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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by greg diamond on March 26, 2005, at 13:11:48
http://www.thisisawar.com/DepressionPills.htm
see attached article (in particular quote below) challenging the philosophy behind psychopharmacology (or at least this author's interpretation). i am writing a personal prose piece on my own experiences and wonder what all of you that post here think. i am perpetually torn!craig
'Commonsense would hardly dictate otherwise for, by suggesting to people that they are merely biologically defective mechanisms capable of handling their emotional/psychospiritual crises only with the aid of a technological crutch, many of the fundaments and principles of psychological healing are completely undermined.
Encouraging patients to give up on personal growth and understanding in favour of pills is, apart from being a philosophy of despair, a recipe for emotional disaster. Thus, helplessness is substituted for mastery, dependency for autonomy, and an unexamined life takes the place of self-discovery.
Moreover, at precisely the time of greatest need, the patient-cum-psychic adventurer is delivered up to a zombie-like state devoid of both mental acuity, and the capacity for deep feeling, self-awareness and self-empathy. That biological psychiatry could so blithely trample underfoot such granite pillars of therapeutic commonsense is chilling.'
Posted by Racer on March 26, 2005, at 17:33:10
In reply to what do you think of these arguments?, posted by greg diamond on March 26, 2005, at 13:11:48
Interesting arguments, but I disagree. I think that they've missed a fairly significant issue: therapy is often a necessary adjunct to medication, and medication is often a necessary adjunct to therapy.
Just as treating some physical illnesses, like Rheumatoid Arthritis, generally require both medication and physical therapy, many mental disorders require -- or at least are more effectively treated by -- a combination of medication and psychotherapy.
As far as I can see, the only entity that seems to say that medication can REPLACE therapy is the insurance industry.
As for the question of whether or not the unexamined life is worth living, I think it's disrespectful to say that one answer is true for ALL people. There are some people who are much better adjusted to their lives if they DO NOT examine their psyches, and they should have the right to choose for themselves whether or not they make such an examination.
There. Them's my opinions, and I'm sticking to them!
(Unless I come up with some better ones...)
Posted by Phillipa on March 26, 2005, at 19:03:00
In reply to Re: what do you think of these arguments?, posted by Racer on March 26, 2005, at 17:33:10
Well said. Fondly,Phillipa
Posted by Larry Hoover on March 26, 2005, at 21:48:21
In reply to what do you think of these arguments?, posted by greg diamond on March 26, 2005, at 13:11:48
> http://www.thisisawar.com/DepressionPills.htm
>
>
> see attached article (in particular quote below) challenging the philosophy behind psychopharmacology (or at least this author's interpretation). i am writing a personal prose piece on my own experiences and wonder what all of you that post here think. i am perpetually torn!
>
> craig> 'Commonsense would hardly dictate otherwise for, by suggesting to people that they are merely biologically defective mechanisms capable of handling their emotional/psychospiritual crises only with the aid of a technological crutch, many of the fundaments and principles of psychological healing are completely undermined.
> Encouraging patients to give up on personal growth and understanding in favour of pills is, apart from being a philosophy of despair, a recipe for emotional disaster. Thus, helplessness is substituted for mastery, dependency for autonomy, and an unexamined life takes the place of self-discovery.
> Moreover, at precisely the time of greatest need, the patient-cum-psychic adventurer is delivered up to a zombie-like state devoid of both mental acuity, and the capacity for deep feeling, self-awareness and self-empathy. That biological psychiatry could so blithely trample underfoot such granite pillars of therapeutic commonsense is chilling.'
Just analyzing the excerpt, it is clear that inflammatory and/or florrid rhetoric is being used to disguise the true arguments being raised. What I like to do is to distill the simplest form of the argument, and see if it stands up.
Premise: Current treatment presents depression as a biological disturbance which has only one possible treatment, medication. The provision of medication is accompanied by active suppression of emotional healing, to produce helplessness, dependency, and self-denial. This culminates in a zombie-state, devoid of cognitive and emotional life.
Somehow, I don't even feel the need to argue against this premise. It is simply false, on its face.
Lar
Posted by Iansf on March 27, 2005, at 1:35:50
In reply to what do you think of these arguments?, posted by greg diamond on March 26, 2005, at 13:11:48
> 'Commonsense would hardly dictate otherwise for, by suggesting to people that they are merely biologically defective mechanisms capable of handling their emotional/psychospiritual crises only with the aid of a technological crutch, many of the fundaments and principles of psychological healing are completely undermined.
>
> Encouraging patients to give up on personal growth and understanding in favour of pills is, apart from being a philosophy of despair, a recipe for emotional disaster. Thus, helplessness is substituted for mastery, dependency for autonomy, and an unexamined life takes the place of self-discovery.
>
> Moreover, at precisely the time of greatest need, the patient-cum-psychic adventurer is delivered up to a zombie-like state devoid of both mental acuity, and the capacity for deep feeling, self-awareness and self-empathy. That biological psychiatry could so blithely trample underfoot such granite pillars of therapeutic commonsense is chilling.'
>
>
I've been taking antidepressants for 15 years and not once have I been in a zombie-like state. Nor has my life gone unexamined. And speaking of lack of examination, the author appears to base his opinion of antidepressants on his pre-existing beliefs, not on an examination of a valid sampling of people who have actually used meds. If he has interviewed anyone, I suspect it's only people he knew supported his position. Put the word out wide enough and it's easy to find people who are anti-meds. And just as easy to avoid talking to people who support their use.
Posted by banga on March 27, 2005, at 8:02:42
In reply to Re: what do you think of these arguments?, posted by Iansf on March 27, 2005, at 1:35:50
I have spent years in therapy, with only partial benefit....I would work like hell to gain insight, change behaviors, do positive self-talk....the effects would last short-term, but eventually they would slide back as soon as I stopped therapy. I had been in therapy for several months when I experienced my first bout of depression with suicidal thoughts....I objectively knew that my life is absolutely fine, NO problems or major stressors. That is when I realized it is largely biochemical and therapy will not do the whole trick.
It is shown by numerous studies that the most effective treatment for depression and anxiety is a combination of medication and therapy--neither does as well alone.
Having said that, medications are overprescribed...I believe one should first try therapy (assuming a person is not actively suicidaL), then add meds if that does not help welll enough. Also, family history is important---if you have relatives with your disorder, there is a higher chance it is at least in part an inherited biochemical dysfunction.
Twins studies support that the cause of the major mental disorders (and personality traits, by the way!) is approx. 50% (give or take) inherited biology and 50% environment. It makes sense to also balance the treatment--biological and 'environmental' (therapy and lessening other stressors) to reflect this.
Posted by Phillipa on March 27, 2005, at 15:44:37
In reply to Re: what do you think of these arguments?, posted by Racer on March 26, 2005, at 17:33:10
How can a pdoc send a pt off with a medication to tx his symptoms, and not provide him with a therapist to give him an outlet for his feelings. When you "think" something, it's not the same thing as talking about it. When you hear your feelings out loud they always sound different. A therapist can for example help you see things in a more positive light or a different one. Yes, therapy is necessary. Fondly, Phillipa
Posted by fachad on March 27, 2005, at 21:32:10
In reply to what do you think of these arguments?, posted by greg diamond on March 26, 2005, at 13:11:48
Below is an excerpt from an alchemical essay written in 1617. If you read between the lines, you will see that many of the issues we struggle with now have been questions reflective people have been asking for hundreds or even thousands of years.
I stuck a few of my "between the lines comments" into the text to suggest some possible lines of thought. My remarks are in parenthesis, to set them apart from the text. I hope you find this Alchemical manuscript interesting and suggestive in your inquiry.
****
A Subtle Allegory concerning the Secrets of Alchemy. By Michael Maier
I had heard that there was a bird called Phoenix, (or, a puvule called Prozac)...whose feathers and flesh (or neurotransmitter reuptake properties)... constitute the great and glorious medicine for all passion, pain, and sorrow;...
This bird I could not indeed hope to obtain entire, but I was seized with an irresistible longing to become possessed of at least one of its smallest feathers; (would you be satisfied with a partial response?)...and for this unspeakable privilege I was prepared to spend all my substance, to travel far and wide, and to endure every hardship.
There was, of course, much to discourage me. Some people denied the very existence of this bird; others laughed at my faith in its wonder-working properties (17th century Scientologists and anti-med naysayers?).
I was thus brought for a time to regard all that Tacitus, Pliny, and all other writers have said as fabulous, and to doubt whether, after all, the different narcotics and opiates were not a better remedy for anger and sorrow than the supposed virtues of the Phoenix (some here at Psychobabble have discussed opiates for depression).
Moreover, I had heard of the simple method of curing these mental ailments suggested by a certain wise man to Augustus, whom he bade run through the twenty-four letters before saying anything whenever he was angry; (compare with Cognitive Behavior Therapy or Rational Emotive Therapy) and this suggestion appeared to supersede all other remedies.
I had also read the books of those moral philosophers who undertake to prescribe an effective remedy for every disease of the mind. (was Dr. Phil blathering on way back in 1617?)
But after giving all these boasted specifics a fair trial, I found, to my dismay, that they were of little practical use.
(...HERE COMES THE BIOLOGICAL ETIOLOGY THEORY OF PSYCHOLOGICAL DISTRESS, and nearly 400 years before the discovery of imipramine and the mono-amine hypothesis)
In many cases, the causes of mental maladies appeared to be material, and to consist in an excess or defect of the bile, or of some other bodily substance; in all these cases a medical treatment seemed to be indicated;
(that was written in 1617. There is nothing new under the sun.)
...whence Galen, that prince among physicians, was led to believe that character depends on temperaments of the body. As a soldier may lose all his bravery and strength by being starved and confined in a close prison, so even a good person may yield to anger, simply through some vicious habit of body...
What has been said about anger applies with equal force to grief; for while the symptoms of anger are more or less mental, those of grief produce a more perceptible and lasting effect on the body.
This great Remedy for anger and grief, then, it would be most desirable to have, if we could only find the Phoenix which affords it, Where shall I look for it? Where shall I enquire after it? Whom shall I ask?
A Subtle Allegory concerning the Secrets of Alchemy (very useful to possess and pleasant to read.) By Michael Maier
http://www.levity.com/alchemy/maier.html
Posted by alohashirt on March 29, 2005, at 23:41:29
In reply to what do you think of these arguments?, posted by greg diamond on March 26, 2005, at 13:11:48
On the balance I think the article is a crock.
On example:
there is a huge body of research into causation of depression
and the relative effectiveness of treatments that the author ignores. Research suggests that for many people medication + therapy are more effective than one or the other and that there
arte some people who simply won't be helped.ADHD
appears to be a neurological condition or a neurological
"type" that processes dopamine differently leading to both
tremendous creativity and energy and disorganization.
Looking at objective criteria like school test results suggests
that stimulant medication has abetter effect than any other treatment regime. Good pdocs also recommend ADHD coaching or support.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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