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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 psych chat on September 15, 2009, at 0:32:36
Psychiatric drugs don't seem to be helping as much anymore. Could it be that lack of motivation - and the feeling of being 'stuck' could be caused by childhood patterns of attachment? I'm thinking - could this be a pattern that manifests as ADD symptoms later in life for those of us who did not have ADD symptoms during childhood? Momentary immobility-does this carry on through adulthood or re-emerge after the event of new trauma?
"However, when even defensive efforts are overwhelmed by the disruptive emotions resulting from unreliable caregiving, we are in the realm of disorganized attachment (Main, 1995, 1999): the only way both self and relationship can be maintained is through momentary immobility: the individual can neither feel (dissociation) nor deal (paralysis)."
If this is the case, are drugs the answer, as opposed to therapy? Perhaps both...
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http://www.trauma-pages.com/a/fosha-03.php
The chronic reliance on defenses against emotional experience instituted to compensate for these lapses in the caregiver's affect-regulatory capacities produces adaptations which are categorized by the attachment classifications, that have been translated into affective functional strategies (Fosha, 2000b). Whereas secure attachment involves the capacity to feel and deal without the need to resort to defense mechanisms, the two types of organized insecure attachment are the result of defensive strategies: the strategy of dealing but not feeling in avoidant attachment, and the strategy of feeling (and reeling), but not dealing in resistant/ambivalent attachment. However, when even defensive efforts are overwhelmed by the disruptive emotions resulting from unreliable caregiving, we are in the realm of disorganized attachment (Main, 1995, 1999): the only way both self and relationship can be maintained is through momentary immobility: the individual can neither feel (dissociation) nor deal (paralysis).
Posted by psych chat on September 15, 2009, at 1:31:16
In reply to Could this be a source of lack of motivation?, posted by psych chat on September 15, 2009, at 0:32:36
I'm overwhelmed. After exploring the various disciplines over the past 20 years or so, I have never recognized a field so divergent and fragmented as psychology. Maybe it is ignorance on my part, but I am so confused right now...
Childhood attachment theory concepts = PTSD for veterans = (c)PTSD for veterans who experienced traumatic childhood = PTSD or (c)PTSD for others not ascribed to a PD = borderline (for women only of course) = depression = duo mergers = permanent brain dysregulation = ADD = anxiety = psychiatrists = personality disorders = cortisol issues = psychotropic drugs = excessive reactivity to stress = brain shrinkage = disorders of self = avoidance = dependency issues = HPA dysregulation = DID = OCD..I can go on and on more...but everything, all the sub-theories- contradict each other in this field.
I appreciate the diverse array of theories and opinions but at the same time, wonder why only a select few are applied to clinical practice....
But no matter how you look at it, aside from genetics or adult trauma, it all seems to go back to childhood or adolescent issues....Is psychotherpy the answer? That's an art too. What are we to do?
http://www.trauma-pages.com/a/fosha-03.php
http://www.selfgrowth.com/articles/Who_s_Really_Running_Your_Life.html
Posted by Dinah on September 15, 2009, at 11:52:01
In reply to everything = everything, posted by psych chat on September 15, 2009, at 1:31:16
I'm afraid your initial post came up blank on my screen. Dr. Bob says that can be fixed by responding to the post, but I can't figure out how to respond to a post when the entire screen is blank.
Let's see if this response to the thread will fix it.
Posted by Dinah on September 15, 2009, at 11:52:36
In reply to Re: everything = everything » psych chat, posted by Dinah on September 15, 2009, at 11:52:01
I learn something new every day.
Posted by Dinah on September 15, 2009, at 11:58:05
In reply to everything = everything, posted by psych chat on September 15, 2009, at 1:31:16
Well....
This is just my own thoughts, mind you, and I could be completely wrong.
My son and I are listening to "A Short History of Nearly Everything", and we recently listened to the sections on cosmology, and at the opposite extreme, quantum physics.
I interpreted what I heard to mean that they really don't understand everything. They come up with theories to try to fit the observed phenomenon into them. Those theories might be more right than anyone can now understand. But they might also be wrong, and will be superseded by as yet unknown theories.
I think psychiatry is not unlike this.
In the meantime, what's important is to improve the lives of those who deal with it. A combination of medication and therapy has been shown to be more effective than either alone, hasn't it?
Posted by Phillipa on September 15, 2009, at 12:54:09
In reply to Re: everything = everything » psych chat, posted by Dinah on September 15, 2009, at 11:58:05
Dinah first you fixed the problem. As for psychiatry I get very confused also as for adult Add that to me doesn't make sense if you didn't have it as a child. All my readings say same. Physics? wow you are one smart cookie!!!!!. By the way an interesting thread to me why has trouble understanding these concepts also. Love Phillipa
Posted by psych chat on September 15, 2009, at 13:30:38
In reply to Could this be a source of lack of motivation?, posted by psych chat on September 15, 2009, at 0:32:36
Hmm, good analogy, Dinah. I suppose my hope rests upon the (perhaps unrealistic) wish that the best practices can be drawn from all these theories and applied consistently in practice...but..maybe doing so is more like rocket science than I initially thought. ;)
Posted by obsidian on September 15, 2009, at 13:55:35
In reply to Re: Could this be a source of lack of motivation?, posted by psych chat on September 15, 2009, at 13:30:38
I like theory, it really helps to make sense of things, clarify things. I like attachment theory a lot. Sometimes a particular piece of theory will make sense to me. I've got to put my thinking cap on, find something that makes sense.
thanks for the info :-)
Posted by seldomseen on September 15, 2009, at 19:38:20
In reply to Could this be a source of lack of motivation?, posted by psych chat on September 15, 2009, at 0:32:36
I would like to propose what might be considered a radical solution (especially coming from a scientist like myself). I would suggest giving up the theory, the desire to understand, draw logical conclusions and identifiy causality.
Understanding our emotions, our motivations and (as extensions from those) our behaviour from a completely rational point of view is, IMO a contradiction and is, also IMO, unlikely to yield productive results.
I think we experience ourselves more than understand ourselves. We learn to recognize patterns of behaviour, and can seek to find solutions to those. But unlike other fields of medicine, in psychiatry understanding the cause doesn't necessarily predict a cure.
However, I do not think psychiatry in any more or less fragmented than any other field of medicine. If one read extensively into the literature on hematology for example, one would come away much more confused than prior to the reading. Yet the blood will still clot, and immune function is maintained.
I think the conclusion that all of medicine is coming to is "the right treatment in the right patient". This is where the wisdom and the experience of good physicians comes into play in our recovery. Which doctor is the best? I say the one that makes you feel better.
Does this mean that sometime physicians can understand us better than we can understand ourselves? Perhaps, but there is a theory floating about somewhere that postulates that a system can not understand itself. This statement might be true.
Seldom.
This is the end of the thread.
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