Friday, September 20, 2019

Comments by edge

Showing 11 of 11 comments.

  • I’m grateful that you shared your powerful speech here. I’m going to need to read it 5X more times before I truly understand the ramifications. I do get that them there are fighting words.

    A great comedian, Mel Brooks, made fun of Hitler with a funny play (now two movies), The Producers. The Producers is about the making of a play titled: Springtime for Hitler. Catchy lyrics include:

    And now it’s…
    Springtime for Hitler and Germany
    Deutschland is happy and gay!
    We’re marching to a faster pace
    Look out, here comes the master race!
    Springtime for Hitler and Germany

    It is springtime for patent protected antipsychotics and the new DSM.
    Here’s one young comic with a parody drug commercial:
    http://www.youtube.com/watch?v=p_27DUYQeJw&feature=related

    In all seriousness, this tragic situation demands that we call in the clowns.

  • Thank you, markps2. I don’t know if the filmmakers can add the voices you describe to the film’s audio, but I think the film would be richer for the inclusion.

    I’ve experienced visual hallucinations myself…faces morphing…seeing the faces of people I know on the faces of strangers and vice versa.

  • I don’t know about God’s answer to psychiatry. God has been diagnosed manic depressive in The Onion.

    Healing Voices is an arresting film already.

    What does a visual hallucination look like? What does it sound like to hear voices? Rarely have I seen these altered states depicted accurately.

    Playing golf, walking on the beach, strolling through the woods, writing in a journal, looking young and hip…these behaviors do not cause problems for an individual hearing things and seeing things. Do they?

    Are these filmmakers prepared to offer a radically different approach for behaviors not quite so cute and cuddly?

  • I’ll second that emotion, Duane and Steve.

    In the spirit of working with government officials, I found this (see below) in my email this afternoon from the Director of the NIMH. I met Dr. Insel one time. Basically he said that mental health treatments SUCK so I subscribed to his blog.

    “Words Matter
    By Thomas Insel on October 02, 2012

    NIMH just reached a milestone — our first grant was awarded 65 years ago last month. Rather than celebrating, this anniversary has been allowed to pass quietly. With so much progress in genomics and neuroscience, we at NIMH have mostly been trying to keep up. But these kinds of anniversaries afford a good time to take stock — all of us at NIMH would be remiss not to consider how far we have come since 1947.

    There have been many achievements: Nobel Prizes, great technologies, new treatments, and a vast enterprise for exploring the brain and behavior. But looking back is also sobering. Our original charge, from President Truman, was simply an executive order to fix the problems of America’s returning veterans who were struggling with “shell shock” or “combat neurosis.” Last month, we received another Presidential executive order. The topic – you guessed it: PTSD and TBI. Mission not accomplished.

    During the same decades when scientific discovery has led to the eradication of many infectious diseases, has converted childhood leukemias from 95% fatal to 95% curable, and has reduced cardiovascular mortality by nearly 70%, our success rate with PTSD has been no better than our success at reducing war or trauma. In fact, for all mental disorders, while we have treatments, we lack cures, we lack vaccines, and we lack diagnostic biomarkers. Most of all, we lack a rigorous understanding of the disorders, at least on a par with our understanding of infectious diseases, childhood cancer, or cardiovascular disease. We need better science at every level from molecular biology to social science. Serendipity helps, but science, science that is rigorous and deliberate and even disruptive, is our North Star. That is why NIMH uses as its tag line that “research = hope.”

    But there are many barriers to progress, not all of them are scientific. Some involve policy, some involve poverty, and remarkably, some are simply linguistic. In mental health, we are stymied by our language. The most obvious linguistic problem can be found in our current diagnostic terms, what my predecessor Steve Hyman has called “fictive categories.” Terms like “depression” or “schizophrenia” or “autism” have achieved a reality that far outstrips their scientific value. Each refers to a cluster of symptoms, similar to “fever” or “headache.” But beyond symptoms that cluster together, there should be no presumption that these are singular disorders, each with a single cause and a common treatment. Recall that Bleuler, who first introduced the term schizophrenia over a century ago, referred to “the schizophrenias.” And with new genetic discoveries, scientists are beginning to describe “the autisms,” a group of neurodevelopmental disorders of diverse causes.

    Those who constructed the DSM were looking for a common language to describe symptoms, not a common biology or a common treatment. As someone who entered psychiatry pre-DSM-3, I can attest to the value of a common language. But there have been costs as well. In DSM-4, for instance, the diagnostic criteria for depression require 5 of 9 features, so it would be possible for two people with 1 of 9 criteria in common to have this same diagnosis. Not exactly “precision medicine,” but this approach has delivered diagnostic reliability. What is missing is validity. DSM never presumed to confer validity or explanatory value, but the field has imbued these symptom clusters with biological meaning, perhaps understandable in the absence of biomarkers or diagnostic tests. Ironically, this linguistic oversight has precluded the development of biomarkers that might confer validity. One reason we do not have biomarkers for mental disorders is our presumption that the biomarker is only valid if it maps on to a “fictive category,” rather than developing diagnostic categories based on the experimental data, as proposed by RDoC, our version of “precision medicine.”

    Language traps us in even more subtle ways. There is no shortage of problematic words in our field. The term “stigma” may perpetuate a sense of being victimized with the unintended consequence of increasing discrimination and exclusion. There is an interesting ongoing debate about calling PTSD a “disorder” when it is unequivocally an injury. And conversely, for some in the autism community, a presumption that autism is an injury when much of the evidence points to autism as a neurodevelopmental disorder.

    As a provocative question for our 65th birthday, I was recently asked if we should continue to be identified as NIMH when we study mental disorders more than mental health? Does the inclusion of “mental health” in our name (in contrast to the National Cancer Institute, the National Institute for Allergy and Infectious Diseases, the National Institute for Neurological Disorders and Stroke) reveal an ambivalence about our mission to transform the understanding and treatment of mental illness, especially serious mental illness? There is no ambivalence, but I appreciate the spirit of the question.

    Some linguistic problems are easily solved. We can improve our current diagnostic categories via RDoC. We can find words that improve on “stigma.” Other linguistic issues, like the name of our institute, require literally an act of Congress. But on all of these issues, we need a broad conversation to help us understand how our language may be holding us back, limiting not only our impact but our imagination. Words matter, often in ways that are both subtle and profound.”

    If you had a chance to tour the research campuses at NIMH, meet with researchers and then do lunch with Dr. Insel himself, what would you talk about?

    I would ask him about the “bipolar boom” because the numbers I’ve seen, they do haunt me.

  • I’m glad I’m not on trial here. I’m going to agree with anonymous that The Infinite Mind was for the masses. Not every show was mainstream however.

    How do we know Lichtenstein isn’t fighting for the civil rights of ALL persons? He’s not a personal friend of mine so I don’t know.

    Look at all the money he raised for this project of his:
    http://www.kickstarter.com/projects/lcmedia/the-american-revolution

    The American Revolution project is about a renegade radio station in Boston in the sixties and seventies.

  • Ted, I loved the personal ad you wrote for the forum here. Marry me? Does it matter that I’m already married? j/k

    Sometimes your fighting words drive a stake through my vampire heart.

    You draw a circle of fire that shuts me out.

    Paraphrasing a Catholic priest, Ron Rolheiser: In a world polarized by competing ideologies and torn by factionalism, we must welcome the stranger, show hospitality to, those who are different from ourselves. In welcoming the stranger, in showing real hospitality to those who seem foreign to us, whom we do not understand, we are given the opportunity hear new promise, to hear a fuller revelation…

    You mention The Infinite Mind. Bill Lichtenstein, the producer of that show, is an award winning journalist and a fellow traveler. Brilliant, mercurial, award winning journalist that he is, he also wears a bipolar label.

    At this very moment, Bill is fighting against the use of seclusion rooms and restraints in schools. See the opinion piece he recently wrote for The New York Times that launched a firestorm: http://terrifyingdiscipline.weebly.com/

    The Infinite Mind would’ve been better with you in it. I would’ve loved to hear you be the host and referee for that last Infinite Mind show on antidepressants.

    The civil rights movement you describe so eloquently would be much stronger with guys like Bill Lichtenstein IN it.

    Hello, stranger.

  • David Oaks is right about social media.

    I find myself reading MiA before I open my morning paper, which is WaPo, The Washington Post.

    If you’re looking for a publicity stunt, why not call for the return of a few Nobel Prizes?

    Everyone agrees that the guy who received a Nobel for developing the icepick through the eyes procedure for emotional distress should lose his Nobel.

    But what about of the dudes who did the research that launched modern day antidepressant therapy? These are those guys, I believe: http://www.nobelprize.org/nobel_prizes/medicine/laureates/1970/speedread.html
    They are dead now, but their work doesn’t look so Nobel Prize worthy to me anymore.

    Color me bitter and angry, I would dare to compare winning a Nobel for the explaining how antidepressants work to winning a Nobel for telling the world that quickie lobotomies work. The ice pick guy was stopped.

    Antidepressants don’t work. Yet antidepressants, which may rarely alleviate depression, may unmask bipolar disorder, may be responsible for the bipolar boom, may lead to suicide and/or murder, are selling strong.

    Just a crazy thought. LOL