Tuesday, November 12, 2019

Comments by Guru3522

Showing 7 of 7 comments.

  • I found this blog post by Dr. Pies as I was looking through his writings, and while I hesitate to claim to understand much of anything about a person I’ve never met, in some way his attitudes towards “patients” make a little more sense to me after reading what he wrote here:

    http://psychcentral.com/blog/archives/2012/06/16/my-fathers-t-shirts-reflections-on-fathers-day/

    Along with the sadness I feel after reading what he wrote, in part because I lost my father quite suddenly at the age of 17, I feel an increased responsibility to remember that we are all much more human than otherwise, especially those persons who cause much pain to others without recognizing that they do, and why.

  • Thanks for your insights, Julie! Sorry, have been away from MIA for a while or I would have responded sooner.

    I completely agree that the end goal should be that I make myself unnecessary, and that respect is above all else what needs to be conveyed. And while that last part about respect would seem like an obvious, “duh” thing to say, I am constantly flabbergasted at the lack of respect, oftentimes quite subtle, that is demonstrated by many clinicians towards those with which they work on a daily basis. This has been true in every single environment that I have worked in over the last several years, and I guarantee that most of the clinicians who I believe show this disrespect would gasp and deny that they do so if it were brought to their attention. In fact on those occasions where I have diplomatically made such comments I have received some variation on that response.

    The thing is, I actually do believe that consciously most of these therapists do not believe that they lack respect for the people that they work with; however the words that they use, the gestures and body language that they give off, the tones of their voices, and the things that they DON’T say strongly illustrate that they see these others as just that, OTHERS, and treat them accordingly.

    Thanks again for your advice, I truly appreciate it!

    Much respect,
    Greg

  • While conducting the literature review for my dissertation, which involved my interviewing 6 adolescents diagnosed with psychotic disorders who were in residential treatment about their experiences with human relationships, I was appalled, yet unfortunately not surprised, to learn that there were ZERO similar studies. The absence of any attention to the subjective experiences of people seen as “severely mentally ill” within academia is quite unfortunate, and reflects the utter lack of respect given to those people whom we clinicians claim to want to understand and assist.

    My project, titled: See Me, Feel Me: Subjective Experiences of Human Relationships Within a Residential Population of Adolescents Diagnosed as Psychotic, was an attempt to give voices to young men and women who are at the same time claimed to be impossible to comprehend and work with and then totally ignored by clinicians and academics. I’ve included a link to my study below, which contains both the abstract and a free PDF copy of the entire project. If anyone is interested in taking a look and giving me feedback, I’d really appreciate it! My email is [email protected]

    Dissertation link:

    http://gradworks.umi.com/36/15/3615265.html

  • Hi Julie- thank you for sharing your story. I am a psychotherapist and agree with many of the points you bring up about how oftentimes “mental health professionals” can be cruel, ignorant, and just plain shitty. I also have struggled with my own difficulties in living for a long time, although I’ve never ended up a patient in a psych ward, coming close in college but being able to convince others I was “normal” enough to walk among them. My main interests are in working with people who have had experiences that some call “psychotic”, doing my best to understand them and their stories, and assisting them in avoiding the more barbaric aspects of the system. My question to you is: in light of your experiences with therapists, what can I do to be helpful to those with which I work? I’d really like to hear others’ thoughts on this question, as well. Thank you!

  • Understood. I must say in closing that I feel you often subtly (and at times overtly) insult those persons which want so badly to discuss real issues with you, and seem to minimize or disregard worthwhile information that runs counter to the ‘state of the art’ research you condescendingly referred to above. I would only ask that you reflect upon the reactions you have received from many of us on this site as you continue putting your ideas out for public comment. Again, I was hoping to speak to real issues and to hopefully learn things from you that I apparently have been unaware of. It seems that I did learn from you; however this knowledge was not related to behavioral genetics. I genuinely wish you well with your work.

  • Hi Bob- Thanks for your reply. I was hoping that you might address the data that I provided in light of your bold claims re: heritability of Schizophrenia. The two points that you make, after what appears to be a subtle intimation that I may be ‘obdurate’, do not address anything that I put forth, as well as have no associated citations. Further, these is a wealth of literature that makes what I view to be a compelling case for the role of childhood trauma, as well as other painful early life experiences, in the etiology and development of human suffering (i.e. “mental illness”). I agree that the answers we seek most definitely include biological, genetic, intrapsychic and interpersonal factors; however I do not feel that some of the information in your original post stands up to the types of scrutiny you make it a point to discuss. I do not say any of this with ill will, or as an attack on anything other than your conclusions and cited evidence. I only do so to ask that you more fully explain how you have reached these conclusions in light of much of the literature which, in my eyes, provides contrary evidence.

  • Hi Bob- I appreciate your comments, but do disagree with your data on the obvious genetic heritability of Schizophrenia. Here’s a section from a recent paper of mine on the issue; I’d love your thoughts if you have the chance:

    Since the famous twin studies, first appearing during the middle part of the 20th century, belief in a genetic cause for Schizophrenia has been repeatedly asserted by many within the field of medical psychiatry, and specific work has subsequently been done in an attempt to discover particular genetic abnormalities responsible for the condition (Karon & Vandenbos, 1981; Boyle, 1990; Tillman, 2008; Williams, 2012). A majority of medical schools teach their psychiatrists in training that evidence for genetic causes and the role of heritability in schizophrenia is all but definitive, and it is exclaimed in the popular press quite often that we are on the brink of the one big discovery needed to at last put this issue to rest (Leo & Joseph, 2002; Joseph, 2003; Tillman, 2008; Williams, 2012).
    Much of the evidence put forth alleging the major role of genetic phenomena in the etiology of Schizophrenia comes from the previously mentioned twin studies (Leo & Joseph, 2002; Joseph, 2003; Williams, 2012). In opposition to data repeatedly referenced by the NIMH, findings drawn from a meta-analysis of all twin studies after 1963 show that identical twins have a concordance rate for Schizophrenia of 22.4%, and that fraternal twins have a rate of 4.6 % (Leo & Joseph, 2002; Joseph, 2003; Williams, 2012). These numbers, while relatively small, do make a case for the influence of genes in the development of psychotic disorders. However, numerous methodological issues have been found with the pool of studies included in this meta-analysis, including “(1) lack of an adequate and consistent definition of schizophrenia; (2) non-blinded diagnoses, often made by investigators strongly devoted to the genetic position; (3) diagnoses made on the basis of sketchy informa¬tion; (4) inadequate or biased methods of zygosity determination (that is, whether twins are [identical or fraternal]); (5) unnecessary age-correction formulas; (6) non-representative sample populations; and (7) lack of ad¬equate descriptions of methods.” (Williams, 2012, Pg. 27).
    These issues aside, the concordance rates for identical twins have indeed been noted as higher than those for fraternal twins, a finding which has been said to indicate the substantial role of genetics in perpetuating psychotic disorders; but is this so? In conjunction with genes, the environmental conditions of both sets of twins must be examined for a verdict to be reached. It has been assumed that fraternal twins and identical twins share similar environments, and that the twins in each pair would be treated by this environment as separate individuals (Karon & Vandenbos, 1981; Karon, 2006; Williams, 2012). A contrary argument is that identical twins are more likely to be treated as one person, and that similar treatment by caretakers in their environment, as well as the lack of a well-defined identity, would likely contribute to the development of psychotic symptomatology (Karon & Vandenbos, 1981; Leo & Joseph, 2002; Joseph, 2003; Karon, 2006; Williams, 2012).
    The second group of sources of research on the role of genetics and heredity in Schizophrenia are adoption studies, of which there have only been 7 major examples to date (Williams, 2012). About half of these have involved cases in which offspring of biological parents diagnosed with Schizophrenia have been followed, having been adopted by parents either diagnosed or undiagnosed. (Karon & Vandenbos, 1981; Leo & Joseph, 2002; Joseph, 2003; Williams, 2012). The other half include cases where the biological parents of adopted children diagnosed with schizophrenia have been sought out so as to determine if they have passed on the condition to these offspring (Karon & Vandenbos, 1981; Leo & Joseph, 2002; Joseph, 2003; Williams, 2012). Along with methodological issues stemming from overly wide definitions of the term ‘psychotic’ that, if corrected, would have found many fewer persons fitting disorder criteria, scrutiny has been focused on the particular times and places in which these parents and children lived (Karon & Vandenbos, 1981; Leo & Joseph, 2002; Joseph, 2003; Williams, 2012). In all cases sterilization policies were in place for individuals who were deemed to have produced schizophrenic offspring, with their progeny almost definitely having been labeled as ‘defective’ and ‘schizophrenic’ (Karon & Vandenbos, 1981; Leo & Joseph, 2002; Joseph, 2003; Williams, 2012). It is likely that the most qualified sets of adoptive parents would not have jumped at the chance to adopt children so designated, meaning that much less fit parents would likely have reared these boys and girls; this issue was not addressed in any of the studies referenced above, significantly limiting validity (Karon & Vandenbos, 1981; Leo & Joseph, 2002; Joseph, 2003; Williams, 2012).
    Finally, much to the continued dismay of researchers the quest to discover specific genetic abnormalities associated with Schizophrenia has not delivered consistent, replicable and definitive findings (Karon & Vandenbos, 1981; Boyle, 1990; Leo & Joseph, 2002; Joseph, 2003; Petronis, et al, 2003; Williams, et al, 2007; Hamilton, 2008; Simons & van Winkle, 2012; Whitaker, 2012; Williams, 2012). The now familiar issues of universality and exclusivity again arise, highlighting the serious issues involved in current genetic research into psychotic conditions (Leo & Joseph, 2002; Joseph, 2003; Petronis, et al, 2003; Williams, et al, 2007; Hamilton, 2008; Simons & van Winkle, 2012; Whitaker, 2012; Williams, 2012). And perhaps most strikingly, many researchers who profess belief in the existence of genes linked to schizophrenic psychoses have voiced serious concern about the future of their discipline (Williams, 2012), with one even going so far as to state that “common genes of major effect…are unlikely to exist for schizophrenia” (Williams, et al, 2007, Pg. 30).
    In light of the major roadblocks that contemporary genetic research into Schizophrenia has encountered, an avenue of study into the effect of environmental phenomena on genetic function and expression has emerged; epigenetics. The term ‘epigenetics’ refers to “the reversible regulation of various genomic functions, occurring independently of DNA sequence, mediated principally through changes in DNA methylation and chromatin structure.” (Rutten & Mill, 2009, Pg. 1045). Many of these changes to the properties of genes have been seen as the result of exposure to insults from the human environment (van Winkle, et al, 2008; Rutten & Mill, 2009), an assertion that has finally given credence to decades of work by researchers and clinicians who have repeatedly pointed out the role of interpersonal phenomena in the development of psychotic conditions (Bettleheim, 1967; Karon & Vandenbos, 1981; Williams, 2012). Among these environmental insults are: maternal stress, one’s ‘rearing environment’, chronic stress in childhood, experience of trauma, living in an urban environment, the experience of migration, and drug abuse (van Winkle, et al, 2008; Rutten & Mill, 2009). The impacts of these negative experiences have been found to include biological and genetic changes, as well as the development of emotional, cognitive and behavioral symptomatology.