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Re: Leaving the site for a while » alexandra_k

Posted by Squiggles on September 24, 2006, at 8:56:50 [reposted on September 25, 2006, at 0:09:11 | original URL]

In reply to Re: Leaving the site for a while » Squiggles, posted by alexandra_k on September 24, 2006, at 2:59:42

> i guess it took a while for the treatments to be developed / made available

Maybe; i think that mistakes are also made,
and in some poor countries, mental illness
is not regarded with the sophistication we have
in the west-- let alone the drugz;

> > Drugz are the answer -- unless you are not
> > seriously mentally ill.
> so if drugs aren't working then you aren't seriously mentally ill?

It could be the wrong drug; this sounds like
a leading question;

> or do you allow that future developments will mean that people who aren't currently being helped by them will be helped by them?

Let's hope that better drugs are developed for
mental illness.
> you don't think there are serious mental illnesses that can't be helped by drugs as a matter of principle?

I don't know. I think that maybe post-traumatic stress may be an example. Soldiers coming back from war, people who have undergone torture, etc. I don't know if all such cases recover or if a mark is left on their psyche for life, that needs treatment. It is possible for a situation to change your brain i think for life. But that would be equivalent to a mental illness from birth wouldn't it?

> your thinking is very much in line with Szatz. he maintains that there aren't any such things as mental illnesses. only illnesses of the brain that should be treated with medications.

:-) Poor Dr. Szatz - i haven't been very kind with him.
> > > Though it is controversial whether psychiatry is best thought of as a medical enterprise.

Well, i guess it depends on the psychiatrist.

> > Really? Who said it was controversial?
> there is controversy. thats what i meant to say.
> > Perhaps you are thinking of psychoanalysis?
> no, i'm talking about psychiatry. the debate around whether psychiatry is a science like medicine, or whether psychiatry is a form of social control that picks up on norm violations by locking people away and drugging them when they exhibit behaviour that we do not value (like political dissent, expressions of economic hardship, delusions and hallucinations which are revered in other societies etc etc).

You're from Mindfreedom aren't you?

> > But I take your point that psychiatry is an applied field.
> > No. I think it is biology.
> i just meant that psychiatry isn't merely descriptive. it doesn't seek solely to classify different kinds of mental illness. in fact... it is a subject of controversy whether the DSM and ICD are scientific taxonomies or not. if there is a science of nosology / classification then it is an infant science indeed. some would scoff at its claim to be attempting a scientific nosology / classification scheme. if whether someone is mentally ill or not is solely an objective matter then nosology / classification can be a scientific enterprise. if whether someone is mentally ill or not depends on value judgement (that the behaviour is harmful or undesirable or unwanted) then it is unclear that nosology / classification can be scientific because science is supposed to be objective and doesn't require value judgements for classification. medicine has been criticised on the same grounds only people aren't locked up and medicated against their will in general medicine, only in psychiatry.

I agree that the DSM is a loose guide-- but that
is to its credit, because they don't pretend to be taxonomically precise.

> psychiatry is also an applied field (as is medicine) because its aim is the prevention and treatment of mental disorder. those seem to require value judgements of what *should* be prevented and what *should* be treated even if the classification scheme / nosology doesn't require value judgements.

Yes, it's not just theoretical. But it is better to practice pharmacology, than to do nothing in the case of severely mentally ill people-- they suffer and others suffer too.

> biology isn't an applied field. it seeks to classify and to develop theories that posit underlying causal mechanisms. then one can interveane on the variables to see whether there is a systematic relationship between them. drug trials aren't very good science at times... need double blind tests (how many of those are there?) on decent sample sizes to figure placebo vs other varieties of med vs the drug you are testing. trouble with these studies is the ethics of placebos (or failure to treat). that doesn't arise for biology.

> > As such it is more interested in treatment than in discovering the real nature of illness.

> > That is not because it is "evil" but because
> > there is a long road to travel to understand
> > the causes.
> yeah. but someone has gotta do it ;-)
> > > I'm not an anti-psychiatry proponent.
> > Oh.
> i'm interested in providing a unifying theory for psychiatry that will help psychiatry progress as a *scientific* enterprise. i won't say 'just like physics' but maybe 'just like biology' and maybe at times 'just like medicine'. there are many different theoretical orientations (e.g., biomedical, psychoanalytic, behavioural and learning, cognitive, sociological, anthropological, evolutionary psychological, social psychology, humanist and existential etc etc) and i'm interested in how much they fit together and how much they conflict with one another in order to develop a unificatory framework. i'm not anti... i'm trying to help :-) i'm not calling for radical overhaul / revolution i'm trying to assemble the present for a more unified future :-)

That sounds like the unified theory of knowledge, lol -- only of the mind. I wouldn't touch that; i would feel safer with an empirical approach.
And it's bound to fall into the hands of the
bureaucrats and then where is the freedom of mentally ill patients?

> > > Typically the biological component has been cashed out as people studying the the bio-chemistry and structure of the brain.
> > >
> > > Typically the psychological component has been cashed out as people studying the cognitive deficits that people may exhibit. (Reasoning biases, inability to do certain cognitive tasks, attribution biases etc).
> > >
> > > Typically the sociological component has been cashed out as people studying the difference in prevalence rates for various illnesses across various cultures. Trying to figure out what aspects of culture are relevant for the difference in prevalence rates.
> > That sounds like statistics, not psychiatry.
> yeah. i provided three methodologies for discovering the nature of mental illness. if we learn more about their nature then that should give us some understanding of causal mechanisms in order for us to develop new interventions however. better treatments. but not just better treatments at the biological level, better treatments at the psychological level as well... people can learn to reason better... interventions at the sociological level as well (pressure for hollywood / fashion to stop presenting people with eating disorders / drug problems as potential role models) etc.

I think you are biased against biological psychiatry-- just reading this makes me think that you include biology in mental illness just to make it look fair; but your real interest is in psychology and sociology--which i believe are contexts within which mentally ill people find themselves. Rarely, can you change the person biological state, by changing the context. I think the Soteria project was one attempt, and I just read of the Leros island-- and all i can say is mentally ill people need drugz and human compassion. But the cause remains biological in most cases.





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