mental illnesses question

[Abreu]

i have been wondering for some time what would happen if a mentaly illed person was put face to face to her illness for example

a person thinks that at midnight is going to turn into a werewolf if someone would restrain that person and show that nothing happened what would happen? i doubt that the person will realize it wasnt true maybe he/she would go even more insane has to get mentaly "broken"and starts killing people

Edited January 6, 2011 by Abreu

[Mrs Zeta]

Mental illnesses are divided into two broad categories: Neuroses and Psychoses. Many patients who have a neurosis, such as severe phobias are treated by facing their object of fear. For example people who are afraid of spiders are made to handle spiders. People who have a psychosis (schizophrenia etc) are not generally aware that they have a problem (i.e. they have a poor insight into their condition), so you can't make them face their problem.

Edited January 6, 2011 by Mrs Zeta

[Marat]

A good book to read on your question would be 'The Three Christs of Ypsilanti.' This study reported on three psychotic patients institutionalized at Ypsilanti, Michigan, who all believed that they were Jesus Christ. The experimenter decided to bring the three 'Christs' into confrontation with each other to see how each of their claims to be the one and only Christ would be affected by encountering someone else with this same delusion.

[imatfaal]

Marat

 

Might give that a try - although I would have thought it would raise ethical issues rather than solve clinical. It sounds interesting and most disturbing - is it a good read and accessible?

 

Corollary - it is unethical or at least ethically dubious to use the results of historical highly unethical studies? ie a fruit of the poisoned tree in research ethics. What about when the displacement is in space not time? obligatory qv the stanford experiment

[Marat]

This question is often raised about the Nazi experiments on identical twins (quite rare to find so many subjects as Dr. Mengele was able to collect) and on changes in human physiology due to freezing temperatures conducted in the concentration camps during World War II. Also, one of the classical and best anatomy texts used in German and Austrian medical schools is based on anatomical studies and photographs taken of corpses from the concentration camps. My view is that everything in history is tainted by evil to some degree: All nations came into existence on the basis of invasions; all institutions were built up over the years by wealth collected from slave labor or by exploiting workers paid less than the minimum wage; the discoveries of many famous people were made possible by careers promoted by racism and sexism, etc., so we can't avoid participating indirectly in the evil that has made the world what it is today. We should instead view using the fruits of past evil as a way to derive at least some good from evil things and in that way mitigate their negative impact.

[lemur]

I think it helps to look at the specific microdynamics of information supply-chains. The only reason it would be unethical to use information from research/experiments is if it would have a promotional effect on future ethics-sacrifices in the interest of data/knowledge-production. The operative question should be what can be done to prevent and/or discourage unethical research/experimentation and who has the power to stop or control such research in the first place. Ultimately, control is in the hands of the researcher and participants, imo. Various policies or censorship can discourage their work but if they truly believe what they are doing is worth the risks and/or sacrifice, they will proceed. The question must also be asked when research censorship goes too far in exercising power vis-a-vis research. E.g. if some government believes that theoretical physics is responsible for the development of WMD, do they have the right to assume their analysis is correct and act accordingly? What if someone dissents from their view and claims it was not physics theory but rather military engineers, commanders, and workers responsible for applying and deploying physics knowledge as weaponry? This example is maybe hijacking the thread since it was not the research itself that was unethical but the application of the knowledge gained.

 

In cases of mentally ill persons suffering from their condition, the most ethical approach is to attempt to consult them (i.e. acquire informed consent) with the (good faith) intention of minimizing the possibility of their suffering. So, for example, you would attempt to discuss with them your idea for confronting their psychosis with a reality you believe could help them recognize the delusional nature of their belief. You would probably want to assure them that if they understand the treatment and still prefer not to proceed, their wishes will be respected. It would also be a good idea, imo, to explain to them why/how you believe they and their condition will be affected by the treatment. They may be able to understand and cooperate, even offering advice or insight into how/why the treatment will or won't work and what effect they expect it to have. You should only violate a person's right to consent when the benefit to them outweighs the risk and disrespect entailed, and when the effect of the treatment is deemed to be sufficiently harmless.

 

In the case of the person fearing spiders, you would not confront them with spiders but you might talk with them about when they begin to feel anxiety, e.g. when seeing photos or video footage of spiders, when seeing a spider in a terrarium, etc. Then you could talk with them about what kind of situation might be tolerable or even comfortable and see if they want to try that first and then repeat the process with other instances they are more sensitive to.

 

In the case of the three Christs (I haven't read this book, btw), I think you could talk with them about their feelings about what it means to be Christ and whether they think it is possible for multiple Christs to exist simultaneously. You might find that they wouldn't be traumatized by meeting each other at all. They might even look forward to the theological interaction. Really, you need to understand the details and contours of a person's belief before assuming anything about them. This experiment of bring three together sounds more like a joke from the perspective of the therapist than a serious approach to understanding the patients' thoughts.