A theoretical model using "indifference curves" from economics
I think this is essentially correct. However, it won't do anymore to convince Bryan than my shorter comments to the same effect because the real crux of the disagreement isn't over what you explained but about what 'mental illness' means.
Bryan gets himself into trouble because he tends to assume there are clear facts about the one right meaning of a word that reflect his intuitions about the principled distinctions in the neighborhood. In the case of mental illness, he seems committed to thinking that a mental illness somehow must mean a condition sufficient to excuse you (completely) from legal/moral responsibility for your actions and substitute in as an excuse where we'd accept a physical illness.
He doesn't seem willing to accept that the ascription of illness has multiple meanings depending on context ranging from: something we think should be fixed, to valid excuse for prescribing/subsidizing drugs, to a condition which justifies making allowances.
This is the same problem he runs into with his stuff on feminism. Sure, he's right that most people don't fully apply the definition the claim to accept about feminism being just the belief that genders deserve equal/fair treatment. But if he wasn't so stuck on the idea that words have a single true meaning he could just accept that (re) definition and make the same points rephrased as claims about how true feminism therefore requires equal focus on male mistreatment.
It's logically equivalent but he'd be a whole lot more likely to convince people like his daughter if he just accepted that many people simply don't want to have to say feminism is bad anymore than they want to say patriotism is and will change the meaning as needed to allow that.
Fine from an individual point of view, but weaker from the societal. You said:
..It makes sense that, as society’s values have moved away from survival-and-reproduction focused concerns, towards more focus on individual autonomy and self-realization (as described by Robin Hanson’s farmer-vs-foragers model) we’ve seen a massive shift in how homosexuality and trans identities are perceived....
Ignore the costs and risks to other people with a hand-wave towards 'individual autonomy and self-realization'? You also say:
...t seems wrong to call people “mentally ill” if they themselves are happy with their indifference curves....
But that ignores that there are whole public institutions dedicated to catching, holding and treating people, against their wills, for mental illnesses that the person does not want treated.
During the Covid panic, people were chased and caught by police simply for walking outdoors on a deserted beach. It was socially acceptable to arrest and detain people who might spread communicable diseases. Sometimes you can read of a tuberculosis+ person being arrested and forced into quarantine. So our tolerant, liberal US society is apparently schizophrenic about disease-spreading behaviors. Coughing on someone to spread disease is bad, but sex that spreads disease is just a choice?
I'm afraid this doesn't clarify things, and it ultimately suffers the similar fate of Bryan's case. You say that people who suffer from depression due to hypothyroidism is constrained because their depression was caused by a physical illness. You say:
> Then, when the person spends all day sitting in their room, one could say “well they’re actually hitting the highest indifference curve available to them, so they’re doing fine!”
You rightly note that this doesn't make sense at all. However, you say that genetically-caused depression does make sense to be called a preference. But all you have to do is modify the scenario:
> "Well, due to genetics, they’re actually hitting the highest indifference curve available to them, so they’re doing fine!”
This is also absurd. It also doesn't make sense to analyze genetic mental illness as a want-to-not-want something because there is no first order want. The person with genetic depression obviously doesn't want to lay around in their room all day either, so they don't *want to not want to* lay around in their room all day. This only makes sense in a metaphorical way.
Maybe it's hard for people without mental disorders to understand. Before I knew I had anxiety (both social and general), I had panic attacks before I knew what they were really like. I had no idea they were panic attacks, because I didn't really know I was "anxious" and they often happened when I didn't feel anxious or embarrassed and didn't have a reason to. When I had panic attacks, I would just pretend like nothing was happening.
Also, I didn't understand why I couldn't have a casual conversation like others without anxiety. I had no wit or ability to follow the flow of a conversation, and I would embarrass myself a lot.
There was no preference to be anxious or quiet or embarrassed. I just was and I didn't really understand what was going on or why I was different from others. Being diagnosed with both anxieties and ADHD clarified a lot of things for me. Unlike my ADHD, I was lucky with pill treatments and basically all the symptoms went away. (Btw, what I have is definitely genetic)
Your definition also suffers from several problems. First of all, it implies that if everyone except depressed people disappeared, then depression wouldn't be a mental illness because it would then be the median indifference curve. Also, some people want to want to go to their 9-5 job as much as the median person, and would pay a lot to enjoy it as much because the sheer time suck that is. But it's not a mental disorder to want to want the median indifference curve.
I highly liked this post . I have struggled a ton with BC and SA conflict here. I have autism adhd and am gay, but im not clasicslly disabled or mentally ill. But i have also struggled to the degree with all of those that i got depressed, and BC description of those just feels unreal
Great post, best summary I have seen so far. Although I would add that there is quite alot of variation outside of WEIRD populations with respects to the relevant social values. And also that if Hanson is right about our current cultural moment being some sort of dreamtime, then perhaps we ought to consider what future humans might think, with their views probably being similar to say Kirkegaard or Gregory Cochran.
I think deafness is an interesting thing to consider in your model. Like deaf people perfering deaf children. The deaf preferences are real but they are staring at the cave wall.
One problem you will run into is the human capacity for deception -- both in terms of deceiving others and in self-deception. So when some people say some form of 'I am happy with my indifference curve', what they are doing is lying to themselves and you. Many people really do say that they like to self-harm, and what they need is for society to accept their desire to attack themselves with razor blades as an eccentric hobby. Should we believe them?
You should see if the DSM-V steering commitee would be interested in this take.