April 17, 2009David Healy Slaughters The Biomythology Of Bipolar DisorderChristopher Lane has an excellent interview on his Psychology Today blog with British psychiatrist David Healy, known to many of you as the author of Let Them Eat Prozac and oddles of journal articles and as one of the brave psychiatrists who stood up to Big Pharma and the SSRI machine. I'll not attempt to recap Healy's interview except to note a few things. He had this to say about "mania" in 2009: "How does our understanding of 'mania' differ today from earlier conceptions of the phenomenon? I point this out because when Lane interviewed me last week, I was roundly criticized by some for stating: "BP2 isn't bipolar disorder, properly understood. There's no mania, there's no hospitalization for mania, and there's no one running naked down the street. The most prominent features of BP2 are depression (and that covers the vast majority of a person's time who is diagnosed with BP2) and bursts of energy, broadly understood. To me, that sounds a whole lot more like depression and agitation than it does manic-depression." Sounds like I am in good company. Healy also makes reference to and uses the Donna document from the Zyprexa documents collection on this site. Healy has plenty more to add, including the classic observation: "Well, I think what Donna's story above illustrates is that pharmaceutical marketing departments are actually the postmodernists par excellence. They treat the human body (including its disorders and complaints) as texts to be interpreted one way this year and in just the opposite way a year or two later. There's much more in the interview and I encourage you all to go read it and go comment over at the PT today website, so the editors there know people are interested in this kind of deep skepticism. Posted by Philip Dawdy at April 17, 2009 12:05 AM
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Many thanks to Dr. Healy. Posted by: Lilly NC at April 17, 2009 12:52 AMFinally! It's really heartening to see this in Psychology Today. Still people will cling to these bogus labels as excuses for restriction of liberty and entitlements for special privileges, but at least change is happening. Posted by: Sally at April 17, 2009 05:45 AMFunny, I was always taught that reporters make some effort to establish accuracy and objectivity - though I guess, in the blogosphere, we can just make stuff up. I wonder if you, or Healy, have actually read Kraepelin or his students at all.
There is a detailed critique of Healy's book Mania by Nassir Ghaemi about Healy's postmodern interpretation of psychiatry and how he get his history wrong, especially the work by Kraepelin which, well before Pharma, characterized the extended view of bipolar disorder. http://metapsychology.mentalhelp.net/poc/view_doc.php?type=book&id=4504 Posted by: Tony at April 17, 2009 08:49 AM"They treat the human body (including its disorders and complaints) as texts to be interpreted one way this year and in just the opposite way a year or two later." Does it matter whether you call it "BP2," "depression with anxiety," or the "Graknar's" disease? As long as the people suffering are getting help from the medicine and/or therapy, who cares what they call it? Posted by: Laura at April 17, 2009 01:03 PMWhat's most fascinating about this to me is that Ghaemi doesn't address the "biomythology of bipolar" in his response. He doesn't argue in any way with the fact that "In the case of bipolar disorder the biomyths center on ideas of mood stabilization. But there is no evidence that the drugs stabilize moods. In fact, it is not even clear that it makes sense to talk about a mood center in the brain. A further piece of mythology aimed at keeping people on the drugs is that these are supposedly neuroprotective—but there's no evidence that this is the case and in fact these drugs can lead to brain damage." I'm not sure I see where the argument about what Kraepelin meant by MDI and Healy's interpretation of it is relevant or significant outside of the historical perspective of biomythology. Ghaemi doesn't dispute the idea the biologically based mental illness is a myth, like say Kraepelin would have. In fact biopsych was the basis for all of Kraepelin's hypothesis which Ghaemi is no longer defending. Amazing stuff. Posted by: Sally at April 17, 2009 02:27 PMActually, Dr. Ghaemi does argue that bipolar disorder is a fundamentally biological illness -- not in his response to Dr. Healthy, though -- but mainly in the context that ALL our mental states are ultimately neurobiological. That does not mean that one's past experiences or current stressors are irrelevant, because our past forms our brains and stressors can overwhelm our brain's coping mechanisms, for example. None of this is particularly controversial, but becomes so when some people want ONLY to treat the brain directly and ignore the wider life circumstances that indirectly affect the brain's generation of our mental status. It is the former approach that is grossly inappropriate and deservedly comes under withering criticism, but the latter is not non-biological in the least. Posted by: dguller at April 17, 2009 02:52 PMLaura said, "Does it matter whether you call it "BP2," "depression with anxiety," or the "Graknar's" disease? As long as the people suffering are getting help from the medicine and/or therapy, who cares what they call it?" I think it does matter to some people. If I had a Bipolar 2 diagnosis I would have a difficult time ever being licensed as a physician or nurse in the state I live in & other occupations as well. Major depression and anxiety are not treated in the same manner. Yes, labels do matter. Posted by: Lisa at April 17, 2009 04:53 PM"They treat the human body (including its disorders and complaints) as texts to be interpreted one way this year and in just the opposite way a year or two later." I really like this analogy of comparing psychiatric interpretation of the human condition as similar to post-modernist theory.. Everyone in Academia knows that post modernism is mostly made up... I suspect it's the same in the psychiatric field...
Among the things I respect about Ghaemi is his laudable tactic of arguing for the biopsych model instead of falsely stating it as a proven fact. I've also been impressed with his critique of adhd. Lisa, you are right that labels matter not only in terms of employability but in terms of insurability and liberty, etc. Posted by: Sally at April 17, 2009 06:51 PMWilhelm Weygandt wrote: Ooh, is that an ad hom, or an ad personam? I'm never quite sure what the difference is. Anyway, why do we need to read the piece you cite, when we have you to hand, to shine a light upon our ignorance with your Great Wisdom? The experts, my friend, are not the eejits with letters, sitting on the sidelines speculating. They are the people who have experienced the group of behaviours that have been dubbed "bipolar disorder". Incidentally, if you wish to talk about insanity, I'll give you a game of invalidation, any day. In fact, I'll give you a head start. I can't say fairer than that, can I? I know you're a bright guy - and if I told you how I know that, you wouldn't believe me - but you do yourself no favours by adopting this dismissive attitude, because you'll learn nothing like that. Unless, of course, you think we have nothing to teach you? Matt Posted by: Matthew Holford at April 17, 2009 08:35 PMDon't forget to leave positive comments at Dawdy's interview on Psych Today also. It's amazing how many people defend drugging children! Posted by: anonymous at April 17, 2009 10:53 PMIt's interesting to note that Healy himself believes that mental illness is real but this doesn't stop him from accurately presenting the science around the issue. Every time some one tells me they are taking psych drugs to correct chemical imbalances, I cringe and it's a really big trend these days as we all know. Posted by: Sally at April 18, 2009 05:21 AMSally wrote: I think mental illness is real, too. Mental illness, I think, is the act (and therefore the mechanical thought process behind the act), associated with trying to fit into a world for which one has had inadequate preparation, and where nobody will take the time to give guidance, such that one may flourish, or even survive, in some cases. Hmmm. That looks like a thoroughly abstract concept - however, it's already been recognized that the behavioural "tools" that people acquire to deal with extreme situations (abuse, for example), are often carried into non-extreme situations, later in life, when they are no longer effective methodologies. One may see this in the aggressive "negotiating" tactics that some use. Anyway, just my tuppence 'orth. Matt Posted by: Matthew Holford at April 18, 2009 11:37 AMMatt, I don't think Philip needs to read history to report what is happening in the present. He can make an epistemological cut. Philip, Okay! I'm leaving... Sorry, but will Esquirol be at he list? Thinking on this: The Irony of all this is, it is the life event or life truam that always triggers the "mental" or "emotional" disorder. Even if there are slight chemical changes , as in a reduction in serotoin or dopamine production, these are simply the effect induced from the "feeling". So therefore, by treating the symptom of the feeling , psychiatry is stabbing in the dark... The emotion of anger is a reaction, and the body produces adrenalin and cortisol to coincide with this. These are age old bosy chemistry reactions and they are there for a reason. But until people deal with what is making them angry it is no use trying to reduce the adrenalin or cortisol with drugs.... It is the same with depression.. The original feeling is produced by thoughts and emotions , usually around the individuals perceptions of events or situations that happen to them... Emotions like depression will never be cured by psychiatric drugs because psychiatric drugs do not and can not address the cause ... Psychiatry aims to dis-empower the individual , first by blaming them for their own suffering... Matt writes: "I think mental illness is real, too. Mental illness, I think, is the act (and therefore the mechanical thought process behind the act), associated with trying to fit into a world for which one has had inadequate preparation, and where nobody will take the time to give guidance, such that one may flourish, or even survive, in some cases." To me the worst thing about the biopsych model is that it separates one's body from one's feelings by saying, "what you're feeling is sick. It's not a valid reaction to some stimulus recent or past, obvious or hidden but instead a chemical response that you can never control. Thus we "sane people must be protected from you." Yuck! Ana wrote: A lack of information? That'd be right! I can't face reading another "factual" book, though - I don't follow most people's train of logic at the best of times. Worse still if they're not there for me to ask clarifying questions of them. Anyway, I'm reasonably satisfied that the "experts" are barking up completely the wrong tree. I don't think I really want to become versed in yet another misguided opinion, even if it's a well-respected one - I've come to the conclusions that I have through assessing the evidence that I've seen with my own eyes, and not in trawling the published works of eminent physicians, not least because, as we know, their opinions are slanted in favour of certain interests. Nope, on the whole, I've come to the conclusion, first, that *all* behaviour is learnt (including behaviour that is dubbed "mental illness"). Second, all behaviour has a positive intent underpinning it. And, third, if one wishes to change that behaviour, one has to uncover the objective of said behaviour, and offer an alternative (ie, either an alternative means of achieving that objective, or an alternative to the objective itself). Unfortunately, people have become so used to employing coercive methodologies (taught them from the cradle, it should be said), that the very idea that an alternative even exists quite escapes them. Like I wrote, before: it's no skin off my nose. Just as long as that type of control freak stays the fuck away from me, that is! Matt Posted by: Matthew Holford at April 18, 2009 07:17 PMThese blog notes illustrate that, despite biological psychiatry's best (or worst) efforts, the mind-body dualism problem is still at the core of our understanding (or misunderstanding) of mental illness (and health). Posted by: Tom at April 18, 2009 07:17 PMMatt: I really like your approach to mental illness. It shares certain insights from certain psychodynamic theories, attachment theory, and schema therapy in which maladaptive schemas are understood to have once been adaptive within the context of a difficult earlier environment. However, they are no longer helpful, because they became rigid and fixed, and applied to all contexts, including the current one in which the schema is unhelpful and problematic. You are absolutely correct that many people struggle with letting go of behaviours that once were helpful, but no longer are. Matt: Oh, and one more thing. Not all behaviour is learnt. Infants have primitive reflexes and behaviours that are innate, and much of our emotional behaviour is equally innate and universal to all human societies. Your theory just needs some minor tweaking. :) Posted by: dguller at April 18, 2009 08:26 PM"I've seen with my own eyes, and not in trawling the published works of eminent physicians, not least because, as we know, their opinions are slanted in favour of certain interests." Matthew, I share the same ideas. Certain interests... Wow!
Matt.. It is interesting that you compare psychiatrists with control freaks.. ;)
I posted a link to this article too...and I won't deny it has great value and that much of David's work has great value... BUT! do y'all know he's a big proponent of electroshock??? how that can be boggles my mind. Posted by: Gianna at April 19, 2009 09:32 AMJust in general, I get a certain queasiness reading posts from people with a clear axe to grind against psychiatry, for both the physicians practicing it and the industry which provides the tools that help so many. The medical ignorance displayed is jaw dropping at times. Does it never occur to some here that treatment can actually be beneficial, even successful, for some, if not many? Posted by: David B. at April 19, 2009 11:01 AMdguller wrote: Well, I'm not sure that a discussion on this level contributes a great deal, but here goes, anyway... Reflexes aren't behaviours, and so should probably be excluded from the argument, unless you can think of a reason why they should be thought of in similar terms. As to "primitive behaviours" (did the adjective apply to both reflexes *and* behaviours?), I'm really not sure what you're referring to, so I can't comment. As to our behaviours being quite similar, across cultures, I have to say that without examples, I'm floudering to respond, again, other than to say that all human beings probably face the same sort of stimulae, and the degree to which they differ in the way that they deal with those stimulae is, in all likelihood, microscopic. Anyway, I don't see this approach as problematic, particularly, much less rigid. It is, after all, a statement of the problem, as perceived, and not an all-encompassing theory that is designed to garner a solution. Nevertheless, it is always useful to have a starting point. Ana: LOL. One of my trolls recently claimed victory, solely on the ground that I responded at all to his/her pointless meanderings (even though my ripose amounted to "fuck off"). Who knows? Perhaps having somebody acknowledge him/her feels like a victory of sorts? Anyway, I'm not perfect: I'll engage in the occasional ad hom, but I will try to make it accurate, or at least descriptive! Matt Posted by: Matthew Holford at April 19, 2009 11:30 AMGreat stuff from Healy. And some great discussion here. Healthy debate and discussion is sorely lacking at the pop-culture level on this issue. Two issues really strike me as turning points in the aggressive fervor with witch the biopsych model for depression/bipolar has been promoted: 1. "...1980 in DSM-III, the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders. The idea was to bridge the gap between the psychotherapists, on the one hand, and the neuroscientists on the other. It was hoped that if both camps could ensure that patients met 5 of 9 criteria for depression, for instance, then at least the patient groups would be homogenous, even if the views on what had led to the problems weren’t." (Healy interview) 2. "The key event in the mid-1990s that led to the change in perspective was the marketing of Depakote by Abbott as a mood stabilizer. Before that, the concept of mood stabilization didn't exist." (Healy) This is classic self-fulfilling prophesy science - inventing, or re-defining a phenomenon to fit the preferred hypothesis. Why this has gone virtually unchecked by popular media and science - remains a mystery to me. It's easy to replace one dogma for another, and Philip (in bio for this blog) is clear to correctly point out he does not support the anti-psychiatry movement. I'm assuming he's referring to that movement's most extreme proponents. I agree. However, I think we can gain important frames of reference via people like Dr. Thomas Szasz (by the way, Dr. Szsasz is a scientist and social critic, whose approach is often used by Scientologists - very important to distinguish these two). Scientology is as dogmatic and unscientific as the pharmaceutical industrial complex. If you have about 4 minutes to view the following video, it really sums up psychiatry and the biopsych myth perfectly, and does so by having its proponents (psychiatrists) unwittingly prove it's all a bunch of fluff. Please look: http://www.youtube.com/watch?v=vgKp6_QRNgk Posted by: The Skeptic at April 19, 2009 01:15 PMTruthman wrote: Well, I suppose we're all control freaks, to a greater or lesser degree (and who wouldn't want to be in control of their own life?). It's when we choose to try to control others, through coercion or otherwise imposing our reality on them, that the issues start. Anyway, I'm pleased to note that one can't libel a demographic, and name-calling isn't libellous, in any event! That said, I'm not sure that I had shrinks in mind, particularly, when I made the comment about control freaks - I've had people trying to cram me into their various pigeonholes for a long time, now, and they get really pissed when I don't fit. Like it's my fault, or something! Matt PS to David B: By their own methodology, shrinks have never cured anybody, which doesn't say a great deal about their methodology, to my mind. As such, being ignorant of their Great Wisdom is no real sin! Posted by: Matthew Holford at April 19, 2009 05:32 PMMatt wrote: "... shrinks have never cured anybody, which doesn't say a great deal about their methodology," I have never heard or read any physician claim they have "cured" someone of a psychiatric disorder. However there are treatments, such as talk therapy, medications, even ECT, that can control symptoms and give people the chance to have a meaningful life again. Matt wrote: "As such, being ignorant of their Great Wisdom is no real sin!" Claiming ignorance as a virtue pretty much nulls your arguments. Healy and Ghaemi, however, have my utmost respect. Posted by: David B. at April 20, 2009 04:41 AMI have no problem with people wanting to be in control of their own lives, but I do have a problem with psychiatrists pushing their own control freak agenda on others... The psychiatric system is like a lot of elite systems, it benefits those who promote the agenda and that agenda is largely promoted by psychiatrists and the pharmaceutical companies who more or less own psychiatry... The patients are merely fodder for the system, food for the mule and cogs in the wheel.. truthman30: Still waiting for your response to Dr. Healy being a strong proponent of ECT, actually co-writing an entire book on the subject. After all, you wrote about how ECT is a monstrous, inhumane form of treatment that destroys lives and can only be supported by sadistic and sociopathic psychiatrists, and yet wrote on a previous thread that Dr. Healy is "a hero" and "Honest, ethical and truthful". I'm curious to see how you can reconcile those contradictory positions. :) Posted by: dguller at April 20, 2009 02:08 PMI have always been a fan of David Healy, even before meeting him at the Big SSRI meeting in 2006. If you read his interview carefully, you will see that he separates out classic manic depression as it once was known - the kind that swoops all the way from mania/psychosis down into psychotic depresson/unrelenting and unremitting suicidality (my words), the kind that does affect one percent of the population or whatever, the kind that is not helped by atypical antipsychotics (in fact he states the opposite, mentioning diabetes, and death from suicide (and, we could add sudden cardiac arrest, profound hyperglycemia, pancreatitis, etc., etc.and in this he is correct. Sadly correct. My understanding of Dr. Healy is that he only supports ECT in such dire cases of manic depression. Not all the popcorn stuff upon which pharma has made its billions, leaving its own trail of lifelong damage or death. It is from the latter that so many of us repel, and the latter from which we can be liberated. In my experience, the former can only be successfully treated with lithium and , when dire, ECT, and shows up in one's life in the late teens and early twenties. We are not talking about fake baby bipolar, bipolar 12, or any other pharma marketing ploys. What I have described is the real deal. In my up close observation. David B wrote: [sigh] I didn't claim general ignorance as a virtue; I haven't made an argument; and I don't wish to be well-informed about a system that doesn't work, thank you very much. Matt Posted by: Matthew Holford at April 20, 2009 03:49 PMDr Guller.. I don't know of any literature relating to Healy and ECT.. Maybe you can illuminate me and provide some? .... Philip Dawdy notes: i edited some insults out of this comment. Posted by: truthman30 at April 20, 2009 03:54 PMSally wrote: Well, "mental illness" isn't a term that I coined! It's a curious thing, though, isn't it? This whole business of trigger events, and whatnot, appears to be completely consistent with my experience, at least, and is flawlessly logical. And yet, there appears to be no mainstream acceptance of this theory (ie, the popular consciousness seems to be saturated with chemical imbalance, when this has long been acknowledged as a marketing gimmick)... I wonder why? There's no question that there's a massive interest attached to convincing as many people as possible that they're ill. And ill in such a way that is completely unproveable: whether one is ill or not appears to be a matter of opinion, not fact. And once one is mentally ill, one will never be mentally well, again. No, there are too many flaws in this model, for my liking. More accurately, nobody's interested in correcting the flaws, such that the system works better for those it's supposed to be serving: the patients. And there's no logical train that I can perceive that suggests that the stated objective (patient wellbeing), is the true priority - so many factors act against patient wellbeing that it just doesn't make sense. And, then, I've only to observe the (frankly insane), behaviour of Blemblebudge, at Harvard, to understand that the wrong people are in charge. Matt Posted by: Matthew Holford at April 20, 2009 05:09 PMtruthman30: My pleasure. He co-wrote the book "Shock Therapy" with Edward Shorter in 2007, which goes over the history and evidence for ECT. In it, he laments the fact that ECT is rarely used, especially given its good evidence in depression, bipolar disorder and catatonia, in particular. I browsed through it in a bookstore, and so I do not have the specific page citations, but the passages that I read were quite clear in his ringing endorsement of ECT. Also, in his "Psychiatric Drugs Explained" (5th edition, 2009), he wrote that those with treatment-resistant depression should "have ECT. This remains the most effective treatment for depression. Today it is usually used as a treatment of last resort but in fact ECT has fewer side effects than many of the other treatments." (p. 65) and that "ECT is as specific and as effective as lithium in the treatment of mania" (p. 93) and is "the most effective treatment for catatonia" (p. 94). So, now you know what your "hero" thinks. I look forward to whether you now view him as a bottom-feeding psychopath, as you view the rest of psychiatry. :) Posted by: dguller at April 20, 2009 06:47 PMPhilip: I appreciate your editing in order to keep this conversation civil. Posted by: dguller at April 20, 2009 06:49 PMI always enjoy reading Matt and truthman's take on psychiatry! you guys rock! Posted by: Stephany at April 20, 2009 09:09 PMMatt, You write: "Well, "mental illness" isn't a term that I coined! It's a curious thing, though, isn't it? This whole business of trigger events, and whatnot, appears to be completely consistent with my experience, at least, and is flawlessly logical. And yet, there appears to be no mainstream acceptance of this theory (ie, the popular consciousness seems to be saturated with chemical imbalance, when this has long been acknowledged as a marketing gimmick)... I wonder why?" I agree. I know you didn't coin the term mental illness. What I dislike about the term is in part explained by your theory. Behavior that is later condemned as being sick/ill...is actually proof that the brain/mind is working well because, being put in any situation, it will adapt to that situation and survive. Post traumatic stress disorder should be renamed as amazingly mentally flexible survival ability, bipolar, as courageous response to unjust world. What about calling depression, "the courage to refuse to participate in being treated unfairly." If these conditions, behavior patterns, what have you were viewed in a positive light, perhaps some of the punitive and degrading parts of "treatment" and "help" would be removed. Instead the current model condemns people for being survivors instead of victims. Just thinking out loud. Posted by: Sally at April 21, 2009 06:29 AMMr Guller .. I will no longer grace you with engagement , I have just realized the futility of entering into any kind of debate with you... And also I have come to the realization that your attitude and patronizing tone in your posts on here are exposing the true colours of psychiatry more than I ever could... :) Posted by: truthman30 at April 21, 2009 11:19 AMWe have asked D. Guller to please leave, please lecturing, asked that he be removed. All to no avail. Unfortunately, this not being a Washington Post Forum button for him. But ignore is the best we can do here. Try it! Philip Dawdy responds: i won't remove dguller. he's not abusing anyone personally as near as i can tell and although i disagree with many of his views he';s welcome to express them. Posted by: sorrowful at April 21, 2009 02:24 PMtruthman30: I'm sorry, but ... WTF? You insulted me and my profession as murderous sociopaths, inhuman narcissistics with god complexes, and bloodthirsty control freaks, and yet MY attitude is "patronizing"? LOLOLOL. That's HILARIOUS. And rather than answer for the OBVIOUS CONTRADICTION between your statement that ANYONE who supports ECT is a monster and your statement that the ECT-supporting Dr. Healy is a "hero" of yours, you tuck tail and RUN?? Seriously?? Dude, you just totally made my day. :D Posted by: dguller at April 21, 2009 02:55 PMdguller wrote: Ooh, I'll take up that gauntlet! I have a fair idea of what "psychopathy" amounts to, and it may be summed up as "a complete lack of empathy," as far as I can establish. I don't see any evidence of that kind of thing in Healy. That said, I don't see that ECT is any more capable of addressing the deficiencies of the "mentally ill," than a sackful of drugs is. Healy's experience, presumably, causes him to believe that ECT is effective. I've never experienced it, from either side of the electrodes, so I'm not really qualified to comment, but I've seen other approaches work, and I've a fair idea why... I don't think ECT is capable of replicating that effect. However, Healy would only be a psychopath, I think, if he knew that what he was saying was false (or didn't scrutinize what he was being told to say), but was being paid (by ECT machine manufacturers, if there are such things), to big the treatment up - the behavioural pattern of many in psychiatry, apparently. Matt Sally wrote: Yes... I think the whole concept of mental illness is founded upon the notion that there is a "right" way to behave. It also seems to ignore external stimuli. For example, parents complain of the aggressive nature of their child, when they do nothing but invalidate and behave aggressively towards him/her themselves, which fact is conveniently not reported to the consulting psychiatrist, I'll be bound. "Why?" I'm told, is a lazy question that shouldn't be asked in a counselling environment, but I think it goes to the very heart of the integrity of the situation... Shouldn't the prospective mental patient be entitled to justify their behaviour (against the behaviour of others), before they're denounced? Matt Posted by: Matthew Holford at April 21, 2009 03:23 PMDo we have any indication, beyond dguller's assurances, that he is in fact a psychiatrist? I don't know many shrinks who have time to instigate pissing matches on internet forums. Philip Dawdy responds: i know he is who he says he is. Posted by: Francesca Allan at April 21, 2009 05:38 PMMatt: You make fair points that I would be hard pressed to disagree with. I wholeheartedly agree with you that when major depression is secondary to issues that are best explored through psychotherapy, then it is malpractice not to encourage patients to engage in whatever model of psychotherapy fits the problem. However, I also believe that there are some forms of depression that are so severe that biological treatments, such as medications and ECT, are necessary. With regards to Dr. Healy, it is not just his “experience” of ECT that shows it is effective. I actually have no idea whether he actually performs it or only refers people to specialists who do perform it. The issue is what the evidence shows, and his work clearly shows that ECT is highly effective for severe depression, bipolar disorder and catatonia, as demonstrated by numerous clinical trials. It is not just his personal opinion. Now, the reason why I brought Dr. Healy up to truthman30 is in regards to a few comments that he made on a previous thread. He wrote: “ECT is a barbaric practice” and that it is “quite simply astounding that you would dare to defend and promote this disgusting abuse of human rights and human life” (FDA Orders Safety Efficacy Data …, April 14, 2009 06:16 PM). He also wrote the following about me: “He makes his money destroying peoples lives, all psychiatrists of his ilk care about is their ego and a paycheck. Most of them are completely mad themselves and a large number of them are sadistic sociopaths, they hate humanity and they hate people. Ultimately it's all a huge power trip for them” and “Psychiatrists are not human, they don't think like human beings, they don't recognize human emotions, personalities or idiosyncratic diversities” (FDA Orders Safety Efficacy Data …, April 16, 2009 02:57 PM). I was curious what truthman30 would say about Dr. Healy who he previously spoke of as “a hero … Honest, ethical and truthful.. Rare for a psychiatrist” (Lower IQ’s in Offspring …, April 17, 2009 05:12 PM) when he learned that Dr. Healy actually was an advocate of ECT, which truthman30 previously described as a “barbaric practice”. And that is where we now stand with a massive glaring contradiction that truthman30 has yet to explain. Instead, he now refuses to engage with me, because of my “patronizing tone”, as if my tone were the problem. Rather, the problem is that he clearly contradicted himself with regards to Dr. Healy. Just thought that you should know some of the history of this discussion. :) Posted by: dguller at April 21, 2009 05:46 PMdguller wrote: You're very kind to say so. I shouldn't really speak for Truthman, when he's perfectly capable of doing that for himself, but I'm pretty brutal in my condemnation of Joe Blindleblatt (I refuse to do him the small courtesy of getting his name right), whom I believe to be a charlatan. Perhaps that's who Truthman was thinking of, when he made those comments. Or The Great Genius Who is Dr Martin Keller. Or The Nematode. I'm not privy to all the information, of course, but I did quite a lot of research on Protocol 329, at one stage. "Self-serving," is about the most diplomatic word that I can think to apply. Even if that kind of thing isn't widespread (I think it probably is, though), the extent to which this "information laundering," undermines the credibility of the whole system should not be underestimated. If I hadn't done the research, and hadn't written the paper, I'd consider myself a fraud if I then claimed it as my work, and put it on my CV (quite apart from the fact that the paper's conclusions didn't actually match the data). And yet this is common practice, in your profession, it seems. Who or what's driving this, erm, scam? I dunno... "It doesn't look good" is probably the understatement of the year. Matt Posted by: Matthew Holford at April 21, 2009 06:07 PMMatt: You are absolutely correct that many key opinion leaders in psychiatry -- and in many other fields of medicine, for that matter -- have engaged in unethical conduct and should be wholeheartedly condemned for doing so. I think that many of us who have been exposed to their shenanigans cannot look upon our field in the same way as before, and have modified our practices, accordingly. I will say this. It is unclear to what extent this type of behaviour occurs. Perhaps with more scrutiny, it will be found that fraud does, in fact, permeate every nook and cranny of psychiatry, and perhaps medicine in general, as well. I think that this is unlikely, but an argument can be made that the influence of drug companies and other financial interests can "nudge" physicians into directions that they would never have imagined venturing upon at the earlier stages of their careers. It is not that they are evil monsters who take malicious joy in harming other human beings, but rather that a series of small, incremental steps -- each easy enough to justify to themselves at the time -- resulted in a path where they have truly become blinded to the folly of their ways, comfortable in their self-justification and self-deception. It is actually quite tragic, in my opinion, how easily any of us can be led down horrific paths. Can we therefore conclude that all psychiatric research is fraudulent and the work of deception and falsehood? I think that is a stretch and requires a lot more investigation to prove, including looking over each and every study and pointing out exactly where the fraud has occurred. That burden of proof has certainly not been met, and so it is premature to call for the abolition of psychiatry on the basis of some scandalous researchers and controversial practices. Otherwise, one commits the fallacy of overgeneralization. Rather than throwing the baby out with the bathwater, it would be better to reform psychiatry into a more humanistic, evidence-based practice that is as free as possible of financial conflicts of interest. We definitely have a long way to go to achieve that goal. Posted by: dguller at April 21, 2009 07:57 PMdguller wrote: I was struck by something that Penny Parks wrote in her seminal(?) work on Inner Child Theory. Not the theory so much, although I think there's more than a grain of truth to the notion that when a person becomes damaged/traumatized, their development with relation to that and similar issues stops, right there, and that they will seek out similar situations, in order to understand and resolve them (or perhaps, more accurately, certain triggers lead them to follow behavioural patterns that are hardwired, at an early age). But rather something she said about the "barometer for success" (my term), in counselling. One judges one's success upon the patient's reaction. "[the traumatic event] doesn't seem to matter that much, anymore," was how she put it into words, I think. In other words, the objective is to have the patient feel OK about whatever it is that's causing them a problem - there are no fixed approaches to this, of course, and the skill of the counsellor is in leading them from where they are, right now, to where they want to be - because they don't know how to get there. "Where they want to be" should always be clarified up front, of course, and then both counsellor and patient are working towards the same thing. It's a curious phenomenon, but agreeing seems to require a great deal less energy (mentally and physically), than not agreeing, with the inevitable consequence that one is drawn towards the agreed solution, as if by magic. That's what I've noticed, anyway. Anyway, I think you're right: I read somewhere, recently, that even students are subject to pharma "gifts". It may never be stated explicitly, but there is always consideration (legal term), flowing in both directions in any contract. Inevitably, when pharma makes a "gift," it expects a return, or a clinician will expect to give something in return, at any rate. Either way, there's scope for a skewed system. And, as you suggest, as more and more gifts are received, the incremental effect is that pharma's interests are represented to a greater and greater degree, and the stated beneficiaries, the patients, are served less and less well. My background's in Law and Financial Compliance, incidentally, which is essentially a study in human nature! In Financial Compliance, there is one, very big flag, when assessing Compliance risk, and that's when a company is operated by marketing people. Seriously - the Manchester University Business School, which devises courses for the International Compliance Association draws attention to it, and the case studies and typologies exercizes bear out the concern - when there's money involved, blind eyes are turned to circumstances that really ought to be investigated. I doubt it's any different in Pharmaworld! Matt Posted by: Matthew Holford at April 22, 2009 05:38 AMdguller, Among the problems are these: what most people think has already been proven by psychiatric research, hasn't; the practice of psychiatry is based on unfounded assumptions marketed as hard science. Like a therapist who wants to continue to get a paycheck by continually circling a "patient's" real problems, you are dodging the real points of this article which are these: there's no evidence that a "mood center" exists in the brain; no measurable chemical imbalance causing mental illness has been shown to exist; and, as Healy states in his response to Ghaemi, the real issue is how to establish the clinical reality of psychiatric conditions. In other words, all of the psychiatric research has not proved that psychiatric conditions are a clinical reality. The gist of psychiatric research has not been to do so, it's been to find drugs that control behavior. So the problem lots of us have is with those of you who keep insisting that they are real conditions. You want to attack us for finding you immoral for acting on the premise that such conditions exist, for making a living from pretending that you have more science behind you than professional ghost hunters, for being angry when so many of us discover the "real medical disease" we were told we had was just speculation. Psychiatry is not about finding the biological roots of emotional distress, it's about creating drugs that control behavior. Sure there has to be some underlying research just to prove the drug stuff isn't quick poison, but as I've pointed out before health insurance companies love these drugs because they don't just save them money by being cheaper than therapy (yes, I concede an unexpected good result of insurance companies), they also save money by causing physically healthy people to commit suicide in the midst of still generating payments before getting old and placing the financial burden of aging on the insurance company. Again, it's not that psych research is fraudulent per se, it's that psychiatry never researches its underlying assumptions. No matter what you think about lithium or seraquel, the research isn't about why your baby is screaming, it's about how well these drugs do at making him shut the f*ck up. Is that research immoral, well, it does bring back memories of Dachau, but the problem, the deception comes in the fact that the research to prove making your baby shut the f*ck up benefits him, you, or the rest of society has never been done, or when it has, the result has been the opposite, that you should let the baby cry. And so psychiatry ignores basic truths of human nature. It's weird that such a large group of people could be so wrong, that no research could be done into whether controlling behavior in the first place is wise or right or helpful, but there it is. Healy, whether you agree with him or not, is probably right that electric shock changes behavior. I have several neighbors who use electric shock collars to train their dogs. Unlike my dog, their dogs walk rapidly down the sidewalk with no extracurricular sniffing, jumping up, or manic tail wagging. However, it's well known that electric shock doesn't seem to work to housebreak or to prevent chewing. The two really bad problems most people can't change in their dogs, and it of course makes biting more likely. My dog, without electric shock, is a tail wagging, butt sniffing hound, a jubilant guy who is house broken and doesn't chew up my sofa. I believe it would be immoral to shock him, also, it would be ineffective as I don't really give a damn if he wants to literally stop and smell the roses on our walks. If I want a creature that won't jubilantly butt sniff and tail wag, it's immoral for me to get a dog. And so with psychiatrists who deny that an entire group of humans, their money base, should be allowed to experience life and emotions, to be human. I would bet that electric shock does the same thing to people it does to dogs, holds them in terrified compliance to rules, while not erasing the neurotic and hopeless behavior of people whose lives are controlled by torture. Posted by: Sally at April 22, 2009 06:08 AMI just noticed my last comment never made it through to be posted... Maybe this one will be censored too?.. Philip Dawdy responds: it was not approved because it was a comment in which you said nothing and only expressed your glee at taunting dguller. it's fine to disagree with dguller and to debate points and so on but straight up taunting i won't accept. Ok , no problem .. Civility it is from now on.. :)
Heading off at a tangent... I just found this, linked in a comment on Clin Psych: http://www.zazzle.com/pharmascold_tshirt-235299321893844811 I would so like this to become bigger than the ubiquitous "Frankie says:.." t-shirts (a 1984 UK-only phenomenon, I think)! Matt Posted by: Matthew Holford at April 22, 2009 04:08 PMSally: You raise many valid points that I cannot hope to respond to in their entirety, and so I will restrict myself to a few comments, if that’s okay. First, there is no need for a “mood center” in the brain. Mood is a complex neurobiological phenomenon that utilizes multiple brain regions, and so the fact that mood doesn’t come nicely together in a single location does not nullify the biological origins of mood itself. Second, I agree that the chemical imbalance theory of mental illness is hopelessly simplistic. That is not to say that some individuals do, in fact, suffer from mental illness due to such chemical imbalances, which are probably those who respond well to medications. It is highly likely that many people have mental illnesses that are not due to chemical imbalances, but could be due to other neurobiological changes that could be more subtle. The fact is that even unified concepts like schizophrenia are likely composed of heterogeneous illnesses that researchers are still trying to uncover to understand which types respond to medications and which do not. Psychiatry is sort of at the same position that medicine was in the late 19th century where anyone who had diffuse swollen tissue was diagnosed with “dropsy” as if it was a single disease when really the swelling could have been due to cardiac disease, renal disease, liver disease, and so on. However, your point is duly taken that we still do not have a good grasp of what constitutes a mental illness. Third, psychological distress does exist, as does the inability to function in satisfying ways as a consequence of that distress. I do not think that you would deny that someone suffering in the throes of a depression that has sapped their ability to enjoy their live and function in a meaningful way does require assistance to help alleviate their distress. The question is how do we understand the depression? Do we understand it as a normal part of life, and thus not really requiring support? Do we understand it as a byproduct of maladaptive schemas rooted in early childhood experiences? Do we understand it as a neurobiological abnormality that requires biological intervention? As much as you may deny it, there is a great deal of research looking into precisely these issues in the medical literature, and there are contentious debates within psychiatry regarding them. Perhaps that may not come across to you, but the fact remains that there is vigorous debate about the nature of mental illness currently going on. Fourth, you make valid points that much of psychiatry can be conceived as behavioural control. That is true, especially with regards to patients who are aggressive, agitated and disruptive whether due to psychosis, mania, developmental delay, or whatever. However, I think that once people are sufficiently calm and stable that the real work must be done in order to help them make sense of their experience and find some meaning in it. Medications play an important role in the former, but only a supportive therapeutic relationship with a clinician can facilitate the latter. Sadly, most of my colleagues are focused on biological treatments, but that is starting to change, at least in my neck of the woods. Fifth, you claim that psychiatry never looks at the causes of a baby’s crying and only seeks to medicate them. I’m not too sure what to make of this claim. Can you elaborate, please? Sixth, you are free to believe whatever you wish about ECT, but just know that the controlled trials have clearly demonstrated its efficacy in extremely severe depression. And I’m not too sure how helping those with severe depression who have completely lost the ability to function at all somehow robs them of the ability to “experience life and emotions, to be human”. From my personal experience, the exact opposite of usually true. Thanks for the well thought out remarks. Posted by: dguller at April 22, 2009 04:25 PMDguller, I claim that psychiatric research rarely looks at the causes of behavior or even the efficacy, appropriateness, or morality of controlling behavior. I think there's data showing that supporting and accepting a la Soteria work better but that research isn't fashionable. Maybe, hopefully from what you write, it's coming into vogue. As for psychiatry looking at the causes of a babies crying, a metaphor, though it may be literally true. Psychiatric research is focused on changing behavior. What if the premise that all behavior is at least to some one in some culture a valid, comprehensible, even reasonable response to some stimulus and then a search for that stimulus were researched? I don't just mean theorized about, but researched. I'm not denying such research exists, but I'm not familiar with such. We've been down the chemical imbalance road before. I don't think it's appropriate for psychiatrists, psychologist, counselors, etc. to attempt to alleviate mental distress. As you know, I'm not about outlawing most of such, at least in consenting adults, but I just don't want it considered medical care. As for ECT, since I don't agree that severe depression is a medical condition and thus don't believe it can be diagnosed, I couldn't comment on purported treatments of such (well, I'm not going to tonight but probably have before;). I remain dubious of the efficacy of ECT and wonder what you mean by "efficacy in extreme depression." It is highly likely that many people have mental illnesses that are not due to chemical imbalances, but could be due to other neurobiological changes that could be more subtle
I have suffered from depression and I am telling you, it comes from life trauma, life events, an inability to cope and it stems from emotional reaction... Most people who have suffered from depression will tell you this.. truthman30: I agree with you that many, if not most, people who suffer from depression have a history of psychosocial stressors acting upon an underlying vulnerability that is partially genetic and partially due to earlier life expeiences that developed maladaptive coping styles. It is my understanding that all of those factors cause depression due to their effects upon the brain. If someone cannot influence the brain, then it cannot be a part of our thoughts or feelings, which is why I said that ultimately all mental illness -- and mental health! -- is fundamentally neurobiological. Perhaps you can direct me to a thought or feeling that is not mediated by the brain? Unfortunately, I haven't read Dorothy Rowe's work, but I have read plenty of other people's writings who do emphasize many of the points that you do, which is why I always try to get a sense of a person's life narrative to help provide them with some meaning for why they are feeling what they do. I have found that to be successful with most patients, but there are always those who are depressed without any of the factors that you have cited, whose depression has come out of the blue from a previously happy and healthy life. I choose to listen to those patients as well, and not try to force them into a box, e.g. "Well, you MUST have some history of trauma, even if you don't remember it!" I'm not going down that path. I suppose the question I have for you is whether you believe in thoughts and feelings that are independent of the brain? Posted by: dguller at April 23, 2009 03:20 AMtruthman30, Do you ever read the last psychiatrist blog? He had this neat yet horrifying post about how doctors think doctors' suicide is caused by unbearable incidents, is a sane response to life, not a psychiatric, i.e. neurobiological illness. And yet the doctors in the study were unable to see it. Here's the link: http://thelastpsychiatrist.com/2009/02/guess_what_isnt_the_cause_of_p.html I think that's the thing with our dguller. He really can't see the flaws in his thinking. To me this doesn't make him neurobiologically ill but a normal human. Still, I'd feel better if he could see the rest of us as normal humans to. Probably it's not going to happen. Posted by: Sally at April 23, 2009 07:22 AMSally: I read the study that TLP cited. It's hardly a groundbreaking gotcha article that damns my profession. In the part that talks about the contributory factors in physician suicide, the FIRST topic is Axis I disorders, particularly mood disorders and substance abuse disorders. So, I'm not too sure about the part where physicians are unable to recognize Axis I disorders in themselves. Also, have multiple life stressors does not automatically imply a major depression or Axis I disorder. Most people are quite resilient and can weather the storms of their lives without meeting criteria for psychic distress or functional impairment. So, in the part of the article where 2/3 of physicians were "burned out" and 1/3 were "depressed", you're assuming that the two terms of synonymous and thus there is a bias, but that is not necessarily the case. Also, they never specify what either term means, and so it is impossible to tell. I think that you and TLP are putting too much weight on an article that ultimately cannot bear it. Posted by: dguller at April 23, 2009 09:58 AMD Guller.. I am trying to avoid going down my previous routes of engagement with out , but I must say I do find your responses extremely frustrating.. If you are dealing with depression as a psychiatrist in clinical practice then you should have read Dorothy Rowe, she is a best selling author in the subject and she is internationally recognised as such.. (well by the field of psychology anyway) and I am telling you as one who has experienced depression that she knows and I know what I am talking about.. It seems so pointless trying to make you understand.. ALL of psychiatric theory and research is flawed and all psychiatric theory is is just that.. it's theory , it is not fact ... I don't mean to attack you personally D Guller, I mean that sincerely, but you have to understand my frustration at the psychiatric system.. Posted by: truthman30 at April 23, 2009 12:30 PMdguller wrote: Sorry to butt in on a conversation, but how is this known?.. It was my understanding that there was no way to measure brain chemistry, other than post mortem, by slicing the brain up, and doing a bunch of tests. Even this methodology would only reveal brain chemistry *at the point of death*, and would, therefore, be an unreliable guide (ie, who knows what kind of chemical changes take place in the brain, immediately prior to death?). I don't know... these claims of chemical imbalance, seemingly unsubstantiated as it is, is one of the reasons why many of the commenters on this thread have so little faith in those who would dole out oodles of drugs to correct a deficiency that may or may not be there, in the first place. And if it is(n't) there, then there's no way of proving that. As Sally suggested, earlier, there doesn't seem to be a whole lot of science involved, here. Matt Posted by: Matthew Holford at April 23, 2009 01:16 PMtruthman30: I'm a little bit confused. Can you please cite the specific sentences in my previous post that you found so "arrogant" and "condescending"? It may just be my tonedeafness -- is that a word? -- but I'm still at a loss regarding your complaint. I will put Rowe's book on my list of books to read about depression, if you recommend it. :) But just based on the introduction of her book that I read on depression, she makes a distinction between unhappiness and depression, which I believe that many people on this website would object to. My understanding was that there is no clearcut distinction to be made, because depression is just a form of unhappiness that has been pathologized, and yet Ms. Rowe seems to share in the idea that there is a big difference between the two. Also, what criteria does she use to make the distinction? What is the evidence for her criteria? Is it more solid than the DSM criteria? Just wondering. :) Also, why do you object to my contention that all our mental life -- good and bad -- are mediated by the brain? I would have thought that this is as uncontroversial a statement as can be. Posted by: dguller at April 23, 2009 01:49 PMdguller wrote: You don't have to go down it, but you need to bear it in mind as a possibility, I think. In any event, I think it rather depends upon how one defines "trauma". A traumatic experience can be anything, provided it is unresolved - a problem unsolved. I've spoken to enough people to know that everybody has plenty of these unresolved issues, occupying valuable processing space. And people are constantly trying to offload their issues onto others, too, I've noticed, though nobody will stick around long enough to explain why, yet. A question for you: how do you *know* that I'm not right? Because you're an acknowledged expert in your field, who's been looking at this stuff for twenty years, and how could I possibly know better than you, when my field of expertise is apparently so far removed from your line of enquiry? But what if I'm right? You will have dismissed me, along with the solution. What if I think faster than you, such that I can solve problems that you haven't even acknowledged exist to be solved, yet? It's possible, if only because I just thought of it. And yet, our physiology must be more or less identical, and electricity, the stuff of neural messaging, can't be capable of travelling faster in my body than in yours. It would be the case, then, not that I thought *faster* than you, but that I thought in such a way as to permit me to arrive at valid conclusions much more quickly. Science fiction, of course, and not to be taken seriously! Matt Posted by: Matthew Holford at April 23, 2009 02:29 PMYou hold out an apple The pony comes trotting over and eats from your hand You attach the pony to a ring exercise machine and watch it go round and round The pony is happy and its not even sure why Your happy; for you have are feeding the pony and it's fun just to try Now this particular pony is a show pony in all the prestige; and you, just this inquisitive by stander of happenstance with an apple and time for a little tease How do these preposterous events unfold is for each to imagine, and thus no conclusions are reached and the pony bamboozled in fashion Oh, the trauma in fiction that will unfold and never be reached Hat Tip to Matthew, and to all a good apple bite for I am amused and thoroughly pleased Ok .. Can I ask you Guller, outside of the psychiatric mindset.. Because it seems to me that you fail to see the many complex facets of the human condition and the experience that we call "life"... I am beginning to think that maybe you see humanity through one very narrow lens of vision.. D Posted by: truthman30 at April 23, 2009 03:22 PMMatt: First, I would never ignore a patient who informed me a history of trauma as a contributory factor to their depression. My point was that if someone presents with a major depression, and denies any significant psychosocial stressors, past or present, then I would not doubt the truth of what they say, because I believe in a theory where they MUST have some clear-cut triggers. Often, there are none. Second, I do not know what your point is that some people can think faster than I can. So what? Can you clarify what you mean, please? Thanks! Posted by: dguller at April 23, 2009 04:17 PMtruthman30: I am interested in literature, philosophy and spirituality. In fact, one of my degrees is in philosophy, and I recently gave a grand rounds on the brain and free will! :) Not so much into art in the form of painting and sculpture, although I was very impressed by the work of Michelangelo when I visited Italy. So, rest assured that I do have a wide view of humanity, but there are some essential features of my worldview, including the fact that our mental life is mediated by the human brain, which has evolved over millions of years into its current form. That is why I am so puzzled by your refusal to answer whether you agree that all our mental states are a result of neurobiology, and if not, then what accounts for them? Also, I'd appreciate your answer to my questions about Ms. Rowe's method of treating depression. How does she differentiate between unhappiness and depression? What gives her criteria validity? What is the evidence that her treatment is effective? Just wondering. :) Thanks! Posted by: dguller at April 23, 2009 04:23 PMWell Guller... I am actually of the opinion that the human brain is an organ within the head of the human body. The human body also has other major organs too, such as the heart etc. Yes of course the brain is a vital and important organ, but it is not the sole entity from where all manifestations of reality and thought emanates from. You should really read the "tibetan book of living and dying" by sogyal rinpoche if you want to touch on some insights or explore these concepts further.... These physical organs and the physical body itself is but the material mater of the body, but there are of course etheric aspects and spiritual aspects that exist beyond the physical body. Human beings and all life is holistic as is the planet earth itself. It is all interconnected , to focus on one aspect is to miss the whole.. By focusing in on the brain and stating the claim that "all our mental states are a result of neurobiology" is extremely simplistic and though of course it is quite appealing for some to go along with your world view , it would in fact go against mine, for I believe , (like Socrates and Beckett and any other humble human being really worth their salt) that we really know nothing, we are quite primitive really. We like to dress things up, and use language and concepts to cloud the reality of simple truths but at the end of the day we are just stupid monkeys clinging to a rock, hurtling thousands of miles per hour around a universe that we no very little about.. There are somethings which should not be meddled with, and the brain and human mind are some of those things Dr Guller.. The Audacity of psychiatry never fails to astound me.. In the words of Zora Neale Hurston , .. Dr Guller... "To know there you got to go there" .. And it is quite clear to me that you do not know "there" .. When psychiatry begins to respect the human condition , I will be willing to develop some respect for psychiatry..
Guller... Also I just wanted to touch on something you said about "often" there are no triggers for depression.. Well, on the one hand you are acknowledging that there can be "trauma" triggers for depression and the other you are saying there are "often" none... So if this is the case... Well no.. Guller.. Further to my last comments.. What do you make of the manifestations of "Guilt" , "Shame" , Regret" , "Grief" , "Sorrow" , "Desire" and "Love" .. Are these but biochemical reactions to you?. .. Truthman30: First, I have much respect for the Buddhist tradition, but anyone who claims that cognition occurs anywhere but in the brain is dead wrong. Emotion is a more complicated phenomenon that intrinsically requires a body in order to manifest itself, but the subjective feelings associated with emotion are ultimately neurobiological in nature. If you doubt that, then you have to explain how stimulating various parts of the brain can generate thoughts and feelings. However, if your position is that our mental life is fundamentally related to being embodied beings, then I would have to agree. Second, what ethereal and spiritual aspects are you talking about? If you are bringing the soul into this discussion, then you will quickly be mired in paradoxes and contradictions, because you are stuck with describing what the soul does, how you know that it does it, and how something immaterial and interact with the material world. Problems galore! Third, I would disagree with you that we “know nothing” and that “none of our opinions are of much consequence”. Yes, we are highly evolved primates on an insignificant part of the universe that will not care one iota when we go extinct. However, to imply that we are completely in the dark and ignorant does not follow. We actually know a great deal about ourselves and the world that we live in, and our knowledge base increases on a daily basis. Naturally, there will be much more that we do not understand, but that does not nullify our current mass of knowledge. I find it odd that, on the one hand, you plead ignorance of essential matters, and on the other hand, claim to know that everything is interconnected and that there are “spiritual” and “ethereal” aspects of reality itself. You cannot have it both ways, my friend! Fourth, I do not mean to focus exclusively on the brain, because there are other factors involved in our mental health. However, everything that is involved in our mental life ultimately must find its origin in the brain. Again, I challenge you to point to a thought or feeling that exists independent of neurobiological pathways being activated. If you can point to one, then feel free to apply for the Nobel Prize, because you will have falsified all of neuroscience in one fell swoop! Now, none of this implies that the ONLY way to achieve mental health is to directly alter the functioning of the brain, because one can do so indirectly through modifying one’s behaviours, interpersonal relationships, and so on. But make no mistake. All of those interventions ultimately are affecting the brain, but indirectly. So, I am not saying that all solutions must be biological in nature, i.e. medications, ECT and psychosurgery, but I am saying that the final pathway must be neurobiological. I hope that clears things up. :) Fifth, depression does have causes. Just because we cannot identify the necessary causes of certain phenomena does not imply that there are no sufficient causes for the phenomena to occur. For example, there are an infinite number of causes when you flip a coin, but it is impossible to pinpoint the definitive causes that made the coin land on heads. That is why we consider it random. Now, with regards to depression, of course there are causes, and we can easily speculate about what caused a particular person to become depressed, but if they deny any triggers, then it would be wrong of us to force our ideas upon them. Hell, even if someone claims that a childhood trauma was the cause of their depression, they might be wrong, because our minds are great at rationalizing a narrative account of our mental life, even when it is clearly false. So, I work with the triggers that people identify, knowing that they may be wrong, but also knowing that it is helpful for their recovery to work with the ideas that they already have and help them make better sense of themselves. However, if someone denies any triggers, then I respect their experience, and you are right that they may not want me to know what the real triggers are. ;) Sixth, all the emotions that you asked me about are not simply biochemical reactions, because they exist in the context of an embodied human being with a central nervous system. In that sense, you are correct that holism is essential to understanding the human condition. That is why philosophical thought experiments, such as the brain-in-a-vat idea, are at bottom incoherent. So, I would say that the emotion of love is caused by sensory information being processed by the brain, activating certain pathways and releasing hormones and neurotransmitters, which results in activating a certain bodily state and mental experience. In order for that to occur, one needs a brain, a body, and an environment. Fortunately, we have all three. :) So, I deny that if you put some neurons in a Petri dish and activated them, then that is “love”. No, those neurons would have to be related to other neurons in a complicated parallel processing brain that is closely intertwined with a physical body. In other words, one requires a whole organism in order to have real emotions and a real mental life in general. Seventh, you seem to reject at a visceral level that your mental life is fundamentally biological. I wonder why. There was a time when it was thought that birds fly due to the hand of God lifting them to the sky. After science uncovered the laws of aerodynamics, the hand of God was no longer necessary, and yet do birds fly less majestically? There was a time when it was thought that real love required Cupid’s arrow, but we abandoned that idea, too, and fortunately people still fall in love all the time. So, why denigrate our biological nature? Why cannot love and guilt still be powerful even if they are essentially biological? Thanks for the stimulating discussion. Posted by: dguller at April 23, 2009 08:00 PMtruthman30: Oh, and I'd still like your answers to my questions about Ms. Rowe. Thanks! Posted by: dguller at April 23, 2009 08:02 PM"modifying one’s behaviours" This comment speaks volumes to me ... This saddens me... This modifying, whether true or false , good or bad, it doesn't matter because the methods and approach that psychiatry uses are currently as primitive and barbaric as a 19th century slaughterhouse.. Posted by: truthman30 at April 24, 2009 02:14 AMdguller wrote: Well, it's my contention that we "slow" our thinking down, as we try to reconcile the irreconcilable, also known as "conflicting messages". Take this business of mental illness, for example. Let's say that I "know" that drugs are incapable of ever providing even palliative care to the mentally ill. Let's say that I'm looking on in mild amusement as clinicians continue to try to justify their use, in the face of repeated failure, and dubious science. Because the clinician is trying to include something that is patently untrue (to me), in his/her calculations, (s)he will never arrive at the correct solution. The falsehood should have been excluded, a long time ago, and yet it continues to be perpetuated. Here's a better example. Let's say that I think I'm a genius, the like of which the world has never seen, and will never see, again. Let's say that the rest of the world thinks I'm delusional. Is the rest of the world right? Or am I? If I put forward arguments that inconvenience the rest of the world, then the rest of the world is motivated to tell me that I'm stupid, or delusional, which would conflict with my own experience of myself. Conflicting messages... Do you know, if one is told continually that one is stupid (and there is no sufficiently compelling/strong countermanding message), one will end up believing it? And when one believes it, one starts behaving as though it were true, thus making it true. That's what I've noticed, anyway. The things that people believe about themselves... You wouldn't believe it. Or perhaps you would! Matt Posted by: Matthew Holford at April 24, 2009 04:42 AM"the hand of God was no longer necessary" Amazingly, Biederman believes the same think. Who needs God, when you can play God. Shall we start the Psychiatry verses God debate now? Posted by: Messenger at April 24, 2009 07:44 AMtruthman30: It appears that you have a visceral dislike of the idea that we are essentially evolved biological organisms who possess remarkable capabilities. Your alternative seems to postulate some magical extra "something" that does ... what, exactly? Can you please provide any facts or arguments in support of your position, other than the fact that the alternative makes your dyspeptic? I'm sorry, but your hurt feelings do not an argument make. :) Also, still waiting on your answers to my questions are Ms. Rowe, which you stated knew far more about depression than anyone in my field. However, it appears that she also makes certain assumptions that you rejected earlier, including the notion that there is a distinction between unhappiness and depression. So, you are once again in a contradiction, and I would appreciate your answer to how you will reconcile it. Posted by: dguller at April 24, 2009 11:52 AMMatt: I think that you're talking about cognitive dissonance, and you are correct that psychiatrists -- like all human beings -- run the risk of being exposed to it. Not especially controversial, I think. Posted by: dguller at April 24, 2009 11:56 AM
(First I would like to say, you strike a condescending tone of perfect pitch) "It appears that you have a visceral dislike of the idea that we are essentially evolved biological organisms who possess remarkable capabilities. Your alternative seems to postulate some magical extra "something" that does ... what, exactly?" says Guller ... Well, Isn't that what makes us human Dr Guller? I suspect that you are the rule as opposed to the exception in your psychiatric profession .. On the subject of Dorothy Rowe.. (basically, just because you did a quick wikipedia search doesn't qualify you to know anything about her literature..) Posted by: truthman30 at April 24, 2009 12:54 PMtruthman30: There is a difference between acknowledging that our knowledge will always be incomplete, and acknowledging that we firmly have evidence of a magical “something” that defines our humanity, and yet is indefinable and undetectable. That is my problem with talking about the soul as that special something that separates us from the animals. Just because great minds in history have postulated its existence is no argument, except based upon the fallacy of authority. Great minds have postulated all kinds of things that have turned out to be wrong. I think that what makes humans special is not some mystical soul, but rather our unique evolved capacities of conscious awareness, the ability to understand our behaviour as the result of reasons, the ability to re-evaluate those reasons in real-time, our ability to control our impulses, our complex repertoire of emotional responses, our incredible development of culture, and so on. None of those aspects of the human condition requires the postulation of anything metaphysical or religious. And if you choose to bring such a concept into the discussion, then the burden of proof is upon you to explain what is is, what is does, and how you know that information. It is not good enough to say, "I can't tell you what it is, but trust me, you totally need it to be human!" I don’t think that believing these facts makes me a shallow person who has never suffered from an existential crisis, because I certainly have experienced my share of emotional turmoil. I find it slightly disturbing that whenever we come to a disagreement, you have to launch a tirade against my character and integrity, highlighting my egotism, my delusions, and my hunger for power and control over my patients. Can we agree to simply stick to the empirical facts and logical arguments, and leave the ad hominem attacks aside? I can assure you that I am not the superficial monstrous character you imagine me to be, and we can disagree with one another and yet still both be fully human. With regards to Ms. Rowe, I didn’t look her up on Wikipedia, but read the introduction to her book on depression on Amazon.com. In the introduction, she specifically describes the fact that there is a difference between unhappiness and depression. My questions still remain valid, because part of your major criticism of psychiatry is its claim to be able to differentiate between the two, and yet Ms. Rowe claims to be able to perform this very task. I wonder why you have nothing but contempt for my field’s criteria to differentiate unhappiness and depression, and yet sing nothing but praises for someone who also makes that distinction. And rather than address this issue, you hurl insults at me. Just like with Dr. Healy’s support of ECT, you refuse to engage in the issue, but rather feel comfortable with mocking and insulting me. So, I would appreciate your answer to how Ms. Rowe distinguishes between unhappiness and depression, whether her criteria are valid, and what is the evidence for her treatment for depression. Posted by: dguller at April 24, 2009 04:33 PM"None of those aspects of the human condition requires the postulation of anything metaphysical or religious." Then you miss the gift and point of true human existence and this unique experience called life; yet more than this, you miss out on the miracle of the true human spirit in each individual patient that stands before you; each and everyone one of them being held out as a testament in this special wonder of their humanity. For God is not a metaphorical presents, or to be coined in terms like religion or metaphysical. You might do well to take a Christ like example before each one of your patients, and see what possible wonders they may present you. Instead of you presenting before them as is the approach with those that refuse to see anything but what is before them in their finite limited science. God and your spiritual self is not in the proof or evidence, and in that which others may come forth with. For those of lesser means can only present lesser arguments. For the answer to your request; you have to allow this opportune opening from within. If your looking outside for those answers; then you will truly never find them, and thus you will never see your patients {those for whom you are there to serve} as equals or with the validity they deserve, and in the end for who they really are. You want proof of God, then only look into the least of those you see as less than human or affirmed in madness; and God is right there in flesh and blood staring directly in the eyes, but you have a choose to be blind or not, listen or be deaf. Posted by: Messenger at April 24, 2009 07:18 PMAhh Finally Mr Guller.. You displayed an emotion.. That's all I was looking for.. The anger you expressed against me here (and those who criticize and attack your profession) is exactly how we feel Dr Guller.. By branding us with these pseudo - mental illnesses you are attacking our character and our integrity... you and your profession , have ruined many many lives in your quest for the holy grail of biological psychiatry.. Your profession has used people like guinea pigs in its obsession with finding the secrets of the mind.. With each new medication you promote , you claim new "magic" to behold .. And with each drug disaster you claim more lives.. Paxil, Zyprexa, Valium .. These are not medicines, these are poisons.. I have every right to attack you and your profession because I have been victimized by you and your profession and I have seen others whose lives have been destroyed by your profession.. I have every right to tell you what depression is because I know depression and I have lived with depression .. You will only ever understand when you "Go There" Dr Guller.. So don't talk tome about what you know! The only perception of mental illness you have is from observation , clinical data and literature .. It's like me saying I understand how a monkey in a cage feels just because I saw one in a zoo... On the Dorothy Rowe issue that you keep bringing up.. truthman30: I think we'll have to stop this discussion, because you refuse to engage with me on the issues at all, and rather keep trying to belittle and insult me in ad hominem attacks. You cited the importance of a soul, and yet do not explain what it is, what it does, how you know about it. You cited the work of Ms. Rowe, and refuse to discuss even the most elementary point. Why I need to read the entire book for you to tell me how she can differentiate between unhappiness and depression is beyond me. You cited Dr. Healy as your "hero", even thought he supports ECT, and refuse to resolve this contradiction. Instead of answering any of these problems, you insult me as an inhuman monster who destroys the lives of my patients. That is nice manouver to avoid addressing the inconsistencies in your position, but does not change the fact that you have contradicted yourself on several occasions. Looking away will not make them go away. :) Perhaps one day when you get your anti-psychiatry Tourette's under control, we can engage in a civil discussion, but sadly, that is not to be at this time. :) Take care. Posted by: dguller at April 25, 2009 04:48 AMMessenger: Proof, please? Any evidence whatsoever for what you stated? Thanks! Posted by: dguller at April 25, 2009 04:49 AMThe Fundamental difference between you and me Guller is that I think in many dimensions while you think in one.. The common experience of people dealing with psychiatrists is that they assess , diagnose and drug people on their symptoms not the cause of their distress. For example, a patient presents himself to a psychiatrist or GP exhibiting symptoms of depression such as low mood, apathy and sorrow. The psychiatrist seems to disregard to the complex ann long multi-faceted life experience of the individual up to that point. The psychiatrist tells the patient that it is their "sick brain" that is at fault. Immediately this causes dis-empowerment , for it voids the individuals ability to be able to help themselves. Psychiatric practice today is a horrendous affair, the system perpetuates itself in order to survive, psychiatry has become more about preservation of an ideology than welfare of human suffering and understanding. That is a great shame and it is up to psychiatrists like yourself to change this... Posted by: truthman30 at April 25, 2009 09:28 AMOk .. Lets Clear this up then shall we Mr Guller.. I said Healy is a hero to me and to those who have been prescribed psychiatric drugs, and I count Joseph Glenmullen , Peter Breggin and Michael Corry amongst my other "hero psychiatrists" .. I call them hero's because they dare to tell the truth about the side effects of psychiatric drugs and the corruption and conflicts of interest that exist between Psychiatry and the pharmaceutical industry that covets it.. I really don't know what Dr Healy's current views on ECT are and I really don't care that he might have used it in the past.. Operative word being "conscience" (look it up in a dictionary).. Dorothy Rowe does differentiate between "depression" and "common garden variety unhappiness" , so do I and so do a lot of people. I have never said otherwise... Dorothy Rowe has many insights about depression, for you to concentrate on one aspect of her thoughts and to make a huge "non-issue" out of it is absolute deflection if ever I saw it.. She believes that depression is a result of beliefs which do not enable a person to live comfortably with themselves or the world. Most notably it is the belief in a "Just World" (that the bad are punished and the good rewarded) that exacerbates feelings of fear and anxiety if disaster strikes. Part of recovering is accepting that the external world is unpredictable and that we control relatively little of it. (amongst other things) Her book , Depression : The Way out of your prison" has a profound affect on me when I was in a deep depression, because I felt she understood completely how I felt and why I felt it.. I would recommend it to anyone who ever feels the painful cloud of depression descending .. I cannot , on the other hand , say that of YOU, or psychiatry in general).. But then again , she is a psychologist and they aren't all about pushing addictive and dangerous drugs on every Tom , Dick and Harry are they? .. Psychologists , in general , take a much more humanist approach to mental and emotional distress.. Psychiatrists on the other hand take a completely inhuman approach to what they call "mental illness" .. Depressed people need to be encouraged to develop "Courage" .. Psychiatry does not provide the tolls for that unfortunately.. Psychiatry exploits fear and the human condition ... All emotions are accompanied by biological changes .. The operative word being .. "accompanied" .. You tale to me about "proof" and "facts" ... There is no proof that "chemical imbalances" cause mental illness .. So until you prove something to me I don't see why I should have to prove anything to you .. You talk about contradiction Mr Guller.. You talk about "inconsistencies" Mr Guller.. I found your comment about "anti-psychiatry" tourette's very funny by the way.. (but other might think you a little mean) I hope you have more respect for your patients than you do for the people who post on here Mr Guller.. I never cited anything about the soul either.. I fear it just might be .. The irony of all this is, when you show your true colors , all you are doing is exposing your profession further ... Heartless, soulless and devoid of conscience.. I feel sorry for you ... Posted by: truthman30 at April 25, 2009 01:33 PMProof of a Soul? What sort of proof would suffice for a psychiatrist? Given most are atheists I should be very keen to hear this... Truthman, I think you are spot on. I think what's most interesting is how Psychiatry has wedded it's world view to biology. It can't possibly account for things that might exist beyond it's ability to measure. This hasn't prevented astrophysics from accepting and enforcing the concepts of Dark Matter or Dark Energy. Guller, Tell me what is the Mind? What is the Soul? Can you prove or disprove the necessity of a non-temporal God? Provide replicated studies for this. Your answer matters not for all the obvious reasons. Posted by: Paul at April 25, 2009 02:28 PMAmazon and Wikipedia are paltry substitutes for the inquirying mind: http://www.dorothyrowe.com.au/ I discovered Dorothy Rowe a few years ago when she was voted the third wisest Britain, though I think she's dropped to fifth place in most recent polls. I see nothing in her work that dguller would argue with, and am perplexed as to why she's held up as a foil to his perspective in this thread. She is a psychologist and he is a psychiatrist, so there's that. But where is the theoretical disconnect? I'm not seeing it. Theoretically she's a schema therapist. dguller has promoted schema therapy on a number of occasions at furious seasons, a blog in which knowledgeable readers discuss mental health theories and protocols. Or not. Knowledge aside, Rowe is famous with the general public for her empathy, straight talk, pragmatism and common sense, sort of like England's Dr. Phil, if Dr. Phil was, say, valuable. Posted by: flawedplan at April 25, 2009 04:18 PMIf the soul or human spirit was ever really considered as something extremely important not to lose as a result of a psychiatric treatment, we would not be questioning psychiatry at all. Psychiatry, the treatment based on psychiatric medication models is the reason so many people here are suffering from loss of spirit and loss of soul, some only to hang on by self-determination and raw human spirit. Sometimes, I would look into the eyes of (dozens and dozens, hell maybe a hundred over the years)patients my daughter was with in psych wards, and their eyes were so empty and lost. One of the most poignant moments I had, was when my daughter was still verbal in a psych ward, and she stood, looking out the wire mesh covered window and said, "I'm still a free spirit, right Mom?" I hate to say this, but 3 years later, I see the empty eyes now, and she's no where close to the person who once said "I'm a free spirit". This stuff breaks people. Like horses. Broken spirits do hold one thing: sorrow, pain, sadness. Where is God in all of this? I believe there is no place for God in psychiatry, for the doctors have taken that place. Posted by: Stephany at April 25, 2009 04:18 PMThanks Paul.. :) If only Mr Guller and psychiatry in general had an open mind and an open heart.. And these are the kinds of people who look after people at their most vulnerable!.. Scary isn't it?..
dguller wrote: "Cognitive dissonance"? I felt sure that there would be some technical shorthand for what I was describing - there usually is. I'd prefer to say "a matter of perspective," which I think conveys more clearly what we're talking about to a wider audience. So, although the concept itself is not controversial, and, if I may generalize, most people would accept that they are apt to give themselves over to this sort of thing, from time to time, the consequences are far-reaching. Let's say that you have a patient who genuinely believes that they possess other-worldly intelligence, for example - not something to be discussed hypothetically, as I have done, but (s)he believes it as a matter of fact. That's delusional, isn't it? What would you do about that? Or what would you say? I'll tell you why I ask those questions, just so you don't think I'm leading you off on some wild goosechase, with the intention of making a fool of you (people often do think that, I've noticed). It's this: it's my belief that everybody on the planet has an identical intellectual capacity. Whether they believe that is another matter. What's more, it's become quite evident that nobody else but me believes it!!!! Matt Posted by: Matthew Holford at April 25, 2009 05:21 PMJesus, guller, I've been staying out of this because I know it's impossible to actually have a conversation with you. But do you not see how you attack people, put them on the defensive, insist they explain their every belief to YOUR satisfaction using YOUR criteria of proof? You're a bully. Oops, excuse me. Lest you attack me for an "ad hominem" attack: you exhibit bullying behaviour. Repeatedly and consistently. That's why you anger people. Surprisingly, people really do not like being bullied. Who the hell elected *you* arbiter of the discussion around here??? It's screamingly obvious that's what you consider yourself. I've rarely seen anyone so bent on controlling a discussion. You are one of the most well defended exhibitors of bullying behaviour I've ever seen, so I expect nothing good will come of this posting. I suppose the fact I've bothered to write this really is some sort of proof that I'm a nutbar. I'm disgusted watching you. I hope the points you score make you very happy. You really are a nasty little person. Posted by: Sherry at April 25, 2009 05:38 PMJesus, guller, I've been staying out of this because I know it's impossible to actually have a conversation with you. But do you not see how you attack people, put them on the defensive, insist they explain their every belief to YOUR satisfaction using YOUR criteria of proof? You're a bully. Oops, excuse me. Lest you attack me for an "ad hominem" attack: you exhibit bullying behaviour. Repeatedly and consistently. That's why you anger people. Surprisingly, people really do not like being bullied. Who the hell elected *you* arbiter of the discussion around here??? It's screamingly obvious that's what you consider yourself. I've rarely seen anyone so bent on controlling a discussion. You are one of the most well defended exhibitors of bullying behaviour I've ever seen, so I expect nothing good will come of this posting. I suppose the fact I've bothered to write this really is some sort of proof that I'm a nutbar. I'm disgusted watching you. I hope the points you score make you very happy. You really are a nasty little person. Posted by: Sherry at April 25, 2009 05:41 PMPaul: First, I would settle for an argument, rather than a proof. Don't just tell me that X is absolutely essential for us to be human, and then be unable to tell me what X is, what X does, and how you know about X. Personally, I look at the word "soul" as a metaphor that we use to describe what is most noble and best about us as human beings, but it does not refer to anything real. It is similar to how in the medieval period, there was the need to purify the heart in order to draw close to God, because it was thought that our intellect and emotions were present in the heart, and they must be purified. However, now we know that the heart does not perform that function, but if you pick up any religious text that speaks of spiritual purification, you will invariably find the phrase “purify the heart”, but it does not mean that there is an actual spiritual heart that must be purified. Second, I am certainly no expert on dark matter, but my understanding is that physicists have indirect evidence for its existence in the form of observations that are best explained by its existence, and have a definition of what dark matter is. It is not a matter of faith as far as I understand it. However, I may be wrong. Third, the mind is a complex entity whose definition will vary depending upon whether you admit only conscious experience as present in the mind. Historically, it was defined in opposition to the body, but current research into the embodied nature of our minds is questioning that assumption, and arguing that much of our subjective experience necessarily requires a body. However, if you want to stick to a limited view, then the mind is the organized and integrated synthesis of conscious experience into a unified subjective experience that involves thoughts, feelings, perceptions, and so on, all bound into a sense of self. Interestingly, in some sense this definition is circular, because “subjective”, “experience”, “conscious” and “mind” are all defined in terms of one another. However, I believe that this is fundamentally due to the fact that our sense of our mind and the minds of others is a biological capacity that is innate and intuitive, but requires a nurturing environment in order to develop to its full capacity. At least, that is according to the mentalizing theory of Peter Fonagy and his colleagues, which is a model that I find quite persuasive, given the amount of experimental evidence it integrates. Perhaps you can argue that the soul is equally innate and intuitive, but the concept of “mind” allows us to better predict and interact with other people, and helps us understand their behaviour, particularly when we assume the intentional stance. That is my argument for the necessity of the mind, even if difficult to define in a non-circular way. I am not sure what argument you can provide for the soul. After all, the soul does to help us interact with people, especially since we can easily get along without such a concept, as evidenced by atheists, Buddhists, and so on. It is neither necessary nor sufficient for ethical behaviour. Fourth, I`m not even going into the necessity of a non-temporal God. All I can say is that perhaps there can be some support for the deist conception of a prime mover who initiated the Big Bang, and then got out of the way, but I find this unpersuasive. However, the theist conception is a non-starter, at least for me. Welcome back. :) Sorry for the double posting. My browser went belly up temporarily. Posted by: Sherry at April 25, 2009 07:53 PMI can tell you one thing, that God isn't arrogant. Posted by: Stephany at April 25, 2009 09:56 PM"Proof, please? Any evidence whatsoever for what you stated?" I provided ample proof: you are just so blind to your soul that you refuse to open your eyes and see this hopeful spirit in others. Do you tell your patients that you are a confirmed atheist and can't treat their soul, because their soul does not exist? This is the model of compassion you function under as a certified almost MD? This is one of the core reasons that the psychiatry you practice fails time and time again. You play God, instead of recognizing you are at the mercy of God. Good luck in your treatment modality. Heck, J. Beiderman Better move over, because a New God has come to town in the name of psychiatry. Posted by: Messenger at April 25, 2009 10:08 PMStephany wrote: LOL. No, you're wrong, there: by his own testimony, we know that Joe Bladdleblurb answers only to God, at Harvard! Matt Posted by: Matthew Holford at April 26, 2009 03:34 AMhttp://www.etymonline.com/index.php Psyche: 1647, "animating spirit," from L. psyche, from Gk. psykhe "the soul, mind, spirit, breath, life, the invisible animating principle or entity which occupies and directs the physical body" (personified as Psykhe, the lover of Eros) Psychiatry: 1846, from Fr. psychiatrie, from M.L. psychiatria, literally "a healing of the soul," from Gk. psykhe- "mind" (see psyche) + iatreia "healing, care."
Matt: Well, I’m not sure what you mean by “other-worldly intelligence”. Do you mean an exceptionally high IQ? How do you identify “this-worldly” versus “other-worldly” intelligence? So, I can’t really answer your questions until I have a few more facts, please. Messenger: First, assertion is not proof. People seem to think that if they just go on and on about God that they have therefore made an argument for His existence. Fortunately, that is not the case. Second, why does one require a soul to have compassion? Do not animals shelter their young? Do animals have souls? I thought having a soul was what differentiated us from animals? Posted by: dguller at April 26, 2009 05:04 AMStephany: Well, according to the Islamic tradition, God IS arrogant. It is one of His 99 Names (Al-Mutakabbir). The rationale is that to be proud or arrogant means to believe that you are better than everyone else, which certainly holds true for God. Posted by: dguller at April 26, 2009 05:07 AMSherry: First, feel free to quote where on this thread I initiated a vicious attack upon other commenters here. Please. It is very easy to make a claim, harder to back it up. The closest thing that you will find is after truthman30 launched a tirade against psychiatry, I asked him to resolve the contradiction between his view that ECT is a barbaric and disgusting practice that only sociopaths would support, and his statement that Dr. Healy is a “hero” of his, but who also supports ECT, and thus should be in the sociopath category, not the “hero” one. Is that what you consider an attack? Questioning the consistency of someone’s position? I did not call him an idiot or a fool. I did not question his integrity or honour as a human being. I just asked him a question. If you are saying that anything I say, given the fact that I am a training psychiatrist and that most people here have been harmed by psychiatry, will be experienced as bullying and harmful, then I would say that that is unfair. That would be like saying that if someone was directly harmed on 9/11, then no Arabs or Muslims would be allowed to post, because the experience would be too difficult. Certainly, not fair. Second, I only brought up proof when truthman30 started talking about the spirit and soul and other dimensions of human experience. I wanted clarification about what he meant by those terms and how he justifies using them. Rather than provide me with that clarification, as usual, he attacked my character, integrity and humanity. Oh wait. But I’m the bully, right? I am always asked for proof for my positions, and I try to justify them the best that I can. I’m not asking for mathematical proof, but only some arguments and some factual support. Is that really unreasonable, or are you endorsing a forum where people can post whatever they want and not be responsible to back their positions up? Third, I’m not the arbitrator and hold no authority here. I’m just asking questions. If you find my questions threatening, then that is your problem, not mine. If you want to go to a psychiatrist-free zone where you are free to bash me and my colleagues to your heart’s content, declaring us inhuman monsters who should be arrested and murdered, then go somewhere else, because anyone is free to post here. I have as much right to challenge some of your views as you have a right to declare them. I just want to discuss the issues, because I think that I have a lot to learn from your experiences, but that does not mean that I will surrender my reason and become a mindless follower of everything that you say. That does not make me a bully or a monster. Truthman30: First, it seems that now you are saying that just because someone endorses ECT, supports the use of psychotropic medications, albeit in a more restricted fashion with full disclosure of the risks involved, then they are not automatically a monster, and can even be a “hero” as long as they have a “conscience”. I am very happy to hear that, because I also support the use of ECT, support the use of medications (in limited situations), and also have a conscience. I suppose that I’m not such a monster after all, eh? Maybe even a hero? After all, I did ruffle a few feathers in my program when I gave a talk about how 50-80% of antidepressant efficacy was essentially placebo. Hmmm. ;) Anyway, I would actually agree with your current position, because I have long been trying to say that just because some psychiatrists have engaged in some behaviour that is dubious and has likely harmed people, it does not follow that their entire body of work must be discarded and rejected. I think that you are saying something similar, because Dr. Healy endorses practices that you consider barbaric and monstrous, and yet he has done other work that does not have to be rejected on the basis of some alleged discretions. We have to be careful not to throw the baby out with the bathwater. According to your earlier view, supporting medications and ECT would automatically disqualify all of one’s positions. I am happy to hear that that is not the case. :) Second, I appreciate your comments on Ms. Rowe’s work, because they have been helpful for me to better understand some of her positions. I still would like some clarification about HOW she differentiates unhappiness from depression, what her criteria are, what she bases them upon, how their validity has been demonstrated, and so on. Just to clarify, the reason why I am pushing you on this issue is that people here criticize psychiatry for attempting to neatly divide mental life into healthy and diseased, for example. And yet Ms. Rowe appears to do the same thing. So, I wonder why she is exempt from that criticism? Either a critique is valid for everyone, including those we like, or it is not a genuine critique at all. That being said, given what you wrote, I would actually agree that she has captured what many depressed individuals have gone through. As flawedplan wrote above, it sounds very similar to Jeffrey Young’s schema therapy, which I actually support the use of. You might find his book on the subject interesting as it attempts to incorporate cognitive, emotional and behavioural components into changing our core schemas, of which he has a pretty exhaustive list. So, I don’t think that we will have much disagreement about Ms. Rowe. Again, my disagreement with you is with your position that when psychiatrists attempt to differentiate unhappiness from depression, we are attempting the impossible, because human experience is too complicated to be nicely divided up, and yet when Ms. Rowe does so, it all makes perfect sense. There appears to be some bias here, but I may be wrong, and would appreciate your clarification. Third, I am sorry if you were offended by “anti-psychiatry Tourette’s” comment. I thought that with all the insults and slanders that you have hurled at me that I could sneak a small jab at you. I have been asking you to keep the insults out of our discussion so that we could focus on the issues, but you continue to feel the need to compulsively throw in ridicule and slurs against me. It is the tic-like nature to your insults that I wanted to highlight, as if you just cannot stop using them despite your best efforts. I’ll tell you what. I will take back that ONE offensive remark if you will take back your offensive remarks equating me with an inhuman sociopath whose only desire is to control and manipulate my patients for the sake of my drug company overlords. Fair enough? Fourth, I never bring up the soul to my patients. If they bring it up, then I will use it, just like if they believe in God, I will use it for their benefit. My personal beliefs are of no consequence with my patients, and a belief in God and the soul can be quite beneficial for well-being, and so I encourage them to nurture those beliefs and to draw upon them for strength. I just happen to disbelieve in both. Fifth, you are correct that you never explicitly mentioned the soul, but only talked about spiritual and ethereal aspects of human beings and the existence of other dimensions of experience. Perhaps if you clarified what these other dimensions are and how they are not just different psychological states of mind that are perfectly accountable by human biology? I mean, just because we have a transcendent experience does not imply that we have actually touched the transcendent, no more than someone with temporal lobe epilepsy having a religious experience means that they have contacted God. I also am amazed by the wonders of human life. I am amazed by our evolutionary history, and the complexity and intricacy of the human brain. I am amazed by our resilience and resourcefulness. I am amazed by our capacity for love and altruism. I am amazed by our capacity to create artistic wonders and to reach new heights. I am fully amazed without the need to postulate for a spiritual, ethereal, other-dimensional “something”. So, do not assume that my disbelief in the soul or spirit or whatever means that I lack wonder, because that is certainly not the case. http://www.antipsychiatry.org/25reason.htm 25 Good Reasons Why Psychiatry Must Be Abolished by Don Weitz 3. Because psychiatrists patronize and disempower people, especially their patients. 4. Because psychiatry is not a medical science. 5. Because psychiatry is quackery, a pseudo-science which lacks independent diagnostic tests, testable hypotheses, and cures for "schizophrenia" and all other types of alleged "mental illness" or "mental disorder". 6. Because psychiatrists can not accurately and reliably predict dangerousness, violence, or any other type of human behaviour, yet make such claims as "expert witnesses", and with the media promote the "dangerous mental patient" myth/stereotype. 7. Because psychiatrists have caused a worldwide epidemic of brain damage by promoting and prescribing brain-disabling treatments such as the neuroleptics, antidepressants, electroconvulsive brainwashing (electroshock), and psychosurgery (lobotomy). 8. Because psychiatrists manufacture hundreds of "mental disorders" classified in its bible called "Diagnostic and Statistical Manual of Mental Disorders" (a modern witch-hunting manual); such "mental disorders" and "symptoms" are in fact negative, class-and-culturally-biased moral judgments for dissident ways of coping with personal problems and alternative ways of perceiving, interpreting or being in the world. 9. Because psychiatrists, blinded by their medical model bias, fraudulently pathologize and label people's serious life or existential crises as "symptoms" of "mental illness" or "mental disorder" such as "schizophrenia","bipolar affective disorder", and "personality disorder". 10. Because psychiatrists compound this fraud by falsely claiming, without scientific proof, that these "mental disorders" are caused by a "biochemical imbalance" in the brain, genetic factors or "genetic predispositions", despite the fact that there are no genetic factors in "mental illness". 11. Because psychiatrists frequently misinform their patients, families and the public by claiming that brain-disabling procedures such as the neurotoxins (e.g.,"antipsychotic medication" and "antidepressasnts"), electroconvulsive brainwashing (electroconvulsive therapy/"ECT"), psychosurgery (lobotomy) and other behaviour modification-mind control procedures are "safe, effective and lifesaving". The exact opposite is tragically true. 12. Because psychiatrists routinely deceive or lie to patients, prisoners, their families, and the public. 13. Because psychiatrists routinely and willfully violate the medical-ethical principle of "informed consent" by misinforming or not informing their patients about the numerous toxic, disabling and frequently permanent effects of the neuroleptics such as memory loss, tardive dyskinesia, tardive psychosis, parkinsonism, dementia (all signs of brain damage), and death. 14. Because psychiatrists routinely threaten, intimidate or coerce many patients - particularly women, children, the elderly, and prisoners - into consenting to health-threatening/brain-damaging "treatment" such as the antidepressants, neuroleptics, electroconvulsive brainwashing, and hi-risk experiments. 15. Because psychiatrists frequently fail to fully inform psychiatric inmates and prisoners about existing safe and humane, non-medical alternatives in the community such as survivor-controlled crisis centres, drop-ins, self-help or advocacy groups, diet, massage, wholistic medicine, affordable supportive housing, and jobs. 16. Because psychiatrists are sexist in frequently stereotyping women in crisis as "hysterical" or "over-emotional", blaming women whenever they voice real complaints and assertively express their feelings and emotions, prescribing massive doses of tranquilizers and antidrepressants to disproportionately large numbers of women, and in sexually assaulting women in their offices and institutions. 17. Because psychiatrists, particularly white male psychiatrists, are homophobic - the American Psychiatric Association (APA) once labelled homosexuality as a "mental illness" or "mental disorder" - and have used forced electroshock on lesbians, trying to coerce them into adopting a heterosexual life style. 18. Because psychiatrists are ageist in prescribing tranquilizers, antidepressants ("medication") and electroconvulsive brainwashing for disproportionately large numbers of elderly people - a form of elder abuse. 19. Because psychiatrists are racist in disproportionately incarcerating and drugging people of African descent, aboringal people, other people of colour and labelling them "psychotic" or "schizophrenic". 20. Because psychiatrists routinely violate people's civil rights, human rights and constitutional rights such as imprisoning innocent people without court trial or public hearing ("involuntary commitment"), and subjecting them to cruel and unusual punishments or tortures such as forced drugging, electroconvulsive brainwashing, psychosurgery, solitary confinement, "chemical restraints", and 4-point or 5-point restraints. 21. Because psychiatrists masterminded the mass murder of hundreds of thousands of vulnerable people including disabled children, the elderly and psychiatric patients during The Holocaust in Nazi Germany, and "selected" hundreds of thousands of concentration camp prisoners for death ("T-4 euthanasia" program) - historical facts still missing in psychiatric textbooks and histories. 22. Because psychiatrists have willingly participated in and administered mind-control experiments in the United States and Canada since the early 1950s - its chief targets have been poor patients, women, dissidents and prisoners. 23. Because psychiatry, particularly institutional-biological psychiatry, is based on the 3 Fs: Fear, Fraud,and Force. 24. Because psychiatry is a form of social control or punishment - not treatment. 25. Because psychiatry, particularly institutional-biological psychiatry, is fascist - a direct threat to democracy, human rights and life. A note from the author:This statement is a slightly revised version of the original written in Spring 1998. Feel free to add and publish your own reasons. I am a psychiatric survivor and antipsychiatry activist who has been involved in the psychiatric survivor liberation movment for 24 years. I am also co-editor of "Shrink Resistant: The Struggle Against Psychiatry in Canada" (1988), host-producer of the antipsychiatry program "Shrinkrap" on CKLN radio (88.1 FM) in Toronto, member of People Against Coercive Treatment (P.A.C.T.), and member of the Ontario Coalition Against Poverty (OCAP).] PLEASE SNOWBALL, COPY AND PUBLISH THIS STATEMENT INCLUDING THE NOTE. NO COPYRIGHT OR PERMISSION REQUIRED. The author, Don Weitz can be reached at his e-mail address: dweitz@interlog.com No Guller, you are the arrogant one, and now I am finished once again with a thread of discussion because of your dominating control issues. Why is it, that people cannot make a comment NOT DIRECTED AT YOU and receive your unwanted response. I directed nothing at you in my comments and frankly you are the reason I stopped commenting and even reading recently. Maybe Philip won't post this, but since he posted Sherry's and other people's I hope this one gets posted just so you know, you cause pain to people here and I think that's sad coming from the very profession that has harmed all of us, you appear cold, and callous. :) have a nice day :) truthman, "23. Because psychiatry, particularly institutional-biological psychiatry, is based on the 3 Fs: Fear, Fraud,and Force." When I read that piece (somewhere, can't remember) I thought those 3 F's are exactly true. Especially inpatient in psych wards, they break people down with fear, based treatment on fraud and force injections to control the patient. I wish I never saw it happen to my child and others, thanks for posting that article. Posted by: Stephany at April 26, 2009 11:19 AM"Third, I am sorry if you were offended by “anti-psychiatry Tourette’s” comment. I thought that with all the insults and slanders that you have hurled at me that I could sneak a small jab at you"
You didn't offend me , you offended those who have been diagnosed with "Tourette's" ... http://www.tourettes-disorder.com/dsm.html I still think you have a a very narrow view of your fellow man and the world that he inhabits and experiences.. The fact that you had no knowledge of Dorothy Rowe astounded me.. I would be interested in your views on the "25 good Reasons that Psychiatry should be abolished" list that I posted previously.. It is interesting to note that Don Weitz is a psychiatrist who was so horrified at the crimes of psychiatry that he decided to speak out.... We need more ethical, brave and courageous psychiatrists like this.. Posted by: truthman30 at April 26, 2009 11:36 AM"Fourth, I never bring up the soul to my patients. If they bring it up, then I will use it, just like if they believe in God, I will use it for their benefit. My personal beliefs are of no consequence with my patients, and a belief in God and the soul can be quite beneficial for well-being, and so I encourage them to nurture those beliefs and to draw upon them for strength. I just happen to disbelieve in both." Do we have the flaming mighty Juxtaposition of principles going on here in this thread? This statement sounds much like a lack of conviction, belief, maybe even some doubt on your part. You actually give those "Chemically Imbalanced" patients so very little credit in their judgment and perceptions; that you can stand there and lie to their face and believe they won't catch on! Is this how you justify telling them this medication or other intrusive treatments will make them feel better or even well? I would like to see exactly how you as a vehement non-believer can encourage "a belief in God and the soul can be quite beneficial for well-being, and so I encourage them to nurture those beliefs and to draw upon them for strength" when you believe this is a lie and paramount to psychosis. Would you not then also have to encourage other delusions that fall outside your realm of pseudo science beliefs "as quite beneficial for well-being". Where exactly do you draw the line between these lies, encouraging a so called false belief system, and real science? I can hardly wait to read your diagnostic response to this seemingly non-scientific approach you appear to be touting here. Do you have some solid evidence about the positive effects faith has in your treatment modality your hiding from us? Or is telling untruth part of the treatment/recovery process in psychiatry now a days? Sounds a little mentally ill or chemically imbalanced in your way of thinking quite honestly! Maybe you are the one that needs the intervention? Posted by: Messenger at April 26, 2009 12:13 PMdguller wrote: Hmmm. Tough one. This is, after all, a hypothetical scenario that I've just dreamt up, for you. This patient of yours believes that they have superhuman intelligence - intelligence that goes beyond that possessed by other mortals. It's a gift from God, and because of this, (s)he answers only to God, because God is the only being more intelligent that (s)he, and is thus the only one with authority over him/her. Now, how to define this superhuman intelligence... Are you asking me what intelligence is? Because the only way that we can know that one person is more intelligent than another is if we have a benchmark, or some kind of measurement, it seems to me. Shall we say that this person has such a benchmark, which (s)he believes is valid, and it is the approval of certain human beings, even though (s)he doesn't answer to other human beings? For some reason this patient of yours craves approval, and when (s)he receives validation from others (but only certain, specific others, whom we've yet to identify the qualities of), this is enough to tell him/her that (s)he's intelligent, or otherwise excellent. Hmmm. I'm not really sure that that's captured the gyst of how I was wanting to characterize this hypothetical patient - it makes them look like a megalomaniac (as I understand that term), when they've really only limited the sources of validation that they regard as, well, valid. Still... Incidentally, viz your response to Stephany, I'm no expert on Islam, but isn't "arrogance" a human concept... Why would a supreme being evidence that sort of behaviour, or have the people who have made those claims of Allah (as is the case, I understand), merely projected themselves upon Him? Mind you, if Allah (or the Christian God), is arrogant, then I perceive that there are plenty of people who have modelled themselves upon Him, as precisely as they are able! Matt Posted by: Matthew Holford at April 26, 2009 12:37 PMMessenger: There is no contradiction between principles here. My personal beliefs are mine alone, and are not necessarily appropriate for everyone, because many people find tremendous satisfaction from their religious beliefs. When I am treating a patient, it is inappropriate for me to attempt to convert them to my personal belief system, just as it would be inappropriate for a Catholic physician to attempt to covert their patients to Catholicism. That is not my job. My job is to help my patients find a coherent narrative for their emotional difficulties, at least in the context of a depression, and if that narrative involves religious beliefs, then so be it. I am not lying to them when I encourage them to cling to their religious faith, if they find sustenance from it. I am not telling them that I believe, but only that they could benefit from their already-present beliefs. I am also not telling them that their beliefs are true, which I agree would consist in lying on my part. I fail to see the contradiction or falsehood here. I am not an apostle of atheism in my office, and I doubt that I should be. I do not believe that religious belief is akin to psychosis, unless they involve hallucinations, delusions, disorganized speech and/or behaviour. Since most religious belief does not involve any of those features, there is no reason to label it psychosis. Remember that part of the definition of “delusion”, for example, is beliefs that are inappropriate given a cultural context. In our Western culture, it is perfectly appropriate to believe in God and religion, and thus it cannot be labelled a delusion, despite what Richard Dawkins claims! :) You can do a quick Pubmed search on the literature on the psychological and physical benefits of religious faith, if you like. There are many articles out there that you’ll probably find very interesting. Now, that doesn’t prove that religion is true, only that it is beneficial to well-being in many cases. Again, no contradiction, as far as I can tell. Please help me to understand why it should be my role as a treating psychiatrist to enforce my personal beliefs upon my patients? Is that REALLY what you want me to do? Stephany: Sorry about that! I'll refrain from commenting on your remarks unless they are directed to me. :) Posted by: dguller at April 26, 2009 02:10 PMdguller: May I recommend a few books you should read (you will really need to go beyond the foot notes to grasp the depth of arguments in this case) that are make much more grounded, philosophical, and intellectual arguments against God; and certainly they are better and stronger arguments than you have presented here in truth. author CS Lewis: "The Problem of Pain" This will make your arguments stronger, and give you even more of a firm foundation to stay a confirmed non-believer Posted by: Messenger at April 26, 2009 02:40 PMPeace be with you Father forgive me. I can't help myself from jumping in here. Doc Guller said, "Second, what ethereal and spiritual aspects are you talking about? If you are bringing the soul into this discussion, then you will quickly be mired in paradoxes and contradictions, because you are stuck with describing what the soul does, how you know that it does it, and how something immaterial and interact with the material world. Problems galore!" He refined his question down to, Don't just tell me that X is absolutely essential for us to be human, and then be unable to tell me what X is, what X does, and how you know about X. Let's solve for X. X is the soul. The soul tells everything physical and mental about you to be you. When you completely quiet the brain, when it has absolutely no thoughts, then you will not just believe in the soul, but you will know it. A lot of those who you claimed philosophized as to the soul, weren't just philosophizing. You, or anyone who hasn't met their soul, can't see the difference between theory and knowing. The soul is a much greater thing than you can even imagine in your 3 dimensional, logic driven, physical world. It is a life force, an energy field if you prefer, that runs through everything, and connects us all. The only way to know it is to quiet your brain. That is very difficult to do. Drugs can help open up your third eye if you will, but they can also be damaging to your soul at the same time. Meditation is the preferred method of getting in touch with your soul, but big egos are very hard to quiet. I guess what I am trying to say is like those pictures you stare at to see the hidden picture within, some people just can't ever see it. The soul is a fact, millions of people know this, and you just can't see past your ego to see the evident truth. As far as all those emotions go, they are all subsets on the only two emotions humans have - Love and fear. Your either acting out of Love, or your reacting out of fear. Even depression. I again I apologize for my pearl casting. love eternal I think Dr Guller is wrapped up in his ego and psychiatric belief system that he seems to forget that many who come to read furious seasons have been damaged and harmed from the very ideology of psychiatry that he hold so dear... Typical psychiatrist .. Fails to see the reality .. Posted by: truthman30 at April 26, 2009 03:53 PMdguller wrote: Sorry for butting in, again, but this is something of a bone of contention with me (and others, seemingly). I think it's fairly non-contentious to agree that it's not appropriate to seek to have others comply with one's own belief system, because the chances of it being a perfect fit for them are infinitessimally small - too all intents and purposes non-existent, in fact. However, when you have a patient in front of you, you are asking a whole bunch of very detailed questions about *their* belief system, I imagine. And, by what you've written, you offer nothing of your take on life, in return. Now, most people, when they're being grilled for information, are acutely aware that they may be being asked in the hope that they get something "wrong," whereupon they will be ridiculed, or punished. Experience tells them this - triggers - there's nothing real about it, of course, except when they meet somebody who does follow that pattern. Nope, if you'll take my advice, you'll offer something of yourself, but just be sure to allow the option of the patient rejecting it - remaining silent, when one disagrees, is a form of communication that makes a lot of people nervous. I used to be one of those people, until it occurred to me why it might be that people went silent, in that way. Matt Posted by: Matthew Holford at April 26, 2009 04:00 PMSo, why does Paul (me) keep referencing astrophysics? What could it possibly have to do with Psychiatry you might imagine.... Well, nothing actually. aside the fact that both institutions are governed with the Iron Fist of the Orc - paid in full by the power of the purse. You see each is beholden to those that fund its ability to operate. Each has KOLs with honor and prestige tied to FRAUD. Astrophysic invents Dark Matter because it's cosmological theotries cannot stand without it. Conveniently, Dark matter cannot be measure just implied - sound familiar? This is no different thatn the chemical imbalance fallacy that still seems to stick around. Proper science requires falsifiability. This is why, IMO, Psychiatry is not a scientific discipline but rather a political one. I hold astrophysics just ever so slightly higher. In a sense, until you grapple with the necessity for a Prime Mover, then everything else is quite moot. Psychiatry cannot help you. The concept of a Prime Mover is orthogonal to their understanding of the nature of existence. What to do. It's called life - it's not pathology. Posted by: Paul at April 26, 2009 04:19 PMMessenger: Thank you for recommending those works by C.S. Lewis. I will certainly look into them when I have the time. Just so you know, I absolutely loved his "Screwtape Letters"! :) Posted by: dguller at April 26, 2009 05:28 PMI believe I mentioned nothing about conversion in my questions? I may wish to mention “Full Disclosure” though. You make an argument that in theory might appear rational and nice, but in real life doesn’t quite hold water in actuality or practice. I also noticed you did not answer the patients’ perceptions question. {But that’s your MO isn’t it; you only answer what you want to answer} I guess they”the Patients” are just broken vessels of chemical imbalance that don’t have the capacity to read into your “bullshit” lies, Right? I really feel sorry for those patients in very true sense, because you couldn’t be more completely and absolutely wrong. You tend to make lots of smoke and mirror statements; but the facts are that your pseudo science has less proof or validly than almost any chosen God based faith. Yet I can’t help but feel that just maybe your trying to touch as few hot buttons among the commenter’s with that catholic reference. I believe that is called baiting. You talk about faith and a soul as positive influences and have even made statements to their therapeutic value. Yet, you say a professional has no business entering this realm even in just honest disclosure. This seems to be contrary statement, and works against that treat the “whole person” therapeutic model. This appears puzzling and counter intuitive really. For you have stated that you believe there is no soul or God in the context of this recognized normal social construct, yet you hold to a belief that would be considered outside the norm, and say that is not a stumbling block in encouraging a patient to follow a personal faith based belief system. Maybe you just don’t see how that on the surface would appear somewhat a lame and weak argument. So then your true argument is that it’s “Faith, God, Soul” are actually real and positive since you accept it as a therapeutic tool of observed wellness results, but it does not hold credence in your personal beliefs. Those seem in direct opposition to good and positive therapeutic balance to many, including some of your colleagues.
If you don't believe in a higher power, yet you say faith has healing and therapeutic value there is an obvious disconnect and counter indication. You deny that that there is a God, yet say you encourage God and faith for its concrete and documented healing powers that you cannot begin to explain in science or diagnostic terms. Do I hear the scampering patter of the placebo effect argument coming to a thread near you soon? 1. I expressed a strong verbal and behavioral affirmation of God. In fact I expressed that God actually spoke to me. God had directed my life in a behavioral path and actions of undetermined origin to this point. Yet it has been revealed to me through auditory and visual Angels appearing directly before me. They have told me that they will direct each step of my journey and you were a non-believer and devil. Psychosis or Faith? 2. I express that God was living within me, {literally}. I felt God's presents and his direct hand touching my life. My pain has been washed away, and now I wish to go out into the world and lead my own life without medical interference. “A Miracle from God has healed me from this state of ignorance”. Psychosis or Faith? 3. I express faith in God, and display a behavior where the patient verbally speaks out in what you might refer to as complete gibberish; though this patient believes it is a manifestation of God speaking through them in a spiritual language. Psychosis or Faith? 4. Patient express vehemently that they are second in line to God, and have the powers and knowledge that surpass other mere mortals: stating further that they are a professor and respected Doctor at a major university Hospital. This patient refuses medications on the grounds that you are trying to lesson his capabilities, status, and credibility. Psychosis or faith? 5. Patient expresses they are God, and are here to heal a suffering world; they have heard the voice that has directed them to spread a message of hope and love throughout this land. Psychosis or faith? 6. Patient expresses they have actually seen God revealed before their very eyes in the very room your standing. They ask you to see God with them. Psychosis or faith? As a non-believer who is in your terms ill, and who is sane? Paul: I see. So dark matter and energy is the equivalent in astrophysics of the chemical imbalance theory in psychiatry. They are both hypotheses that have no firm empirical confirmation, and yet continue to persist even in the face of contradictory evidence, thus appearing unfalsifiable, and therefore unscientific. Fair enough. Again, I cannot speak to astrophysics, and so will have to leave it to experts in that domain to defend dark matter and energy. With regards to psychiatry, I agree that the chemical imbalance theory is grossly simplistic, and I really do not know anyone who holds it in its caricatured form. Most researchers are looking into the role of multiple neurotransmitter systems (including serotonin, norepinephrine, dopamine, acetylcholine, glutamate, GABA), hormones, growth factors, and their roles in different neurobiological pathways. This research involves studying animal models, human imaging, and neurological lesion studies. Given the massive complexity of the brain, it is unlikely that we will ever find a single unified cause of depression or schizophrenia, for example, especially since both are likely heterogeneous illnesses, similar to dropsy in the 19th century. I don’t know of any researchers who claim that our current neuroscientific knowledge is advanced in any way, and most will admit that it is still quite primitive. However, I think it is a safe bet that a better understanding of the brain will lead to a better understanding of the mind, and so the research continues. I suppose one way to falsify this theory is to discover a mental state that is not associated with any brain state. That discover would certainly be worthy of a Nobel Prize! :) But your points are certainly valid that psychiatrists and researchers have been quick to point to clear answers to questions of mental health based upon neuroscience that are not supported by the facts. Perhaps that inappropriate use of tentative scientific conclusions is what is especially unscientific about those questionable individuals who promote inaccurate theories of mental illness. However, I disagree that research into the brain in order to understand our mental life is somehow inherently unscientific. It is still in its infancy, and more research, not less, is the answer, I think. Even in relation to treatment, I disagree with you that psychiatry is unfalsifiable. I mean, various treatments that were very popular were found to be completely ineffective following controlled trials. Look at Gabapentin and Topomax, for example. They were VERY popular several years ago, and their efficacy was falsified. So, I’m not too sure exactly what aspects of psychiatry are unfalsifiable, except for some standard Freudian ideas about repression. ;) Regarding your comments about the Prime Mover, I do not see how postulating an eternal Prime Mover to cause the Big Bang helps eliminate the feared infinite regress. If the Prime Mover can stretch back into infinity, then why can’t the singularity that “banged”? And even if the Prime Mover could be demonstrated to be necessary, then it does not follow that it did anything afterwards or has any of the properties that we associate with God. I also think that David Hume was dead right that when we are talking about the cause of the universe, all we can rely upon are analogies based upon human experience, which is, say, limited when it comes to creation. So, plenty of problems with that account that make it unpersuasive for me. I hope that you and your medical patients are well. :) Posted by: dguller at April 26, 2009 07:05 PMdguller: "I wanted clarification about what he meant by those terms and how he justifies using them." Did you miss this? http://www.etymonline.com/index.php Psyche: 1647, "animating spirit," from L. psyche, from Gk. psykhe "the soul, mind, spirit, breath, life, the invisible animating principle or entity which occupies and directs the physical body" (personified as Psykhe, the lover of Eros) You are by definition a soul doctor. Reconcile this for me? Thanks! Posted by: flawedplan at April 26, 2009 08:47 PMSorry, I missed this dguller. I also am amazed by the wonders of human life. I am amazed by our evolutionary history, and the complexity and intricacy of the human brain. I am amazed by our resilience and resourcefulness. I am amazed by our capacity for love and altruism. I am amazed by our capacity to create artistic wonders and to reach new heights. I am fully amazed without the need to postulate for a spiritual, ethereal, other-dimensional “something”. So, do not assume that my disbelief in the soul or spirit or whatever means that I lack wonder, because that is certainly not the case. That works for me. Still, there's no denying that academic psychiatry has repudiated the "soul doctor" identity in favor of the medical model. There is no better evidence that psychiatry has lost its way than the fact it rejects its own definitional properties. Any psychiatrist who hasn't wrestled with and does not talk openly about this conflict is a mental midget, and not worth taking seriously. Which is to say I appreciate your consideration of the deep shit. Posted by: flawedplan at April 26, 2009 09:11 PMMessenger: First, even though I disbelieve in God and the immortal soul, if a patient who is in the throes of a depression tells me that their faith in God and their sense of community with their church has helped prevent them from committing suicide, then I will complement them on their faith and ask them what it means to them. I usually then explore with them what it is about their faith that helps give them strength in order to help bring it out into the open for them. I mean, I was a believer at an earlier time in my life, and so I do understand the appeal and benefits of faith. I ended up rejecting it due to intellectual inconsistency and after finding spiritual sustenance in Buddhism, which denies both God and an immortal soul. So, I can support my patients’ religious faith by drawing upon my earlier experiences, even though I reject their beliefs as false. Second, you make comments about full disclosure. Why do I need to disclose my personal religious beliefs? Again, would you make this demand of a believer? What if their patient is an atheist? Wouldn’t the patient feel slightly intimidated and judged by their physician, knowing that they are a believer whereas they are not? The whole POINT is to create an atmosphere that is non-judgmental and supportive. That means that I keep my judgments to myself and try my hardest to validate and empathize with my patients. If you are arguing that that is impossible unless I share their beliefs, then I would have to disagree with you. Human empathy is non-denominational. Third, there is a difference between a belief being true and its being beneficial. Fourth, I was not trying to bait Catholics. Just picked a random example without any real justification. I can change the example to Lutheran, if you like? Fifth, I actually do not know if the benefits of religious faith are placebo. I haven’t the foggiest notion of the causal mechanisms, although I suspect that conditioning and expectations do play an important role. Sixth, with all the cases that you cited, I would need to know much, much more information than you provided, including demographics, social supports, marital status, the presence of children, the onset, frequency, intensity of those “experiences”, whether there are any mood or anxiety components, whether those experiences cause the patient any significant psychological distress and/or interfere with their ability to function properly at work, at home, and so on. But generally, if someone is functioning perfectly well in their life and finds emotional sustenance from their experiences, I would not categorize them as psychosis. You have to remember that clinically relevant psychosis causes severe impairment in the lives of patients. Now, if any of those patients were married with children, and suddenly began having visions that made them quit their job, abandon their family, and begin living on the street, stop caring and grooming for themselves, and wildly preaching to pedestrians, then I would certainly consider a psychosis being present. There may be a medical reason for their behaviour, or it may be psychiatric. An investigation would be warranted. flawedplan: If the soul is simply a synonym for the mind, then I have no problem with treating the soul, but that word has connotations, including immortality, that have no place in my practice. Now, I like a quote by an Italian philosopher who said: "Yes you have a soul, and it is made of little robots". The little robots are the mindless cells that are organized in such a way that your conscious self (or soul) emerges. Nothing immortal or supernatural going on. Again, in that sense, I have no problem believing in a soul. :) Thanks for your etymological digging. :) Posted by: dguller at April 27, 2009 03:42 AMMatt: I’ll respond to some of your previous posts later today, but I just wanted to respond to your last one briefly. You are correct that I ask many questions to try to get a good sense of what it is like to be the patient, going through their current situation through the prism of their past experiences and other factors. What I try to offer of myself is non-judgmental support, a better way of understanding their thoughts, feelings and behaviours so they are less debilitating, but no impression that I know the Truth. That is why I am wary to bring my personal beliefs into my sessions. Actually, I have never been asked my religious beliefs ever! So, I suppose that is a good thing, but if I was asked, then I might turn the question back to my patients, asking them why it is important for them to know what my faith is, what they imagine my faith to be, and so on, because the sessions are supposed to be about them, focusing upon their needs and values. This is usually because outside of our sessions, they are so focused upon the needs of other people to be able to focus upon themselves. And sometimes silence is important, especially for someone who is distressed by it. But I do appreciate your advice. I certainly would not say that I will NEVER disclose personal information, because I have brought up personal experiences to patients in the past, when I thought that would be helpful. However, my focus is always upon what I think will help the patient move forward. Thanks! Tadt: What you describe as the soul can easily be described as the brain, which “tells everything physical and mental about you to be you”. That is one of my main problems with talk about the soul. Either the soul is described as some kind of animating principle or it is described in a way synonymous with an ordinary mind. The problem with the former is that I do not know what it means. The problem with the latter is why you have to postulate an entity in addition to the mind in order to explain the mind. It just seems unnecessary. Anyway, I suspect that the real motivation behind a soul is its property of immortality. And what do you mean by “completely quiet the brain”? No EEG waves? Do you mean brain death? And when I have no thoughts, then I will “believe” and “know” the soul? Aren’t beliefs thoughts? If I have no thoughts, then won’t I also have no beliefs? Oh, and my ego is not blinding me from seeing the intuitively obvious truth of the soul. There is no need to attack me in defense of your position. Let us just stick to the logic and facts. I could easily explain your beliefs as secondary to certain psychological features of your personality, but that would be a fallacious way of arguing, and so I won't. As Dostoevsky wrote: "Psychology is a two-edged sword!" Posted by: dguller at April 27, 2009 04:08 AMMessenger: Sorry, just one more thing. You wrote: “If you deny there is a Soul, God, Faith; then tell me how you’ll treat this whole person and validate their life experience in a positive light without knowing or accepting that belief as real, fact, or valid?” Here, you have conflated many different things. I do deny that there is a soul and a God. I do not deny that there is faith. Faith obviously exists. I accept their belief is real and is a fact and is valid for them. I just reject that the content of their belief is true. dguller wrote: ...I suppose one way to falsify this theory is to discover a mental state that is not associated with any brain state. That discover would certainly be worthy of a Nobel Prize! :)..." I'm butting in, again, but I have to disagree with you, there (as to the unified theory)... As far as I can tell, the human brain works on the basis of binary logic. Clearly, given the complexity of choices and decisions that face each and every one of us, each day (most made with incomplete/false information), it might not be that straight forward to demonstrate that *everything* a person does is a matter of yes/no, but I find the argument "it's more complicated than that," to be a bit simplistic in and of itself, and, well, a bit lazy, to be honest. This binary logic manifests itself in many forms of argument. Dialectic, for example, which I'm very fond of, as a methodology. Anyway, a Nobel Prize? Who did you have in mind as the receiver of this gong? And a mental state not associated with any brain state? I'm not sure that I understand the distinction (in fact, I don't!). Are they not synonymous? And why would such a discovery be worthy of note, and reward? Matt Posted by: Matthew Holford at April 27, 2009 04:48 AMIncidentally, apropos my last comment, dguller, you may find that if you do ever construct a proveable, unified theory of mental illness, or whatever-you-want-to-call-it, then unless it involves some money heading the way of certain, "powerful" interests, it is likely to be mothballed. Or is that just me being cynical? You may be sure that if your unified theory impacts on any existing, "powerful" interests, it (and you), will almost certainly come in for some virulent attempts at discreditation. That's what I've noticed, anyway. However, putting my cynical head back on, again, if your theory involves the use of lots of pharmaceuticals, you'll probably gets oodles of research grants! Matt Posted by: Matthew Holford at April 27, 2009 05:07 AMGuller, The is issue with Dark Matter is that it cannot be measured but is imputed. So, by proposing a solution that cannot be measured how should one falsify this argument? See the problem? Yet, every Pop Culture Astronomy Magazine splashes countless colourful articles on the mystery of Dark Matter and it's equally mysterious companion Dark Energy. The so-called Chemical Imbalance is measurable if you're dead (not too long though...), however. Without an established baseline who knows what, if any, imbalance should be or what it means. Yet, for many years and presently this is what passes for informed consent and was known to be unprovable. I call this FRAUD. So, there are differences, but FRAUD is the denominator. Neither camp is doing nearly enough to stop its perpetuation or engage in a proper discussion. When the APA buys primetime air and publicly disavows the notion of a chemical imbalance and apologizes to patients and doctors alike for the lies of so many years then I will have reason not to suspect FRAUD. Lastly, if you don't believe in the Soul I doubt you'll be able to cure an illness of the Soul. Thank goodness we still have pills, no? Posted by: Paul at April 27, 2009 05:58 AMdguller, you say "I just want to discuss the issues, because I think that I have a lot to learn from your experiences" This is not at all true. You are not at all interested in discussion as most people know it. You are interested in academic debate, in scoring points no matter what the expense and in winning. You remain silent or become defensive in the face of repeated assertions that you have not listened or heard what people have said. People KNOW when they've been heard, trust me on that. That is your arrogance and bullying behaviour at work. That is why few here believe you when you say "I have a lot to learn." You exhibit no real interest in learning, only in scoring points and in winning. Of course, you'll come back with more of your aggressive questions, demanding I meet some criteria of "proof" acceptable to you. That is your controlling behaviour at work, your arrogant sense that you somehow deserve to hold others to some level of discourse which *you* get to define. Not for you the hard work of maintaining your own blog. Nope, you think you should get to moderate the tone and content of someone else's. No, I do not expect to be in a shrink-free zone. In fact, there are psychiatrists who read this blog and chime in from time to time. I have never taken most of them to task because they have not exhibited the arrogant and bullying behaviour you and a few others have. These quieter folks actually DO seem interested in learning from the experience of others. I still always wonder how it is you have the luxury of such vast amounts of time on your hands to come here and engage in endless hours of nitpicking with people you clearly find your intellectual inferior. Posted by: Sherry at April 27, 2009 06:15 AMMatt: You were asking me about a hypothetical patient who believes that they have superhuman intelligence, and refuse to answer to other people, because they are intellectually inferior, and only answers to God due to His possession of intelligence superior to his own. But then you say that this person does answer to the approval of certain special people, and that if he does attain their approval, then he takes it as proof that his intelligence is, in fact, superior. Now, that is a contradiction, but that does not nullify your example, since people behave in contradictory ways all the time! :) However, I still require additional information. When you say that he refuses to answer to people, does that include his refusal to listen to people who tell them to stop at red lights, to avoid harming the elderly? I guess I need to know how he behaves in the world, given these extraordinary beliefs. Can he interact with people in a meaningful way? Can he work? Can he maintain his hygiene? Does he engage in dangerous behavior that could harm himself or others? Also, how does he account for the fact that there is information that I likely know that he does not know, such as my birth date, the names of my wife and son, and so on? How firmly does he hold these beliefs? Does he consider the possibility that he could be wrong? How long has he held these beliefs? What value does he assign to these beliefs and what meaning do they hold for him? Does he have family members who can provide collateral information about what he was like before and after he started to have these beliefs? Are they concerned about his well-being? Psychiatry is a theory in it's base of treatment and diagnosis it's all about people's theory and opinion due to no biological proof mental illness exists. My theory about psychiatrists is that they have no heart and soul, and this discussion proves my theory correct in the fact that a psychiatrist has admitted to not believing in souls or God, that is exactly the last person I would want to care for my body and mind if I was sick from anything. I appreciate the psychiatrists here who have not taken apart this comment section full of people harmed by psychiatry, and as far as the one who says there is no soul or God---what a sad existence, and alarming that a person would go into a profession where the very soul of human beings that are in spiritual emergencies when they are in psychois or severe state of mind--wow to have a person not believe in anything but pills to help me get through that emotional and profound crisis of my soul....I would get as far away as possible and that goes for anyone in my life not just doctors. It is the crippled and broken spirit in my daughter I see every day who is a result of that kind of psychiatric heartless and soul-ignoring care, and I would like to say that psychiatry has ruined her, stole her away from herself, and left us all standing staring at open space with feeble attempt to fill it and give her some quality back that can never really be replaced. Sherry, Matt, Messenger, Tad, Francesca, FP, Sorrowful and others have been through far too much to receive such crap from a psychiatrist and I applaud the ones sticking in on this thread taking us into the area that is so profound, the spiritual and soul of all of us, it's not so abstract, and it certainly isn't found in a text book, abstract or in a paragraph written by guller. Posted by: Stephany at April 27, 2009 11:07 AMPaul: It certainly would be a breath of fresh air for leaders in psychiatry who previously exalted a debunked theory of mental illness would publicly declare that they were wrong. Sadly, I wouldn’t hold my breath for that to happen. I will say this. I still think that the underlying assumption that inspired the monoamine hypothesis is valid. That assumption is that our mental life is ultimately dependent upon our neurobiology, and that symptoms of mental illness – and health – must have neurobiological correlates. That is certainly not going to be the whole story, no more than understanding cardiac physiology alone will explain all features of cardiac disease, since underlying dietary and other lifestyle factors is also important. However, it would be a mistake to ignore the heart in that context just as it would be a mistake to ignore the brain in the context of psychiatry. There is still much learning to be done about how the brain works, and perhaps with better in vivo functioning imaging of neurotransmitter levels and binding in the brain, better answers will be forthcoming. Only time will tell. The question is whether to abandon the research project of studying the brain according to neurotransmitters, hormones, protein factors, genetics, neural pathways, and so on? I do not think so. The best option, I think, is to be very cautious and tentative about the conclusions that we draw from current research and not jump to conclusions without independent confirmation by other researchers of whatever findings make it into the headlines. I think that we are both in agreement about this particular issue. Regarding your concluding remark, you are correct that I am not in the business of healing people’s souls, especially the immortal kind! Rather, I am in the business of healing people’s minds, personalities and selves. If that is all you mean by “soul”, then I suppose I am in that business. If you mean something else, then I would appreciate what your conception of the soul is. Oh, and pills do serve a useful purpose in some severe cases, but I prefer to try other non-pharmacological interventions first, depending on the case, of course. Matt: First, I honestly do not know whether or not the brain operates according to binary logic at a fundamental level. It certainly sounds plausible, especially given the fact that the law of contradiction holds true everywhere except at the quantum level. Second, I agree that our mental states are essentially brain states operating within the context of being part of the central nervous system of an embodied being interacting with an external environment. Third, I think it would be significant if someone could demonstrate the presence of a mental state independent of an underlying brain state, because that would fly in the face of the central assumptions of neuroscience, which it seems you and I share. That would be worthy of a Nobel Prize, because it would demonstrate the falsity of a centrally held scientific dogma. Fourth, your cynicism has strong doses of realism. ;) Rather, I am in the business of healing people’s minds, personalities and selves. If that is all you mean by “soul”, then I suppose I am in that business. If you mean something else, then I would appreciate what your conception of the soul is. Oh, and pills do serve a useful purpose in some severe cases, but I prefer to try other non-pharmacological interventions first, depending on the case, of course. What kind of healing to you do on their minds? "Spiritual emergencies" ... Couldn't have put it better myself! :) Posted by: truthman30 at April 27, 2009 12:17 PMStephany, truthman30: I would tell you what I do, but honestly, I do not think that you really care. I could tell you that spend most of my sessions with my patients talking to them about their lives, their stresses, their thoughts, their feelings, their past experiences, the importance of being mindful and accepting, the importance of keeping their core values present when making choices, and the need to believe that past ways of being may have worked, but must be let go in order to make way for something new to grow that is better suited to their current life situation and more consistent with their personal values as human beings. I could tell you how I try very hard to build a good alliance by really trying to get a sense of a person and to make them feel validated and understood. Occasionally, I even prescribe medications, when I feel they are necessary. I could tell you that, but all you would hear is me as a satanic murderer who sees people as bags of protoplasm and tools to be manipulated for my sick amusement and financial gain for the sake of my drug company masters. Oh, and that I strangle puppies and poison schoolchildren, too. Posted by: dguller at April 27, 2009 02:01 PMdguller wrote: ...Are they concerned about his well-being?" Oh, dear! You're following a line of enquiry that I'm unable to assist you with, to any great extent. Let's say that the family has its own axe to grind (not least because it may have contributed to your patient's current state, and so, given that they are likely to omit any salient information about their own conduct, it's best to leave their testimony out of the picture, for the time being. Let's just say, then, that they have cut off all communication with your patient, and their inclination to assist you is similarly limited. The upshot is that you have only the patient, the patient's view of reality, you and your version of reality with which to work. Everything else may be flavoured, and unreliable. Anyway, let's re-cap... This patient thinks (s)he's phenomenally intelligent, that much we know. As intelligent as (s)he imagines God to be, although whether (s)he has ever met God, such that (s)he (or we), may test that belief, is unclear! So, how does (s)he come to believe him/herself to be massively intelligent? Well, we think it's through validation from other (lesser), mortals... I'm not sure why (s)he would accept the validation of these lesser mortals, though. I should have thought that one through! OK, how about this: when (s)he does or says something, and these lesser mortals are impressed, (s)he understands that to mean that they are not capable of doing or thinking the thing that (s)he has just said or done. Rather than explain this impressive saying, or deed, in order to de-mystify it, (s)he keeps the thing secret, thus establishing him/herself as the sole keeper of this "great knowledge". In other words, (s)he perceives that the fewer people possess a certain skill, or knowledge, the more valuable (in financial terms, probably), it is, when I would argue that ubiquity demonstrates a thing's value more clearly. (S)he thinks also that it means that (s)he will continue to be validated by these lesser mortals, when anybody could tell him/her that any magic trick gets boring after the second or third demonstration! As to the stuff about interaction, work, hygiene, understanding the basis and meaning of legal rules, and so on... I don't know. Is that pertinent? I know that "traditionally," these are societal norms, tick-boxes, that we expect civilized people to accomplish, but outside that compliance, do they really mean anything? Let's say that your patient perceives that others' conduct towards him/her doesn't really alter whether (s)he makes the effort, or not, and so these norms are things that are complied with as is convenient, rather than being the framework of his/her existence. "Does he consider that (s)he could be wrong?" Ooh, now that's an interesting question. You've got me, again! Let's say that (s)he's aware that there is certain information that (s)he does not have access to, but that (s)he believes that his/her overwhelming intelligence will permit him/her to overcome these minor obstacles, because the missing information is generally only of a superficial nature, and the absence thereof will not prevent him/her achieving what (s)he wants to achieve. Hmmm. That all looks highly unsatisfactory! I think there's only so much that can be achieved, working with a hypothetical model (which is, incidentally, based on several (most?) people that I've met, probably including myself!). Matt Posted by: Matthew Holford at April 27, 2009 02:28 PMStephany: First, just because I disbelieve in God and in an immortal soul does not imply that ALL psychiatrists disbelieve like I do. That’s just basic logic. Second, the fact that I disbelieve in God and the soul does not imply that I am cruel, inhuman or lack compassion and empathy for people. That’s just basic psychology. Third, do you REALLY question all your physicians about their religious beliefs? After all, you do not want anyone treating your mind OR your body who does not believe in God and the soul, right? Fourth, find ONE QUOTE of mine where I say that I ONLY believe in pills to help people go through their crises. JUST ONE. Or admit that you are a LIAR.
Guller, The problem with your point is that Psychiatry is far from cautious. It is hyper-aggressive especially with children. I'm not under any delusion that Psychiatry will abandon its cash cow in the interests of helping people. I invite you to go undercover and stay as an in-patient for some time. Make sure you have your exit legally well covered. Come back and tell us your findings. Repeat, as necessary. Believe me, without you MD or PhD credentials in tow, its a very different place once the visitors leave. For a bit of realism, try refusing medications and food from time to time, be a bit argumentative, try telling the APRN that you won't take scripts from her because she isn't an MD - this is always good for show... No, I don't think Psychiatry is about helping. It's about controlling, imo. Posted by: Paul at April 27, 2009 03:18 PMdguller wrote: I'm still not sure I understand the distinction you make... Are we talking about "conscious" and "unconscious" minds, or something? So, while our conscious learned experience (say), tells us, for example, to be fearful of a given thing (spiders, for the sake of argument), our dissociated, unconscious self is saying "chill out: it's a spider, and not a particularly big one, at that"? Taking that line of argument to one logical end, is it possible that an arachnophobic's learned experience has taken over from his/her logical, unconscious self? Alternatively, is the split between conscious and unconscious a pile of discredited crap?!! Or, is the concept of conscious/unconscious merely a way of explaining a phenomenon such as the one I've put forward, with the phobic? Anyway, overturning scientific dogma might impress the Nobel Committee - I wouldn't know, but I imagine that there are quite a few people who have based their careers on the current state of the art (dogma!), and wouldn't be too happy about an advance of this nature, fundamental as it appears to be, from your comments. It's easy to see why some people have so little faith in the motives of those in charge, when there's money involved! Matt Posted by: Matthew Holford at April 27, 2009 03:19 PMNo Guller , I do not believe you are satanic or a murderer.. I think you are misguided ..
dguller wrote: Hmmmm, you may feel provoked, but assuming that you're confident that you've never advocated drugs as the sole solution, then you're requiring Stephany to admit to something quite unpalatable, which would cast doubt on everything else that she's said, presumably. You can't possibly expect her to do that. While you may not hold drugs to be the sole solution, nevertheless you regard them as an option (and I would add that my quack most certainly regarded them as the sole solution - he had no others for me, anyway). Now, at what point do you decide that writing a prescription is likely to help a given patient? And has the time lag between first appointment>first script dropped, since you first began practising? I may be wrong, but I've noticed that people tend to accelerate towards their favoured solution (in any given environment). A clinician who favoured drugs would, according to my hypothesis, issue more scripts, and sooner, the longer they were in practice. And that's assuming that there were no external influences, such as pharma marketing, to flavour their own, unbiased judgment! Anyway, you may as well know that Stephany is a friend of mine, which isn't to say that you are not, of course! However, that comment looked a bit aggressive, for my tastes. Matt Posted by: Matthew Holford at April 27, 2009 04:45 PMPaul Oh, I stand corrected, I did not mean to write ALL psychiatrists and doctors, just guller. Oh, I am mistaken, I stand corrected, guller does not only believe in pills. Why you feel so enraged to call me a "LIAR" (that's a guller quote and caps are part of it)is beyond me. Feeling a little flustered, Guller? that's a shame. Posted by: Stephany at April 27, 2009 05:31 PMI appreciate the psychiatrists here who have not taken apart this comment section full of people harmed by psychiatry, and as far as the one who says there is no soul or God---what a sad existence, and alarming that a person would go into a profession where the very soul of human beings that are in spiritual emergencies when they are in psychois or severe state of mind.
http://www.transpersonal.com.au/psychosis.htm From the above link for interest here: "Psychosis The difficulty faced by conventional learned Transpersonal in dealing with this psychosis is that, like all fields of Psychology, Transpersonal is ultimately founded on the words of Descartes (considered by many to be a father of Western Psychology) - most commonly remembered from the words "I Think, therefore I Am". Sparkles and small pebbles of truth said in jest? "I could tell you that, but all you would hear is me as a satanic murderer who sees people as bags of protoplasm and tools to be manipulated for my sick amusement and financial gain for the sake of my drug company masters. Oh, and that I strangle puppies and poison schoolchildren, too." "The man that continually denies his soul, someday shall awake to find he has none" - unknown Posted by: Peanut Gallery at April 27, 2009 05:49 PM"Without an escort you are bewildered (even) ~ Rumi (13th century Sufi poet) But, who makes the decision or choice to want that new transformed life? when suffering at the hands of doctors that make decisions that affect the body and mind, then it was not our decision.
The news is not all gloom and doom though; just discouraging for those that are in need with a "Spiritual Emergency" http://www.chafer.edu/journal/back_issues/v10n1/Boyd-psychiatry.pdf Posted by: Messenger at April 27, 2009 06:00 PMI found this abstract worth looking at for interest re: this fascinating thread: http://psychservices.psychiatryonline.org/cgi/content/abstract/58/9/1193 2007 APA The Relationship Between Psychiatry and Religion Among U.S. Physicians OBJECTIVE: This study compared the religious characteristics of psychiatrists with those of other physicians and explored whether nonpsychiatrist physicians who are religious are less willing than their colleagues to refer patients to psychiatrists and psychologists. METHODS: Surveys were mailed to a stratified random sample of 2,000 practicing U.S. physicians, with an oversampling of psychiatrists. Physicians were queried about their religious characteristics. They also read a brief vignette about a patient with ambiguous psychiatric symptoms and were asked whether they would refer the patient to a clergy member or religious counselor, or to a psychiatrist or a psychologist. RESULTS: A total of 1,144 physicians completed the survey, including 100 psychiatrists. Compared with other physicians, psychiatrists were more likely to be Jewish (29% versus 13%) or without a religious affiliation (17% versus 10%), less likely to be Protestant (27% versus 39%) or Catholic (10% versus 22%), less likely to be religious in general, and more likely to consider themselves spiritual but not religious (33% versus 19%). Nonpsychiatrist physicians who were religious were more willing to refer patients to clergy members or religious counselors (multivariate odds ratios from 2.9 to 5.7) and less willing to refer patients to psychiatrists or psychologists (multivariate odds ratios from .4 to .6).
Paul: No argument there. You are correct that there has to be a major revision of how inpatient units are operated, especially since psychiatric inpatients are amongst the most vulnerable patients around, and thus can easily be abused. Posted by: dguller at April 27, 2009 06:04 PMStephany, Spiritual emergency or crisis is a far better understanding of the true nature of "mental illness". I think, though, unless you treat it as such early on, the damage done to brain by psychotropics can be irreversible. Now you have an added chemically induced brain issue in addition to the original problem. I don't know how to turn this about. It's like a supertanker in narrow straits. It's a veritable nightmare. I guess (as I have oft opined) the piles of bodies are not yet high enough nor reek sufficiently for the needed action. Posted by: Paul at April 27, 2009 06:51 PMStephany: Really? It's "beyond" you why I called you a liar? Hmmm. Maybe it's because you LIED about me. And I am not "flustered". Look it up. While you're at it, look up "liar", too, since you seem to misunderstand that word, as well. You are right that I got angry, especially since you wrote a post dripping with self-righteous victimhood, standing atop the moral high ground, piously calling unto the other commenters to rally around your standard against me, and then LIED through your teeth about me. Sorry, but if you're going to get on that high horse and wave that flag, then get your damned facts straight. Posted by: dguller at April 27, 2009 06:52 PMPeanut Gallery: Yes, you got me. I do strangle puppies and poison schoolchildren. My secret's out. Posted by: dguller at April 27, 2009 06:56 PMStephany: Wow. What a great survey you found. One of its interesting findings: Psychiatrists are more likely to be Jewish than non-psychiatric physicians. I suppose that is evidence of the historic tensions between Jews and non-psychiatric medicine. Also, I wonder what it is about Jews and the attraction to become Nazi-like human rights violaters? Hmmm. Now that's a deep thought. Oh, and the survey showed that although psychiatrists tend to be less religious, they are more spiritual, according to that survey. Not exactly a bunch of nihilists, eh? Posted by: dguller at April 27, 2009 07:02 PM"Oh, and the survey showed that although psychiatrists tend to be less religious, they are more spiritual" Um, no. They were "more likely to *consider* themselves spiritual but not religious" (emphasis mine). Big difference, big difference. Posted by: Sherry at April 27, 2009 07:13 PMActually, psychiatrists were not found to be more spiritual. They reported themselves more likely to consider themselves spiritual and not religious - there is a vast difference between the two. I think it's a fair question to ask a psychiatrist of their (lack of) religious affiliation when considering taking one on to treat you - buyer beware. Posted by: Paul at April 27, 2009 07:18 PMPeace be with you Doc Guller It's tad, that extra t was either a typo or some kind Freudian slip. I knew you wouldn't get it. You can't imagine something that you can't measure with some physical device. That's fine as long as your measuring some physical, but it can't work when you try to measure something beyond the physical. To anyone who has witnessed what I will call the burning bush experience for lack of a better term knows it is real and it is not of the mind. Because you can't see the picture hidden in the picture does not make those who can wrong. I will clarify some of your questions, though as I referred earlier I feel I am just casting pearls before swine. And what do you mean by “completely quiet the brain”? No EEG waves? Do you mean brain death?It seems weird that you act so confused in these two questions, but then nail it on the head by your next one. And when I have no thoughts, then I will “believe” and “know” the soul?I said you will know the soul! Do you believe in your father? Don't you know him, and not really believe in him? Aren’t beliefs thoughts? If I have no thoughts, then won’t I also have no beliefs?Yes! At last your beginning to make progress. Beliefs are thoughts, just like the thought that because you can't recognize what others recognize therefore the others must be wrong. That last thought is very egotistical by the way, and I don't mean that as an attack, but as the way you present yourself. If you stop all your thoughts, including all your beliefs, then the soul takes over. You haven't done it so you don't understand it, and therefore can't believe it. But if you could do it then you would KNOW it, and that is different than believing it. It seems that a profession which could believe in Drapetomania and Hysteria wouldn't fine it so hard to believe in a god. There is probably more evidence that a god exists then there is that mental is an illness. Lastly how can a Buddhist believe in reincarnation, but not the immortal soul? What reincarnates the worm food? I hope someone out there fines comfort in these words, because I really doubt that they will help doc Guller. love eternal Guller, I have to say that spew you ranted toward me is one of the worst ones I've encountered at this site ever. Nice job, and very professional of you, just what I expected, thanks. Posted by: Stephany at April 27, 2009 08:34 PMSince we are using the word "LIAR' Dguller I will address you directly; Please tell us that at the Mental Hospital where you are doing your residency. Please tell everyone here that anything less than 100% of the inpatients being treated at this psychiatric facility are not on at least one (if not several) psychotropic medications. Go ahead, this is your chance to grand stand and make us all believers (OK not really, but? laughing) Is there even one inpatient not on psychotropic medication to your knowledge; even if they are pregnant? Posted by: Messenger at April 27, 2009 08:55 PMsadly, this thread is now closed. Posted by: Philip Dawdy at April 27, 2009 09:15 PM |
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