Giving up reason for lack of knowledge

"If you are'nt the culprit, then your brother is."
Jean de La Fontaine: The wolf and the lamb.

We live in the 21th century. At least, that's what they tell us. We believe in scientific and technical progress, and most of us in western societies appreciate their benefits and the comforts they provide. Most of the time, we aren't even aware that we all use the spin-off of "science", that we all take advantage of its consequences in one way or another. Many people longing for "good old times" don't even realize that they couldn't dispense with these comforts any more.

Most of us think of themselves as acting and behaving in a logical and rational way in their everyday life and they believe that to be true. Some of us even claim that they are rationalists and, quite obviously, they are convinced of it.
From time immemorial, we are the heirs of uncountable lines of thinkers, philosophers, intellectuals and scientists. As a rule in all western countries, the educational system - i.e. going to school - endeavours to provide all with access to the means and techniques, in short to pass on the fully tested knowledge thus gained by our forebears. Teaching and education early on in our life enable us to efficiently make use of our brain abilities and, eventually, to pass on our knowledge to our descent, while possibly somewhat enhancing it with every new generation.

Known frontiers of the universe have been expanded. Man has walked on the moon and has begun exploring space. Every day, additional secrets of matter and of energy are uncovered. Researchers recently achieved deciphering the human genetic code, thus paving the way for numerous medical advances. New approaches and treatments are on their way, which were'nt even dreamed of only few years ago. When untimely wear and tear or decay, accident or illness jeopardize the functioning of, among other organs, the kidneys, the heart, the liver or the lungs, replacing these damaged organs with grafts from human donors has become possible, thus saving or prolonging lives which hitherto had been thought to be condemned within a short time.

All these technical feats and still many more, all our knowledge about the world surrounding us, as well as the knowledge about ourselves who are part of this world, all result from implementing the "scientific method". In simpler words, they result from applying logic and reason (the rational method) to help satisfying our curiosity and our inborn need to understand things and events. From results arrived at, we may feel with some confidence that the rational method has demonstrated its power, its reliability and its efficiency. We even may say that it is the only known method available to man which may lay such claim.

With the help of the rational method, we presently know the causes of numerous infectious diseases, their ways of spreading, the mechanisms of their actions, and this knowledge provides us with the means to fight them successfully. Man even succeeded in completely rooting out several of the most dreaded diseases. In our advanced countries nowadays, nobody would still cling to ancient beliefs according to which such now sporadic or even disappeared diseases were some kind of God's scourge - plague, cholera, etc. - sent to punish mankind for its sins.

Thanks to the rational method, every day we add to our knowledge of the structure and the workings of our body (of all our organs). Our understanding of the origins and of the mechanisms of numerous diseases which interfere with the functioning of our body is steadily growing. This knowledge and this understanding enable us to fight diseases with results which frequently are totally successful (i.e. recovery) or perhaps may sometimes prove only partially so (they provide significant mitigation of symptoms, however), but the outcomes are almost always predictable. Nowadays, such well-known diseases are'nt any more thought of as resulting from someone's fault, even when these diseases are very serious ones such as, for example, some cancers which still resist the most recent of treatments.

Yet, circumstances still happen today when people presumed to be responsible for diseases are sought after and wrongly pointed out as the guilty party. The disease called osteogenesis imperfecta (brittle bone disease) is a good example well known by many lay persons. In individuals affected with this disease of genetic origin, bone formation does not proceed normally but leads to the development of exceedingly fragile and brittle bones. As a consequence, multiple bone fractures occur without apparent cause. Such fractures occur already in infancy and childhood. Not long ago, well-meaning but ignorant teachers, nursery nurses, social workers and even doctors, after observing such fractures, accused parents of beating their children (some parents were even wrongly given prison sentences, their children were taken away from them).
In this especially illustrative example, the origin of the charges, the source of the stigma is instantly obvious: quite evidently, it is the widely shared ignorance about the disease which is responsible for the accusations, for the charges of and the beliefs in ill-treatment. First, generally accepted but wrong ideas and opinions make up for ignorance; second, the need for scapegoats usually follows: somehow there has to be a fault - the fractures are solid evidence of it, aren't they? - , hence there also has to be a guilty party lurking somewhere which should be flushed out (and some parents beat their children, isn't that current knowledge?)
Such suspicion is immediate, especially in times when ill-treatments of children are so much advertised in media and in the press. And in this instance, aren't the parents the first obvious and available suspects? Since they are those who have most opportunities and the means to commit the crime in the first place, fictitious but apparently plausible grounds for misbehavio[u]r or mischief would be readily thought up and ascribed to them. Later on, this ignorance about the actual causes of the fractures is also likely to incite some people to stigmatize parents in the eyes of their own children, because ignorance and stupidity quite often belong together. Distress will then add itself to pain.
Later still, children themselves said to have been ill-treated may even, when grown-up, inherit the bad reputation of their parents (skeletal deformities may still be present and visible to breed malevolence of others towards them), because ignorance and malicious gossip also frequently go hand in hand. It would be no great wonder then if the fantasy of ignorant people were to attribute to them all kinds of supposed wrongdoings.
Benevolent people may retort that I gave a caricatured description, because I chose as an example the brittle bone disease, which is a quite uncommon condition still ignored by many. Because ways of thinking and behavio[u]rs evoked about this disease's consequences are rooted in ignorance and superstition, they may be said to verge on obscurantism. This would support believing that they surely are quite the exception in our enlightened times!
If that's also what you think, then I am afraid to tell you that you are mistaken. False ideas such as those evoked above are much more frequent than you would suspect, they even may be held by a non negligible number of educated people who may claim they know what is "science" because, when they were students, they attended a few lectures about "science".
Such kinds of witch hunt exist today because they reflect a very common cast of mind which outlived the alledgedly "dark" Middle ages and can still be found today, even among very respectable members of the elite.

Chronic mental disorders (serious psychotic mental disorders) are much more common than "brittle bone disease". Some epidemiologists evaluate their frequency at 3-5% of all people all over the world (this is debatable, but that's still another story; here, let us tentatively accept these figures).
Neither causes nor mechanisms of mental disorders are known at present, whatever so-called experts (some of them doctors!) may claim and try to convince of miscellaneous fallacies the public at large (as well as the ill persons themselves!). Both this ignorance and the innate need of the human species for explanations of any phenomenon that it runs into lead to imagine and to think up causes and hypothetical mechanisms of these disorders. Such fallacies entail witch hunts: when unusual phenomena or unproper behavio[u]r are witnessed, people immediately, automatically suppose that some error has been made or that a fault has been committed which should require someone to blame or a guilty party. Thus let us search for him/her and flush them out!

Every time when we are confronted with a disorder about which we know next to nothing as far as its origins and mechanisms are concerned, how come that always people are coming up with the contention that necessarily, somebody should exist somewhere who should be held responsible for it?

This claim notwithstanding, nobody in his right mind would say that somebody should be held responsible, for example for diabetes, a disease which can be treated effectively although no actual cure is yet available. Nobody questions the biological nature of diabetes and, despite the obvious (but possibly because of it!), persons afflicted with diabetes don't think they are responsible for it, neither do they feel guilty of it nor do they blame others for some "fault" they would have been responsible for to "cause" the disease.
The same could be said in relation with multiple sclerosis, a disease which damages the sheaths protecting nerve cell processes everywhere in the central nervous system. Although causes of this disease are still at issue and no truly satisfactory treatment (cure) is yet available, the biological nature of multiple sclerosis is not in doubt. Nobody, however, would dare expressing the view (thus risking being ridiculous) that it should constitute a valid reason for holding its victims responsible for it!
Examples could be endlessly multiplied, illustrating the fact that "biology" in no way should be thought of as synonymous either of responsibility or of guilt, nor could these be attributed to the victims themselves or to others. But what's the use? Some people keep insisting on such view whatever you may try explaining to them... perseverare diabolicum...

Some people, however, - doctors among them! - in our french speaking countries, when talking about chronic mental disorders such as schizophrenia for example, say that "whereas biological theory allowed to take away some suffering from the parents, it also has at the same time transferred the burden of suffering onto others who suffer as well, i.e. the schizophrenics". Pending further information, every doctor should by now have learned that, as all other living beings, we exist and function only by and through biology. Would these dreamers care to explain, once and for all, what they mean by such preposterous oxymoron as a "non biological disease"?
Some of these thinkers claim that "according to the 'biological theory' [of schizophrenia], parents are not the cause of schizophrenia of their children; therefore, if the accusing finger of the psychiatrist should not any more be pointing at the parents, this however amounts to now pointing it at the [ill] children themselves".
Such nincompoops should be taught some good sense in order to avoid sticking out their finger and undiscriminatingly pointing it at anything and everything (moreover, might that not be risky?) Where do they get this permanent obsession from, this need to point out people as being responsible for a mental disorder, or this need for finding them guilty of causing it? Are mental diseases necessarily and always somebody's fault? Why not fate's fault, for once?

The same people tell us that schizophrenia should result from "the meeting of a part of biology with a part of environment" (whatever that means), a fact which "would now be generally acknowledged" (so they would have us believing). Quite obviously, those who utter such balderdash don't understand what they are talking about. They are merely demonstrating that they don't know what is biology, that they don't understand the interplay of biology and environment any better.
They mix up genetics with biology as a whole whereas genetics are only a small part of biology. They set what they think is biology - and actually is genetics - against environment, and they don't realize that environment without biology makes no sense at all.
Some french speaking doctors believe that "DNA predestines the patient for what he is going to live through and somehow makes him responsible for his disease". Everybody, and doctors in the very first place should know the meaning of genes (and DNA). As stated by R. Plomin et al. (Behavioral Genetics, Freeman & Co., New York 3rd ed. 1997, p. 278), "Genes are not destiny. Genetic effects represent probabilistic propensities, not predetermined programming". Doctors should explain that to lay persons and to their patients (of course, in order to be able to do so, they should have learned about it, they should understand it themselves, they should not have forgotten all about it since their stay at medical school...)
Moreover, whoever could maintain such nonsense as that the DNA of genes would make its bearer/owner responsible for, among others, his height, the color of his eyes, the size and shape of his nose, and even his ideas or his opinions would be predestined as well?
Weren't such ideas and views already expressed by XIXth and XXth century woolly-minded and dangerous ideologists and by dictators of evil memory to justify, among others, genocides, extermination of whole populations on an industrial scale, goulags etc. ?
All that has been written so far should convince you that, far from pointing at a new guilty party which would substitute for an older one, on the contrary the biological "theory" of mental disorders has relieved all parties by giving up the disastrous construct (not a theory!) of a fault to be ascribed to someone as the cause of the illness.
Some rather arrogant "professionals" nevertheless still cling to such ideas, they suggest that parents of children afflicted with mental disorders should examine their conscience (in order to find out what fault they committed to bring about the illness of their child[ren]).
Such self appointed "professionals" have a short memory indeed. Shouldn't they first reappraise their own behavio[u]r - not so long ago - based on the nefarious theories of Leo Kanner and of Bruno Bettelheim about autism? Don't they know what has become of these "theories" today and doesn't that give them food for thought?

Systematic confusions of correlation with relation of causes and effects were already exposed in several instances elsewhere on this website. Such errors were reviewed and debunked in a masterly manner by the late Dr Petr Skrabanek in his book entitled "Follies and Fallacies in Medicine" (item n° 11 under our heading "Livres" [books]). It is one of the sophisms which is frequently expressed by our psychologists and by our psychiatrists. I am convinced that a large part of the ill persons' hardships and of those round about them results from the stubborn will to spread and to enhance this sophism in mental health circles as well as in the public at large.
It is not my task to unearth the deep reasons why mental health professionals persist in holding such views. If I were to try, I would lay myself open to precisely the same criticisms I aim at numerous "psy" workers: ascribing to the patients and to the members of their families motives and intentions resting on no solid evidence, but which they actually get only from their own, rather twisted imagination. Thus I leave to others the task of finding out why so many people claiming to be "professionals" persistently stick to such unsupported and phony notions.

Disagreements, divergences in opinions, contradictory aspirations, conflicts and even confrontations arising within families between members of successive generations were known from the beginning of time. They always constituted an inexhaustible source of inspiration for novels and all kinds of fiction. Famous epic stories from antiquity mentioning them have come down to us. Life nowadays also has its numerous little and short-lived family spats and arguments, or more seldom true quarrels followed by enduring hurt feelings also may arise. A large majority of these arguments are usually rapidly settled without causing a lot of fuss or getting printed on the front page of newspapers, nor do they cause disease. If things were different, then we may bet that the social entity named family should have vanished from earth, completely and a long time ago!
Nobody seems to realize that conflicts between generations are the result of an established and unmodifiable fact of life that stares them in the face: although children age, grow up and become adults, parents and children never are simultaneously the same age, which means that they never have the same experience of life, the same outlook on all things and on life at the same time. Parents and children just have to make the best of this situation. Since this has always been so, one should acknowledge that, by and large, both children and parents seem to manage not too badly.

Indeed, a vast majority of families are spared the development of a chronic psychotic mental disorder in one of their members, even when some "violence" is present between grown-ups and their children. Even when a mental disorder develops in one child, its siblings are only very rarely affected, although they live in the same family environment. Conversely, even in well-to-do families where every member lives on the best terms with all the others, schizophrenia nevertheless may develop in one teenager whereas the other children are spared.

When the mental disorder breaks out, in most instances the ill person him/herself is not aware of it. Taken singly, the various signs and symptoms of the mental disease are never specific. Hence, parents and people around the ill person cannot immediately recognize these signs and symptoms for what they actually are: the signs of a mental disorder. Lack of understanding and misunderstandings ensue and become the rule. Necessarily, because of the disease going on unrecognized, the ill person and the other members of the family are continuously at cross-purposes. All justified and unjustified grievances will pile up on both sides because nobody is realizing that the source of the lack of understanding lies in the ignored mental disorder.

Sooner or later the atmosphere at home deteriorates too much and most if not all members of the family can't stand it any more. The behavio[u]r of the ill person may give cause to worry about his "physical" health. All sleep poorly or not at all and eventually end up in dire need of rest. Family life is seriously disturbed, which also may tell on the efficiency at work. Then, faced with a lot of questions they are unable to answer, relatives eventually call on a psychiatrist.

In Belgium, to get your ill relative examined by a psychiatrist is no easy task. This specialist almost never accepts visiting patients at home, patients have to go on their own and of their own accord to his consulting room (for most of our psychiatrists, this would be evidence of the patient's will to undergo therapy which, according to them, is of the essence, a prerequisite for the treatment to succeed).
Quite frequently, however, convincing the ill person to consult a psychiatrist is anything but a rest cure. Weeks of not necessarily very peaceful discussions and trials may be needed in order to bring him/her to go to the doctor. On the other hand, it is not less difficult to convince the psychiatrist to listen to and hear out both the parents and their ill son/daughter, out of as well as in his/her presence. Unfortunately, the latter is not yet the way of most of our belgian psychiatrists.

When, at last, the psychiatrist meets one party - and, sometimes perhaps, he may meet the others as well - , weeks or even months may have passed with their share of misunderstandings, of worry, of anguish. The ill person has withdrawn into his/her illness, he/she nurses his/her fantasies or delusions and blames all around him/her as well as the world at large for the ills and evils that plague him/her.
As for the other members of the family, their nerves are badly shaken, they are exhausted, the smallest unimportant annoyance they happen across may trigger them off to blow their tops.

When called on for the first time, doctors or psychiatrists witnessing this situation see only the outcome of a process whose onset and development they did not live through themselves and could of course not observe. This notwithstanding and on the only basis of their intuition, their "clinical expertise", their psychology, their feeling or whatever (you name it), they may soon decide (after some conversation lasting at most one hour but often more likely less) that parents are highly neurotic persons and that their behavio[u]r is generating suffering (i.e., their behavio[u]r is iatrogenic, in other words they are the cause of the disease).
That will clinch the case: guilty parties were found and exposed as required, all else will follow naturally from the psychiatrists' apriorisms which I dare you to question.

Isn't that an especially illuminating example of the fallacy that the association in time of two phenomena should mean that one phenomenon should, necessarily, be the cause of the other one (although you could find lots of other examples of the same brand of error in reports of the W.H.O., they are errors all the same!)

Any sensible person should realize that signs and symptoms of mental illness in one member of the family can not, at first (at the onset) be understood by his/her relatives, they are unsettling - to say the least - and they may even be frightening. They are thus very likely to generate a parody of neurosis in the other members who are confronted with these signs for days on end. That's some psychiatrists who dream up things the wrong way around and would us swallowing such nonsense!

One of the most fundamental principles of justice in democracies is the presumption of innocence. On the contrary, should most of our psychiatrists and many psychotherapies adopt, in a systematic way, the idea of presumption of guilt, reminding us of totalitarian regimes?

Many of our french speaking psychiatrists and psychologists seem to be unacquainted or at odds with simple, obvious and logical explanations of events (i.e. sensible explanations). They seem to prefer confusing causes with effects, mixing up consequences and causes in an absurd whirl of reasons, motives, alledged results, etc., which one of them even has dubbed the "circular causality"! Shouldn't such way of "reasoning" and of doing things be felt as an extraordinary demonstration of

denying or perverting reason, a mental torture on the pretence of treatment and care, taking up a perpetual stance of suspicion, some kind of a psychiatrist's paranoia?

First published: 3 January 2003 (J.D.) Last modified: 21 February 2003

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