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  #1  
Old 08-06-2011, 12:14 AM
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Default Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

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  #2  
Old 08-06-2011, 02:36 AM
thprop thprop is offline
 
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Default John has gone off the deep end

I have little respect for John anymore. His critique of string theory was taken apart in his diavlog with George Musser. He insists that we have free will because it is good to have. Jerry Coyne dismiised those arguments.

Now he is into conspiracy theory. Here are a few counters to Whitaker:
Carlat

A debate on the subject

A mental health professional who says to take his research seriously

John lets his own feelings override science.
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  #3  
Old 08-06-2011, 09:45 AM
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Default Re: John has gone off the deep end

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Originally Posted by thprop View Post
I have little respect for John anymore. His critique of string theory was taken apart in his diavlog with George Musser. He insists that we have free will because it is good to have. Jerry Coyne dismiised those arguments.

Now he is into conspiracy theory. Here are a few counters to Whitaker:
Carlat

A debate on the subject



A mental health professional who says to take his research seriously

John lets his own feelings override science.
I'm about 16 minutes into the diavlog. I don't know whether I've lost respect for John or not because I'm rather familiar with his overall take on psychiatry and psychiatric medications and also his tendency to get agitated over something he just read that confirms some previous idea he had (confirmation bias).

But, so far, all I can say is that I wish he was more measured in expressing radical opinions.

Thank you, thprop, for your links.
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  #4  
Old 08-06-2011, 02:17 PM
Wonderment Wonderment is offline
 
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Default Re: John has gone off the deep end

Quote:
But, so far, all I can say is that I wish he was more measured in expressing radical opinions.
I love John, but it's probably best for him not to come on BHTV the morning after he's under the impression that he's just read the most important book in the whole wide world.

John gets passionate about radical ideas (a trait I have some personal familiarity with), and he is a tad conspiratorial and susceptible to polemical anti-authoritarian arguments (I prescribe a homeopathic dose of anti-Prozac once a year to cure this malady).

I'm glad George tried to talk John down from the most radical claim about the MSM being in cahoots with Big Pharma not to review groundbreaking books.

Having said all that, I'm certainly disgusted by overprescribing practices of physicians (as Ocean has pointed out before, most are general practitioners, not psychiatrists) regarding stimulants for children (Ritalin, Adderall, etc.) and anti-depressants for anyone who walks in the door feeling sad or fatigued. There's also the huge problem that psychiatrists no longer can afford to do therapy and have to see 4 patients an hour (or something like that) for med-management.

The jury is still out on anti-depressants. It's clear that they help some people (beyond placebo effect), while they may do nothing except placebo for millions of others who have had them prescribed.

On anti-psychotics, there is no question that the medications can successfully treat many forms of severe mental illness. Of course, they have serious side effects. What doesn't? The idea that schizophrenics should be left unmedicated sounds completely whacko to me.
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  #5  
Old 08-06-2011, 10:47 AM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

Quote:
Quoting thprop:
John lets his own feelings override science.
I don't know about all of his diavlogs, but in this one he seemed pretty even handed in his critique of Whitakers book. In fact, the closing paragraph of the Carlat piece says this:

Quote:
Whitaker does a great job documenting an astonishing rise in psychiatric disability, but he erroneously blames the drugs, when the actual causes are more nuanced and multifactorial.
This may be simply Carlat's opinion because he disagrees or maybe Whitaker doesn't go as far as Carlat is implying or maybe he's correct in his evaluation of the book. At any rate, I think John, although he likes the book wasn't being over the moon about it.
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  #6  
Old 08-07-2011, 09:38 AM
willmybasilgrow willmybasilgrow is offline
 
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Default Re: John has gone off the deep end

Quote:
Originally Posted by thprop View Post
I have little respect for John anymore. His critique of string theory was taken apart in his diavlog with George Musser. He insists that we have free will because it is good to have. Jerry Coyne dismiised those arguments.

Now he is into conspiracy theory. Here are a few counters to Whitaker:
Carlat

A debate on the subject

A mental health professional who says to take his research seriously

John lets his own feelings override science.
Yes, regarding Carlat. I also urge other commenters here to go to Carlat. There are some excellent comments there.

Such as:
"The Harvard psychiatrists refuting Bob [Whitaker] were truly laughable. They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. There was not one substantive argument that the way they practice medicine is actually doing good. And then for Dr. Rosenbloom to take pride in the fact that their department was actually one of the first to acknowledge “discontinuation” and "rebound" twenty or more years after the drugs were introduced just added insult to injury as far as I was concerned. This is what is so frightening about psychiatry – there is some gross disconnect between the doctors and their patients. What the doctors “see” and the patients describe is completely at odds. Until that comes into alignment we are in for some serious trouble and the trends Whitaker describes will only get worse. "
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  #7  
Old 08-07-2011, 09:50 AM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
There are some excellent comments there.

Such as:
"They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. "
sounds like the comments section at BHtv.

PS. has your basil grown?
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  #8  
Old 08-07-2011, 10:12 AM
willmybasilgrow willmybasilgrow is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by badhatharry View Post
sounds like the comments section at BHtv.

PS. has your basil grown?
Finally yes. That was the name I chose for myself originally on BhTV because I was creating a log in, and glancing around the room for objects. I saw my little basil plant on the window sill. I was a novice gardener then. Four, five or however many years later, I've found that full sun, lots of water, and benign neglect are great ingredients that go into letting my basil grow (and grow and grow).

Thanks.
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  #9  
Old 08-07-2011, 11:55 AM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
Finally yes. That was the name I chose for myself originally on BhTV because I was creating a log in, and glancing around the room for objects. I saw my little basil plant on the window sill. I was a novice gardener then. Four, five or however many years later, I've found that full sun, lots of water, and benign neglect are great ingredients that go into letting my basil grow (and grow and grow).

Thanks.
fresh basil is very, very good.
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  #10  
Old 08-07-2011, 10:01 AM
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Default Re: John has gone off the deep end

Quote:
Originally Posted by willmybasilgrow View Post
Yes, regarding Carlat. I also urge other commenters here to go to Carlat. There are some excellent comments there.

Such as:
"The Harvard psychiatrists refuting Bob [Whitaker] were truly laughable. They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. There was not one substantive argument that the way they practice medicine is actually doing good. And then for Dr. Rosenbloom to take pride in the fact that their department was actually one of the first to acknowledge “discontinuation” and "rebound" twenty or more years after the drugs were introduced just added insult to injury as far as I was concerned. This is what is so frightening about psychiatry – there is some gross disconnect between the doctors and their patients. What the doctors “see” and the patients describe is completely at odds. Until that comes into alignment we are in for some serious trouble and the trends Whitaker describes will only get worse. "
You picked on among many comments. I read many comments that were not favorable to Whitaker at all.

When you talk about a disconnect between what doctors and patients describe, you must be talking about ex-patients. Current patients come to see their psychiatrists because they are to some degree or the other satisfied with the results. Otherwise they wouldn't come.

I find interesting how many people use internet sites to pour their grievances about all kinds of things. One of the popular topics is, of course, psychiatry. Unless they present a form of mental illness that would merit mandatory treatment, most people are free to choose whether to see a psychiatrist or not. If someone thinks that their problem would be better addressed without medication, in therapy or some other way, no one will stop them when they seek that kind of help. What's the problem then?
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  #11  
Old 08-07-2011, 10:07 AM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by Ocean View Post
When you talk about a disconnect between what doctors and patients describe, you must be talking about ex-patients. Current patients come to see their psychiatrists because they are to some degree or the other satisfied with the results. Otherwise they wouldn't come.
This is defintely not true. While people may think that the time spent on the couch is a waste of time and that it's not helping, there is a strange psychology that tells them that their dissatisfaction may be (and probably is) resistance to therapy and that they should stick with it. It's a win-win for the practitioner.
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  #12  
Old 08-07-2011, 10:22 AM
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Default Re: John has gone off the deep end

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Originally Posted by badhatharry View Post
This is defintely not true. While people may think that the time spent on the couch is a waste of time and that it's not helping, there is a strange psychology that tells them that their dissatisfaction may be (and probably is) resistance to therapy and that they should stick with it. It's a win-win for the practitioner.
Badhat, you're confusing the practice of psychiatry with psychoanalysis.
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  #13  
Old 08-07-2011, 11:53 AM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by Ocean View Post
Badhat, you're confusing the practice of psychiatry with psychoanalysis.
may I remind you that you are ignoring me. But I'm sure that what I said would be applicable to psychiatry as well as to psycoanalysis. Besides those two are not mutually exclusive.
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  #14  
Old 08-07-2011, 11:58 AM
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Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
may I remind you that you are ignoring me. But I'm sure that what I said would be applicable to psychiatry as well as to psycoanalysis. Besides those two are not mutually exclusive.
Your response certainly reminds me of why I'm ignoring you.
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  #15  
Old 08-07-2011, 12:03 PM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by Ocean View Post
Your response certainly reminds me of why I'm ignoring you.
It makes no difference to me. If you can't see the coercive, assymetrical quality of the profession that's too bad. This is not to say that there is no benefit. It's just a recognition of the way the system operates.
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  #16  
Old 08-07-2011, 12:02 PM
AemJeff AemJeff is offline
 
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Default Re: John has gone off the deep end

Quote:
Originally Posted by badhatharry View Post
may I remind you that you are ignoring me. But I'm sure that what I said would be applicable to psychiatry as well as to psycoanalysis. Besides those two are not mutually exclusive.
They're pretty much are mutually exclusive. One requires an MD and the other doesn't. A psychiatrist can prescribe medication, a psychoanalyst can't. Psychoanalysts engage in talk therapy ("the couch") and group therapy, and other behavioral modalities. Psychiatrists engage in the practice of a medical specialty (just like cardiologists, rheumatologists neurologists, and every other medical specialty.) There's really very little in common between them.
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  #17  
Old 08-07-2011, 12:05 PM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by AemJeff View Post
They're pretty much are mutually exclusive. One requires an MD and the other doesn't. A psychiatrist can prescribe medication, a psychoanalyst can't. Psychoanalysts engage in talk therapy ("the couch") and group therapy, and other behavioral modalities. Psychiatrists engage in the practice of a medical specialty (just like cardiologists, rheumatologists neurologists, and every other medical specialty.) There's really very little in common between them.
Oh really? so when did psychiatrists stop practicing psychoanalysis? They just push pills now?
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  #18  
Old 08-07-2011, 12:57 PM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by sugarkang View Post
What is the standard tool for psychiatrists?
So you want to play Jeff's shell game, eh? Have fun.
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  #19  
Old 08-07-2011, 12:58 PM
AemJeff AemJeff is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by badhatharry View Post
So you want to play Jeff's shell game, eh? Have fun.
harry, it's called "parsing the English language." Many people engage in it with great success!
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  #20  
Old 08-07-2011, 05:57 PM
willmybasilgrow willmybasilgrow is offline
 
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Default Re: John has gone off the deep end

What a shame this thread has gotten hijacked. It's really boring, guys!
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  #21  
Old 08-07-2011, 06:43 PM
Ocean Ocean is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by willmybasilgrow View Post
What a shame this thread has gotten hijacked. It's really boring, guys!
I actually agree with you. There's a lot of drama to be had at the drop of a hat. No pun intended.
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  #22  
Old 08-07-2011, 09:41 PM
eeeeeeeli eeeeeeeli is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by Ocean View Post
I actually agree with you. There's a lot of drama to be had at the drop of a hat. No pun intended.
Yes, very silly.

Hey, kudos on the shout out, Ocean. I too, find you one of the more reasonable people around here. Helps keep us honest!
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  #23  
Old 08-07-2011, 09:51 PM
Ocean Ocean is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by eeeeeeeli View Post
Yes, very silly.

Hey, kudos on the shout out, Ocean. I too, find you one of the more reasonable people around here. Helps keep us honest!
Thanks!
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  #24  
Old 08-07-2011, 06:10 PM
AemJeff AemJeff is offline
 
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Default Re: Jeff has gone off the deep end

Sorry Basil, but I doubt this is going to end any time soon.
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  #25  
Old 08-07-2011, 06:20 PM
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Default Re: Jeff has gone off the deep end

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Originally Posted by AemJeff View Post
If I have a problem (and I do!) it has to do with unwillingness to let things go and stop defending what I've said until long after it's become clear that there's neither good faith nor good will to be had from some of my interlocutors.
More double-talk.
Quote:
Simply pointing to a conversation and applying an adjective isn't an argument. In fact, have you ever offered a detailed argument, as opposed to catty insinuations and muddled retorts that ignore whichever parts of your interlocutors' arguments you either don't understand or don't find convenient?
Muddled and catty...man, I suck.
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  #26  
Old 08-07-2011, 06:24 PM
AemJeff AemJeff is offline
 
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Default Re: Jeff has gone off the deep end

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Originally Posted by look View Post
More double-talk.Muddled and catty...man, I suck.
I'm not sure you quite understand what "double-talk" means; but "muddled and catty" - I think we're onto something there!
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  #27  
Old 08-07-2011, 06:31 PM
sugarkang sugarkang is offline
 
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Default Re: Jeff has gone off the deep end

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Originally Posted by look View Post
As far as your Nazi comparison, I understand your point: Liberals here tend to think they're doing God's Work by attacking conservatives with insults and name-calling. Also, they seem to think that Godwin's Rule is a scientific principle, or something.
I really wasn't trying to call the Gang of 12 a bunch of Nazis. And I really didn't. But apparently it's an affront to all senses. Call Republicans racists and xenophobes everyday. That's no problem. Yay! Casually slander a person. I never knew it could be this much fun!

And if anyone wants to take an honest look at the conversation between Jeff and Harry, I left it all out in the open and made it as easy to read and honest as possible. Whatever Ocean's criticism was, it was completely irrelevant as to the conversation between Jeff and Harry. I stand by my characterization of events.

Now, how can liberals plead for the mercy of Palestinians, or the poor in America, or the unfortunate anywhere, when they unthinkingly insult anyone and everyone with whom they disagree on an internet message board? I've almost never seen an earnest effort by the Gang of 12 to empathize with differing opinions. Not that they're under any obligation. But if you can't be civil on a message board, how is it that you think you're qualified to create peace for Israel/Palestine? The really big stuff is somehow going to be easier than the small stuff?
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Last edited by sugarkang; 08-07-2011 at 06:35 PM..
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  #28  
Old 08-07-2011, 06:45 PM
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Default Re: Jeff is deep

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Originally Posted by sugarkang View Post
I really wasn't trying to call the Gang of 12 a bunch of Nazis. I didn't even call them Nazis, but it's an affront to all sense. Call Republicans racists and xenophobes everyday. That's no problem. Yay! Casually slander a person. I never knew it could be so fun!

And if anyone wants to take an honest look at the conversation between Jeff and Harry, I left it all out in the open and made it as easy to read and honest as possible. Whatever Ocean's criticism was, it was completely irrelevant as to the conversation between Jeff and Harry. I stand by my characterization of events.
I know you weren't calling them Nazis. By Godwin's Rule I meant the way they overreact at a the mention of Nazis, as if it were an actual disqualifying action.

Quote:
Now, how can liberals plead for the mercy of Palestinians, or the poor in America, or the unfortunate anywhere, when they unthinkingly insult anyone and everyone with whom they disagree on an internet message board. I've almost never seen an earnest effort by the Gang of 12 to empathize with differing opinions. Not that they're under any obligation. But if you can't be civil on a message board, how is it that you think you're qualified to create peace for Israel/Palestine peace? The really big stuff is somehow going to be easier than the small stuff?
Many of them suffer from low emotional IQ. They have the need to express anger or superiority or whatever, and a message board is a convenient conduit. Dispensing with civilized discourse is considered a noble act sanctioned by Alinsky
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  #29  
Old 08-07-2011, 11:09 PM
sugarkang sugarkang is offline
 
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Default Re: Jeff is deep

Quote:
Originally Posted by look View Post
I know you weren't calling them Nazis. By Godwin's Rule I meant the way they overreact at a the mention of Nazis, as if it were an actual disqualifying action.
Oh, I know. I didn't mean to sound defensive, but I guess it's a reaction against the mob.

Quote:
Many of them suffer from low emotional IQ. They have the need to express anger or superiority or whatever, and a message board is a convenient conduit. Dispensing with civilized discourse is considered a noble act sanctioned by Alinsky
Well, I didn't even bother to point out, in clearer terms, that the primary objection Jeff seemed to have in that pointless spat had much more to do with vicariously protecting the honor of Ocean's social standing as a psychiatrist (versus the lowly psychotherapist) when all Harry seemed to care about was the actual job description. Jeff's assigning blame outward rather than inward is telling, I think. And I think if you weren't actually in the Gang of 12 and compared the actual text versus my interpretation of them, I think at least half of the disinterested readers would see my version as accurate. That's obviously my own bias. You'd have to get over the "N" word and I guess that's a hard thing to do.
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  #30  
Old 08-07-2011, 10:01 AM
badhatharry badhatharry is offline
 
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Default Re: John has gone off the deep end

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Originally Posted by willmybasilgrow View Post
Such as:
"The Harvard psychiatrists refuting Bob [Whitaker] were truly laughable. They seem to think that all it takes for them to be convincing is to say “I don’t agree” and issue a few ad hominem attacks. There was not one substantive argument that the way they practice medicine is actually doing good. And then for Dr. Rosenbloom to take pride in the fact that their department was actually one of the first to acknowledge “discontinuation” and "rebound" twenty or more years after the drugs were introduced just added insult to injury as far as I was concerned. This is what is so frightening about psychiatry – there is some gross disconnect between the doctors and their patients. What the doctors “see” and the patients describe is completely at odds. Until that comes into alignment we are in for some serious trouble and the trends Whitaker describes will only get worse. "
PS. This reminds me of the reason Popper's concept of falsifiability came into being.

Quote:
That is to say, he saw that what is apparently the chief source of strength of psychoanalysis, and the principal basis on which its claim to scientific status is grounded, viz. its capability to accommodate, and explain, every possible form of human behaviour, is in fact a critical weakness, for it entails that it is not, and could not be, genuinely predictive. Psychoanalytic theories by their nature are insufficiently precise to have negative implications, and so are immunised from experiential falsification.
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  #31  
Old 08-06-2011, 02:43 AM
cosmic_electrons_dancing cosmic_electrons_dancing is offline
 
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Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

A welcome discussion about the single most important malady of our age: emotional disturbance/schizophrenia. Perhaps it is again time to offer the groundbreaking and pioneering work of Murray Bowen MD. Bowen studied, in depth, the schizophrenic "in situ" that is to say: in the family. The interested reader could easily Google "Bowen Theory" or: "Societal Emotional Process" for more information.

Also, thank you for the hat tip to Ocean. Thoughtful comments are always deeply appreciated!
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  #32  
Old 08-06-2011, 05:17 AM
jerusalemite jerusalemite is offline
 
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Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

Read Dr. Marcia Angell's articles in the "New York Review of Books" (http://www.nybooks.com/contributors/marcia-angell/). John Horgan is spot on about string theory (last week) and the inefficacy of antidepressants.
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  #33  
Old 08-06-2011, 06:42 AM
SkepticDoc SkepticDoc is offline
 
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Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

I hope John and George are not covert Scientologists...
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  #34  
Old 08-06-2011, 07:09 AM
Starwatcher162536 Starwatcher162536 is offline
 
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Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

I'm twenty-five minutes into this and have heard John mention some dozen times that anti-depressants can improve behavior in the short term but incur long term costs. What are these long term costs?
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  #35  
Old 08-06-2011, 07:20 AM
Starwatcher162536 Starwatcher162536 is offline
 
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Default Re: Science Saturday: The Mental Illness Epidemic (John Horgan & George Johnson)

After sampling John many times over a wide variety of topical subjects it becomes clear that John's claims of being an (?ex?) hippie have truth to them.
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  #36  
Old 08-06-2011, 08:23 AM
frontier_sally frontier_sally is offline
 
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Default Sleep and Depression

Very interesting diavlog. Defintely going to check out Whitaker's book, John.

One question (maybe Ocean has some insight here): What is the status of research on the link between sleep and depression? In particular, sleep deprivation as a treatment for depression. Is this treatment considered 'alternative'? How often is it attempted as a modern treatment of depression? Is there enough anecdotal evidence and/or solid research to warrant more funding/media attention for sleep-modification treatment(s) of depression, especially in light of the high potential costs of coventional psychopharmacology?

Okay, that was more than one question...
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  #37  
Old 08-06-2011, 09:46 AM
Ocean Ocean is offline
 
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Default Re: Sleep and Depression

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Originally Posted by frontier_sally View Post
Very interesting diavlog. Defintely going to check out Whitaker's book, John.

One question (maybe Ocean has some insight here): What is the status of research on the link between sleep and depression? In particular, sleep deprivation as a treatment for depression. Is this treatment considered 'alternative'? How often is it attempted as a modern treatment of depression? Is there enough anecdotal evidence and/or solid research to warrant more funding/media attention for sleep-modification treatment(s) of depression, especially in light of the high potential costs of coventional psychopharmacology?

Okay, that was more than one question...
The quick answer is that it is impractical.
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  #38  
Old 08-06-2011, 09:28 PM
Hal Morris Hal Morris is offline
 
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Default Re: Sleep and Depression

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Originally Posted by Ocean View Post
The quick answer is that it is impractical.
Well, Ocean that's got the virtue of brevity alright, but I'd like to know more. Will put in my 2 cents that, I've been on antidepressants (primarily prozac and welbutrin) for around 20 years, which has been very beneficial, but it might be said that I was self-medicating with sleep deprivation before that time.

I'm not sure I should call it self-medicating or sleep-deprivation
, but I would have terrible days if I got 8 hours of sleep, and could generally operate very well on 5-6 hours sleep (with a run or some other aerobic exercise as soon as I got up).

I have a funny story about how I first decided to go the Prozac route (here I have to say that a certain amount of publicity was useful in causing me to seek out a psychiatrist who I knew was likely to prescribe it to me). The funny thing is, at the time, Michael Moore was known only as the guy who did "Roger and Me", but then for a while he had a TV show examining with some humor and/or ridicule whatever he thought were disfunctions in American life, and he happened to have a piece called "Prozac for pets". Prozac was almost obscenely expensive at that time, which was probably part of the appeal for MM -- kind of like diamond necklaces for dogs might have been the angle he was going for. But the nice old couple were telling how much good it had done for their dog, who used to spend all his time "worrying the same old bone", and how he was now much more cheerful and doggy. My wife and I saw this and it kind of clicked "worrying the same old bone" seemed somewhat like my experience.

I took one break from it, and used the same low-sleep and exercise discipline I'd used in the past which worked well until a very difficult experience came along and I went into classic depression for the first time in my life, complete with sharp weight loss (previously the diagnosis was "anhedonia" and I ate a bit too much if anything). After a few months in which long walks in the woods kept me from totally going off the rails, I went back on it and have been since then. Some time I'd like to try going off it again, but not with my current stressful life.

Frankly, I haven't yet listened to the diavlog at all, but will, and probably will say some more about free will, as I am not called the ontological comedian for nothing (well, only by myself).
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  #39  
Old 08-06-2011, 09:49 PM
Ocean Ocean is offline
 
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Default Re: Sleep and Depression

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Originally Posted by Hal Morris View Post
Well, Ocean that's got the virtue of brevity alright, but I'd like to know more. Will put in my 2 cents that, I've been on antidepressants (primarily prozac and welbutrin) for around 20 years, which has been very beneficial, but it might be said that I was self-medicating with sleep deprivation before that time.

I'm not sure I should call it self-medicating or sleep-deprivation
, but I would have terrible days if I got 8 hours of sleep, and could generally operate very well on 5-6 hours sleep (with a run or some other aerobic exercise as soon as I got up).

I have a funny story about how I first decided to go the Prozac route (here I have to say that a certain amount of publicity was useful in causing me to seek out a psychiatrist who I knew was likely to prescribe it to me). The funny thing is, at the time, Michael Moore was known only as the guy who did "Roger and Me", but then for a while he had a TV show examining with some humor and/or ridicule whatever he thought were disfunctions in American life, and he happened to have a piece called "Prozac for pets". Prozac was almost obscenely expensive at that time, which was probably part of the appeal for MM -- kind of like diamond necklaces for dogs might have been the angle he was going for. But the nice old couple were telling how much good it had done for their dog, who used to spend all his time "worrying the same old bone", and how he was now much more cheerful and doggy. My wife and I saw this and it kind of clicked "worrying the same old bone" seemed somewhat like my experience.

I took one break from it, and used the same low-sleep and exercise discipline I'd used in the past which worked well until a very difficult experience came along and I went into classic depression for the first time in my life, complete with sharp weight loss (previously the diagnosis was "anhedonia" and I ate a bit too much if anything). After a few months in which long walks in the woods kept me from totally going off the rails, I went back on it and have been since then. Some time I'd like to try going off it again, but not with my current stressful life.

Frankly, I haven't yet listened to the diavlog at all, but will, and probably will say some more about free will, as I am not called the ontological comedian for nothing (well, only by myself).
Interesting story, Hal.

Sleep deprivation works for many, not all. It works while you're doing it and the effect goes away as soon as you go back to a more normal sleep pattern. Most people that I know aren't willing to be sleep deprived. It has also long term problems, including possible decreased concentration which can interfere with driving or operating heavy machinery. Most people aren't willing to go for long walks in the morning either.

I recommend my patients who get depressed during the winter months to consider light therapy, or try to be outdoors daily for at least 30- 45 minutes, bundled up if needed. Noon is a great time because of the intensity of light then.

It's interesting that you distinguish periods of anhedonia from a period of clinical depression. I agree that they are different. Perhaps one indicates a predisposition to the other, but certainly not the same.

If at some point you and your treating physician decide that it's a good time to go off medications, the recommendation is to do it gradually, tapering off to avoid discontinuation syndrome or relapses. Once you're off it, you can use other strategies to reduce stress, manage anxiety or negative thinking, and physiologically boost your mood with exercise, light, and perhaps mild sleep deprivation. I would be careful with the latter, and would advise to be under medical supervision at least for a while to make sure you don't end up experiencing other mood problems (irritability or hypomania).

How do you like that? As you can imagine it wouldn't be appropriate for me to get into any more detail or individualized advice. These are general recommendations. You would have to consult your doctor for more detail.
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  #40  
Old 08-07-2011, 09:06 AM
Hal Morris Hal Morris is offline
 
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Default Re: Sleep and Depression

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Originally Posted by Ocean View Post
Interesting story, Hal.

It's interesting that you distinguish periods of anhedonia from a period of clinical depression. I agree that they are different. Perhaps one indicates a predisposition to the other, but certainly not the same.

If at some point you and your treating physician decide that it's a good time to go off medications, the recommendation is to do it gradually, ...
A bit too much advice though I don't want to be too hard on your doctor-ly impulses. I was just trying to contribute something in the manner of dinner conversation.

Do you know in certain philosophical discourses, "patient" and "agent" are treated as opposite poles of something-or-other?

I could go riffing on about Thomaz Szatz (who I think has not done much good for the world), and modern libertarians, and maybe Michel Foucault as an alternate way of demonizing therapy. So many thoughts so little time.

Best Regards,
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