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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dr. Bob on September 12, 2001, at 16:58:20
[Posted by Elizabeth on September 11, 2001, at 12:50:15]
> > The National Liberation Front of the American mentally ill was created with one purpose. To free the oppressed mentally ill from the idea they have a "mental problem."
>
> Dr. Bob, I know you wanted followups to be posted to PSB, but I feel that my remarks are more relevant here. My ideas on the subject don't arise from politics, but from my heritage as a scientist and as the daughter of a philosopher/historian of science and a biomedical ethicist.
>
> I think the problem is the dualism that creates the whole idea of "mental" versus "neurological" problems in the first place. It's time for psychiatry (and psychology), by whatever names, to take a jump from the middle ages to the 21st century.
>
> An incidental benefit of this type of change would be that we would all be "liberated" -- and simultaneously, people with all types of chronic medical illness would have the opportunity, e.g., to work with social workers.
>
> At the same time, because of current scientific and technological limitations that prevent us from understanding the pathophysiology of these diseases, I feel that empirical-descriptive psychiatry still does serve a useful purpose.
>
> -elizabeth
> ["The Pact Against Vitalism," if you want a catchy organisation name :-)]
>
> p.s. If I haven't mentioned it already, I *loathe* the expression "chemical imbalance." Blatantly phony "brain science" stuff like that only contributes to the idea that the "mental = physical" concept is bogus. (It's been said that you can tell something's not a science if the name contains the word "science" -- e.g., social science, cognitive science, computer science. Not globally true, but very suggestive.) Just thought I'd share that thought in case anybody has any related thoughts.
Posted by Dr. Bob on September 12, 2001, at 16:59:40
In reply to Redirected: Psychiatry and Neurology, posted by Dr. Bob on September 12, 2001, at 16:58:20
[Posted by MB on September 12, 2001, at 1:24:48]
> < snip >
>
> > There is something especially frightening about mental illness to most people (including those of us who suffer from it I think).
>
> < snip >
>
> I think it's partially instinctual. A friend's dog was epileptic. He had a seizure and the other dog ripped it's throat open, nearly killing it. The vet said it was totally normal, that in the animal kingdom (well, at least in dogs) the mentally "abnormal" are immediately gotten rid of...probably something to do with natural selection and keeping the unfavorable traits out of the gene pool. I'd like to think that we've evolved to the point, as a species, that compassion and empathy would overide an outmoded trait like agression toward the ill, but, sadly, it hasn't.
Posted by Dr. Bob on September 12, 2001, at 17:00:33
In reply to Re: Psychiatry and Neurology, posted by Dr. Bob on September 12, 2001, at 16:59:40
[Posted by NLFAmerica on September 12, 2001, at 16:34:53]
> Why is it that two diseases that both involve abnormal amounts of the neurotransmitter dopamine are treated by two different types of doctors? By that I mean schizophrenia and Parkinsons disease. In schizophrenia there is generally acknowledged to be too much dopamine, whereas in Parkinsons the problem is too little dopamine. One is treated by psychiatry (schizophrenia) and the other is treated by Neurology (Parkinsons). Why is that? Is it perhaps because schizophrenia is a "scarier" disease than Parkinsons disease? Is it perhaps because in the past schizophrenics were considered to be freaks and just institutionalised and thrown away by society?
>
> The fact of the matter is that both of these diseases are basically opposite ends of the pole, yet both involve serious biological changes in the brain and CNS. Personally I believe schizophrenia should be viewed in the exact same light as Parkinsons disease and should thus be considered a bona fide neurological disease and treated by neurologists.
>
> In severe clinical depression four things generally happen. Patients develop serious negative changes in sleeping, eating and sex drive cycles. They also oftentimes develop serious cognitive problems such as difficulty focusing, remembering, thinking clearly, making decisions, etc. All of the above are Central Nervous System controlled ie; "brain controlled." Sleeping is a brain/CNS controlled thing. So is appetite and sexual drive and function. Cognition is without a doubt brain controlled. Thus clinical depression is in reality also a type of Neurological disease.
>
> In the most effective depression treatment available, psychiatrists seek to induce generalized seizures in severely depressed individuals. As time and ECT sessions go by, the seizure threshold goes up. As the seizure threshold goes up, many depressed patients seem to do better. Same thing is being found for the new VNS or Vagus Nerve Stimulation implant which was originally developed to treat refractory epilepsy. Now its being researched by a handful of forward thinking neuropsychiatrists as a treatment for refractory depression. And guess how it works? By pushing up the seizure threshhold...the same thing ECT does, but without causing the seizure. Hmmmmmmmmm, wow it seems there is a big relationship to severe mental illness and Neurology and the brain.
>
> Seems like the handwriting is on the wall folks.
>
> Isnt it time to just cut thru the crap and begin looking at mental illness for what it really is? not mysterious psychological mumbo jumbo but in fact genuine medical illnesses? This wont happen as long as psychiatry is the main provider for mental health. Psychiaty needs to be absorbed into Neurology before serious mental illness will begin being viewed as bona fide brain based medical problems.
>
> Keep in mind Im talking about the more serious forms of mental illness here. I have no problem with the typical dysthymic depressed person going to a social worker to talk. Thats fine. But what about that person who has SEVERE major depression, manic depression, schizophrenia, treatment resistant depression or severe OCD? Im sorry, but I dont think psychiatry does that hot of a job at treating these folks. Getting a mere response to drugs and getting to 50% is one thing. Getting a consistent full remission and staying that way is totally another. I dont believe psychiatry does all that great of a job at achieving full remissions for many patients with more severe mental illness. And I believe much of the reason for this is the lack of rigorous Neurologically based approaches in psychiatric diagnosis and treatments. Just my personal opinion.
>
> Psychiatry needs to be absorbed by Neurology, severe mental illness needs to begin being viewed as neurological (brain) problems and the psychology stuff needs to be trashed. Then maybe more people would begin getting the real treatment they need and more people with severe mental illness would achieve FULL and CONSISTENT Remission and not just a response.
>
> NLF of American Mentally Ill
Posted by Mitch on September 12, 2001, at 23:47:55
In reply to Re: Psychiatry and Neurology, posted by Dr. Bob on September 12, 2001, at 16:59:40
> [Posted by MB on September 12, 2001, at 1:24:48]
> > > There is something especially frightening about mental illness to most people (including those of us who suffer from it I think).
> >
> > < snip >
> >
> > I think it's partially instinctual. A friend's dog was epileptic. He had a seizure and the other dog ripped it's throat open, nearly killing it. The vet said it was totally normal, that in the animal kingdom (well, at least in dogs) the mentally "abnormal" are immediately gotten rid of...probably something to do with natural selection and keeping the unfavorable traits out of the gene pool. I'd like to think that we've evolved to the point, as a species, that compassion and empathy would overide an outmoded trait like agression toward the ill, but, sadly, it hasn't.
Ironically, *destructive* personalities get(temporarily) *awarded* and reinforced by their people for their deeds. A good example is Adolph Hitler and Saddham Hussein. These people were/are pathological to the human race and yet were elevated to deified status by their own people blinded by irrationality. Hopefully, our living instinct to cooperate with each other will prevail over dead instincts to endlessly compete and kill. Gladly, Hitler failed and Hussein, et al, will fail as well.
Posted by Squiggles on September 13, 2001, at 14:45:48
In reply to Redirected: Psychiatry and Neurology, posted by Dr. Bob on September 12, 2001, at 16:58:20
> [Posted by Elizabeth on September 11, 2001, at 12:50:15]
>
> > > The National Liberation Front of the American mentally ill was created with one purpose. To free the oppressed mentally ill from the idea they have a "mental problem."
> >
> > Dr. Bob, I know you wanted followups to be posted to PSB, but I feel that my remarks are more relevant here. My ideas on the subject don't arise from politics, but from my heritage as a scientist and as the daughter of a philosopher/historian of science and a biomedical ethicist.
> >
> > I think the problem is the dualism that creates the whole idea of "mental" versus "neurological" problems in the first place. It's time for psychiatry (and psychology), by whatever names, to take a jump from the middle ages to the 21st century.
> >
> > An incidental benefit of this type of change would be that we would all be "liberated" -- and simultaneously, people with all types of chronic medical illness would have the opportunity, e.g., to work with social workers.
> >
> > At the same time, because of current scientific and technological limitations that prevent us from understanding the pathophysiology of these diseases, I feel that empirical-descriptive psychiatry still does serve a useful purpose.
> >
> > -elizabeth
> > ["The Pact Against Vitalism," if you want a catchy organisation name :-)]
> >
> > p.s. If I haven't mentioned it already, I *loathe* the expression "chemical imbalance." Blatantly phony "brain science" stuff like that only contributes to the idea that the "mental = physical" concept is bogus. (It's been said that you can tell something's not a science if the name contains the word "science" -- e.g., social science, cognitive science, computer science. Not globally true, but very suggestive.) Just thought I'd share that thought in case anybody has any related thoughts.Well, this is the kind of subject that merits
a tome on the philosophy of science and
the understand of the mental illness - it's so
huge. I will leave the philosophical problems
aside for now, which are at the bottom of things
imho, and just say that Psychiatry is Neurology
or at least used to be before Psychology split
into so many "silly" directions. The split
between the body and the mind in treating mental
illness is really a new thing, and I think it
started with the Behaviourists like Wundt.Squiggles
Posted by Elizabeth on September 14, 2001, at 8:06:43
In reply to Re: Redirected: Psychiatry and Neurology, posted by Squiggles on September 13, 2001, at 14:45:48
> The split
> between the body and the mind in treating mental
> illness is really a new thing, and I think it
> started with the Behaviourists like Wundt.The split between psychiatry and neurology really began with Freud, but the behaviourists didn't help any. < g >
-e
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