Four Assumptive Worlds of Psychopathology I: Setting the Social Constructive Stage
I will be looking at two fundamental ways in which this syntactic issue is at play when applying this linguistic notion about branching to the domain of psychopathology. First, there is an important way in which the left-branching and the accompanying passive voice is indicative of an absence of certainty in the domain of psychopathology. Those who are working in this domain are often “kidding themselves” if they believe there is clarity and certainty in the field. As Gary Greenberg noted in his Atlantic article, the field might be saturated with “incurable hubris.” As we will note in a later essay, this hubris is particularly prevalent in the use of DSM to classify different types of psychopathology. As a psychologist, I note that “hubris” is likely to be coupled with anxiety and that both lead to a rigidity of thought and action. We desperately long for objective truth when our analysis of psychopathy is saturated with hubris and anxiety—but find that the domain of psychopathology is embedded in constructivism. The subject is elusive, leading to misunderstanding and misdirection in the specific modifiers (such as money and confusion) being attached to this domain
There is a second, perhaps more profound, implication associated with this syntactic analysis. Left and right branching tends to shift the way in which we view causality. Causal analysis is a critical issue in the domain of psychopathology—as we shall note throughout this series of essays. The direction of causality is clear when the subject comes prior to the modifiers. We can say: “the boy hits the ball” or we can say: “the boy hits the ball out of the park”. In either case, it is the boy who is the primary cause. Nothing changes with the addition of more modifiers. When the subject follows the modifiers then causality can be confusing. We say: “The ball was hit by the boy”. This is the same thing as “the boy hit the ball.” However, we are a bit more in doubt, for the ball seems to be particularly important. In some way, did the ball choose the boy who is to do the hitting? Of course not.
If we replay “boy” with “mental patient” and replace “ball” with “violence”, then the issue becomes a bit more in doubt. “The mental patient became violent” is not quite the same thing as “violence was exhibited by the mental patient”. This second statement doesn’t differ much from “violence seems to have overtaken the mental patient.” These left branching statements seem to place some causality in the state of violence: is this person becoming ‘unstable’ because of the violence (or is the violence a symptom of the patient’s mental instability)?
On the surface, these variations in the presentation of a description seem trivial; however, I would suggest that they are not and that any thoughtful review of contemporary theories about and strategies for treating psychopathology must address the often-subtle issue of implicit (as well as explicit) causality. A sequencing of causality is critical in seeking to understand and treat psychopathy. While semantics plays an important role in the diagnosis and classification of psychopathology, syntax (or at least the fundamental ordering of causality) plays a role in the formulation of assumptions about etiology and, subsequently, treatment.