![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Scott L. Schofield on April 8, 2000, at 10:55:54
BIOLOGY OR PSYCHOLOGY?
The best answer to this question may be “either and both”.Many of us here have been diagnosed as having a mental illness. “Mental illness” is NOT “mental weakness”. The diagnoses that we are most familiar with include:
1. Major Depression (Unipolar Depression)
2. Bipolar Disorder (Manic Depression)
3. Dysthymia (Minor Depression)
4. Seasonal Affective Disorder (SAD)
5. Schizophrenia
6. Schizo-Affective Disorder
7. Obsessive-Compulsive Disorder (OCD)
8. Post-Traumatic Stress Disorder (PTSD)All of these disorders have one thing in common. They are not our fault. Each has both biological and psychological components. We all begin our lives with a brain that is built using the blueprints contained within the genes we inherit from our parents. Later, hormones change the brain to prepare it for adulthood. The brain can be changed in negative ways by things such as drugs, alcohol, and injury. The brain is also changed by the things we experience.
How we think and feel are influenced by our environment. Probably the most important environment is the family, with the most important time being our childhood. We all have both positive and negative experiences as we travel through life. How we are as adults is in large part determined by these positive and negative experiences. They affect our psychology, our emotions, and our behaviors. All of us can be hurt by unhealthy negative experiences.
Some of us are also hurt by unhealthy brains. Medical science has long recognized that many mental illnesses are biological illnesses. Even Sigmund Freud, who we know for his development of psychoanalysis, proposed a role for biology in mental illness. The first solid evidence for this concept in modern times came with the discovery of lithium in 1947. Lithium was found to cause the symptoms of bipolar disorder (manic-depression) to disappear completely, allowing people to lead normal lives. Lithium helps to correct for the abnormal biology that is the cause of bipolar disorder. Later biological discoveries included the observations that Thorazine (an antipsychotic) successfully treated schizophrenia, and that Tofranil (an antidepressant) successfully treated depression. Again, these drugs help to correct for the abnormal biology of the brain that accompanies these illnesses.
What about psychology? This can be a two-way street. The abnormal biology that occurs with some mental illnesses affects our psychology – how we think, feel, and behave. On the other hand, our psychology can also affect our biology. Often, the emotional stresses and traumas we experience change the way our brains operate. This is especially true of things we experience during childhood. These stresses can trigger the start of major depression, bipolar disorder, schizophrenia, and other mental illnesses. In order for this to happen, however, there must be a biological weakness to begin with. Not all doctors agree with all of this, but the vast majority of our top researchers in psychiatry do.
It is important to understand that not all psychological and emotional troubles are biological in origin. Again, we are all products of our environments – family, friends, enemies, school, work, culture, climate, war, etc. Environments that are unhealthy often produce unhealthy people. This, too, is not our fault.
In conclusion, regardless of the cause of our illness, it is important that we treat both the biological and the psychological. We will all benefit if we do.
- Scott
Posted by boB on April 8, 2000, at 17:55:15
In reply to BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 8, 2000, at 10:55:54
Research has found statistical correlations between many of the symptoms you describe and biological conditions relating to the brain. The correlations do not prove causation.Psychopharmaceuticals in many cases seem to eliminate the symptoms. Some of the people who take meds are also included in research projects that identify specific changes that result from the meds.
Studies of medically endorsed drug use do not end discussion about causation, nor whether symptoms that might be diagnosed as minor depression, bipolar depression, post traumatic stress, and seasonal effective disorder are reactions to situational causes and could alternately be resolved by changes in situations.
I, for one, have no problem with people choosing the medical/pharmaceutical path. But I consider it to be not only unscientific but also a violation of my human rights when medical licensing and academic direction are corrupted by the profits of drug manufacturers to claim an exclusive right to define the nature of my and my fellow citizens' understanding of our brief lives.
Posted by Scott L. Schofield on April 8, 2000, at 19:46:40
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by boB on April 8, 2000, at 17:55:15
> Research has found statistical correlations between many of the symptoms you describe and biological conditions relating to the brain. The correlations do not prove causation.
1. Major Depression (Unipolar Depression)
2. Bipolar Disorder (Manic Depression)
3. Dysthymia (Minor Depression)
4. Seasonal Affective Disorder (SAD)
5. Schizophrenia
6. Schizo-Affective Disorder
7. Obsessive-Compulsive Disorder (OCD)
8. Post-Traumatic Stress Disorder (PTSD)These are not symptoms. They are clinical diagnoses. I don't believe I listed or referred to a single symptom of anything in my previous post.
Of the diagnoses I have listed, are there any for which you believe that biology is the causative agent?Of the diagnoses I have listed, are there any for which you believe that biology is the agent for its perpetuation?
Of the diagnoses I have listed, are there any for which you are sure that biology is neither the causative agent nor the agent for its perpetuation?
Just curious.
- Scott
Posted by boB on April 8, 2000, at 22:09:00
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 8, 2000, at 19:46:40
(reference to list in previous post)
> These are not symptoms. They are clinical diagnoses. I don't believe I listed or referred to a single symptom of anything in my previous post.DSM-IV diagnoses are a nomenclature for groups of symptoms.
>
>
> Of the diagnoses I have listed, are there any for which you believe that biology is the causative agent?
>
> Of the diagnoses I have listed, are there any for which you believe that biology is the agent for its perpetuation?
>
> Of the diagnoses I have listed, are there any for which you are sure that biology is neither the causative agent nor the agent for its perpetuation?
>Of the diagnoses you have listed, the observation of the clinical practioner is the causative agent. The practitioner's preference for a common nomenclature, in this case DSM-IV, causes the practitioner to form an opinion based upon the practitioner's observation of symptoms. The practitioner's opinion is known as a diagnosis.
The diagnostic methods inferred by DSM-IV's inventory of diagnoses include subjective and projective tests, but not as often chemical tests or biologal measurements. The nomenclature of DSM-IV was derived from the review of collected data, which included data derived by subjective tests, objective tests and neurobiological research.
Biology is the study of biological relationships and conditions. All human action, even religion, is caused and perpetuated by biological relationships because every living thing is classified as a biological organism. Biological conditions are clearly involved in the causation and perpetuation of all of the classifications of symptoms to which you refer.
Posted by Scott L. Schofield on April 9, 2000, at 0:29:42
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by boB on April 8, 2000, at 22:09:00
> (reference to list in previous post)
> > These are not symptoms. They are clinical diagnoses. I don't believe I listed or referred to a single symptom of anything in my previous post.
> DSM-IV diagnoses are a nomenclature for groups of symptoms.No. I don't think so. My unschooled perception of the DSM is that it is a listing of the clinical diagnoses of specific named medical conditions for which each is prescribed a precise algorithm of symptom identification and inclusion based upon observational statistics. That's what it looks like to me, anyway.
> > Of the diagnoses I have listed, are there any for which you believe that biology is the causative agent?
> >
> > Of the diagnoses I have listed, are there any for which you believe that biology is the agent for its perpetuation?
> >
> > Of the diagnoses I have listed, are there any for which you are sure that biology is neither the causative agent nor the agent for its perpetuation?> Of the diagnoses you have listed, the observation of the clinical practioner is the causative agent.
This is witty, but shallow and meaningless rhetoric. Of course, I'm supposed to append a IMHO. I would still be interested to see your response to at least one of these questions.
> The practitioner's preference for a common nomenclature,
I should hope a practitioner would be in favor of the use of a common (standardized) nomenclature. Don't you?
> in this case DSM-IV, causes the practitioner to form an opinion based upon the practitioner's observation of symptoms.
I prefer the word "encourages" to "causes". It just sounds better to me.
> The practitioner's opinion is known as a diagnosis.
The practitioner's choice of a particular diagnosis is his opinion.
> The diagnostic methods inferred by DSM-IV's inventory of diagnoses include subjective and projective tests, but not as often chemical tests or biologal measurements. The nomenclature of DSM-IV was derived from the review of collected data, which included data derived by subjective tests, objective tests and neurobiological research.Sounds pretty good. I am particularly fond of your use of the word "method". It reminds me a bit of the word "algorithm".
> Biology is the study of biological relationships and conditions.I know I can be a stickler for words. The definition of biology is both simpler and broader.
BIOLOGY:
The science of life and of living organisms, including their structure, function, growth, origin, evolution, and distribution.
* biology \Bi*ol"o*gy\, n. [Gr. ? life + -logy: cf. F. biologie.] The science of life; that branch of knowledge which treats of living matter as distinct from matter which is not living; the study of living tissue. It has to do with the origin, structure, development, function, and distribution of animals and plants.
Source: Webster's Revised Unabridged Dictionary, © 1996, 1998 MICRA, Inc.* Unfortunately, this definition leaves out such things as protistans, bacteria, fungi, and, depending on who you listen to, viruses. (Personally, I don't see how viruses cannot be considered life. Although viruses really do suck, they still use DNA, even though they have to steal it).
> All human action, even religion, is caused and perpetuated by biological relationships because every living thing is classified as a biological organism. Biological conditions are clearly involved in the causation and perpetuation of all of the classifications of symptoms to which you refer.And these truths we hold to be self-evident.
Looking back on my original post, I see that I mentioned something about it being important to understand that not all psychological and emotional troubles are biological in origin. I also notice that I stated an opinion that it is important that we treat both the biological and the psychological. Additionally, I don't see that I have specified any biological treatments. Drugs would be included, but not exclusive.
I'm not really sure why we are having this discourse. What is your thesis?
Sincerely,
Scott
Posted by Little Bo Peep on April 9, 2000, at 2:57:28
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 9, 2000, at 0:29:42
Maybe enviromental vs. physiological would be better?
Posted by bob on April 9, 2000, at 12:47:38
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 9, 2000, at 0:29:42
You know, I knew this biology teacher once who would, on the first day of class, say to his students:
"What does 'biology' mean? Okay, let's break it down. 'Bi' -- that means two. 'Ology' -- the study of. So, biology is the study of two things: plants and animals."
He was serious.
Anyway, creating a dichotomy such as biology vs psychology may be problematic in that (a) it falls back on the old Cartesian mind-body duality bugaboo, and so (b) goes back to far older philosophical mistakes (to Aristotle) by raising the questions of a First Cause. Who cast the first stone -- body or mind?
Reducing the problem to biology since, from a purely mechanistic point of view, psychology and mind are expressions of biological constructs, is also problematic in that this approach ignores super-biological constructs such as cultures and societies that have lives of their own outside of the sway of any biological construct to modify in any significant way (outside of such biological constructs as, say, Gandhi, Jesus, or Hitler). boB, you seem particularly tuned into the illnesses of our culture -- how well can you track the initial cause of these cultural illnesses back to a specific biological source?
just wondering,
bob
Posted by boB on April 9, 2000, at 16:22:53
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 9, 2000, at 0:29:42
>> I'm not really sure why we are having this discourse.
Because your post seemed to address issues I had posted over several days. Once i responded, we were engaged more or less in a one on one dialogue. We must both be interested in testing the limits of our understanding.
SLS> What is your thesis?
reply> I'll get to that....
boB > DSM-IV diagnoses are a nomenclature for groups of symptoms.
SLS> No. I don't think so. My unschooled perception of the DSM is that it is a listing of the clinical diagnoses of specific named medical conditions for which each is prescribed a precise algorithm of symptom identification and inclusion based upon observational statistics. That's what it looks like to me, anyway.
Reply - the definition you offer of DSM-IV diagnosis is weak because it is a string of prepositional phrases. My statement that “DSM-IV is a nomenclature” is a statement to which opposing attorneys often stipulate when qualifying expert testimony. The phrase “specific medical conditions” is actually quite vague, referring basically to the consensus of included practitioners. But your reference to “each is prescribed a precise algorithm of symptom identification and inclusion based upon observational statistics,” is accurate, except for the “precise” part. Obeervation that a subject does not have telephone is a component of the “precise algorithm” by which clinicians are encouraged to derive a diagnosis of “schizoid personality.” (At least it was in an earlier DSM - don’t have the latest version in front of me) Anyway, such subjective measures, and subjective tests like Rorshac and draw a person are also impricise, and widely criticized as measureing the test giver as much as the test taker.
Once a practitioner reaches a verdict (sorry) based on DSM, pharmaceutal suggestions often follow. Lost in the process is an understanding by the subject (patient) that the subjective tests used to derive the diagnosis relate only vaguely to precise neurochemical conditions.boB> Of the diagnoses you have listed, the observation of the clinical practitioner is the causative agent.
SLS> This is witty, but shallow and meaningless rhetoric. Of course, I'm supposed to append a IMHO.
reply: In your humble opinion indeed, but actually my analysis is a precise analysis of the process. To understand my thesis, my response (which you apparently don’t yet recognize), and finally the complex causation of conditions classified in DSM-IV, one needs to obey such precise rules of language.
To say a general feeling of meaninglessness and malaise is “the biology of depression” is not precise use of language - it is rather a lay understanding, and contains the elements of a medical folklore.
SLS> I would still be interested to see your response to at least one of these questions.
reply> you have seen it, but apparently do not yet recognize it. You called it shallow and meaningess rhetoric.
boB > The practitioner's preference for a common nomenclature,SLS> I should hope a practitioner would be in favor of the use of a common (standardized) nomenclature. Don't you?
Reply: more or less, but I would hope practitioners continue to be scientists, and as such seek to advance the collective understanding while realizing limitations of the present understanding, rather than become authoritarians who insist on the correctness of their present understanding.
boB > in this case DSM-IV, causes the practitioner to form an opinion based upon the practitioner's observation of symptoms.
SLS> I prefer the word "encourages" to "causes". It just sounds better to me.
reply: Granted. Attribution of motive is a fundamental error in any public discourse. I actually noticed the same error, once I had posted. We are shooting from the hip in this dialogue and I am posting scantily edited, complex and wide-ranging replies that stretch the limits of my ability. I am not conducting research, siting sources, or even spending a day away from my text, and the second opinion I seek is the one you offer.
boB > The practitioner's opinion is known as a diagnosis.
SLS> The practitioner's choice of a particular diagnosis is his opinion.
reply If a=b and b=c then a=c. Or more simply, in this case, if a=b then b=a.
boB > The diagnostic methods inferred by DSM-IV's inventory of diagnoses include
subjective and projective tests, but not as often chemical tests or biological
measurements. The nomenclature of DSM-IV was derived from the review of
collected data, which included data derived by subjective tests, objective tests
and neurobiological research.SLS> Sounds pretty good. I am particularly fond of your use of the word "method". It
reminds me a bit of the word "algorithm".reply I think we are reading the same book on this one. My point, which approaches my thesis, is that in this case a does not equal b, but is similar to b. “A” would be the collected data used to compile the DSM-IV nomenclature, and “B” would be the diagnoses rendered in clinical settings based on the nomenclature.
My thesis is that the necessities of practice and of specialization dilute the ability of practitioners and specialists to fully understand the complex genetic, experiential, cultural, neurochemical relationships they define as disorder. Disorder is a definition, not an exact condition. An understanding of the arbitrariness and ambiguity of diagnosis leaves room for more complex understanding of contributing circumstance. My thesis, since you asked, is that our current medical culture is more oriented toward changing the biological condition of the subject ( i.e. patient) rather than explaining and effecting specific and systematic conditions that effect the individual subject and groups of subjects.
boB > Biology is the STUDY OF biological relationships and conditions.
SLS> I know I can be a stickler for words. The definition of biology is both simpler and broader.
BIOLOGY:
The science of life and of living organisms, including their structure, function,
growth, origin, evolution, and distribution.* biology \Bi*ol"o*gy\, n. [Gr. ? life + -logy: cf. F. biologie.] The science of
life; that branch of knowledge which treats of living matter as distinct from
matter which is not living; the STUDY OF living tissue. It has to do with the origin,
structure, development, function, and distribution of animals and plants.
Source: Webster's Revised Unabridged Dictionary, © 1996, 1998 MICRA,
Inc.Reply> You offer a better definition, compiled by dictionary editors.
My point was that biology is a STUDY, a point to which we both referred.
My response to your query “Of the diagnoses I have listed, are there any for which you believe that biology is the causative agent?” is that the study does indeed lead to the diagnoses, and the conditions to which the diagnoses refer do indeed involve living tissue. But that is not the equivalent of saying “low serotonin levels cause depression.”My point is that the convenience (and profitability) of medications, and our present fascination with laboratory discoveries is contributing to a bit of ignorance (not paying attention to) circumstances that can contribute to the biological conditions we define, classify and often treat with neurotropic pharmaceuticals. Contributing to this particular area of ignorance is the role of pharmaceutical sales forces in developing the language whereby we understand conditions diagnosed as disorders. The pharmaceutical sales force has a vested interest in maintaining a certain cultural direction, and has little reason to suggest that people might be to hard by those cultural forces.
As a collectivity, the pharmaceutical industry contributes to research that advances its market share, but does not contribute nearly as much, or at all, to research that might explain our growing fascination with human fabrications. This dichotomy is occurring at a time when human fabrications are becoming increasingly dangerous to the broader biological web of living organisms.
SLS> (in reference to his initial post) I stated an opinion that it is important
that we treat both the biological and the psychological. Additionally, I don't see
that I have specified any biological treatments. Drugs would be included, but
not exclusive.boB> I recognize that. I am responding to the weight given to pharmaceuticals, which enjoy the advantage of “hard” research, at the expense of psychology, which includes social psychology and is stunted by being informed by “soft” research. My thesis, is that the “soft” sciences desperately need to be informed by the “hard” research that is driven by market forces to contribute more to pharmaceutical than experiential treatment of personal, social and mental difficulties.
I hope it is clear I am not out to prove Steve wrong, but to implore, at a time when this summer is likely to be hotter than last summer, when CO2 levels are likely to be higher this year than last, when more species will be rendered extinct, when a greater portion of the American population will be in prison this year than last, (among other indicators of sociopathology) that research and clinical psychiatry look closely at our relationships within natural world and within human society and share with us the “hard” science that will encourage us to seek less, not more, and to be more satisfied with who we are rather than constantly pursuing happiness.
(J-Criminy that’s a long sentence)
Posted by KarenB on April 9, 2000, at 16:25:59
In reply to BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 8, 2000, at 10:55:54
Scott,
I would theorize that some individuals are born with a predisposition to certin diseases or disorders - but not the full blown disorder from birth. Then, by and by, I think faulty thinking and/or behavior actually causes physical damage. For example, in the Bible, we are instructed not to "let the sun go down on our anger...," etc. etc. I believe we are instructed in such things because unforgiveness, and so on cause real psychological AND physical damage, not to mention spiritual.
The problem is, even though I may talk it out, forgive, ask forgiveness, let go and all that, I am now stuck with the neurochemical damage caused by my actions (and the actions of others, as in dysfunctional families). Since to date, no one knows how to REVERSE or fix the damage, we have meds.
So there you have it. Biology and Psychology are both responsible. Not to mention spiritual illness we are all born with. That's my $.02
Was that the question?
Karen
Posted by boB on April 9, 2000, at 23:42:27
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by KarenB on April 9, 2000, at 16:25:59
Are your sure of your presumption that : to date,
no one knows how to REVERSE or fix the damage, we have meds.
Is that not based primarily on your own experience. It seems to me you can not really offer a precise explanation of what physical damage might have been done. All we have is a statistical correlation between certain behavioural/mental irregularities and a group of neurochemical findings. that is a far cry from proof of physical damage, and even further from a conclusion that the damage is irreperable or is not repaired in many cases by other means which are not included in studies.To reach this conclusion you must presume that i, for one, have not experienced equally devastating symptoms and endured or overcome them without the use of licensed meds.
Posted by MSD on April 10, 2000, at 1:10:35
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by boB on April 9, 2000, at 23:42:27
The "do not let the sun go down on your anger" is no doubt good advice but what I wonder is can anyone turn your emotions on and off like a light switch? It doesn't seem to work for me, of course I am a far cry from normal.
Posted by brooks on April 10, 2000, at 2:42:04
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by MSD on April 10, 2000, at 1:10:35
> The "do not let the sun go down on your anger" is no doubt good advice but what I wonder is can anyone turn your emotions on and off like a light switch? It doesn't seem to work for me, of course I am a far cry from normal.
You're right, of course - it's easy to say but virtually impossible to do, without God's help - normal or not.
brooks
Posted by Scott L. Schofield on April 10, 2000, at 11:17:09
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by boB on April 9, 2000, at 16:22:53
I give up.
You win, we lose.
- Scott
----------------------------------
> >> I'm not really sure why we are having this discourse.
>
> Because your post seemed to address issues I had posted over several days. Once i responded, we were engaged more or less in a one on one dialogue. We must both be interested in testing the limits of our understanding.
>
> SLS> What is your thesis?
>
> reply> I'll get to that....
>
> boB > DSM-IV diagnoses are a nomenclature for groups of symptoms.
>
> SLS> No. I don't think so. My unschooled perception of the DSM is that it is a listing of the clinical diagnoses of specific named medical conditions for which each is prescribed a precise algorithm of symptom identification and inclusion based upon observational statistics. That's what it looks like to me, anyway.
>
> Reply - the definition you offer of DSM-IV diagnosis is weak because it is a string of prepositional phrases. My statement that “DSM-IV is a nomenclature” is a statement to which opposing attorneys often stipulate when qualifying expert testimony. The phrase “specific medical conditions” is actually quite vague, referring basically to the consensus of included practitioners. But your reference to “each is prescribed a precise algorithm of symptom identification and inclusion based upon observational statistics,” is accurate, except for the “precise” part. Obeervation that a subject does not have telephone is a component of the “precise algorithm” by which clinicians are encouraged to derive a diagnosis of “schizoid personality.” (At least it was in an earlier DSM - don’t have the latest version in front of me) Anyway, such subjective measures, and subjective tests like Rorshac and draw a person are also impricise, and widely criticized as measureing the test giver as much as the test taker.
> Once a practitioner reaches a verdict (sorry) based on DSM, pharmaceutal suggestions often follow. Lost in the process is an understanding by the subject (patient) that the subjective tests used to derive the diagnosis relate only vaguely to precise neurochemical conditions.
>
>
>
> boB> Of the diagnoses you have listed, the observation of the clinical practitioner is the causative agent.
>
> SLS> This is witty, but shallow and meaningless rhetoric. Of course, I'm supposed to append a IMHO.
>
> reply: In your humble opinion indeed, but actually my analysis is a precise analysis of the process. To understand my thesis, my response (which you apparently don’t yet recognize), and finally the complex causation of conditions classified in DSM-IV, one needs to obey such precise rules of language.
>
> To say a general feeling of meaninglessness and malaise is “the biology of depression” is not precise use of language - it is rather a lay understanding, and contains the elements of a medical folklore.
>
> SLS> I would still be interested to see your response to at least one of these questions.
>
> reply> you have seen it, but apparently do not yet recognize it. You called it shallow and meaningess rhetoric.
> boB > The practitioner's preference for a common nomenclature,
>
> SLS> I should hope a practitioner would be in favor of the use of a common (standardized) nomenclature. Don't you?
>
> Reply: more or less, but I would hope practitioners continue to be scientists, and as such seek to advance the collective understanding while realizing limitations of the present understanding, rather than become authoritarians who insist on the correctness of their present understanding.
>
> boB > in this case DSM-IV, causes the practitioner to form an opinion based upon the practitioner's observation of symptoms.
>
> SLS> I prefer the word "encourages" to "causes". It just sounds better to me.
>
> reply: Granted. Attribution of motive is a fundamental error in any public discourse. I actually noticed the same error, once I had posted. We are shooting from the hip in this dialogue and I am posting scantily edited, complex and wide-ranging replies that stretch the limits of my ability. I am not conducting research, siting sources, or even spending a day away from my text, and the second opinion I seek is the one you offer.
>
> boB > The practitioner's opinion is known as a diagnosis.
>
> SLS> The practitioner's choice of a particular diagnosis is his opinion.
>
> reply If a=b and b=c then a=c. Or more simply, in this case, if a=b then b=a.
>
> boB > The diagnostic methods inferred by DSM-IV's inventory of diagnoses include
> subjective and projective tests, but not as often chemical tests or biological
> measurements. The nomenclature of DSM-IV was derived from the review of
> collected data, which included data derived by subjective tests, objective tests
> and neurobiological research.
>
> SLS> Sounds pretty good. I am particularly fond of your use of the word "method". It
> reminds me a bit of the word "algorithm".
>
> reply I think we are reading the same book on this one. My point, which approaches my thesis, is that in this case a does not equal b, but is similar to b. “A” would be the collected data used to compile the DSM-IV nomenclature, and “B” would be the diagnoses rendered in clinical settings based on the nomenclature.
>
> My thesis is that the necessities of practice and of specialization dilute the ability of practitioners and specialists to fully understand the complex genetic, experiential, cultural, neurochemical relationships they define as disorder. Disorder is a definition, not an exact condition. An understanding of the arbitrariness and ambiguity of diagnosis leaves room for more complex understanding of contributing circumstance. My thesis, since you asked, is that our current medical culture is more oriented toward changing the biological condition of the subject ( i.e. patient) rather than explaining and effecting specific and systematic conditions that effect the individual subject and groups of subjects.
>
> boB > Biology is the STUDY OF biological relationships and conditions.
>
> SLS> I know I can be a stickler for words. The definition of biology is both simpler and broader.
>
> BIOLOGY:
>
> The science of life and of living organisms, including their structure, function,
> growth, origin, evolution, and distribution.
>
> * biology \Bi*ol"o*gy\, n. [Gr. ? life + -logy: cf. F. biologie.] The science of
> life; that branch of knowledge which treats of living matter as distinct from
> matter which is not living; the STUDY OF living tissue. It has to do with the origin,
> structure, development, function, and distribution of animals and plants.
> Source: Webster's Revised Unabridged Dictionary, © 1996, 1998 MICRA,
> Inc.
>
> Reply> You offer a better definition, compiled by dictionary editors.
> My point was that biology is a STUDY, a point to which we both referred.
> My response to your query “Of the diagnoses I have listed, are there any for which you believe that biology is the causative agent?” is that the study does indeed lead to the diagnoses, and the conditions to which the diagnoses refer do indeed involve living tissue. But that is not the equivalent of saying “low serotonin levels cause depression.”
>
> My point is that the convenience (and profitability) of medications, and our present fascination with laboratory discoveries is contributing to a bit of ignorance (not paying attention to) circumstances that can contribute to the biological conditions we define, classify and often treat with neurotropic pharmaceuticals. Contributing to this particular area of ignorance is the role of pharmaceutical sales forces in developing the language whereby we understand conditions diagnosed as disorders. The pharmaceutical sales force has a vested interest in maintaining a certain cultural direction, and has little reason to suggest that people might be to hard by those cultural forces.
>
> As a collectivity, the pharmaceutical industry contributes to research that advances its market share, but does not contribute nearly as much, or at all, to research that might explain our growing fascination with human fabrications. This dichotomy is occurring at a time when human fabrications are becoming increasingly dangerous to the broader biological web of living organisms.
>
>
>
> SLS> (in reference to his initial post) I stated an opinion that it is important
> that we treat both the biological and the psychological. Additionally, I don't see
> that I have specified any biological treatments. Drugs would be included, but
> not exclusive.
>
> boB> I recognize that. I am responding to the weight given to pharmaceuticals, which enjoy the advantage of “hard” research, at the expense of psychology, which includes social psychology and is stunted by being informed by “soft” research. My thesis, is that the “soft” sciences desperately need to be informed by the “hard” research that is driven by market forces to contribute more to pharmaceutical than experiential treatment of personal, social and mental difficulties.
>
> I hope it is clear I am not out to prove Steve wrong, but to implore, at a time when this summer is likely to be hotter than last summer, when CO2 levels are likely to be higher this year than last, when more species will be rendered extinct, when a greater portion of the American population will be in prison this year than last, (among other indicators of sociopathology) that research and clinical psychiatry look closely at our relationships within natural world and within human society and share with us the “hard” science that will encourage us to seek less, not more, and to be more satisfied with who we are rather than constantly pursuing happiness.
>
> (J-Criminy that’s a long sentence)
Posted by KarenB on April 10, 2000, at 12:27:52
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 10, 2000, at 11:17:09
> I give up.
>
> You win, we lose.
>
>
> - Scott
Yeah, me too. I'm not up to it, boB. Don't think anybody truly KNOWS anything about this subject, anyway.Karen
Posted by Scott L. Schofield on April 10, 2000, at 12:53:06
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by KarenB on April 9, 2000, at 16:25:59
> Scott,
>
> I would theorize that some individuals are born with a predisposition to certin diseases or disorders - but not the full blown disorder from birth. Then, by and by, I think faulty thinking and/or behavior actually causes physical damage. For example, in the Bible, we are instructed not to "let the sun go down on our anger...," etc. etc. I believe we are instructed in such things because unforgiveness, and so on cause real psychological AND physical damage, not to mention spiritual.
>
> The problem is, even though I may talk it out, forgive, ask forgiveness, let go and all that, I am now stuck with the neurochemical damage caused by my actions (and the actions of others, as in dysfunctional families). Since to date, no one knows how to REVERSE or fix the damage, we have meds.
>
> So there you have it. Biology and Psychology are both responsible. Not to mention spiritual illness we are all born with. That's my $.02
>
> Was that the question?
>
> Karen
-------------------------------------
Hi Karen.
This sounds pretty good to me. The details of my current thoughts regarding some of this stuff may be a bit different than yours, but I find your approach toward understanding the relationships between the biological and the psychological to be quite similar to mine.=> The following is not directed at anyone, not even Bob ("bob" as opposed to "boB"), whose posts I always take great delight in reading and learning from - previous post included. :-) No heated arguments are being solicited. However, goal-oriented discussion is important, productive, and often delightful. Of course, anyone may argue if they would like to. I know I often do. Anger feels good. I just don't want to right now.
Perhaps my first post is more ambiguous than I hoped it would be. I thought I was pretty clear in describing my thoughts regarding the relationship between mind (psychology) and body (brain). I did try to keep it simple, though. I just brushed the tip of the iceberg. I don't think this was a titanic mistake. A more complete treatise on this topic would be prohibitively long and unnecessary.
When reviewing some of the replies to my initial post, I can't help but to wonder if the posters spent enough time reading it. I did focus quite a bit more on those mental illnesses for which I deem biology to play a major role, for it seems they are the ones more often encountered on this board. I am certain that I tried to establish a basis for a model of the dynamics between the biology of the brain and the psychology of the mind as they relate to mental illness. It is, of course, just one model. I think it is a pretty good one, though. It might even work in real-life.
I did neglect a HUGE point. Just because abnormal biological function may be responsible for sustaining a mental illness, this does not mean that an exclusively psychological approach will not effectively treat it. I believe that "depressive pressure" can trigger major depression. Remove the negative pressure. Apply positive pressure. Why not? There are plenty of scientific studies that demonstrate the efficacy of psychotherapy for treating major depression. I believe such negative pressures can cause medication break-through or perhaps even prevent a response to medication in the first place. This would argue in favor of combining both biological and psychological treatments.
I think it is obvious that some mental illnesses are biologically very "hard". They have at their root an abnormality of structure and/or function, and seem to respond only to somatic therapies. Schizophrenia displays a degenerative process. Ventricles grow in size, and brain tissue is lost. There is often a strong pattern of heritability in these illnesses - genetics. Bipolar I disorder easily fits into this category. This becomes particularly apparent in closed populations.
This is serious stuff.
Although I love talking philosophy, I find it to be a nearly worthless tool in this case, only serving to confuse things. It confounds attempts to figure out what is really going on here. I often worry that philosophies and schools of thought sometimes present dangerous obstacles in the pursuit of medical understanding and effective treatments to ease suffering and save lives. They limit perspective. For instance, I adore chiropractic for its understanding and effective treatment of many spinal maladies and their neurological consequences. However, I would not want to allow Palmer chiropractic PHILOSOPHY to persuade a physician to treat a case of syphilis with vertebral adjustments, and give it six months to work. (I don't think the majority of chiropractors any longer work this way).
I do see the importance of developing different approaches (philosophies?) as frameworks within which to investigate and understand things. I just feel a bit uncomfortable when philosophy determines the way results of experiments are interpreted, let alone determine experimental design in the first place.
Man, I know I started something with this one. I can here it now. "Is not the scientific method a philosophy?" (an attempt to preempt a "Bobber") :-)
The brain is real. The psyche is just as real. I am partial to treating them both as real objects. It seems to work for me.
Let's get to the bottom of all of this, and not waste time in the pursuit of creating philosophical or ethereal constructs for the sake of playing tennis.
Please give me time to catch my breath before flaming me. Thanks.
"The brain determines the mind as the mind changes the brain."- Me (from a previous post - shameless)
- Scott
Posted by Cptn. boB on April 10, 2000, at 15:46:05
In reply to Re: BIOLOGY or PSYCHOLOGY ?, posted by Scott L. Schofield on April 10, 2000, at 12:53:06
SLS,
Feeling flamed is a matter of perspective. My intent is not, by any means to flame or to play tennis.My life is as much at risk as those of people here claiming this diagnosis or that, and perhaps much more at risk because of my own distance from the social norm, and because I make noise about my distance.
You are correct that it is nearly impossible to broach any linguistic construct without ultimately discussing philosophy. The only way we can avoid discussion the broaches philosophy in a discussion of science is to accept someone elses authority reagarding philosphic slant. If we are smart enought to use computers and to discuss the neurchemistry of meds, we are probably smart enough to consider philosophic implications of our positions.
The mind/body question might appear philosophical but is one that is widely discussed in the literature of science. Among materialisticly oriented scientists and among some spiritually oriented materialists, (there are such people, of pagan persuasions) mind cannot be seperated from body. Eco-pschologists are suggesting that mind, or the sense of self, must be extended to include environment and experience.
The inseparable relationship between biology and psychology is evident in the breadth and depth of the study of biological psychology.
If you feel individually attacked, it might be because you occupied a theoretical foxhole near the approach to this important field of study, biolical ecological psychology. My primary interest in psychology is in ecological psychology, and my critique of my more academically accomplished eco-psychology peers is that they are not embracing the field of biological psychology. Maybe I am over here with the wet brain and chemistry club training to better challenge my eco-psych peers.
Anyway, I read your "i surrender" post first, and, being an experienced combatant, was doubtful that you would be a very compliant prisoner. For my part, I admire spritited mental resistance and combativeness, so don't feel flamed just because the discussion is challenging.
To Karen B., yes, turning on and off the emotions, regardless of what some may say, is difficult. The point of psychopharmacology is to create chemical switches to accomplish the task, but the shear strength of emotion (limbic drives?) are such that chemicals alone can seldom resolve an individual's emotional conflict, much less our social conflict. God help us though if we were living through this highly artificial, constructed culture without the aid of meds.I would suggest, for the sake of considering where we are at as a society, to consider simply the question of noise. We are subjected to an increasing amount of sustianed noise, which, my guess is, causes us to make more GABA to suppress our natural urge to react to stimulus. More GABA likely means upregulation of GABA-sensitive synapses, and likely reactions by other networks of other neurotransmitters that act in symbiotic tension with GABA.
There are lots of studies that address the neurological and psychological reactions to sustained noise levels. Environmental psychology is collecting many of these studies.
My point is that there are a number of hard, wet-brain biological problems caused by envrionmental and experiential conditions unique to industrialized culture. Then , there are other such problems that are being solved by industrialized culture. For an individual, access to meds might be a godsend, but for a person concerned about the direction of culture as a whole, neurochemistry is an essential element of explaining the etiology of environmental and experiential injury, and chemicical fixes are not a sufficient answer to collectively resolve the problems.
One other word, chemicals work for those with the health insurance or income available to afford a pdoc and a scrip. For those who are somewhat more likely to be injured - poor folks in threatening communities, the option is to take poorly manufactured aminergic agents (cocaine, meth), to regulate their serotonint and dopamine with weed and opiates, or to get an education and try to find ways to both define the problem in precise terms through study, including that of biological psychology and social psychology.
Me, I am a guerilla student, and an amature scientist, and hopefully a field medic in the war on drugs. For whatever that is worth.
This is the end of the thread.
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