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Sensitive topic here. Came up in one of my discussion forums. I'm newer to, specifically, discussing addiction. But the concept of "disorder" across the spectrum of behavior health fields is something I've studied and written about for years. Would welcome dialogue with addiction peers (especially hearing from advocates and those failed by existing system) about this article.
Want to put this disclaimer up front (will be repeated below in my original draft writing this)...
Disclaimer
I do not dispute nor seek to invalidate any personal experience of what helped someone. If calling something a "disorder" genuinely improved their personal quality of life, where quality is self-defined without oppressive social manipulation, then to some extent I don't care what they think. I'm excited that something worked. Any genuine success in this challenging area is win. And it's an important data point to gather and take note of. That being said, I do also think it's important to get the story as correct as possible about what science can and can't science about higher-level cognitive function.
Original Post From the Forum
Context
Another user had written that "Science has shown that opioid addiction is a disorder of brain structure".
My Reply
Depending on how one understands the term "disorder", this statement can be dangerously misleading and inaccurately understood by even savvy readers.
The fact of the matter is that science has no mechanistic explanation for higher level experiences of thoughts, emotions, and personality.
Calling something "ordered" or "disordered" is an act with widespread ramifications and is something that can be interpreted twenty different ways if we're not careful. I've written about this quite a bit, most recently in an article about how great care needs to be taken with the use of the term "functional" in the world of disability rights. As detailed in this recent article: "most people we meet will not have the exact same concept of ostensibly clear-cut things, like animals. Their concepts might actually be radically different from each other. The research transcends semantic arguments, too. It could help track how public perceptions of major public policies evolve over time and whether there’s more alignment in concepts or less."
The article was published earlier this year by researchers at UC Berkeley, and I've been begging and pleading with them to fund a similar study on public understanding or misunderstanding of concepts relating to "disorder" and "function" in the fields of psychology, mental health, and addiction. It needs to be peer-led, and it needs to be highly aware (as studies almost never are) of ongoing ableism, racism and other bias (including values-based ideological assertions) baked into the core of our medical knowledge base.
Also, I do want to note that I don't want to dispute or invalidate any personal experience of what helped. If calling something a "disorder" genuinely improves personal quality of life, where quality is self-defined without oppressive social manipulation, then to some extent i don't care what they think. I'm happy for them and it's important data. That being said, I do also think it's important to get the story as correct as possible about what science can and can't science about higher-level cognitive function.
This additionally has ramifications for statements such as "their disorder took their life". If disorder is wholly a "brain flaw", society bears no responsibility. If disorder is, partly, sometimes, a natural reaction to external social factors, society bears huge amounts of responsibility. It's thus incredibly dangerous, oppressive, and disempowering to let society off the hook and blame everything on the faulty brain theory. We better be darn sure we're right because if you're wrong on that, you're helping enable social oppression.
Again, this isn't some binary. I'm not saying "it's all the brain" or "it's all social factors". I'm saying it's about getting the accurate observative description of the situation as correct as possible. And I'm terrified at how poorly modern behavioral health does in this regard. Would love support from some entity to give this topic the analysis it deserves. It's a crime that this topic isn't currently funded or given prominence.
This is my best attempt at exploring this with the limited resources at my disposal.
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