*A thread*

Imagine if u believed (not as a skeptical hypothesis, but genuinely believed) that all psychiatric medications are ineffective & harmful for vast majority of ppl who take them, imagine the epistemic demands this would place on the rest of ur worldview. /1

You would have to explain how an entire medical & scientific profession (& society in general) has arrived at the opposite conclusion over the last 60-70 years. You would have to discredit the entire body of research as flawed, unreliable, conflicted. /2

You would have to question the intelligence, knowledge, or motives of generations of clinicians & researchers; you would have to see signs of corruption & cover-up at every step of the way; you would have to see psychiatric textbooks & education as instances of propaganda. /3

If u are doing all that epistemic work, it would be a short step for u to question: Does mental illness even exist? Are we just medicating deviance & ordinary distress?! (And vice versa; if u start off with 'mental illness is a myth', it'd be a short step to ques med efficacy) /4

Imagine believing all that... you would be filled with anger, frustration, outrage at the state of affairs. So much corruption, ignorance, harm! Why can't people see? Why won't people open their eyes? /5

As @Huwtube discussed in an Aeon article recently, when individuals hold unusual beliefs, they will also tend to hold other beliefs that are thematically similar. To come to believe something strange, ppl also need to relinquish other beliefs that stand in the way. /6

Now, you can believe all that & there are in fact a lot of ppl who already do believe do all that... my task here is not to *refute* that; I am simply musing over how one belief begins to unfold into something that, at least on appearance, looks a lot like conspiracy thinking. /7

This is complicated by the fact that aspects of this story are true... there *is* exaggeration of efficacy & neglect of harms; there *are* conflicts of interest; there *is* diagnostic imperfection & uncertainty; there is, to some degree, institutional corruption... /8

How does a rational and reasonable critical line of inquiry prevent itself from degenerating into conspiracy thinking? I think one aspect of this, among others, is the existence of rational and reasonable grounding beliefs, which keep the range of possible beliefs in check. /9

For instance, I have grounding beliefs about the self-correcting nature of science; I have grounding beliefs about the intelligence, knowledge & motives of clinicians & researchers... these grounding beliefs keep me in check as I entertain various (skeptical) hypotheses. /10

But someone else may not have these grounding beliefs & they may disagree with me... say because they have witnessed or experienced repeated persecution, or because they have repeated traumatic & negative experiences with the medical community. /11

I'm obviously coming at all this with reference to my own beliefs & my judgements of what appears to be reasonable and what appears to be conspiratorial, & these are merely preliminary thoughts on an otherwise immensely complicated topic. U can disagree. /12

But I think it is worth paying attention to the epistemic demands of various critical beliefs & what grounding beliefs are present to provide checks on what one is willing to entertain. /13