Mad Lit

Let's break this down because there's a lot of misinformation here: "We have definable pathology." No, the mental health field does not really have this. In mental health, diagnoses are descriptions. They are voted into existence by a small group of people. They shift wildly with culture, politics, and incentives. There are no biomarkers for diagnosis. So if pathology means "socially agreed upon labels" then calling it pathology is misleading. "We have known mechanisms, basic behaviorism works across pigeons, cats, rats, and humans." Yes, we know how behaviorism works across species. No this does not establish a theory of mind, meaning, identity, suffering etc. This knowledge does not justify clinical authority over human inner life. "We have objective outcome measurements." This is just flat wrong. Outcome measures in therapy are self-report questionaires, therapist interpreted ratings, standardized psychological tests. These are heavily subject to interpretation, theory laden, sensitive to context, easily gamed and reinterpreted, etc. In medicine for example, if blood pressure is lowered or tumor is removed, that is objective. "improvement in anxiety" for example, is a completely different animal. "diagnoses in medicine are often wrong." This is a false equivalence. Medical diagnoses can be wrong. But when they are, they are wrong against an external reality. Errors can be verified or corrected in various ways. Wrong diagnoses have clear failure signals. Mental health has no independent ground truth. Medicine (not psychiatry) does. Worsening mental health can be reframed as progress. Misdiagnosis often can't be detected at all. In other words, error in mental health is unbounded. In medicine it's bounded.