Chapter 3: Pseudo-scientific Misdirection—How Philosophical Trends and Personality Psychology Obstruct Our Understanding of Mental Disorders

Positioning in the Four-Layer Interaction Framework: This chapter is the methodological critique of the entire book—before entering the four-layer framework (genetics → development → metabolism → society), we must first clean up the "pseudo-scientific" traditions that obstruct scientific understanding. Philosophical speculation and personality psychology have long dominated explanations of mental disorders, but they lack a biological foundation, fail to explain the root causes of mental disorders, and cannot provide effective intervention pathways.

3.1 Wittgenstein: The End of Logic, the Struggle of Life

Ludwig Wittgenstein, one of the greatest philosophers of the 20th century, is renowned for his rigorous logic and profound insights into the philosophy of language. However, this giant of thought lived a life filled with suffering and struggle unimaginable to ordinary people.

Wittgenstein was born into one of the wealthiest families in Europe, but this family was also overshadowed by tragedy—of his four older brothers, three chose suicide. This familial mental vulnerability forced Wittgenstein to repeatedly confront death and despair during the critical period of his upbringing.

He himself battled severe depression and intense suicidal thoughts throughout his life. He once confessed to a friend that before meeting Bertrand Russell, he had experienced "nine years of loneliness and misery, during which he constantly thought of suicide." Even after Russell recognized his philosophical genius, he would often visit Russell late at night, pacing and talking, claiming he was going to commit suicide when he left. When Russell asked if he was thinking of logic or his sins, Wittgenstein replied: "Both."

During World War I, he volunteered for the military, partly driven by a desire to "confront death," hoping that this extreme experience would make him a "decent man." It was under the immense mental strain of war that he happened to read Tolstoy's The Gospel in Brief, a book that "virtually kept him alive."

Wittgenstein's life is the most direct rebuttal to the advice to "just cheer up." He possessed the clearest logical mind and the most profound capacity for speculation, yet he could not free himself from inner turmoil through "thinking things through." His suffering was the product of intertwined biological, psychological, and environmental factors, far from being a simple matter of thoughts.

3.2 Nietzsche: The Elegy of the Will to Power, the Fall of the Mind

Friedrich Nietzsche, the philosopher who shocked the Western world with his declaration that "God is dead," became a pioneer of modern thought through his fierce critique of traditional morality, religion, and culture, and his call for the will to life and the Übermensch. Paradoxically, however, this philosopher who championed the "will to power" ended his life in a tragic mental breakdown.

Nietzsche's health had always been poor, plagued by migraines, failing eyesight, and digestive ailments. But what truly brought about his fall was the mental breakdown on the streets of Turin on January 3, 1889—he embraced a horse being whipped by a cabman and then sank into complete madness. For the next decade or so, until his death in 1900, he spent his days in an asylum or under the care of his family, never regaining his sanity.

Whatever the specific cause of Nietzsche's mental breakdown (syphilis, a brain tumor, and hereditary psychiatric illness are all debated), his example clearly demonstrates that even the philosopher with the strongest mental will cannot resist the erosion of the brain by physical illness. His "will to power" ultimately failed to conquer biological pathology, proving once again that mental health issues are not merely problems of thought, but have deep biological foundations.

3.3 Camus: The Limitations of the Philosophy of the Absurd in the Face of Science

Albert Camus, the French writer and philosopher renowned for his philosophy of the "absurd," once proposed that "there is but one truly serious philosophical problem, and that is suicide." His The Myth of Sisyphus explores the meaning of revolt within the absurd through the story of Sisyphus endlessly pushing a boulder up a hill.

However, Camus's philosophical discourse on suicide suffers from two fundamental problems:

First, the belief that suicide has "little to do" with society. Camus wrote in The Myth of Sisyphus: "Society has little to do with such beginnings. The worm is in the heart. We must look for it there." This view reduces suicide entirely to an individual's inner problem, decoupling it from the social environment. This contradicts his own assertion that the absurd is born of the confrontation between human needs and the silence of the world—if human beings are social entities, and if the absurd is the result of the interaction between humans and the world, how can an extreme act like suicide have "little to do" with society? Such rhetoric ignores the immense impact of external factors, such as social pressure, family environment, and cultural background, on an individual's mental state.

Second, the lack of a scientific basis in understanding the causes of suicide. Camus attributed suicide to a "loss of life's meaning"—"those who commit suicide are often, on the contrary, assured of the meaning of life"—a judgment that is purely a product of philosophical speculation rather than empirical research on those who commit suicide. In fact, the causes of suicide are far more complex than a "loss of meaning": suicide in patients with major depressive disorder is often driven by emotional collapse and anhedonia caused by neurotransmitter metabolism; suicide in patients with bipolar disorder is frequently associated with the dangerous combination of impulsivity and despair during mixed episodes; suicide in patients with substance use disorders is closely linked to impaired judgment and failures in impulse control. These mechanisms, which neuroscience had not yet revealed in Camus's era, were beyond his understanding and prediction.

More fundamentally, Camus's dismissive attitude toward the natural sciences exposed the limitations of his worldview. In The Myth of Sisyphus, he complained about physicists explaining the universe with "atoms and electrons," declaring, "The soft lines of these hills and the hand of evening on this troubled heart teach me much more." This rejection of scientific explanation is consistent with his earlier claim that individual suicide has "little to do" with society—both prioritize subjective experience over objective knowledge.

This is not to say that Camus's philosophy is worthless—his insights into the "absurd" and his call for "revolt" remain profound literary and philosophical contributions. But when we discuss the specific question of "how to understand and prevent suicide," what we need is verifiable scientific knowledge, not philosophical speculation. As Albert Einstein commented on Friedrich Engels's Dialectics of Nature: if the manuscript had come from an author who was not otherwise interesting as a historical figure, then from the standpoint of contemporary physics, there would be no special interest in publishing it.

3.4 Freud and Psychoanalysis: An Unverifiable "Science"

Sigmund Freud's psychoanalytic theory, including core concepts such as the subconscious, pansexualism, and the Oedipus complex, attempted to establish psychology as a "science." However, these concepts face a fundamental problem: unfalsifiability. According to Karl Popper's criterion of demarcation, if a theory cannot be empirically tested and falsified, it cannot be called a scientific theory.

Freud himself hoped that the development of neuroscience would validate his theories. However, modern neuroscience has not confirmed concepts like the "Oedipus complex" or "penis envy," but has instead established an entirely different explanatory framework—models based on neurotransmitters, neural networks, genetic variations, and developmental abnormalities.

3.5 Personality Psychology: How "Character" Obscures the Biological Foundation

"Character is destiny"—this widely circulated maxim implies that mental disorders are problems of personality, problems of "who you are." Personality psychology is built precisely on this assumption, attempting to explain human behavior and emotions using "personality traits."

However, from the perspective of the four-layer interaction framework, so-called "personality" is merely the result of the interaction among four levels of factors: genetics, development, metabolism, and the social environment. The "extroversion" exhibited by bipolar disorder patients during manic episodes and their "withdrawal" during depressive phases are not "shifts" in personality, but direct consequences of the disease process on brain function. Repeated mood episodes may also produce a "scar effect" (Scar Effect), leading to lasting changes in certain personality traits—high neuroticism and low agreeableness can persist even during periods of remission (Quilty et al., 2009).

The problem with personality psychology is that it mistakes the "effect" for the "cause." When a person remains in a depressive state for a long time, personality scales will indicate "high neuroticism" and "low extraversion"—but these "traits" are results of the disease, not its causes. When scientifically explaining mental disorders, what we need is not "character descriptions," but causal chains that can be traced down to the neurobiological level.

3.6 The Scientific Controversy of Psychotherapy

3.6.1 The Scientific Crisis of Mindfulness-Based Interventions

Mindfulness-Based Interventions have been highly acclaimed in recent years; however, their scientific foundation is far less solid than advertised. Jon Kabat-Zinn, the founder of Mindfulness-Based Stress Reduction (MBSR), once admitted himself: "90% of the research [on positive impacts] is sub-standard."

Mindfulness intervention research suffers from the following methodological flaws:

1. Lack of active control groups: Many studies compare mindfulness to a "waitlist" (i.e., doing nothing) rather than to a true placebo (such as relaxation training)—making it impossible to distinguish whether the efficacy stems from "mindfulness" itself or from the expectancy effect of "doing something."
2. Inadequate sample sizes: A vast number of studies have sample sizes that are too small, resulting in insufficient statistical power and susceptibility to false-positive results.
3. Short-term follow-ups: Most studies only evaluate short-term outcomes, lacking long-term follow-up data.
4. Publication bias: An analysis by Coronado-Montoya et al. (2016, PLOS ONE) found an unusually high proportion of positive results in mindfulness studies, strongly hinting at the existence of publication bias.

Philosophers make a living of speculation, yet they cannot save themselves through it—the mental predicaments of Wittgenstein, Nietzsche, and others have already proven this. Why, then, should we believe that "mindfulness," once secularized from Buddhist meditation, can alter neurotransmitter metabolism in the brain?

3.6.2 The Chaos of the Psychological Counseling Industry

Currently, the psychological counseling industry suffers from a severe imbalance between commercialization and professionalization. Many training institutions adopt a "double-harvesting" model: on one end, they charge learners exorbitant training fees, claiming they can secure internships upon completion; on the other end, they charge clients counseling fees. However, the vast majority of learners barely secure any counseling cases after completing their studies, turning instead to "emotional companionship" services—which has seriously drifted away from psychological counseling and entered a gray area.

The most scientific branch within psychology is, to this day, probably only neuropsychology—the branch that integrates with neuroscience. As for schools like psychoanalysis and humanistic psychology, their concepts lack scientific foundations, their theoretical self-consistency is insufficient, and their evaluation of efficacy relies far too much on subjective reports.

Basic principles for choosing psychological counseling:

1. Prioritize the psychiatry department of a regular hospital—although hospital psychiatry departments also vary in quality, there is at least basic medical oversight.
2. Do not easily trust psychology certificates from any institution—their professional value is highly questionable.
3. Self-rescue is paramount—in the treatment of mental disorders, medication is the cornerstone, and psychotherapy is secondary.
4. Beware of advertisements claiming "learn this and cure yourself"—this is commercial marketing, not scientific fact.

3.6.3 The Proper Positioning of Psychotherapy

Critiquing the lack of scientific rigor in psychotherapy does not mean completely dismissing its value. Psychotherapy does indeed play a supporting role in the following scenarios:

• Cognitive Behavioral Therapy (CBT): In conditions such as depression, anxiety, and obsessive-compulsive disorder, CBT, as an adjunct to pharmacotherapy, helps patients identify and modify unhealthy thought patterns. Its evidence-based support is the most robust among all psychotherapies.
• Dialectical Behavior Therapy (DBT): For patients with severe emotional dysregulation and impulsive behavior (such as borderline personality disorder), DBT teaches emotional regulation and distress tolerance skills, backed by solid evidence-based support.
• Interpersonal and Social Rhythm Therapy (IPSRT): For patients with bipolar disorder, IPSRT emphasizes maintaining regular social rhythms and sleep-wake cycles, which helps stabilize mood.

But it must be made clear: for illnesses that meet the diagnostic criteria for a "mental disorder," psychotherapy cannot replace pharmacotherapy; for emotional fluctuations that do not meet diagnostic criteria, talking with others may help, but it should not be equated with "treatment." In short—"if you are sick, take medicine." This is not a rejection of psychotherapy, but a respect for the biological nature of mental disorders.

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The core argument of this chapter: Philosophical speculation and personality psychology have long dominated our understanding of mental disorders, but they lack a biological foundation and belong to a "pseudo-scientific" explanatory paradigm. To truly understand mental disorders, we must step outside these traditional frameworks and enter the realm of natural science—genetics, neurodevelopmental biology, neurochemistry, and connectomics. The following chapters will unfold from these four levels in turn.

References:

• Quilty, L.C., et al. (2009). Personality traits and course of bipolar disorder. Journal of Affective Disorders, 129(1-3), 1-13.
• Coronado-Montoya, S., et al. (2016). Reporting of nonrandomized evaluations of clinical and psychosocial interventions. PLOS ONE, 11(4), e0153368.
• Cuijpers, P., et al. (2019). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. World Psychiatry, 18(3), 363-364.