Ad hominem: attack on the person arguing rather than the argument itself. How is pointing out the fact that you're whining about relevancy rather than addressing my points an attack on you?

The fact that the WHO's, APA's, AMA's and whoever else's opinion on this matter might be wrong IS relevant. Mainly because you're the one who keeps bringing their opinion up. If we define a mental disorder as what those organizations say it is (as you have been doing), then the fact that they aren't trustworthy means that this debate needs to think long and hard about whether or not we need another definition for it. Either way, the fact that they can't be trusted on this means that their opinions can't be used here. So stop using them. If you have another argument, then use it.

Hugbug, I think you make good points about the whole milk thing, but I'm not sure that it's a reason to say that the whole healing arts industry is flawed. But, since you do not seem to trust anything that medical, psychology, or psychiatric researchers say, then it's impossible to continue this discussion. You sound like one of the old school scientists who argue that only physics is the true science.

Mistermook, thank you for clarifying your position in this area. It sounds somewhat like Hugbug's position. But again, how can a discussion about it's being a mental illness continue if you reject those institutions that support the premise?

Am I wrong in thinking that both of you would reject any mental illness definition for the reasons you've stated? Or are some mental illnesses clearly "mental illness" in your opinion?

Actually, I did give a criterion early on about what would make me accept a scientific study on pedophilia. The researchers had to be drawing from a pool of non-criminals. The studies that GabyBee linked did not fit it. One person did come up with one study performed on non-criminals, which I accepted.

I don't think that psychology as a whole is without merit, just that popular psychology - and healthcare in general - isn't without corruption, like most things. Especially at the very top, where it becomes deeply intertwined with politics. (And also, physics is weak. Applied mathematics is THE true science! )

As for the definition of a mental illness, I kind of like iCad's definition from a couple pages back.

1. It must cause symptoms/dis-ease in a person
2. It must be testable
3. It must be curable or reducible

If you take schizophrenia, it fits all three. It causes significant problems, enough to cause dis-ease in a person. Doctors can test for it and come up with results. Finally, it can be treated. Depression also fits the bill.

It's not a perfect definition, but I can work with it.

I like most of the critera except for #3 because there are illnesses that are not curable or reducible, ever. Treating schizophrenia? I haven't heard of any really good outcomes with that one. Some illnesses are managed, somewhat, with drugs, but not really and not completely.

It's possible that pedophelia might have a treatment, but it hasn't been found yet. I've trotted out this article before because I find the ramifications of treating brain injury amazing. There is that piece about "Alex" who developed a taste for children and that preference went away when they removed his brain tumor. Yes, it's only one case, but I believe there are others and while it doesn't prove anything yet, it points to something that should be researched.

That's what I meant for reducible: that the symptoms can be reduced by some means. Imbalances in brain chemistry can possibly be altered, like with depression and anti-depressants. It doesn't get rid of depression, but it reduces the symptoms by putting a band-aid on the brain, so to speak.

And, as I pointed out before, the orbitofrontal cortex deals with decision-making and reward, not the generation of desires. For Alex to start the behavior, he must have had some tendency in that area to begin with. Think of it as being drunk. Your judgment is impaired and inhibitions are lowered, but you're not going to start doing anything that wasn't in your nature already. Alcohol doesn't affect the desire-generating part of the brain (the back/brainstem) so much as it affects the front (decision-making and morality center) and sides. Which is why I hate it when people say things like "I'm not really an anti-Semite, the alcohol made me say it!". Yeah, they are, they just temporarily shut off the part of their brain that tells them it's not a good idea to say those things.

I tend to look at soft sciences as naturally suspect. I think that's probably a healthy, grain of salt sort of attitude. That doesn't make them useless, but it demands that you're always questioning things that aren't solid, factual sorts of things. Basic premises, data sets, survey size and biases? These are important things. When someone tells you something absolutely always is so they're fucking out of their minds when the subject regards something as soft as "how people act and why." With other sorts of doctors you can look at the tumor and go "I'll cut that out, it's a tumor." With people's heads, it's always going to be a balancing act of art and guesswork with the data at hand unless and until someone maps the human mind out like a software program and we're suddenly able to empirically sort every bit of head into their proper bins and such.

As a diagnostic tool therefore, I appreciate things like the DSM 5. They're like all the charts and spreadsheets you have for a business or economics class, or a book of regulations designed to keep your employees from inviting lawsuits and criminal behavior. But it has to be a tool, it must not be a dictionary, because you can look at all the data in the world for soft sciences sorts of things and still not answer important questions like "Why" or "Will this happen and when?" You can't even pick out the inevitable "does not conform to data, but still happens because people are fucked up" things that leave people scratching their heads and grad students sharpening their pencils trying to write thesis around the fringe cases.

And ultimately, part of the problem with diagnosing pedophilia as anything right now has to do with sample size and sample bias. Doctors have enough trouble diagnosis and treating depression, because they admit there's a social stigma. I can't imagine how terrified of your own head you'd have to be to overcome the social stigma of pedophila to get treatment, and since there are reporting requirements in some places (I think, don't quote me on this one, I just seem to recall there being some) then I can't imagine someone self-reporting for treatment when that invites criminal investigations and maybe even mandatory perpetual incarceration as a function of "treatment."

So my grain of salt on the whole idea of "data" regarding pedophilia is rather large - which is why we keep bringing up homosexuality. It's not because we're suggesting that homosexuality is "also icky" like pedophilia, but that the social stigma of homosexuality caused what was probably a similar skewing of the data in previous times with less severe consequences. I think we can all agree that homosexuals have and are sometimes treated badly, but that known pedophiles likely have no friends whatsoever. Just because now "Of course we know they are completely different" has absolutely no relevance to ignoring the bias in the prior studies. How do you treat people who won't come in for treatment? How do you know you're treating everyone who needs treatment if the only people you're treating are the ones who you've incarcerated? Those are just the easy questions, and if you're dealing with something as complicated as human sexuality I don't think the easy questions are even the tip of the iceberg.

Other things psychology diagnoses? I suppose they're better at that, especially the ones that are explicitly brain chemistry issues and common enough maladies that there's gross sample sizes both for the issue and the treatment. Even if those things are also not entirely understood and complicated, it's difficult to argue with "people complain of x, we give them y, and they're fine." But I think it's more likely that some of the most common examples of these sorts of things are things that are explicitly extreme in their severity - we might be stumbling around about bipolar disorders and schizophrenia too, but they're life-limiting enough sometimes that there's a rather large and consistent public "push" to "fix it." And depression? ADD? I'm less comfortable with those, but at least the sample sizes are broad and deep. I'm not saying I think they're exactly right, but they're approaching the thing from the place I'd start and then, decades later, try to figure out if I were wrong. I think chasing down empirical data is a good start too, but even with empirical data in psychology there's still the issue of bias and sample size and a host of other issues when you're talking about a fringe paraphilia or something like that.

But what I think is most likely, regarding psychiatric sciences, is that it's probably about the same place as all the other social sciences. It's really new. Even being as old as Freud and "well, we all talk about people" it's still really new. I think there's still a certain amount of categorically biased nonsense bullshit in it that people haven't shaken loose, even when they've been trained to think and try to prevent those things from happening. I see it with "business" sorts all the time who've dealt with a certain situation for a long time, long enough to regard themselves as "expert" in the subject, or maybe they're like Gaby and they've read something about something and didn't really consider the nuance of the source or the potential wider issues of "once we put people in it, and not just words." Theres a bit of blindness that develops in that sort of thing, and that's why science is awesome in that it seeks to wreck that blindness - but for it to do that you've always got to be ready to challenge assumptions and definitions. Especially definitions, because when someone says that they know enough to say what something is, they're implying an awful lot of implicit knowledge regarding what it isn't. That's often practical and useful and legally correct, but it doesn't make it right.

I remember your saying that before. I think the article was suggesting something different, that it was not, in fact, "within Alex" any more than any aberrant behavior is within any of us. One could argue that the range of behaviors/motives/desires is within anyone's grasp and, given the right set of circumstances, could be manifested. Actually, I think I would argue that.


MisterMook, That was an excellently worded analysis. I think I see the "softer" sciences about the same way as you described. It's useful as the best reference we have right now.

I wasn't aware that The Atlantic writers were trained psychiatrists. Speaking of motives, what makes a better story? "At any moment, you too could become a pedophile or go off the deep end and commit homicide/suicide!" or "It's difficult to prosecute people when their behavior is influenced by brain tumors". Writers have to write what will sell. Otherwise, their works get vetoed by editors because they refuse to put two of their characters into a relationship that would inevitably turn out abusive and so none of their work gets published. Not that I have personal experience or anything.

This is one of the biggest problems of the soft sciences. There's no hard data, so it's soft and malleable. And thus, people can use it to further their agendas. Like evo-psych, which on a scale of hardness where applied mathematics is a solid brick of diamond, is the fluffy throw pillow of science.

Now, if everyone who got a tumor in the same area of the orbitofrontal cortex - or had a deformity in that area - started getting pedophilic urges, that would suggest a definite connection. As it is, we have a sample of one. But given that area's functions...saying that it's responsible for his pedophilic tendencies is like blaming the air conditioning system going out for the fact that you're at the equator in the middle of summer.

The Atlantic writers were reporting a story, not creating it.... This isn't anything that is widely accepted, but, again, it points to a possibility. Our understanding of life, the universe, and everything isn't really static. Sure, "42", but we're still trying to grasp it all and we keep seeing new aspects.

Even within the "soft" sciences, there are agreed upon protocols and methods. You might dismiss it all out of hand, but...that's why we can't get anywhere in this discussion.

Again, the tumor thing was not evidence, but suggests a need for further study. I keep trying to point out that we don't have all the answers YET, but if we don't consider the possibilities, we'll never get any of them. All science works with that premise. You're arguing that there is no cure for being a pedophile. You may be right. I consider the experiences outlined in this article to point to the possibility that there is a cure for it. Of course, we need further studies and your suggestion about how to go about that is good.

VerDeTerre, I understand how you might want to believe that there's a cure, but it doesn't work that way. We already have a good idea of what parts of the brain do, no matter what science fiction might try and tell us. There are studies currently ongoing where researchers take an electromagnet and fire it at the brain to alter the electric signals in neurons. They can get real results doing this. Some people report feeling a ghost go by as they pass one area, feeling cold as they point it at another. We're already manipulating the brain. For that matter, lobotomy used to be a common "cure" for mental illness and "undesirable" personalities, so we have documentation of what happens when you remove each area. Cut out Broca's area and people have trouble understanding words. Cut out the mirror and they can't form eloquent sentences. Cut out the orbitofrontal cortex, and people stop feeling motivated to do anything besides survive. They still do things, but they don't have any mental reward attached to the more complex things, like that warm and fuzzy feeling you get from doing the right thing or guilt for doing the wrong thing. They have impaired judgement, and since there's no reward in what they do or punishment for making the wrong decisions, they can start doing destructive things. For instance, cutting themselves just so that they can feel something. And in their personal life, they may begin doing things that alienate their friends and family, because they can't think their decisions through.

No, we don't have all the answers, but that is hardly the mystery you're making it out to be.

And all I would say is to look very long and hard at anything that "cures" "ailments" of the brain that are not tumors, etc with empirical fail/cure states. I think there's a danger of people "curing" mental illnesses sometimes the same way an army might cure poor service at a restaurant. Lacking any appreciable understanding, fix the problem by complete destroying it and everything around it, or forcing behaviors upon the subject, or whatever. Psychiatry is a couple hundred years old, even accepting a tremendous acceleration in human learning that suggests that how we look at the human mind might be as primitive as Galileo peeking out upon the heavens, with things like the DSM playing the role of the Church. Which, of course, doesn't mean they're completely wrong about everything or even wrong about anything - just that my surety and confidence won't be supporting them. We're very much in the "set something in fire to see how it burns" mode of psychology just yet. That's great if you need the forest cleared, but I question what we're missing while we watch the fire.

EDIT: Gaby, you missed this one for your Disagree button.

I don't know if it will be classified as a mental disorder, but it should be classified as something that helps with intervention and helps the person get treatment so they won't hurt anyone. I think it would help to treat the people with the desires as people who need help and support and not as criminals or sickos. In college I had a friend who confessed to me that he liked barely pubescent boys. My reaction was maybe not the most constructive. I sternly said to never, never act out on it and basically treated him differently afterwards. I didn't mean to be so harsh and condemning, but I couldn't get over it. I can't imagine him hurting anyone though, and what he needs is a support group and someone to listen to him and help him. I couldn't do that for him, and I feel guilty, but then again I think that someone with professional skills would be more suited. I don't know if there is a 'cure,' but sincere therapy and support groups go a long way.