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                                             May 25, 2009


   Our somewhat crazy roomate has gotten a bit
   crazier of late, leaving me pondering a few
   things about the nature of identity, the value
   of humanity, and so on.


   On the subject of treatment of addiction, I'm
   suspicious of anything but cold turkey --
   dancing your way out by shuffling between            But: there may be
   different drugs seems like a process doomed to       cases where sudden
   fail, a trading of one addiction for another.        withdrawl is too
                                                        strenuous, too
   It seems to me that the right thing                  great a risk (IANAD).
   to do is to detox completely --
   having yourself locked in a padded
   room, if necessary -- to find out        And the trouble
   who you are, and how your brain          with that theory,
   works, and then see what you can do      of course is that
   with yourself.                           you can't separate
                                            self from environment     A variant
      But what about the case of "mental    so neatly -- self-        of the
      illness", where there's a flaw in     discovery in a padded     "ivory
      brain chemistry that requires some    cell is unlikely to       tower"
      form of medication as a necessity     succeed.                  myth.
      to be anything like "normal"?
                                                    Hence the strategy
      (It certainly can't be unusual for            of half-way houses,
      people who are "mentally ill" to              the gradual re-entry
      gravitate toward self-medication              into the world.
      with "recreational" drugs.)

         Then you can't just say "no drugs":
         you're stuck with distinguishing        The roomate got crazier
         between officially proscribed Good      after being moved off a
         Drugs, and unofficially obtained        methodone-like drug, and
         Bad Drugs--                             then adopting alcohol
                                                 and speed.
            The nature of your identity is
            then determined by official
            decree of medical personnel --
            who themselves are after all
            fallible human beings.

            Certainly it's not difficult to think
            of cases where the medical profession        It does seem likely
            was taken with fads that in                  though that the
            retrospect look like they were               medical profession
            without much scientific foundation:          would do a better
                                                         job than the subject,
               lobotomy                                  if only because they're
               electroshock                              outside of that
               freudianism                               judgement altering
                                                         feedback loop --

                                                         Consciousness
                                                         tweaked by cycles
                                                         of external
                                                         and internal
                                                         chemistry swings.

                                                         The trouble with that
                                                         theory though, is that
                                                         in the absence of
                                                         direct, long-term
                                                         observation, the
                                                         physician must rely
                                                         a lot on self-
                                                         reported symptoms.

                                                            Instead of risking
                                                            drug-induced
                                                            delusions, they're
                                                            at risk of
                                                            delusion induced
                                                            by junkie-patter.

                                                            The addict
                                                            quickly learns
                                                            what to say
                                                            to keep the
                                                            drugs flowing.

   A question:

   Do you have any right to blame such a
   "mentally ill" person for their behavior,
   e.g. for their drug addictions?

      My suspicion is that the answer is "yes".

      The idea that insanity completely
      absolves one of responsiblity is
      loaded with problems.

         Drug addicts use whatever
         excuses and justifications
         come to hand, and this is
         a ready made excuse for
         anything.  "Hey man, it's
         a junkie thing."
                                                  If you're sane enough to be
         I would argue that many                  walking around free outside
         people who are "insane"                  of an institution, then
         are indulging in                         you're sane enough to be
         insanity, on some level                  held responsible for your
         they're willfully insane.                actions.

            The diagnosed schizophrenic           The person involved is
            that occasionally goes off            likely to play this card
            their prescribed meds                 either way, as convenient:
            because life is more
            interesting that way.                 "Don't blame me, I'm ill";

              That's an obvious case,             "Don't lock me up, I'm not
              but only the most                   crazy."
              obvious one.

              Another would be someone who
              refuses to seek treatment
              because they know what
              they're going to be told and
              they don't want to hear it.

              Another might be someone who
              has violent episodes whenever
              they go into a bar; but                There may not be any
              instead of avoiding bars,              way to *cure* your
              they continue to go into them--        insanity, but aren't
              in the full knowledge of               there coping
              what's going to happen.                mechanisms you can
                                                     use to minimize the
                                                     problems stemming
                                                     from it?

                                                         If you refuse to
                                                         find or use those
                                                         coping mechanisms,
                                                         then what does
                                                         that mean, precisely?


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