It is just scientific enough to be worth capturing

Saturday, June 1st, 2019

The APA highlighted a bunch of heroes and trailblazers from its past, but for every great hero celebrated on posters, there is an embarrassment buried somewhere deep in an archive, like Scott Alexander’s favorite, Dr. Anglin, who gave the APA Presidential Address in 1918 and declared that the greatest problem facing psychiatry was…the dastardly Hun:

The maxim that medical science knows no national boundaries has been rudely shaken by the war. The Fatherland has been preparing for isolation from the medical world without its confines. Just as, years ago, the Kaiser laid his ban on French words in table menus, so, as early as 19 14, German scientists embarked on a campaign against all words which had been borrowed from an enemy country. A purely German medical nomenclature was the end in view. The rest of the world need not grieve much if they show their puerile hate in this way. It will only help to stop the tendency to Pan-Germanism in medicine which has for some years past been gaining headway. ‘

The Germans excel all other nations in their genius for advertising themselves. They have proved true the French proverb that one is given the standing he claims. On a slender basis of achievement they have contrived to impress themselves as the most scientific nation. Never was there greater imposture. They display the same cleverness in foisting on a gullible world their scientific achievements as their shoddy commercial wares. The two are of much the same value, made for show rather than endurance — in short, made in Germany…

In the earliest months of the war it was pointed out that there are tendencies in the evolution of medicine as a pure science as it is developed in Germany which are contributing to the increase of charlatanism of which we should be warned. A medical school has two duties — one to medical science, the other to the public. The latter function is the greater, for out of every graduating class 90 per cent. are practitioners and less than 10 per cent, are scientists. The conditions in Germany are reversed. There, there were ninety physicians dawdling with science to every ten in practice. Of these 90, fully 75 per cent were wasting their time. In Germany the scientific side is over-done, and they have little to show for it all, while the human side is neglected. Even in their new institutions, splendid as they are in a material sense, it is easily seen that the improved conditions are not for the comfort of the patients.

Out of this war some modicum of good may come if it leads to a revision of the exaggerated estimate that has prevailed in English-speaking countries of the achievements of the Germans in science. We had apparently forgotten the race that had given the world Newton, Faraday, Stephenson, Lister, Hunter, Jenner, Fulton, Morse, Bell, Edison, and others of equal worth. German scientists wait till a Pasteur has made the great discovery, on which it is easy for her trained men to work. She shirks getting for herself a child through the gates of sacrifice and pain ; but steals a babe, and as it grows bigger under her care, boasts herself as more than equal to the mother who bore it. Realising her mental sterility, drunk with self-adoration, she makes insane war on the nations who still have the power of creative thought.

But it is especially in the realm of mental science that the reputation of the Germans is most exalted and is least deserved. For every philosopher of the first rank that Germany has produced, the English can show at least three. And in psychiatry, while we have classical writings in the English tongue, and men of our own gifted with clinical insight, we need seek no foreign guides, and can afford to let the abounding nonsense of Teutonic origin perish from neglect of cultivation.

The Germans are shelling Paris from their Gothas and their new gun. Murdering innocents, to create a panic in the heart of France! With what effect ? The French army cries the louder, “They shall not pass ” ; Paris glows with pride to be sharing the soldiers’ dangers, and increases its output of war material; and the American army sees why it is in France, and is filled with righteous hatred. Panic nowhere. Vengeance everywhere. What does the Hun know of psychology? His most stupid, thick-witted performance was his brutal defiance of the United States with its wealth, resources, and energy. That revealed a mental condition both grotesque and pitiable.

After the war a centre of medical activity will be found on this side the Atlantic, and those who have watched the progress medical science has made in the United States will have no misgivings as to your qualifications for leadership. If we learn to know ourselves, great good will come out of this war.

I was reminded of how English beat German as the language of science.

Scott Alexander makes the larger point that psychiatry has always been the slave of the latest political fad:

It is just scientific enough to be worth capturing, but not scientific enough to resist capture. The menace du jour will always be a threat to our mental health; the salient alternative to “just forcing pills down people’s throat” will always be pursuing the social agenda of whoever is in power; you will always be able to find psychiatrists to back you up on this.

Comments

  1. Graham says:

    I’d prefer it if the psychiatrists suddenly became nationalist Anglo-supremacists. How do I sign up for that?

  2. Kirk says:

    I’d be happy if the crooked bastards just became objective neutrals in all regards, but that ain’t happening.

    See, here’s the thing: Everything, absolutely everything in the realm of human endeavor becomes polluted by the human factor. You go back and look at the early Christian Church, and what do you find? Politics, politics, and more politics. There’s all this millenialist end-of-the-world BS, there are these bizarre little communitarian cults everyone has forgotten and swept under the rug when they do bother to go back and look, and the whole thing starts to look suspiciously like a modern-day “political movement” in many of the details.

    To me, it’s simple: Word of God, through Christ. Not much there to argue about, lads… But, they did. Oh, dear God, but they did. All the schisms, all the infighting, the outcasting, the insanity of it all. Follow the histories, and it’s quite breathtaking. Not to mention, off-putting.

    Then, you take a look at a lot of science, like the way the various sects and factions fight, excommunicate each other, and you’re going “My God, this looks like the early church…”. And, it is like the early church, because that’s how people do this stuff, which is in and of itself, insane.

    Look at the huge “wars” in science over theories like continental drift and the channeled scablands here in my home state. From the way the guys who first proposed those theories were treated by the established types, you’d have thought they were advocating for raping children, or something. Literally insane reaction to the simple proposal of a better theory. The establishment was wedded to the existing paradigm as though it were religion, and displayed a religious fervor in denial.

    You look at it all as being a part of the same continuum, and the only conclusion you can really reach is that people are fundamentally irrational, and entirely too prone to grabbing an idea and holding on to it with way more fervor than is really justified at all. And, they take it so damn personally, too–Apparently having invested way too much in the idea that they were right, and being unwilling to accept that they might have gotten something so wrong.

    I mean, seriously–Go look at all the early nutball stuff that went on in early Christianity, and then compare that to the things that go on in all the various “schools of thought and science”, and then tell me that there aren’t analogies to be seen, equivalencies to be observed. Same sh*t, different people, different issues–Only thing that’s the same is that the same fundamentally irrational species is doing the same thing, over and over again in another realm.

    It’s why I really don’t think that what we have today is “science” or “scientific”. It’s “Sciencism”, pure, unthinking belief. There’s no rational thought going on with many of the adherents–They believe what they believe as fervently as any 10th Century monk, and what they believe has as little basis in objective reality as most of that monk’s did.

    I dunno, anymore. You tell me humans are rational, thinking beings in either the individual or the collective, and I’m just going to hoot derisively and point at you, whilst flinging poo.

    Because, frankly, judging from what coming down from the trees has done for you lot, I’m going back.

  3. Paul from Canada says:

    “…You tell me humans are rational, thinking beings in either the individual or the collective, and I’m just going to hoot derisively…”

    I mentioned in a comment on another thread, about the model of human cognition with the three part lizard/monkey/robot brain. As I mentioned, the monkey is usually in charge, and the robot is the newest and weakest member of the team.

    One of the problems with humanity, and it took me many years to make peace with this, is that we are not in any way shape or form rational most of the time. What we think happens is that we make decisions after sober reflection of the facts. What really happens, is that we make a decision based on emotion, and then rationalize it post-facto.

    We THINK, we chose our new car because we weighed factors like price, value, reliability, comparison
    of reviews, crash worthiness, etc.etc. What we really do is chose the one we rally like (the red one!), and trick ourselves into believing we made a sober considered choice after the fact.

    The guy who writes the Dilbert cartoons goes into this a lot. He talks a lot about “persuasion”, and predicted Trump’s win early on the basis of psychology and “persuasion”. As part of his interest in “persuasion” and studying of same, he became a licensed hypnotist, and uses this as an example of his contention that we are NOT rational first, that we make emotional decisions which we then justify after the fact.

    The argument he makes is as follows. He gets a subject and hypnotizes them. Now normally, this person keeps his wallet in his back pocket, so under hypnosis, he gets the subject to more his wallet to his front pocket.

    After waking his subject, he asks him about his wallet. The subject produces it from his front pocket, and the hypnotist asks why it was there, after all, the subject usually keeps it in his back pocket. EVERY test subject, always comes up with a rationalization as to why it was moved, like it was irritating or itching, or something. None ever said “I don’t know”.

  4. Graham says:

    Paul,

    Well put. I had a similar conversation with a colleague a while back.

    I don’t think we are incapable of reason, but our reason operates within constraints at one end and limits at the other. For me, it’s a bit like free will and related to it as a concept. An extraordinary amount of what to me is unnecessary effort has been devoted to defending or undermining the absoluteness of both.

    The thing that strikes me is the number of people who are both stunned and horrified by that. I think something has gone wrong in our collective brains, again, or the education that comes to us in school and pop culture, or too many people think they are Vulcans [of whom I routinely point out their "Logic" in no way resembles logic], or there are too many influencers on the internet proclaiming themselves pure rationalists and their assumptions the defining and self-evident axioms of Reason. They somewhat straddle the political spectrum.

    Until recently probably most people would not have thought or worried about these definitions too much. Now many are alarmed to be told they are not pure reasoning machines. Not unlike how economists are shocked we are not pure calculating machines.

    No s@#t, collective Sherlocks.

    The thing to accept is that all that is OK. We are not actually under any obligation to be that. No one said we had to be. No one in actual authority, at any rate.

    I have taken a long time to get to the idea that there is no such thing as a rational/logical end, save that it is merely a means that actually serves some higher end, in which case the eventual ultimate goal will be pre-rational. Even survival, which for some is the definition of a rational goal, and I can see that as a plausible axiom, is really a bio instinct.

    And that’s OK. We’ll probably always have different goals and axioms and argue over them, and that’s OK too. If we stop, it might be because all have been persuaded by one set, but that won’t be a wholly rational process either. It might be a fear or shame process, as in the past.

    And at the micro level, we should be OK when we can’t provide a rational explanation for every daily life action or momentary whim. We used to all know it. It’s OK.Sometimes it will be hypnosis, sometimes it will really itch, sometimes maybe we will know the difference.

    Even the gods of old had unexplained impulses, and we are but products of nature.

  5. Graham says:

    I mean, we are vastly better at higher reasoning than your average groundhog, but only because we need to be, and even that is shaped by our biology.

    Some of us, like the groundhog, still don’t know enough not to run into traffic. Those furry buggers might be outpacing some of us in that field of study, actually.

    Why did I raise them? I rather enjoy spotting them. They are almost omnipresent on Ottawa’s highway verges and some other spots. Still, I did see a fallen groundhog yesterday who hadn’t got the traffic memo.

    One of my friends despises them because she has several times nearly injured horses in their stupid holes, but I still appreciate them.

  6. Graham says:

    Perhaps I should admit that scarcely anyone I know quite agrees with me on this part in particular:

    “I have taken a long time to get to the idea that there is no such thing as a rational/logical end, save that it is merely a means that actually serves some higher end, in which case the eventual ultimate goal will be pre-rational. Even survival, which for some is the definition of a rational goal, and I can see that as a plausible axiom, is really a bio instinct.”

    Everybody’s pet belief/value/identity/cause is rational to them. I’ve been and will be again guilty of it too. But arguing otherwise gets things going.

  7. Alistair says:

    I worry a lot about rationality too. It took me a long time to grudgingly accept that most people are really bad at it, and use reason as a drunk uses a lamppost – more for support than illumination. I then had to deal with the conclusion I was probably one of them.

    By way of reassurance that we might not be completely screwed, I offer the following heuristics for auto-sphinxing.

    1. You have changed your mind about 1 or more important thing in the last few years, on the basis of better evidence or argument.

    2. You are genuinely uncertain of the facts or ethics of an important issue.

    3. You wish that a lot of what you believe to be true, wasn’t.

    4. You have a conscious ethic, and are aware of incompleteness/problems with it.

    5. You views don’t neatly align with any large social movement; there’s an element of heterodoxy.

    6. You enjoy arguing, and hearing a novel and well-constructed argument you haven’t encountered before.

    7. You have high openness and low agreeableness (OCEAN).

  8. Graham says:

    Alistair,

    Is that list your own? It’s quite good and rightly challenging, probably for all.

  9. Alistair says:

    Graham,

    It’s a partial list of my own.

    I started to think about heuristics that could be useful in checking for self-serving bias, that would be resistant themselves to being captured by the monkey brain.

    Of course, they may themselves be the artefact of a particularly clever trap set by my monkey brain.

  10. Kirk says:

    It’s an excellent heuristic.

    That OCEAN acronym, though… I think I recognize it, but I can’t put my finger on it. Where does that come from?

  11. Graham says:

    I want to be able to tread a narrow line- to be able to reason and analyze without self-serving bias or to the extent possible against any other of my biases, without accepting the idea that I have a rational or moral obligation to accept as definitive the goals, desires or axioms of others.

    This is not an easy thing at all.

  12. Graham says:

    It’s the distinction between the maximum use of reason, logic and analysis as tool for understanding information, and just being asked to substitute my own biased with someone else’s.

  13. Paul from Canada says:

    Alastair,

    I love the list. I am adding it to my library where I keep my aide memoir of logical fallacies and similar things.

    I am very relieved to find that I can apply most of them to myself, although what you said about clever traps by the monkey brain applies.

    I commented on a different thread that I like the commentary of Gwynne Dyer, because his opinions on a subject were not predictable, and I saw that as the sign of an actual thinker.

    You list works to illuminate that ides.

    Ideas are messy and contradictory, and one of the very irritating thing about the current political and cultural orthodoxy, is its predictability. Talk to a “woke” person about any topic, and you can predict within a minute of two, what heir “opinion” (I use the term loosely), what heir opinion will be on ANY topic.

    A truly interesting person will have doubts and contradictory opinions, heterodox, as you put it.

  14. Paul from Canada says:

    Kirk,

    OCEAN

    -Openness
    -Conscientiousness
    -Extroversion
    -Agreeableness
    -Neuroticism

    The “Big Five” personality traits I mentioned in our discussion of IQ etc.

  15. Graham says:

    When I started out, everybody was still huge for Myers-Briggs and I think it still has a large following. I still see people giving four letter identifiers on social media from time to time, although I can no longer immediately decipher them.

    I remember in the late 90s and early 2000s twice taking paid training courses that used the DISC model, another one that was then popular.

    These of course more personality modeling and behavioural typing, or out and out “how to read people and manipulate them” efforts, rather than efforts to define reason. But definitely in the same wheelhouse as Big Five. Big Five appears to be the most popular today. It’s certainly popular with the rightthinkers, too. It’s a pretty good tool for self-examination as long as it doesn’t start to define the world.

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