While it'd true that it is internally consistent, I feel like the "disease = constrain" framework is not a very useful way to think about mental illness/health. Consider a person with OCD who feels a compulsive urge to wash his hands every 15 minutes. Probably this person would fail the gun-to-the-head test, so, according to Brian's defi…
While it'd true that it is internally consistent, I feel like the "disease = constrain" framework is not a very useful way to think about mental illness/health. Consider a person with OCD who feels a compulsive urge to wash his hands every 15 minutes. Probably this person would fail the gun-to-the-head test, so, according to Brian's definition, he does not suffer from mental illness, but simply has a very strong preference for washing his hands.
It's true that this approach gives a consistent model of mental illness, but are we really prepared to say that the compulsive hand-washed does not suffer from any mental problems? Even if this person admits that his behavior is irrational (i.e., he understands that the benefits of the incessant hand washing are small compared to the cost)? Even if he finds his compulsion extremely disruptive?
If you define preferences to be whatever-people-actually-do-when-they-don't-have-a-gun-to-the-head, of course this is a preference and not disease. Personally, though, any definition of disease that does not count a life altering compulsion to wash your hands as a disease seems contrary to common sense.
To my mind, an important feature of mental illness that Brian's view is missing is the existence of intrusive thoughts of the kind and intensity that lead OCD patients to engage in their compulsions. It's like having a little voice in your head incessantly telling you to do something. You can write off these thoughts as preferences, but, at the risk of repeating myself, this seems to me contrary to common sense.
Really, I think the problem is that the market-based theory Bryan is trying to fit mental illness into is based on the idea of markets being efficient at fulfilling preferences for rationally self-interested actors. Notice that this implies that rationality, or at least average mental functioning approaching it, is a prerequisite the entire system itself is founded upon. So mental illness, where there is a disturbance to mental functioning severe enough to impede everyday rational action, is by definition outside the domain of analysis of markets and economistic preferences. You can't use a system of analysis on a domain where it's undefined, and I think that's what's happening with any attempts to explain mental illness in this manner, and why it falls so short in terms of meshing with basic common sense.
While it'd true that it is internally consistent, I feel like the "disease = constrain" framework is not a very useful way to think about mental illness/health. Consider a person with OCD who feels a compulsive urge to wash his hands every 15 minutes. Probably this person would fail the gun-to-the-head test, so, according to Brian's definition, he does not suffer from mental illness, but simply has a very strong preference for washing his hands.
It's true that this approach gives a consistent model of mental illness, but are we really prepared to say that the compulsive hand-washed does not suffer from any mental problems? Even if this person admits that his behavior is irrational (i.e., he understands that the benefits of the incessant hand washing are small compared to the cost)? Even if he finds his compulsion extremely disruptive?
If you define preferences to be whatever-people-actually-do-when-they-don't-have-a-gun-to-the-head, of course this is a preference and not disease. Personally, though, any definition of disease that does not count a life altering compulsion to wash your hands as a disease seems contrary to common sense.
To my mind, an important feature of mental illness that Brian's view is missing is the existence of intrusive thoughts of the kind and intensity that lead OCD patients to engage in their compulsions. It's like having a little voice in your head incessantly telling you to do something. You can write off these thoughts as preferences, but, at the risk of repeating myself, this seems to me contrary to common sense.
Really, I think the problem is that the market-based theory Bryan is trying to fit mental illness into is based on the idea of markets being efficient at fulfilling preferences for rationally self-interested actors. Notice that this implies that rationality, or at least average mental functioning approaching it, is a prerequisite the entire system itself is founded upon. So mental illness, where there is a disturbance to mental functioning severe enough to impede everyday rational action, is by definition outside the domain of analysis of markets and economistic preferences. You can't use a system of analysis on a domain where it's undefined, and I think that's what's happening with any attempts to explain mental illness in this manner, and why it falls so short in terms of meshing with basic common sense.