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Psychiatry Wars: a lawsuit that put psychoanalysis on trial

theguardian.com

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Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#61

Post by chris_wot »

throwaway0asd wrote: post #40
knaik94 wrote: post #25

Earlier quoted context omitted.

I would appreciate it if you did say more. I don't understand how you came to the conclusion that psychologists hate medicine. In most cases psychologist and psychiatrist work together to provide treatment to a patient. Why would psychologists see the use of medicine as failure?

Psychiatrists prescribe medications and psychologists perform counseling. The role of prescriptive medication is to modify behavior that either increases focus or stabilizes emotionally heterogeneous states. That medication is often issued in consultation between a psychiatrist and the treating psychologist to enhance receptivity to counseling (or other social contexts) otherwise it may interfere.

There are few psychologists who deride medication just because they can’t prescribe it. In fact, it’s largely the other way around - psychiatrists look down upon psychologists and often decide their work.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#62

Post by renewiltord »

haswell wrote: post #26
renewiltord wrote: post #10

Earlier quoted context omitted.

Quoted post unavailable.

First, I fully support the use of drugs, and I've been on antidepressants. I've also had surgeries, and have had the "good stuff" on a few occasions. Drugs are a necessary part of modern healthcare. > People are pointlessly scared of drugs ... I exercise zero willpower to avoid them People are appropriately scared of drugs. You are very fortunate to have that willpower. I exercise no willpower when I think about the…

But that's the point. I have no willpower. I just don't need it for opiates. And it's quite clear that the effect varies for people. Some people experience addiction and others don't.

I'm glad the present system doesn't have holier than thou doctors sitting around lecturing you while your vision whites out in pain. And you know what? I'm glad that there are medical staff out there intelligent enough to be aware of this for physical pain.

The mental guys haven't quite figured it out yet - mostly because their studies don't replicate so they have very little knowledge.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#63

Post by csours »

I have some thoughts about this, but I'm afraid the nuance won't translate well.

If a person's situation is causing harm or trauma, fix that first.

I understand the brain as a set of modules with soft wiring when you are born. There are tendencies, but no well worn pathways. In people with profound mental health issues, those modules and wires are fundamentally damaged in some way.

For other people, the pathways they build between modules may be damaged by trauma. Some modules may be miscalibrated.

In either case, medication may help a person feel and perform better.

In either case, therapy may help a person to understand themselves and to modify cognitive behaviors. To break loops. To understand sensations and emotions. To connect with other people.

---

An analogy - if you sprain an ankle, you may take medication for the inflammation, and you may also go to a physical therapist to build back muscle and functionality etc.

Don't take the analogy too far - I'm only saying that layered treatment can be much more effective than a single solution.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#64

Post by woojoo666 »

yamrzou wrote: post #2

Fascinating story. Thanks for sharing. > Ray’s mother asked the Lodge to give him antidepressants. But to the Lodge psychiatrists the premise of this form of treatment – to be cured without insight into what had gone wrong – seemed superficial and cheap. Drugs “might bring about some symptomatic relief”, Ross, Ray’s psychiatrist, acknowledged, “but it isn’t going to be anything solid in which he can say, ‘Hey, I’m a…

Drugs can give you the insight to change your perspective though. From my understanding, depression is a deadly spiral of mental state leading to chemical imbalance which further reinforces the mental state, making it impossible to see outside that worldview. Thus drugs can take you out of that cycle and give a glimpse outside, and then even after the drug wears off the change in perspective is persistent.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#65

Post by bsder »

yamrzou wrote: post #2

Fascinating story. Thanks for sharing. > Ray’s mother asked the Lodge to give him antidepressants. But to the Lodge psychiatrists the premise of this form of treatment – to be cured without insight into what had gone wrong – seemed superficial and cheap. Drugs “might bring about some symptomatic relief”, Ross, Ray’s psychiatrist, acknowledged, “but it isn’t going to be anything solid in which he can say, ‘Hey, I’m a…

> “I promise you that no drug that you can take can make any permanent changes to edit your mind”

I don't agree. I know a couple people with mental illness that seems to be due to runaway "feedback loops". Drugs seem to reduce the "gain" on those loops and enable them to actually live life.

Besides, most research I have seen seems to indicate that the people who get appropriate amounts of both medication and therapy seem to have the best outcomes.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#66

Post by skissane »

woojoo666 wrote: post #64
yamrzou wrote: post #2

Fascinating story. Thanks for sharing. > Ray’s mother asked the Lodge to give him antidepressants. But to the Lodge psychiatrists the premise of this form of treatment – to be cured without insight into what had gone wrong – seemed superficial and cheap. Drugs “might bring about some symptomatic relief”, Ross, Ray’s psychiatrist, acknowledged, “but it isn’t going to be anything solid in which he can say, ‘Hey, I’m a…

Drugs can give you the insight to change your perspective though. From my understanding, depression is a deadly spiral of mental state leading to chemical imbalance which further reinforces the mental state, making it impossible to see outside that worldview. Thus drugs can take you out of that cycle and give a glimpse outside, and then even after the drug wears off the change in perspective is persistent.

> From my understanding, depression is a deadly spiral of mental state leading to chemical imbalance

There has never been any good scientific evidence that depression (or any other mental health issue for that matter) involves a “chemical imbalance”. It is, at the very best, a debatable and unproven hypothesis - yet many think it is some proven fact. To pick out just a couple of the numerous sources which confirm this, see https://www.nature.com/articles/s41380-022-01661-0 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1277931/

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#67

Post by DangitBobby »

dleslie wrote: post #34
98codes wrote: post #5

Earlier quoted context omitted.

While what they're saying is true, to me it rings just as misguided as not taking pain medicine when you have a broken leg until it has properly set first. Medication for neurological issues isn't and shouldn't be the end-all-be-all but can indeed be a way to manage the issues at hand while teaching the tools needed to deal with the symptoms via therapy if possible.

Taking pain killers can exacerbate injuries by masking the pain caused by behaviours that cause additional trauma. I've seen a child's broken arm go from a scheduled intervention to an emergency surgery because the xray techs manipulated it poorly. The kid felt nothing thanks to the opioids she was given, and so didn't protest when they made a further mess of it.

What's the takeaway here? We all know physical pain serves a purpose.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#68

Post by DangitBobby »

philosopher1234 wrote: post #39

Psychoanalysis is criminally underrated in the US. It’s detractors broadly don’t understand it. It has the potential to seriously help tons of people, but it is understandably challenged, as it represents a painful reckoning with yourself. Who would want to find out that their personality causes many of their problems? Maybe it requires a bit of masochism to take advantage of.

Every single person I know on any sort of mental health medication also had therapy before and after being prescribed it. Therapy does help, especially when your illness requires you to learn how to cope with your condition (and the fact that things are just harder for you for no good reason).

Two people very close to me are fucked without medication. My wife was anxious to the point of having regular panic attacks, which caused exhaustion and spirals of depression, and her fear of panic attacks was so great that it caused more of them, and made her want to die. With medication, she simply doesn't have them anymore.

My brother is bipolar and has to take lithium (and maybe something else) to stay normal. We've had a couple of emergencies where he's run out of medication or tried to ween off of it (once at the suggestion of his psychiatrist, the fucking idiot), and things deteriorate quickly, going from doing incredibly well to being so paranoid at work he can barely hold it together.

Not really sure how their personalities could cause these problems? Even if they are personality defects in some way, those aspects of their personalities must be suppressed or they simply will not function and would probably ultimately be miserable until they just killed themselves. It isn't necessarily a helpful insight to learn that a disease if part of _you_.

Regardless, I just don't think it makes any sense to ascribe these problems to personality, and the tendency to do so in the past led to many people being denied medication that could actually help them.

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#69

Post by skissane »

98codes wrote: post #5
yamrzou wrote: post #2

Fascinating story. Thanks for sharing. > Ray’s mother asked the Lodge to give him antidepressants. But to the Lodge psychiatrists the premise of this form of treatment – to be cured without insight into what had gone wrong – seemed superficial and cheap. Drugs “might bring about some symptomatic relief”, Ross, Ray’s psychiatrist, acknowledged, “but it isn’t going to be anything solid in which he can say, ‘Hey, I’m a…

While what they're saying is true, to me it rings just as misguided as not taking pain medicine when you have a broken leg until it has properly set first. Medication for neurological issues isn't and shouldn't be the end-all-be-all but can indeed be a way to manage the issues at hand while teaching the tools needed to deal with the symptoms via therapy if possible.

> to me it rings just as misguided as not taking pain medicine when you have a broken leg

This is a bad analogy in so many ways. Most pain medications are short-acting, so one knows pretty quickly whether they work. People prescribed antidepressants are told to wait weeks to see positive results, and a large percentage of them won’t actually see any-and even those who do see positive results, it is often unclear if the improvement is actually due to the medication, or due to something else instead (therapy, lifestyle changes, self-limiting disease course, etc).

If someone out there is taking antidepressants, and they feel it works for them-great. But having tried a range of antidepressants over the years (SSRIs, MAOIs, SNRIs), I’ve reached the conclusion that for me, they are pointless-I’ve never got any benefit from any of them. Some people will swear that they’ve saved their life - I see no reason to argue with that, it could well be true - but I’m sure there are many other people out there just like me. It’s a game of chance, and deciding not to play (or to stop playing) can be a rational and informed decision (at least for some people in some circumstances.)

Re: Psychiatry Wars: a lawsuit that put psychoanalysis on trial

#70

Post by aatd86 »

DangitBobby wrote: post #68
philosopher1234 wrote: post #39

Psychoanalysis is criminally underrated in the US. It’s detractors broadly don’t understand it. It has the potential to seriously help tons of people, but it is understandably challenged, as it represents a painful reckoning with yourself. Who would want to find out that their personality causes many of their problems? Maybe it requires a bit of masochism to take advantage of.

Every single person I know on any sort of mental health medication also had therapy before and after being prescribed it. Therapy does help, especially when your illness requires you to learn how to cope with your condition (and the fact that things are just harder for you for no good reason). Two people very close to me are fucked without medication. My wife was anxious to the point of having regular panic attacks,…

From experience, the brain is basically processing inputs (perceptions) and then outputs thoughts or actions.

The issue is when either the inputs are distorted or the processing is being interfered with.

Caffeine for instance can induce psychosis in some people by indirectly effecting dopaminergic response (via its action on adenosine receptors).

Other drugs can do the same. (we all know that marijuana can induce "bad trips").

But really, everything we perceive are inputs that can startup brain work. And some inputs are stored in memory.

One thing that can work is metathinking, i.e. awareness of one's own brain processing (observing one thoughts and bodily sensations for instance, basically meditation).

That's the processing part but one should also avoid distortions by avoiding psychoactive substances (alcohol, tea or coffee included).

Psychiatry doesn't work too well because it is underfunded and is stuck on alleviating symptoms. Psychiatrists are the first to admit that they don't really know how things work.

There are some weird stuff that can be discovered at the brain level once someone monitors their own thoughts/ brain chatter but this is somewhat esoteric. That's the realm of yogis, qigong practionners etc but there is too much folklore and I won't delve into that. Doesn't seem scientifically proven although I have my own experiences.

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