"Schizophrenia", "Symptoms"
By Elliot Temple
Originally posted on the Beginning of Infinity List, August 22, 2011

When you suggest to parents that children should have more freedom, and other things along those lines, they raise various objections. A standard example is, "If the child has more freedom, he might not go to bed at bedtime." Or maybe he'll eat candy until "hyperactive".

A rational person hearing this can easily make a false assumption: that the complaint is the child won't go to bed at bedtime *and then something bad will happen* (e.g. the child's growth will be scientistically stunted, he'll be tired and cranky, he'll make noise at 2am, the neighbors will disapprove, etc...)

The parents themselves will often offer some claims/justifications/excuses like this for why it would be bad. These are made up after the fact of desiring and enforcing bedtime, and accompanied by confabulation that they were considered in advance and self-deception that they are the current motivations.

That is not what parents are primarily worried about. They want to have a child that goes to bed at bedtime, regardless of whether there is any further issue or not. When they say, "What if my child doesn't go to bed at bedtime?" they mean it *literally* -- that itself would automatically be a problem to them.

So there's nothing deeper, nothing behind it.

Mental illness "symptoms" work the same way. The "symptoms" themselves *are the entire problem*. People with those "symptoms" are problematic *without further consideration of anything* because those "symptoms" (e.g. unwanted behaviors) are the whole "problem".

Normally in medicine when a diagnosis is made by symptoms alone, it can turn out to be false even if the symptoms are real -- they could be caused by something else. But with mental illness, the diagnosis cannot be wrong in that way because psychiatrists do not diagnose whether there is an underlying condition, they simply "diagnose" whether the "symptoms" (which are the entire "disease") are present or not.

So: the "symptoms" *are* the whole problem just as the not going to sleep at bedtime *is* the whole problem -- there's nothing deeper.

To clarify the parallel: people are not worried that their kid won't go to sleep at bedtime and this will cause some unpleasant thing as a consequence. And nor are they worried that someone will have autism or schizophrenia and it will cause some unpleasant thing as a consequence. Schizophrenia's "symptoms" and lack of bedtime are deemed bad in and of themselves (kind of like as a moral principle) even if the consequences are good (similar to it being deemed bad/sinful to have a medical illness cured by a witch, even if the cure works).

This helps explain why psychiatry (and a lot of parenting too) is so focussed on treating symptoms rather than any underlying condition. If you get the symptoms to go away then the whole problem people were having -- the person's (mis)behavior -- is gone. The "mental illness" consisting of its "symptoms" themselves cannot outlast it's symptoms like a medical disease can. (Though of course insufficient eagerness to conform/"behave" can outlast misbehavior and cause "relapses".)

(For more of Elliot Temple's writing, visit www.fallibleideas.com )