I agree with you about the risk of unnecessary treatment. It’s kind of sad really. I’d like to see a society where we do recognize young people who may be more vulnerable to psychosis……and where we also recognize that this often means they may have distress in their life that needs to be addressed, and/or that they have a unique mind with some creative potential, and give them assistance in finding effective ways to deal with everything, rather than just trying to numb them up with drugs.

But my dreaming about this is probably a sign of some sort of psychiatric disorder. Maybe the DSM V will clarify exactly which one.

If somone is vulnerable because their unresolved earlier experiences stimulate a response in the presence of representative stimuli then psychotherapy may aid in resolving these interpretations and that may be ok.

The currently proposed DSM V however is identifying “Psychotic Risk Syndrome” for inclusion and the risk is that psychiatrists administer neuroleptics on the basis that pre-emptive treatment will ensure an individual does not become psychotic.

Great to hear that you will be doing this important work! People like you, acting and speaking out, is most likely to be the thing that will finally change the system! (That is also the contention of the really important book I’m reading right now, Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?)

Well I certainly agree with you that we should never be telling people that it is “all” about their vulnerability (especially when we don’t even know for sure who has any special vulnerability, or not.) And I agree that the mental health system is usually all too quick to offer such stupid interpretations.

Even in cases where we do know that someone has a certain vulnerability to a kind of problem – such as the redhead with sensitive skin who is easily sunburned – there is still the story of how they got exposed to the sun, why was the sunscreen forgotten, etc.

I’ve also argued elsewhere that the factors that make people vulnerable to mental and emotional problems may be factors that are helpful, not harmful, in other respects. This fits well with your example of how vulnerability to sunburn may be part of something positive, which is the ability to get more vitamin D even in an environment with very limited sunlight.

I think we agree on this in most respects…..

I just don’t like the idea that we tell people it’s all (even if “all” only means a predisposition, a vulnerability, and not the “illness” itself) in their individual biology without acknowledging that there, in fact, is no such thing as a purely individual biology that happens totally independent from the environment, that isn’t in any way a reaction to it.

The stress-vulnerability-model is usually employed to minimize the importance of trauma on people’s psychological well-being, and to tell them it’s all their own (individual and independent from any environmental factors biology’s) fault.

Well, I agree that statements about peoples supposed vulnerability can be misused, and there are a lot of dangerous aspects to this notion. You are correct I think to point out the possibility that “vulnerability” can be used to minimize the hidden trauma a person was exposed to, or to paint a picture of a person as defective. And since we really have no way at this point of being sure that any individual has any particular degree of vulnerability, it’s always just speculation to think that one person is more vulnerable than another, but the mental health system is generally guilty of declaring that it knows people have a vulnerability just because they have the problem, or because someone else in the family has the problem.

On the other hand, I’m not sure it helps to dig in our heels and say that extra degreees on vulnerability definitely don’t exist. It puts us in the role of denying a lot of evidence that suggests (even if it does not totally prove) the opposite, and that makes us look “out of touch with reality” or with what most people would think is probably reality. And if it is true that some people have more vulnerability than others, then it could be unfair to them to not admit that is possible. After all, if one knows one is more vulnerable to sunburn, then one can take precautionary steps, rather than keep on struggling to understand how the sun is somehow secretly beating down more horribly on oneself compared to others. It does at least seem that some people need more sleep, more social support, more of this or that in order to do well. People are different in many ways, and I’m happy to be open to considering the possibility of such differences, as long as they are not assumed or used as blanket cover-ups for the existence of abuse.

I still don’t agree in the increased vulnerability. Even an increased vulnerability to sunburn is a reaction to environmental factors, in the end. There’s a lot of abuse and neglect going on in families, in society, that doesn’t look like abuse or neglect, that looks just perfectly “normal”, so we tend to deny it. Dysfunctional communication patterns, purely emotional abuse and neglect are often easily overlooked. Also, if you presuppose a genuine vulnerability, that isn’t a response to any environmental factors, but simply a genetic predisposition, you still sort of tell people that maybe not their suffering as such, but nevertheless its specific character, intensity, is their own (biology’s) fault. It’s like telling people: “If it wasn’t for your vulnerability, you’d probably only experience a little stress, anxiety, or a mild depression. (And you wouldn’t cause us quite as much trouble as you do.)” In a way that, too, is devaluing people’s experience, and denying the fact that there is a whole lot of abuse and neglect going on, also where we’d never expect it, and thus hardly ever recognize, almost perfectly disguised as “normality”.