When I describe mental illness as “an extreme, socially disapproved preference,” the most convincing counter-example people offer is depression. Do I really think people “want to be depressed” or choose depression as a bizarre alternative lifestyle?
My quick answer: These objections confuse preferences with meta-preferences.
No one chooses to have the gene for cilantro aversion. Yet people with the cilantro aversion gene are perfectly able to eat this vegetable. They just strongly prefer not to.
Similarly, when I say that alcoholics are people who value heavy consumption of alcoholic beverages more than family harmony, this doesn’t mean that they like having these priorities. If they could press a button which would eliminate their craving for alcohol, I bet many alcoholics would press it. But given their actual cravings, they prefer to keep drinking heavily despite the suffering of their families.
The same holds even more strongly for the typical person diagnosed with clinical depression. Most people with loving families and successful careers are happy. Clinically depressed people, however, often have both loving families and successful careers, yet still want to kill themselves. Their preference is so extreme that it confuses the rest of us. They’d almost surely rather have a different preference. But it is their preference nonetheless.
Not convinced? Think back to the early 1970s, when psychiatrists still classified homosexuality as a mental disorder. I object, “Mental disorder? No, it’s just an extreme, socially disapproved preference.” When critics incredulously respond, “Do you really think people choose to be gay?,” I say they’re confusing preferences with meta-preferences. To be gay is to sexually prefer people of your own gender. This doesn’t mean that gays want to feel this way. If a gay-to-straight conversion button existed in the intolerant world of 1960, I bet that most gays would have gladly pushed it for themselves. Even today, I think many gay teens would press the conversion button to fit in and avoid conflict. But so what? Hypothetical buttons can’t transform a preference into a disorder.
Is this all just a word game? No. The economic distinction between preferences and constraints that I’m drawing upon has three big substantive implications here.
First, people with extreme preferences could make different choices. People with cilantro aversion are able to eat cilantro. Alcoholics are able to stop drinking. The depressed can refrain from suicide. And so on. This is fundamentally different from my inability to bench press 300 pounds – or live to be 150 years old.
Second, as a corollary, people with extreme preferences can – and routinely do – respond to incentives. People with cilantro aversion are more likely to eat cilantro if other foods are expensive or inconvenient. Alcoholics respond to alcohol taxes – and family pressure. Depressed parents may delay suicide until their kids are grown. Even in a tragic situation, incentives matter.*
Third, as a further corollary, people with extreme preferences can – and routinely do – find better ways to cope. People reshape their own preferences all the time; perhaps you can do the same. Failing that, perhaps you can discover more constructive ways to satisfy the preferences that you’re stuck with. For example, if you’re extremely depressed despite great career success, you really should try some experiments in living. Perhaps you’ll be miserable whatever you do. But if you’ve only experienced one narrow lifestyle, how do you know? Maybe you’d feel better if you tried putting friendship or hobbies above “achievement.”
It’s tempting to insist that there’s something pathological about having conflicting preferences and meta-preferences. On reflection, however, these conflicts are a ubiquitous feature of human existence. Almost everyone would like to feel differently in some important dimension. Almost everyone reading this probably wishes they were less lazy, more patient, more outgoing, more loving, more ambitious, or more persistent. But you still are the preferences you really have. There’s plenty of room for improvement, but that doesn’t mean you’re sick.
* I’m well-aware that many physical symptoms also respond to incentives. You can pressure a diabetic to lose weight, which in turn reverses his diabetes. But all of these incentive effects require time to work. The symptoms of mental illness, in contrast, can and often do respond to incentives instantly, because they are choices that are always within your grasp. “I’m divorcing you unless you stop drinking right now” is a viable threat. “I’m divorcing you unless you stop being diabetic right now” is silly one.
READER COMMENTS
Matthias Görgens
Mar 26 2019 at 10:06am
The divorce threat is unlikely to work on the depressed, I’d assume.
Marek
Mar 26 2019 at 11:11am
I think the most obvious flaw in your argument is in putting a distinction between constraints and preferences. A preference can be so strong that it becomes a constraint (for example my preference for drinking water). Therefore everything is a preference, to one degree or another. It seems weird to make a distinction between people whose suffering is caused by a 100% preference (a need to take insulin to copy with diabetes) and a 99% preference (a need to take drugs to cope with their psychological condition). Where do you put the threshold that turns a preference into constraint? Moreover, there are degrees of diabetes too.
The reason your argument fails, then, is because you have not proved conclusively (indeed, at all) what amount of preference is there to depression (and it seems clear it spans the whole spectrum of 0% to 100% across individuals and even across time for a single individual).
You seem to think that a person cannot stop being diabetic. You presumably say this because diabetes is somewhat well understood as a failure to produce one protein. What makes you so sure that severe depression is not similarly caused by a similar failure, just one we haven’t yet understood simply because brain is vastly more complicated than pancreas?
It appears that you treat psychological phenomena as entirely divorced from the genetics and neurology but in many cases the link between the two is obvious (like various brain damage induced disorders) and it’s clear we’ll discover many more links once we understand the brain better (since we arguably just scratched the surface of what’s going on).
Mark
Mar 26 2019 at 11:37am
This seems like a word game. A depressed person can choose not to commit suicide, but they can’t choose not to be depressed (at least in the short run). By analogy, a diabetic person can choose not to eat lots of sugary foods that makes their condition worse, but they can’t choose not to be diabetic (at least in the short run).
Depression and most mental illnesses are limitations on one’s mental ability, similar to low IQ. Sure, a person can cope with the condition, just like a low-IQ person might choose a career or lifestyle that requires less IQ, but the condition itself is a disability and not a preference. A depressed person is mentally unable to experience joy just like a low-IQ person is mentally unable to do certain cognitively challenging tasks.
Miguel Madeira
Mar 26 2019 at 12:55pm
And a person who prefers lamb to pork could choose to eat pork instead of lamb, but can’t choose to prefer pork to lamb; in these point, what is the difference?
Jay
Mar 26 2019 at 8:58pm
Saying that the cure for depression is willpower (or incentives) is like saying that the cure for paralysis is strength. It’s both obviously true and utterly useless. Depression is the absence of willpower in much the same way that paralysis is the absence of strength; a restatement of the problem is not a cure.
Chris Lawnsby
Mar 26 2019 at 12:51pm
Extremely interesting.
But then depression isn’t a “preference”–preferences seem to be exclusively for behaviors if I’m understanding your argument.
Miguel Madeira
Mar 26 2019 at 12:53pm
I think a better counter-example will be schizophrenia – how having hallucinations could be considered “a preference”?
Or autism – how a difficulty in understanding non-verbal and or non-literal communication could be considered “a preference”?
Some symptoms of both schizophrenia (social isolation, avolition) and autism (obsessions, rigid routines) can be considered preferences, but not the ones that I mentioned above.
In contrast, schizoid personality disorder (social isolation + avolition + intense fantasy/introspection) could indeed be considered only a preference (because, unlike in the hallucinations of schizophrenics, schizoids know the difference between the fantasies and reality, but prefer the fantasies).
C
Mar 26 2019 at 1:18pm
How would a schizophrenic respond? The argument here – it seems to me – isn’t that you can cure the disease but instead you can get the person suffering to act as if they aren’t. The utility of that is an open question. But if you gave some with schizophrenia a million dollars and said “Please act like you’re not hearing voices” would they be able to do it?
I have a relative with Autism – I’m not a doctor but I would describe his condition as fairly extreme – and he does respond to incentives. The idea that it’s a lack of incentive that stops him from being able to form complete sentences is absurd but there’s a matter of what’s possible for him to take into consideration.
JFA
Mar 28 2019 at 11:37am
“The idea that it’s a lack of incentive that stops him from being able to form complete sentences is absurd”… That is absurd, but that is kind of what Bryan is arguing.
“but there’s a matter of what’s possible for him to take into consideration”… and this is the point of most of the criticisms. Bryan seems to think that there are no limitations on what people can take into consideration. Bryan’s argument is that given any “bad” action a person performs, they could have always chosen a “good” (not “better” but “good”) action. Full stop. No qualifications. If you think there are qualifications, then you think Bryan is wrong.
Julia
Apr 8 2019 at 11:34am
I worked in a psychiatric hospital, and when people have been hospitalized involuntarily, a lot of how they get out is when their symptoms are non-obvious enough that a doctor is convinced they can function well enough to leave. So for a person with serious depression I saw a doctor literally tell someone who wanted to leave, “I will sign off on you leaving once we can have a conversation without you crying.” It took the person several days after that to be able to have a 15-minute conversation without crying. Likewise if you’re having a psychotic episode, getting to leave the hospital basically depends on you being able to act like a person who’s not currently psychotic (which might mean you still hear voices but can act normally despite that, rather than being obviously distracted by internal stimuli). People who badly want to leave a hospital don’t just stop displaying symptoms when there’s a strong incentive to do so.
JFA
Mar 26 2019 at 1:30pm
Yeah… this is pretty weak sauce. Let’s just take this statement: “People with cilantro aversion are more likely to eat cilantro if other foods are expensive or inconvenient.” Well, if those people literally do not like the taste of cilantro (due to genes that change how their taste buds react to cilantro) and think that adding cilantro to their food will make it taste worse, my bet is that when the price of fresh parsley or dill increases, those people with cilantro aversion just decide not to season or garnish their food with a green herb.
Maybe Bryan could have used the example of “if cilantro were the only thing a person with cilantro aversion had to eat for a few days and that is the only way this person could survive”. Obviously the person would eat it and Bryan would hale this, saying, “See, this person with cilantro aversion will eat cilantro; they just strongly prefer not to. Thus you can change your preferences.” Of course, any thinking person would see this as utterly ridiculous.
I agree with Bryan that people do respond to incentives, but I also think Bryan’s problem is that he believes in some radical libertarian (philosophical not political) free will in which there are no constraints on people’s choices.
When the schizophrenic says penguins talk to him at the library, should we interpret that as he just really wants his perceptions to not correspond to reality? Or might there actually be some constraint that affects his perception?
I think Scott Alexander’s post noting the blurry line between preferences and constraints provides much more food for thought than Bryan’s post above. https://slatestarcodex.com/2015/10/07/contra-caplan-on-mental-illness/
Hazel Meade
Mar 26 2019 at 1:53pm
If you ask any neurobiologist they will tell you that brains are physical things. Our medical practice has an odd distinction between physical illnesses of the brain, such as brain tumors or Alzheimer’s disease which has known behavioral effects, and “mental illness”. This leave us to make these arbitrary and often false distinctions between illnesses like “depression” any any other neurological disease. Brains are complex, and frankly medical science doesn’t really know what’s going on in a lot of cases. It’s quite possible that “clinical depression” is just a name for a neurological disorder that hasn’t yet been scientifically understood well enough to state exactly what is going on. The fact that people with various disorders classified as “mental illness” respond to incentives doesn’t mean much – a person suffering from chronic pain will deal with the pain if the incentives are strong enough. This is true of any disease. Also, sometimes depression goes away with better diet and exercise, so some of these cases might not be responses to incentives, but just people getting better through natural physical healing of whatever neurological problem caused the depression.
Ultimately, I personally think it’s irrational to separate “mental illness” into a special category that people can just overcome by thinking differently. The brain is a physical thing not some magical ming-energy floating around inside our heads.
Hazel Meade
Mar 26 2019 at 2:30pm
The symptoms of mental illness, in contrast, can and often do respond to incentives instantly, because they are choices that are always within your grasp.
I really don’t think this is true.
Jim Rose
Mar 26 2019 at 4:26pm
The rapid effectiveness of lithium in treating manic depression in 1949 were known to szasz but seems to ignore them.
Alex
Mar 27 2019 at 1:15am
” If a gay-to-straight conversion button existed in the intolerant world of 1960, I bet that most gays would have gladly pushed it for themselves.”
Straw man argument Bryan. Obviously, if a gay person lives in a place where being gay makes his life impossible, he would rather not be gay, but only because of the social context. If that same person on that same time moved to an island where being gay is perfectly fine, he would happily stay gay. You keep repeating that homosexuality was considered a mental disorder in the 70s as if this would prove anything, but the 70s what the stone age for psychology. Psychology was dominated by environmentalism (we are what we learn) and the blank slate. 40 years of twins and adoption studies have shown conclusively that this is not true. In the words of Robert Plomin “genetics is not the only thing that matters but it matters more than everything else combined”
Then you go to say that “The depressed can refrain from suicide”. Well, maybe they can, maybe they cannot. Usually what happens is that they can until they cannot. What is very clear by now is that depression, like all mental disorders, has a genetic cause. The GWAS studies are even finding the genes that cause it. Hopefully this would lead to better treatments. A few weeks ago the FDA approved the first fast acting antidepressant ever (The SSRIs take 6 weeks to kick in and about a third of the patients don’t respond):
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm632761.htm
Joris
Mar 27 2019 at 5:47am
Suppose you are a brain in a vat that is inside a robot on wheels. The robot is inside a maze. The only way to get out of the maze is to continue turning right.
The brain can control the robot but in a very flaud way. When the brain signals straight, the robot goes straight 100% of the time. When the brain signals left, the robot goes left 100% of the time. However when the brain singals right, the robot goes right only 30% of the time and either goes straigth of left 70% of the time.
The brain wants to get out of the maze and knows it has to get the robot to turn right all the time. Therefore it signals to turn right 100% of the time when the possibility to do so presents itself. However the robot still goes another direction 70% of the time.
Now is you repeat this experiment many times, only very rare lucky casses the brain will get of the maze. Does this mean the brain prefers to stay in the maze?
No it turns out that the robot not only reponds to signals from the brain but also to signal from outside. Flashing lights are installed on all points where you can turn right. It turns out that when these lights are installed and the brain signals right, the robot now turns right 50% of the time (It als will turn left only 80% of the time when the brain signals left but this is inconsequential). The brain will get of the maze more often. Does this mean that because the robot responds to the lights (incentives) this changes the brains preference.
Now the real question is, are we the brain, the robot, ot both?
I think in general we are both but it depends on the subject we are talking about and the words we use. When we talk about what people actually do, we are talking about the robot. When we talk about how people feel, we are also talking about the robot. Yes you could say the robot has preferences and yes the robot is part of us. However most people think of themselfs as the brain, especially in the context of free will and making concious or rational choises. So when the brain has a different preference than the robot it is very confusing to say that preference of the robot is the real (rational) preference and that people (the brain) choose for their preference (the robots action) conciously.
RPLong
Mar 28 2019 at 10:35am
Bryan, how many times have you actually attempted to overcome a depressed person’s depression through the use of incentives? Don’t just write about it, go out there and try it out. Some of us have, and the results are not very good. It’s the actual empirics of your claims that defeat them.
KevinDC
Mar 28 2019 at 11:25am
Like most people in the comments, I find Bryan’s argument unpersuasive. What I don’t understand is why Bryan finds his own arguments persuasive, in light of other research he’s endorsed. For example, Bryan has read and seems to accept the research on ego depletion – see here for example https://www.econlib.org/archives/2012/01/kahneman_mental.html
Bryan seems to acknowledge that people can’t choose what their preferences are. Gay people can’t make themselves genuinely prefer the opposite sex, alcoholics can’t make themselves genuinely not want alcohol, and people like me can’t make myself not find bell peppers repulsive. But, Bryan says, while they can’t choose what to prefer, they can still choose how to act in light of what they prefer. Gays could force themselves to be with opposite sex partners (or stay unattached), alcoholics can force themselves not to drink, and I could force myself to gag down bell peppers – at least if faced with sufficiently strong incentives. This, Bryan says, shows their behavior to be a preference, not a budget constraint.
Quick digression. As a man well into his middle age and a lifelong econ nerd, Bryan is probably not the most athletic man in the world. The prospect of running a mile in 8 minutes is probably an awful one for him to consider. However, suppose an evil fitness enthusiast promised to inflict horrific torture on all of his children unless he ran a mile in 8 minutes or less. And lets further suppose that Bryan, desperate to save his children, manages to run a mile in 8 minutes. I imagine Bryan’s response would be to say “Yes, you see, this shows that me not running that fast for that long is a preference, not a budget constraint. I could do it, I just find the experience awful and unrewarding so I choose not to.” Rather than refuting his model, he would say this is consistent with his model.
So what’s my point? Well, Bryan knows about ego depletion. He knows that people have mental defaults, and that acting contrary to those defaults takes deliberate effort, and that people’s ability to put forth that effort is limited. Mental energy and willpower are limited resources. And the limits of your mental stamina and willpower are budget constraints just as the limits to your physical stamina is a budget constraint. You can’t choose to have limitless mental stamina anymore than you can choose to have limitless physical stamina. Just because Bryan could, given sufficient incentives, run an 8 minute mile, this does not mean he could run at that pace for six hundred miles straight. He would run against the budget constraint of limited physical stamina regardless of incentives. And just as other people can force themselves to act contrary to their own mental defaults with sufficient incentives, this does not mean they can do so for life, or even for very long. They run into a budget constraint of limited mental stamina. Bryan could avoid this problem by working in an additional premise that “People have unlimited willpower and mental resources for endless amounts of time, therefore limited physical stamina is a budget constraint but ego depletion and limits to willpower are not budget constraints” but I think we’d all agree that’s an absurd premise. But as soon as you acknowledge that willpower is a limited resource and ego depletion is a real phenomenon, his whole “budgetary constraint vs preference” argument comes crashing down.
As a postscript, this is not to say that I agree with Bryan’s chosen framing of the issue. My whole point is that even if we choose to grant his contention that psychology is best understood by interpreting it under the banner of consumer choice theory, his argument still doesn’t make any sense.
JFA
Mar 28 2019 at 11:48am
I agree with you that Bryan isn’t even close to correct on this issue, but I’m not sure I would use ego depletion as a good example as that seems to have a mixed record at replication. I think people are missing the Szaszian lens through which Bryan seems this problem. Basically unless there is something “physically” wrong (like a lesion of some sort) with the persons brain, all mental “illness” should be construed as a preference. This view had its uses in a time when gay men were being forcibly committed for mental illness, but this way of seeing things seems to be situated in a pre-genomic, pre-neuroscience framework.
KevinDC
Mar 28 2019 at 12:19pm
Hey JFA –
Thanks for the response. It’s a fair point about ego depletion (and quite a lot of other psychological science) having replication issues. But I still stand by my critique. Even if we toss out all research on ego depletion, Bryan’s case would still depend on the premise that “willpower and mental stamina are eternally unlimited.” If he doesn’t hold that as a premise, he would need to explain why mental stamina isn’t a budget constraint but physical stamina is. I don’t think the claim that willpower and mental stamina are limited needs the research into ego depletion to be upheld – I think that is pretty self evident. And as long as you acknowledge that willpower is not unlimited and mental stamina is not infinite, I think my critique holds. He has no principled reason to call physical stamina a budget constraint but finite willpower a preference.
JFA
Mar 28 2019 at 12:45pm
Agreed.
JFA
Mar 28 2019 at 1:18pm
It’s articles like these (which demonstrate an extremely radical view of personal responsibility and blameworthiness) that make me doubt Bryan will actually do a good job in writing his book on poverty.
Hazel Meade
Mar 28 2019 at 1:20pm
I agree. Depression is caused by a disorder in serotonin production. Arguing depression is a preference is basically saying you can will your body to make more serotonin, which is not really that different than saying that a diabetic can will his body into producing more insulin. There is a “physical” problem in the brains of depressed people.
wd40
Mar 28 2019 at 11:35am
If you are diabetic, you cannot will yourself to be non-diabetic (and before sufficient knowledge was obtained, people did not know how to mitigate its effects). We usefully call diabetes a disease of the pancreas 0r physical illness not a preference or meta-preference, even if people can now undertake behavior that mitigates its effect. If you are depressed you cannot will yourself to be not depressed (if medicines do not help). Why label depression an extreme meta-preference rather than a mental illness? If you are bipolar, your behavior during the polar-states undermines what you try to achieve in the normal state. That behavior seems to be intransitive and therefore irrational. Some individuals with schizophrenia do take anti-psychotic drugs despite their bad side-affects. It seems tautological to say they were rational when they were schizophrenic. I read about a schizophrenic purposely destroyed his eyesight, Although one could always find a story to explain why this promoted his meta-preference, such story telling violates Occam’s razor. While I always appreciate the push of economic thinking into new areas, I think that the economics should be treated as a theory of general behavior-most people, most of the time act rationally (and thus when price goes up, the demand goes down), but some people do act irrationally most of the time, but not on all dimensions.
JFA
Mar 28 2019 at 1:05pm
“The symptoms of mental illness, in contrast, can and often do respond to incentives instantly, because they are choices that are always within your grasp.”
I can offer someone $10 to hold their breath for 30 seconds and they are happy to do it. But I have yet had someone take me up on the offer of $1200 for them go without air for 30 minutes. Because their actions immediately respond to the $10 incentive, people’s desire for oxygen must just be a really strong preference.
Swimmy
Mar 28 2019 at 9:06pm
What I’m seeing is a tautology: “If you point a gun at someone and say ‘your money or your life’ and they hand you their wallet, they have a preference for handing you their wallet. Not wanting to have a gun pointed at them is a meta-preference.” Sure, I guess. But is it interesting? The “big substantive implications” are where we would look to know.
Depressed people can choose not to kill themselves. Yep, I agree. But they can’t choose not to have constant intrusive thoughts about suicide, not without treatment (or time, because depressive episodes clear up on their own usually, just like common colds do). As a formerly suicidal person, I can tell you this: I absolutely could not stop thinking about it. Could. Not. In the same way that I can’t stop breathing. It was my first thought on waking up, it was my last thought on going to sleep, and it was at least 50% of the thoughts in between. If your spouse suddenly died, would you be able to choose to stop thinking about her? If you’ll accept personal introspection as evidence for dualism and free will, I hope you’ll accept my personal introspection as evidence for this. (If your introspection tells you something different, all I can say is that you shouldn’t assume your brain works like others–millions more will say the same.)
Most antidepressants take at least a month to do anything–frequently longer. It would be ridiculous to say “I’ll divorce you unless you stop being diabetic right now.” It would be equally ridiculous to say “I’ll divorce you unless you stop having suicidal ideation right now.” You might say “I’ll divorce you unless you get treatment for your depresssion,” which would be more comparable to “I’ll divorce you unless you fight your diabetes by losing weight.”
I don’t think “It is better for depressed people to seek ways to not be depressed, than to continue being depressed and killing themselves” or “depressed people have significant trouble getting treatment even though they want to not be depressed” is controversial or differs from what most people believe.
Do you agree with the above? If so, I don’t think your view is all that different from most people’s–you’re just using “preferences” in a different way than most people. Kind of like how Austrian economists often use it.
But if you insist that this is profound, I think you’re gonna have to roll diabetes up into your “preferences” ball. In this post you compared symptoms at the wrong level. When you compare at the right level…
Uncontrollable suicidal ideation:depression::uncontrollable blood sugar levels:diabetes
Getting therapy/medicine:depression::losing weight:diabetes
…you can see they’re not very different.
Julia
Apr 2 2019 at 4:33pm
“Depression” and “killing yourself” are not the same thing – one is a condition, and the other is an action. People will respond to incentives not to kill themselves (e.g. not to hurt their families), but can they use incentives to stop having symptoms of depression (low mood, insomnia, low energy, thoughts of suicide, etc?) This seems absurd.
Kevin Jackson
Apr 5 2019 at 5:15pm
I see a few problems here.
1. Physical diseases may involve a change in constraints, but the behavior of sick people is better modeled by preferences. I never push the limits of my physical constraints when healthy, and it is quite likely that my daily routine is still within my constraints when when I have a cold (or flu, or injury, etc). But I have a much greater preference for staying home at those times. My physical constraints are not the relevant factor here.
But what is the difference between an irrelevant constraint and an undetectable constraint (as in the case of depression)? There is none. But then we must demand proof of constraint from sick people, since any socially disapproved behavior from anything less than a constraint is just another preference. Perhaps this means a full battery of physical and mental tests (repeated daily of course) or perhaps we can all just keep a pistol handy to apply the gun to the head test.
Or perhaps we can recognize that extreme preferences vary from run of the mill preferences in more than just degree.
2. Of the three substantive implications, I find I agree with the first, but the second and third are ridiculous. The definition of substance abuse can be summed up as “failure to respond to incentives to stop abusing the substance”. An alcoholic who responds to incentives to stop drinking is not an alcoholic! Likewise, coping and changing preferences are the exact opposite of the behaviors shown by people diagnosed with the three sample mental illnesses. “Recurrent”, “often”, and “repeated” indicate a lack of change, not the potential to change.
But implications 2 and 3 are corollaries of the first. So there must be some problem with the first implication. I think it’s the difference between choosing in a single instance and choosing over a period of time. An alcoholic might be able to about taking a drink if you put a gun to his head, but cannot make the same choice over an extended period of time. (One year, according to the DSM IV.) But this bears some more thought.
3. Although presented as a new way of looking at mental illness, this actually describes a very old fashioned view. And so while I disagree with that view, this analysis helps me understand it, which I appreciate.
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