Posted by pseudoname on June 9, 2006, at 15:18:46
In reply to APs in kids on radio today, posted by pseudoname on June 9, 2006, at 10:47:15
Both Cohen (the social worker) and Lieberman (the pdoc) constantly interrupted each other, talked over the other's turn so that nothing could be understood, did not reply to the other's substantive points, and engaged in ad hominem attacks. Purile.
I wanted to shout at them, What the h*|| is your problem! Stop interrupting each other!
Lieberman ultimately demonstrated the worst behavior with this snotty rebuttal: "Dr Cohen, are you a psychologist or a social worker? So you have no scientific or medical background."
If I were refereeing a debate, Lieberman would've defaulted at that point.
Desperate to regain deference to his psychiatric majesty, Lieberman ended the show with this pointless jab: "The journals that [Dr Cohen] publishes in are not considered to be very influential."
Oh, well. That's that, then. Q.E.D.
Lieberman also misrepresented Cohen's paper as saying that there is no underlying biology to depression, that depression is just "angst in living" and "disappointments." Cohen is actually more coy than that in the paper, never quite asserting one way or the other whether depression may have a biological basis. That sort of smarmy equivocation seems like a much more darning criticism of the paper. Didn't Lieberman actually read it?
Cohen is hardly blameless. He seems to have a Peter Breggin-ish anti-medication agenda. He makes too many arguments at once, latching onto anything that makes medication use look in any way dubious. That sort of attitude just tires me, and it detracted from any worthwhile points he was making.
For example, I have never understood how anyone can get behind the claim that psychiatric medicines target the symptoms, not the underlying disease. Cohen seems to think this is some kind of objection to their use. How?!
I think Cohen's drug-centered (as opposed to disease-centered) model of drug treatment for depression is fairly attractive, but I also think that a lot of pdocs and patients already think in those terms fairly often. People should be more explicit about it and that would be useful, but outside of psych med advertisements and naive GPs, it is hardly the radical new paradigm he thinks it is.
Anyway, the disease model (i.e., abnormality) was created long before drug treatments and is wholeheartedly embraced in non-drug treatments like psychotherapy by social workers.
Cohen made the great point that scientific research evidence doesn't seem to have much impact on what prescribers do.
At bottom, Cohen and Lieberman disagreed about whether the use of psych meds in the population as a whole helps or hurts. Cohen says they may mean as much harm to some people as benefit to others. Lieberman just trotted out a list of celebrities who've been helped by drugs; he seemed to have no comprehension of Cohen's point.
poster:pseudoname
thread:654263
URL: http://www.dr-bob.org/babble/20060604/msgs/654902.html