Nature vs Nurture Debate in Extreme Cases of Isolation

Short Answer Q’s

When Rosenhan states that one cannot understand mental illness without understanding the environmental context in which a person with a diagnosis lives, he is explaining why diagnoses alter the way the environment of the patient is perceived. For instance, he describes how a pseudopatient participant in his study was diagnosed with schizophrenia and therefore all his relationships were viewed as having a degree of ambivalence—but none of it was true: the diagnosis was framing the perception, but the diagnosis of course was false. Rosenhan argues that it should be the other way around, but it is not: the “perception of his circumstances was shaped entirely by the diagnosis.” In another case, pseudopatients took extensive notes during their stay in the psychiatric ward, a behavior that should have produced more remark by nurses, but it did not: all of these behaviors were viewed as an extension of their “pathology” and not as the actions of a sane person.

Thus, what Rosenhan means is that individuals should be understood first and foremost within the context of their environment. Only then should one set about embarking on a diagnosis of a person. By incorrectly assuming that one is insane without understanding the person’s environment, one makes the mistake of engaging in confirmation bias. The doctor or nurse assumes that the person has a mental disorder and everything the person does is then interpreted from the standpoint of that perception, which is informed by bias. Bias should not be part of any perception or diagnosis, and to correct for that, one should look first at the environmental context of the person and how the behavior fits with the context. If the behavior is inappropriate to the context, it is likely that one needs to investigate and ascertain why.

The sociological and historical reasons women tend to internalize problems and develop mental disorders such as depression, anxiety, and eating disorders as related in the Rosenfeld and Smith article have to do with gender conceptions and with biological and racial differences. Different role positions play a part in that women tend to have less autonomy and are often putting others first, whereas men are more independent and self-serving (Rosenfeld & Smith, 2010). It is also explained that women tend to have stronger social ties, and so for them externalization of the problem is not an issue the way it is for men, who tend to be more anti-social. Women are more likely to feel overwhelmed by the demands the family ties place upon them and they are more likely to have personal characteristics of low self-esteem and a low sense of mastery. They tend to have more of an emotional reliance than do men. However, the main reason that they internalize problems is that unlike men they put the needs of others first more often than their male counterparts do.

All of this is viewed from the standpoint of a white, patriarchal society. When the researchers examine African-American culture, they find that African-Americans show that “socializing practices encouraging high self-regard along with high regard for others benefit mental health” (Rosenfeld & Smith, 2010, p. 256). The researchers thus suggest that white women should follow the example set by black women and participate in social outings, practices and customs that create stronger senses of self-worth and self-appreciation.

The singular piece of evidence from the article “Extreme Isolation” that shows that human development must be environmental, not biological, is that Ana and Isabelle had in common being isolated from all society at a young age, yet both showed marked improvements in their cognitive development once they began to be socialized and cared for in a more humane way. Ana was able to show development in terms of interacting with others and engaging in imaginative play, even though she only reached the stage of a 2.5 year old’s mentality by the time she died. Isabelle developed more extensively and could not really be differentiated from a normal child once she was fully socialized—so there were some differences, but these were probably a result of the fact that Ana had a disease and Isabelle did not.

Based on their own experiences, it could be concluded that nurture plays a significant role in the development of the child through the various stages of cognitive and physical growth. For example, Isabelle was deathly afraid of males when she was discovered. Ana could not walk or talk. Yet both girls began to overcome these challenges after being introduced into society and receiving a proper nourishment that is critical for each stage of healthy growth.

The girls did not proceed in growth at the same rates or to the same extent, but they did both make progress, indicating that all they were lacking was the right care. It was speculated that Ana likely would have developed fully well had she been cared for appropriately from the beginning, but she had become mentally retarded. This suggests that the girls were not biologically damaged from birth, but that Ana’s biology became retarded after years of neglect. But in spite of that retardation, she was still able to overcome initial handicaps that seemed to prevent her from having a normal cognitive or physical growth.

One of the reasons health care has become a business rather than a healing profession is that doctors are trained primarily to have technical skills rather than bedside manner skills. Lown (2007) rejects the idea that health is a technical field and he argues that people are human beings who have social and psychological needs that are not met by today’s practicing physicians. Everything has become far too technical. One other reason for this is that the health insurance business has taken over the health care industry and turned every person and every procedure into something that can be easily placed into a business model. It dehumanizes patients and orients the entire health care field towards profits rather than toward seeing individuals as people.

The biomedical model that has been adopted in the field desensitizes health care practitioners to the complexity of the whole person and to the need to provide care for the whole person. Instead, focus is on treating individual or isolated problems and symptoms. Treatment is seen as a source of revenue, which has nothing really to do with the health of the person. The person is not really seen at all as a person but as a source of profit. Instead of teaching things like preventive health and helping people to learn how to lead healthy lives, health care providers focus only on the technical aspects of treatment because this keeps the focus on profits and that is how the commodification of health care came about. It is kept in that state because of financialization and the need for the health insurance industry, which invests large sums in the equities market, to do its part in maintaining the entire economic system, which the world has come to rely more and more upon.