On Trusting Yourself, Knowing You Are Not Trustworthy

There’s a good article here about the biases we all hold. I mean bias in the psychological sense.

I learned a lot about bias as an undergraduate, and tried to root out as many as I could over the years. I can’t say that I’m perfect (who is?), but I think I’ve gotten better.

I thought this related interestingly to my work on schizophrenia because I want to take seriously people’s narratives about what they think caused their psychosis, and what happened when they went psychotic. But I also want to take into account that we are imperfect when it comes to these things. We tend to overestimate bad things that happen to us, for example. Still, I think it’s important to take the agent seriously.

In practicing the biopsychosocial model, interviews with the client are paramount. However, other data is collected, such as interviews with other people, school records, and so forth. This, I think, is good. It takes into account the individual, and also refers to other data so we can glean a picture of what possibly caused the illness in this particular case, and what treatments we should apply for health. This is a strength for the biopsychosocial model.

After reading about bias, you should be skeptical about yourself. If you aren’t you didn’t take the data seriously. But there are ways to reduce bias, and it’s good to apply them. This could make a better place for all of us. This means you don’t have to remain skeptical of yourself. But it does mean you need to constantly work on yourself.

If you live in a constant state of skepticism about yourself, that’s probably not healthy. But a light dose of skepticism is good.

Breaking from Reality

Most people give credence to biomedical research over biopsychosocial research, thinking, I suppose that biomedical research shows us about reality. I don’t want to argue that it doesn’t. What I do want to do is argue for the social sciences as giving us information about the nature of reality.

For example, we know that Holocaust survivors are at-risk for developing schizophrenia. This gives us reason to think that exposure to trauma, psychological hardship, and so forth, can trigger psychotic symptoms. What we can’t do is replicate those conditions, and randomly assign people to Holocaust-like conditions.

What we can do is look at other instances where trauma may have caused a break from reality. For example, we can look to the Ghost Dance.

I invite you to watch this video, and consider whether the restrictions of liberty, trauma, and hardship, etc., caused the break from reality which was the Ghost Dance.

Causing Psychosis: What We Can and Can’t Know

I want to argue, using the biopsychosocial model that, for any case of psychosis, we cannot, currently, say for sure what the ultimate cause of it is.

The biopsychosocial model can be thought of as both a theory of causes, and a theory of treatment. When thought of as a theory of causes, one looks at biological, psychological, and social factors involved in the development of psychosis.

We may find that, for example, there’s excessive pruning of neurons in the brains of most people with schizophrenia. But we may not know why that happens. It could be they are born prone to developing psychosis. It could be they are neurotypical, and have experienced a lot of hardship. It could be that, psychologically, they are vulnerable to stressors.

These can all be causes, and they can all contribute to one developing psychosis. For any individual person, they may not know what caused their own psychosis.

Think of global warming. We know that the Earth is warming at alarming rates. But, at any given place, it may be warmer or cooler. Just because one area experiences warmth or cooling doesn’t mean we can assign this to global warming. Global warming is an effect that is broad, and covers the entire Earth.

In the same way, psychosis may affect individuals, but each individual has had a different upbringing, social environment, experiences, and each individual reacts to their environment in different ways.

For some people, the biomedical explanation may be sufficient. For others, however, we may need to look at social and psychological factors. Teasing apart causes in any particular case would be difficult, and that’s more the job of clinicians and case managers, who are “on the ground” and working with the client.

As for me, when I look at data, I am looking at groups of people, and making connections. I may be focusing on social causes at the moment, but that doesn’t mean I don’t think other causes may be involved in particular cases.

Thinking about Social Causes

The biopsychosocial model was never developed fully theoretically. Yet, I, and many researchers, think it shows promise. In this essay, I want to think about how a brain condition can have multiple causes. In doing this, I will make analogies with broken bones and physics, and posit social causes.

The cause of a broken bone may be many things. It could be one is vulnerable to breaking bones; there is something about one’s bones that make them prone to breaking. If this is the case, a minor bump, simply standing up, or fall could cause a broken bone.

One could get a broken bone by accident, in playing a sport.

One can get a broken bone by being assaulted by another person.

We have no problem thinking about different causes of broken bones.

Yet, many people have trouble understanding how there could be different causes for brain disorders. This seems to me not an especially difficult problem when we look at non-brain pathologies.

Causes, especially social or psychological causes, may seem strange because we cannot directly perceive them. We cannot see stress or trauma. Yet we seem to have no problem talking about these things, and, in the literature, we see a body of data that strongly suggests causation between stress, trauma, and brain disorders.

Let’s look at stress, for a moment. There’s a whole body of research on how stress can cause a variety of physical problems. Most people, and most professionals, do not have a problem assigning stress as a cause to things like acne, sleep problems, weight loss, overeating, and so forth.

Yet, many people, especially those who hold firm to the biomedical model, would have a problem assigning invisible causes to physical illness, such as brain illness.

This need not be that case.

To see why, let’s turn to introductory physics.

Although the aim in physics as a science is probably to find testable hypotheses, much of physics is theoretical, and deals with both visible and non-visible things. We cannot see gravity, for example. Yet, the average person understands the basics of how gravity works in everyday life, and physicists have a good understanding of how gravity works in the universe. We posit a name for such a thing—calling it gravity—because we can, or rather Newton could, see that things must be pulled to the Earth.

In the same way, I want to posit social causes. A social cause is not a force acting directly upon one’s body, that we know of. It may very well be, I would need more data in order to posit a social force in that way. What we can probably say is that, whatever we make of the psychological, be it material or immaterial, the social can act upon the mind*, and affect it in both positive and negative ways.

This is easy to see, when we look at the literature, but it’s difficult to find a theory and proper understanding of it.

I do not want to imagine the mental or psychological as something mystical and beyond comprehension. I do not think many things in the universe are mystical or beyond comprehension. I may not currently understand such things, but that does not mean human beings cannot understand them.

I also do not want to posit too many things; I want my theory to be as simple as I can make it. This is just keeping with Occam.

Likewise, in keeping in the tradition of many empiricists and philosophers, I take it that the universe makes sense. It is not disordered. It may be surprising, or counterintuitive, at times, but it is not disordered. For me, what’s disordered is my mind*, when I am psychotic. But even then, there’s some sense to it. I do not magically know how to speak Arabic—which I don’t know when I’m sane—when I’m psychotic. My mind* can only scramble, order, disorder and reassemble things I know, and it can create just so long as I am, at any rate, creative, when I am psychotic.

So I want to posit social causes, which are causes just like any direct, physical cause. This is what I mean by cause.

Much has been made of making psychology, sociology, and other social science into hard sciences. Many think this is not possible.

I think, when we are dealing with the social sciences, we are dealing, in a way, with the same kinds of things as theoretical physicists are dealing with. What I mean by that is that we are dealing with many things interacting, we are dealing with complex causes, and we are dealing with forces acting upon things which are not, necessarily, directly touching. I do not have the understanding of physics that I’d like to have in order to make this comparison even more compelling, but I’m not trying to make the social sciences into hard sciences in order to make them more credible in whatever way. I’m making this analogy because I think it’s true, and, after looking at data, think there’s some merit to it. We do not have a problem, normally, thinking that the Sun affects the Earth, even thought these two objects do not touch. In a similar way, I want us to think about social causes as one social event affecting a person, even though they may not be touching.

In this way, I believe in the armchair, but I also believe in experimenting. Because there’s only so much we can directly observe. Our personal observations may lead us astray, which is why I refer to the data, which I am keen to look at.

So, social causes, I want to think are just as real and forceful as physical causes.