perm filename CHAP7[4,KMC]18 blob
sn#079838 filedate 1974-01-02 generic text, type T, neo UTF8
00100 EVALUATION
00200
00300 The primary aim in constructing this model was to explore,
00400 clarify, develop, test and improve -all with a model- a theory having
00500 explanatory value. To satisfy this aim, the model must meet norms of
00600 internal consistency (systemicity) and norms of external
00700 correspondence with observation (testability). A secondary aim would
00800 involve pragmatic norms of application. These aims are not unrelated
00900 but the primary one is more fundamental since useful applications
01000 require some degree of consistency and correspondence to observation.
01100 As emphasized in Chapter 2, a model in the form of an
01200 algorithm consists of a structure of functions or procedures whose
01300 inner workings are sufficient to reproduce the outward symbolic
01400 behavior under consideration. The theory embodied in the model is
01500 revealed in the set of statements which illuminate the connections
01600 betweeen input and output, i.e. which describe how the structure
01700 reacts under various circumstances.
01800 What constitutes a satisfactory explanation has been treated
01900 in 2.1. The "fit" or correspondence with facts of observation as
02000 indicated by measurements and empirical tests indicating the degree
02100 of faithfulness of the reproduction were described in Chapter 6.
02200 Given that the model has met the above criteria, what does it as an
02300 artifact tell us about naturally-occurring paranoid processes?
02400 First, the model attempts to revisualize or reconceptualize
02500 the phenomena of paranoid disorders. It draws attention to factors
02600 (such as the scan for malevolence and humiliation) which might not
02700 otherwise be attended to. Paranoid disorders are not viewed as
02800 first-order "diseases" but as a mode of processing symbols secondary
02900 to a primary disturbance. The patterns of linguistic paranoid
03000 behavior observed in an interview are produced by an underlying
03100 organized structure of rules and not by a variety of random and
03200 unconnected mechanical failures. Second, the underlying structure
03300 consists of an algorithm, an organization of symbol-processing
03400 strategies or procedures. Third, the model as an analogy indicates
03500 that to change this structure, its procedures must be accessible to
03600 reprogramming in the higher-level language of the algorithm. Finally,
03700 as a conceptual reform, the model suggests that other types of
03800 psychopathologies might be viewed from a symbol-processing
03900 standpoint.
04000 Decision procedures for consensus acceptability of a model
04100 sometimes depend not so much on truth, an elusive state, as on
04200 whether a majority of the relevant expert community believes the
04300 theory or model to approximate truth to some unknown and unknowable
04400 degree and to be better than promising available alternatives, that
04500 is, to be the best we can do for the time being. A model is tenable
04600 as long as it is worth working with by improving it, extending it,
04700 devising experiments and tests to probe it, and applying it in
04800 contexts of practical action. Validation is ultimately a private
04900 experience of the individual. Empirical truth or falsity cannot be
05000 proven with certainty, but their presence can be assayed by some sort
05100 of critical assessment and deliberation. We can forgive models for
05200 being only nearly true. A theory or model may bring cognitive or
05300 pragmatic comfort, not because it is TRUE but because it represents a
05400 workable possibility which is an improvement over its contending
05500 rivals.
05600 Cognitive comfort is a type of intellectual satisfaction.
05700 Pragmatic comfort accrues from applications to problems in order to
05800 make things work the way humans want them to work efficiently in
05900 practical contexts of technological action. For the pragmatist, a
06000 model is a means to an end; for the theoretician, an explanatory
06100 model is an end in itself. It is hoped that this paranoid model can
06200 contribute to understanding one of the mysteries of human conduct,
06300 the paranoid mode. There remains the enigma of the paranoid "streak"
06400 which renders whole nations susceptible to ideological convictions
06500 in which Elsewhereans are believed to be malevolent oppressors.
06600 It is a truism of methodology textbooks that an infinite
06700 number of theories or models can account for the same data of
06800 observation. Without questioning whether "infinite" means
06900 indefinitely large or just more than one, we must allow for rival
07000 explanations. For a rival to be a live and tenable option, it should
07100 be truly alternative (i.e., not just a family version saying the same
07200 thing in a different way), and be confirmable or disconfirmable by
07300 tests.
07400 Although I hold that faithful reproduction, fidelity as
07500 measured by indistinguishability along specific dimensions, is a
07600 proper and major test for the adequacy of simulation models, it would
07700 be a bonus if our model could satisfy the function of making possible
07800 new knowledge through prediction. The term "prediction" has a
07900 spectrum of meanings ranging from forecasts to prognoses to
08000 prophecies to precise point-predictions in time. To predict (and to
08100 postdict) from a theory or model is to derive and announce a fact
08200 prior to knowledge of its actual occurrence. However one needs
08300 knowledge of the kind of fact expected, the conditions which produce
08400 it and the circumstances under which it will occur. The interest in
08500 prediction may stem from a desire (1) to confirm or disconfirm a
08600 theory or model or (2) to obtain useful information about the future,
08700 as in weather forecasting. Celestial mechanics provides the ideal of
08800 accurate long-range predictions. But even astronomers, with the
08900 advantage of studying isolated and repetitive systems, have their
09000 troubles. In 1759 Halley's comet arrived four days later than
09100 predicted. In spite of our advanced 20th century knowledge, a
09200 prediction made in 1962 was off by eight days, that is, twice as bad.
09300 (In fairness we must make allowances for the fact that great masses,
09400 distances and velocities are involved).
09500 Predictions of individual human behavior are severely limited
09600 by our restrictions of knowledge. For example, (1) sufficient
09700 knowledge of initial conditions may require that we know the whole
09800 past history of an individual (something not yet achieved for even a
09900 single person), (2) individuals do not remain isolated over the time
10000 stretch of the prediction; they interact with other individuals of an
10100 unknown nature, (3) since life is a fortuitous flux of chance
10200 intersections of independent causal chains, one would also have to be
10300 able to foresee events of the physical environment and its changes,
10400 (4) the process of observation needed to obtain information for
10500 predictions may have non-negligible and unforeseeable effects on the
10600 observed.
10700 In one sense our paranoid model makes moment-to-moment
10800 predictions and asserts new counterfactuals about behavior in a
10900 psychiatric interview. That is, if an interviewer says X under
11000 conditions Y, then the model's response will be characterized by
11100 z1...zn, and the same holds true for paranoid patients.
11200 Counterfactual prediction means that on the basis of observed
11300 behavior we are willing, with an inductive risk, to assume the
11400 presence of unobserved behavior potentials in a model's or patient's
11500 repertoire of capabilities.
11600 Predicting new kinds of events or properties, instead of
11700 kinds we are already familiar with, would represent a genuine bonus,
11800 indicating the model is more than ad hoc and has excess content. It
11900 would give both clinicians and investigators something to look for.
12000 This novelty could arise in two ways. First, the model might
12100 demonstrate a property of the paranoid mode hitherto unobserved
12200 clinically. In principle this could come about because the I-O
12300 behavior of the model is a consequence of a large number of
12400 interacting hypotheses and assumptions chosen initially to explain
12500 frequently observed phenomena. When the elements of such a complex
12600 conjunction interact with highly variable inputs they generate
12700 consequences in addition to those they were designed to explain.
12800 Whether any of these consequences are significant or characteristic
12900 of the paranoid mode remains a subject for future study.
13000 It is also possible that a new property of paranoia may be
13100 discovered in the clinical interview, although perhaps everything
13200 that can be said about paranoid dialogues has been said. If a new
13300 property were found, a search for it might be conducted in the
13400 model's behavior. If successful, this again would add to the model's
13500 acceptability.
13600 A second novelty might arise in the behavior of the model in
13700 some new situation. Since it is designed to simulate communicative
13800 behavior in an interview situation, the "new" circumstance would have
13900 to involve some new type of linguistic interaction to which the model
14000 is capable of responding. From its behavior one might then predict
14100 how paranoid patients would behave under similar circumstances. The
14200 requisite empirical tests and measures would show the degree of
14300 correspondence between patient and model behaviors.
14400 This possibility is of importance in considering emancipatory
14500 therapies for patients entangled in the quandaries of the paranoid
14600 mode. Since the model operates at a symbol processing level using
14700 natural language, it is this level at which linguistic and
14800 conceptual skills of clinicians can be applied. Language-based or
14900 semantic techniques do not seem very effective in the psychoses but
15000 they are useful in states of lesser severity. A wide range of new
15100 semantic techniques, including extremes, could be tried first on the
15200 model without subjecting patients to blind experimentation.
15300 While we have used the model principally to explore a theory
15400 and to study psychiatric judgements, its potential use as a training
15500 device has not escaped our reflections. Medical students and
15600 psychiatric residents need "disposable patients" to practice on
15700 without jeopardy (to either). A version of the paranoid model can
15800 display the changes in its inner states during an interview.
15900 Whether the optimal goal of interviewing (gathering relevant
16000 information without upsetting the patient) has been achieved, can
16100 thus be estimated. A beginning interviewer could practice in
16200 private or with a supervisor present. Many interviewers have reported
16300 that the model has a definite effect on them. The student can get
16400 the feel of the paranoid mode long before he interviews an actual
16500 patient. The effect of various interviewing styles might be
16600 studied and compared.
16700
16800 Although this simulation of paranoia covers a variety of
16900 facts, it is circumscribed in what it attempts to explain. The
17000 proffered explanation is local and restricted in that it accounts for
17100 only one type of symbol-processing mode. Past attempts at grand-
17200 scale explanations of all mental processes in all contexts have
17300 failed. A preferable strategy, successful in other sciences, is to
17400 build one circumscribed and tested theory or model at a time so that
17500 the field can gradually move forward a step at a time, each step
17600 gaining consensus before attempting the next.