The Delusion Illusion

There's a very interesting discussion in the comment thread on this post at Respectful Insolence; it's about something that's definitely been on my mind a lot as a skeptic, which is the problem of Why People Believe Weird Things.

Here's how it starts:

... [T]he people who claim that the vaccine is useless, and that polio eradication is the result of sanitation, must be mentally challenged at some level. There are not many of them I don't think --- their numbers obviously are a lot less than the incidence of schizophrenics, for example, and I have to wonder about the ability of those folks to organize rational thinking.

What this commenter is doing is trying to grapple with how a person could believe something that is obviously false. (In this instance, it's not just obviously false but also dangerous, in that the belief that vaccines don't work leads people to decide not to vaccinate themselves or their children, which undermines herd immunity and puts other people at risk of disease).

The conclusion he comes to --- that it must be mental illness that makes them cling to their counterfactual beliefs, despite any and all contradictory evidence you might throw at them --- is one I've seen a lot of people use to try and explain other people's mind-bogglingly irrational beliefs or bizarre or evil actions. I see it most often in this latter context, where someone commits a horrible crime, like mass murder, and in the news coverage the label "disturbed" or "troubled" or "mentally ill" or "unstable" gets attached to the perpetrator. (Even if he had never been to a psychiatrist in his life.)

It's easy to understand why a non-mentally-ill person would think that --- you see someone do something that you would never do, that you cannot even fathom doing, and you want to know what could possibly drive someone to do it. If imagining yourself in their shoes doesn't give you an answer, you're left with the possibility that this person must differ from you in some fundamental way.

You don't usually have enough information about the person to guess at how they differ from you, why they make a choice that you would not make under the same circumstances. (Just so you know, the choice I'm thinking of is the choice to become an anti-vaccine activist, not the choice to commit mass murder. Insert joke about the indistinguishability of those two things here.)

Anyway, for people with no experience of mental illness themselves, "mental illness" seems to function as a kind of conceptual black box that can be invoked to explain anything anyone does that otherwise defies explanation.

It also works to preclude introspection, to cordon off the person being labeled as mentally ill as not needing any more explanation. If someone is violent, their violence is a symptom of "mental illness," not a universal human tendency aggravated by social conditions. You don't have to ask any questions about, say, which human lives society values over others, or about whether there might not be conflicting cultural messages about violence (i.e., violence is bad but you're not a man unless you are capable of violence), or anything like that. No one need be examined or judged except the person who acted out.

Similarly, if someone is being illogical, or ignoring evidence, or deceiving hirself about something, you need not ask whether you might not be deceiving yourself about something else. The person making the illogical argument is not demonstrating the limitations and biases of human thought, to which all people are susceptible --- no, they're just crazy.

It's an easy explanation, but it's wrong and it makes life a lot harder for people who do have mental illnesses.

Here's another comment that explains how that works:

People who argue against vaccination are dangerous extremists. They are irresponsible and willfully ignorant. Their lies and manipulation are not a political issue for me, they're an intensely personal slight on who I am, and a threat to my very life.

It's clear that you can't grasp why your ableist language is problematic in this context, so I'll break it down for you.

1. Virtually the entire foundation of the anti-vax movement is the lie that vaccination causes autism and other developmental disabilities.

2. These people refer to non-neurotypical and developmentally and physically disabled people as "vaccine damaged", "broken", "stolen", "lost", and "soulless", among others.

3. Their argument is that death by vaccine preventable disease is better than life with a disability.

4. When presented with the fact that many disabled and chronically ill people are at greater risk of dying of VPDs they often claim that it's simply Darwinism in action, that the virus is cleaning up the gene pool.

5. It is not uncommon for these people to abuse, and even kill, their own disabled or non-NT children. When they do so they are often lionised by their peers, told what good parents they are, and let off by the just system because having to live with their (now dead charge) meant they'd "suffered enough."

Ergo, when you breeze in and spew back the same rhetoric as them, equating their deliberate cruelty and ignorance with developmental disability, then you're as bad as they are. You're saying "These people are bad, they're doing the wrong thing, they must be mentally disabled."

I can bring a fairly recent comparison to mind, that of the media reaction to pretty much every instance of an American gunman mowing a group of innocent people down. Do they say "He must be angry" or "He's a truly awful man"? No. They claim he must be autistic, or schizophrenic. Just like you they conflate wrongdoing with disability or mental illness, because Cthulhu knows there isn't already enough stigma around either topic, or enough fear or disgust at those of us on the receiving end.

Clear now? If the anti-vax monkeys shit in their hands and fling it, you're not going to make them stop by curling one out into your own palm, and lobbing it into their cage.

This same commenter also makes another important point, that being delusional is not at all like being a crank with a megaphone (or a seat in the U.S. House of Representatives):

The kind of fixed, delusional beliefs that go along with schizophrenic mental illness are typically just as distressing to the person with the diagnosis, if not more so. Watching someone in the grip of a florid delusion is very different to watching the majority of the anti-vax crowd's stubborn refusal to heed facts. I've seen people with various MIs, eating disorders in particular, who know that all food isn't poison, but can't make that inner dialogue relinquish the claims it makes. With my OCD I am excruciatingly aware that doing Y won't stop Z from happening, but knowing that truth, and feeling that it's safe to act on it feel like they're a million miles apart. 

So obviously, anyone who is genuinely suffering compulsions or delusions requires help and support, and an understanding that it's not deliberate. The anti-vax crowd requires a cluebat to the brain, perhaps in the form of a trip to somewhere that VPDs roam unchecked.

I've never been delusional, exactly, but I have had severe depression, and what this person says about knowing that what you're thinking is wrong but still being powerless to stop the thoughts rings very, very true.

I can't imagine a person stuck in that kind of epistemological nightmare state would be very likely to get up on a soapbox to try and convince other people to adopt the same delusions.

No, that sounds more like the behavior of someone who has never had cause to question their own grip on reality.

Anyway, I'm going to bastardize Occam's Razor and say that you don't need invoke a relatively uncommon phenomenon* to explain something that could just as easily be accounted for by something more commonplace.

Normal, baseline human thought is prone to a whole bunch of biases, errors, shortcuts and unconscious distortions that make each person a sort of Unreliable Narrator** of their own life.

Here are a few that I could see making someone think vaccines cause autism:

1. People prefer stories to lists of things that happened. (Thus, if one thing happens after another thing, you might see a connection between the two, even if there is none. Also, one person telling a very personal, emotional story is going to move you more, and stick in your mind longer, than someone throwing a bunch of statistics at you.)

2. People tend to idealize the past. If you didn't notice that your child was different right away, but only once they started to miss developmental milestones, you might start remembering them as more ideally "normal" than they really were as infants.

3. People like to think they are more or less in control of what happens in their lives. So thinking that their child is autistic because they chose to vaccinate hir might, weirdly, be less scary than thinking their child just is autistic and there was no way they could've prevented it***.

4. People's experiences color their view of the world. Along with #1 and #2, this one could make a person who had seen their "normal" baby suddenly develop autism in toddlerhood blame vaccines, and also greatly overestimate how drastically the prevalence of autism has risen. (At the same time, this explains why so many people feel like they can just opt out of vaccination; unless they're a lot older than most new parents are, they don't know what a lot of the vaccine-preventable diseases were like.)

5. People also tend to believe what the people around them believe. If your friends tend to mistrust doctors and medicine, and prefer "alternative" medicine, you might find it easier to believe that modern medicine's great accomplishments, including mass vaccination, aren't really that great and doctors just took credit for something that was already happening (e.g., the first comment I quoted, where the commenter mentioned having heard people say that improvements in sanitation, not Jonas Salk's vaccine, were responsible for eradicating polio in the U.S.), or even that modern medicine is making us sicker than we were in the idyllic past. (See also #2).

Finally, I don't have data on this (will look for some, but that's another post), but I strongly suspect that believing something made your child autistic correlates with seeing autism as The Worst Thing Ever.

*Mental illness is actually not super-uncommon, but it is still definitely a minority experience

**Everyone else is even less reliable at describing your life, though. So you still win.

***This probably won't matter to people who've managed to accept their child's autism; they tend to care less about why their child is autistic and more about how to help them live a full, independent life.