![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 30 to 54 of 89. Go back in thread:
Posted by fred on May 10, 2000, at 15:12:50
In reply to Fred, you just don't get it…, posted by Janice on May 10, 2000, at 12:08:58
> Janice the issue is FORCED treatment.
>
> •Fred, your issue is forced treatment.I was responding to Nancy's thread about her school paper. I thought she had better hear another opinion of ECT, other than the one you gave her. The issue of the thread was not forced treatment or your personal experience. Maybe you should start a new thread?
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I was responding to this post on May 8 at 9:22> > Thanks guys! All are great ideas. I like the forced treatment...mmm..that might be interesting to tie in with electroshock. Just a question, but has anyone had electroshock done?
I was discussing forced treatment specifically ECT and offering personal experience.
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> •You honestly don't have any idea about my opinions.
> ~~~~~~~~~~~~~~~~~
All I know is what you've posted here.
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I most likely won't respond to anymore of your postings.
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I don't think there is anything to be gained from continuing this dialogue either, So at least we end on that note of agreement. Good Afternoon. fred
Posted by Janice on May 10, 2000, at 16:47:14
In reply to Re: one note of agreement /janice, posted by fred on May 10, 2000, at 15:12:50
i don't want 'to get your world'.
Janice
sorry fellow psychobabblers for having to see me stoop to these low levels. I don't know if it's a maturity issue, impulse control, or I am right. Please forgive my pettiness. Janice
Posted by fred on May 10, 2000, at 18:55:05
In reply to You finally get it Fred…, posted by Janice on May 10, 2000, at 16:47:14
Please forgive my pettiness. Janice
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Consider yourself forgiven :)
fred
Posted by Vesper on May 11, 2000, at 17:26:04
In reply to Electroshock is not so shocking anymore…, posted by Janice on May 9, 2000, at 17:55:06
There is a button in my car labelled "ECT"
When you press it, you change the shifting pattern of the automatic transmission.It is supposed to stand for Electronically Controlled Transmission, but every time I press it I expect a little jolt followed by memory loss.
Posted by claire7 on May 11, 2000, at 20:45:51
In reply to Re: Electroshock/My car(they are related, really!), posted by Vesper on May 11, 2000, at 17:26:04
> There is a button in my car labelled "ECT"
> When you press it, you change the shifting pattern of the automatic transmission.It is supposed to stand for Electronically Controlled Transmission, but every time I press it I expect a little jolt followed by memory loss.
> Outsider, here. Eavesdropper, if you will.
Beenreading this board for a week or so. Janice, to an outsider, you are the bully here. I recognize you because I;m a bully, too. I think you got into this innocently enough, but once you were called on it, the hairs on your neck stood up and you went into attack mode instead of stopping to think about experience different from yours. If you could perhaps let down your defenses for a moment and REALLY think about what
Fred's experience has been, maybe you'd learn something. (I admit I'm not impartial. My Mom had ECT back in the 60's, it took her years to overcome the horror of it. Now that she's 79 she's having it every 3 weeks. At present I think (i KNOW) it's a lifesaver, but back then, and for anyone for w2hom it is or feels forced, it's a hell I doubt you can imagine. Could YOU try to be a little more compassionate? )
Posted by quilter on May 11, 2000, at 23:37:19
In reply to Re: Electroshock/My car(they are related, really!), posted by claire7 on May 11, 2000, at 20:45:51
> > There is a button in my car labelled "ECT"
> > When you press it, you change the shifting pattern of the automatic transmission.It is supposed to stand for Electronically Controlled Transmission, but every time I press it I expect a little jolt followed by memory loss.
> >Thanks for the giggle, Vesper! I can relate. Quilter
Posted by Dr. Bob on May 12, 2000, at 4:00:49
In reply to Personality disorder is not so shocking anymore , posted by fred on May 9, 2000, at 18:26:06
> I think I could spot you in a crowd. Narcissistic Personality Disorder walking- you're showing baby!!!
> If you stick an electric curling iron up your ample bum...
> I think this board systematically excludes anyone whose experience doesn't echo the majority.
> You are a victimizer...
> I have nothing to apologize for.
This board more or less systematically excludes anyone whose behavior is repeatedly uncivil. I'm going to try to block you from posting.
Bob
PS: I hope this new registration system makes it easier than last time...
Posted by Greg on May 12, 2000, at 8:09:49
In reply to Re: Electroshock/My car(they are related, really!), posted by claire7 on May 11, 2000, at 20:45:51
While I am an advocate of free speech, and believe that EVERYONE is entitled to their opinion, I think this whole discussion has gone too far. If I were a new person to this board and the first post I read was this one, I would leave and never return! And that would be a crying shame. I think we're all here to get support, not to take each other's inventory.
Just my humble opinion.
Peace,
Greg> > Outsider, here. Eavesdropper, if you will.
> Beenreading this board for a week or so. Janice, to an outsider, you are the bully here. I recognize you because I;m a bully, too. I think you got into this innocently enough, but once you were called on it, the hairs on your neck stood up and you went into attack mode instead of stopping to think about experience different from yours. If you could perhaps let down your defenses for a moment and REALLY think about what
> Fred's experience has been, maybe you'd learn something. (I admit I'm not impartial. My Mom had ECT back in the 60's, it took her years to overcome the horror of it. Now that she's 79 she's having it every 3 weeks. At present I think (i KNOW) it's a lifesaver, but back then, and for anyone for w2hom it is or feels forced, it's a hell I doubt you can imagine. Could YOU try to be a little more compassionate? )
Posted by SLS on May 12, 2000, at 9:02:26
In reply to Re: ECT literature search, posted by Blue Cheer on May 10, 2000, at 1:00:15
Hi Cam. Hi Blue Cheer.
> > ECT is the treatment of choice in pregnant women with major depression.How prevalent is the practice of choosing ECT as the first treatment? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.
> > The high levels of cortisol in a pregnant mom's blood stream do more damage to the baby than either ECT (and it's prep meds) or the SSRIs.
Does ECT exert a greater effect on HPA function than do antidepressants?
> > but I am told (especially by the people with refractory bipolar disorder that I have presented to)
Is success rate of ECT as high for bipolar depression as it is for melancholic and psychotic depressions?
> > Fred, I am not trying to discount your experience, especially the part about 'forced treatment'. I have not heard of anyone in my area, who wasn't a danger to themselves and not refratory to all medication, to be forced to have an ECT. I actually have never heard of anyone being forced, but then again, I've never asked.
If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints? I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.
> ECT is arguably the most effective treatment in the history of psychiatry, but efficacy isn't everything. I've been hospitalized for mania and depression for over 30 years, and have taken 55 Rx psychotropic drugs (56 counting one dose of topiramate). I've read literally hundreds of articles on ECT, from Dr. Max Fink's _Convulsive Therapy_ to articles in _Good Housekeeping. =) In fact, I just read one in the current issue of _Psychology Today_ (p. 23 or 28?). It describes a treatment-refractory bipolar patient who underwent a series of 18 ECT treatments, and now has difficulty remembering where she lives if she strays farther than 4 blocks from her home.
How long has this condition persisted? This is not unusual with bilateral treatments, but is usually temporary. I experienced this for about a month after a series of 6 unilateral followed by 6 bilateral treatments. In addition, the period of time during which a course of treatments is given is sometimes lost from memory, similar to an alcohol "black-out".
> Also, I've witnessed the results of ECT in acute-care psychiatric facilities as recently as 1995, and in long-term facilities from the 60's through the 80's. ECT advocates claim an 80% improvement rate as opposed to a 65% improvement rate for drugs -- in depression. My experience has been that approximately one in five improve, and not without sequelae.
Non-response to antidepressants is a prognosticator of poor response to ECT.
> Although movies have depicted it as a barbaric assault, I'd rather weigh the risk/benefit ratio. Many treatments in medicine are theoretically unappealing (defibrillation of the heart), and not well understood, yet they can be life-saving, too. Although it's a powerful intervention in severe medicine-resistant mania, schizophrenia, and suicidal states (neuroleptic malignant syndrome, too), I'd only use it as a last resort for major depression.
I didn't know it was used for neuroleptic malignant syndrome. In what ways is it helpful? How long does the therapeutic effect last? Are maintenance treatments necessary?
> Even if it works, booster treatments are often required and sometimes fail. Then you're back to psychopharmacology -- square one.
This would not be square one if previous pharmacological intervention had not initiated a response. Often, it takes ECT to bring someone out of a pharmacologically treatment-resistant depression, whereafter, they can be maintained on the same drugs that they were previously unresponsive to.
> rTMS is an alternative and safer treatment. ~~~ Blue Cheer
rTMS has proved to be disappointing. On the other hand, vagus nerve stimulation (VNS) seems to be providing some impressive results. To me, this treatment seems very similar to the implanted portable defibrillators used for cardiac conduction disorders.
It is refreshing to encounter a discourse that is not polarized. (I am not in a position to cast the first stone). Thanks guys.
- Scott
Posted by boBB on May 12, 2000, at 20:13:27
In reply to Re: here we go again (sigh), posted by Dr. Bob on May 12, 2000, at 4:00:49
The curling iron/ample bun comment was clearly out of line in civil conversation, and the claim to be able to diagnose an individual in a crowd, on site alone, is poor practice of a diagnostic method that is widely questioned anyway.
Dr. Bob, or the university, owns the site and the hardware that serves it. By reading ISP numbers and setting cookies, he likely knows more than the rest of us do about how this individual has previously behaved here.
I advocate for clear rules of dialogue, which bar threats or implications of personal injury, and which bar malicious, demeaning and derogatory comments. But it seems problematic to allow relatively anonymous individuals to offer diagnoses while at other times an offer of a diagnosis is considered to be derogatory.
Minimizing someone’s experience of oppression further victimizes the person. Fred may use poor style to write “you are a victimizer” but he might accurately write “you are a person who victimizes.” I wonder if it is fair to exclude him (on this charge) simply because he does not know how to verbally parry and fight using the editorial style of the American Psychology Association.
Psychiatry has a long and rich history of abuse, torture and self-service. The father of modern pshyc was a reputed cocaine addict. Institutions tend to constantly claim their past problems were recently solved, and seldom recognize and account for how their problematic past contributes to current decisions.
In a legal system that claims to allow free speech, and that allows some licensed companies to push psychotropic drugs through persuasive, motivational advertising, while other non-licensed individuals are locked up for life or even threatened with lawful execution for selling very similar drugs, we should be very cautious about who we exclude from public discourse about psychotropic meds and other treatments.
The University of Chicago is a public institution. While Dr. Bob does us all a favor by maintaining this site, his effort also serves his professional purposes by providing proof of public service as is required of tenured members of major academies.
Though I lack detailed knowledge of the University’s history, I suspect it involves large grants of land and other wealth that came over to Anglo-Europeans by divestiture of older, and (I believe) wiser cultures. Even the wood frames of the buildings that house the University was likely hauled down from northern forests which were taken by dubious treaty from Chippewa, Osage, Mennominee and other nations.
My point is that, regardless the letter of the law, or the nuance of administrative rule, this site and this discussion is a public franchise.
Well, I aim to prove Fred wrong on one point. This board has not yet systematically excluded me, and I definitely do not echo the majority. I don’t want to see Fred’s perspective cut out simply because he has not had the same opportunity as I have to make his controversial arguments in an articulate voice.
Okay, back to the discussion of depression...
Any recent regular reader knows I think most depression is situational. I think our culture, with the loss of community, destruction of species and long term ruin of the climate is something worth being depressed about. I think anyone who is not affected by sorrow for the resources we wantonly consume is both sick and morally weak.But out of deference to the medical model, and out of sincere admiration for the practice of science, I wonder what research is being done into depression and the role of amino acids that are precursors of the neurotransmitters associated with depression, specifically, (I think I recall) tryptophan and lysine.
I know that, at a time when a situation was driving my routinely dark mood to an untenable depth, my use of a protein supplement rich in these amino acids correlated to an improvement in my outlook.
Posted by Cam W. on May 12, 2000, at 22:37:02
In reply to Re: ECT literature search, posted by SLS on May 12, 2000, at 9:02:26
Hi Scott
> How prevalent is the practice of choosing ECT as the first treatment [in pregnancy]? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.
I was paraphrasing from a study I had read. If a pregnant woman were taking an MAOI, after failing other ADs, I believe that many docs would opt for ECT rather than risking damage to the fetus. Granted, SSRIs have supplanted ECT in North America. I am not sure what Europe is doing. A quick search on Pub Med gives mixed reviews. Case reports of complications interspersed with articles stating the safety of ECT in pregnancy. The article I have at work wasn't listed.
> Does ECT exert a greater effect on HPA function than do antidepressants?Most definitely!
> Is success rate of ECT as high for bipolar depression as it is for melancholic and psychotic depressions?I don't know for sure, but I do know that it is used quite extensively in refractory cases of bipolar disorder, psychotic depressions, and atypical depressions.
> If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints? I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.I have since talked to a couple of psychiatrists at work and yes, ECT without patient consent (but usually with family consent) is sometimes necessary, when traditional treatments aren't working.
Making a long thread even longer - Cam
Posted by Kim on May 12, 2000, at 22:53:28
In reply to Re: here we go again (sigh), posted by boBB on May 12, 2000, at 20:13:27
At the top of MY babble page it says "This is a board for mutual education and support." Some of the postings on this particular thread have been neither educational nor supportive.
Having had extensive experience with the issue of "free speech" in the context of my professional life, I will add the following in a spirit of education: "FREE SPEECH" is subject to restrictions on the time, place, and manner in which it is presented. (Classically, you may not yell "fire" in a crowded theatre.)
Similarly, I do not believe it is appropriate to allow anyone to repeatedly violate the supportive atmosphere which has been created on this board. As posters to this board, we have created a society which has proved to be remarkably well mannered in dealing with differences of opinion. Strong opinions can be offered without resorting to name-calling or personal attacks.
The vast majority of the members of this board strive to keep this a safe, civilized forum. And the majority of us feel some degree of vulnerability due to our situation. It would be unjust (and very, very sad) if we need to weigh the danger of being attacked before participating in Psycho-Babble.
IMHO
Kim
Posted by bob on May 13, 2000, at 1:54:51
In reply to Free Speech, posted by Kim on May 12, 2000, at 22:53:28
well said, kim
Posted by Phil on May 13, 2000, at 6:10:09
In reply to Re: Free Speech, posted by bob on May 13, 2000, at 1:54:51
> well said, kim
>>I second that.
Posted by Elizabeth on May 13, 2000, at 13:35:31
In reply to Re: here we go again (sigh), posted by Dr. Bob on May 12, 2000, at 4:00:49
> [foulness snipped]
>
> This board more or less systematically excludes anyone whose behavior is repeatedly uncivil. I'm going to try to block you from posting.
>
> Bob
>
> PS: I hope this new registration system makes it easier than last time...Dr. Bob saves the day again. :-)
Posted by Elizabeth on May 13, 2000, at 13:48:49
In reply to Re: ECT literature search, posted by SLS on May 12, 2000, at 9:02:26
> > > ECT is the treatment of choice in pregnant women with major depression.
>
> How prevalent is the practice of choosing ECT as the first treatment? Is there any difference in the rate of ECT usage between different countries? Sometimes, the treatment of choice of clinical researchers is not the treatment of choice of the local practitioner.I don't know the answers to these questions (and I would like to -- they are good questions), but my guess is that SSRIs have more or less replaced ECT. They seem to be perfectly safe (though if I were in that situation I might want to see if I could get through the 1st trimester without the SSRI, just to be extra cautious).
I'd be kind of worried about exposing the fetus to the general anasthetics and neuromuscular blocking agents used in ECT, personally! Not sure this is justified, it's just my gut reaction.
> If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints?A person should not be committed for any of those things. AFAIK, a particular diagnosis is *never* a sufficient reason to commit someone involuntarily (in any of the 50 States, anyway).
> I'm not saying that this is a bad thing. Why would ECT be exempt from this sort of rationale? After all, it is effective. Neuroleptics are not without side effect liability, either temporary or permanent.
Indeed, I think it's safe to say that there is no such thing as an active drug that has no side effects and no risks!
> Non-response to antidepressants is a prognosticator of poor response to ECT.
It's true. There's a selection bias at work, in that people who have ECT are usually those who've failed multiple antidepressants. Also, sometimes it's used as a last resort for conditions for which it's not necessarily indicated, such as severe nonmelancholic depression; this further affects the apparent success rate.
Posted by Elizabeth on May 13, 2000, at 14:05:02
In reply to Re: ECT - Scott, posted by Cam W. on May 12, 2000, at 22:37:02
> I was paraphrasing from a study I had read. If a pregnant woman were taking an MAOI, after failing other ADs, I believe that many docs would opt for ECT rather than risking damage to the fetus.
This seems like a poor strategy to me. I'm pretty sure there is little evidence either way as to whether MAOIs have any teratogenic effects, so you'd be taking a risk, but I think the risk of ineffective ECT (ECT is believed to be a poor antidepressant for those with atypical features, the group most likely to be taking MAOIs) is greater. IMHO, a better argument can be made for substituting ECT for tricyclics or lithium.
Posted by boBB on May 13, 2000, at 14:10:10
In reply to Re: here we go again (sigh), posted by Elizabeth on May 13, 2000, at 13:35:31
Well, if that is the way you feel, I guess I will stop posting here.
It seems the mutual education and support wanted by users of this board is one where the pro-university, pro-medical industry, pro-collegiate-speach camp is supported, and where those who engage in conversation styles more common to poor neighborhoods are excluded. It seems people here generally want their medical model of themselves as sick, helpless victims reinforced and any other kind of education excluded.
It is perfectly okay for you to sit in a comedy club or tune in the comedy channel and listen to a person engage in political speach that includes insults, curses and name calling but when a person uses this style of speech outside a capitalist, paid venue relationship, it seems unacceptable.
Why is it that so many people here claim to have problems with rage and call it a medical problem, but when someone expresses legitimate rage, it they are treated with utter contempt? It sounds to me like those who like to call themselves sick and whine about being stigmatized are afraid their paper-thin analysis of themselves will fall apart if exposed to any other point of view.
You educate me only as to your narromindedness and you support me or my ally Fred none whatsoever. If I have anything to say here, you can expect it to be said with audacious rage, and using another alias and alternate ISP's and with all cookie's blocked so as to end-run any attempts to censor my speach in this PUBLIC RESOURCE
Fred's speach was nowhere near equivilant with yelling fire in a theater. It was annoying because in impinged on your world view. Get a clue. This kind of speach is all over the internet. Frankly, all of this medical model BS and diagnosis of supposed illness, in cases where people to numb to hear the voice of their conscience are called depressed, is a personal insult to me and to all living beings. Your insistence on the medical model, coupled with a legal system where I can be committed with no benifit of a jury hearing is a real physical threat to me.
Posted by Elizabeth on May 13, 2000, at 14:46:51
In reply to Re: here we go again (sigh), posted by boBB on May 12, 2000, at 20:13:27
> The curling iron/ample bun comment was clearly out of line in civil conversation,
Oh, that wasn't the only one...
> and the claim to be able to diagnose an individual in a crowd, on site alone, is poor practice of a diagnostic method that is widely questioned anyway.
What, the "look and feel" method? It's quite common in all branches of medicine.
In any case, it's obvious enough that this was not intended to be a diagnosis at all, but a personal insult (which is offensive to those who truly suffer from severe personality disorders, as well as to the individual who is being insulted).
The argument that Dr. Bob is an agent of the state is a specious one. He has a tenuous link to the government; that does not make this a government forum. Even if he were acting exclusively as an agent of the University of Chicago, it is a private university and as such is allowed quite a bit of latitude in making appropriate rules, including codes governing behavior. (Heck, even public schools can do this.) To my knowledge, there is no legal doctrine (and no interpretation of "common sense")
t under which Dr. Bob might be required to allow unrestricted speech on this forum.> I advocate for clear rules of dialogue, which bar threats or implications of personal injury, and which bar malicious, demeaning and derogatory comments.
I agree. Fred's behavior clearly falls into the "malicious, demeaning, and derogatory" category. It is not his unpopular opinions that are the problem; it is the way he chooses to express them.
> But it seems problematic to allow relatively anonymous individuals to offer diagnoses while at other times an offer of a diagnosis is considered to be derogatory.
Again, a question of intent and context.
> Psychiatry has a long and rich history of abuse, torture and self-service.
Medicine in general does. (Ever read _The House of God_? It's not as exaggerated as one would like to think.)
> The father of modern pshyc was a reputed cocaine addict.
And your point is...?
> In a legal system that claims to allow free speech, and that allows some licensed companies to push psychotropic drugs through persuasive, motivational advertising, while other non-licensed individuals are locked up for life or even threatened with lawful execution for selling very similar drugs, we should be very cautious about who we exclude from public discourse about psychotropic meds and other treatments.
I believe that, if he were capable of practicing some restraint in making personal attacks on other posters, Fred would be welcome to express his controversial opinions and even his bitterness and rage. In any case, it's wholly inappropriate of you to consider this forum as part of the "legal system." It is easy to cry "censorship" whenever someone tries to set appropriate limits.
> My point is that, regardless the letter of the law, or the nuance of administrative rule, this site and this discussion is a public franchise.
No, it really isn't. Your argument is, at best, far-fetched.
> Well, I aim to prove Fred wrong on one point.
Only one? Not very ambitious. :)
> This board has not yet systematically excluded me, and I definitely do not echo the majority. I don’t want to see Fred’s perspective cut out simply because he has not had the same opportunity as I have to make his controversial arguments in an articulate voice.
His perspective is not cut out. Any person who shares his opinions is free to express them as long as that person is able to behave appropriately. Being undereducated is not an excuse for being abusive.
> Okay, back to the discussion of depression...
> Any recent regular reader knows I think most depression is situational. I think our culture, with the loss of community, destruction of species and long term ruin of the climate is something worth being depressed about.The glaring flaw here is that (most) depressed people are not depressed "about" those things. I think it's nice that you care so much about important issues, and obviously many other people here do too, but these issues simply do not have a personal, direct impact on most depressed people. If depression can be said to be "situational," it is most likely personal stress, and not political angst, that is responsible.
> I think anyone who is not affected by sorrow for the resources we wantonly consume is both sick and morally weak.
Affected: normal. Driven to depression: doesn't happen. Unless perhaps you're defining "depression" in some unorthodox way.
> But out of deference to the medical model, and out of sincere admiration for the practice of science, I wonder what research is being done into depression and the role of amino acids that are precursors of the neurotransmitters associated with depression, specifically, (I think I recall) tryptophan and lysine.
L-tryptophan is an effective antidepressant, if that's what you mean, but there is still some controversy over how it might be manufactured safely.
> I know that, at a time when a situation was driving my routinely dark mood to an untenable depth, my use of a protein supplement rich in these amino acids correlated to an improvement in my outlook.
(Correlation doesn't equal causation.)
Some people believe that amino acid supplements such as l-tyrosine and d,l-phenylalanine have improved their moods, FWIW.
Posted by bob on May 13, 2000, at 15:21:39
In reply to Re: I'm outa here (middle finger raised), posted by boBB on May 13, 2000, at 14:10:10
Questioning what can be interpreted as the status quo is one thing -- persistent personal attacks accompanied with an expressed lack of intention to reconsider what was said and whether it was appropriate.
boBB, in spite of your concern over how "offensive" you might come off, at least as you've expressed it in other posts, from what folks (including me) have said about you lately you should see this isn't the case. Sure, you go on the attack quite often -- but you attack structures and systems of belief. When it comes to individuals, your comments have always been more along the lines of "wake up and smell the coffee" than slurs or insults. Furthermore, you try to present if not evidence, but a logical argument for your views.
You may write like a cattle prod, but you poke it where it needs to get poked and you give reasons that are often compelling and, in any event, deserve close attention.
Fred started off with a serious issue for consideration -- forced treatment (and ECT). His explanation was personal experience, which is highly-valued commodity around here. But rather than arguing issues, he resorted to persistent and unrelenting personal attacks as his way of making a point.
You may consider him an ally, but all his method did was clamp shut minds almost as tightly as his own. Your methods are quite a bit different. Given that you're a writer and have shown you know quite a bit about discourse styles, I thought you'd be able to recognize the difference.
No, this is not a theater, nor is it Comedy Central nor the rest of the internet. It may be a public forum, but electronic forums like this -- particularly those run by universities or other government institutions -- do have policies of appropriate use. Quite frankly, even if Dr. Bob was a rabid supporter of First Amendment rights, his employers could still force him as moderator to enforce those conditions of appropriate use or shut down the board. This may be a public forum, but participation is voluntary. Furthermore, I doubt that anyone could make a case for access to Babble being a right protected by the ADA or something similar. In choosing to participate, you choose to abide by the board's conditions of use.
Fred had a very important issue to discuss -- one which most of us probably know nothing about -- but he chose to wage a personal vendetta instead of trying to educate us. Maybe Janice could have handled it differently, but I doubt that I would simply have turned the other cheek if I had been Fred's target instead.
Electronic text is a notoriously difficult medium for expression, and smilies do little to improve it. I've been a regular user of email and other forms of electronic communication for a little more than 15 years, and I've seen hundreds of cases where people read far too much into what someone else has said, blowing statements into issues far out of proportion with what was said. I've been on both sides of that argument myself.
It can be very difficult to keep a cool head when you have so little context beyond the words -- inflections, body language, facial expressions -- to go on. But this isn't the Martha Stewart's Living Plan-a-Hampton's-Beach-Party bulletin board -- it's one to which people can bring some rather raw nerves and sensitive topics. The "conditions of use" at the top of the Babbleland page aren't meant to snuff out minority opinions -- they're meant to snuff out forest fires before they spread and destroy this board.
So boBB, if you're so offended by this small community's standards for civility -- well, I *will* miss your thought-provoking, well-argued wake-up calls. But if you think you're taking a stand, fighting for an important cause -- I think you need to see who around here is doing that cause some good versus who around here is hurting his or her own cause through their choice of actions.
sincerely,
bob
Posted by SLS on May 13, 2000, at 15:30:01
In reply to Re: ECT literature search, posted by Elizabeth on May 13, 2000, at 13:48:49
> I'd be kind of worried about exposing the fetus to the general anasthetics and neuromuscular blocking agents used in ECT, personally! Not sure this is justified, it's just my gut reaction.With me, they used Valium as the anesthetic and atropine as the neuromuscular blocking agent. What are your thoughts as to how these drugs may hurt the fetus?
Is atropine considered a muscle-relaxant?
How does Valium exert its muscle-relaxant effects?> > If someone is committed to a hospital for schizophrenia, psychotic mania, or psychotic or suicidal depression, is it not common for him to be forcibly treated with medication or placed in restraints?
> A person should not be committed for any of those things. AFAIK, a particular diagnosis is *never* a sufficient reason to commit someone involuntarily (in any of the 50 States, anyway).
Perhaps I should have been more specific. I didn't mean that a person is to be involuntarily committed for having been diagnosed with one of these afflictions, but rather that they be in such a condition as to "require" it. I am pretty sure that there are statutes in most states prescribing detailed definitions of these conditions and allowing for commitment. I think the notion of "being a danger to themselves or others" is in there somewhere.
Do you feel that commitment is ever in the best interests of the afflicted person?
> > Non-response to antidepressants is a prognosticator of poor response to ECT.
> It's true. There's a selection bias at work, in that people who have ECT are usually those who've failed multiple antidepressants. Also, sometimes it's used as a last resort for conditions for which it's not necessarily indicated, such as severe nonmelancholic depression; this further affects the apparent success rate.
There certainly is a bias. In many situations, as in those you have mentioned, the recognition of this association is moot. You just have to roll the dice. However, the bias may be the de facto realization of a biological condition. This observation has heuristic value. Perhaps it will be helpful in figuring out what's going on.
One thing worth considering is that for most of the cases in which ECT is employed, the patient is not treatment-naive. Prior exposure to antidepressants may reduce the likelihood that they will be responsive to ECT.
By the way, its nice to see you again. I hope school has gone well and that the beast has been kept at bay.
I know I always have to ask you these questions, but what does "AFAIK" stand for? I wish I had a dictionary.
Be well.
Sincerely,
Scott
Posted by Cass on May 13, 2000, at 15:53:19
In reply to Re: I'm outa here (middle finger raised), posted by boBB on May 13, 2000, at 14:10:10
> Well, if that is the way you feel, I guess I will stop posting here.
Hi boBB,
I sure hope you're not really going to stop posting here. I think your honest and insightful voice on this board is invaluable. You are appreciated. I get a lot out of your posts. PLEASE STAY.
Cass
Posted by Mark H. on May 13, 2000, at 18:10:51
In reply to Re: I'm outa here (middle finger raised), posted by boBB on May 13, 2000, at 14:10:10
Is there evidence that ECT is being administered in the United States at this time without patient consent? In the case of someone who is declared incompetent by court order (or has not reached the age of majority), who is permitted to give consent for ECT if not the patient, and under what circumstances? Is it used in VA hospitals without patient consent? State hospitals? If so, which facilities in what states?
If you know of any recent articles or surveys on the use of ECT as a non-elective treatment, I'd be very interested in reading them. (I already own a copy of Toxic Psychiatry, which is several years old. I am interested in verifiable practices that exist today.)
The abuse of ECT in the past has been well documented, and the topic (and treatment) was very nearly beaten to death in the media. However, if it is still going on (abuse, that is, not use), I know a couple of people who might be interested in helping bring it to light.
Sincerely,
Mark H.
Posted by Elizabeth on May 14, 2000, at 4:23:26
In reply to Re: I'm outa here (middle finger raised), posted by boBB on May 13, 2000, at 14:10:10
Sorry you're feeling oppressed. I hope you can find somewhere where you feel more welcome and don't feel a need to engage in harrassment or throw temper tantrums.
Posted by Elizabeth on May 14, 2000, at 4:24:27
In reply to Re: Evidence For Forced ECT?, posted by Mark H. on May 13, 2000, at 18:10:51
> Is there evidence that ECT is being administered in the United States at this time without patient consent? In the case of someone who is declared incompetent by court order (or has not reached the age of majority), who is permitted to give consent for ECT if not the patient, and under what circumstances?
I can't answer any of your other questions, but it would be a parent or legal guardian.
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