RE: Natural Order & Belief

From: Stathis Papaioannou <stathispapaioannou.domain.name.hidden>
Date: Sat, 25 Nov 2006 14:45:59 +1100

John,
I apologise if you thought I was referring to you in any way: I was just trying to
make a general point about how we come to accept some beliefs and reject others.
Perhaps I should not have used the pejorative terms, but I think it is a fair question:
how do we know if a belief is crazy or stupid? Nature does not care about
epistemology, only about utility, and brains have evolved to process evidence and
arrive at conclusions because it assists survival. Psychotic illness disrupts the normal
reasoning process and leads to delusions. The most important feature of these is not
that they are false, but that they occur as a result of a pathological process which
leads to morbidity and sometimes mortality.
You make an interesting point about fixed *true* beliefs, not covered by the definition
I gave below: it is actually possible to be right but still be delusional. For example, a
patient believes with utter conviction that his wife was having an affair with his neighbour
because the neighbour painted his fence green and green is her favourite colour.
The patient is treated with antipsychotic medication and after a few weeks realises that
it was crazy to come to the conclusion that he did and apologises to his wife and the
neighbour, whom he had confronted prior to treatment. Months later, his wife leaves him
for the neighbour: it turns out that they had been having an affair all along! Nevertheless,
the patient had still been delusional because (a) most reasonable people would see the
conclusion he drew from the green fence, and the conviction with which he held it, as very
dubious, and (b) he himself saw the conclusion as dubious after treatment with antipsychotic
medication.
Stathis Papaioannou
> Stathis: thanks for the psichiatry class.
>
> You brought in a new questionmark: "crazy". As George Levy has proven, we
> all are crazy - my contention was: in that case such (general) craziness is
> the norm, eo ipso we all are normal.
>
> Is normalcy composed of delusions?
> Then why the (p)scientific identification of the "delusion-
> n -psychiatry", which, - btw - is not that impressive to those who are not
> standing on the shoulders of psychiatry.
> You successfully wiped out the validity of that definition
> (one by one). [you left out the case, if someone has a 'fixed'
> belief, which, however is NOT false (in unidentified opinions) - is also no
> delusion. ]
> So: "delusion" (which I have not involved) is not applicable.
> If one thinks: it is, it is not valid (i.e. not applicable again?).
>
> The only solution to your post I can find is in the last par., if it refers
> to me. I value your right to tell your opinion and also value your opinion,
> but question the term 'stupid'.
> In who's terms? by what (cultural?) norm?
>
> Stupid seems to me a negative connotation, just could not formulate in
> general applicability the 'positive' features against which the deficiency
> would constitue stupidity. I would easily fall into a series similarly to
> your series about 'delusion' - invalidating every aspect one by one, by the
> rest.
>
> Yet: I believe in stupidity, just cannot identify it beyond my personal
> feelings. I even feel a difference between a stujpid bum and a stupid ass, -
> could not express it scientifically.
>
> Thanks for your thought provoking reflections.
>
> John
>
>
> ----- Original Message -----
> From: "Stathis Papaioannou" <stathispapaioannou.domain.name.hidden>
> To: <everything-list.domain.name.hidden>
> Sent: Thursday, November 23, 2006 5:25 AM
> Subject: RE: Natural Order & Belief
>
>
> John,
>
> Some people believe crazy things... literally crazy things, and they require
> treatment for it. The definition of a delusion in psychiatry is:
>
> "A fixed, false belief which is not in keeping with the patient's cultural
> background."
>
> So someone may have a belief that is false, but not fixed, i.e. he will
> revise his belief
> in response to contrary evidence, and that isn't a delusion. Or someone may
> have a
> belief that is both false and fixed, but it is shared by the cultural group
> to which he
> belongs, and that isn't a delusion either. This latter provision was put in
> mainly to exclude
> religious beliefs.
>
> Usually there are other markers of mental illness as well as the delusion
> allowing one to
> make a diagnosis and decide on treatment: hallucinations, sleep and appetite
> disturbance,
> personality changes and so on. Very rarely, these other signs are absent,
> and you are faced
> with deciding whether the patient is mentally ill or just has weird beliefs.
> The only investigation
> which is of help in these cases is a trial of antipsychotic medication: this
> has a false negative
> rate, in that in a minority of cases clearly psychotic symptoms do not
> respond to medication,
> but a negligible false positive rate, i.e. if the beliefs go away with
> antipsychotic medication and
> return on cessation of medication then they are definitely psychotic.
> Religious and other cultural
> beliefs do not change with medication.
>
> In other words, it is usually possible to know if someone is crazy, but more
> difficult to know if
> they are just stupid.
>
> Stathis Papaioannou
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Received on Fri Nov 24 2006 - 22:46:53 PST

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