Social contracts and sanity

Humans are social animals. To be social animals means being part of a cooperative crowd, relying on the group for safety, sustenance and providing back to the society in some meaningful way.

Our sense of identify is both tied up with defining ourselves comparatively with the crowd and individually as not the crowd. Adolescence sees this in it’s strongest form – the urge to not be defined as our parents, yet trying to find a group that we feel we belong to.

Part of this belonging to a group involves give and take. We give to the group and we take from the group. This is the reciprocation contract. If I give to you, then you will give back to me. There is the more altruistic contract which has become the pay it forward contract. When I give to you, you will give back to someone king of like me in a situation kind of like this one. The closeness of this “kind of” is quite variable and can more easily be seen as passing on good deeds. It is a rare individual who receives nothing but bad deeds and passes on nothing but good deeds.

We fall down miserably when we are removed from those who we feel we belong to. This can happen for a number of reasons: we realise we don’t belong to them, we move geographically or philosophically away from them, they don’t feel we belong to them and the group becomes dangerous, in someway, to our wellbeing.

Groups do more than hold us up when we fall down, they do more than provide the bits of sustenance that we  can not provide ourselves – they help us stay sane. Sanity, in this definition, is knowing how our own personal view of the world compares to the consensus of the group we most commonly interact with. A groups view of the world can significantly deviate from groups around them, and then the lack of “sanity” applies to the group, rather than the individual. 

Consider a member of some kind of subculture who believes any radical thought – lets say invisible fairies are running the world. Because the individual belongs to a group of people who believe the same thing, they are just all deluded. If an individual thinks this outside of a group, the person is called insane.

This suggests that a way of finding sanity is to find others who see the world you do.

Now the thought that invisible fairies are running the world seems pretty ridiculous to most people. Lets substitute the words “invisible fairies” to “supreme being” and it becomes less odd. Call that “supreme being” the devil and it goes to more odd. Call it “God” and it becomes less odd. The idea is the same, but the group you align to when you change the invisible something somehow changes the sanity level of the group. More insane if there are less numbers, more insane if there are more numbers.

Groups can be seen as islands in a sea of people. As you depart your views from the group you are most closely aligned with, you enter a “no mans land” between the groups, leaving islands and sailing on the sea. This is your most perilous time as you are quite lost without fixed points to steer yourself with. If you sail far enough away from the islands of groups such that you can no longer navigate by their beliefs, you can be lost in the sea of insanity, until you but up against a new island of people who see the world as you do.

You can lead a horse to water…

You know the old saw about the horse?

“You can lead a horse to water, but you can’t make it drink”

It is a good saying when thinking about aiding someone else in their personal evolution.

We often think we know the best water, the best source and the best way to drink. That may be true for us, and it may even be true for someone else, but if you push them to do it your way, then they don’t own that process and have a fair chance of rebelling against your rules, your system and your truth. So instead, consider this new variant of the saw:

“You can lead a horse to water, but trying to make it drink is a foolish waste of energy”

This reminds you to let the horse drink if it is thirsty, in it’s way, at it’s time. It also reminds you not to be foolish or waste your strength trying to make the horse do it your way.

Now consider this variant:

“You can’t make the horse drink, but you can lead it to water”

This variant takes out your own powerlessness, which decreases your frustration in the circumstance where the horse doesn’t want to drink. You don’t have to make it drink, but you can lead it to the water.

“The horse can drink when it wants to, and you can point out where there is water”

The power in this variant is two fold. You acknowledge that the horse has choice to do or not, as it sees fit. It also demonstrates that you are only showing a way, but acknowledging there are other sources, and thus different ways.

See what works for you.

Diagnosis vs Formulation

I went to an autoelectrician the other day to get the headlights for my car fixed. He suggested that it was probably the headlight switch in the colum, but wasn’t going to commit to that without checking it out. He also said it could be a fuse, the relay, wiring, a problem with the Earth and a few other possibilities. After looking at it, he gave a positive diagnosis of a damaged switch. He said I might be able to get a second hand one, or I might be able to purchase it first hand from the manufacturer (I have an old car, kind of like me).

I asked him how he knew and he said he tested the inputs and outputs of the switch and could definately say that the switch was not relaying the proper information. This was his test that validated his diagnosis, which was one of the probable expected diagnosies he had formulated in our initial discussion.

Similarly I went to a doctor (general practitioner) with a really sore throught a few years ago. He listened to my symptoms, took a look at my throat and told me I had tonsillitis. He proscribed some antibiotics specific to this kind of infection as my treatment. I asked him how he knew I had tonsillitis and he described the way to tell inflamed tonsils and the low likelihood of it being anything else. I asked him if there was any actual test he could perform to be certain and he offered to take a sample and have a lab test it. This would prove, conclusively, that I had tonsillitis. 

I went to see a psychiatrist many years ago. He listened to my list of symptoms and told me I had cyclothymia. I asked how he knew and he said I fitted enough of the profile of cyclothymia for him to diagnose it as such. I asked if there as any test he could perform to make sure and he said there was not and pointed out that mental health diagnoses do not work that way. He prescribed medication to fix it. I looked up the medication and it’s primary side effect is that if you don’t have cyclothymia before taking the medication, you probably will after taking it. Not a good selling point. I went back to the psychiatrist and asked for another option.

What gets me is, how can they call it a diagnosis when there is no test to actually prove conclusively that their opinion is correct? Isn’t that a formulation, not a diagnosis?

For example, schizophrenia has an interesting diagnostic criteria. The combinations that this “diagnosis” can demonstrate are huge, the causes are varied. You only have to display two of five major categories, each major category has multiple sub categories which you only need one in to make that category count. What conclusive test is there? No blood test, no scan, no reflex or pain test. Nothing.

Schizophrenia is not an isolated mental illness in this respect. Consider borderline personality disorder. It’s diagnostic criteria are also quite strange. One must demonstrate five of a possible nine symptoms for an extended period of time. Again, there is no actual test. 

This blog does not preclude the possibility that either of these, or many other labels, actually exist. The formulation of these theories for a person quite often give added insight for the practitioner to look for specific indicators, history factors and give guidance for proposed treatment and recovery plans. What I object to is the use of the word “diagnosis” without an actual test. Giving such authoritative chronic diagnoses limits people to believing that they are stuck with this illness for the remainder of their lives and thus cannot get better, lessen their symptoms and get back to leading a worthwhile life.

You can change your behaviours. You can thrive.