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The Broken Window Fallacy

Any attempt by the mental healthcare establishment at arguing that harsh medicine may effect the best cure, is negated by the “broken window fallacy”.

This fallacy is based on a parable, introduced by French philosopher Frédéric Bastiat in 1850, to illustrate why destruction, and the money spent to recover from destruction, is not actually a net benefit to society. The parable, also known as the broken window fallacy or glazier's fallacy, seeks to show how opportunity costs, as well as the law of unintended consequences, affect economic activity in ways that are unseen or ignored. [NB: This is not to be confused with former New York City Mayor Rudolph W. Giuliani's "broken windows policy", to aggressively police quality-of-life offenses.]

 

The Parable of the Broken Window:

A shopkeeper’s son carelessly broke a pane of glass in the shop window.  The shopkeeper called a glazier to fix it, and paid him for the service.  Spectators offered their condolences to the shopkeeper, saying “Everybody must live, and what would become of the glaziers if panes of glass were never broken?" 

But then suppose it was discovered that the little boy was actually hired by the glazier, and paid a dollar for every window he broke. Suddenly the same act would be regarded as theft: the glazier was breaking windows in order to force people to hire his services.

Bastiat argued that society endorses activities that are morally equivalent to the glazier hiring a boy to break windows for him (e.g., the "Cash for Clunkers" program, planned obsolescence, and superfluous public works projects).  He said "Society loses the value of things which are uselessly destroyed"; to break, to spoil, to waste, is not to encourage national labor; or, more briefly, "destruction is not profit."

In the context of mental healthcare, the fallacy translates to an assumption that “breaking” a patient might have positive value, in the way that the Marine Corps considers it beneficial to break a new recruit in boot camp.  The military uses this process to strengthen nerves, build character, erode individuality, and make warriors out of kids who are just out of high school.  

Compared to boot camp, the history of psychiatry is littered with far more gruesome forms of torture masquerading as “treatments”, such as exorcism, trephination (drilling holes in the head), straitjackets, ice water baths, insulin coma, and lobotomy.  All of these had in common shocking and traumatizing the patient – aimed at “knocking sense into his head”.   Although most of these treatments didn’t work, except to subdue the patient from shock, they provided income for the doctors who performed them.   In the short term, the so-called treatments also made the patient’s family feel like they were making an effort to help. 

In a ghastly way, this is analogous to the economic "benefit" of the broken window creating business for the glazier who replaces it. 

Treatments involving forcible trauma to the patient’s brain - either literal or figurative - still exist today.  Although such procedures might work for some patients, they certainly don’t work for all of them.  Furthermore, unlike a broken window, patients have rights under the law, and responsibilities to other people.  The “breaking” process can create unintended consequences for many other individuals who are connected with the patient, such as family, friends and business associates.  For example, a patient's young children might be adversely affected by the patient's anxiety from bad memories of the treatments.

Furthermore, the efficacy of psychoactive pharmaceuticals has advanced so rapidly in recent years, that they have surpassed nearly all historical remedies for psychiatric patients.  It simply isn’t necessary to literally knock sense into the heads of psych patients anymore... if it ever was.

The window metaphor also extends to transparency versus opacity.  Unfortunately, even in the 21st century, mental healthcare presents a competent, caring façade, but often a cruel, heartless reality lurks behind that mask.  This charade has to end.  We need transparency and accountability in the psychiatric care business.  We need a public awakening to the importance of mental healthcare, and a commitment by society's leaders to bring the industry up to date.