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Abstract
This article evaluates modern psychological theory and practice. It explains how opportunistic psychological diagnoses are created and destroyed, fueled by public credulousness and the absence of scientific discipline within psychology. A case history is included to show the consequences of these trends and practices.
Contents
1 Science
1.1 Definition
1.2 Britannica: Falsifiability
1.3 Explanation versus Description
1.4 Legal Precedents
1.4.1 Daubert Standard
1.4.2 McLean v. Arkansas Board of Education
1.5 Royal Society
1.6 Skepticism
1.7 Science and Pseudoscience
1.8 Role of Theory
1.9 Dried Gourd Science
1.10 Summary
1.10.1 Isaac Newton
1.11 Magical Thinking
2 Psychology
2.1 Theoretical Unification
2.2 Psychology's Critics
2.2.1 Sigmund Freud
2.2.2 Karl Popper
2.2.3 Sigmund Koch
2.2.4 Richard P. Feynman
2.2.5 Ronald F. Levant
2.2.6 Thomas R. Insel
2.3 Historical Highlights
2.3.1 Drapetomania
2.3.2 Lobotomy
2.3.3 Homosexuality
2.3.4 Refrigerator Mother
2.3.5 Recovered Memory Therapy
2.3.6 Asperger Syndrome
2.3.7 Not Otherwise Specified
2.3.8 Cognitive-Behavioral Therapy
2.4 Analysis
2.4.1 Mental Illness Defined
2.4.2 Evolution of Diagnoses
2.4.3 Asperger Syndrome Diagnosis Benefits
2.4.4 Abandonment of Asperger Syndrome
2.5 Psychiatry
2.6 Neuroscience
2.7 Objective Diagnosis
2.8 Summary
3 Case History
3.1 Introduction
3.2 First Meeting
3.3 Starting Out
3.4 Factitious Disorder/Munchausen Syndrome by Proxy
3.5 The Family Outing
3.6 Hell Hath no Fury
3.7 The M-Word
3.8 The Plea
3.9 Dangerous Lies
3.10 Double Down
3.10.1 Joan's Game Plan
3.10.2 Legal Advice
3.11 Visiting the Grown-Up's Table
3.12 Update
3.13 Conclusion
4 Appendices
4.1 Why Asperger's is Gone
4.2 Mind versus Brain
4.3 Newtonian Gravitation
4.3.1 Relevance to Science
4.3.2 Comparison with Psychology
List of Figures
1 Isaac Newton in thought 2 The “Family Outing” site
1 Science
Before discussing psychology's relationship with science, we must first define science.
1.1 Definition
The central goal of science is to understand the natural world. To meet this goal, science crafts explanations — “theories” — that are compared to nature, and if the comparison fails, the theory must be discarded. This requirement to compare theories to nature is called falsifiability1, and falsifiability is the cornerstone on which science is built.
The falsifiability criterion forges an essential link between scientific fields, scientific theories, and nature:
1.2 Britannica: Falsifiability
The online Encyclopedia Britannica entry for the term falsifiability2 says that falsifiability is “... a standard of evaluation of putatively scientific theories, according to which a theory is genuinely scientific only if it is possible in principle to establish that it is false.” The entry then offers counterexamples: “According to [Karl] Popper[3], some disciplines that have claimed scientific validity — e.g., astrology, metaphysics, Marxism, and psychoanalysis — are not empirical sciences, because their subject matter cannot be falsified in this manner.”
1.3 Explanation versus Description
A scientific theory that makes general statements based on specific observations, that predicts phenomena not yet observed, is said to explain some aspect of reality. Another class of theory, one that merely describes reality without offering an explanation, isn't scientific on the ground that one cannot falsify general principles that haven't been articulated or predictions that haven't been made. One can only contradict the original observation, but contradictions aren't falsifications because a contradiction can itself be contradicted in turn, ad infinitum, with no chance for resolution or contribution to the corpus of human knowledge. Here's an example:
1.4 Legal Precedents
1.4.1 Daubert Standard
Because of science's important role in modern society, and because of the many science pretenders at large, it has come to pass that, in the interest of justice, the legal system has defined science as it relates to expert testimony. As one such example, in Daubert v. Merrell Dow Pharmaceuticals, Inc.4, the U.S. Supreme Court produced an influential ruling now known as the Daubert standard5. At risk of oversimplification, Daubert says that scientific expert testimony must derive from scientific methodology, using a list of requirements that closely resembles the definition of science provided above, including the phrase “Empirical testing: whether the theory or technique is falsifiable, refutable, and/or testable.”
1.4.2 McLean v. Arkansas Board of Education
An earlier legal ruling6, whose purpose is to keep religion out of public school science classrooms, defined science this way:
Apart from improving society's understanding of what constitutes science and distinguishing religion from science, this ruling's existence reveals how a scientific standing confers validation to ideas. This makes that standing a prized possession, to the degree that the legal system must sometimes step in and draw a line in the sand.
1.5 Royal Society
Science's focus on empirical evidence means there's no role for authority in science, contrary to appearances, and this has been true across the history of science. The Royal Society7, the oldest scientific institution in the world (founded in 1660 CE), chose as their motto Nullius in Verba or “Take nobody's word for it”8. The society explains their motto this way:
It is an expression of the determination of Fellows to withstand the domination of authority and to verify all statements by an appeal to facts determined by experiment.9
This addresses one of the more pervasive public misunderstandings of science — that it relies on authority and expertise. This is quite false — as shown in the above quotation, science explicitly rejects authority.
About this issue Richard P. Feynman10 said, “Science is the organized skepticism in the reliability of expert opinion.”
Science's attitude toward authority and expertise can be summarized by saying that the greatest amount of scientific eminence is trumped by the smallest amount of scientific evidence.
1.6 Skepticism
An important corollary to science's focus on empirical evidence is an attitude of skepticism toward untested claims. This skeptical outlook is formally recognized in the null hypothesis11, the idea that there's no relationship between a cause and an effect until empirical evidence supports it. The null hypothesis is a cornerstone of scientific experimental design — properly designed studies presume there's no relationship between two phenomena under study, and require that evidence contradict this default assumption.
1.7 Science and Pseudoscience
An example may show the importance of the null hypothesis and of skepticism:
To summarize this point, to a scientist, Bigfoot's existence hinges solely on empirical evidence, while to a pseudoscientist, Bigfoot exists because it hasn't been proven not to exist. And because no one can possibly prove Bigfoot's nonexistence, the pseudoscientist is secure in his belief.
1.8 Role of Theory
To summarize the above sections, scientific fields are defined by theories — theories that:
The most reliable and robust theories express their principles in mathematical equations.
Properties of a scientific theory include an intellectual framework that makes general statements derived from specific observations, as well as the ability to predict empirical phenomena not yet observed — for example, Charles Darwin's14 theory of natural selection anticipated much of modern biology with a handful of empirically testable principles. Most important of all, a scientific theory must be open to unambiguous falsification by way of empirical tests, or in other words, by a meaningful comparison with reality.
1.9 Dried Gourd Science
Readers unfamiliar with science may question whether the above requirements are too strict — aren't we defining science too rigidly? Might we sometimes throw away useful observations and theories by applying overly strict rules? To answer, let me offer my cure for the common cold.
In my cure I shake dried gourds over the cold sufferer until his symptoms abate. The cure might take three days, maybe a week, but it always works. It's 100% effective, it's repeatable with different subjects and different gourds, it can be replicated in different laboratories, it's empirical, it might have been falsified but wasn't, so where's my Nobel Prize?
Here's another question — what's wrong with this cure? Here's a short list:
About the class of pseudoscience described here, Richard P. Feynman10 said, “The first principle is that you must not fool yourself — and you are the easiest person to fool.”15
This pseudoscience example is meant to show how an absence of theory, skepticism and critical thinking can lead to perfect nonsense masquerading as science.
1.10 Summary
Based on these points it's possible to broadly say what science is and is not. If a field produces explanations, if it shapes theories that connect seemingly unrelated observations, makes unambiguous theoretical claims preferably in the form of mathematical equations, accurately predicts phenomena not yet observed, and can be falsified by empirical observation, it's science. If a field only offers descriptions, descriptions that can be trivially and inconclusively contradicted by other descriptions, without ever rising to the level of theory shaping and empirical tests, it's not science.
1.10.1 Isaac Newton
Figure 1: Isaac Newton in thought
For a picture of science, imagine Isaac Newton16, who observed a falling apple, then looked at the moon and saw a connection between the motions of the apple and the moon, then wrote a mathematical equation17 that explained the falling apple, the orbit of the moon, and the motion of every other massive object in the universe. That's science.
1.11 Magical Thinking
Let me connect the above points to two modern social problems — magical thinking and phony victimization.
I ask my readers to remember this distinction between magical thinking (true until proven false) and scientific thinking (false until proven true) for examples that follow in which people seek victim status by describing imaginary crimes.
2 Psychology
Human psychology is defined as study of the mind and behavior20. This represents a serious obstacle to meaningful science, because the mind is not a thing, it's an idea, consequently it cannot be a source of empirical evidence. This, in turn, means psychology must get along without falsifiable theories — or, for that matter, any empirically testable theories at all.
In an informal ranking of sciences based on scientific substance, psychology lies between biology21 and astrology22. Biology has empirically testable, falsifiable theories like evolution23 and natural selection24, so it's firmly based in science. Astrology has testable theories, but they've been proven false, so astrology might be described as a failed science — unless someone takes it seriously, in which case it's a pseudoscience. Because psychology has no testable empirical theories it cannot be described as a science, but because of its many avid practitioners and followers it has acquired a wholly undeserved scientific reputation.
Another way to say this is that, because it cannot craft or test scientific theories, psychology is forced to operate at the dried-gourdDriedGourd level of science — it thinks its methods work, but it cannot test this assumption using reliable science.
2.1 Theoretical Unification
Readers may object that all of psychology shouldn't be judged by the dismal state of clinical psychology and psychiatry, that using a single word to describe them all is misleading. But when applied to a science, a single word is sufficient. If an airplane disintegrates in flight, an investigation might discover that its designers ignored theories from aeronautics' parent field (i.e. physics), or that the accident reveals a new physical principle that theoretical physics needs to accept (like the role played by metal fatigue25 in the in-flight failure of the deHavilland Comet aircraft26).
Because physics is a science, its empirical, falsifiable theories unify the field and its applications. Physical theory and practice are joined — a new theoretical finding has immediate effect on practice, and unexpected results arising in practice have an effect on theory.
In the same way, because biology is a science (because scientific biological principles unify theory and practice), new theoretical findings like epigenetics27 inform all of biology as well as coordinating theory and practice.
In medicine, clinics cannot apply treatments that haven't been tested for efficacy and safety or that don't conform to medical and biological theories. This is possible because modern medicine is an application of biological science.
The above principles would apply to psychology except for the fact that the mind cannot be a source for reliable empirical evidence, so psychologists cannot create scientific theories about it and the unifying effect of theory is absent. This theory vacuum explains why there are so many small divisions within the field — the American Psychological Association (APA)34 lists 54 divisions — that's more divisions than an ice cream store has flavors.
2.2 Psychology's Critics
Among the psychologists who have analyzed their own field, the views expressed in this article are by no means out of the ordinary. Starting with Sigmund Freud and extending to the present, many critics have made the same points in different ways. Here's a representative sample:
2.2.1 Sigmund Freud
In his 1895 unpublished work “Entwurf einer Psychologie” (draft of a psychology), later translated to English as “Project for a Scientific Psychology”, Sigmund Freud28 reluctantly came to the conclusion that the chasm separating the mind from physical reality could not be bridged, and therefore that psychology could not become scientific. About this effort Freud later said, “Why I cannot fit it together [the organic and the psychological] I have not even begun to fathom.”29
Aware of the negative implications of this work for his field and his personal standing, Freud directed that the book not be published during his lifetime, so its release was delayed until 1950.
2.2.2 Karl Popper
Originally trained as a psychologist and earning a Ph.D., philosopher of science Karl Popper3 eventually came to the conclusion that psychology cannot be science for lack of a grounding in empirical evidence and falsifiability. About this change in outlook Popper said, “I began to feel more and more dissatisfied with these three theories — the Marxist theory of history, psychoanalysis, and individual psychology; and I began to feel dubious about their claims to scientific status.”30 Popper went on to identify the defect these fields have in common — their theories can't be falsified.
2.2.3 Sigmund Koch
A notable psychology critic and philosopher of science, psychologist Sigmund Koch31 was selected to edit a major work titled “Psychology: A Study of a Science” (Koch, 1959-63)32, which became a six-volume series. About this work, Koch came to these conclusions:
The hope of a psychological science became indistinguishable from the fact of psychological science. The entire subsequent history of psychology can be seen as a ritualistic endeavor to emulate the forms of science in order to sustain the delusion that it already is a science.
The truth is that psychological statements which describe human behavior or which report results from tested research can be scientific. However, when there is a move from describing human behavior to explaining it there is also a move from science to opinion31.
2.2.4 Richard P. Feynman
Well-known for his irreverence and wit, Nobel Prizewinner Richard P. Feynman10 often criticized psychology for its scientific pretensions. In a now-famous address entitled “Cargo Cult Science”, Feynman said:
I think the educational and psychological studies I mentioned are examples of what I would like to call Cargo Cult Science. In the South Seas there is a Cargo Cult of people. During the war they saw airplanes land with lots of good materials, and they want the same thing to happen now. So they’ve arranged to make things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head like headphones and bars of bamboo sticking out like antennas—he’s the controller—and they wait for the airplanes to land. They’re doing everything right. The form is perfect. It looks exactly the way it looked before. But it doesn’t work. No airplanes land. So I call these things Cargo Cult Science, because they follow all the apparent precepts and forms of scientific investigation, but they’re missing something essential, because the planes don’t land.33
2.2.5 Ronald F. Levant
While president of the American Psychological Association34, Ronald F. Levant35 began an initiative to move clinical psychology toward an evidence-based practice model and away from its reliance on anecdote and narrative. It seems psychologists weren't ready for this change — about their response, Levant said:
Some APA members have asked me why I have chosen to sponsor an APA Presidential Initiative on Evidence-Based Practice (EBP) in Psychology, expressing fears that the results might be used against psychologists by managed-care companies and malpractice lawyers.
To respond, I would start by drawing attention to the larger societal context in which we live. The EBP movement in U.S. society is truly a juggernaut, racing to achieve accountability in medicine, psychology, education, public policy and even architecture. The zeitgeist is to require professionals to base their practice to whatever extent possible on evidence. Thus, psychology needs to define EBP in psychology or it will be defined for us. We cannot afford to sit on the sidelines.36
Levant's critics were right — modern psychological practice is entirely unscientific and an initiative such as he proposed would only have focused public attention on that fact, with significant legal exposure and little compensating advantage. So Levant's initiative failed.
2.2.6 Thomas R. Insel
While director of the National Institute of Mental Health (NIMH)37 (2002-2015), Thomas Insel advocated for a shift toward science-based mental health treatments. About the version of the Diagnostic and Statistical Manual of Mental Disorders (DSM)44 that had just been released (version 5), Insel said:
The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity.
Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment. Patients with mental disorders deserve better.38
Over time, as serious problems with the new DSM version became more apparent, the NIMH ruled that its categories would no longer be accepted as the basis for scientific research proposals,39 for the reason that the DSM has no scientific content.
Insel's predecessor at the NIMH (Steven E. Hyman40) and his successor (Joshua A. Gordon41) both also advocate for a transition to science in psychology.
2.3 Historical Highlights
Because psychology can't craft or test empirical theories, a review of its history shows an aimless drift from one fad to another, each abandoned after either inspiring public outrage or proving itself to have no practical value. Here are some highlights:
2.3.1 Drapetomania
Before the U.S. Civil War psychologists invented Drapetomania42, a mental illness diagnosis that presumed to explain why slaves ran away from their masters. Drapetomania was used to justify the racist policies of the era and force free men and women back into the hands of their “owners.” There was no corresponding mental illness to explain why slave owners believed it was moral to own a human being, but the slave owners, not the slaves, paid the psychologists. Unlike the other examples in this list, psychologists now accept that Drapetomania was pure pseudoscience.
Outcome: abandoned.
2.3.2 Lobotomy
In the 1930s psychologists invented a simple procedure that greatly improved the behavior of mental patients. Before the procedure, patients might rant and yell for hours, making life miserable for everyone. After the procedure, patients became much more docile and manageable. The procedure involved inserting an icepick into the patient's prefrontal cortex and moving it around, slicing through brain tissues. This produced a dramatic improvement in behavior, but as a side effect the patient lost any resemblance to a human being. Called “Lobotomy”43, the procedure reached its peak popularity in the 1950s, was eventually applied to 40,000 people, but has since been abandoned. The Wikipedia Lobotomy article43 includes this quote: “The purpose of the operation was to reduce the symptoms of mental disorder, and it was recognized that this was accomplished at the expense of a person's personality and intellect.”
Outcome: abandoned.
2.3.3 Homosexuality
In the mid-20th century homosexuality was formally identified as a mental illness and various treatments were devised including chemical castration. Since then two things have changed: the public has begun to accept homosexuality, and even psychologists realized their “treatments” weren't working. Eventually homosexuality was removed from the DSM44, psychology's standard diagnostic manual, but this hasn't prevented some psychologists from offering ineffective and harmful Conversion Therapy45 treatments. Because of its potential for harm this therapy has been declared illegal in many regions46.
Outcome: abandoned.
2.3.4 Refrigerator Mother
Over the decades some organic ailments have been misidentified as mental illnesses amenable to psychological treatments, among which were the various forms of autism. At the height of psychology's popularity, autism was widely blamed on “refrigerator mothers”47, emotional cripples unable to bond with their children. Fortunately for many innocent and caring parents this fad didn't last and autism was eventually identified as an organic, not mental, ailment.
Outcome: abandoned.
2.3.5 Recovered Memory Therapy
In the 1990s a fad psychological treatment called Recovered Memory Therapy48 (hereafter RMT) became popular. In this therapy, psychology clients “remembered” being victims of horrible crimes that were supposedly suppressed from the conscious mind. Recovered memory therapy seemed to bring hidden traumatic memories into conscious recall, but the role of fantasy and invention — in both therapist and client — seems not to have been adequately guarded against. The result was that many people were accused of imaginary crimes.
The apparent goal of RMT was to confer victim status to people who, for one reason or another, couldn't function in modern times — people who demanded sympathy and money for imagined wrongs. But to work as intended, RMT relied on a pseudoscientific standard of evidence — claims were assumed true until proven false. Unfortunately for the phony victims, this collided with today's scientific and legal standard in which claims are assumed false until proven true (innocent until proven guilty).
The legal system required some time to awaken, but before too many lives were destroyed, it caught on. About the time virgins began reporting imaginary rapes49, the courts realized they were being played, the wrongly accused were released, the phony victims got no more attention and the therapy lost its popularity.
Outcome: abandoned.
2.3.6 Asperger Syndrome
Even though it's been abandoned, Asperger Syndrome50, also known as “Asperger's”, is regarded by many as the perfect mental illness diagnosis. With a minimum of acting ability nearly anyone could get the diagnosis, it produced sympathy, special education funds and attention, and a number of important historical figures (Isaac Newton, Thomas Jefferson, Albert Einstein and Bill Gates among others) were assigned the diagnosis. These factors made Asperger's the first genuinely attractive mental illness, it resulted in an epidemic of phony diagnoses and nearly bankrupted some school districts who were obliged to provide special education funds for the victims of this cruel ailment.
Asperger's was popular with overcontrolling parents, who would assign it to their above-average children in order to shame them into acting more “normal.” But it was also popular with youngsters — after all, wouldn't you like to have the same mental illness as Albert Einstein or Bill Gates?
In resonse to public outrage, and to limit further damage to psychology, Asperger's was removed from the standard diagnostic manual (the DSM44), but because psychologists aren't obliged to honor the DSM's contents, Asperger therapy, like Conversion Therapy46 and others, might reappear as public tastes change.
Outcome: abandoned.
2.3.7 Not Otherwise Specified
Until recently the DSM44 contained a catch-all “diagnosis” of Not Otherwise Specified (NOS)51. Psychologists applied it to people who couldn't be easily assigned another diagnosis. Its apparent purpose was to avoid ever having to tell someone, “There's nothing wrong with you — go home and enjoy your life.”
Imagine an actual medical doctor telling his patient, “You have a bad case of Not Otherwise Specified. Take two aspirin and call me in the morning.”
In the most recent DSM (version 5) (2013)52, examples of “Not Otherwise Specified” have been either dropped or renamed “Not Elsewhere Classified (NEC).”
Outcome: abandoned/renamed.
2.3.8 Cognitive-Behavioral Therapy
Cognitive-Behavioral Therapy53 (hereafter CBT) is a widely practiced therapeutic method in psychiatry and clinical psychology. In spite of its questionable evidentiary basis it's been a mainstay of psychological practice for many decades. Many therapists are confident that CBT is effective and distinct from other therapies, in spite of the many studies that contradict this belief. In a recent meta-analysis54, CBT and other therapeutic methods were carefully compared but no statistically significant difference was detected between them. In another study55 CBT was broken down into its component parts to see which were most effective. This study showed a similar result — the separately applied components produced nearly identical clinical responses, and more important, the responses appeared before any of the tested components should have been able to distinguish themselves.
Faced with these outcomes, a skeptical scientist would suggest that these therapies represent examples of the Placebo Effect56, where any plausible faux therapy might produce the same result, but psychologists seem unwilling to consider this possibility.
Outcome: still widely practiced.
These are only a few highlights in psychology's history, examples that show a pattern of opportunism, lack of discipline and disregard for the null hypothesis11 that a more thorough reading of psychology's history only confirms.
2.4 Analysis
When psychology has been set aside in favor of neuroscience, when it's become a historical footnote with no living proponents (true now for alchemy), historians will write a more complete and detailed history than appears here. Those historians will have the advantage of seeing present-day psychology through the lens of neuroscience's future achievements — they will know which “mental illnesses” turned out to be physical illnesses with mental symptoms, which were pure invention, and they will know there are no true mental illnesses as that term should be defined:
2.4.1 Mental Illness Defined
A true mental illness would be one that exists only in the mind, not the brain or the body, and can be unambiguously and objectively diagnosed, treated and cured by mental health practitioners in such a way that (as with cancer and heart disease) all competent practitioners concur with the original diagnosis, the selected treatment, and the outcome.
Writers in that future time will have an advantage we do not — the existence of reliable science based on theory and observation, of topics presently studied by psychologists. Why is that important? Well, when a psychologist says there's an ailment called Asperger Syndrome, evidence-based critics can't say there's no such ailment. Because there's no theoretical support or reliable evidence, the psychologist can't claim the ailment is real (although many do), but for the same reason critics can't say Asperger's is not real. This is the burden faced by people who struggle against pseudoscience — in some cases, the pseudoscience is so far divorced from reality that there's no science to counter the nonsense. This is certainly true for psychology — apart from not being a science itself, the field is disconnected from legitimate scientific fields that might either lend weight to its conclusions or support evidence-based criticism.
2.4.2 Evolution of Diagnoses
Having said that, on surveying the fads that punctuate the history of psychology, it becomes apparent that they represent a learning process. Identifying homosexuality as a mental illness was a low point even for psychology, and it was quickly undermined both by biological studies and changing public attitudes. The “Refrigerator Mother” idea, apart from having no supporting evidence, victimized a large fraction of the population with no apparent purpose. Recovered Memory Therapy was far worse, in both its scale and effects — using narratives that in some cases were completely absurd (virgins accusing family members of rape), it victimized both the accusers and the accused.
But psychologists learn from their mistakes, and Asperger Syndrome proves it — it was a remarkable pseudoscientific achievement. There was never such an appealing diagnosis, and there may never be again:
2.4.3 Asperger Syndrome Diagnosis Benefits
When analyzing a controversial social issue, one normally presents a two-column list showing both advantages and drawbacks, but with respect to Asperger Syndrome, there are only advantages — unless you're a taxpayer, or you have a measure of personal integrity, or you want your children to succeed at an activity apart from playing the system, or you possess self-respect and want your children to acquire that trait, or you are a scientist and expect society to be guided by reason and evidence.
2.4.4 Abandonment of Asperger Syndrome
As psychological diagnoses go, Asperger Syndrome was spectacularly successful, but it became a victim of its own success — too many people acquired the diagnosis, the burden on taxpayers became too great, and the diagnosis deprived too many children of a sense of personal responsibility and purpose. Eventually public outrage over these outcomes caused the diagnosis to be discredited and removed from DSM-562 (psychology's “bible”).
This doesn't mean Asperger Syndrome has been declared false. That's not how psychology works — because of an absence of science and reliable evidence, old diagnoses tend to be abandoned in place, not refuted. A prominent psychologist and professor, one of those who voted Asperger Syndrome out of the DSM63, acknowledged this in an interview64, saying about Asperger's, “We don’t want to say that no one can ever use this word ... It’s not an evidence-based term. It may be something people would like to use to describe how they see themselves fitting into the spectrum.”
On that basis, and acknowledging the interviewee's professional status4, we can infer that Asperger Syndrome's status as a mental illness isn't based on evidence or science, it's caused a lot of public controversy, professionals now discourage the diagnosis, but if people would like to say they have it, let them. Professor Lord might as well have added, “And why not? It's all make-believe anyway.”
For contrast, imagine a medical doctor saying, “You don't have cancer, but if you would like to say you have it, no problem.” Reality doesn't work that way66, but psychology does.
2.5 Psychiatry
Those in psychology who proclaim a scientific standing for their field are misleading the public, but psychiatry67, by crafting a deceptive association between psychology and medicine, is particularly deplorable. Psychiatry (both training and practice) seems designed to misleadingly suggest that the mind can be treated using reliable, evidence-based medical methods. But this is false — psychiatry is not a legitimate field of medicine, and contrary to all appearances, there are no mind doctors. Psychiatrists are psychologists who have acquired a medical degree.
2.6 Neuroscience
Over time psychology will be entirely replaced by neuroscience68, the scientific study of the brain and nervous system. By studying tangible physical things neuroscience has the enormous advantage over psychology that it can produce reliable empirical evidence and falsifiable theories. It has the drawback that the human brain is very complex, such that a deep understanding of its workings may be decades away.
2.7 Objective Diagnosis
Once reliable brain models have been developed, in partnership with advanced brain scanning methods they should make objective, non-invasive clinical diagnostic methods possible for the first time. I imagine this conversation in a future neurological clinic:
Patient: “Let me tell you what I think is wrong with me.”
Clinician: “Please don't — we'll locate the problem with these instruments. Like a blood test or an X-ray, they can produce an objective diagnosis without relying on what you think is wrong with you. In fact, your self-report would only confuse the process. Remember psychology?”
2.8 Summary
To close this section, we can compare psychology to science by saying that, if the null hypothesis11 were to be enforced in psychology, if empirical evidence and falsifiable1 theories were required, the field would collapse.
3 Case History
3.1 Introduction
I include this section for two reasons:
This first-person narrative provides a real-life account of psychology's terrible effect on the people it's meant to help, by enabling bad actors and by burdening children with bogus diagnoses and treatments.
I'm the first-person in this narrative. In my adventure-filled life I've been in danger any number of times — an armed standoff with pirates in the Indian Ocean during my solo world sail69, many grizzly bear close encounters during Alaska expeditions70, and a few close calls during my years as a stunt pilot. But my most dangerous personal experience resulted from naively accepting a housewife's plea that I befriend her intelligent son. In retrospect I would prefer to meet a grizzly bear in a dark wood — even if the bear tore me to pieces, at least I would understand his behavior.
Although this account is true, for legal reasons all names and some events are changed.
3.2 First Meeting
Among other things71 I'm a successful computer programmer, author of some well-known programs72. This means parents, usually mothers, sometimes contact me to ask for advice and guidance for their children. Over decades I've become less enthusiastic and more guarded about this sort of cold contact — parents tend to have unrealistic assessments of their childrens' intellectual abilities and to be frank, some women have motives apart from enriching the lives of their children.
The woman I will call Joan (all names are changed) contacted me and asked me to befriend her son, whom she described as very bright, misunderstood and isolated. I was immediately skeptical — what kind of mother calls a perfect stranger and, with no preliminaries, encourages him to befriend her son? And how often is a son accurately described by his mother? I declined Joan's request and closed the contact.
This only increased Joan's fervor. For the next few months she contacted me repeatedly, by telephone and email, and I declined repeatedly. I would have demanded that she stop contacting me but we had a mutual acquaintance I didn't want to offend.
Seven months later, on the occasion of a public appearance, Joan showed up and presented her son Jim (all names changed), who turned out to be very bright after all, but entirely isolated. We immediately began discussing some pretty advanced topics — logic, mathematics, computer programming.
In retrospect I should have noticed some weird aspects of the situation — how was such a bright, personable kid so completely isolated? Bright kids his own age, interested in technical activities, would have been a much better choice than me, and in a normal family he would already have such companions.
3.3 Starting Out
In a conversation about the outdoors Joan said something I found strange. She said, “I don't like the desert.” I have a hard time imagining someone not liking the desert, but I didn't understand what she meant until much later.
Jim and I began to enjoy each other's company, for a number of reasons including the fact that until we became friends Jim had never been treated with understanding and respect. During this phase it came out that Joan was fully immersed in psychology — therapists were wise guides in the trackless wilderness of adult life, psychology explained reality, that sort of nonsense.
But Joan didn't just read the trash pop-psychology books that lined her shelves. When an issue came up that Joan couldn't decipher, she would call a therapist and get a ruling5. On one particularly stressful occasion she called two therapists, then announced the outcome as though a scientific discovery had been made. It never occurred to her that because she paid the therapists and telegraphed her preferences through various unsubtle mechanisms, the outcome was entirely predictable.
Some of my readers may anticipate the next revelation — Joan acquired bogus mental illness diagnoses for each of her children, forced them into therapy and spent much time discussing psychological ailments and therapeutic methods. Jim got an Asperger Syndrome diagnosis — a diagnosis, now abandoned73, that could be applied to any bright kid. As bright as he was, Jim didn't see through the psychology charade, consequently he saw himself as defective, in need of mental correction. This resulted partly from his loyalty to his mother, partly from inexperience with basic life issues.
For Joan, psychology wasn't about understanding or self-improvement, it was about authority and control, and in an earlier era religion would have served the same purpose6. By acquiring pseudo-medical diagnoses for her children, Joan created a control strategy unavailable to parents who expect to interact with their children through reason and mutual respect. If Joan saw a behavior she didn't like, it was a symptom of mental illness. Her children didn't have the life experience required to see through her machinations and over time they became her emotional hostages.
My friendship with Jim changed all that. He knew I respected him, admired his intellectual ability, and this began to undermine Joan's authority-based control scheme. John, Jim's father, saw a change in Jim but didn't fully grasp its implications, saying in an email, “During this one year of your interaction, [Jim] has grown up from a child to a teenager, and I credit you with part of his positive outlook on life today.”74 By contrast, as she saw her faux authority wither away, Joan began a slow burn.
About this time Joan wrote me, saying, “It's nice that my son has a friend who understands the words he uses.”75 Well, in fact it was nice — but over time, less so for Joan.
3.4 Factitious Disorder/Munchausen Syndrome by Proxy
I've already described how Joan acquired diagnoses for each of her children and consulted with therapists about pedestrian issues, but as time passed I began to see more peculiar behaviors. One was the enthusiasm with which Joan described her childrens' psychological diagnoses and symptoms, another was her recitations of their “medical plans”. I resisted explaining to Joan that psychology isn't a medical field and doesn't have medical plans.
Even more oddly, when her children drifted away from the aberrant behavior she expected, behavior consistent with their diagnoses, if they instead showed neurotypical behavior, Joan became anxious, as though something had gone wrong. In other words Joan exhibited the opposite of normal parental behavior — for some dark personal reason and oblivious to how she looked to outsiders, she pushed her children toward abnormal behavior.
About this time, in a conversation with a doctor and without revealing any identities, I described Joan's behavior. The doctor promptly said, “That's Munchausen76, and it's dangerous.” I decided to look into this. According to the Wikipedia entry:
Factitious disorder imposed on another (FDIA), also known as Munchausen syndrome by proxy (MSbP)7, is a condition where a caregiver creates the appearance of health problems in another person, typically their child. This may include injuring the child or altering test samples. They then present the person as being sick or injured. This occurs without a specific benefit to the caregiver. Permanent injury or death of the child may occur.
The cause is unknown. The primary motive may be to gain attention.76
In old-style MSP, a mother8 would use poison to induce symptoms in her children and gain attention. In modern MSP, psychological diagnoses often stand in for poison: “In factitious disorder imposed on another, a caregiver makes a dependent person appear mentally or physically ill in order to gain attention.”76
It won't surprise my readers to hear that psychologists have a diagnosis for this behavior — the title of this section — but in spite of how dangerous it is (“MSP isn’t just a condition; it’s child abuse and it’s a crime.”77), the diagnosis is rarely assigned to anyone. Medical practitioners have no problem identifying MSP (as was true in this case), but psychologists are reluctant to make it a formal diagnosis. The reason? In modern times most therapists are women, and an even higher percentage of therapy clients are women. If word got out that therapists were willing to diagnose MSP, clinical psychology would collapse. Another reason is once the diagnosis is made and because of the danger, many jurisdictions require a police report.
And worse, mental health practitioners are sometimes maneuvered into assisting MSP perpetrators: “... unique to this form of abuse is the role that health care providers play by actively, albeit unintentionally, enabling the abuse.”76 This means the mental health business to some extent relies on “diagnosing” factitious disorders in their clients' children.
At this point readers might wonder, given how much weirdness I was seeing, why didn't I just withdraw? Easily answered — everyone could see Jim was benefiting from my friendship and I didn't want to abandon him, allow him to fall under Joan's spell once again. But in retrospect, I underestimated how dangerous Joan would become once Jim began to doubt his mother's world view.
3.5 The Family Outing
John, Jim's father, was as dysfunctional as Joan but in a different way (Joan was a simpleminded loon, but John had a history of violent behavior). One day John proposed a family outing that included climbing a hill. By that time I had begun to doubt everything about these people, so I visited the site in advance and discovered a nearly vertical cliff, a technical climbing site equipped with a safety line (see Figure 2).
Figure 2: The “Family Outing” site
This was the first serious disagreement. I showed Joan and John a picture of the cliff and argued that it wasn't remotely appropriate for a family outing — the climb's advanced physical demands would place the children in danger. I wasn't just speculating — I have a lifetime of outdoor experience and some knowledge of technical rock climbing78 — the parents should have listened to me. The ascent was too steep for normal hiking and required climbers to grip a safety line while climbing.
Joan and Jim refused to reconsider the outing, for reasons I couldn't fathom at the time — the outing was to go forward. I went along, not because I had changed my mind about the danger, but because I knew I would be the only person with the skills required to rescue someone on a steep slope.
My plan was to stay below the children for the entire ascent and descent. During the descent, as I dreaded, Jim lost his grip on the safety line and fell. I had been maneuvering to stay below the children and happened to be perfectly positioned to grab Jim out of the air as he sailed past.
Those with little life experience might think, “Wow! Thanks for rescuing my son!” would be an appropriate response, but this isn't what happened — in fact Joan was barely able to conceal her resentment. After some thought I was forced to the conclusion that my rescuing Jim thwarted Joan's twisted plan to create an injured or permanently handicapped child, one who would never escape her orbit.
One more thing — to rescue Jim, I had to touch him, and Joan noticed. Why do I mention this seemingly unimportant detail? Read on, pilgrim.
3.6 Hell Hath no Fury
This section will only make sense if I explain that in Joan's world, there was no visible daylight between “I want” and “I deserve.” There's a common psychological term for this that I'll resist using.
Some time after the cliff rescue (which was never mentioned again) it came out that John was having an affair, which precipitated in Joan what can only be described as a full break from planet Earth. Joan's grip on reality had never been that secure, and this revelation caused her anchor to come loose. But even while drifting in a parallel universe, Joan continued to scheme.
In her twisted mind Joan had begun to see me as a replacement for her unfaithful mate, and the news about the affair only served to thrust this fantasy into the foreground. Moving beyond her increasingly affectionate emails, Joan chose a moment sitting next to her husband to announce she loved me, in a manner and tone of voice that could only sanction an equally overwrought reply. Instead I replied, “Thank you, that's very nice.”
My goal was to clearly say I wanted to be friends with Jim and everything else was background noise I would happily do without. Expressed another way and for me, the only interesting thing that issued from Joan was her son. I could satisfy Jim's voracious intellectual curiosity9, validate his identity as a person, and see the world through his eyes. Any one of these would have justified our investment in time, but together they produced friendship.
I wasn't unaware of the risk in clearly expressing myself — as a single man I've been in any number of hell-hath-no-fury79 episodes with women who expected to be able to change my marital status. But I had failed to take into account the possibility that Joan was a psychopath.
3.7 The M-Word
Made furious by my rejection and oblivious to any other issues, Joan decided to drive me away in such a way that Jim wouldn't be able to figure out why I had withdrawn. In this plan Joan managed to underestimate both Jim and myself.
At that point Joan's imagination began writing checks her intellect couldn't cash. In an email she encouraged me to remain friends with her son as long as I liked, then expressed her belief that a child sitting on an adult's lap constituted molestation in and of itself.
When I read Joan's claim equating lap-sitting and molestation, I saw at once that she intended to apply magical thinkingMT to acquire for herself the coveted status of victim, using her son as a proxy. Joan had missed out on the Recovered Memory Therapy2.3.5 era, where this kind of fantasy temporarily made its way into courtrooms, and it seems she wanted to resurrect that unfortunate era.
I took a deep breath. Entirely out of touch with reality, Joan had introduced the M-word into our written communications and, despite that it was part of an absurd claim and bore no relevance to my friendship with her son, I had no choice but to withdraw.
In the weeks after my departure Joan put on a show of trying to get me to resume my friendship with her son, saying things like, “Your continued presence in his life is more than welcome.”80 But that wasn't going to happen — I finally realized how dangerous she was.
3.8 The Plea
On realizing I would no longer be visiting, Jim called me on the telephone and asked for a resumption of our friendship. His plea was perfectly logical: there was nothing inappropriate in our friendship, we both benefited from it, therefore it should continue.
By then I knew what was at stake. If I withdrew, Jim would have to sit alone in his room, doubt his sanity and personal value, and resent my having abandoned a valuable friendship. If I didn't withdraw, Joan had clearly telegraphed that she would make a false and dangerous accusation of wrongdoing with a child. But instead of revealing these details, I explained to Jim that Joan's life was ruled by belief, not evidence, and some of her beliefs were dangerous10.
To make my point I quoted Joan's lapsitting-as-molestation belief and explained what the word “molestation” means to an adult — how dangerous it is when spoken in malice by an irresponsible person.
Until then my interactions with Jim had been informed by a high regard for truth and candor, mutual respect, and logic. But this conversation represented a sudden descent into the messiness and uncertainly of adult life, and Jim began to panic. He said there was no way his mother would do something so terrible as lie about a crime, therefore I was acting irrationally and throwing away our friendship for no reason. I realized that, because of his limited life experience, I wouldn't be able to explain the situation to him, so I said something I hated hearing when I was Jim's age: “When you're older, you'll understand.” I made it clear that I valued our friendship, but Joan was dangerous.
After a long, tense pause, Jim and I switched to a more pleasant topic — we discussed the Riemann Zeta Function81 for a few minutes, then signed off just as though we would be speaking the following day (when in truth, it would be five years before our next contact).
On hearing of our phone conversation and still hoping to get me to reverse my decision, Joan emailed an objection, saying, “You've said I have told [Jim] you have intentions about him that will/can harm him [...]. That's your own imagination, not my position.”82 Thinking this message might prove particularly useful, I added it to the Joan archive.
I imagined that would end things, which meant I still didn't understand Joan.
3.9 Dangerous Lies
It soon came to Joan that, despite her campaign of narcissistic fury and righteous entitlement, I wasn't coming back. So she moved to the last phase of her game plan (see Joan's Game Plan) — she swore out a civil court petition, making the exact accusation I had expected based on her M-word email11. That was the day I realized Joan was a textbook psychopath — malicious, indifferent to anything but her immediate twisted needs, profoundly dysfunctional, and unable to imagine the consequences of her actions.
When I received her petition I wondered whether Joan knew the difference between criminal and civil law — that people who make criminal accusations in civil court only make themselves look opportunistic and ignorant. And she clearly didn't realize I had archived her emails.
Joan's primary error was to assume that, because she discarded emails once read, therefore others did the same. That was naive — on witnessing her behavior, a rational correspondent would archive every word she put in writing. In this case, those emails proved she was mentally unbalanced and a transparent liar.
It was a short hearing — I testified that I possessed a complete archive of Joan's emails and those written messages flatly contradicted her statements under oath. I had prepared some examples, but on hearing about the email archive, Joan fell silent and offered no defense. The Court realized she was lying and ruled accordingly. Elapsed time ninety seconds.
3.10 Double Down
Joan hoped to keep Jim in the dark about the hearing, but by applying a bit of computer expertise he thwarted her childish scheme and got hold of the petition. On seeing the written record of Joan's treachery and betrayal, Jim's perception of his mother changed immediately and permanently. His idealism now in tatters, he resolved never to speak to Joan again. He realized I had been exactly right about Joan and that my withdrawing was the only choice. This was Jim's first step into adulthood.
After the hearing I ordered a criminal background check and discovered Joan had accused other men in much the same way — she had a history of lying under oath about sex crimes12. On reading the report I felt perfectly stupid for not ordering an advance background check and for trusting someone so obviously untrustworthy.
Joan's criminal background report showed a perverse, escalating pattern of lies that I should have uncovered before getting entangled in her web. Over time Joan got tired of pedestrian lies, such that — not unlike an addict's accelerating hunger for drugs — she needed bigger lies, about bigger crimes, in more courtrooms.
That background revealed a predatory game plan that I immediately recognized:
3.10.1 Joan's Game Plan
- Persuade the victim to meet her child — “How could you pass up a chance to meet my brilliant son?”
- Become furious at rejection of amorous overtures, swear revenge.
- Try to elicit compromising responses to leading inquiries — “[Jim] now has pubic hair, haven't you noticed?” (“Don't know, don't care, haven't you noticed?”)
- Darkly hint that something unsavory is taking place and reject any defense — “People who defend themselves only look guilty!”
- Deceitfully delay the victim's departure — “... just your imagination, not my position.”
- After the victim departs, swear out a civil court petition that accuses him of something horrible — “... preying on my mentally retarded son.”
The entire game plan was present in this case, the quotations above are real but edited for length.
I would like to have gotten Joan's dangerous behavior into the local public record so my neighbors would be forewarned/forearmed, but I'm not one of those people who think instituting legal actions is a good idea. Also, just thinking about Joan provoked a wave of disgust. So I let it pass.
But Joan volunteered for the next step in her public exposure. Six months later, still furious at me for seeing through her and rejecting her romantic overtures, Joan swore out a new civil court petition that tried to blame me for destroying her relationship with her son. It appears to have escaped Joan's attention that Jim's furious reaction to her original accusation13 proved she had lied. That connection was beyond Joan's reasoning abilities, but not the Court's, and more important, Joan hadn't the slightest idea how her behavior looked to others.
Joan also objected to an earlier version of this all-names-changed article, which details her toxic behavior to a wide Internet audience. But her argument was a courtroom classic, known to all legal professionals — in order to object to this fictional-names article, Joan would have to argue that it is about her, while arguing that it isn't about her. She clearly hadn't given that any deep thought, which in her life was a recurring theme.
It seems Joan's past victims had been reluctant to publicly expose her false testimony under oath, which although understandable, only encouraged her to choose another victim and escalate her lies. I understood these issues when I wrote this article, and I published it as a matter of principle. My point? When Joan lied about me, she chose the wrong victim.
In my prepared courtroom remarks I explained that Joan spent months trying and failing to get me together with her son, then brought him to a place she knew I would be. After Jim and I became friends she drove me away by trying to move things in a romantic direction, then insisted that I resume my friendship with her son. When I refused she accused me of something vile and false, under oath, in a claim flatly contradicted by her prior written words. I added that Joan had a history of lying under oath about sex crimes, and she was severely dysfunctional.
3.10.2 Legal Advice
Joan had been served with my remarks in advance and could have offered any defense she cared to, but it seems she got some sage legal advice from an unknown source. Apparently Joan was warned not to object to being described as severely dysfunctional. The reason? If she objected to that description Joan would make it material to the proceeding, and on that basis I was ready to present expert testimony that she was a Munchausen by Proxy76 perpetrator, a danger to her children, and she would likely lose custody (Child Protective Services was investigating Joan at the time). If she instead stood mute, her dysfunctions would become a stipulation84 (an issue on which both sides agree) and she would no longer be able to enter into legally binding contracts. Both were bad outcomes, but the second less so.
And to think — Joan could instead have hired an attorney who would have reviewed the facts, then warned her what would happen if she filed another petition.
In a repeat of the first hearing, after my testimony Joan fell mute (thus conceding the truth of all my claims) and the Court once again realized she was lying. He congratulated me on my presentation, dismissed her petition and gaveled the hearing to a close14.
As I left the courtroom I remembered that Joan once said, “I don't like the desert.” I finally understood what she meant — someone told her you can't sue nature.
3.11 Visiting the Grown-Up's Table
To a degree I had never seen before, Joan didn't live in reality, and rarely visited. In her plastic-teacup world she paid therapists to accept anything she cared to say, like the virgin rape victims in Recovered Memory Therapy2.3.5 — “Yes, dear, whatever you say, dear.” But in her courtroom appearances, including those revealed by the criminal background check, grown-ups found no connection between Joan's words and reality.
In the two hearings I witnessed, the Court listened to her claims, then waited for Joan to back up her words with evidence. But after briefly speaking Joan stood smug and content, expecting her fantasies to stand on their own, as they did with therapists. The core problem was that Joan didn't do reality, she did psychology, and therapy means paying someone to be on your side.
The courts always ruled against her, but to Joan, courtroom appearances represented a victory for the sort of intellectual mediocrity psychologists dispense to people trapped in perpetual infancy. Do you have a child intelligent enough to move out of your understanding and control? No problem — we'll thwart his personal development by branding him mentally ill, then force him into therapy — therapy often paid for with public funds. Does your son's face light up when a friend visits? And do they touch each other15? Maybe it's molestation — it can't possibly mean mathematics is interesting, or that mutual respect is its own reward.
I'm a seasoned world traveler69, but despite my wide experience Joan was the vilest organism I've ever encountered — predatory and parasitic in equal measure. She was a textbook psychopath — she would repeatedly engage in the most destructive behavior with her children and with people in the community around her, then complain about how unfairly she was treated by her victims.
One could say that Joan, a pseudoperson with no reliable principles, found herself attracted to psychology, a pseudoscience with no reliable theories. They were made for each other.
I imagine a scene in Joan's elementary school. Each girl is asked to describe what she wants to be when she grows up. Joan's classmates express their ambition to be astronauts, explorers, scientists. Now it's Joan's turn — she stands up and says, “I'm going to tell horrible lies about men and make them give me money ... wait, why are you all looking at me that way?”
3.12 Update
In spite of Joan's fervent wishes and valiant efforts, Jim caught on and left her house. As an adult he contacted me and we resumed our friendship.
Jim now writes computer programs, something I've done in the past72. We share an enthusiasm for logic and mathematics85. Where we differ is that Jim expects psychology to produce something worthwhile. I think in time he'll grow out of that.
I might have helped a little, but as a child Jim rescued himself from Joan's toxic fantasy world by learning logic and mathematics, which among other things represents a source of certainty in an uncertain world. In psychology, you're right because you pay a therapist to agree with you, but in mathematics, you're right because you've turned a conjecture86 into a theorem87 (a true statement). The difference? In psychology, as in religion, to stay right you have to pay more money. In mathematics, a useful theorem speaks truth to the ages.
Jim has more or less patched up his relationship with his mother. He can visit her house and be civil, but he doesn't have unrealistic expectations.
As for Joan, she's been told that, despite her obvious mental defects, if she makes another false accusation under oath, she'll be prosecuted and/or committed — she must curb her dangerous impulses or she'll be taken off the streets.
As for myself, when people call and ask me to meet their children, I tell them to read this article, then I hang up.
3.13 Conclusion
One of my reasons for writing this article was to satisfy an obvious unmet need. When I met Joan there was no available account of how many felony crimes a housewife can get away with if she happens also to be a psychopath. Now that this article exists, future victims of future Joans have no excuse.
My other reason, and consistent with a legal requirement for articles describing living persons, is that no one will know who Joan is, but everyone will know what she is.
4 Appendices
4.1 Why Asperger's is Gone
In a positive development, earlier versions of this article, as well as public outrage, contributed to the abandonment of the Asperger Syndrome diagnosis. This outcome shouldn't surprise anyone, because in time all mental illness diagnoses are abandonedHistorical Highlights. Imagine this exchange:
4.2 Mind versus Brain
A trained actor can be given a list of symptoms of a mind dysfunction such as Asperger Syndrome, Posttraumatic stress disorder (PTSD)89 or another mental dysfunction, rehearse for a while, then visit a psychologist, acquire the diagnosis and begin collecting disability payments. This is true because most psychological diagnoses rely entirely on self-reporting90, on what a person says about himself, consequently they're very unreliable. (Those who doubt this should read about the Rosenhan Experiment91.)
It's been suggested that some of the more popular and lucrative diagnoses (Asperger Syndrome92 in particular) are given out based on credible acting performances rather than objective dysfunctions — but this can only be suggested, not established scientifically, because there are no laboratory tests that can objectively confirm or deny the presence of these conditions, or even their existence.
Our trained actor can be given a list of symptoms of a brain dysfunction such as a stroke or a tumor, rehearse for a while, then present himself at a medical clinic, but the outcome will not be the same — an actor cannot pretend to have a medical dysfunction, because medicine doesn't rely on self-reporting, it relies on science.
That's the difference between mind and brain, and between psychology and science.
4.3 Newtonian Gravitation
In a famous and probably fanciful anecdote, Isaac Newton16 was said to be sitting under an apple tree when an apple hit him on the head and caused him to begin thinking about gravitation. By reflecting on the motions of small nearby masses and large distant ones, Newton arrived at what we now call Newtonian gravitation93, a relatively simple theory that describes the forces and motions of all massive objects, based on this equation94:
$$F = G \frac{m_1 m_2}{r^2}$$
Where:
- F = force with units of Newtons.
- G = the Gravitational Constant95.
- $m_1$, $m_2$ = masses of objects 1 and 2, kilograms.
- $r$ = distance between $m_1$ and $m_2$, meters.
This is a very important equation in physics and, even though there is a more accurate gravitational treatment in modern relativity theory, this simple form is still used for problems involving velocities much less than that of light, and is central to the problem of calculating spacecraft trajectories.
Because this equation applies to all masses, it's been subject to rigorous empirical testing, and because it's expected to apply to all masses in the same way, it has resulted in new scientific discoveries like Dark Matter96 and Dark Energy97, examples where applying Newton's equation produced unexpected outcomes.
4.3.1 Relevance to Science
Newton's equation is an example of science at its best. It uses mathematics to make a clear, objective theoretical statement that can be empirically tested, compared to nature, and if this comparison were to fail, the theory would be regarded as falsified. Newton's theory applies to all masses in the universe, and it's easy to test in such a way that differently equipped observers are forced into agreement about its meaning and its effect on nature.
4.3.2 Comparison with Psychology
In science, a theory's credibility relies only on the degree to which it agrees with nature, with reality. A theory might be discarded, falsified, if a key theoretical test fails — if nature disagrees. Agreement between scientists is relatively easy, because all scientists can examine the same evidence, and science is steered, not by eminence, but by evidence.
In psychology, an idea's credibility relies on the number of votes cast by psychologists. An idea might be abandoned (without ever being falsified) in the same way — a count of votes among psychologists. Asperger Syndrome92 acquired gravitas and acceptance by psychologists casting votes. It was abandoned the same way — after much public controversy it lost out in a vote of experts. Apart from panels of voting experts, agreement between psychologists is nonexistent, because psychology is steered by opinion and fads, not by evidence, and certainly not by science.
Footnotes
References
1 Falsifiability — with respect to a theory, the falsifiability criterion means the theory can in principle be proven false in empirical tests.
2 Criterion of falsifiability (Britannica) — a definition of science that requires falsifiability.
3 Karl Popper (Britannica) — philosopher of science.
4 Daubert v. Merrell Dow Pharmaceuticals, Inc. — an influential U.S. Supreme Court ruling that changes the standards for scientific testimony.
5 Daubert standard — the prevailing U.S. standard for scientific expert testimony.
6 McLean v. Arkansas Board of Education — an influential legal ruling that relies on a definition of science.
7 Royal Society, the oldest scientific organization in the world, dating to 1660 CE.
8 Nullius in verba — motto of the Royal Society.
9 Royal Society : History — includes an explanation of the Society's motto.
10 Richard P. Feynman — scientist and philosopher of science.
11 Null hypothesis — the scientific precept that there is no relationship between a cause and an effect until empirical evidence supports it.
12 Pseudoscience — claims, beliefs and/or theories that assert scientific validity but that fail one or more of science's requirements.
13 Argument from ignorance — a logical error having to do with proof of a negative.
14 Charles Darwin — scientist, co-originator of the theory of natural selection.
15 Cargo Cult Science — Richard P. Feynman's 1974 Caltech commencement address.
16 Isaac Newton — very influential scientist.
17 Newton's law of universal gravitation — the gravitational theory that predated relativity.
18 Magical thinking — in psychiatry, an irrational belief that thinking about something makes it true.
19 Presumption of innocence — the modern legal standard of evidence that resembles science.
20 Psychology — study of mind and behavior.
21 Biology — the study of life and living organisms.
22 Astrology — a pseudoscience that claims to divine information about human affairs and terrestrial events by studying the movements and relative positions of celestial objects.
23 Evolution — the theory that species evolve by means of natural selection.
24 Natural selection — a theory describing the mechanism by which evolution works.
25 Material Fatigue — the weakening of a material caused by repeatedly applied loads.
26 de Havilland Comet — a notorious example of metal fatigue leading to an in-flight failure.
27 Epigenetics — the study of heritable phenotype changes that do not involve alterations in the DNA sequence.
28 Sigmund Freud — very influential founder of psychoanalysis.
29 Metapsychology — a study of psychological theory as opposed to psychology itself.
30 Karl Popper on The Line Between Science and Pseudoscience — A summary of Popper's evolving outlook on the definition of science.
31 Sigmund Koch — Psychology's Antihero — an influential psychology critic and philosopher of science.
32 Psychology: A Study of a Science — editor: Sigmund Koch
33 Cargo Cult Science — a now-famous address by Richard P. Feynman about psychological and other kinds of pseudoscience.
34 American Psychological Association — a professional psychological organization.
35 Ronald F. Levant — past president of the American Psychological Association, critic of psychology's unscientific practice.
36 Evidence-based practice in psychology — Levant, 2005.
37 National Institute of Mental Health — the primary U.S. government agency with responsibility for mental health issues.
38 Transforming Diagnosis — Thomas R. Insel, former NIMH director.
39 NIMH funding to shift away from DSM categories — an important change in the NIMH's attitude toward science.
40 Steven E. Hyman — NIMH director (1996-2001).
41 Joshua A. Gordon — current (at time of writing) NIMH director.
42 Drapetomania — a faux mental illness diagnosis that presumed to explain why slaves ran away from their masters.
43 Lobotomy — a now-infamous invasive procedure meant to treat mental disorders.
44 DSM — the Diagnostic and Statistical Manual of Mental Disorders, psychology's “Bible”.
45 Conversion Therapy — a discredited and dangerous clinical practice meant to change a person's sexual orientation.
46 House Democrats seek to ban gay conversion therapy nationwide
47 Refrigerator mother — a phony psychological diagnosis.
48 Recovered Memory Therapy — a bogus therapy that claimed to uncover what were often fantasy memories.
49 Family Airing Its Trauma to Aid Others — an account of the Beth Rutherford virgin-rape episode.
50 Asperger Syndrome — an abandoned pseudoscientific diagnosis.
51 Not Otherwise Specified (NOS) — a mental illness “diagnosis” that was applied when no more specific description seemed appropriate. Its apparent purpose was to avoid having to tell people they weren't mentally ill.
52 DSM-5 — the current DSM version at the time of writing.
53 Cognitive-Behavioral Therapy — a very popular form of talk therapy.
54 Cognitive-behavioral therapy versus other therapies: redux. — a meta-analysis that finds no difference between CBT and other therapies.
55 A component analysis of cognitive-behavioral treatment for depression — this study found no difference between separately applied elements of CBT.
56 Placebo — a discussion of the Placebo Effect, in which an ineffective agent produces measurable results.
57 Diagnosis of Asperger syndrome — a description of Asperger Syndrome and its associated symptoms.
58 Goldwater rule — an informal name given to Section 7.3 of the American Psychiatric Association's (APA) code of ethics, which declares it unethical to diagnose people not personally interviewed.
59 The Benefits of Asperger’s Syndrome — a listing of famous people given the Asperger Syndrome label.
60 Rising autism numbers a challenge for public schools
61 Asperger’s Syndrome and obtaining social security disability benefits
62 DSM-V And How It Affects The Diagnosis Of Asperger’s Disorder
63 Diagnostic and Statistical Manual of Mental Disorders — psychology's “bible”.
64 A Powerful Identity, a Vanishing Diagnosis — about the abandonment of Asperger Syndrome.
65 Catherine Lord, Ph.D. — Professor of Psychology in Psychiatry and founding Director of the Center for Autism and the Developing Brain.
66 Auburn Woman Sentenced to Prison for Fraud — an egregious account of diagnosis fakery.
67 Psychiatry — a specialty that tries to build a bridge between psychology and medicine.
68 Neuroscience — the scientific study of the nervous system.
69 Confessions of a Long-Distance Sailor — an account of my four-year solo sail around the world.
70 The Day of Seven Bears — a rather dangerous encounter with seven Alaska brown bears all in close proximity.
71 Biographical Note — my brief C.V..
72 Apple Writer — my best-known program, an early word processor.
73 A Powerful Identity, a Vanishing Diagnosis — about the abandonment of Asperger Syndrome.
74 Personal written communication, 12.15.2004.
75 Personal written communication.
76 Factitious disorder imposed on another, also known as Munchausen Syndrome by Proxy (MSP).
77 Munchausen’s Syndrome by Proxy : “MSP isn’t just a condition; it’s child abuse and it’s a crime.”
78 Climbing — one of my rock climbing articles.
79 Hell Hath No Fury — an abbreviation of the famous line “Hell hath no fury like a woman scorned,” by William Congreve (1670-1729), an English playwright and poet.
80 Personal written communication, 12.15.2004.
81 Riemann zeta function — a fascinating topic, but a bit technical.
82 Personal written communication, 01.20.2005.
83 MSP : Warning Signs — a list of the behaviors typical of MSP perpetrators.
84 Stipulation — an agreement between parties in a legal dispute.
85 Introduction to Calculus — my tutorial for beginners.
86 Conjecture — in mathematics, a proposition for which no proof or disproof has yet been found.
87 Theorem — in mathematics, a statement that is formally proven based on other statements, theorems and axioms.
88 The Role of Genetics in the Etiology of Schizophrenia : National Library of Medicine
89 Posttraumatic stress disorder (PTSD) — a dysfunction said to result from traumatic experiences.
90 Self-report inventory — a summary of the problems associated with self-reporting in psychology.
91 Rosenhan Experiment — a now-famous experiment in which a group of mental health professionals gained admittance to a mental hospital by faking symptoms.
92 Asperger syndrome — an abandoned pseudoscientific diagnosis.
93 Newton's law of universal gravitation — a fundamental part of pre-relativistic physics.
94 Newton's Equation : Modern Form
95 Gravitational constant — an important physical constant.
96 Dark matter — a theory describing the anomalous motions of galaxies.
97 Dark Energy — a theory describing an anomaly in the expansion of the universe.
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