Scheule: Even if one girl lies about hearing demons, it’s nonsense to believe this explains the entirety of diagnosed schizophrenics.

I can’t vouch for Caplan’s views, but certainly Thomas Szasz has never claimed anything of the sort.

Scheule: Alternatively, Caplan thinks the girl is telling the truth but doesn’t want to call it a disease–but c’mon, she feels non-existent spiders itching around subdermally. If that’s not an illness, please, what is?

Smallpox is a disease. Feeling non-existent spiders itching around under your skin is a hallucination, not a disease.

Depending on the breaks, the hallucination may be a symptom of some identifiable neural disease. Or it may not be. Lots of well-defined neuropathologies can result in hallucinations, such as Parkinson’s disease, or brain tumors, or for that matter the syndromes that result from certain kinds of drug abuse. But lots of unpleasant things can also happen to your body without being to anything that you could call a “disease.” If you intend to bring in the medical model, it’s up to you to explain what the disease actually is and produce some evidence that it’s present in this case.

You might say, “Oh, well, the disease here is schizphrenia.” But just referring back to a term explicitly defined through a grab-bag of loosely-related symptoms, rather than in terms of etiology, doesn’t cut much ice. Since schizophrenia is defined in terms of things like the experience of hallucinations, citing it as the explanation for hallucinations is either tightly circular, or at best an unbacked promissory note for a physiological explanation, rather than the explanation itself. It’s hard for me to see what function, if any, pseudomedical terms like “schizophrenia” serve in helping us to understand what’s going on with someone like Tiffany Sitton.