![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 44. Go back in thread:
Posted by Phillipa on February 13, 2007, at 20:52:14
In reply to Everything I believe may be wrong, posted by Squiggles on February 13, 2007, at 17:59:07
Me too . So what's possible about you? Love Phillipa
Posted by munificentexegete on February 14, 2007, at 6:05:05
In reply to Everything I believe may be wrong, posted by Squiggles on February 13, 2007, at 17:59:07
> it's possible :-)
>
> Squigglesbut how will you know you have found the real truth when you get there?
Posted by Larry Hoover on February 14, 2007, at 7:34:02
In reply to Everything I believe may be wrong, posted by Squiggles on February 13, 2007, at 17:59:07
> it's possible :-)
>
> SquigglesEverything? Possible, theoretically, but with a vanishingly small probability.
Who among us hasn't ever changed their mind? Was there something wrong with the previously held belief? No. It was quite appropriate in its time frame. Belief is contextual, with respect to time. A changed belief can be a stronger one than one that is never challenged.
Please free yourself from judgmental words like "wrong". They serve no purpose whatsoever.
Belief is in a constant state of change. Surely, that doesn't apply to all of our beliefs, at the same moment. But nor are they all fixed and stable. What is learning, but changing belief?
I'm glad to hear you are at a state of flux in belief. Please, embrace it.
Lar
Posted by Squiggles on February 14, 2007, at 8:02:06
In reply to Re: Everything I believe may be wrong » Squiggles, posted by Larry Hoover on February 14, 2007, at 7:34:02
"state of flux" -- so that's what the
kids are calling it now; in my younger
days it was called "dazed and confused".I think what you say about context and belief
is very true. Sometimes bits of information
and memories rearrange a "picture" you have
of some topic. Belief and truth are not the
same thing, after all. You can believe something
that is false, and never know it.Squiggles
Posted by laima on February 14, 2007, at 8:49:44
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 14, 2007, at 8:02:06
Perhaps a positive spin is that you can feel good about being open-minded? As in, being able to challenge and develop your views as you gather new information? This certainly should be more accurately "true" than holding on to beliefs, even when evidence piles against them to challenge them. What's "true" often seems messy and complex.
Posted by Squiggles on February 14, 2007, at 8:56:45
In reply to Re: Everything I believe may be wrong » Squiggles, posted by laima on February 14, 2007, at 8:49:44
>
> Perhaps a positive spin is that you can feel good about being open-minded? As in, being able to challenge and develop your views as you gather new information? This certainly should be more accurately "true" than holding on to beliefs, even when evidence piles against them to challenge them. What's "true" often seems messy and complex.Yup: open-minded as opposed to right. I still think that there are cause(s) to mental illness,
i just hold back on arriving at conclusions without questioning and considering ALL possible connections. I think that searching for a historical trend over a lifetime is possibly as difficult as searching for that gene that is supposed to have the mark 'BP II' on it.Squiggles
Posted by laima on February 14, 2007, at 10:45:28
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 14, 2007, at 8:56:45
You can know complexity :)You can be fairly certain than this complexity regarding "mental illness" will likely persist to be the case for quite some time, if not always. I think your picture is likely clearest though if you continue to keep your mind open to consider new possibilities as they arrise.
> Yup: open-minded as opposed to right. I still think that there are cause(s) to mental illness,
> i just hold back on arriving at conclusions without questioning and considering ALL possible connections. I think that searching for a historical trend over a lifetime is possibly as difficult as searching for that gene that is supposed to have the mark 'BP II' on it.
>
> Squiggles
Posted by FredPotter on February 14, 2007, at 19:20:13
In reply to Re: Everything I believe may be wrong » Squiggles, posted by Larry Hoover on February 14, 2007, at 7:34:02
and remember . . .
The truth is: there is no truth
and
all models are wrong though some may be useful
Posted by Squiggles on February 14, 2007, at 20:00:58
In reply to Re: Everything I believe may be wrong, posted by FredPotter on February 14, 2007, at 19:20:13
> and remember . . .
>
> The truth is: there is no truth
>
I wouldn't go that far; some propositions must be true.> and
>
> all models are wrong though some may be usefulDefinitely - useful is what we want in medicine; sometimes the discovery of *why* something is useful comes later-- serendipity :-)
Squiggles
Posted by FredPotter on February 14, 2007, at 22:32:00
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 14, 2007, at 20:00:58
> > and remember . . .
> >
> > The truth is: there is no truth
> >
> I wouldn't go that far; some propositions must be true.
>JUST an old Zen saying
> > and
> >
> > all models are wrong though some may be useful
>
> Definitely - useful is what we want in medicine; sometimes the discovery of *why* something is useful comes later-- serendipity :-)Uncanny the way that happens.
THE reason I suppose for models being wrong but sometimes useful is that they are designed to be simplifications. Statistical modellers see them this way anyway but not all math modellers
Fred
Posted by linkadge on February 15, 2007, at 10:31:33
In reply to Re: Everything I believe may be wrong, posted by FredPotter on February 14, 2007, at 22:32:00
If everything you believe is wrong then then believing that everything you know is wrong would be wrong which would mean that not everything you believe is wrong.
Linkadge
Posted by Squiggles on February 15, 2007, at 11:13:35
In reply to Re: Everything I believe may be wrong, posted by linkadge on February 15, 2007, at 10:31:33
> If everything you believe is wrong then then believing that everything you know is wrong would be wrong which would mean that not everything you believe is wrong.
>
> Linkadge
>
>
>So, i guess you've read Zeno's paradoxes?
It was a matter of speaking of course; i did not
mean "everything", but rather i may have started with the wrong foundations in psychiatry, and come to the wrong conclusions.It's possible. :-)
Squiggles
Posted by linkadge on February 15, 2007, at 13:43:52
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 15, 2007, at 11:13:35
>but rather i may have started with the wrong >foundations in psychiatry, and come to the wrong >conclusions.
I think it is more than possable.
Linkadge
Posted by Squiggles on February 15, 2007, at 14:02:39
In reply to Re: Everything I believe may be wrong, posted by linkadge on February 15, 2007, at 13:43:52
> >but rather i may have started with the wrong >foundations in psychiatry, and come to the wrong >conclusions.
>
> I think it is more than possable.
>
> Linkadge
>
>Why do you think that?
Squiggles
Posted by linkadge on February 15, 2007, at 16:04:19
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 15, 2007, at 14:02:39
I know that my own opinions and beliefs about psychiatry have evolved over the years.
Linkadge
Posted by Squiggles on February 15, 2007, at 16:10:07
In reply to Re: Everything I believe may be wrong, posted by linkadge on February 15, 2007, at 16:04:19
> I know that my own opinions and beliefs about psychiatry have evolved over the years.
>
> LinkadgeCare to elucidate? The message is a tad cryptical.
Squiggles
Posted by laima on February 15, 2007, at 17:04:10
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 15, 2007, at 16:10:07
I thought to jump in with an observation that even the "expert" professional opinions on psychiatry keep evolving and hopefully becoming more sophisticated-
> > I know that my own opinions and beliefs about psychiatry have evolved over the years.
> >
> > Linkadge
>
> Care to elucidate? The message is a tad cryptical.
>
> Squiggles
Posted by Squiggles on February 15, 2007, at 17:12:46
In reply to Re: Everything I believe may be wrong » Squiggles, posted by laima on February 15, 2007, at 17:04:10
>
> I thought to jump in with an observation that even the "expert" professional opinions on psychiatry keep evolving and hopefully becoming more sophisticated-
I just finished reading the story of a young
man who took his life on account of every treatment failing, despite his father's high
position in our country. This is nothing new,
unfortunately. We are all hoping for better
understanding, better knowledge. The area of
mental illness requires the best and the brightest, because it is so complex. Education is important, medical care, and scientific integrity; and a sympathetic ear of course.
Expensive stuff!Squiggles
Posted by laima on February 15, 2007, at 18:21:27
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 15, 2007, at 17:12:46
That's a very tragic story. Let's be glad that we're no longer in the middle of the previous century, that we are benefiting from more treatment options and far more nuanced comprehension of mood disorders now than existed then. Maybe in the next century people will look back onto our time like that, too. But there's still a long way to go, and today's rules of thumbs could well be overturned in the future. Yes, definately a field for the best and brightest minds- let's hope they get the funding they need, and aren't wooed or forced into overly simplistic fixes which are easy to sell and fund. Also good we get to exchange information and notes. It can't hurt to be as aware as possible. And still, I think it's better to be doubtful once in awhile than to cling to any ideas or treatments which aren't working out, or to dismiss ideas that could help but aren't immediately attractive. So I still think you are doing alright to be wondering if everything you believe might be wrong- you could be keeping your door open this way.
Posted by Squiggles on February 15, 2007, at 20:01:02
In reply to Re: Everything I believe may be wrong » Squiggles, posted by laima on February 15, 2007, at 18:21:27
>
> That's a very tragic story. Let's be glad that we're no longer in the middle of the previous century, that we are benefiting from more treatment options and far more nuanced comprehension of mood disorders now than existed then. Maybe in the next century people will look back onto our time like that, too. But there's still a long way to go, and today's rules of thumbs could well be overturned in the future. Yes, definately a field for the best and brightest minds- let's hope they get the funding they need, and aren't wooed or forced into overly simplistic fixes which are easy to sell and fund. Also good we get to exchange information and notes. It can't hurt to be as aware as possible. And still, I think it's better to be doubtful once in awhile than to cling to any ideas or treatments which aren't working out, or to dismiss ideas that could help but aren't immediately attractive. So I still think you are doing alright to be wondering if everything you believe might be wrong- you could be keeping your door open this way.I'm always looking at all the different causes
for mental illness. In studying the history and
the massive collection of research, it's obvious that mental illness can have many diverse causes-- from genetic, to life tragedies, to viruses, to brain damage, to endocrinological diseases... and on; this is what makes it so complex--it is the kind of illness that requires science as well as detective work in a person's life.But the results are always miserable, and i agree with you-- we have more treatment options. I read that on "About" [i think] that on average it takes 8 different medication treatments to arrive at something tolerable-- you just don't get that kind of problem with other illnesses.
Neurology may be our best bet in the future-- if we can actually scan brain disorders and get a parallel picture; alternatively, a panacea-- that's what i like-- a drug that stabilizes all mental disorders of the affective type at least :-).
Squiggles
Posted by munificentexegete on February 15, 2007, at 20:36:50
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 15, 2007, at 20:01:02
> >
> > That's a very tragic story. Let's be glad that we're no longer in the middle of the previous century, that we are benefiting from more treatment options and far more nuanced comprehension of mood disorders now than existed then. Maybe in the next century people will look back onto our time like that, too. But there's still a long way to go, and today's rules of thumbs could well be overturned in the future. Yes, definately a field for the best and brightest minds- let's hope they get the funding they need, and aren't wooed or forced into overly simplistic fixes which are easy to sell and fund. Also good we get to exchange information and notes. It can't hurt to be as aware as possible. And still, I think it's better to be doubtful once in awhile than to cling to any ideas or treatments which aren't working out, or to dismiss ideas that could help but aren't immediately attractive. So I still think you are doing alright to be wondering if everything you believe might be wrong- you could be keeping your door open this way.
>
> I'm always looking at all the different causes
> for mental illness. In studying the history and
> the massive collection of research, it's obvious that mental illness can have many diverse causes-- from genetic, to life tragedies, to viruses, to brain damage, to endocrinological diseases... and on; this is what makes it so complex--it is the kind of illness that requires science as well as detective work in a person's life.
>
> But the results are always miserable, and i agree with you-- we have more treatment options. I read that on "About" [i think] that on average it takes 8 different medication treatments to arrive at something tolerable-- you just don't get that kind of problem with other illnesses.
>
> Neurology may be our best bet in the future-- if we can actually scan brain disorders and get a parallel picture; alternatively, a panacea-- that's what i like-- a drug that stabilizes all mental disorders of the affective type at least :-).
>
> Squiggles
Mental Illness has been the source of much confusion and debate specifically over the last 100 years in particular.In my view Mental Illness can only be a synonym for neurological disease:
Mental = Neurological
Illness = Diseaseit is a term of the vernacular, a layman's version of a medical term, nothing further.
As such Mental Illness exists only when neurological disease is identified in a patient. We can thus distinguish illness from problems in living. If one feels depressed or anxious, one is not ill by default, if one feels scared or even commits a crime, one is not by default ill. If one feels happy and then sad one is not ill by default. If one has an overactive imagination or dresses or speaks esoterically or eccentrically one is not ill by default. Illness of any sort can only be defined by its detectable presence in an individual.
Parkinson's disease is a Mental Illness, it has a pathophysiology being the decay of the dopaminergic system. If we define schizophrenia as an overactivity in the dopaminergic system, then it too would be a Mental Illness. If we define bipolar as the overactivity followed by the under activity of the serotogenic system, then it too becomes a Mental Illness. However, without any pathophysiology schizophrenia and bipolar are meaningless, not mental illness at all, nothing more than metaphoric terms allowing doctors to define the well as diseased.
Redefine them as illnesses by all means, but don't insult our intelligence and expect us to admire the counterfeit.
Posted by Squiggles on February 15, 2007, at 21:05:44
In reply to Re: Everything I believe may be wrong, posted by munificentexegete on February 15, 2007, at 20:36:50
Brilliant! I've never seen it put so well.
Thank you.
Squiggles
Posted by lcat10 on February 17, 2007, at 13:36:24
In reply to Re: Everything I believe may be wrong, posted by Squiggles on February 15, 2007, at 21:05:44
Did I miss something? Is this thread related to medicaitons for depression?
Posted by Squiggles on February 17, 2007, at 15:01:12
In reply to Re: I'm confused, posted by lcat10 on February 17, 2007, at 13:36:24
Me too; it just seemed to take a detour;
Squiggles
Posted by Larry Hoover on February 18, 2007, at 9:48:11
In reply to Re: Everything I believe may be wrong, posted by munificentexegete on February 15, 2007, at 20:36:50
> Mental Illness has been the source of much confusion and debate specifically over the last 100 years in particular.
>
> In my view Mental Illness can only be a synonym for neurological disease:
>
> Mental = Neurological
> Illness = Disease
>
> it is a term of the vernacular, a layman's version of a medical term, nothing further.
>
> As such Mental Illness exists only when neurological disease is identified in a patient.... Illness of any sort can only be defined by its detectable presence in an individual.I much prefer the original Old French meaning for disease, in any case.... from "diseasu", not at peace.
I think you've gone astray from your premise. Detectability is not restricted to e.g. instrumental observations. Illness/disease is still most often detected behaviourally. We "rule out" various potential disorders, rather than verifying one in particular. Moreover, instrumental findings are often found to have provided both false positive and false negative assignments. Neither one precludes disease, but merely our understanding of what disease exists, if any. You are substituting interpretation for raw data observations. It is the difference between knowing something is wrong and what is wrong. There is no a priori requirement to know what is wrong before one can take steps to remedy the discomfort. The nature of the "something wrong" is often enough.
> Parkinson's disease is a Mental Illness, it has a pathophysiology being the decay of the dopaminergic system.
Parkinson's Disease existed, both as a human experience and as a concept, long before we had any knowledge of the pathophysiology. Did it suddenly spring into existence when we discovered the decay in the subtantia negra?
> If we define schizophrenia as an overactivity in the dopaminergic system, then it too would be a Mental Illness. If we define bipolar as the overactivity followed by the under activity of the serotogenic system, then it too becomes a Mental Illness. However, without any pathophysiology schizophrenia and bipolar are meaningless, not mental illness at all, nothing more than metaphoric terms allowing doctors to define the well as diseased.
I don't think a lay person needs to think "dopaminergic" to understand that a schizophrenic is having a different experience of the common reality than they themselves are having. Meanings of words have social components quite apart from their more technical definitions. It is true, most psychological diagnoses are behavioural. That does not invalidate the diagnoses themselves. The absence of evidence is not evidence of absence.
> Redefine them as illnesses by all means, but don't insult our intelligence and expect us to admire the counterfeit.
I am indeed concerned about redefinition going on.
I am always struck by one key element in the diagnostic assessment of psychological illness, such as defined in the DSM. It is the presence of phrasing such as "causing marked impairment/distress"....
Now, I know that diagnoses can be imposed upon the unwilling; distress and impairment are subjective. I prefer to see the psych diagnoses as working hypotheses, rather than as constructs with perfect validation. As hypotheses, the existence of exceptions serves to suggest a boundary condition not yet understood very well.
Consider diabetes. There are boundary blood sugar concentrations arbitrarily setting an exclusion/inclusion decision on the exocrine gland disease. Yet, I have no doubt there are people with lower blood sugar concentrations with undoubtable symptoms of the disease, and those above the threshold absolutely oblivious to the condition. And as to treatment, the dose of insulin required, even the type of it, is not found by a priori criteria. It is found by experiment.
I agree with you that we have only a weak and preliminary conceptualization of the relationship between brain tissue and biochemistry and the resultant cognition and behaviour. I also agree that it is unpleasant to be experimented on (a thesis that I infer from your arguments), yet that is all we have. It is all we have ever had.
Lar
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.