![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Eddie Sylvano on May 19, 2003, at 10:56:21
Did anyone else happen to catch yesterday's "This American Life"? You can listen to it here: http://www.thislife.org/ra/207.ram
The show's focus was on people with developmental disorders. The first segment was an inspirational piece on mentally retarded people who produced a movie (among other things). It was nice. What interested me, however, were the last couple of segments about more emotionally disturbed individuals. One of the subjects was a 7 year old boy who suffers from a genetic defect, leaving him with a faulty heart, deformed brain, and rapid cycling bipolar disorder. The kid had it horrible! He would torture animals, destroy everything he could get his hands on, self-injure, became obsessed with death, black holes eating the universe, people being killed by evil ceiling fans. It just went on and on. This kid was totally, totally out of his own control, and darker than the back holes he obsessed about. It was an extremely sad story. Anyway, his mother finally decided one day that perhaps it wasn't her bad parenting causing this, and took him into a pdoc, who gave him Zyprexa. Surprise! He got better instantly, and his life is changed. The mother (and the NPR reporter) seemed flabbergasted by this.
The segement after this was about a 37 year old retarded man who had been doing relatively well until a couple of years ago, when he suddenly withdrew from everyone (quit his job, stopped activities, didn't talk much). The guy had such an unusual disorder at birth that it was named after him. Still, when this sudden change happened, everyone was mystified as to why. "What made him do this? What was he thinking?" was the question brought up throughout the segment. "We've asked him dozens of times." It never once occured to anyone that it *wasn't* a social event or decision on his part. Everyone in these stories looks for a personal reason for behavior; a rational motivation on the part of the person in question. So ingrained is the idea of volition in all forms of action that no one considered the idea that these people were damaged to the point that any semblance of volition is gone. These people aren't making decisions. They're an exaggeration of the processes that drive us all, and maybe we don't want to accept that. It makes total sense to me that our brains are automatic. There is no magical hand outside of the physical structure that is *us*, which makes decisions. We're all automatons in a sense, but very sophisticated ones. When the processes aren't working right, it becomes more obvious that we're our brains, and not vice versa. If the brain isn't working, neither are we. We're like HAL at the end of 2001, as Dave pulls out the modules and our simpler rules become manifest. I don't think people will ever accept this fact, much like we still cling to the idea that as a species, we're divinely exaulted with a soul. We're not special, we're just complex, and it's a convincing ontological illusion. Until we appeciate that fact, we're always going to be chasing ghosts in the machine as we attempt to understand ourselves and our problems.
Posted by Snoozy on May 19, 2003, at 13:06:14
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
I never seem to catch the Sunday broadcast, but they air it a couple of times during the week here, I'll definitely try to catch it.
I suppose it makes some sense to believe that there's a choice behind everything we do. The alternative is accepting the fact that things can be random and out of our control. I wonder if this is a cultural thing? This is not to say that we are slaves to our biology. I don't think Ken Lay can say "I had no choice in scamming billions of dollars - I'm hardwired to be a sleazeball". This is probably just belaboring the obvious though.
I thought the '90s were the proclaimed "Decade of the Brain". It's 2003 - they haven't figured it out yet? :)
No, we're not really special - but we do have opposable thumbs!
My mind is going....there is no question about it.
Posted by Tabitha on May 19, 2003, at 13:52:25
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
I think you've hit on the key fear behind much of the anti-med sentiment.. it's just so hard to accept we're not as 'in control' as we want to believe.
Posted by whiterabbit on May 19, 2003, at 14:20:46
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
Since I began psychiatric treatment, I've been impressed over and over on how brain function (and disfunction) can be compared to a computer.
Of course, the brain is a much more complex and marvelous structure than the computer but, not being the creators of the human brain, we don't understand all its processes and capabilities, while we can understand the computer and its similarities to the mind.I used to work with a wonderful young woman who has Tourettes Syndrome. Although she had some kind of medication that would help her to control the tics, she said that it made her feel sedated and she chose to not use it, preferring to endure the stares and whispers of other people. I was always impressed by her courage and fine personality, and at the office we all became fiercely protective of her.
It became obvious that Tourettes in no way affected her intelligence. She was funny and bright and did well at college. In observing her spasms, this is when I first became aware of how completely the different parts of the brain can operate independently of each other, and this helped me to understand my own illness. I was always bewildered and confused by the incessant stupidity of my actions, how I could have so little control, why I never learned. Any 5-year-old would know better than to do some of the things I did but I couldn't stop myself, I couldn't stop myself. No matter how unwise, unhealthy, unsafe, irrational or illegal, I did it anyway.
Watching my young friend with Tourettes, I began to understand that my lack of control was not caused by sheer stupidity. I realized that it's possible to be intelligent or even hyper-intelligent (like a savant) in some parts of your brain, while another part of your brain is totally mis-firing. I have a charming and personable cousin with a bad case of OCD - he'll go outside 20 or 30 times during the day to make sure his car doors are locked...it's pretty bizarre, right out of the "Stepford Wives". Obviously, there's a signal switch in his brain
that's "stuck", triggering this obsession. Surely he knows, he KNOWS, that he's going to find the car doors locked because he's already checked 10 times that morning, the last time just 1/2 an hour ago, but he feels compelled to keep checking.Watching this behavior, one begins to comprehend the roots of an obsessive disorder like gambling.
Everyone has heard about the housewife or the hard-working family man - seemingly normal, stable, average Americans - who go behind the spouse's back and gamble away the house and their life savings, and they don't even stop there. They get loans, borrow money, max out credit cards, and they lose all of that too. What rational person would behave in this manner? Unfortunately, you can be quite rational and still have a gambling problem.I continue to marvel at the difference in myself now that I'm taking effective psychiatric medication. How do they come up with this stuff?
The first big difference I noticed was this: my internal time clock was reset. As long as I take my Seroquel, I go to sleep at night and get up in the morning like other people. This is an astounding change - since my preteens, I've preferred to stay up at night and sleep in the daytime. This is quite a handicap, something I've had to work around and tried to adjust to all my life. I can't tell you what a relief it is to be on the same schedule as everyone else; I feel a lot more human, less vampirish. The miraculous thing, to me, is that Seroquel is not a "sleeping pill" (although it will make you very tired until you've adjusted to it). It doesn't knock you out
like traditional sleep aids, and you don't need to keep increasing the dosage for it to remain effective. Somehow, this drug has altered the chemistry in my brain to put me in a normal sleep cycle. I've literally been "re-programmed" in this way, and in others. Just as dazzling as the sleep change is the "moderation valve" that was installed in my head. I now have much more control over my actions than I did before, particularly with my old demon - alcohol. I can stop myself from getting drunk. If I run out of liquor, I don't get in my car at midnight to go and buy more. I don't drink enough to make myself sick.I've been warned by psychiatrists and even my angel therapist that I shouldn't be drinking at all. (I did say that I have MORE control, not total control.) Although my drinking doesn't worry me nearly as much as it does them, and I'm pretty happy with myself for being able to set and follow some limits (no hard liquor, etc.) where before there were NO limits at all, I suppose that it's hard for me to be safe, to completely stop playing with fire. Still, my candle no longer burns at BOTH ends. Thanks to medication.
-Gracie
Posted by Eddie Sylvano on May 19, 2003, at 15:20:43
In reply to Re: This American Life (NPR)-developmental disorders » Eddie Sylvano, posted by Tabitha on May 19, 2003, at 13:52:25
> I think you've hit on the key fear behind much of the anti-med sentiment.. it's just so hard to accept we're not as 'in control' as we want to believe.
--------------------And as Snoozy mentioned, we don't want to accept the idea that criminals had no control over their actions. Accountability is at the heart of law and religion, and it would seem like Pandora's box to say that there is no free will.
I can't begin to explain the basic rules that account for all of human behavior, but I'm sure they're there, just as they are for beagles, houseflies, and crabgrass. It's easier to accpet the idea that houseplants are bound in their behavior by simple rules, because they exhibit very mundane behaviors (grow towards light, sink roots towards gravity, etc). When you're attempting to solve a difficult mathematical model, there is a technique that says, essentially, simplify the problem to it's most basic constituents. If you can generalize a difficult problem to a simpler, but logically similar problem, you can cut out the extraneous details that cloud the issue. Life is all based on the same processes employed in various guises and degrees of complexity, but is still the same at heart. It also uses a very obfuscated method of solving its problems, employing trial and error rules, the most effective of which win out. This proces, played out over billions of generations, results in a mind boggling number of simple rules, whose interactions become exponentially more diverse as the number of them rises. Compared to the purposeful design of a computer program, this results in a hopeless mess of rules that just happened to work, and will probably be impossible to tease out of the whole. Saying that we're based on simple rules doesn't mean that we'll ever understand them.
The part that most people probably get hung up on is the idea of predestination. If we're robots following simple rules, doesn't that mean that all of our future actions are set in stone? In a sense, yes. The neat trick with people, though, is that our rules allow for much more environmental sensitivity than simpler systems. The fact that you're reading this post means that it could change your future behavior. The knowledge given to you every second by myriad sources is employed by your brain's program to modify it's behavior. On top of that, you have no way of knowing what kinds of information or input you'll get from day to day. Today, for example, my girlfriend warned me of a speed trap on my usual route home. Hence, I'll take a different route. Had she not told me this, I would likely have gotten a ticket. In smaller and smaller ways, these types of behavior modification happen all the time. The net effect of all this is beyond all hope of predicting, much like the weather, but is still a series of smaller, dumb interactions. To take Snoozy's example, the groundwork for Kenneth Lay to take advantage of a percieved loophole in accounting code was likely in place before the particular circumstances that put him into a position to do so arose. His inputs all conspired to make his particular mind believe that this would be advantageous enough to pursue. Had anything else happened during that time to cuase him to question this course of action, he might have stopped. No one else experienced the same unique set of inputs during their lifetime that he did, so no one else would have behaved in exactly the same way. I'm sure it seemed to him as if he were forging his own future, but that's only an interpretation of the big picture. What he didn't have control over were the trillions of smaller events that led him to such a system of beliefs, geographical location, group of peers, job, and so on. Worded differently, your current actions are based largely on your experiences up until that microsecond, and those prior experiences are similarly based, all the way back to the big bang (if you want to be philosophical). To say otherwise is to introduce some sort of supernatural force that acts on the scene.
When you push a series of stacked dominoes, you don't see one "decide" to do something like fall at a novel angle. The only way for us to be any different is to be made of atoms that have some sort of transcendant free will, much like the errant dominoe. Free will is an intractable engineering problem.
Anyway, I've rambled a lot here. I probably need to think of some better analogies to describe this.
Posted by Snoozy on May 19, 2003, at 16:14:29
In reply to Re: This American Life (NPR)-developmental disorders, posted by whiterabbit on May 19, 2003, at 14:20:46
I hear Microsoft is coming out with "Brain XP" :)
It was really interesting what you said about Tourette's. For a long time I have thought that there must be something similar going on between Tourette's and OCD. I saw this great documentary about Tourette's some years ago - Twitch and Shout. I've never known anyone who has it though. I'm all too familiar first-hand with OCD though :(
I know what you mean about the internal time clock thing. I'm also someone who becomes awake at night, and wants to sleep during the day. I don't know - there's something nice about being up at 3 or 4 a.m. The world around us is asleep and I feel like I'm safe. I've thought I should get a job in a time zone 12 hours away and telecommute!
Posted by whiterabbit on May 19, 2003, at 23:26:47
In reply to Re: The mind is a terrible thing......to waste » whiterabbit, posted by Snoozy on May 19, 2003, at 16:14:29
The big problem I had with being a night person is that the rest of the world wants you to be awake when they are. When I was young - about 250 years ago - and single, I tried to work the night shift at the hospital as much as possible, and I was happy doing that. It's hard with a young family, though. Your husband wants you to go to bed when he does and your kids want to see you once in awhile. I would have definately stayed with the evening or night shift if I was on my own, and I tried it for awhile, but I felt like I was missing too much time with my son. Plus - now this was a long time ago but it pains me to this day - for some reason, my own mother seemed determined to sabotage my night job. She would call me several times a day for any made-up reason at all, even though I begged her not to. I would try to explain that for her to call me at 2:00 in the afternoon was like me calling her every night at 2am just to chat (hell why didn't I do it??) but she ignored me. She would call and let the phone ring 100 times if that's what it took to wake me up, and then act surprised and hurt when I bellowed at her. I don't know WHAT was going on in her mind, if it was a control thing or she just hated me or what. After almost a year of this torture (I was young and strong or I never would have made it that long), I had to give up. I couldn't smear on enough makeup to hide my raccoon eyes and I was sick with exhaustion. (Incidentally, I finally stopped talking to my mother for many years. I hated her.)
It's ironic that now I'm on the same schedule as the rest of the world, it's no longer important for me to be in sync. My son is 21 and will soon be leaving home to do his own thing. My husband was busily divorcing me when he had a heart attack, so I'm helping him get back on his feet
so he can go on with his plans. (It's okay now, though - I've finally realized that I'll be a lot better off without him.) And even though Mom and I are making tentative steps to reconcile, she KNOWS I won't take any more of her crap. If she starts up again, she'll lose me forever and she knows that too. And she knows I know, so no more games.It's very possible that once I'm on my own, I will revert to being a nighthawk. Very possible.
-Gracie
Posted by jay on May 20, 2003, at 3:18:13
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
I was DX'ed with a formal developmental disorder at 2 years of age. I struggled with everything, and basic motor skills, speech, reading, math, etc, was all messed up. Man, it was hard as hell..and I remember the frustration, the anger, of not being able to speak right, etc. I couldn't write properly. It took four years of speech, writing, and physical therapy to help me cope. Of course back then they never (rarely) gave meds like nowadays.
I think that is partly the reason for my problems today...is I am still that _developmentally challenged_ kid, and everyone expects me to operate at some high-level of functioning. I am good at fooling people, and have great socail skills. In many ways I wish I had gotten the help and support I needed instead of always being refered to as a 'high-functioning retard'.
Posted by noa on May 21, 2003, at 19:23:10
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
Interesting. I love This American Life. I haven't heard it in a while because they moved it on me and I still haven't figured out the new schedule. Something to work on doing.
Posted by Snoozy on May 24, 2003, at 1:53:04
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
I got a chance to listen to the show today, it was really good, thanks for mentioning it.
It's amazing to hear what the Zyprexa did for Sam. I can't even begin to imagine how horrible the kid felt before. It would be very interesting to hear how he does over the years.
Posted by bookgurl99 on May 26, 2003, at 21:50:58
In reply to This American Life (NPR)-developmental disorders, posted by Eddie Sylvano on May 19, 2003, at 10:56:21
> One of the subjects was a 7 year old boy who suffers from a genetic defect, leaving him with a faulty heart, deformed brain, and rapid cycling bipolar disorder.
I'm really glad that this kid Sam found help. What I'm not glad about, though, is that his mother -- who lives in my area -- is a total news hound who has had several articles done on her boy. His picture was on the front page of a local weekly paper here. I think it's unkind to publicly label your kid with a mental illness; he may not want it to be so known when he's out there applying for his first job in 9 years.
From what I've read here, I think that the mom likes to do media in order to assuage her own guilt for Sam's misbehavior She wants all the info to be out there so people that saw him as a terror when he was young will know that it was really not her fault. Part of me thinks that she feels that it really IS her fault.
> The segement after this was about a 37 year old retarded man who had been doing relatively well until a couple of years ago, when he suddenly withdrew from everyone (quit his job, stopped activities, didn't talk much). Still, when this sudden change happened, everyone was mystified as to why. "What made him do this? What was he thinking?" was the question brought up throughout the segment. "We've asked him dozens of times."Actually, did you hear that Vincent was put on Prozac? It still didn't kick him out of the dumps, though I'd call that the result of SSRI apathy.
I think he was bored after doing the same things for 12 years. Who wouldn't?
* * *
It's true, though, that oftentimes our beliefs about our capacities to choose are exagerrated. Even a few days on Straterra, and I felt quite motivated. And, when I was hypothyroid, I had horrid ocd symptoms that were not cured by 'therapy' but by proper treatment and meds.It makes me think that people who do _not_ experience any mental illness need to get off their high horses sometimes. For example, I have one friend who regularly puts down another guy with social phobia. The social phobia guy, normally a smart science lab type, is dopey and slow on Paxil. And he _still_ drinks when he tries to go out and meet dates. The other guy is constantly putting down his inability to 'face it.' I figure he's just on the wrong meds. Sometimes I wish the judgemental one would get a taste of mental illness just to see what it's like.
*sigh* I'm still crabby about that mom draggin' her kid all over the media. I gotta go to bed.
books
Posted by Snoozy on May 28, 2003, at 0:55:36
In reply to Re: This American Life (NPR)-developmental disorders, posted by bookgurl99 on May 26, 2003, at 21:50:58
Hi -
Wow, that's really sad about that kid's mom. When I heard the show, I was wondering how they found this kid's story.
I've been thinking about what you said about people who just don't get it when it comes to mental illness. Can someone actually believe that if a social phobic had a choice, they would continue to be phobic? Or depressed, or anxious, or have panic attacks? That they "choose" to suffer?
I've got two theories going at the moment. I don't think you hear a lot of "get over it" directed at people with schizophrenia (I'm really hoping not anyway!) Most people will never experience the kind of symptoms that a schizophrenic has, but almost everyone has been sad, feeling down, a little anxious or shy maybe. And they associate their experience of these things with what depression, social phobia or panic attacks are like. They don't appreciate how different these things are from their experience.
An example I'm sure you can relate to: a migraine isn't "just" a headache. But sometimes people will think you just need to pop a couple of aspirin and "get over it".
I suppose the charitable way to look at it is that it's a subconscious response. People don't want to think that they could suffer these conditions, so it's easier to say "get over it" or "it's all in your head".
It's remarkable what a difference a medication that works can make. If there was an AD that worked as well as the triptans do on migraines, with no big side effects....uh-oh, I better not start thinking that - too depressing!
> > One of the subjects was a 7 year old boy who suffers from a genetic defect, leaving him with a faulty heart, deformed brain, and rapid cycling bipolar disorder.
>
> I'm really glad that this kid Sam found help. What I'm not glad about, though, is that his mother -- who lives in my area -- is a total news hound who has had several articles done on her boy. His picture was on the front page of a local weekly paper here. I think it's unkind to publicly label your kid with a mental illness; he may not want it to be so known when he's out there applying for his first job in 9 years.
>
> From what I've read here, I think that the mom likes to do media in order to assuage her own guilt for Sam's misbehavior She wants all the info to be out there so people that saw him as a terror when he was young will know that it was really not her fault. Part of me thinks that she feels that it really IS her fault.
>
>
> > The segement after this was about a 37 year old retarded man who had been doing relatively well until a couple of years ago, when he suddenly withdrew from everyone (quit his job, stopped activities, didn't talk much). Still, when this sudden change happened, everyone was mystified as to why. "What made him do this? What was he thinking?" was the question brought up throughout the segment. "We've asked him dozens of times."
>
> Actually, did you hear that Vincent was put on Prozac? It still didn't kick him out of the dumps, though I'd call that the result of SSRI apathy.
>
> I think he was bored after doing the same things for 12 years. Who wouldn't?
>
> * * *
>
>
> It's true, though, that oftentimes our beliefs about our capacities to choose are exagerrated. Even a few days on Straterra, and I felt quite motivated. And, when I was hypothyroid, I had horrid ocd symptoms that were not cured by 'therapy' but by proper treatment and meds.
>
> It makes me think that people who do _not_ experience any mental illness need to get off their high horses sometimes. For example, I have one friend who regularly puts down another guy with social phobia. The social phobia guy, normally a smart science lab type, is dopey and slow on Paxil. And he _still_ drinks when he tries to go out and meet dates. The other guy is constantly putting down his inability to 'face it.' I figure he's just on the wrong meds. Sometimes I wish the judgemental one would get a taste of mental illness just to see what it's like.
>
> *sigh* I'm still crabby about that mom draggin' her kid all over the media. I gotta go to bed.
>
> books
>
>
>
This is the end of the thread.
Psycho-Babble Social | 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.