Mitchell of Research to be Done wrote this post after he and I and some other friends had a great discussion about social justice and giving people the benefit of the doubt, and how to adjust our beliefs and expectations when we’re proven wrong time and time again.
It wasn’t so long ago that Lawrence Krauss defended Jeffrey Epstein in the wake of accusations that Epstein had had sex with underage prostitutes, and I thought, “Well, that’s messed up, but maybe I can see how someone might think some of the things he thought, even while being incredibly mistaken.”
While it’s possible that Krauss was simply incredibly mistaken about the situation with Jeffrey Epstein, I am forced to acknowledge that an environment in which such accusations are so easily dismissed is an environment in which it would be easier for someone who frequently engaged in sexual harassment to continue to do so without consequence. While it’s possible that Grothe just didn’t understand where the women who blogged about harassment in the skeptic community were coming from, I am forced to acknowledge that an environment in which the concerns of women are not taken seriously is an environment in which someone who doesn’t respect the women in their workplace is less likely to be called out on it. While it’s possible that Shermer was just having a really bad day when he compared criticisms of his comments to witch hunting and Nazism, I am forced to acknowledge that an environment in which criticisms made by women are routinely gaslighted in this way is one in which women would find it more difficult to criticize problems like sexual harassment.
I want to believe the best of those I have looked up to in the skeptical and scientific community. I want to, but I am finding it more and more difficult. In each of the above examples, my initial instinct was to assume good faith, and later events made me feel naïve for doing so. Later events made it obvious that none of these people just needed someone to sit down and civilly explain things to them.
In watching conversations in the skeptic community over the past few years, nearly every time I have seen someone say something that I thought was harmfully wrong, but said to myself, “They probably just don’t get it.”, later events have suggested that much deeper problems “just not getting it” were at work. It feels like whenever my instinct has been to give someone the benefit of the doubt, it’s later come about that their actions have been consistent with those of someone steering the community in a direction that benefited them at the expense of others*.
I don’t know what to do with this realization. I don’t want to be overly cynical, but I also don’t want to be naïve. I would rather not go through life assuming that every time anyone says anything that reinforces problematic ideas that person is secretly twirling their misogyny mustache and readjusting their monocle of twisted rationalization. At the same time, I want my perceptions to be accurate, and it seems clear that they haven’t been particularly accurate recently.
I put the question to the audience: at what point is the assumption of good faith not deserved? How do you decide when trust is overly naïve or mistrust is overly cynical?
If we err too far on the side of giving people the benefit of the doubt, we run the risk of providing leeway and power to people likely to abuse what they’re given, as seems to have been the case in situations like the examples above. I also find that, at least in my case, I am more likely to identify with people whose good faith I assume. That is, if we assume that I’m a thoughtful, well-intentioned person, and that Public Figure X is not, but I think they are, then when I see Public Figure X excoriated for saying shitty things, my reaction is going to be partially, “Jesus, these social justice people might one day get all angry at me for just misunderstanding something, too!”. If, however, I don’t assume that similarity, I am less likely to see the legitimate complaints against Public Figure X’s actions as unfair or ridiculous, because I won’t be able to as easily imagine myself saying those same things while honestly misunderstanding. It it seems to follow from that that if we assume good faith, we might, correspondingly, assume that the shit storms that we see are more unreasonable than they actually are.
On the other hand, if we err too far on the side of assuming the worst, then, well, we are unfairly assuming the worst.
In the grand scheme of things, maybe there is no good answer. Maybe the only actionable solution is to continue calling out bad behavior, and to not apologize for calling it out, and to pay attention when it starts to look like a pattern. I know one thing I have gotten out of recent events is that I’m going to be enormously more wary of the suggestion that people would come around if only we would engage more civilly**. That ship has sailed. Too many important problems, both with people and organizations, have been identified by skeptics who were unwilling to compromise on calling out bad behavior.
But I genuinely am curious: what say you, skeptics? Are there any decent rules of thumb for separating good faith from bad faith? When do you assume honest ignorance and when do you assume willful blindness? Are there any decent rules of thumb for how to engage (or not engage) if the truth is uncertain?
Or, in short: what is there to be learned from all this?
*I want to be clear at this point: I do not, in any of the above situations, think that any of these people ever consciously thought, “What I really want is a community steeped in harassment and misogyny.”. I simply think that they are capable of rationalizing behavior that has that effect when it benefits them, even when it has a detrimental impact on the community.
**I also can’t help but notice a certain massive irony in all of the calls for civil discussion over the last couple of years in light of the fact that all three of the people I use as examples in this post are operating on a civility level which we might fancifully term “Lawsuit”.
Mitchell Greenbaum is a geeky, poly, kinky, skeptic blogger who writes about social justice, relationships, depression, and chronic pain at Research to be Done, and engages in a wholly excessive amount of… auto-metacognition? Or does it make more sense as meta-auto-cognition? He isn’t really sure, but playing with prefixes is fun and writing bios is hard. True story.
Content note: graphic descriptions of abortions and miscarriages
Being both a feminist and a skeptic means walking the fine line of critiquing the way science and medicine are practiced without denying their importance and validity, of empowering individuals who have faced abuse by these institutions without promoting at-best useless and at-worst dangerous pseudoscience to these individuals instead.
The author, Inga Muscio, describes the several clinical abortions she had: they were painful and terrifying:
Have you any idea how it feels to willingly and voluntarily submit to excruciating torture because you dumbly forgot to insert your diaphragm, which gives you ugly yeast infections and hurts you to fuck unless you lie flat on your back? I had to withstand this torture because I was a bad girl. I didn’t do good, I fucked up. So I had the same choice as before, that glowing, outstanding choice we ladies fight tooth and nail for: the choice to get my insides ruthlessly sucked by some inhuman shit pile, invented not by my foremothers, but by someone who would never, ever in a million years have that tube jammed up his dickhole and turned on full blast, slurping everything in its path.
Muscio, who is very clear about her opinions on “Western medicine” (she at one point refers to it as “that smelly dog who farts across the house and we just don’t have the heart to put out of its misery”), eventually gets pregnant again, and this time she tries something else:
I started talking to my girlfriends. Looking to my immediate community for help led me to Judy, the masseuse, who rubbed me in places you aren’t supposed to rub pregnant ladies. She also did some reflexology in the same vein. Panacea told me where to find detailed recipes for herbal abortifacients and emmenagogues. Esther supported me and stayed with me every day. Bridget brought me flowers. Possibly most important was the fact that I possessed not one single filament of self-doubt. With that core of supportive women surrounding me and with my mind made up, I was pretty much invincible.
So, one morning, after a week of nonstop praying, massaging, tea drinking, talking and thinking, I was brushing my teeth at the sink and felt a very peculiar mmmmbloommmp-like feeling. I looked at the bathroom floor, and there, between my feet, was some blood and a little round thing. It was clear but felt like one of them unshiny Super Balls. It was the neatest thing I ever did see. An orb of life and energy, in my hand.
But lest you think Muscio intends this as a solution just for herself, she concludes, disturbingly:
Concentrating on the power within our own circle of women was once a major focus of the women’s health movement. I think we would benefit from once again creating informal health collectives where we discuss things like our bodies and our selves. If we believed in our own power and the power of our immediate communities, then abortion clinics, in their present incarnation, would be completely unnecessary. Let the fundamentalist dickheads burn all those vacuum cleaners to the ground. if alternative organic abortions were explored and taken more seriously, there wouldn’t be much of an abortion debate. Abortion would be a personal, intimate thing among friends.
Can you say Amen.
I finished the essay feeling confused. Although Muscio explained that “clinical” abortions were painful and felt wrong to her, she did not even attempt to explain her fury at abortion providers (whom she seems to think are all men). She did not explain why (or even whether) a painful and scary medical procedure that aborts a fetus is any different from a painful and scary medical procedure that stops a tooth infection or removes a tumor. Would she advocate “alternative organic” methods for those problems, too?
Her graphic imagery of vacuum cleaners, blood, and gore is never explained or justified in any way. She just doesn’t like the idea of abortions, and this, apparently, is reason enough to let abortion clinics go extinct.
Muscio further erases the fact that women, too, can and do perform abortions, and her implication that only women can understand the female reproductive system is extremely cisnormative (and also simply wrong; any doctor who has spent years studying those organs and operating on them and helping to keep them healthy surely knows more about them than I, a cis woman, do).
But I think I’m most disturbed not by Muscio’s ideas, but by the editor’s decision to publish them in this anthology.
How would a young person, perhaps not very knowledgeable about abortions, perhaps who has grown up being told they are awful and immoral, perhaps in need of (or at risk of needing) an abortion themselves, react to reading this piece? What decisions would they make about their health? I’m wondering if the editor thought about this before choosing to publish the essay.
On one hand, I see the value of publishing and reading all kinds of narratives about reproductive health, including this one. In our rush to portray abortion as a standard, no-big-deal sort of medical procedure, advocates for reproductive rights sometimes lose sight of the fact that, like any other medical procedure, abortion can be terrifying and traumatic completely independently of the fact that it’s so stigmatized.
Fear of medical procedures (and fear of pain) is something that people are expected to magically “outgrow” when they stop being children. Some do, but some don’t. Doctors don’t always know how to respond to adult patients with extreme fear, and often respond without empathy or compassion. This is only one of many reasons some people turn to practitioners of alternative medicine for help.
Understanding this is essential if we are to help people find healthcare that works (both by actually getting them physically better and by treating them with dignity and care). But the essay was presented in the book without any sort of commentary. While the book’s editor isn’t necessarily condoning or supporting the ideas in the essay, she is nevertheless promoting them by giving them wider circulation than they would otherwise have.
People may read the essay and become convinced that prayer and herbal tea can actually abort a fetus, and that getting an abortion performed by a medical professional is always a horrible experience to be avoided at all costs. That someone would end up with an unwanted child is probably the best case scenario of taking Muscio’s advice, as alt-med remedies can be actively harmful and dangerous.
(In fact, in the essay, Muscio elaborates on the specific “herbal remedies” she used. One of them was pennyroyal, which was implicated in the death of a woman who used it to try to induce an abortion. She didn’t know that she had an ectopic pregnancy. In general, the history of herbal abortifacients is, as i09 puts it, terrifying.)
Giving people medically accurate information about reproductive health is a crucial part of progressive activism. While one might argue that left-wing distortions of science and medicine are more well-intentioned than their right-wing counterparts, the end result is absolutely identical: people don’t understand how their bodies really work, how medicine works, which medical interventions are supported by the evidence and which are not. People feel ashamed of seeking out medical care that works.
I know that there are compelling reasons to publish this essay as is. I can understand why the author of this book might’ve done it. But I wouldn’t. It seems irresponsible.
I’m traveling to Columbus, Ohio for the Secular Student Alliance conference, and CaitieCat has written a guest post so that you’re not too bored in my absence!
I was thinking about Schrödinger’s Rapist, the concept that to a woman faced alone with a man she does not know, it is rationality in action if she decides to be careful about how she interacts.
Now, this concept makes MRAs lose their NUT, and I can’t help but think it’s got to do with an inability to understand how reasoning works. That’s the charitable answer; the uncharitable ones are, I think, obvious.
So here’s an analogy: You’re walking down the street. You see a dog, loose, no collar. You don’t know whether the dog is escaped from someone’s house, or feral. You know nothing about the dog or its history.
Would you go over and start petting its muzzle?
Probably not. Why? Because you don’t know. It could be that this dog is feral and rabid, or it could be a sweet-natured lap dog. Basic rationality says that there’s little to be gained by treating the dog as anything but a possible object of fear at this point. You don’t know the dog, you don’t know its habits, you don’t know its mind, you don’t know if it’s been trained as an attack dog. You just don’t know.
Now, that rationality? That’s not in any way saying “all dogs are trained attack dogs which will bite you if you give them any chance at all”. That would be irrational; many dogs you encounter will be with people who love them, people who care about them, people who would help that dog not be a dog who bites people.
So you act as though any dog you don’t know could bite you, because it’s basic common sense, no?
Now go back up there, and change the concept of “dog” to “man”, and “bite” to “rape”.
THAT is Schrödinger’s Rapist. Not a belief that every man WILL rape. Simply a common-sense approach that any man you don’t know could rape, and when alone with such a person, taking a reasonably cautious approach.
How can men interact with this belief? By putting themselves in the mind of someone who doesn’t know what a wonderful person they really are, and thinking – hey, how would I as someone else know that I the real person aren’t a rapist? Well, they don’t. So you make a little effort to show the ways you’re not: you try not to walk close behind her, you don’t stare at her, you visibly involve yourself in other things, whatever.
It’s a simple issue in formal reasoning, the difference between:
– all dogs are dangerous animals which bite
– ANY dog could be a dangerous animal which bites.
One is an argument from the specific to the general, and is bad reasoning. The other is of an unknown-truth-value situation, where caution is obviously the prudent and rational answer.
And if you can’t see the difference between those two, maybe consider taking an intro course in reasoning.
CaitieCat is a 47-year-old trans bi dyke, outrageously feminist, and is a translator/editor for academics by vocation. She also writes poetry, does standup comedy, acts and directs in community theatre, paints, games, plays and referees soccer, uses a cane daily, writes other stuff, was raised proudly atheist, is both English by birth and Canadian by naturalization, a former foxhole atheist, a mother of four, and a grandmother of four more (so far). Sort of a Renaissance woman (and shaped like a Reubens!).
Of course, some positions are truly anti-skeptical and/or irrational, but in that case, you can show why they’re not with evidence. For instance! “Anti-vax is an irrational position because all the evidence shows that vaccines are really useful, and no credible study shows that vaccines cause autism.” Or! “It’s not very skeptical to say that mental illnesses are just made up by Big Pharma. Have you spoken with people who have mental illness? Have you researched its neuropsychological correlates?”
But it’s not sufficient just to say something like, “I’m a Real Skeptic so I believe X.” or “You only think Y because you’re being irrational.”
First of all, even assuming for a moment that you, personally, are thinking rationally/skeptically, the fact that your opponent disagrees with you does not necessarily prove that they are not thinking rationally/skeptically. Shockingly enough, rationality and skepticism, when applied to the same issue, can still lead to wildly different conclusions! Some people have studied the evidence and think religion is good for mental health in general. Other people have studied the evidence and think religion is bad for mental health in general, or that its good effects are moderated too much by other factors. Some people have studied the evidence and think that it depends. All of these positions may be products of rational thinking. However, one or more of them may still be wrong, because rationality is not a panacea. It’s just a useful process that often produces good results.
Second, by painting yourself as a True Skeptic/Rationalist and your opponent as a hysterical over-sensitive irrational whiner, you’re engaging in a cheap rhetorical ploy that doesn’t actually 1) prove your point or 2) falsify your opponent’s point. It simply attempts to curry favor to your side through the use of buzzwords like rationality and skepticism.
What you are doing, oh person who probably loves to bloviate about logical fallacies, is begging the question. “I am a rationalist and you are not because my position is right and yours is wrong. My position is right and yours is wrong because I am being rational and you are not.”
Somewhere within whatever issue you’re attempting to needlessly obfuscate lie falsifiable claims that you’re simply ignoring. For instance, if rape culture does not exist, you would not expect rape to be treated more leniently than other crimes. But it is. If rape culture does exist, you might expect rape victims to be blamed for their rapes more frequently than other crime victims are blamed for the crimes committed against them, and they are. If rape culture does not exist, you might not expect people to feel sorry for rapists who have their “lives ruined” by being accurately accused of rape, but they do. If rape culture does not exist, you might expect all rapes to be treated as equally “legitimate,” but they are not. The point is not which of us is being “rational” about this and which of us is a “True Skeptic.” The point is, in which direction does the evidence generally go?
And when scientific evidence has not been accumulated yet, there are still ways in which you can think rationally about the issue. Someone yesterday demanded me to find them statistics on the frequency with which white people touch the hair of people of color without their permission. First of all, if you expect such a study to come out of an American research university, you simply don’t understand how underrepresented people of color are as university faculty, and how unlikely white people are to just spontaneously choose to study an issue such as this (although perhaps it’s happened, I’m not a human research database). Second, riddle me this: if it is not the case that white people frequently touch the hair of people of color without their permission, why does basically every person of color say that this has happened to them? Why have many of them writtenblogpostsandarticlesaboutthis? Do you think people of color just got together in some secret cabal to plan a conspiracy in which they accuse white people of constantly touching their hair without permission? If so, what motivation do they have for doing this? You’re a Skeptic/Rationalist, aren’t you? By all means, propose an alternative hypothesis to explain this!
Calling yourself skeptical/rational is not enough to make you so. Calling your opponent anti-skeptical/irrational is also not enough to make them so.
P.S. This is only tangentially related, but if you’re a man arguing with a woman and you’re leaping to call her “hysterical” and “irrational,” pause for a moment and consider the historical and cultural implications of this.
Sea turtles (superfamily Chelonioidea) are found in all of the world’s oceans except the Arctic. They spend the majority of their lives in the sea, but females return to shore to lay eggs. All seven surviving species of sea turtle are on the endangered species list. Like many marine animals, they are threatened by oil spills, pollution, and fishing (they are often accidentally caught in nets). They are also in danger of poaching, as their meat, shells, and even their flippers are sold in some countries.
Sea turtles are also threatened by climate change. Because they use shorelines as nesting areas, rising sea levels may destroy those habitats, and the extreme weather brought by climate change may decimate their nests and eggs. Further, as global temperatures rise, so does the temperature of the sand in which sea turtle eggs are laid. Studies suggest that higher sand temperatures can have devastating effects on eggs and hatchlings, causing more female offspring, more deformities, more deaths of eggs and hatchlings.
The Whooping Crane (Grus americana) is an endangered bird native to North America. Before Europeans colonized the continent, there were probably over 10,000 of them. By 1938, that number was down to 15 due to hunting and habitat destruction. Thanks to a sustained and expensive conservation effort, the population has now recovered to about 382. However, during the past two years, five Whooping Cranes have been illegally shot.
Imagine you’re a biologist specializing in sea turtles and the effects of global warming on them. You’re well aware that there are many species adversely affected by global warming, and even more species adversely affected by human activity in general. For instance, many species of birds are threatened by power lines, skyscrapers, and other things that they can accidentally fly into and die. This obviously isn’t an issue for sea turtles. But sea turtles and global warming is what interests you and what you’ve decided to study.
Now imagine that every single time you write a paper or give a talk or submit a grant proposal about sea turtles and global warming, someone–probably a climate change denialist–shows up to be like “Yeah well it’s not a climate change thing! Many other species are affected by human activity! Why don’t you focus on those? Why don’t you talk about manatees? Why don’t you talk about Whooping Cranes?”
You probably know where I’m going with this, right?
Men and women (and those who identify as neither) are all harmed by the patriarchal society we have created. Nobody–or very few lucky individuals, perhaps–wins this game. Everyone is screwed by gender roles. Everyone faces denial and victim-blaming if they report sexual harassment or assault. Everyone is threatened by bullying and exclusion if they step outside of their roles.
But men and women are not always harmed in the exact same ways or by the exact same facets of the system.
When I wrote about street harassment a few weeks back, a bunch of people showed up to inform me that this is “not about gender.” Men get harassed on the street too. Anyone can be harassed. Anyone can be subject to unwanted, creepy, objectifying, humiliating sexual attention. This is true.
But the dynamics play out in different ways. Because it happens more to women than to men, the cumulative effects–the fear and self-objectification and distrust–are different. Because so many women are socialized believing that their looks are all that matters, it’s different. Because so many men are socialized believing that they must want sex all of the time, it’s different. Because women are so much more likely to be sexually assaulted, it’s different. Because men are more likely to have learned how to fight back and defend themselves, it’s different.
Gender is undeniably a way in which we organize our social world. So it makes sense that gender could also be an important lens through which to analyze society and social interactions. Most things, in fact, are gendered in some way. Yesterday in my psychology of gender class, the professor noted that housework is a gendered phenomenon, unlike, say, walking into a bookstore. When most people picture housework, they probably picture a woman doing it–or, at least, they picture men and women doing different types of housework (cooking/laundry/dishes versus yardwork/plumbing/painting). Walking into a bookstore, on the other hand, is something you can easily picture either a man or a woman doing.
But what about after they walk in? Which sections of the bookstore do they go to? Which books do they buy? Do they read those books alone in the armchair or on the subway, or do they read them in a book club?
Gender is a useful and fascinating lens to use, but it is only one of many. You could also use race, or class, or nationality, or any number of other social distinctions. Many social phenomena are racialized or…classified? There has to be a word for that.
Even with these, of course, people will show up bloviating about how “we’re all human” and “seeing race makes you the racist” and “everyone has problems” and “it’s not about gender.”
If you take these claims in good faith, you might assume that people who say this just don’t care very much about examining social divisions and inequalities and would prefer to look at problems facing everyone. Even then, however, the problems that face everyone don’t face everyone equally.
However, no matter how well-intentioned these people are, what they’re doing (purposefully or otherwise) is supporting the status quo, in which these distinctions are kept invisible and treated as irrelevant–a practice that only serves those in power.
Gender is an analytic framework that interests me, so I use it. As a woman, I use this framework from a woman’s perspective; it’s not my place to speak about men’s experiences. (Plenty of writers, by the way, use this framework from a man’s perspective, such as Ally Fogg and Figleaf.)
The point of the opening analogy, by the way, was not to compare men or women to animals or to suggest that women are like sea turtles or men are like Whooping Cranes or even that human threats to animals are like patriarchy (although perhaps you could view it that way)*. It was only to show that sometimes, it’s useful to look at an issue through a particular lens–for instance, examining threats to sea turtles by looking at climate change. Both sea turtles and Whooping Cranes are harmed by human activity, such as poaching and habitat destruction. But if we had to pretend for the sake of argument that climate change does not exist and that all animals are equally in danger and that humans screw over all animals, we would miss a vital point about sea turtle eggs and warmer temperatures.
And, by the way, nobody would accuse a sea turtle expert of not caring about Whooping Cranes or of actively hating Whooping Cranes simply because they happen to be more interested in studying sea turtles. Nobody would accuse a biologist who studies climate change of not caring about poaching simply because they’re more interested in how animals are harmed by climate change.
So no, I don’t have to talk about men every time I talk about women. I don’t have to pretend that there are no differences in how men and women are affected by things. As far as I’m concerned, it is about gender–and about race, and about class, and about everything else–and feel-good platitudes about how “we’re all the same species” only have the effect of hiding these important phenomena.
*Analogies Are Imperfect™, so please don’t derail the comments with discussions of the weaknesses of this particular analogy.
Now up: Jennifer Michael Hecht, a poet and author of three books about history. She has a PhD in the history of science from Columbia, and teaches at the New School and Columbia.
4:05: The first thing we can do to forward the goals that we have is to show up. To do what you’re doing right now. From The Happiness Myth: “It’s great to come out of the closet, but you also have to leave the house.”
Also, it’s important to remember that we’ve been here for a while. There have been atheists/secularists throughout history, including women. I’ll be focusing on one story, but I had a smorgasbord of women doubters, atheists, secularists to choose from. Even in the bible: Job’s wife says, “Curse god and forget him.”
4:14: Margaret Sanger was an atheist–“no gods no masters” comes from her. But she brought birth control to women in the U.S. Of course, there’s the whole thing with the eugenics…
4:16: Today I want to talk about someone you’ve never heard of. Her name is Clémence Royer. She translated Darwin’s work into French and claimed (unlike Darwin) that it proves atheism. Because she wrote an introduction to the French translation in which she connected Darwin’s ideas to atheism, she had a profound effect on how evolution was perceived in France–as atheist and anti-religion.
It’s not just building on Darwin, though, but also on Paul Broca’s work. Broca basically founded anthropology and neurology and discovered that a lesion on a certain part of the brain–the third left frontal convolution of the brain–you will have trouble speaking, even if your intelligence is perfectly intact. This came to be known as Broca’s area, and the affliction as Broca’s aphasia. The Catholic Church was troubled by this because the belief was that the brain has nothing to do with thought.
4:21: Broca was an atheist, and he and his atheist friends decided to form the Society of Anthropology based on Royer’s interpretation of Darwin. At first it’s men only, and Royer petitions to join and is denied. But she appeals to Broca and he lets her in.
The members later formed another group: the Society of Mutual Autopsy. It was intended to annoy the Catholic Church. For 30 years, as they died, these scientists dissected each other’s brains to try to find more phenomena like Broca’s aphasia. In her last will and testament, Royer states that she wants to donate her body to science. These scientists were lending meaning and ritual to their deaths while also advancing science.
4:26: The 1893 Freethought Convention was dedicated to the rights of women, and Royer was celebrated there. But we’ve forgotten that this is part of the history of secularism.
Royer believed a lot of the things people said at the time, and believed that she’d been born with a man’s brain.
4:29: The idea of science being on our side comes up a lot and people love to talk about who’s brains are like this and whose are like that. Maybe we should ask them why they never study the difference between the brains of tall men and the brains of short men. They have all sorts of social differences, too. But only certain differences are politicized.
Atheism used to be much more respectable. Edison was an open atheist and declared so right on the cover of the NYT. He got some backlash, but he survived. But the Soviet Union was atheist, and so it became treasonous to be an atheist. The 1950s were when god went into our money and into our pledge.
But our most murderous enemy is no longer the atheist Soviet Union, but rather places that are more religious than us.
4:31: Just by showing up, we see each other and see the crowd and encourage each other. Even if you don’t see exactly how you’re helping each other. Learn your empowering history. The knowledge of it may have been lost, but the change in the culture persists. We don’t remember these French anthropologists anymore, but at the beginning of the 20th century France separated church and state for the first time.
4:33: Know some feminist theory, even though it can be dense reading. It teaches us the subtle ways we take advantage of our privileges, such as where we live or our skin color or our money. You have to give away a little bit.
4:38: Audience asks Hecht to spell all the French names. lolz
4:41: Audience question: :What’s the best way to repopularize the atheist-ness of these historical figures?
Hecht: Micro histories tend to include atheists, but the larger, more general accounts leave them out. I have no doubt that there have been more nonbelievers in history than believers.
It’s the first panel of WiS2!! The topic is faith-based pseudoscience and the panelists are Carrie Poppy, Sarah Moglia, Rebecca Watson, and (Surly) Amy Roth. The moderator is Desiree Schell.
2:05: Panelists are introducing themselves! Rebecca’s talking about Skepchick: “We also have Teen Skepchick, which is just like Skepchick except without the profanity.”
Desiree: We’re not talking about “faith” just in terms of religion, but in terms of belief-based treatment in general. So homeopathy, anti-vax, and all that is included.
2:08: Amy: A really good example of this is homeopathy. Homeopathy “works” on the principle that “like cures like.” So if someone has certain symptoms, you cure them by finding something that would cause the same symptoms in a healthy person–something that might be poison. You dilute it into water or alcohol. And you shake it. “We’re not gonna get into the details of why, that’s just silly.” You continue to dilute it until there’s not even a molecule of the poison left. They take what’s left, which is basically water or alcohol, and they put it into a sugar pill and give it to you.
Amy’s getting volunteers to take the happy sugar pills!
Here’s how it works. You take the alternative medicine, and either you feel better for whatever reason and you assume that it works, or you get worse and you die. Or you eventually go to a real doctor and you forget about the part where the altmed didn’t work.
2:14: Rebecca: Homeopathy started in Germany in the 18th century and came to the U.S. mainly thanks to the same woman who started the Christian Science movement, which doesn’t believe in medicine but rather praying away illness. They do support homeopathy, however. So religion was an integral part of the way homeopathy was popularized in the U.S.
Amy: At the time, blood-letting was the most popular treatment, and homeopathy sure felt better than that!
Carrie: People who practice altmed are often very religious, although when I was religious this sort of thing was very looked down upon.
Rebecca: I grew up Baptist and even meditation was seen as “the work of the devil.” But even that validates it–“it’s evil, but it works.” You’re still saying it works.
Desiree: There are a lot of similarities. Reiki is very similar to faith healing, for instance.
Carrie: Faith healing is a term for anything where you’re not using “medicine” to heal someone–just waving your hands and stuff like that. Reiki requires “certification,” where you go to someone else who’s been “certified” and get trained.
Rebecca: There’s certification for reiki?
2:19: Rebecca: Pretty much every religion has pseudoscience in it. Creationism is a good example. Creationists believe that god made the world within the last 5,000-or-so years. Another example is female genital mutilation; adherents believe that women need to be cut to make them pure and chaste. The Jewish tradition of male circumcision is similar, and has actually spread disease and led to the deaths of infants.
Another example is the war on women. This is also full of pseudoscience, such as the idea that women who are raped can’t get pregnant. This was something actually said by an elected politician [“Not anymore!” -audience member]. Or, women can’t have contraception or abortion because they are equivalent to murder. This has NO basis in science–only in religious belief.
2:24: Sarah: The idea that god “has a plan” for everyone or that “everything happens for a reason” is another example, and a terrible thing to say to someone who has an illness. But it’s often said to sick people and it discourages them from seeking treatment because it leads them to believe that god will help them through it.
Rebecca: The Secret, too, is faith-based pseudoscience. The “Law of Attraction” (a theory, rather, not a law) states that you can get anything you want in the universe if you pretend you have it. If you pretend hard enough, the universe will give it to you! One idea is that you create a “vision board” where you put things that you want. (Rebecca’s would have a unicorn on it.)
This may seem innocuous–just people pretending to have what they don’t have–but the people most attracted to this idea are the people who are most desperate. And what it’s saying is that kids with cancer just aren’t wishing hard enough. It’s victim-blaming.
It’s become like a religion–people treat it like one.
2:28: Desiree: I want to talk about this idea of “what’s the harm.” Do these things have varying levels of harm? Or all they all harmful?
Amy: Is the law of attraction like the Underpants Gnomes? Step one, collect underpants, step two, ???, step three, profit?
[lots of laughs]
Amy: They’re all harmful. If someone does a “detox” diet, they might not kill themselves per se, but you get a positive response from society for doing something that’s actually harmful, and people end up believing that there are toxins in everything and that they can’t trust their doctors and etc. etc.
Sarah: Are they using altmed in conjunction with going to the doctor, or are they doing it instead of going to the doctor? One is more harmful than the other. Also, there are secondary harms–for instance, sharks are killed to make powder that’s supposed to have some sort of effects.
Amy: Some animals are almost extinct because of this.
Carrie: Yes, there are varying levels of harm, but you can’t estimate how someone might have very little harm for you might have much more harm for someone else. When I was pretending to convert to Mormonism, they told me that there’s no such thing as intersex people and that it’s very “clear” which sex you’re supposed to be.
2:33: Rebecca: Chiropractors also use pseudoscience and believe stuff that has no basis in anything.
2:37: Desiree: It seems that both religious and secular pseudoscience targets women. Is that just my biased perception? If not, why is that?
Amy: That’s because according to our gender roles, the woman is the one who’s in charge of the family, and the shopping and healthcare for the family. So a lot of altmed products are marketed towards women and they “empower” women in a sense because they allow women without much money to be able to afford “healthcare” when perhaps they couldn’t afford to go to an actual doctor. You’re doing something active for your child if you’re buying them some sort of medicine.
Sarah: It also has to do with the fact that modern medicine does not treat men and women equally. For instnace, women are more likely to die of heart attacks because doctors don’t take women’s reports of pain seriously. When I had a Crohn’s flareup at 15, doctors were like, “Oh, you’re just being hysterical.” It can get frustrating after seeing doctor after doctor and you might end up going to a naturopath instead, because they spend much more time with each patient than real doctors do. We need to empower women to speak up and tell doctors that they can’t ignore them, and that they need healthcare.
Anemia is a good example. Women often get it and it’s often attributed to women’s periods. But actually, it can be due to a gastrointestinal bleed, which is really serious. Women should be able to speak up and say that no, it’s not just because of their periods.
Rebecca: The concept of “women’s intuition” also has to do with it. People believe that men use logic and reason, while women have this “other way of knowing” that they should be proud of. But the problem with that is when you find empowerment in something that doesn’t exist.
Jenny McCarthy–[audience groans]–advocates against vaccines because she claims they cause autism, even though all the research says otherwise. Jenny has a son, and when he was very young she believed that he was a “magic angel being with psychic powers called a crystal child” and that she was an “indigo child,” which is also a magical being. [WHAT?!?!?!] Apparently being blonde and blue-eyed has something to do with it? (Kinda racist.)
What happened was that Evan (the child) was diagnosed with autism and the crystal child stuff went away. Instead, Jenny began advocating against vaccines because she believed that that’s what caused it–against the advice of her doctor.
How this ties into empowerment is that Jenny called this “being a tiger mom.” She wasn’t going to just sit back and let the experts decide what was right for her son; she was going to take charge because of her “intuition.”
One writer, an About.com editor, has an autistic child and says that some people criticized her for not being more like Jenny and not being like a “tiger mom.” But she did her own research and chose to trust her doctors, and felt less like a woman for doing so. That’s the problem with presenting magical powers as “empowering” for women. That’s why I argue strongly for empowering women through science and education, and encouraging women to be more skeptical and to fight for themselves.
Amy: Jenny McCarthy has managed to indirectly kill a bunch of people. Just last week a baby died of whooping cough because it wasn’t vaccinated. Everyone, when you go home, get yourself a pertussis booster shot and save a baby.
2:45: Desiree: We’ve talked about a number of other issues besides vaccines and homeopathy. What’s your perspective on the fact that we always take on these two subjects? If we were to go somewhere else with our skepticism, where would you want to go?
Sarah: We need to make skepticism more human-focused. Why do so many women believe in pseudoscience? Why are women predominantly affected by this? rather than simply sitting on our high horses. We need to have more compassionate and focus on the people affected rather than on the problems themselves. [applause]
Amy: I know we’re all atheists and agnostics here, but [some] churches do a really good job of empowering women. If a religious woman decides she’s going to give up god, is she going to find something comparable in our community? If you need help with your baby, if you need advice with your relationships, the secular community should provide that.
Rebecca: We should take advantage of the people in our community. We had a Blog Against Disableism Day on Skepchick, which Sarah participated in. People with disabilities don’t necessarily want an able-bodied person lecturing at them about why they should give up pseudoscience. Someone who has struggled with the same issues might do a better job.
Same applies to women. Having women talk about the same issues that male skeptics talk about might also help reach out to women. Likewise for mothers–Elyse Anders has done a great job writing about raising children, whereas I couldn’t do that.
Amy: People think that talking about this stuff will “dilute” skepticism or atheism, but you can have all kinds of groups. There’s room for all of us.
2:52: Carrie: People focus on homeopathy because it’s hilarious. But the most important things you can tackle are the ones that matter to people who matter to you. If your mom sees a chiropractor, read about chiropractic and see why people believe in it and try to look at it from the point of view of your loved one who believes in it.
Rebecca: The war on women’s rights so obviously overlaps with the goals of the skeptic movement. We need to educate people on the science. There are feminist groups involved in this, but I’ve always wanted skeptic/secular groups to get more involved (although some already are).
Sarah: Part of the problem with our movement is that we like to consistently cite studies and data. But that’s hard to relate to someone who isn’t very educated or interested in science. I’m really mad that pseudoscientific people have co-oped the term “holistic,” because there is a lot to say for the idea of caring for a person rather than a disease. It’s really scary to have a serious illness and have someone come into the hospital room and say “What’s your living will?” We really do need to focus on the whole person and promote patient-centered care.
2:57: Desiree: Audience questions!
Rebecca just drank some of Amy’s fake-poisoned water and spat it out. Amy: “Thanks for not doing the spittake in my face.”
Audience question: What can we do to help lost and suffering people from a secular point of view?
Amy: We need to be better at providing social support.
Rebecca: Altmed conferences/fairs attract a huge number of people. Someone needs to step up and be the Oprah of critical thinking, because the current Oprah is not.
Sarah: The problem is we have Bill Maher. Who doesn’t believe in germ theory.
Rebecca: Skepticism does tend to be in-your-face and about telling people, “Your belief is wrong and here’s why.” But there’s another side of it–the compassionate side. It’s always been there but it hasn’t been stressed. It’s the side that says, “We want to save people’s lives. We want to stop people from being taken advantage of.” I’ve always known that we need an Oprah, but it’s not going to be me. I’m too mean.
3:02: Audience question: Harvard recently conducted a study showing that over 50% of patients reported improvement even when they knew that something is a placebo. So what’s the problem?
Rebecca: Everyone go read Trick or Treatment. It’s written by a former homeopathic doctor. It discusses in detail how we know what works, regardless of whether or not we know how it works. It talks about the first controlled experiment, when many sailors would die aboard boats and a doctor on board decided to split the sailors up into four groups. One group got apples, one got salted beef as usual, another got limes, and another got something else. The group given the same stuff died. The group that got apples didn’t get worse. And the group that got limes got better. It might be considered “alternative medicine,” but it works.
When we talk about pseudoscience, we’re not talking about stuff that we don’t know how it works. We’re talking about stuff that’s been shown not to work. That study about placebos suggests that we shouldn’t give placebos without being honest about what they are.
Carrie: I’d have no problem with homeopathy if it said on the carton that it’s placebo.
Amy: Who knows which disease the example from Trick or Treatment discussed? [Scurvy!]
Also: Hawthorne Effect. When people know they’re being watched, they get better. It works with doctors, too–you want to please your doctor so you feel better and report feeling better.
Carrie: My partner and I play that “please the doctor” game all the time.
3:07: Audience question: What do you think about religion taking over instead of getting help for mental health issues?
Rebecca: Scientology is really bad at this. They have a number of sham organizations and one of them is dedicated to ending the practice of psychiatry entirely. And that’s really harmful, because they blame the people with mental illness for not being “clear” and needing more “auditing.”
Carrie: There can be good motivations behind this, because there are a lot of unsolved problems in psychology. But psychologists admit that. That can only be solved with more science, not less.
Rebecca: Outside of the sphere of real mental illness, it can be beneficial to have someone in the community whom you trust and can go to to talk about your problems. I wish there were more secular alternatives to the religious leaders who serve this function. And with religious leaders and psychics it can get out of hand.
Amy: Should we have a skeptics’ confession box at events?
Rebecca: I would like to be the person hearing the confessions because there would be some juicy shit!
3:10: Audience question: Those of us who think that skepticism can be used to address social issues (stop and frisk, immigration, etc.) are accused of mission drift. It seems that the skeptic movement doesn’t want us.
Amy: Start your own group:
Rebecca: It may seem that the larger skeptic movement doesn’t want you, but everyone on this panel wants you! You get to decide which groups you support, which conferences you attend, etc. You can vote with your dollar.
And the people who are already working on this issue can use a healthy dose of skepticism. A few years back the government convened a panel to determine when women should start getting breast cancer screenings. The panel saw that between the ages of 30 and 40, there were a lot of false positives and it was having a negative impact. So they recommended that the age be pushed back to 40.
I first saw this news on a feminist blog, and the blogger was furious because it’s “just a panel of men who have no idea what women go through” and who just want to not worry “poor hysterical women” with false positives. But that’s wrong! The recommendation was based on solid evidence, and luckily a lot of skeptics in the comments corrected that blogger and pointed out the actual evidence that this was based on.
It’s very important for the feminist blogger to see this and adjust her point of view. What then happened was that on another feminist blog, which was concerned with issues of race, noted that the recommendation that was put out was “for the average woman.” But the average woman is white. When Black women get breast cancer, it tends to happen much earlier and be much more aggressive. So Black women shouldn’t necessarily follow those guidelines. So this is a good example of skeptics getting involved in the feminist movement and making it better.
Encourage leaders of groups to get involved in the issues you are about. And if they won’t, start your own blog or group. That’s why we have guest posts at Skepchick, that’s why we have Skepchickon in July.
3:15: Sarah: Maybe some organizations do consider social justice to be mission drift. But the students in this movement are overwhelmingly supportive of making skepticism and secularism about social justice. There are lots of students here, especially student bloggers. [HI!!!] They’ve called us [the Secular Student Alliance] out, asking why our conference is predominantly white. They raised tons of money for Light the Night, which went to cancer research. We have students doing grassroots activism every single day. College is a very formative time in people’s lives–I became an atheist in college. High school and college are the time to reach people; if someone’s been doing pseudoscience for 20 years it’s gotten ingrained, but if you reach people during high school or college, you can change their minds.
This is the third post in my SSA blogathon! Don’t forget to donate!
Last quarter I took a psychology class called Social Stigma. Social stigma, to quote the great Wikipedia, is:
the extreme disapproval of (or discontent with) a person on socially characteristic grounds that are perceived, and serve to distinguish them, from other members of a society. Stigma may then be affixed to such a person, by the greater society, who differs from their cultural norms.
In the first class, the professor ignited a debate by asking the question, “Does anyone deserve to be stigmatized?” As examples, she used neo-Nazis and pedophiles.
We were really divided. The understandable knee-jerk response is that, yes, some people do things that are so terrible that they deserve to be stigmatized. However, I came down on the “no” side for several reasons.
First of all, there’s a difference between condemning someone’s actions and stigmatizing them. Although we may talk about certain actions as being “stigmatized,” the way the phenomenon of stigma operates is that it puts a mark of shame on an entire person, not just on something they did. When someone does a thing that is stigmatized, we don’t just think, “Oh, they’re a good/cool person but I don’t like that they did that.” We think, “This person is bad.” They’re immoral or vulgar or even mentally ill (transvestic fetishism, anyone?).
When a group is stigmatized, they are considered less than human in some ways. Whichever aspect of them is stigmatized becomes the whole of their identity in our eyes, and often this means that even if they change the actions that caused them to fall into that category in the first place, the stigma remains. This is the case for ex-convicts, for instance, who are often denied housing, employment, and other opportunities simply because they used to be criminals, served their time, and are now trying to contribute productively to society.
So, stigma and social disapproval are not the same thing; there are some key distinctions between them that I think may have been lost on some people during that class discussion.
Second, there’s a bit of an idealist in me that wants to teach people why doing bad things is bad rather than just keep them from doing those things for fear of stigmatization. And I get that practically it doesn’t matter, and if the only way to prevent people from doing bad things was to make them afraid of stigma, I’d accept that.
But the thing is, if the only reason you don’t do a bad thing is because you’re afraid that people will judge you, what happens if/when you become reasonably sure that you can do it without getting found out?
Take sexual assault. Being a convicted rapist is actually a very stigmatized identity–it’s just that rapists rarely become convicted rapists. Rape is known to be a Very Bad Thing, but rapists know that they can get away with it if they commit it in certain ways. Despite the stigma, rape is pervasive and rape culture exists.
Third, what we stigmatize does not always correlate well with what is actually harmful to society. Rather, we stigmatize things for knee-jerk emotional reasons, and then we invent post-hoc explanations for why those things are harmful. That’s how you get the panic about gay teachers converting students to homosexuality (has there ever been any evidence for that?), abortion causing mental illness, same-sex couples being unfit to raise children, atheists being immoral, and so on.
We didn’t decide to stigmatize same-sex love, abortion, and atheism because they were harmful to society. We decided they were harmful to society because we were stigmatizing them. And now, even as modern science and research knocks these assumptions of harm down over and overagain, bigots still cling to the fantasy that these things are harmful. That should tell you something.
Fourth, wielding psychological manipulation as punishment really, really rubs me the wrong way. The attitude that if someone does something bad they deserve to be cast out and hated and seen as inhuman scares me. I think it’s very normal and understandable to want to punish someone for doing a horrible thing, but, as I wrote after the Steubenville verdict, I’m not sure that that’s the most useful and skeptical response. I feel that our primary concern should be preventing people from doing bad things (both first-time and repeat offenses) and not satisfying our own need for revenge by punishing them.
Stigma is a blunt weapon. By its very definition it transcends the boundaries we try to set for it (i.e. condemn an action) and strongly biases our views of people (i.e. condemn a whole person). That’s why “hate the sin, love the sinner” just doesn’t work. If we are to promote rationality in our society, we should find ways to prevent crime and other anti-social acts without using stigma and cognitive bias as punishment.
This is the second post in my SSA blogathon! Don’t forget to donate! This post comes from a reader’s request.
In less than two weeks, I’ll be off to Washington, DC for the second Women in Secularism conference, to which I get to go primarily thanks to the generosity of an FtB reader who gave out a bunch of grants. Yay!
10. Cards Against Humanity. It’s not a secular con without it. It’s always the first thing to go into my duffel bag.
9. Washington, DC. I rarely have occasion to travel there, but it’s a beautiful city. Last time I was there it was December, which was slightly unpleasant, but this time it won’t be. Maybe I’ll have a bit of time to just walk around and explore, too.
8. Using my new business cards! I didn’t really give them out at Skeptech because I basically knew everyone there. But I’ll probably find a use for them at WiS2. Check them out, I designed them myself!
7. Seeing Susan Jacoby speak. I laughed out loud numerous times while reading her book The Age of American Unreason recently, and that rarely happens while reading nonfiction. I disagreed with her on some things, primarily relating to technology, but for the most part reading the book made me want to shout “fuck yes” periodically. She’ll be speaking about the history of women in secularism and I’m sure it’ll be similarly awesome.
6. Getting out of Evanston for three days.Every time I do this, I feel refreshed and destressed. There are great things about living at a university campus, and there are not great things about it. I look forward to sleeping in a comfortable bed and without drunk students yelling beneath my window (and now that I’ve said that won’t happen, just watch it happen anyway :P).
5. Friends! I’ll get to meet a bunch of lovely people with whom I correspond online but have never actually seen in person–Tetyana of Science of Eating Disorders, Ania and Alexander of Scribbles and Rants, and Melody of CFI-DC (who just might be involved in this conference somehow…). I’ll also get to see people I’ve already met: Kate and Andrew, obviously, Sarah Moglia, and tons of other people I’m probably forgetting.
4. Getting to see Stephanie, Greta, Rebecca, and Amanda speak–again. While seeing and meeting new speakers is always exciting, seeing the ones that I already know will be awesome is arguably even better.
3. Blogging! Lots of blogging! I’ll be doing it. I might even liveblog if I can get good enough wifi access. Taking notes/writing about talks is not only helpful for those who end up reading it; it also helps me better remember what I’ve learned, which is often a problem for me since I’m not an auditory learner at all. So sharpening my liveblogging skills will be great.
2. I know I already mentioned Amanda Marcotte, but her talk seems so cool that it warrants its own list item. It’s called “How Feminism Makes Better Skeptics: The Role Rationality Plays in Ending Sexism.” I think this is extremely important because there are so many people who still believe that feminism and skepticism are incompatible. There are also many feminists who take a very anti-skeptical stance to both feminism and other issues, which is why you sometimes see extreme science denialism and adherence to pseudo-religious dogma in the feminist movement. So I’m very curious to see what Amanda has to say about feminism and rationality.
1. Spending a weekend with a bunch of fantastic secular activists. Although I always enjoy the actual talks and panels at conferences, the best part by far is the feeling of being around so many people with whom I can fit in. There’s no other feeling quite like that.
If you’re going to WiS2, let me know and come say hi! 😀
Now, to be clear, I haven’t read either of these books. I might, just to see the full depth of his arguments. But I decided to read the interview anyway and assume that he accurately represented his own claims in it.
Parts of the interview, I think, are really on point. Greenberg discusses the history of the DSM (the manual used to diagnose mental disorders) as a way for psychiatry as a discipline to establish credibility alongside other types of medicine. He criticizes the DSM on the grounds that the mental diagnoses that we currently have may not necessary be the best way to conceptualize mental illness, and he thinks that once we gain a better understanding of the brain we will find that they have little to do with the physical reality of mental illness:
Research on the brain is still in its infancy. Do you think we will ever know enough about the brain to prove that certain psychiatric diagnoses have a direct biological cause?
I’d be willing to bet everything that whenever it happens, whatever we find out about the brain and mental suffering is not going to map, at all, onto the DSM categories. Let’s say we can elucidate the entire structure of a given kind of mental suffering. We’re not going to be able to say, “here’s Major Depressive Disorder, and here’s what it looks like in the brain.” If there’s any success, it will involve a whole remapping of the terrain of mental disorders. And psychiatry may very likely take very small findings and trump them up into something they aren’t. But the most honest outcome would be to go back to the old days and just look at symptoms. They might get good at elucidating the circuitry of fear or anxiety or these kinds of things.
I don’t know if he’s right. But I suspect that he might be.
He also makes a great point about the fact that we often assume that anyone who acts against social norms, for instance by committing a terrible crime, must necessarily be mentally ill:
It’s our characteristic way of chalking up what we think is “evil” to what we think of as mental disease. Our gut reaction is always “that was really sick. Those guys in Boston — they were really sick.” But how do we know? Unless you decide in advance that anybody who does anything heinous is sick. This society is very wary of using the term “evil.” But I firmly believe there is such a thing as evil. It’s circular — thinking that anybody who commits suicide is depressed; anybody who goes into a school with a loaded gun and shoots people must have a mental illness.
Greenberg also discusses how mental diagnoses have historically been used to perpetuate injustice, such as the infamous “disorder” of “drapetomania,” which was thought to cause slaves to try to escape their masters, and the fact that homosexuality was once considered a mental illness (and other types of sexual/gender variance still are).
He also talks a lot about how the DSM and its categories are tied in with all sorts of things: scientific research and mental healthcare coverage, for instance:
To get an indication from the FDA, a drug company has to tie its drug to a DSM disorder. You can’t just develop a drug for anxiety. You have to develop the drug for Generalized Anxiety Disorder or Major Depressive Disorder. You can’t just ask for special services for a student who is awkward. You have to get special services for a student with autism. In court, mental illnesses come from the DSM. If you want insurance to pay for your therapy, you have to be diagnosed with a mental illness.
The point about needing a DSM diagnosis in order to receive insurance coverage is really important and cannot be overstated (in fact, I wish he’d given it more than a sentence, but again, he did write books). As someone who plans to eventually practice therapy without necessarily having to formerly diagnose all of my clients, this matters to me a lot, because it may mean that I might have to choose between diagnosing and working only with clients who can afford therapy without insurance coverage (which, at at least $100 per weekly session, would really not be many).
But sometimes Greenberg makes a good point while also making a terrible point:
One of the overlooked ways is that diagnoses can change people’s lives for the better. Asperger’s Syndrome is probably the most successful psychiatric disorder ever in this respect. It created a community. It gave people whose primary symptom was isolation a way to belong and provided resources to those who were diagnosed. It can also have bad effects. A depression diagnosis gives people an identity formed around having a disease that we know doesn’t exist, and how that can divert resources from where they might be needed.
First of all, we don’t “know” that depression “doesn’t exist.” We know–or, more accurately, some of us suspect–that the diagnosis we call “major depression” might not map on very accurately to what’s actually going on in the brains of people who are diagnosed with it. What we call “major depression” is a large cluster of possible symptoms, and since you only have to have some of them in order to be diagnosed, two people with the exact same diagnosis could have almost completely different symptomology. Further, because depression can vary like a spectrum in its severity, the cut-off point for what’s clinical depression and what’s not can be rather arbitrary. It’s not like with other types of illnesses, where either you have a tumor or you don’t, either you have a pathogen in your bloodstream or you don’t.
Second, Greenberg doesn’t seem to extend his analysis of the effects of the Asperger’s diagnosis onto other disorders. There is absolutely a community of people who have (had) depression, eating disorders, anxiety, and so on. Those communities are absolutely valuable. My life would be demonstrably worse without these communities. They haven’t “diverted resources” from anything other than me wallowing in self-pity because I feel like I’m the only person going through these things–which is how I used to feel.
Right after that:
What are the dangers of over-diagnosing a population? Are false positives worse than false negatives?
I believe that false positives, people who are diagnosed because there’s a diagnosis for them and they show up in a doctor’s office, is a much bigger problem. It changes people’s identities, it encourages the use of drugs whose side effects and long-term effects are unknown, and main effects are poorly understood.
Greenberg is correct that false positives are a problem and that diagnosing someone with a mental illness that they do not have can be very harmful. However, his dismissiveness of the problem of false negatives–people who do have mental illnesses but never get diagnosis or treatment–is stunning coming from someone who is a practicing therapist. Untreated mental illnesses are nothing to mess around with. They can lead to death, by suicide or (in the case of eating disorders) otherwise. Even if things never get to that point, they can ruin friendships, relationships, marriages, careers, lives. While I get that Greenberg has an agenda to push here, some acknowledgment of that fact would’ve been very much warranted.
In short, Greenberg seems to make the logical leap that many critics of psychiatry and the DSM do; that is, because there is much to criticize about them and because it’s unclear how valid the DSM diagnoses are, therefore depression is “a disease that we know doesn’t exist” and antidepressants are harmful (that’s a whole other topic, though).
Antidepressants may very well be harmful. Diagnostic labels may also very well be harmful, for some people. But I think the stronger evidence is that untreated mental suffering is harmful, and sometimes therapy just isn’t enough and cannot work quickly enough–for instance, for someone who is severely depressed to the point that they can’t possibly use any of the insights they may gain in therapy, or to the point that they are about to commit suicide.
I hope that one day we’ll have all the answers we need to minimize both false negatives and false positives. But for now, we don’t, and I worry that attitudes like Greenberg’s may prevent people from getting the help they urgently need, as much as they may simultaneously promote vital criticism and analysis of psychiatry and the DSM.
Note: I didn’t fact-check everything Greenberg said in the interview because I’m hoping that The Atlantic employs fact-checkers. But if you have counter-evidence for anything in that article, even parts I didn’t quote here, please let me know.