Realism within psychology - Essay Example

?Realism within psychology: There exist myriad factors which might become a limitation in the process of making realist assumptions. One such factor is related to almost similar set of symptoms displayed by patients suffering from different kinds of psychological disorders. In this case, realist assumptions become hard to make and the final opinion given by the psychologist most often turns out to be subjective. Anti-social disorder, bipolar, borderline personality disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder more or less share the same symptoms changing a patient in a way that identifying the root cause or disorder becomes a complex procedure, so making a realist assumption about the disorder and reaching the final decision as objectively as possible becomes literally an ordeal. People with schizotypal personality disorder display odd behaviors that are similar to schizophrenia to the extent that some individuals with this personality disorder are wrongly diagnosed with schizophrenia (Healthism, 2012) which is how realism within psychology becomes limited. Most disorders display the same set of symptoms including anger, depression, anxiety, and restlessness and research related to trends of personality disorders claims that “such behaviors may not be easily distinguished from similar behaviors displayed by other people from time to time” (Tunner, 2012). Though the standards to diagnose any mental or personality disorder vary between cultures, but DSM-IV can help in classifying abnormality and increasing the extent of realism within psychology. It uses a multi axial system which helps in differentiating disorders which are otherwise difficult to diagnose and which “involves an assessment on several axes” (American Psychiatric Association, 2000) which can profoundly help in identifying disorder objectively. However, The National Institute of Mental Health USA further stresses on existence of anti-realism within psychology by claiming that like many other psychiatric illnesses, “borderline personality disorder is often underdiagnosed or misdiagnosed” (Paris, cited in NIMH, 2012) because the symptoms are interrelated mostly. Another factor suggesting existence of anti-realism within psychology is related to identifying the root cause of a certain disorder. It so happens frequently that the patients themselves do not know the root-cause of their symptoms and the psychologist has to wildly guess or assume it from a detailed and comprehensive study of the patient’s history, relations, and other particulars. One research study analyzing origin of mental illnesses reveals that “as of 2002, scientists do not know why some people become mentally ill while others do not” (Advameg Inc., 2012) which suggests that psychologists and other professionals treating such illnesses often do not have a sound knowledge about the origin due to which many diagnoses are not smartly engineered as is frequently observed. The same study further claims that much research needs to be done to determine the extent of realism within psychology as “although theories abound, the precise etiology or origin of all mental illnesses remains uncertain” (Advameg Inc., 2012). However, proponents defending the larger extent of realism within psychology argue that recent years have witnessed a radical change in the way mental illnesses are diagnosed (QMI AGENCY, 2012). Despite a variety of overlapping symptoms, the diagnostic criteria for multiple psychiatric disorders made common now helps in effective identification. The need to detect the root cause flawlessly is also recognized on a greater level now as one Harvard University study suggests that “it’s time to start diagnosing mental illnesses by their root causes rather than their outward symptoms” (QMI AGENCY, 2012). In contrast, it is claimed that “the causes of schizophrenia are poorly understood” (Advameg Inc., 2012). Unfortunately, different subtypes of such disorders share similar root causes which creates hurdles in reaching a definite decision thus strengthening the argument of anti-realism within psychology. Another study claims that depression in both elderly and children is often misdiagnosed and unrecognized because a lot of conflict occurs over deciding the origin or root cause (Advameg Inc., 2012). The fact that there is no clearly detectable single root cause for all mental illnesses like there is most of the times for physical illnesses explains why anti-realism impacts the science of psychology to a larger extent. Negative diagnosing prompts some critics of realism within psychology to claim that “psychiatric diagnosis is like looking at the world through wrong end of a spiritual telescope” (Breggin, 2010). The impact culture may have on the assumption and diagnosing in psychology is severe (Alarcon, Westermeyer, and Foulks, 1999). Biochemical imbalances are often triggered and exacerbated by environmental, cultural, and emotional stresses. “The cultural perspective on psychiatric diagnosis has experienced uneven levels of reception and actual implementation” (Alarcon et al., cited in Alarcon, 2009). Cultural difference is an important factor which hinders the realist assumption making skills of the psychologist. Environment is also a significant factor and it is claimed that “environmental risk factors for mental illness produce graded changes in the function of one or more brain circuits, producing graded changes in cognitive processes supported by those circuits” (Buckholtz, cited in QMI AGENCY, 2012). It is also argued that psychiatric diagnosis might not be relevant to culture thus undermining the importance of cultural factor. In a study discussing if psychiatric diagnosis is universal or relevant to culture, Canino and Alegria (2008) claim that “there is little consensus on the extent to which psychiatric disorders or syndromes differ on their core de?nitions and constellation of symptoms as a result of cultural or contextual factors” (p. 237). Still to help the patient, the psychologist essentially needs to imagine things from the patient’s cultural and environmental perspective. This necessitates a comprehensive knowledge of a variety of cultures and environments from which the patients belong. It is hard to remember the individualistic norms and values of different cultures all the time since a psychologist has to deal with not one, but many patients in a day. Every individual’s psychology is different from that of all other people in the world. People are not like objects that have the same characteristics. “The recognition that human beings actively construe and even construct the phenomena they encounter, and the further recognition that the impact of any objective stimulus depends on the subjective meaning attached to it by the actor, have long been among psychology's most important intellectual contributions” (Robinson et al., 1995, p. 2). “Diagnosis is probably the dominant topic of discussion and debate in the psychiatric field today” (Alarcon, 2009). When a patient of any psychological disorder seeks help, decision should not be made relying on ambiguous origin, causes or symptoms of the disease as it could ruin someone’s life. It is often debated that realist assumptions are seldom made by the psychologists and most of the decisions happen to be subjective in nature. An interesting question is raised by Patil and Giordano (2010) in their study regarding how psychiatrists could issue diagnoses and prognoses which appear to be objective in nature while actually relying on epistemology which is largely subjective. Owing to so many overlapping symptoms and blurred root causes, it is repeatedly suggested in the ongoing debate over realism vs. antirealism that no concrete treatment and outcome could be planned for any mental or personality disorder because most of the assumptions related to basic causative factor are made subjectively which in turn restricts the extent of realism. It is claimed by Dr. Peter Breggin that though psychiatric diagnosing gives us important information about ourselves, “in reality, psychiatric diagnosing is a kind of spiritual profiling that can destroy lives and frequently does” (Breggin, 2010). This is because no matter how extensively history is taken and studied by a psychologist, chances are that the actual cause might still be left overlooked and unperturbed. Whether or not an essential criterion for a disorder exists, “clinicians ultimately use their common sense when referring children for treatment” (Canino and Alegria, 2008, p. 239), which limits the process of making realist assumptions. However, the reality is that the cultural differences between the psychologist and the patient can significantly mar the decision making process which strengthens the argument of anti-realism within psychology. It is stressed that though medical diagnoses are real, psychiatric diagnoses in contrast are often negative and are not genuinely medical either. “Psychiatric diagnoses are not genuinely medical. There are no objective tests. Psychiatric diagnoses are not rooted in science but in opinion” (Breggin, 2010). In the contemporary age when the society is becoming increasingly multicultural, psychologists have to deal with patients belonging to different cultures having their distinct sets of values, norms, trends, and traditions. Correct and flawless assumption regarding the root cause and diagnosis as discussed above unequivocally holds extreme importance for planning treatment and outcome. Szasz (cited in Patil and Giordano, 2010) disputed psychiatric claims of realism claiming that psychiatric concepts when diagnosing lack validity and the descriptive objectivity. Facts should be appreciated when assessing a patient with a mental illness in a pure manner “as reality is seen through the spectacles of one theory or another. We have therefore to make a continual effort to discount theoretical prejudices” (Jaspers, cited in Patil and Giordano, 2010). There is a lack of precision in psychiatric diagnoses which is why making realist assumptions in clinical psychology can prove to be beneficial in multiple ways. Professor Kendell (cited in Rollin, 1976, p. 348) has disapproved such psychologists and psychiatrists who by failing to understand the limitation of psychology and psychiatry, deduce extravagant and unjustified conclusions from the results they obtain through highly sophisticated sources like multivariate analysis. Some critics of realism have gone as far as to say that “the destructiveness of psychiatric diagnoses could fill a book” (Breggin, 2010). In contrast to unjustified and negative psychiatric conclusions, making reality based assumptions would prove to be highly beneficial for the patients. Psychiatric decisions are made by differentiating what seems normal with what appears to be abnormal upon observing an individual and “the distinction(s) between normality and pathology entail assumptions that are often deeply presupposed” (Patil and Giordano, 2010). However, relying on DSM-IV for diagnosing each disorder as realistically as possible is not enough even as “DSM-IV has not formally incorporated social or cultural factors as exclusionary criteria of disorders” (Canino and Alegria, 2008, p. 238). Another limitation of DSM-IV is that “there is no assumption that all individuals described as having the same mental disorder are alike in all important ways” (Zimmer, 1999). Psychologists and psychiatrists should be aspired to making assumptions about humans as realistic as possible as negative diagnosing can potentially ruin a patient’s life for ever. There has been undoubtedly a significant increase in the interest shown in assessing the extent of realism within psychology in the recent years. Basically all assumptions, based on whichever class, leading to conclusions in psychiatry are made by assessment based on deeply subjective emotional states (Kendell and Jablensky, 2003). There are some strengths and weakness of other classes of psychological assumptions too like idealism and critical realism as research suggests. Idealism differs from realism in that it stresses on not perceiving the world as it is because our assumptions made about it could be wrong in contrast to the philosophy of realism. Modern idealism in psychology suggests that perceptions are influenced by assumptions, “some of which derive from cultural conditioning” (Smith and Darlington, 1996, p. 14). Proponents of idealism argue that realists tend to accept the objects of perception as they are thus, ignoring the difference between how anything actually is and how it appears to us. Proponents of critical realism, however, claim that idealism is a weak philosophy, that it is totally invalid and self-contradictory and any assumptions made based on idealism are flawed and can only lead to futile diagnoses and incorrect interpretations of myriad psychological phenomena (Watkins, cited in Smith and Darlington, 1996, p. 15). Idealism is further criticized because it suggests that a suffering individual could be responsible for his/her problems thus potentiating the stigma associated with any psychological disease. So realism is better in that it regards any mental illness “as no less biological in basis than then diabetes or asthma (Smith, 1994, p. 23). It is argued in context of strengths of critical realism that assumptions could be wrong but only critical realism “could account for differences and errors in perception because only from a realist viewpoint could such aspects of perception be identified in the first place” (Anderson, cited in Smith and Darlington, 1996, p. 15). References: Advameg Inc. 2012, History of theories about mental illness, viewed, 18 October, 2012, Advameg Inc. 2012, Mental Illness, viewed, 18 October, 2012, American Psychiatric Association 2000, Diagnostic and Statistical Manual of Mental Disorders, 4th edition, USA: Prenhall. Alarcon, RD 2009, Culture, cultural factors and psychiatric diagnosis: review and projections, World Psychiatry, vol. 8, no. 3, viewed, 18 October, 2012, [Online] Available at Alarcon, RD, Westermeyer, J, and Foulks, EF 1999, Clinical relevance of contemporary cultural psychiatry, The Journal of Nervous and Mental Disease, vol. 187, pp. 465–471. Breggin, P 2010, The Hazards of Psychiatric Diagnosis, The Huffington Post, viewed, 18 October, 2012, Canino, G, and Alegria, M 2008, Psychiatric diagnosis – is it universal or relative to culture?, Journal of Child Psychology and Psychiatry, vol. 49, no. 3, pp. 237–250. Healthism 2012, Personality Disorders | Symptoms and Treatment, viewed, 18 October, 2012, Kendell, R, and Jablensky, A 2003, Distinguishing between the validity and utility of psychiatric diagnosis, American Journal of Psychology, vol. 160, pp. 4-12. NIMH 2012, Borderline Personality Disorder, viewed, 18 October, 2012, Patil, T, and Giordano, J 2010, On the ontological assumptions of the medical model of psychiatry: philosophical considerations and pragmatic tasks, PHILOSOPHY, ETHICS, AND HUMANITIES IN MEDICINE, vol. 5, no. 3, viewed, 18 October, 2012, [Online] Available at QMI AGENCY 2012, Study suggests radical change in the way mental illness diagnosed, SUN NEWS, viewed, 18 October, 2012, Robinson, RJ, Keltner, D, Ward, A, and Ross, L 1995, Actual Versus Assumed Differences in Construal: “Naive Realism” in Intergroup Perception and Conflict, Journal of Personality and Social Psychology, vol. 68, no. 3, viewed, 18 October, 2012, [Online] Available at Read More