who spend much time spinning careful narratives about their work in long Discussion sections. But you don't get a medal for trying in science.
It is hardly a compliment to psychology that they gave birth to the meta-analysis [1]. Note that getting some result in an experiment, then having the result overturned in a meta-analysis is the functional equivalent of not having done the experiment at all. In fact, it is inferior to doing nothing, because you have just wasted everyone's time.
> The list of faulty or outright fraudulent experiments done by psychologists grows ever longer.
So what social-psychological experiments are bogus?
The most famous problem experiment I can think of is Zimbardo's fake prison, and IIRC the primary objection was that the effect was too strong. He let it go on too long and everyone was disgusted.
Rosenhan's experiment is bogus, yes, but I have to wonder... psychiatrists were condoning lobotomies just 15 years earlier. Is it likely that an entire discipline could turn itself around in that time? (Which doesn't excuse Rosenhan, of course)
I am 100% open to your thesis but would like more data.
The problem with the Stanford Prison Experiment was that the guards were secretly coached by the researchers to get the effect their hypothesis predicted, not that "the effect was too strong": https://www.vox.com/2018/6/13/17449118/stanford-prison-exper...
The results of the Milgram experiments were selectively publicized to sound more provocative. The context of the experiment was the trial of the nazi Adolf Eichmann, who plead during his trial that he was merely "following orders." (There is a myriad of evidence that he was in fact an enthusiastic ideologically motivated nazi who believed in what he was doing.)
The idea that a 'normal person' might become a nazi if ordered by an authority figure was provocative, since it suggested the potential to be a nazi existed in many if not all of us. The disturbing and provocative result of Milgram's experiment seemed to suggest that 'regular people' could indeed become nazis if given orders from an authority figure.
The deceit occurred when the results to publish were cherrypicked from a larger set of experiments performed by Milgram and his team, in which various variables were tweaked. The people from New Haven (home to Yale University) were most likely to comply when given orders from a man dressed like a scientist and were less likely to comply when the orders were given by people in other sorts of costumes. Why? Because people in New Haven had pride in their community, in the university located in their community, and had a belief in the necessity of science. They complied when they were told that compliance would further scientific progress, which they considered to be virtuous. These people were in fact motivated by ideology, just as Adolf Eichmann was. Just as Adolf Eichmann believed in the necessity of the nazi ideology, these people believed in the necessity of scientific progress.
So what did the experiments actually show? It showed that many people are willing to commit atrocities if they believe the ends justify the means. That's not really a provocative result.
I think that early social psychology had a problem with misusing statistics(not necessarily with fraudulent intention) , but I do not believe this extends to psychology, psychiatry, cognitive sciences more generally.
While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted or encouraged by the experiment is suggested, but there's no argument for it. Even beyond that, the article doesn't even hint at an argument that the DSM-IV set back psychiatry (except offering the bare assertion that reductionism is false).
Of course, the DSM is very controversial, and many people could fill in the argument, but this article doesn't do it.
Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period. Only to be told that the experimenters had sent none.
Or at least that's the version told in Adam Curtis' documentary The Trap (part 1)[1] which engages in Curtis's usual enthusiasm for fashioning a sweeping historical narrative out of somewhat sparse materials - in this case presenting the "Thud" experiment and its followup as a pivot point in the tale of how R. D. Laing's anti-psychiatry ironically led to the advent of the DSM IV era.
However that may be, if Curtis' account of the followup is correct it seems harder to argue the diagnostic prowess of the psychiatrists was not open to question, regardless of the status of the original experiment.
>article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period
'a hospital' - which hospital?
Makes sense to carefully re-examine the other claims of the paper.
> Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period.
The reason is simple. This article is pure propaganda along the lines of the book "The great pretender" by Susannah Cahalan.
The experiment might have flaws, but this second part is conclusive and no critics ever address it.
This is just another brick on the long propaganda road to a destination that is very worrisome.
My default position on the follow-up is likewise skepticism. It seems like the filters at the time were so low that it is likely the follow-up is just a better constructed lie.
This is standard fare for the source. The Spectator generally pick one of the authors' bugbears (usually Muslims, The Left, or Political Correctness Gone Mad), write a beautifully written and entertaining piece, all the time aggressively mixing and conflating fact and fiction with a slightly sneering tone. For example: https://outline.com/nMzA8N
Did it set back psychiatric practice? Maybe not. But did the Rosenhan experiment set back the public perception of psychiatry? How could it not? If you remember that suicide hotlines are life-saving interventions, and that a lot of don't call them because they think they're staffed by "head-shrinkers"...
At the very least, Rosenhan convinced a lot of people that the Church of Scientology might be right about something.
Correct me if I'm wrong, but this is a review of a book that purports to make the case you're stating is not made here. That seems like a high bar for a review to me. Unless, do you mean you've read the book and the book fails to substantiate this claim?
Obviously a review can't give the argument in its full detail, but that doesn't mean this presentation is good.
Did the DSM-IV result in inaccurate diagnoses? Worse treatment? The review doesn't clearly state a single negative consequence. For that matter, reading the review, I can't even be sure if the book argues that the DSM-IV was bad, or if that's merely the review authors' opinion. I expect that kind of clarity from a review, and it's missing here.
Or again, on the point about the DSM-IV being a response to Rosenthal, what I'd like to read is something along the lines of "Cahalan's book presents detailed evidence that the DSM-IV was [influenced/prompted by/etc] the reaction to Rosenthal's experiment".
In defense of the reviewer: the worst issue might be a case where the title simply promises more than the article delivers. And the reviewer typically doesn't write their title, so it may be the editor who is to blame.
It no doubt aided the movement to deinstitutionalize patients with mental illness. Between 1955 and 1994, most state hospitals for the mentally ill were closed. This was done with the best of intentions, but the implementation led to the current mess where many severely mentally ill people are without adequate treatment and are homeless or imprisoned.
There's a great graph[1] showing per capita US institutionalization rates from 1934-2000, differentiating between prison, mental institutions and the combined total. The aggregate rate of US institutionalization is about the same as it was in 1954ish, the holding pen has just changed.
The graph is from a blog post on Volokh Conspiracy[2] about a paper from American Criminal Law Review [3] entitled "Is Mass Incarceration Inevitable"
Yeah, I wish the article was more clear on why Rosenhan's article was important and what exactly is claimed in The Great Pretender.
Re-reading the article, It seems to suggest that it undermined public trust in forced psychiatric treatment. I can only guess that the author believes this was for the worse and is the titular setback?
If you mean Freudian psychoanalysis, you're right. Freud was a quack. The word "pseudoscience" was literally coined just to describe him.
If you mean all psychotherapy is bullshit, you're wrong. There are bad therapists just like with everything else, but good psychotherapists have saved a lot of lives over the years.
And if, on the off chance, you think all therapy is bullshit despite never having had therapy yourself... well, nobody is that stupid, right?
Within the humanities there will probably always be a lot of people who love Freud because he lets them say subversive things about society.
But in the sciences he’s been debunked. Any Psych 101 book will tell you his methods are no longer used. Their most direct descendant, psychodynamics, is very different from its ancestor.
Within the sciences, check out Karl Popper’s work on falsifiability. Freud is his example of pseudoscience: it sounds smart, and it can explain lots of things in retrospect, but if you write down it’s predictions in advance they often don’t match outcomes. Practitioners don’t acknowledge this or try to correct it.
These experts never explained why homosexuality was considered a mental illness and later that decision was reverted.
Neither of those changes was ever justified.
It's almost like those decisions are made with no objective criteria.
For those missing context, "Gender Identity Disorder" in the DSM-IV, which described transgender identity itself as a mental illness, was replaced with "Gender Dysphoria" in the DSM-V, which was scoped specifically to the depression/pain of feeling socially in the wrong gender role, as well as the feeling of one's body being wrong.
The DSM does cite academic sources IIRC, but they're listed as a while for the book, rather than being referenced by specific sections or criteria, which is a common critique of the DSM in general. Additionally, Ray Blanchard, an academic who believes transgenderism is caused by "autogynephilia"/"autoandrophilia" (i.e. a sexual fetish caused by attraction to oneself as the desired gender), was a member of the committee who decided the DSM-V definition.
So no, OP, academics who didn't support trans politics weren't scared off by the community.. Ray Blanchard played a big role. As for the "minimum of real science," there's a lot of sociological and psychological work that goes into the DSM. Some of the pressure was certainly political/social, like the removal of homosexuality was decades ago, but there are sources listed in the back of the book, even if it takes some digging.
Disclaimer: am trans, am really done with justifying my existence but I felt I should share what I know.
> Additionally, Ray Blanchard, an academic who believes transgenderism is caused by "autogynephilia"/"autoandrophilia" (i.e. a sexual fetish caused by attraction to oneself as the desired gender), was a member of the committee who decided the DSM-V definition.
[EDIT: do the people downvoting this care to explain why they disagree with it? Just because one person was involved is not evidence other people weren't scared off because of harassment. Nor is it evidence that there was no harassment. If you disagree, why?]
His role and behavior is independent of whether there was harassment of academics from people. He may have had that role and either one of these three options could possibly have happened: 1) no harassment of academics from people 2) some harassment 3) a lot of harassment.
To claim that Blanchard’s involvement is evidence that there was no harassment, you’d have to demonstrate that somehow that involvement is incompatible with 2) or 3).
> not evidence other people weren't scared off because of harassment
If that abomination of a researcher wasn't scared off, it's pretty strong evidence that there wasn't any significant harassment that had a chilling effect on discussion. (You can apply all the "autogynephilia" testing and logic to most cis women and they'll come out with a strong diagnosis. Whatever you think about the nature of transgenderism, applying that particular theory leads to nothing but pain and abuse.)
> If that abomination of a researcher wasn't scared off, it's pretty strong evidence that there wasn't any significant harassment that had a chilling effect on discussion.
Just because one person wasn't scared off doesn't mean they didn't get a lot of harassment. I don't know whether they did or didn't, but the fact that they weren't scared off is not evidence they didn't get lots of harassment.
And that doesn't mean other people weren't scared off. Different people have different tolerances for harassment, and differing degrees to which they want to be involved in a particular matter.
> You can apply all the "autogynephilia" testing and logic to most cis women and they'll come out with a strong diagnosis. Whatever you think about the nature of transgenderism, applying that particular theory leads to nothing but pain and abuse.
This has absolutely nothing to do with the content of any of my comments.
"academics [...] weren't scared off" isn't a claim that not a single person was scared off, but that as a group they were not scared off. If one of the worst members wasn't scared off, that's a good piece of evidence.
> This has absolutely nothing to do with the content of any of my comments.
I'm explaining why he's one of the most extreme members of that group, which is needed to support my main point.
"If one of the worst members wasn't scared off, that's a good piece of evidence." Yes, I think that him being one of the worst has zero bearing. You made the claim - why do you think it's good evidence?
> You can apply all the "autogynephilia" testing and logic to most cis women and they'll come out with a strong diagnosis.
That is not true. Trans women score much higher on tests of autogynephilia.[1] This is even found to be true in amateur surveys.[2] Trans females score the highest, then cis males, then cis females. Trans males have the lowest scores for autogynephilia.
> The results showed that, overall, transsexuals tended to place more importance on partner’s physical attractiveness and reported higher scores on Blanchard’s Core Autogynephilia Scale than biological females.
This study isn't super helpful because it doesn't give a number for cis men to compare to. But being able to statistically distinguish between 41 and 35, standard deviation 10, or between 3.08 and 2.93, standard deviation 1.4, doesn't exactly give a ton of evidence to the idea that your test groups have fundamentally different underlying reasons for feeling female.
And I wouldn't be surprised if the huge difference on "Attraction to Transgender Fiction" or "Interest in Uncommitted Sex" are begging the question. If you filter biological women on the same criteria you'd probably have similar answer patterns there.
Also the "autogynephilic transsexual" group is the one closer to the "biological female" group on a bunch of these metrics.
It really seems like you're asking, "Must I believe this?" instead of "What is true?" You picked a couple of questions on the survey to try to dismiss the study. Someone believing the opposite of you could have picked "attraction to male physique" (where trans women score lower) combined with "attraction to feminine males" (where they score higher) to bolster the autogynephilia theory. There's also the complication that trans women seem to be closer to men in other psychological measures (less masochism, less jealousy, preference for younger partners).
Pretty much all studies are complex enough that one can poke a couple holes in them this way. If that's enough to dismiss a study, then it's hard for us to believe anything in soft sciences.
And yes, the first study only looked at trans and cis women. But did you look at the amateur survey? It also surveyed trans and cis men. It reproduced the results of the academic study despite the creator of the amateur survey having no knowledge of it. That's some pretty convincing evidence in my book.
Also, do you have any studies that show that the majority of cis women would be considered autogynephilic? Because the only study I've found that asserts this is Autogynephilia in Women[1], which counted women as autogynephilic if they answered anything other than "never" to 9 questions about potentially arousing experiences. If someone answered "on occasion" to any question in that list, they were considered autogynephilic. When one of the questions is, "I have been erotically aroused by imagining that others find me particularly sexy, attractive, or irresistible.", it's easy to see what the authors of the study were trying to do. Nobody who is testing for autogynephilia uses such a low threshold.
Let me put it this way: Being able to distinguish groups is not enough. The core of the theory is that these people have a fundamentally different underlying reason for feeling female.
I'll keep this study in mind, but without more context it doesn't seem to show a difference like that on 90% of the parameters. With more numbers maybe it would... but I don't have them.
I picked those questions because they showed some of the strongest statistical results. But they also have a very obvious alternate explanation that needs to be tested.
Especially because:
"Transsexual participants were categorized as autogynephilic
or non-autogynephilic based on their scores on the Core
Autogynephilia, Autogynephilic Interpersonal Fantasy,
Attraction to Feminine Males, and Attraction to Transgender
Fiction scales."
This desperately needs a comparison where they apply the same technique to the biological female data.
(Though that the last one is really tricky, because maybe a better analogy is "waking up as a woman, as usual, hooray" fiction and that's far too bland and common to be a genre.)
> It reproduced the results of the academic study despite the creator of the amateur survey having no knowledge of it. That's some pretty convincing evidence in my book.
Convincing of some overall trends. But the theory is much more than that.
> Also, do you have any studies that show that the majority of cis women would be considered autogynephilic?
No, I haven't spent that much time on this subject before to the point of digging up studies.
> No, I haven't spent that much time on this subject before to the point of digging up studies.
What? But you said this earlier:
> You can apply all the "autogynephilia" testing and logic to most cis women and they'll come out with a strong diagnosis.
Why did you state that as fact when you had no clue what the academic consensus was? If you’re going to make such assertions, you need to base them on evidence.
God forbid I use wikipedia once in my life. Is that the only part you want to reply to, not the substantive parts?
Let's just use the main study you linked to. It shows biological females scoring 5.07 out of 9 on "core autogynephilia", with a standard deviation of 3.5.
> The claim wasn't that there was or wasn't harassment, but that harassment was the cause of the change in policy.
hsyqiwgx wrote "The trans community lobbied and bothered academics ... until the academics threw up their hands and decided their funding wasn't good enough to justify having a spine".
sterlind replied "So no, OP, academics who didn't support trans politics weren't scared off by the community."
The claim that both of these people were talking about, concerned academics being harassed and as a result being scared off.
And just because that one person was involved, doesn't mean that other people weren't scared off.
I'll just note you're only asking one side of this argument for any validation of their claims. And that side has provided more validation than the other.
What I did was not simply asking a person to back up a claim they made. If that was the case you could call me out for inconsistency.
I was responding to a person who had claimed to have provided some evidence that they had not actually given.
I responded to a sentence that was presenting a claim, and also implying that the evidence for their claim was given earlier in their comment, which I did not believe was the case.
That sentence was: "So no, OP, academics who didn't support trans politics weren't scared off by the community".
That 'So no' implies that the evidence for the claim has been given earlier in their comment. I did not see any evidence in their comment, so I asked if they could provide some.
Then they did, and you've called that evidence unconvincing. But it is still evidence. More than the zero you've gotten (or requested) from the original claim.
No, I did not see any evidence there at all, and I wrote my comment on the basis of that.
Having seen the subsequent replies, I can now see how other people have taken it as a form of evidence.
While I can now see why other people might consider it evidence for the claim, I do not consider it to be such myself (in the sense of 'evidence' being something that supports a claim).
Ah, so you’d also agree homosexuality is a mental illness that “political groups” lobbied to change? Because, from the perspective of someone who isn’t a conspiracy theorist or bigot, it looks like the DSM updated their definition as more research and academic interest rendered the old definition outdated.
There's an actual, interesting question here, away from the Culture War fighting, which we can have if we want it: How much of any academic field is due to the culture that field is immersed in, and how much is due to empirical evidence and people attempting to be unbiased?
For example, there's the existence of Jesus Christ: Modern historians agree that there was a man named Joshua-son-of-Joseph who was a heretical rabbi in the First Century Middle East who got crucified by the local authorities. Why? Is it because the evidence for him is just that good, or is it because most scholars in Christian countries were Christian and, therefore, unapt to question their surrounding culture?
With Jesus, it's because of the evidence, as it happens, but the question is there, and hooting it down does a disservice to larger questions all fields have to confront as they mature.
As society changes, what it means to be maladapted to that society also changes.
It's amazing how many people will agree with that statement (because... duh) and then freak out when someone points out it's impossible to talk about the DSM without talking about dominant beliefs regarding "what society should be like". I.e., without talking about politics and labor economics.
There are many topics covered by the DSM that are maladaptations to this society but a) would not have been maladaptations in previous soecieties, and b) might not be maladaptations in future societies.
Is it even possible to talk about something like whether some particular aspect of human sexuality is a disorder using only "real science", and on a related note, what does "real science" mean here? E.g., there have certainly existed human societies with no strong taboo around human nakedness, and in those societies Exhibitionistic Disorder wouldn't even make any sense to talk about.
Similarly, it'd hard to imagine ADD being anything other than a perfectly normal non-maladaptive variation in personality prior to industrialization.
As a practicing scientist, I'm honestly not sure how "real science" is supposed to given an answer a question like 'is being transexual maladaptive?" It's just not a scientific question. There are lots of related scientific questions about human biology. But ultimately, it's a question about how those biological facts interact with social constructions.
Can you tell me, concretely, what you mean by "real science" here?
Not the OP, but I think you’ve actually made exactly the point quite well yourself.
The field of study is not supposed to be “do we like this sort of people and get along well with them” or “are they well adapted behaviorally to be productive members of society” but rather an actual set of illnesses which can be diagnosed, treated, and conceivably cured. We do in fact prescribe powerful pharmacological agents based on these criteria, after all.
And yet, as the Director of the NIMH rightly laments, "DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure."
It is in essence a type of culture war hiding behind a so-called diagnostic manual. In that sense it is more aptly described as a dictionary, whose lexicon is revised more based on their perceived common usage more than hard scientific study.
> It is in essence a type of culture war hiding behind a so-called diagnostic manual
Right, OP was complaining that DSM changed because of politics, and my point was... "yeah, no shit, politics is inseparable from what the DSM is trying to do".
OP can't point to "real science" justifying either the original definition or the changed definition, because both are inherently outside the domain of science.
Framing the DSM-5's redefinition of gender identity disorder to gender dysphoria as academics "not having a spine" and not "real science" is a disgustingly transphobic opinion, whether you intend it to be or not.
This isn't an empirical science. We shouldn't keep shitty and harmful labels on people who are deeply struggling with their identity.
I think it would be more productive to show how the author is incorrect instead of declaring his statement "a disgustingly transphobic opinion".
The DSM has always been political, though lately it's gotten worse. For the DSM-5, task force members were required to sign NDAs[1] Trans activists also tried (unsuccessfully) to get Dr. Kenneth Zucker & Dr. Ray Blanchard kicked off the task force.[2]
Due to the NDAs, we'll probably never know the full extent to which political pressure shaped the DSM-5.
> "We shouldn't keep shitty and harmful labels on people who are deeply struggling with their identity."
But the same argument could equally be applied to a group with a dysphoria that everybody loves to mock: furries. How would you make your statement work for a specific dysphoria and not every other dysphorias?
(Maybe it should work for every dysphoria? I'd be okay with that since it's a logically consistent viewpoint at least.)
But doesn’t there exist a plausible biological pathway for transsexuals to develop a brain structure similar to the opposite sex whereas no similar plausible biological basis can be proposed for having developed the brain of a fictional anthropomorphic animal?
I'm not sure how that's relevant. Setting aside that being plausible doesn't mean it's true, would you be less supportive of gender dysphoria if there were no plausible biological explanation for it? Alternatively, if there were a plausible biological pathway for people having species dysphoria, would you be more supportive of furries?
Isn't "brain structure [characteristic of a] sex" basically pseudoscience? We're rocking different hormone mixtures and maybe slightly different average skull sizes, but I'm under the impression that the later at least doesn't manifest in any measurable innate cognitive differences between males and females. That stuff went out the window with phrenology I think.
If you look at MRIs of human brains, you can determine the sex with pretty high accuracy. Researchers have even trained machine learning algorithms to differentiate with >90% accuracy.[1]
Researchers have tried this on transgender brains and come up with mostly noise. When they do find differences, it appears that the brains of trans-women are unlike cis-women. Ditto for trans-men.[2]
I am very confident that there is a ton of publication bias in any transgender research. If you publish a politically incorrect result, you risk your career.
On one hand, viewed through the lens of cold logic, it's no different from reassignment surgery and therefore their desire to modify their bodies is valid. On the other, it's difficult to honestly say that they would not be severely harming themselves by doing so.
The experiment sounds plausible, whether or not it happened or was done properly. But the claimed response of the hospitals also sounds perfectly reasonable to me. What do people expect?
A virtually infinite number of things can cause symptoms which have some overlap with schizophrenia, and that's why today (I'm not an expert, but I'm assuming what I know of is representative) on intake they classify someone as "schizophreniform" - apparently a fancy way to say "looks like/might be schizophrenia" without committing to anything.
For every person that has a chronic condition, there are going to be many that have one episode and it never recurs. Maybe it was a virus. Maybe they had some weird allergic reaction. Hospitals are never going to know for sure what's wrong with everyone, so the humane thing is not to insist they determine whether the remainder is "real" or not.
Being involuntarily admitted as a psych patient has permanent consequences, and it's uncomfortable to think about someone who doesn't "deserve" the stigma being caught up in it. I think an obsession with this scenario drives the people who crusade against psychiatry. But putting more pressure on medical professionals to always get it right is only liable to make things worse. You can't get better results by applying thumbscrews to people who genuinely try their best to deal with a fundamentally intractable problem.
This did jump out at me:
"then, as now, no scans, no blood tests, no laboratory findings allowed them to distinguish the mad from the sane"
In the 21st century, I believe hospitals in the US typically screen for likely drugs first, when someone appears to have psychotic symptoms. But they also (at least where I know about) do pretty comprehensive blood tests that show clear metabolic abnormalities and then just discard the results when they don't know what it means. So in a sense, sure, there's no blood test for mental symptoms, and yet if positive tests for various things are routinely met with a shrug and typical psychotropic drugs administered, then the statement is misleading.
> But the claimed response of the hospitals also sounds perfectly reasonable to me.
Keep in mind, a major part of his paper was about how the pseudo-patients were admitted after describing extremely limited and mild symptoms. And a major part of the investigation was determining that, at least in one case, this is untrue; Rosenhan claimed to have extremely severe symptoms, including suicidal ideation.
In other words, it now sounds like the hospitals responded reasonably, but Rosenhan's paper claimed something quite different.
It's reasonable for people to find that sleazy and dishonest, it just seems somewhat...academic...to me.
Because what else can be done except to say "ok, there are symptoms, now the symptoms went away, huh." If he was honest, it doesn't reflect that badly on the professionals because there's always going to be cases that fit the pattern.
His distortion seems exactly like every pop-sci article today that is written for outrage-clicks. It seems kind of quaint, even though granted it's an influential paper.
> His distortion seems exactly like every pop-sci article today
The distinction is that pop-sci articles are just journalism. Most academics take pop-sci journalism in their field with a grain of salt at most, and usually a hard eye-roll.
Real scientific journal/conference articles are held to real standards. Exaggerating or misreporting results in a scientific article is basically malpractice. It's by far the worst (scientific) thing that a scientist can do.
Generally these diagnoses require the symptoms to persist for 6 months plus be so severe they disrupt your life.
And they are basically defined by clustering of symptoms. This is driven by welfare/insurance reasons. You need a diagnosis to get benefits.
And while they often can't treat the underlying problem for schizophrenia and other diseases, they can definitely treat the symptoms. So if you have some of the same symptoms by some other unique variant of the disease, the treatment may still by useful.
And while they often can't treat the underlying problem
for schizophrenia and other diseases, they can
definitely treat the symptoms.
Yes. Let's not throw the baby out along with the bath water!
Psychiatry is far, far from perfect. It is a discipline that is still taking its tiniest of baby steps into the realm of actual usefulness.
I think any psychiatrist would be willing to openly admit this; that the mind is still largely a mystery to us and we have probably centuries of learning to do, due to the extreme difficulty of studying a living mind, much less performing repeatable experiments upon them.
And yet criticism of psychiatry so often misses the point! The medicines are sometimes hugely beneficial. Sometimes not. But I know lives that have been transformed for the better thanks to them.
Hm, the experiment took place before 1973 and involved 8 pseudo-patients, all anonymous. This person was able to deanonymize and locate 3 of the pseudo-patients. Because they didn't find all 8 they then claim the study was fraudulent and never involved 8 people. That seems an absurd conclusion. It's not reasonable to think one could find all the anonymous/identity cloaked participants in a nearly 50 year old study.
Given that the researcher was a participant directly, and that he lied about his actions (he in fact presented suicidal thoughts, etc), I believe the balance of evidence says we should reject the study.
I agree completely the study is useless and should be withdrawn. But the author did not prove or even reasonably establish at all that there were 3 and not 8 participants. Not finding 5 out of 8 anonymous participants in a half century old study is to be expected. Even decloaking 3 was remarkable. Look at how hard it is to deanonymize data even now with the computational power, combined with endemic surveillance and monitoring of the public. It's totally unreasonable to conclude the other 5 didn't exist.
Even without the anecdotal information that things were not presented as they were told, the study is still, and always has been, useless. If someone presents at an asylum begging to be admitted, and describing strange symptoms that they say are causing them distress, it is reasonable to admit them for observation.
The problem of false priors, deliberate misdirection, and motivated reasoning are insidious. Having to un-learn false models is difficult and expensive, personally, bit especially socially.
Even if Rosenhan's experiment was a fraud, the notion that psychiatric institutions or the field of psychology does not engage in the practice of arbitrary, thinly-supported, or entirely fictitious diagnosis, or failure to account for changes in condition, at least at times isn't disproved. And ... at least to my lay understanding ... this does seem to manifest elsewhere than in Rosenhan's accounts.
There are two competing sets of motivated reasoning to be considered here, which makes determination of ground truth that much more difficult.
My propositions serve as elucidations in the following way: anyone who understands me eventually recognizes them as nonsensical, when he has used them—as steps—to climb beyond them. (He must, so to speak, throw away the ladder after he has climbed up it.)
He must transcend these propositions, and then he will see the world aright.
-- Tractatus Logico-Philosophicus 6.54
This leads to the challenge over time of finding oneself having climbed the ladder, but in discussions with others, constantly confronted with it, and having to explain around or over it. Wittgenstein's Ladder becomes, when erected horizontally across a passage of understanding rather than vertically to greater heights or across gulfs, Wittgenstein's Barricade.
It's this constant having-to-retread-fundamentals which seems to actively impede further development of knowledge and understanding, and which I've found increasingly intolerable in much popular media and discussion. Worse when it's not even the fundamentals which are being retread, but someone's self-serving current reformulation (often worse than the original). See Schopenhauer's "On Authorship".
> Forced incarceration is pretty rare, and doesn't seem likely to become common or misused in severe ways.
How do you know if it's pretty rare? I'm unaware of anyway for people to collect data on it. I'm doubtful anyone can get justice when it happens, unless insanely rich and or large media following while being wrongly forcibly incarnated.
I'm not aware of many limitations besides some people getting their driver's license taken away. I think most people don't seek treatment because they don't really believe in the psych illnesses. Also the baggage that comes with relying on medication with the short or long term side effects.
> Forced incarceration is pretty rare, and doesn't seem likely to become common or misused in severe ways.
Quite on the contrary. For a recent example of misapplication on the thousands see [1].
The idea that the deliberate misapplication of these "laws" doesn't exist or is minimal in the current year is completely false.
I agree that forced incarceration is pretty rare now, but it was much more common at the time of the Rosenhan study. Electroshock therapy was also in vogue, and psychiatric lobotomy was still practiced in some countries
This is the first time I'm hearing that it was a hoax from the start. I've heard this study referenced more times than I can count in discussions on mental illness and mental hospitals. Could it really be that it was complete horseshit?
Certainly the original paper failed even the most basic norms, and large parts of if were clearly fabricated, and the remaining ones cannot be verified now.
Ultimately he claimed to have eight pseudo-patients, but investigation has turned up three, and none match what was described in the paper. (Eg, Rosenhan said it was easy to be admitted, even after showing limited symptoms, but he was actually only admitted after showing extreme symptoms. He said life while admitted was dreadful, but one of the subjects was dropped because he found it peaceful and helpful.)
Occam's razor suggests that there were only 3-4, he lied about their results, and made up the rest. But maybe there were some others, and maybe some of them actually had experiences similar to the paper? But even so, at best, he lied, filtered data, and reported very mixed results as being anything but. More likely....yes, complete horseshit.
There's no real defence of his work possible; at this point it's just speculating over whether it was all lies, or just a misleading mixture of lies and truth, and trying to estimate the damage it did.
> It's still entirely possible that it happened as reported, but that the (properly) confidential records were destroyed/lost.
Did you read the article? This isn't possible at all.
> the distinguished psychologist Eleanor Maccoby, who was in charge of assessing Rosenhan’s tenure file, reported that she and others were deeply suspicious of him, and that they found it ‘impossible to know what he had really done, or if he had done it’, granting him tenure only because of his popularity
True, this is just circumstantial.
> At various times, Rosenhan had proffered sometimes contradictory biographical fragments about pseudo-patients 2 through to 8, but even with the assistance of a private detective, these leads led nowhere.
Hmm, it'd be hard for everything to have happened as reported, given that what was reported contradicted itself.
> In a larger sense, it scarcely matters, because Cahalan uncovered so much other evidence of Rosenhan’s malfeasance and lies.
Hmmmmmmmm...
> He claimed, for example, to have carefully coached his volunteers before sending them forth. Bill Underwood and Harry Lando emphatically denied this.
OK, now we know it didn't happen as reported even in cases where there wasn't an internal contradiction in the reporting.
> Lando appears to have been dismissed from the study, not because he violated protocol, but because, as Rosenhan incredulously noted about his confinement, ‘HE LIKES IT!’
The "throw away any data you don't like" school of research.
> Most damning of all, though, are Rosenhan’s own medical records. When he was admitted to the hospital, it was not because he simply claimed to be hearing voices but was otherwise ‘normal’.
Note that this is what he reported he had claimed.
> On the contrary, he told his psychiatrist his auditory hallucinations included the interception of radio signals and listening in to other people’s thoughts. He had tried to keep these out by putting copper over his ears, and sought admission to the hospital because it was ‘better insulated there’. For months, he reported he had been unable to work or sleep, financial difficulties had mounted and he had contemplated suicide. His speech was retarded, he grimaced and twitched, and told several staff that the world would be better off without him.
Not sure why you're being down voted. Maybe just tone with the 'hmmmmm' and such. Anyway, I agree that there appears to be ample evidence for this conclusion.
The fact is psychiatry today still lacks tests or any proof of its claims of "chemical imbalance", which remains unproven. No one had established a profile for what a "balanced brain chemistry"looks like, nor do they test for any brain chemistry imbalance.
Diagnosis is still left to the subjective assessment of the practitioner before prescribing powerful psychotropics that DO change brain chemistry in unpredictable ways, and cause a host of side effects often worse than the original symptoms.
So the argument today that psychiatry lacks any scientific basis and rigor for its practices is still very valid and legitimate.
This seems overly pessimistic to me, there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, despite the fact that we don't have a complete understanding of the complete mechanism of action.
If I do a study showing that handwashing in surgeons measurably reduces risk of infection, does the fact that I don't know about microbes make lacking in scientific rigor and remove its scientific basis?
>> there are drugs that significantly improve patients wellbeing and do so consistently and repeatably,
No, there are not. A given drug may work consistently for some people, while having no effect, or detrimental effects on other people with the same diagnosis.
Either you misunderstand or you're being disingenuous here.
"Consistently and repeatedly" does not mean "this works 100.0% of the time."
Would you deny that exercise fails to consistently and repeatably help people lose weight? Would you say that existing treatments for heart attack victims fail to consistently and repeatably help victims? Would you say umbrellas fail to consistently and repeatably stop rain from falling on your head?
None of these things work 100% of the time, but they are frequently successful.
Psychiatry is a field still in its infancy due to the difficulty of studying the mind. We should hold it accountable for its failings and work to make sure it improves. But, it has successes as well.
It's not the only game in town when it comes to mental health, for sure, but it's also compatible with a lot of other things that can have great benefits for mental health. Meditation, lifestyle changes, exercise, therapy, environment... none are incompatible with psychiatry, which is not perfect but can be a valuable tool in the toolbox.
There are, in cases, effective drugs. There's also a long history of failed or discredited treatments (chemical and otherwise), as well as theoretical models.
Mind: I'm not arguing that science doesn't make mistakes. Science is a mistake-making-and-correcting process. But there are certain fields of science, somewhat more so in the social than physical and biological sciences, in which a widely-adopted plausible theoretical understanding seems missing.
Science seems to move through stages, of observation and categorisation, to individual models of localised predictive (or descriptive) understanding, to a fundamental theoretical underpinning.
Geology and biology are interesting cases, each being effectively ancient, but for which the establishment of the underlying theory lies largely within human memory.
In the case of biology, taxonomic classification, Darwin's theory of evolution based on variation, inheritence, and selection, Mendelian genetics, and finally the discovery of the structure and reading of DNA and RNA by Watson, Crick, and others (1950s) cast the final links in the chain. We're strengthening those, but the underlying model seems largely complete.
(I'd count concepts of dissipative systems as largely conformant with this model, though important additions.)
For geology, similarly, there was the notion of stratigraphy, which established an ordering but not a specific timescale for geology. Understanding of that didn't occur until the work of Rutherford, Soddy, Holmes, and Boltwood, largely in the first decade of the 20th century.
At the time, the leading scientific value for the age of the Earth was 20 millions of years, by William Thomson, Lord Kelvin (reduced from an earlier estimate of 100 million years). Rutherford and Boltwood's initial measurements based on radioactive decay demonstrated a timescale of billions of years, subsequently refined to the present value of 4.6 billion +/- 1% in the 1950s.
That still didn't explain much geological activity, particularly vulcanology, earthquakes, uplifts, and subsidence (though sedimentation and erosion were well understood). That required the notion of plate tectonics and continental drift, formally adopted only in 1965-1967 (by various conferences / professional bodies).
Plate tectonics, driven by residual thermal heat of formation and radioactive decay in the Earth's core and mantle is now considered the theoretical underpinning of all of geology. It's formal adoption is 55 years old, for a study that's existed since the time of ancient Greece.
The social sciences -- sociology, psychology, political economy, and political science -- lack any such empirically demonstratable and falsifiable theoretcal underpinning. To a large extent they've resisted adopting one.
That last point isn't uncommon -- biology certainaly resisted evolution, and geology plate tectonic (see Naomi Oreske's works on this topic, themselves fascinating studies of the evolution of scientific theory: https://www.worldcat.org/search?qt=worldcat_org_all&q=au%3Ao...).
And as with pre-genetic biology, pre-tectonic geology, pre-Newtonian physics, and pre-Mendeleevian chemistry, there are useful concepts, models, methods, and mathematical relations in these fields. But not a true unifying theoretic basis.
Since you used the word resisted, it sounds like you're suggesting that there is an existing demonstrable and falsifiable underpinning for one or more of the social sciences which has not been adopted. What would that be?
It would be more accurate so say that they've resisted looking for one. And even that's a bit unfair, since doing proper experiments (with basic features like a control group, never mind replication or blinding) in sociology, economics, or political 'science' is somewhere between crushingly expensive and outright impossible.
The increasing specialisation both between and within academic domains, grants-making processes, various forms of gatekeeping and academic jealousies, all contribute to this.
The capitalist-communist antipathy throughout much of the 20th century also created major impediments, on both sides. Each camp was highly ideologically motivated, each used a consolidation of political power to drive academic policy and practice, and each side tended to both cultivate groupthink around certain concepts and mark others as taboo.
The Soviet Bloc notably preempted explorations in biology. The Western states greatly suppressed anything remotely touching on Marxist concepts (of which there is both bad and good). There were some shared areas of neglect (notably environmental concerns) and of focus (nuclear energy, weapons, jet propulsion, and space flight).
The interactions of power, ideology, and academic interests is ... pretty fascinating of itself.
Soddy himself is a partial answer, in the case of economics, though I find Georgescu-Roegen generally a more complete treatment. The fact that Nobel-prize-winning economists are on record stating that economics still has no coherent theory of growth (the subject of its most notable foundational text) is ... significant. Steve Keen has been addressing that and strikes me as solidly convincing:
There's the difficulty economics has, generally, in even settling on basic questions: what is wealth (is it a stock or a flow? how is it measured?)? What is money? What is value?
W. Brian Arthur notes in one of his books that virtually all economics is aimed at policy, and that as a consequence there's very little purely theoretical foundation. (His own contribution has been on complexity economics, with several interesting contributions and two notable seminars.)
Of the set of sciences here, political science is the one I can comment the least on, though if it should also happen to revolve and evolve largely around policy rather than theoretic discussion, it may be afflicted by similar dynamics as economics, and a casual observation suggests it is.
My reading is that the social sciences generally should probably be formulated as systems sciences, and there've been some attempts, mostly solidly rejected, at doing so. Norbert Weiner's exceedingly cringily-named On the Humane Use of Human Beings (the book is vastly better than its title suggests) was an attempt at this. There's another by Alfred Kuhn (no relation to Thomas), of the University of Cincinnati, The study of society : a unified approach (https://www.worldcat.org/title/study-of-society-a-unified-ap...)
The systems dynamics approach of Jay Forrester and others would be another.
The organisation of M.I.T.'s study of psychology, "Brain and Cognitive Sciences" (formed through departmental mergers in 1986) reflects one approach.
My view of pscyhology and sociology is that they are studies of behaviour, of individuals and groups, on the basis of perceptions, information processing, and interactions, subject to evolutionary and other influences, as well as various pathologies.
Many psychological disorders seem to me more akin to cancer in physical medicine, as opposed to infectious diseases: they concern symptom clusters which may have multiple and diverse underlying etiologies, rather than of specific cause-centered disorders.
The distinction is that if you can identify a specific underlying causal agent (say: bacterium or virus, or some environmental insult), you can focus treatment on eliminating or attacking that specific cause.
If you have a symptom cluster with multiple possible etiologies, you risk falling into the One True Way trap, thinking that one identified cause is all causes.
Robert Sapolsky's lecture on depression and the various ways in which various types of behaviour-regulating neurotransmitters can malfunction is an example of the underlying messaging complexity within psychology:
I'm less versed again on sociology, and would speak less to its specific failures and more what I've noted looking through survey texts: that there doesn't seem to be any single underlying organisational premise. Again I'd suggest that this be as a systems science, here looking at groups of people (from couples/teams to all of humanity), and various behaviours. "Evolution" here would include both biological and cultural transmission of information.
It needn't even be chemical; any sort of differential test that proves a deviation from baseline measure and treatment that helps mediate a return to that profile would at least be good science and may good medicine.
Maybe someday we'll have wide access to inexpensive monitoring techniques that could fill this need.
> So the argument today that psychiatry lacks any scientific basis and rigor for its practices is still very valid and legitimate.
It's been said that psychiatry is the new religion and psychiatrists the new priests for a reason. Any good actor with enough information can pretend he has a mental illness and fool psychiatrists. Not only that, you can have psychiatrists come up with different diagnoses for the same individual - even to the point of contradicting each other. And there is no scientific way to show one psychiatrist is correct or not.
Just like religion was the best we could do with level of knowledge we had in the past. Psychiatry is sadly the best we can do with the current level of knowledge. It's pretty much voodoo, but it's better than the voodoo that came before it. If neuroscience ( an actual science ) lives up to its potential, then we'll finally be able to toss psychology into the same waste bin we put astrology in and perhaps psychiatry can have a scientific foundation.
Does the data actually show that women working in research produce less accurate results than male researchers? Without seeing any solid evidence I feel obliged to be skeptical of this. Furthermore not every field diversified at the same rate or during the same time period. If what you're suggesting is true, I would expect to see a correlation between when a field diversified and when the quality of that research fell. Even if there are other factors in play, if the signal is there you should be able to measure it. And if the signal is immeasurable then I think it may as well not be there.
Please don't take HN threads into flamewars like this. We ban accounts that do that. Flamebait like "It is risible to think a woman could be as audacious as a Galileo" will particularly get you banned here, so no more of that please.
Of all the risible things one could say about gender and science, chief among them would surely be that testosterone leads to better scientific discoveries. Also you ignore the fact that the status quo which Galileo and Heaviside had to contend with was established and maintained by men.
Milgram, Zimbardo all these experiments from the 50's onwards are junk. Doesn't mean it set back psychiatry.
How psychiatry works is you get something that you intuitively think is true, make up a experiment to prove it (so it's ok for others to agree without getting in trouble)
If psychology wants the status and rewards of being considered a legitimate science, it needs to make dramatic changes. In the meantime any initial result psychological research produces must be considered not just preliminary, but suspect.
[1] https://en.m.wikipedia.org/wiki/Power_posing [2] https://science.sciencemag.org/content/348/6239/1100.2