Monday, June 3, 2013

Is religious fundamentalism a mental illness? (i.e. can you catch a mental cold?)

Evolutionary biologist and atheist free thinker Jerry Coyne at Why Evolution is True
blogged on a recent short article at The Raw Story about remarks made by Karen Taylor, neuroscientist and author of the book Brainwashing: The science of thought control.

The headline leads with her speculation that certain religious beliefs might eventually be treated as mental illnesses, with religious fundamentalism as the cited example.  This was slightly misleading because her point wasn't really about religion, but that a developing science and technology of thought intervention opens up possibilities and realities that are not morally neutral and that we should start preparing our ethics to handle them.  A reliable technology for disposing of a belief and replacing it with another would force decisions on us we currently don't have to think about.  The right decision it might not be as easy as banning it's use.

Of course the ensuing discussion in the comments covered all the bases about the moral pitfalls of treating beliefs as illness.  Commenters called out the dubious ethics of labeling someone who disagrees with you as sick (that this makes up a sizable fraction of all internet discourse was not discussed). The Soviet enforced hospitalization and "treatment" of dissidents as proxy punishment was properly brought up.  Coyne and followers were also dubious of the epistemic validity of equating beliefs with illness, and at first I agreed.
Religious beliefs can hardly be thought of as mental illness.  Taking the word of large numbers of people or even the word of as little as one very charismatic individual is common human behavior.  These are just purchases in the marketplace of ideas, not signs of underlying disease.

But the more I thought about it, the more I thought I might still be missing the point because of the different ways we think of mental illness versus illness in general.

The general construct illness is fairly broad and contains many variations on the theme.
One may be ill as the result of a hereditary or congenital problem with one's own structural or functional physiology, e.g.. Spina bifida, Prader-Willi syndrome, juvenile diabetes, or cystic fibrosis.  One may be ill as the result of a spontaneous malfunction that develops in an otherwise normally functioning body;  multiple sclerosis say, or developing breast cancer as a result of having BRCA1. The common thread of these illnesses are that they are the result of being put together wrong somehow or something in you spontaneously failing.  The source of the illness being an internal and inherent quality of one's particular body.  On the other hand, one may be ill as the result of infection by some external pathogen (e.g. food poisoning, measles, aids) or exposure to some kind of toxin. The illness is not the result of your individual variation, but of widespread human susceptibility to the outside agent like the Spanish Flu of 1918.  We also understand that there are interactions. Dangerous allergies are the result of a nominally harmless (or minimally harmful in the case of say bee stings) external agent interacting with a unique inherent individual physiology.  Likewise external carcinogens do not induce disease uniformly, interacting more pathologically with the physiology of certain individuals.

On the other hand when we think of mental illness our current conventional wisdom doesn't include the pathogen or toxin model that would support a concept of a belief as an illness in and of itself.  At least part of the reason is easy to spot.  This is incompatible with concepts of absolute liberty of thought supported by free will.  Beliefs are just thoughts, volitional products of our own agency. If they are bad, it is because the brain holding them is too faulty to act at liberty with free will. A bad belief (if there is even such a thing) can't be an infection of an intact brain. Ergo, mental illness must be inherent. You cannot be MADE mentally ill by the thoughts that get into your head. The logic being that if the just the thoughts were making you ill, you'd just flush them out yourself and replace them with better thoughts of your own.

The failure of the free will doctrine undermines this however.  So it's quite reasonable (albeit potentially frightening for all the reasons lightly touched in the third paragraph) to talk about thoughts as agents of sickness the same way we talk about having a cold or exposure to poison ivy or ingesting strychnine.

One source of our fear is of course the social stereotype and stigma of mental illness. While the term itself denotes the mere fact of being sick in or by ones thoughts and emotions, the social connotations imply a severe, intractable, quasi-criminal existential threat, or a permanent invalid. This not only causes people to react to mental illness in inappropriate, unhelpful and excessive ways, it also causes them to require claims that something is a mental illness meet that criteria.  There's even a confounding ambivalence between the conceptions of threat vs. sufferer.  There's an insidious cultural mythology about schizophrenia that the psychosis somehow overrides the ability to be miserable. Spend a week on a psych ward and you learn that is not the case. Psychosis is a wholesale distributor of profound human misery and despair.

But the fact remains, mental illness in the public mind implies permanent menace or permanent uselessness. In our minds, there are no mental health equivalents to having a cold, or being laid up with a mental equivalent of home-puking-your-guts-out-you-poor-thing. In those physical analogs the ailments are mere impediments to flourishing, calling for the right measures of aid, healing, and understanding.  We have trouble seeing mental illness this way. It's getting better but we have a long way to go.  This is not to say that we don't respond to mental suffering or struggle properly either.  Coming to the aid of someone mentally and emotionally overwhelmed by circumstances (divorce, job loss, death of loved one) is common practice. So is trying to help someone who we realize has misunderstandings that cause them to suffer and grossly impede their ability to flourish. Yet we can't quite bring ourselves to acknowledge them as sickened or afflicted in the same fashion we acknowledge someone with Influenza. They have to be broken by it some way first, and even then there are lots of reservations.

The point of all this being that until our conception of mental illness develops the same level of nuance that our conception of physical (read not-mental) illness has, tagging anything as a mental illness will be problematic. The originator may have a very properly nuanced claim about why a certain thing can be properly called such, and may even articulate the nuance well. Yet until society is ready to receive that nuance without recasting it into the misconceptions that currently hold sway this this will remain a risky business indeed.

Still one can't rule out an eventual utility to letting some beliefs get treated as illness.  Take a case where a person has trust issues and has come to believe their spouse is unfaithful. There may have even been a past indiscretion, but they've worked hard to reconcile.  The transgressor has repented, and is genuinely sorry, and for all practical purposes can be trusted, but their spouse just can't shed the belief in their infidelity.  They know that this is because of the trust issues. They have an adult understanding of the psychogenic source of the the belief's persistence.  If there were a reliable methodological aide to changing that belief, and if they wanted to access it for the purpose of allowing their relationship to flourish going forward, would it be ethical not to provide it?  It may not be possible to abdicate our obligation to solve ethical questions just because they wouldn't exist without the methodology.

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