Posted by alexandra_k on September 24, 2006, at 2:59:42 [reposted on September 25, 2006, at 0:09:10 | original URL]
In reply to Re: Leaving the site for a while » alexandra_k, posted by Squiggles on September 23, 2006, at 22:03:03
> No, just had to do some other things.
Okay :-)
> it's just
> that serious conditions require medical
> intervention.but there are serious conditions that aren't helped by medical intervention, aren't there? the ones that aren't helped by medical intervention... might be better helped by other varieties of intervention, that was my thought.
> No. I am extremely fortunate and greatful
> to my doctor for treating me successfully.
> For 25 years, I have been able to lead a
> normal lifethat is terrific :-)
> - something that the victims of
> neglect and ignorance in the past, could only
> make entreties and plead for help.i guess it took a while for the treatments to be developed / made available
> Drugz are the answer -- unless you are not
> seriously mentally ill.so if drugs aren't working then you aren't seriously mentally ill?
or do you allow that future developments will mean that people who aren't currently being helped by them will be helped by them?you don't think there are serious mental illnesses that can't be helped by drugs as a matter of principle?
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.
> > Though it is controversial whether psychiatry is best thought of as a medical enterprise.
> 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).
> 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.
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.
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 :-)
> > 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 am a little wary of the 'worse prognosis thing...'
> > But I guess that is an issue for general medicine too...
> > Telling people how long they have to live...
> > And that they will never be able to walk again...
> > And such.
> Yes, if i were a doctor i would not do that--
> it's cruel and may even be false, but they
> are relying on historical data i guess.Yeah :-(
I think the worst thing a doc can say is 'you have this dx which means you are chronic but should grow out of it in old age' or whatever. given the current dx categories are inadequate... given how much that kind of information tends to take away hope and make it more likely that the person will come to believe it and thus make it so... i'm seriously concerned about the ethics of that. that is why it is important to get the dx categories right. so we don't harm people by making generalisations that are false :-(> Research methods is not my field, so I
> don't understand some of the concepts
> here.it isn't really mine either. i'm probably misusing concepts all over. sigh.
take care.
poster:alexandra_k
thread:688931
URL: http://www.dr-bob.org/babble/social/20060922/msgs/688959.html