Psycho-Babble Medication | about biological treatments | Framed
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Re: Article on Brain Laterality and Emotions-Noa

Posted by Adam on November 12, 1999, at 11:12:02

In reply to Re: Article on Brain Laterality and Emotions, posted by Noa on November 12, 1999, at 2:52:19

In the case of OCD, the diagnosis is usually pretty clearcut, from what I understand, but there
are exceptions, and also people who don't respond to standard treatments. It is for them that
other diagnostic stratgies might be really important, I believe. I also feel that, in general,
the less subjective the diagnosis, the better. There is certainly somthing to be said for the
"art" of medicine, and I know from experience that some doctors just have an intuitive gift that
makes them brilliant diagnosticians. But since that's not true of everyone, I think the less
we need to rely on intuition the better. If depression, OCD, psychosis, etc. are all (at least
at some level) fundamentally physioligical/biochemical conditions, then they must have physiological
and bichemical markers that doubtlessly could be detected if we knew where to look. If those
markers could be correlated to a particular treatment strategy, then hopefully it would take some
of the guesswork out of selecting the right drug and/or psychotherapy.

Dr. Rapoport was actually never my physician. Access to her was facilitated somewhat in that I had
some inside information (her exact location and personal phone number at the NIH, for instance).
She really didn't need to spend much time with me to point me in the right direction, and after that
I only saw her a couple more times in passing. My "physician" actually was Dr. Susan Swedo (who is
no longer at the NIMH, I guess) and my therapist was Dr. Charles Mansueto, a psychologist specializing
in behavioral therapy and the treatment of OCD/OCD spectrum disorders. Dr. Mansueto is in Silver
Spring, Maryland, and in his circles is quite well known, from what I understand.

I never, ever would have been able to afford the services of Dr. Mansueto if I had not been enrolled in
a study. As I said, this was luck almost entirely. I can only say I was extremely fortunate to
be in the right place at the right time.

> WOW, Adam.
> THanks for telling your story.
> I also hope for a time when either the knowledge gained from imaging research is used to develop more specific diagnostic screening tools, or that using the imaging technology to directly screen for disorders, will be routine.
> Where are still far from that. Notice how small the study's N is. The imaging technology is still so expensive that the studies are only looking at small numbers, which to me is problematic in two ways. 1. the studies are still small enough to be vulnerable to criticism about generalizability, and 2. the prospect of using the imaging techniques in the clinical setting to diagnose disorders is still a long way off.
> But the fact that this type of research is coming out with such fascinating info thrills me.
> I read Rappaport's book The BOy Who Couldn't Stop Washing. Very interesting.
> BTW, how did you find Rappaport as a doc to work with given how high profile she is? Was access an issue?




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