On Dis-ease Essay

This essay has a total of 1289 words and 6 pages.

On Dis-ease

Sam Vaknin's Psychology, Philosophy, Economics and Foreign Affairs Web Sites

We are all terminally ill. It is a matter of time before we all die. Aging and death
remain almost as mysterious as ever. We feel awed and uncomfortable when we contemplate
these twin afflictions. Indeed, the very word denoting illness contains its own best
definition: dis-ease. A mental component of lack of well being must exist SUBJECTIVELY.
The person must FEEL bad, must experience discomfiture for his condition to qualify as a
disease. To this extent, we are justified in classifying all dieases "spiritual" or
"mental".


Is there any other way of distinguishing health from sickness - a way that does NOT depend
on the report tha the patient provides regarding his subjective experience?


Some diseases are manifest and others are latent or immanent. Genetic diseases can exist -
unmanifested - for generations. This raises the philosophical problem or whether a
potential disease IS a disease? Are AIDS and Hemophilia carriers - sick? Should they be
treated, ethically speaking? They experience no dis-ease, they report no symptoms, no
signs are evident. On what moral grounds can we commit them to treatment? On the grounds
of the "greater benefit" is the common response. Carriers threaten others and must be
isolated or otherwise neutered. The threat inherent in them must be eradicated. This is a
dangerous moral precedent. All kinds of people threaten our well-being: unsettling
ideologists, the mentally handicapped, many politicians. Why should we single out our
physical well-being as worthy of a privileged moral status? Why is our mental well being,
for instance, of less import?


Moreover, the distinction between the psychic and the physical is hotly disputed,
philosophically. The psychophysical problem is as intractable today as it ever was (if not
more so). It is beyond doubt that the physical affects the mental and the other way
around. This is what disciplines like psychiatry are all about. The ability to control
"autonomous" bodily functions (such as heartbeat) and mental reactions to pathogenes of
the brain are proof of the artificialness of this distinction.


It is a result of the reductionist view of nature as divisible and summable. The sum of
the parts, alas, is not always the whole and there is no such thing as an infinite set of
the rules of nature, only an asymptotic approximation of it. The distinction between the
patient and the outside world is superfluous and wrong. The patient AND his environment
are ONE and the same. Disease is a perturbation in the operation and management of the
complex ecosystem known as patient-world. Humans absorb their environment and feed it in
equal measures. This on-going interaction IS the patient. We cannot exist without the
intake of water, air, visual stimuli and food. Our environment is defined by our actions
and output, physical and mental.


Thus, one must question the classical differentiation between "internal" and "external".
Some illnesses are considered "endogenic" (=generated from the inside). Natural,
"internal", causes - a heart defect, a biochemical imbalance, a genetic mutation, a
metabolic process gone awry - cause disease. Aging and deformities also belong in this
category.


In contrast, problems of nurturance and environment - early childhood abuse, for instance,
or malnutrition - are "external" and so are the "classical" pathogenes (germs and viruses)
and accidents.


But this, again, is a counter-productive approach. Exogenic and Endogenic pathogenesis is
inseparable. Mental states increase or decrease the susceptibility to externally induced
disease. Talk therapy or abuse (external events) alter the biochemical balance of the
brain. The inside constantly interacts with the outside and is so intertwined with it that
all distinctions between them are artificial and misleading. The best example is, of
course, medication: it is an external agent, it influences internal processes and it has a
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