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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 47. Go back in thread:
Posted by Susan47 on July 23, 2004, at 16:02:45
In reply to Re: Yes Dr. Bob I wish you would. Where are you?, posted by fires on July 23, 2004, at 14:32:19
Do you know us? You assume we're lying, you've said yourself you think some of us are posting under different id's.
Are you okay?
Posted by Susan47 on July 23, 2004, at 16:05:44
In reply to welcome, susan.... » Susan47, posted by chemist on July 23, 2004, at 14:50:24
Thank you so much. I've been having a really rough time in therapy and quit. I also am having side-effects from my meds; they're making me anxious. That's better than being depressed, but marginally. On the other hand, I'd rather be anxious and alive then depressed and suicidal. Although, anxiety makes me feel pretty suicidal sometimes too.
Thanks for listening.
Posted by Susan47 on July 23, 2004, at 16:07:15
In reply to Re: welcome, susan...., posted by B2chica on July 23, 2004, at 15:23:09
.......
Posted by chemist on July 23, 2004, at 16:21:15
In reply to For Chemist, posted by Susan47 on July 23, 2004, at 16:05:44
> Thank you so much. I've been having a really rough time in therapy and quit. I also am having side-effects from my meds; they're making me anxious. That's better than being depressed, but marginally. On the other hand, I'd rather be anxious and alive then depressed and suicidal. Although, anxiety makes me feel pretty suicidal sometimes too.
> Thanks for listening.hello there, susan...this crowd on PB is quite exceptional, and i do hope that you stick around here and social: this is a very supportive and kind group. visit the other boards as needed, as there is solace in every corner...you are in good hands here...be well, and all the best, chemist
Posted by shadows721 on July 23, 2004, at 18:06:29
In reply to Re: Yes Dr. Bob I wish you would. Where are you?, posted by fires on July 23, 2004, at 10:35:25
The ONLY way to deal with trolls is to LIMIT your reaction to reminding others NOT to respond to trolls.
Posted by Dr. Bob on July 26, 2004, at 17:21:05
In reply to Thanks Pegasus, posted by Susan47 on July 22, 2004, at 17:44:46
> "I can't understand the rationale behind Fires' thinking."
> I can't stop myself from having opinions, and I think sometimes those opinions do need to be expressed.
> If someone is using the Board to let off steam, that's one thing, but in my opinion no one should accuse anyone of anything here.
> Is it okay to say that? I really hope so.
> I hope it is, because maybe that's a much better way of expressing myself..That was in fact much better, thanks. But just to be clear, if expressing opinions or letting off steam means accusing someone of something, I'd rather that be done elsewhere.
Further discussion of posting policies should be redirected to Psycho-Babble Administration. Thanks,
Bob
Posted by fires on July 26, 2004, at 17:52:18
In reply to scientific research » fires, posted by pegasus on July 26, 2004, at 17:00:30
> Hey fires,
>
> A while back I asked you not to post to me, and I said I wouldn't post to you. But the way things are going lately on the board gives me more confidence in myself and in you. So, I'd like to rescind my ban.
>
> I disagree below with some things that you said, so I'm nervous that I'll get attacked. Please know that I'm replying to you with good intentions, which are to respectfully disagree with a couple of your conclusions, and to amicably explain why I disagree. I welcome explanations of why you think my reasoning and conclusions may be wrong.
> >
> > Personal testimonies of any medical/therapy treatment don't cut it with me. I'm open minded, but I don't have a hole in my head. :)
> >
> > Also, extraordinary claims require extraordinary proof.
> >
> > Also, the MPD people can't refute the science supporting the scientific MPD research. They can only say that their experiences override science.
> >
>
> I think you have a lot more faith in science than I do! Speaking as a scientist, I've read lots of scientific research that has been later refuted when new evidence comes to light.
>
> Moreover, I think that a lot of things don't lend themselves well to traditional scientific study. Which doesn't mean that they aren't real phenomena. Therapy is a prime example. Love is another.
>
> The problem with therapy is that evaluating it's effectiveness requires considering the personal subjective experience of the client. Personal subjective experience isn't the type of thing that is easy to quantify, and therefore, traditional scientific research methods don't work well to examine it. Here's a link about this that you may find interesting: http://www.nova.edu/ssss/QR/QR4-3/gordon.html
>
> That's just one link. This type of discussion is all over the internet. If you want more references, let me know.
>
> Personally, I believe that people's experiences can override the results of scientific research. There is so much that we don't know yet, and scientific results are so dependent on the theories that we have, and the questions that we ask. I believe that we often ask the wrong questions or ask questions in the wrong way, and so get "scientific" results that don't actually reflect reality very well. Especially in terms of wiggly things like therapy and mental health. In my opinion, listening to people's experience is not only valid, but essential, as a check on relying too heavily on the flawed system of scientific research. These experiences may even inform future research that will someday show that what they've experienced is explainable. Or not.
>
> Also, I want to explain that I am not anti-science. I think scientific research has contributed a lot, and I've participated in a fair amount of it myself. I just also believe that it is limited, and easily misinterpreted.
>
> pegasus
>Wow. Long article -- which I admit I only skimmed. First, If things don't lend themselves to "traditional scientific study" they certainly won't be any more easily studied by any other type of "science."
To quote Michael Shermer, a wel known skeptic:
"The second popular notion that skeptics are closed-minded to certain beliefs comes from a misunderstanding of skepticism and science. Skeptics and scientists are not necessarily “closed-minded” (though they may be since they are human). They may once have been open-minded to a belief, but when the evidence came up short they rejected it. There are already enough legitimate mysteries in the universe for which evidence provides scientists fodder for their research. To take the time to consider “unseen” or “unknown” mysteries is not always practical. When the non-skeptic says, “you’re just closed-minded to the unknown forces of the universe,” the skeptic responds: “We’re still trying to understand the known forces of the universe.”
Re: Listening to patient's experiences. Yes we should listen,but we don't need to except the experiences without proof. Examples: People have claimed to have been abducted by aliens. People have claimed to have been cured of all types of illnesses by "faith healers." Some say that they can communicate with the dead.
Imagine if therapists blindly excepted the tales of paranoid schizophrenics!
I'm out of time. BTW, you don't have to say that you respectfully disagree with me. I asssume that all disagreements with me are respectful until proven otherwise.
bye
Posted by pegasus on July 26, 2004, at 18:32:40
In reply to Re: scientific research, posted by fires on July 26, 2004, at 17:52:18
Whoa, I'm confused about how this reply ended up in this thread. But whatever, I'm happy to talk about this here.
I agree with a lot of what you say, but it does sound to me as though you are overgeneralizing. For example, I agree that one shouldn't take the statements of hallicinating schizophrenic at face value. Perhaps we shouldn't take anyone's comments about their personal experience at face value. But we can respectfully consider them. We can believe that there is some possibility that those experiences are true. We can evaluate other evidence (i.e., sympoms of schizophrenia) when deciding whether to allow the possibility of those experiences reflecting reality. That's all I was advocating. I'm not advocating blindly accepting things that people say.
Requiring scientific research or "proof" to support a phenomenon before we believe that it might be real seems like a very stiff criterion to me. I think if we demand that, then we'll end up not recognizing lots of things that might be really happening. Sometimes there just isn't "proof", and it's up to us to choose whether we'll acknowledge possibilities, rather than only certainties. The lack of proof doesn't prove that the phenomenon doesn't exist. If you don't want to acknowledge possibilities, that's up to you. Personally, I would find acknowledging only certainties to be very limiting, and that's how I read your Michael Shermer quote.
You said "If things don't lend themselves to "traditional scientific study" they certainly won't be any more easily studied by any other type of "science." I would strongly disagree with this statement. There are other paradigms of study. For example, case studies. The article I cited got into that a bit at the end, but not much.
Also, I would suggest that if something can't be studied, it may still be a real phenomenon, worthy of our attention. To me, "proof" is not a reasonable gold standard for what is worthy of consideration. Maybe that's where we fundamentally disagree.
pegasus
Posted by AuntieMel on July 27, 2004, at 8:46:52
In reply to Re: scientific research, posted by pegasus on July 26, 2004, at 18:32:40
<< Requiring scientific research or "proof" to support a phenomenon before we believe that it might be real seems like a very stiff criterion to me. I think if we demand that, then we'll end up not recognizing lots of things that might be really happening.
That's the chicken and the egg problem, isn't it. Or a catch-22. Columbus requires proof that the world is round before he takes his trip. Trying to take a trip is the only way to supply the proof.
I guess Columbus *could* wait for someone else to supply the proof - but if everyone thinks that way it won't get done. And Europe would be mighty dang crowded.
Posted by Ilene on July 27, 2004, at 12:28:35
In reply to Re: scientific research, posted by pegasus on July 26, 2004, at 18:32:40
There are practical reasons for wanting proof that psychotherapy will help you. You could be wasting large amounts of time and money, and opening yourself up to emotional manipulation.
Therapy was never very useful to me. I think my particular difficulties are biological. I might try therapy again, however.
I'm also disturbed by how dependent some people are on their therapists.
Posted by pegasus on July 27, 2004, at 14:42:45
In reply to Re: scientific research, posted by Ilene on July 27, 2004, at 12:28:35
Yes, absolutely, it's nice to have proof, if you can get it. I'm just saying that if you limit yourself to pursuing treatments that are "proven" to be effective, then you might miss something that would be effective that hasn't been proven. Which is a shame if the treatments that do have proof don't happen to work in your particular case. Because it's notoriously difficult to study psychological treatments (because of the internal and subjective nature of most of the processes and results), most available treatments don't have scientific proof to back them up.
Also, as a scientist, I'd like to point out that scientific proof is a rare and elusive beast. Most research is limited in scope and applicable only to the narrow conditions included in the particular study. Most research only points in particular directions, rather than proving anything.
Personally, I've had great results with types of treatments that do not have scientific proof backing them up. And yet, I think we all need to make that call for ourselves. If you think it's best to rely only on proven treatments, then that is definitely what you should do, and I wholeheartedly support that. Just realize that there may be valid reasons for others to make other decisions.
pegasus
Posted by partlycloudy on July 27, 2004, at 14:57:45
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 14:42:45
I would like to frame this post, if I may. It's beautifully put.
Posted by Larry Hoover on July 27, 2004, at 15:27:14
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 14:42:45
> Yes, absolutely, it's nice to have proof, if you can get it. I'm just saying that if you limit yourself to pursuing treatments that are "proven" to be effective, then you might miss something that would be effective that hasn't been proven. Which is a shame if the treatments that do have proof don't happen to work in your particular case. Because it's notoriously difficult to study psychological treatments (because of the internal and subjective nature of most of the processes and results), most available treatments don't have scientific proof to back them up.
>
> Also, as a scientist, I'd like to point out that scientific proof is a rare and elusive beast. Most research is limited in scope and applicable only to the narrow conditions included in the particular study. Most research only points in particular directions, rather than proving anything.
>
> Personally, I've had great results with types of treatments that do not have scientific proof backing them up. And yet, I think we all need to make that call for ourselves. If you think it's best to rely only on proven treatments, then that is definitely what you should do, and I wholeheartedly support that. Just realize that there may be valid reasons for others to make other decisions.
>
> pegasusWell put. Hear! Hear!
If I may be so bold as to extend your comments....We have no objective proof of pain. We have no objective proof of major depression. We have no objective proof of fatigue. We have no idea if different individuals are even talking about the same thing when we they use those terms. Declaring a disorder or a treatment to be subjective may well be a true statement, but that does not make such a declaration, in order to dismiss or trivialize the experience of anybody else, fair, valid, or responsible.
Lar
Posted by fires on July 27, 2004, at 16:56:37
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 14:42:45
> Yes, absolutely, it's nice to have proof, if you can get it. I'm just saying that if you limit yourself to pursuing treatments that are "proven" to be effective, then you might miss something that would be effective that hasn't been proven. Which is a shame if the treatments that do have proof don't happen to work in your particular case. Because it's notoriously difficult to study psychological treatments (because of the internal and subjective nature of most of the processes and results), most available treatments don't have scientific proof to back them up.
>
> Also, as a scientist, I'd like to point out that scientific proof is a rare and elusive beast. Most research is limited in scope and applicable only to the narrow conditions included in the particular study. Most research only points in particular directions, rather than proving anything.
>
> Personally, I've had great results with types of treatments that do not have scientific proof backing them up. And yet, I think we all need to make that call for ourselves. If you think it's best to rely only on proven treatments, then that is definitely what you should do, and I wholeheartedly support that. Just realize that there may be valid reasons for others to make other decisions.
>
> pegasusI tried many meds over the last 20 years for "off-label" uses, so there was no proof that they worked for what I had -- but they did not defy current scientific knowledge.
Some of the "New Age" theapies are contrary to science as we know it.
Posted by Ilene on July 27, 2004, at 17:32:52
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 14:42:45
> Yes, absolutely, it's nice to have proof, if you can get it. I'm just saying that if you limit yourself to pursuing treatments that are "proven" to be effective, then you might miss something that would be effective that hasn't been proven. Which is a shame if the treatments that do have proof don't happen to work in your particular case. Because it's notoriously difficult to study psychological treatments (because of the internal and subjective nature of most of the processes and results), most available treatments don't have scientific proof to back them up.
>That makes it terribly difficult to decide whether to start psychotherapy and what kind of therapist to look for.
> Also, as a scientist, I'd like to point out that scientific proof is a rare and elusive beast. Most research is limited in scope and applicable only to the narrow conditions included in the particular study. Most research only points in particular directions, rather than proving anything.
>CBT is supposedly the only kind that's been shown to work. I don't know if that's because it's fairly structured, so it's easier to quantify, because it just happens to have been studied more, whether it actually is superior, or for other reasons. There are certainly people who have "failed" CBT, or rather, CBT has failed them.
> Personally, I've had great results with types of treatments that do not have scientific proof backing them up. And yet, I think we all need to make that call for ourselves. If you think it's best to rely only on proven treatments, then that is definitely what you should do, and I wholeheartedly support that. Just realize that there may be valid reasons for others to make other decisions.
>How did you decide on those treatments?
Of course I realize that other people have their own criteria for making decisions, but I think it's important to be an educated consumer. I'm the person who always reads Consumer Reports before buying anything. I read opposing political opinions, too.
Posted by AuntieMel on July 27, 2004, at 17:50:54
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 14:42:45
<Most research only points in particular directions, rather than proving anything.
Or disproving anything.
I write geophysical software. In general, the software follows "proven" equations......
BUT, like studies of therapy types, the data we work on is a discrete sampling of a continuous function.
So, even though it is hard science, there are also subjective modifications.
Posted by fires on July 27, 2004, at 18:12:44
In reply to Re: scientific research, posted by Ilene on July 27, 2004, at 17:32:52
Posted by pegasus on July 27, 2004, at 22:36:50
In reply to Re: scientific research, posted by Ilene on July 27, 2004, at 17:32:52
> That makes it terribly difficult to decide whether to start psychotherapy and what kind of therapist to look for.
Yes it does, unfortunately. We're often left needing to use criteria other than scientific evidence. Having hard studies would be easier. And yet in the real world, we often don't.
> CBT is supposedly the only kind that's been shown to work. I don't know if that's because it's fairly structured, so it's easier to quantify, because it just happens to have been studied more, whether it actually is superior, or for other reasons. There are certainly people who have "failed" CBT, or rather, CBT has failed them.
Right, exactly. CBT has some evidence to back it up, and it certainly does seem to help, especially for depression. But it doesn't seem to work for everyone and every type of problem. Too bad.
> How did you decide on those treatments?
Well, I used my common sense and my gut feelings. I looked around a lot to find a therapist that felt right to me, and a method that made sense to me. And I checked in with myself frequently to see if I thought I was making progress, and still finding the process to make sense. Sorry, I wish there was some easier, more systematic way to find it. But the good news is that this way of finding good therapy does seem to work at least sometimes. It's a lot harder, I would guess, when if one doesn't trust their gut feelings about things.
> Of course I realize that other people have their own criteria for making decisions, but I think it's important to be an educated consumer. I'm the person who always reads Consumer Reports before buying anything. I read opposing political opinions, too.
Yes, I would agree with this. I was also encouraged by the Consumer Reports study of psychotherapy methods a while back which showed that all the methods they examined (including CBT) gave fairly equivalent positive results. This doesn't prove anything - because it could be that everyone they asked naturally got better on their own with time. But it's possible also that engaging in any type of psychotherapy can be helpful. Some people consider that this study may indicate that having a therapeutic relationship is what is helpful, and not so much the exact things that you do during therapy.
I think we fundamentally agree. I guess maybe I'm more interested in exploring outside the bounds of what research can show me. But I'm not saying that research is useless.
pegasus
Posted by AuntieMel on July 28, 2004, at 12:12:14
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 22:36:50
>> That makes it terribly difficult to decide whether to start psychotherapy and what kind of therapist to look for.
>Yes it does, unfortunately. We're often left needing to use criteria other than scientific evidence. Having hard studies would be easier. And yet in the real world, we often don't.
Another catch-22. Unfortunately, those needing the help the most are the least able to research methods and interview therapists.
In that case when just getting started you either have to rely of a referral from the med-guy or hope for the best. Then, gut reaction can at least tell you if you are being harmed, in which case (easier said than done) you try again. Or give up.
If you aren't harmed by the first try and are at least a little improved, then you can use that strength and insight to find the next 'better' therapist. At least you have an idea of what doesn't work for you. And that is - ta da - research.
Posted by Ilene on July 28, 2004, at 19:59:07
In reply to Re: scientific research » Ilene, posted by pegasus on July 27, 2004, at 22:36:50
But it's possible also that engaging in any type of psychotherapy can be helpful. Some people consider that this study may indicate that having a therapeutic relationship is what is helpful, and not so much the exact things that you do during therapy.
>That's something I wonder about.
Posted by Ilene on July 28, 2004, at 20:15:39
In reply to Re: scientific research » pegasus, posted by AuntieMel on July 28, 2004, at 12:12:14
> In that case when just getting started you either have to rely of a referral from the med-guy or hope for the best. Then, gut reaction can at least tell you if you are being harmed, in which case (easier said than done) you try again. Or give up.
>I got a referral to a social worker from a former pdoc. We lasted about three sessions. I thought she was brainless. I think I need to work with someone who can out-argue me. My most recent pdoc said I was too smart for my own good, because I could always think of a reason why something wouldn't work or wasn't right.
(We were doing psychotherapy of a sort, too. I was seeing her for an hour a week. Part of the time was spent on meds, and part of it on other things. She was the one who got me started on my diary, which I was (am) posting online on Social. It made her laugh. What I really liked about her was that she *listened*, she read the articles I brought her, and she took me up on my suggestions, such as trying Cytomel.)
Posted by AuntieMel on July 29, 2004, at 20:36:34
In reply to very well said Ilene!! (nm) » Ilene, posted by fires on July 27, 2004, at 18:12:44
Posted by fires on July 29, 2004, at 21:58:37
In reply to Re: are you ok fires? (nm) » fires, posted by AuntieMel on July 29, 2004, at 20:36:34
I'm doing ok, but not very well. Waiting to see Neuro. at UCLA in late August. Also, looking into surgical/endoscopic treatments for GERD. To think that a Pdoc recommended therapy for those things!? Yikes!
Posted by Ilene on July 29, 2004, at 23:33:19
In reply to Re: are you ok fires? » AuntieMel, posted by fires on July 29, 2004, at 21:58:37
Did you say you had POTS? I have a related condition, called neurally mediated hypotension.
Posted by fires on July 30, 2004, at 0:23:40
In reply to Re: are you ok fires? » fires, posted by Ilene on July 29, 2004, at 23:33:19
> Did you say you had POTS? I have a related condition, called neurally mediated hypotension.
Yes. It appeared I had NMH for a very brief time , but then I was misdiagnosed with Parnate caused tachycardia, then anxiety,then I DXed myself with POTS and showed a Cardio. my "home" BP/Pulse test results.
An earlier Holter monitor test, and then an event recorder showed POTS (the subtype without hyotension).
bye
Have you ever been Dxed with Chronic Fatigue Syndrome? Many of those patients have NMH or another type of dysautonomia.
bye
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