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The DSM is not medical science – it's a social control manual

https://github.com/stagas/papers/blob/main/dsm_arguments_against.md
15•stagas•1d ago

Comments

mschuster91•1d ago
> The DSM is not medical science - it's a social control manual disguised as healthcare. It transforms human suffering into profitable disorders while ignoring the social conditions that create distress. It's time to abandon this harmful system and embrace approaches that actually help people heal.

We'd need to abandon a lot of things... not just our economic system but also how we live, i.e. urbanization. Just like you can't just coop tens of thousands of chickens into a mega shed without having to deal with psychological (ever saw chicken peck each other half dead?) and physiological (bird flu!) issues, you can't coop millions of humans into megalopolises with no greenery and barely any space...

cafard•1d ago
What little I know of classic literature suggests that predominantly rural societies (and cities running to the low tens of thousands) were acquainted with mental disorders.
piva00•1d ago
In the past week it's the third time I've read a comment on HN with this rhetoric against urbanisation/denser cities. I'm really curious on what has triggered this, has that argument appeared in some widely viewed YouTube video? Is it spreading through some other ways in social media?

It's rather bizarre to see this pattern emerge out of nowhere, three very different threads where someone comes ranting about urbanisation or dense cities.

lurk2•1d ago
This isn’t really a new sentiment on HN. It chiefly comes here via a loose network of right-wing influencers on Twitter who adopted the attitude from early 20th century ultranationalists, Ted Kacynzski’s Industrial Society and Its Future, and (perhaps most significantly) the work of John B. Calhoun [0], who studied the impacts of overpopulation in captive rats. This influence network was quite likely bought out by Peter Thiel in the last decade and skews young, educated, and male, so there is a lot of demographic overlap with Hacker News (you can watch links and discussion topics diffuse between the Twitter network and Hacker News to confirm this for yourself).

You occasionally see urban skepticism coming from left-wingers (usually techno-skeptic climate doomers convinced the world ended yesterday), but in those spheres urbanism is generally viewed much more favorably.

[0]: https://en.wikipedia.org/wiki/John_B._Calhoun

mschuster91•1d ago
> You occasionally see urban skepticism coming from left-wingers (usually techno-skeptic climate doomers convinced the world ended yesterday), but in those spheres urbanism is generally viewed much more favorably.

I'm one of these, but for another reason: hyper-dense urban areas are much more expensive to build (especially skyscrapers, they require massive amounts of concrete), and all sorts of other technology to work. In rural areas, you need streets and that's it (give them autonomous cars or their own electric cars to move around), in urban areas to cope with the masses you need trains (which are, again, expensive to build, just look at my home city of Munich). Additionally, we already have millions of units that stand empty in rural areas in Germany, so it doesn't make sense to build extremely expensive urban housing.

And from the medical side of things, which is my original post's point, we have seen in the coronavirus pandemic just how much faster the virus swept through urban areas than it did in rural areas. Makes sense, given that viruses depend on high contact frequency and density. And with Japan and its hikikomori, caused partially by young Japanese having not much place of their own to live in, we see the extreme end of the psychological effects of too dense living.

piva00•1d ago
> I'm one of these, but for another reason: hyper-dense urban areas are much more expensive to build (especially skyscrapers, they require massive amounts of concrete), and all sorts of other technology to work. In rural areas, you need streets and that's it (give them autonomous cars or their own electric cars to move around), in urban areas to cope with the masses you need trains (which are, again, expensive to build, just look at my home city of Munich). Additionally, we already have millions of units that stand empty in rural areas in Germany, so it doesn't make sense to build extremely expensive urban housing.

It's much more expensive to build and maintain a vast network of roads, sewage, water, power lines across a huge area servicing fewer people. You don't need skyscrapers to build a denser city, you live in Germany so you are aware of that.

Trains are expensive to build but the costs get spread out over a massive amount of people, it's economies of scale at play, which you do not get if you don't build dense enough places, you might have 10-50k people paying for each 500 metres of rail construction, the same for sewers, electricity, water, rubbish disposal, so on and so forth. That won't ever be possible if everyone lived in similar densities as rural areas, it's simply not economically possible for society to provide all the necessary modern infrastructure to people spread out.

mschuster91•1d ago
> It's much more expensive to build and maintain a vast network of roads, sewage, water, power lines across a huge area servicing fewer people. You don't need skyscrapers to build a denser city, you live in Germany so you are aware of that.

We already have built all that infrastructure over the last millennia. We have roads everywhere, we have water and power everywhere, and 99.99% are attached to a sewer mains. That's the fucking point. We have more than enough housing, it's just the basic infrastructure like 5G and fiber internet that drives people away from the rural areas, caused by politicians thinking "we don't need 5G on every cow pasture" (yes, literally, that was an actual quote).

piva00•23h ago
Do you think this infrastructure just sits there, being used all the time, without requiring constant replacement/maintenance?

All the roads everywhere are only possible when maintained, you are in Germany so you are very familiar with Autobahn closures for it. The same is needed for all power lines, water lines, sewage, internet infrastructure, cellphone infrastructure, etc. they are constantly being repaired, expanded, and replaced by better technology.

All of that is only possible through economies of scale, you simply cannot have all the necessary infrastructure expected from a contemporary life style in good functioning state without a large cohort of people sharing the financial burden to maintain it, the less dense it is the more expensive it is to maintain each metre of power lines, sewage, water, roads, etc. per capita.

I do not understand what you aren't understanding.

> it's just the basic infrastructure like 5G and fiber internet that drives people away from the rural areas, caused by politicians thinking "we don't need 5G on every cow pasture" (yes, literally, that was an actual quote).

Because to do that it needs to be subsidised by someone else, the 10 people in a town without 5G coverage are not enough to support the installation, and upkeep of multiple towers to service them, 5G has quite shorter range compared to 4G/3G. Fibre needs to be rolled out, trenches dug, switching infrastructure somewhere not too far away to maintain a good SNR.

The basic infrastructure can only exist if there are enough people to pay for it, if it's already difficult to subsidise this use even with the dense population centres paying for it, how exactly do you see it being paid by in your fantasy?

KingMob•1d ago
Looking at the overall contents of that repo, it looks like some rando just chose Github over Dropbox to store their notes. Not sure why HN should care.
lurk2•1d ago
> Please don't post shallow dismissals, especially of other people's work.

https://news.ycombinator.com/newsguidelines.html

KingMob•21h ago
In an era when RFK Jr. is spouting similar nonsense from the highest levels of government and doing tremendous damage to people's health, refraining from calling out cranks is not the higher virtue.
lurk2•1d ago
Interesting notes. I’ve made a few of these observations on my own and came to largely the same conclusion; clinical psychiatry is inherently normative. Viewing behavior as disordered in particular requires a frame of reference for what constitutes desirable behavior.

Humans being made to conform to the requirements of (industrial) society, rather than the other way around, is one of many cart-driving-the-horse norms that emerged around the turn of the 20th century; the invention of jaywalking, mills waking up entire towns with steam whistles, leisure time being sacrificed to purchase consumer goods, etc.

There is a balance to be struck. It’s entirely natural that the behavior of every individual will need to be regulated to the extent that coordination is possible (else, it becomes impossible for us to even engage in a conversation mediated by language); even so, there is a tendency to assume that it is the duty of the individual to radically change himself, or else to be blamed and categorized as a good-for-nothing in the event that he fails to so change himself. This can appear sensible until it is considered that small accommodations here or there will not inconvenience us much, but will make a world of difference to the person being accommodated.

Where this gets complicated is when we get into issues of affirming delusion or being asked to make accommodations for behavior one considers to be immoral, but I suspect that the world would be a substantially more pleasant place to live in if people gave more consideration to the different manners in which we could all potentially be living in it.

Simulacra•22h ago
The DSM had always been interesting to me because most of it is so broad, that you could apply it to just about anyone. I really believe the pharmaceutical industry has pushed to expanded the DSM beyond relevancy to sell more pills.

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