“Subconscious” is not synonymous with “unintentional.” It just means you’re not willing to acknowledge those intentions. Most “professionals” ARE covering up intentionally, even if it is not something they are consciously aware of doing. Any time someone gets defensive when presented with contrary evidence, they are intending to cover up.
Exactly! As long as the status quo is an easy way to financial success, as long as big corporations are making buckets of money, any “reform” will be considered threatening to those piggies with their snoots in the trough. Stop feeding the piggies and you may have a chance at real change. We need to stop rewarding failure with more money!
I am sorry if I misinterpreted your comments. I have seen OD trainings and participated in one myself. It seems like a great approach. I’m also not opposed to the availability of drugs to assist anyone who finds them helpful. My point would be more that Dr. Jureidini should not expect to be congratulated for his success. As has been clearly demonstrated with many examples, successful healing of patients is threatening to the status quo, and anyone who is successful can expect to be attacked as a quack, a religious nut, or an irrationally hostile force. Initial reactions to Bob’s book are more proof. No one can really undermine his basic premises, yet he’s seen as a kook or an antipsychiatry nut or a “Scientologist,” as if any of those are scientific analyses of his work. And such tactics are generally successful, and will be until the public catches on that the mainstream of psychiatry does NOT have our best interests at heart.
David didn’t “reform” Goliath and convince him not to attack. He beat him physically and defeated him. Peer workers are a great option, but they need to understand that their efforts will be OPPOSED by the mainstream system, and that system must be DEFEATED in terms of losing its power before any peer “reforms” can become mainstream and the label-and-drug model dies a well-deserved death.
That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!
Hey, that’s what ECT is all about – inducing seizures! Why could a spontaneous seizure not cause improvement? Of course, both cause brain damage, at least potentially, but if the docs are INDUCING seizures, I suppose brain damage is potentially therapeutic!
I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.
I LOVE the “Stop it!” skit! But you are right. The problem is opposing goals. The peer movement’s intentions were contrary to those of the main MH system, and so they had to be coopted or snuffed out. And the MH system was very effective in doing so. You can’t change the basic purpose of the MH system. It’s built in.
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Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.
Mark, you have not contacted me by email or responded to my emails. I’m not sure you even received them at this point. I will no longer be able to post your comments until you contact me and we can have a conversation. Again, my email is [email protected] or [email protected]. It’s also listed in the “About” section of your home screen. Meanwhile, all of your posts will simply stay as “pending” until I hear from you. I’m not sure what else to do to get a response from you.
So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.
POSTING AS MODERATOR: I honestly don’t have any idea how to unsubscribe you. Perhaps one of our tech staff can help? You can find them in the “About” section under “Staff.”
Motivational Interviewing has a lot of useful techniques and is or should be very much client directed. The coach or “therapist” finds out what motivates the CLIENT from their own viewpoint and then helps examine which current behavior gets them closer to that goal FROM THE CLIENT’S POINT OF VIEW.
How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”
And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!
Mark, I am giving you until the end of today to respond to my emails or give me a working email address. If this does not occur, I will be forced to remove your right to post here, as having a working email is part of the posting guidelines.
Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?
You do realize that many women are unable to establish positive sexual relationships as well, don’t you? I would love to see you address this issue as part of your presentation.
Posting as moderator: MARK, PLEASE CHECK YOUR EMAIL. I have sent several messages. If you are unable/unwilling to respond to emails, you are not allowed to post at MIA. Please write me back so we can discuss your prior posts. It’s not OK to keep saying you are waiting for them to be posted when I’ve told you my concerns and you have failed to respond.
Please write me back or I will have to stop posting your comments. If that email doesn’t work, please get me one that does ASAP.
Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.
You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.
Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.
They should not be “involved,” they should be the central architects of any such effort. Who knows better than those with “lived experience” what actually does and does not help???
Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
When advocating for foster youth for 20 years, I saw many who became aggressive on stimulants and were then re-diagnosed with “bipolar disorder” instead of stopping the stimulants. It was extremely common but very hard to get anyone to discuss seriously, even though a good number of the psychiatrists I worked with admitted it occurred.
Something is seriously wrong with a system in which we can talk about “”moving toward shared ownership and dialog.” What kind of help can be going on where shared ownership and dialog is not already THE central concept we are operating on? How can a therapist know what is helpful if they aren’t having shared dialog with their client????
How can you say it “works for everyone” when so many people report no benefits or harm from DBT? I see a bunch of useful skills which could be helpful in the hands of a competent therapist but how many therapists are that competent? And why can’t others not trained in DBT employ or teach the same skills? Mindfulness, for example, is swiped from Buddhism, and there are many who understand mindfulness well who have zero connection with DBT. There are plenty of other examples.
The research I’m familiar with suggests that it is not “ineffective methods” but rather lack of emotional preparation and appropriateness that undermines success. Therapy success appears to be associated more with therapist characteristics than by method or school of therapy employed.
I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
Again, please remember that NNT and other stats are based on the assumption that symptom reduction is the goal. This is a false outcome, as symptom reduction does not translate automatically into better outcomes.
It is not the job of others to demonstrate that Ritalin’s benefits do not outweigh the risks overall, it’s the job of those promoting the “treatment” that they do by a significant margin. If there is no major improvement in outcomes, then by definition, the treatment risk outweighs the benefit, unless you are claiming absolute zero risk. Even in the latter case, you’re still advocating for wasting money on something that doesn’t really work.
The burden of proof is on those claiming a treatment effect.
There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.
I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.
BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.
These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.
I think you nailed it here! It’s not that I object to anyone “identifying” with a particular “diagnosis” as an identity. It’s the effect of legitimizing these “disorders” as valid entities rather than social constructions that some people like to use as “explanations” for their uniqueness. The idea that diversity is “neuro,” aka CAUSED by neurological differences, plays completely into the hands of those who want to blame the brain for everything wrong with human beings’ behavior while letting our social structures off the hook. I know that a lot of people WITHIN these movements don’t believe that, but those running the show don’t care, they are still getting support for their label-and-drug approach that’s keeping them rich and protecting those in charge from having to examine the society they are creating and promoting.
How about “unconventional?” Or “unique communicators?” I think it is the idea that neurology and only neurology creates and defines these differences, along with the idea that “neurotypicals” can somehow be defined and dismissed as “normal,” that causes offense.
I can’t agree with that definition. Stigma implies an unfair negative bias based on a label or category. Prejudice implies specific actions taken as a result of believing in the superiority of one group over another. Discrimination is specific acts to harm someone in a category against which one is prejudiced. There are frequently no legal consequences to prejudice and discrimination, and in fact, they are often rewarded. I remember in 6th grade or so standing up for a kid labeled as “mentally retarded.” He was being harassed, so most definitely acts of prejudice. I’m sure he was also not included in people’s social groups, which is a form of discrimination. You know who got punished when I stood up for him? ME! I was “accused” of being a “retard lover” or some such thing. This went far beyond “stigma.” Where are the legal consequences for such acts?
It is a technique, not a “therapy.” The drive to create a manualized “therapy” is very strong, as it emphasizes making long-term clients and avoiding insight-driven healing. But no one can do therapy based on one technique or a manualized set of techniques that avoid connection with the client. CBT is only useful in the context of a larger “therapeutic relationship” where there is trust and sharing and humility between “patient” and “therapist.” This situation rarely happens, so most experience CBT as rather disconnected and intellectualized, and invalidative of the legitimacy of their actual issues and needs.
I was referring to calling other people “autistics” not claiming that label for yourself. Generalization is the problem.
Why not simply point out that some people are prone to violence and need to be dealt with for the safety of society? No one would argue with that premise. But the idea that “medication” is the best answer or is consistently effective is not supported by the number of “medicated” kids who remain violent, or even become violent on the drugs. I’ve worked in the foster system and kids mental health so I know what I am saying.
I see the thought behind your questions. However, by referring to a group of people as “Autistics,” you are making demeaning generalizations as if a person getting this label is somehow described and defined by it. This is a large part of why folks here object to the DSM mentality – labels such as “autistics” are inherently dehumanizing and don’t allow for discussion of either causes or options.
Are you aware that many of these kids your mom worked with, probably 90% or more, are already “medicated?” And yet are still violent?
Things are not as simple as you attempt to portray. Have you read “Anatomy of an Epidemic?” I am betting the answer is “no.” Maybe you should read the book and you will start to understand why people get upset about what you seem to accept as reality.
It sounds like they are training sociopathic traits into people!
The only thing that made me effective as a therapist was my willingness to let down my barriers and feel what the client/”helpee” was feeling. That is completely what guided how I would intervene. If a person can’t do that and still “maintain boundaries,” they have no business trying to help anyone emotionally. They need to get their own help first!
I respect your views on this. But I can tell you from past experience that this line of discussion is not productive and travels far from the realm of the “mental health” system. You will have to respect my judgement on this one. I am speaking from hard experience attempting to moderate such a discussion. So I’m not going to defend my decision. It’s already been made many months ago.
I don’t disagree with you. But COVID is off topic and has not led to productive conversations as a topic. You actually posted the first one on the topic and I should have disallowed it. Some of the more far-fetched comments that DO have to do with psychiatry are allowable as long as they are on topic and not insulting to individuals or groups. I don’t judge by the content except to the degree that it is not on the topic at hand, and I even let a lot of THAT go if it’s productive conversation. But COVID is not a topic that is either on topic or leads to productive exchanges, so that’s why it has been stopped.
POSTING AS MODERATOR: We are not going to go down the COVID path again here. It leads nowhere but to off-topic arguments. Both sides got one “hit” in. That is all I will allow.
Please write me at [email protected] with Amy such concerns. It can take up to a day for something to post, but things do inexplicably disappear from time to time. I don’t recall moderating any of your posts.
The problem is, the assumption that all of these “disorders,” created by committees and literally voted on, are “brain disorders.” There is not one of these “disorders” which is proven to be caused entirely or primarily by biological causes, let alone a single cause for a single “disorder.” The most optimistic data suggests a 10% biological contribution, while environmental causes account for 80% or more of “mental illness.” So be careful not to simply repeat beliefs you have heard. Read Robert Whitaker’s books and then take another look.
Oh, I agree absolutely! ANY potential causal agent with REAL evidence should be explored. Even if only 10% of sufferers have low folate, we can heal 10% of the population with a simple, cheap and safe intervention! We just have to stop expecting that EVERYONE will get better if their folate and betaine are increased. Let’s find the real cause in each case instead of assuming one solution will fix everything.
Just for the record, John Nash recovered without or despite his psychiatric “help,” and spent many years avoiding the psych system before his spontaneous recovery. The movie played it differently because they didn’t want to discourage current patients from using their “meds.” Nash complained about this to the producers but was not listened to.
Good information, but it clearly suggests that “schizophrenia” is not caused by a particular genotype, but is a very complex phenomenon that includes many possible causal factors.
You are denying reality. The point of the articles is that the Star-D has falsified outcomes. If you choose not to believe that (belief is not science) that is up to you, but don’t try to claim that later science is responsible for updating fraud. When the authors have been confronted with their false conclusions they have doubled down, not reconsidered. It was a handy conclusion that people like you want to believe, so they believe it.
Did you read about the Star-D study? It wasn’t wrong or incomplete data. They ALTERED the outcomes. They LIED about the results. That’s different from being overridden by new and more accurate data. Do you just not want to accept that fact?
The fact that there is newer research has no bearing on the clear attempt to falsify the data in the study. Doesn’t that concern you? That the studies aren’t reporting the truth?
I don’t think he’s trying to prove his points are not opinions. He’s trying to show that the entire subject is based on opinion. I don’t think he is in a position or needs to do so. I think it’s OK to identify however you like, and it’s OK for him or you to have an opinion about it. It’s just not science.
You are sharing the “general consensus” that we’ve all been taught to believe. I suggest you read some of these stories from real people who totally believed what you say and had not so great or horrible experiences.
I’m puzzled also hoe “the right medications” are going to help with anything but #1. And of course, research has never really shown “chemical imbalances” to be real, measurable things. So you actually make a great argument that medication is at best a very small part of any treatment approach, yet you seem to be arguing it’s the whole thing.
“Depression” is not caused by one thing. That’s the first error of psychiatry – lumping all “depressed” or “manic” people together as if their behavior or emotions tell us what is wrong with them or what they need. Saying someone “has depression” tells us very little about why or what to do about it. “Treating” something makes no sense if that “thing” isn’t really a thing at all, but a phenomenon with many possible causes and solutions.
It is not about Clozapine per se. It’s about doctors playing fast and loose with the facts and the system being based on incorrect assumptions and guidance. I’d say it’s one more example of how patients are assured that doctors have all the know-how to use these drugs responsibly when they really do not, no matter how responsible they are. By the way, I consider it a pretty cheap shot to toss out that doctors have to be “lazy and negligent” to make Clozapine use a risk not worth the benefits. There are very good reasons it fell into disuse, as you very well know, and they had nothing to do with negligence.
If I can’t discuss concerns about a comment or thread, then I can’t work with you. It’s part of the rules of posting. Otherwise, you can post whatever you want and I have nothing I can do except not publish your posts. Obviously, I have a concern to discuss. If you can’t do it, I’m sorry, but that means you won’t be allowed to post.
I need to talk to you but your email does not function, in fact, appears to be a fake email. I will have to block your submissions until you post with a functioning email address. It is a requirement under the posting guidelines.
Depression is about a lot of things. The first mistake of psychiatry is assuming that depression or anxiety or any emotional phenomenon is always caused by the same thing.
15% certainly does not suggest CAUSALITY. It suggests vulnerability of certain genetic subgroups, who may have many other things in common, not a ‘schizophrenia gene.’ Causality figures would need to be in the 85-90% range. 15% says that at least 85% is NOT caused by genetics. So genetics is a secondary factor.
Abilify is an antipsychotic, most definitely prescribed frequently for “bipolar disorder.” It is only used as an adjunct for depression if regular “antidepressants” are judged not to work. Not sure where you’re getting this false information.
The “low serotinin” theory of depression has long since been debunked. Additionally antidepressants are notoriously ineffective with youth and especially children. You are operating on faulty assumptions and criticizing others for not sharing them with you. Try reading some of the stories before you judge.
You say a lot of things here you have repeated because you heard them somewhere, but most of the people on this site have a lot of direct experience with the system themselves and understand it’s not so simple. Clearly, Brittney’s life didn’t suddenly get all better when she got treatment, did it? Additionally, the issue of the guardianship was fraught with all kinds of conflicts of interest and personal agendas above and beyond any “mental health” concerns. You might want to read Anatomy of an Epidemic and get an idea why people have concerns about the “mental health” system instead of assuming everything you’ve heard is automatically true and people who don’t agree are irresponsible or ignorant.
POSTING AS MODERATOR: We are drifting over into areas of politics that transcend “mental illness,” largely because of the nature of this article. But we need to keep focused on the “mental health” themes and whether “mental illness” focus obscures structural violence. There are many other contexts besides Gaza to draw on.
Of course, I was being totally facetious. There is no benefit from electrocuting someone into a seizure!
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“Subconscious” is not synonymous with “unintentional.” It just means you’re not willing to acknowledge those intentions. Most “professionals” ARE covering up intentionally, even if it is not something they are consciously aware of doing. Any time someone gets defensive when presented with contrary evidence, they are intending to cover up.
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I wish I had a plan!
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Exactly! As long as the status quo is an easy way to financial success, as long as big corporations are making buckets of money, any “reform” will be considered threatening to those piggies with their snoots in the trough. Stop feeding the piggies and you may have a chance at real change. We need to stop rewarding failure with more money!
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And GO, ALEW!!!!
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I am sorry if I misinterpreted your comments. I have seen OD trainings and participated in one myself. It seems like a great approach. I’m also not opposed to the availability of drugs to assist anyone who finds them helpful. My point would be more that Dr. Jureidini should not expect to be congratulated for his success. As has been clearly demonstrated with many examples, successful healing of patients is threatening to the status quo, and anyone who is successful can expect to be attacked as a quack, a religious nut, or an irrationally hostile force. Initial reactions to Bob’s book are more proof. No one can really undermine his basic premises, yet he’s seen as a kook or an antipsychiatry nut or a “Scientologist,” as if any of those are scientific analyses of his work. And such tactics are generally successful, and will be until the public catches on that the mainstream of psychiatry does NOT have our best interests at heart.
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David didn’t “reform” Goliath and convince him not to attack. He beat him physically and defeated him. Peer workers are a great option, but they need to understand that their efforts will be OPPOSED by the mainstream system, and that system must be DEFEATED in terms of losing its power before any peer “reforms” can become mainstream and the label-and-drug model dies a well-deserved death.
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Exactly!
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That’s why I recommend self-directed reality checking. The person him/herself has to decide if it’s real, and our efforts should focus on helping them evaluate the evidence rather than telling them what to think. I sometimes thing psychosis itself is a rebellion against being required to think a certain way. In any case, I never found telling people “what’s true” to be particularly helpful, though I did sometimes challenge them to ask themselves if their beliefs are “true” or opinions they held. Challenging thinking can be really good, but trying to substitute our thinking or society’s thinking for someone else’s own evaluation – probably not going to be helpful!
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Hey, that’s what ECT is all about – inducing seizures! Why could a spontaneous seizure not cause improvement? Of course, both cause brain damage, at least potentially, but if the docs are INDUCING seizures, I suppose brain damage is potentially therapeutic!
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I think the best response is, “What evidence do you have that makes you think the CIA is watching you?” Just saying someone’s wrong is rarely therapeutic in the least. But there are people who have expertise in this area whom you might want to consult.
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Nice!
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I LOVE the “Stop it!” skit! But you are right. The problem is opposing goals. The peer movement’s intentions were contrary to those of the main MH system, and so they had to be coopted or snuffed out. And the MH system was very effective in doing so. You can’t change the basic purpose of the MH system. It’s built in.
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They were actually initially banned in Germany for these very reasons. It’s a very real problem.
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Sure thing!
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Again, I think you are playing fast and loose with the stats here. There is not a 30% complete remission with ADs. 30% beat out placebo by a significant margin. This does NOT suggest complete remission, in fact, a whole industry has developed around supplementary “AD” treatment for those with only “partial remission.” There is not a record of consistent benefit. 30% improving compared to placebo also means 70% do not. That’s a pretty crappy track record from any kind of treatment.
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It sounds like you’ve had a lot who are that way. No therapist should believe they know more than the patient about their own situation!
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POSTING AS MODERATOR:
Mark, you have not contacted me by email or responded to my emails. I’m not sure you even received them at this point. I will no longer be able to post your comments until you contact me and we can have a conversation. Again, my email is [email protected] or [email protected]. It’s also listed in the “About” section of your home screen. Meanwhile, all of your posts will simply stay as “pending” until I hear from you. I’m not sure what else to do to get a response from you.
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So you only find out if it “works” after the fact. There is no evaluation that can predict the outcome of ECT, and I believe you know this is true. “Evaluations” in the “mental health” world rarely produce anything concrete that could be counted on to relate to predicted results. 30% of SSRI recipients improve in the short term (at best). How do we know which 30% will improve? We have no clue whatsoever. And that is typical.
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POSTING AS MODERATOR: I honestly don’t have any idea how to unsubscribe you. Perhaps one of our tech staff can help? You can find them in the “About” section under “Staff.”
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Motivational Interviewing has a lot of useful techniques and is or should be very much client directed. The coach or “therapist” finds out what motivates the CLIENT from their own viewpoint and then helps examine which current behavior gets them closer to that goal FROM THE CLIENT’S POINT OF VIEW.
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How would one know in advance who fits into this “sliver?” And with the attendant risks of severe congnitive symptoms DEVELOPING as a result of ECT, even in people who had none to start with, how can this possibly be consistent with a “first, do no harm” approach to medicine? Sounds more like Las Vegas “medicine” to me – “Come on, baby, give me a 7, give me a 7…”
And no, “everyone” does not accept that ECT comes with “real cognitive risks,” based on my reading of the literature, in fact, the idea is denied or minimized chronically. Nor are patients almost ever informed of these cognitive risks even if the doctors do acknowledge them. You seem to have a very rosy view of how “informed consent” is handled in the “mental health” fields!
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Posting as Moderator:
Mark, I am giving you until the end of today to respond to my emails or give me a working email address. If this does not occur, I will be forced to remove your right to post here, as having a working email is part of the posting guidelines.
My email is [email protected] or [email protected]. Please contact me TODAY.
Thanks.
— Steve
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I think you mean the one I wrote to Mark about his email not functioning?
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Sorry, I don’t have the context here. What did I say? Most likely I was not referring to you, as I generally avoid referring to individuals and if I do so I make it quite clear. I don’t remember directing anything toward you recently. Can you remind me what I said?
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You do realize that many women are unable to establish positive sexual relationships as well, don’t you? I would love to see you address this issue as part of your presentation.
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Posting as moderator: MARK, PLEASE CHECK YOUR EMAIL. I have sent several messages. If you are unable/unwilling to respond to emails, you are not allowed to post at MIA. Please write me back so we can discuss your prior posts. It’s not OK to keep saying you are waiting for them to be posted when I’ve told you my concerns and you have failed to respond.
Please write me back or I will have to stop posting your comments. If that email doesn’t work, please get me one that does ASAP.
Thanks!
—- Steve
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Posting as moderator:
Your email does not seem to have worked, it bounced back as not existing. I need a functioning email to have continued posts be published. I edited this one and removed the parts violating our Guidelines, but I can’t continue to do that. Please get back to me with a functioning email – it is an official requirement to post at MIA.
Thanks in advance.
Steve McCrea, Moderator
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You are denying Kirsch’s reviews of the literature clearly showing an increase in suicidal thinking when taking SSRIs? I am also not aware of ANY review suggesting that suicide rates are reduced by SSRI or other antidepressants? Lithium is the only drug I know of that has evidence supporting this possibility, and that has more recently been called into doubt.
Your willingness to make claims unsupported by literature reviews makes it hard to take your comments as unbiased.
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They should not be “involved,” they should be the central architects of any such effort. Who knows better than those with “lived experience” what actually does and does not help???
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Any of these things can be helpful if practiced by someone who has the proper attitude and has dealt with his/her own issues. The big problem is that there is no way to measure therapeutic competence, nor any training that assures it will be developed. Having clients/users themselves decide what works for them seems like the best solution. Dubbing someone a “therapist” because they completed a certain set of courses or a supervised internship with another person who may or may not have those skills and attitudes is simply misleading.
I agree that simplifying and “common-izing” our helping approaches is the way to go.
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But that would require a level of honesty the industry does not appear willing to exercise.
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When advocating for foster youth for 20 years, I saw many who became aggressive on stimulants and were then re-diagnosed with “bipolar disorder” instead of stopping the stimulants. It was extremely common but very hard to get anyone to discuss seriously, even though a good number of the psychiatrists I worked with admitted it occurred.
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Something is seriously wrong with a system in which we can talk about “”moving toward shared ownership and dialog.” What kind of help can be going on where shared ownership and dialog is not already THE central concept we are operating on? How can a therapist know what is helpful if they aren’t having shared dialog with their client????
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How can you say it “works for everyone” when so many people report no benefits or harm from DBT? I see a bunch of useful skills which could be helpful in the hands of a competent therapist but how many therapists are that competent? And why can’t others not trained in DBT employ or teach the same skills? Mindfulness, for example, is swiped from Buddhism, and there are many who understand mindfulness well who have zero connection with DBT. There are plenty of other examples.
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The research I’m familiar with suggests that it is not “ineffective methods” but rather lack of emotional preparation and appropriateness that undermines success. Therapy success appears to be associated more with therapist characteristics than by method or school of therapy employed.
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I just think certain individuals don’t have the capacity to do what is necessary to help another person emotionally. It doesn’t matter how much training is provided. An openness and ability to hear what others are saying and feeling and to hear the feelings behind the presentation, to listen deeply and be willing to be humble and to not seek to control the situation – there are a lot of skills and qualities that can’t be taught. The proof is in the results, and I’d have to say the average therapist doesn’t get real results. Most have a few techniques and tricks, and some are inherently destructive and have no idea how to be otherwise. There are those with the skills to be helpful in that role, but they are rare in my observation. And some have advanced degrees and some have been volunteers with 20 hours of training or none at all. The idea that a therapist can be created by proper training is, to me, a pipe dream. Some of it simply can’t be taught, even if the therapist goes through therapy him/herself.
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Again, please remember that NNT and other stats are based on the assumption that symptom reduction is the goal. This is a false outcome, as symptom reduction does not translate automatically into better outcomes.
It is not the job of others to demonstrate that Ritalin’s benefits do not outweigh the risks overall, it’s the job of those promoting the “treatment” that they do by a significant margin. If there is no major improvement in outcomes, then by definition, the treatment risk outweighs the benefit, unless you are claiming absolute zero risk. Even in the latter case, you’re still advocating for wasting money on something that doesn’t really work.
The burden of proof is on those claiming a treatment effect.
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Excellent advice!
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There are no long-term reviews of the literature showing improved long-term outcomes. This includes Barkley and Cunningham in 1978, Swanson in 1993, and the Oregon State Medication Effectiveness Study in 2002 or so. There are also observational studies, including the MTA 3, 6 and 9 year followups (there were some benefits at the one year mark), the Quebec study, the Raine study in Australia, and a comparative study between the USA and Finland done in the 2000s or so.
I’m sure you can dig up some individual studies that will show an improvement in one area or another, but reviews look at a lot of studies over time, and they tell us whether or not individual studies are anomalous or what subgroups might benefit. Many comparisons have shown again and again that kids who take stimulants over time time don’t do any better than those who don’t. They don’t necessarily do worse, either (though both Raine and Quebec did show some negative outcomes), but of course, there are adverse effects, especially loss of height compared to the average. So if there are adverse effects and no clear and significant benefits, it’s not a good bet to use such an intervention broadly as stimulants have been used. Millions and millions of kids are taking these for years for very little overall benefit, notwithstanding some small reduction in car accidents. I think this should be known. Your assurance that “you are wrong” is of course as scientific as “I don’t want it to be true.” If you want to make a real argument, please show us some long-term studies that find a significant benefit for stimulant users over a long period of time (years). I’m always happy to look at studies. But making claims that there are long-term benefits without evidentiary backup won’t work for me.
BTW, I have no doubt many people feel they benefit greatly from “symptom reduction,” and I don’t want to deny them any of these benefits. I just think we need to be honest in admitting that short-term behavioral improvement from the adult viewpoint does not necessary translate into long-term improvements in test scores or delinquency or college enrollment or mood or self-esteem measurements. People can’t make good decisions on bad information.
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These things are only “more effective” based on the very narrow definitions of “success” that are promoted by those favoring the drug paradigm. Stimulants, for instance, do have an effect of “reducing the core symptoms of ADHD,” aka making most kids less active, more focused, etc. However, looking at long-term outcomes, stimulants have never been shown to do anything to improve school outcomes, reduce delinquency, increase college admission, or even improve self esteem. It is misleading at best to say that “stimulants are effective” when they don’t actually improve the things people want to see improved for their children. These definitions of “success” limit us to looking at “symptom relief” and avoid looking at long term outcomes and also discourage looking for real solutions that last. It enables makers of antidepressants to claim that ADs are “just as effective” as quality therapy, because both reduce the “symptoms.” This obviously neglects that as soon as we stop the “antidepressants,” the “symptoms” tend to come back, often worse than ever, while effective therapy makes it possible to live with “less symptoms” over a longer period of time without ongoing “treatment.” How these can be called equivalent outcomes is beyond comprehension, but they get away with it by defining success “treating” these “disorders” by reducing their “symptoms” instead of by improving the quality of life for the client for the long term. It’s not accidental. It’s defined this way to ensure that the drug market remains lucrative and people don’t start demanding higher quality interventions.
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I think you nailed it here! It’s not that I object to anyone “identifying” with a particular “diagnosis” as an identity. It’s the effect of legitimizing these “disorders” as valid entities rather than social constructions that some people like to use as “explanations” for their uniqueness. The idea that diversity is “neuro,” aka CAUSED by neurological differences, plays completely into the hands of those who want to blame the brain for everything wrong with human beings’ behavior while letting our social structures off the hook. I know that a lot of people WITHIN these movements don’t believe that, but those running the show don’t care, they are still getting support for their label-and-drug approach that’s keeping them rich and protecting those in charge from having to examine the society they are creating and promoting.
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How about “unconventional?” Or “unique communicators?” I think it is the idea that neurology and only neurology creates and defines these differences, along with the idea that “neurotypicals” can somehow be defined and dismissed as “normal,” that causes offense.
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I can’t agree with that definition. Stigma implies an unfair negative bias based on a label or category. Prejudice implies specific actions taken as a result of believing in the superiority of one group over another. Discrimination is specific acts to harm someone in a category against which one is prejudiced. There are frequently no legal consequences to prejudice and discrimination, and in fact, they are often rewarded. I remember in 6th grade or so standing up for a kid labeled as “mentally retarded.” He was being harassed, so most definitely acts of prejudice. I’m sure he was also not included in people’s social groups, which is a form of discrimination. You know who got punished when I stood up for him? ME! I was “accused” of being a “retard lover” or some such thing. This went far beyond “stigma.” Where are the legal consequences for such acts?
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What is “scientific” about the DSM? Perhaps the author needs to look up what “scientific” really means.
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I agree 100%!
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Actually, they provide a LOT of “education,” even at official institutions. It’s kind of sick!
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I had a lot of clients blaming their parents for their issues. Often, they were at least largely correct.
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It is a technique, not a “therapy.” The drive to create a manualized “therapy” is very strong, as it emphasizes making long-term clients and avoiding insight-driven healing. But no one can do therapy based on one technique or a manualized set of techniques that avoid connection with the client. CBT is only useful in the context of a larger “therapeutic relationship” where there is trust and sharing and humility between “patient” and “therapist.” This situation rarely happens, so most experience CBT as rather disconnected and intellectualized, and invalidative of the legitimacy of their actual issues and needs.
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I was referring to calling other people “autistics” not claiming that label for yourself. Generalization is the problem.
Why not simply point out that some people are prone to violence and need to be dealt with for the safety of society? No one would argue with that premise. But the idea that “medication” is the best answer or is consistently effective is not supported by the number of “medicated” kids who remain violent, or even become violent on the drugs. I’ve worked in the foster system and kids mental health so I know what I am saying.
And am I wrong that you never read the book?
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I see the thought behind your questions. However, by referring to a group of people as “Autistics,” you are making demeaning generalizations as if a person getting this label is somehow described and defined by it. This is a large part of why folks here object to the DSM mentality – labels such as “autistics” are inherently dehumanizing and don’t allow for discussion of either causes or options.
Are you aware that many of these kids your mom worked with, probably 90% or more, are already “medicated?” And yet are still violent?
Things are not as simple as you attempt to portray. Have you read “Anatomy of an Epidemic?” I am betting the answer is “no.” Maybe you should read the book and you will start to understand why people get upset about what you seem to accept as reality.
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I agree 100%.
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đ
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It sounds like they are training sociopathic traits into people!
The only thing that made me effective as a therapist was my willingness to let down my barriers and feel what the client/”helpee” was feeling. That is completely what guided how I would intervene. If a person can’t do that and still “maintain boundaries,” they have no business trying to help anyone emotionally. They need to get their own help first!
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I respect your views on this. But I can tell you from past experience that this line of discussion is not productive and travels far from the realm of the “mental health” system. You will have to respect my judgement on this one. I am speaking from hard experience attempting to moderate such a discussion. So I’m not going to defend my decision. It’s already been made many months ago.
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Posting as moderator:
I don’t disagree with you. But COVID is off topic and has not led to productive conversations as a topic. You actually posted the first one on the topic and I should have disallowed it. Some of the more far-fetched comments that DO have to do with psychiatry are allowable as long as they are on topic and not insulting to individuals or groups. I don’t judge by the content except to the degree that it is not on the topic at hand, and I even let a lot of THAT go if it’s productive conversation. But COVID is not a topic that is either on topic or leads to productive exchanges, so that’s why it has been stopped.
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POSTING AS MODERATOR: We are not going to go down the COVID path again here. It leads nowhere but to off-topic arguments. Both sides got one “hit” in. That is all I will allow.
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I think I just approved your post earlier this morning. It was just waiting for moderation.
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Posting as moderator
Please write me at [email protected] with Amy such concerns. It can take up to a day for something to post, but things do inexplicably disappear from time to time. I don’t recall moderating any of your posts.
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Actually, very few even bother with brain scans.
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The problem is, the assumption that all of these “disorders,” created by committees and literally voted on, are “brain disorders.” There is not one of these “disorders” which is proven to be caused entirely or primarily by biological causes, let alone a single cause for a single “disorder.” The most optimistic data suggests a 10% biological contribution, while environmental causes account for 80% or more of “mental illness.” So be careful not to simply repeat beliefs you have heard. Read Robert Whitaker’s books and then take another look.
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Oh, I agree absolutely! ANY potential causal agent with REAL evidence should be explored. Even if only 10% of sufferers have low folate, we can heal 10% of the population with a simple, cheap and safe intervention! We just have to stop expecting that EVERYONE will get better if their folate and betaine are increased. Let’s find the real cause in each case instead of assuming one solution will fix everything.
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Just for the record, John Nash recovered without or despite his psychiatric “help,” and spent many years avoiding the psych system before his spontaneous recovery. The movie played it differently because they didn’t want to discourage current patients from using their “meds.” Nash complained about this to the producers but was not listened to.
https://www.mentalhealthforum.net/forum/threads/john-nash-healing-from-schizophrenia-the-real-story.34784/
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That all makes sense. There will never be one “cause” because it’s not one thing that is happening for the same reason. People need to think!
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Good information, but it clearly suggests that “schizophrenia” is not caused by a particular genotype, but is a very complex phenomenon that includes many possible causal factors.
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Can you identify the comment by the first line of text? I don’t want to remove the wrong comment!
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You are denying reality. The point of the articles is that the Star-D has falsified outcomes. If you choose not to believe that (belief is not science) that is up to you, but don’t try to claim that later science is responsible for updating fraud. When the authors have been confronted with their false conclusions they have doubled down, not reconsidered. It was a handy conclusion that people like you want to believe, so they believe it.
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It may not be damaging, but it is certainly not scientific.
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Did you read about the Star-D study? It wasn’t wrong or incomplete data. They ALTERED the outcomes. They LIED about the results. That’s different from being overridden by new and more accurate data. Do you just not want to accept that fact?
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The fact that there is newer research has no bearing on the clear attempt to falsify the data in the study. Doesn’t that concern you? That the studies aren’t reporting the truth?
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The fact that sharing decision making is even a point of discussion says a lot. Why would you NOT share decisions with the person making them?
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Posting as moderator:
There’s no function to edit approved posts. The only solution I can propose is to submit your new post as a new post.
Hope that helps!
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See my emails to you.
I don’t think he’s trying to prove his points are not opinions. He’s trying to show that the entire subject is based on opinion. I don’t think he is in a position or needs to do so. I think it’s OK to identify however you like, and it’s OK for him or you to have an opinion about it. It’s just not science.
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Not a problem. All part of my day.
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Please let me know if I did this wrong, Tom.
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Well said!
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You are sharing the “general consensus” that we’ve all been taught to believe. I suggest you read some of these stories from real people who totally believed what you say and had not so great or horrible experiences.
I’m puzzled also hoe “the right medications” are going to help with anything but #1. And of course, research has never really shown “chemical imbalances” to be real, measurable things. So you actually make a great argument that medication is at best a very small part of any treatment approach, yet you seem to be arguing it’s the whole thing.
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“Depression” is not caused by one thing. That’s the first error of psychiatry – lumping all “depressed” or “manic” people together as if their behavior or emotions tell us what is wrong with them or what they need. Saying someone “has depression” tells us very little about why or what to do about it. “Treating” something makes no sense if that “thing” isn’t really a thing at all, but a phenomenon with many possible causes and solutions.
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It is not about Clozapine per se. It’s about doctors playing fast and loose with the facts and the system being based on incorrect assumptions and guidance. I’d say it’s one more example of how patients are assured that doctors have all the know-how to use these drugs responsibly when they really do not, no matter how responsible they are. By the way, I consider it a pretty cheap shot to toss out that doctors have to be “lazy and negligent” to make Clozapine use a risk not worth the benefits. There are very good reasons it fell into disuse, as you very well know, and they had nothing to do with negligence.
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Depression most often involves having a shitty life. What is used to measure that, Scott?
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There is not “line blurring” going on. The lines ARE BLURRY and what most object to is trying to make them seem like they are not.
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I think you are missing the point.
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If I can’t discuss concerns about a comment or thread, then I can’t work with you. It’s part of the rules of posting. Otherwise, you can post whatever you want and I have nothing I can do except not publish your posts. Obviously, I have a concern to discuss. If you can’t do it, I’m sorry, but that means you won’t be allowed to post.
Steve
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As in we have to talk.
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POSTING AS MODERATOR:
Hi, 27/2017,
I need to talk to you but your email does not function, in fact, appears to be a fake email. I will have to block your submissions until you post with a functioning email address. It is a requirement under the posting guidelines.
Steve
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Depression is about a lot of things. The first mistake of psychiatry is assuming that depression or anxiety or any emotional phenomenon is always caused by the same thing.
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15% certainly does not suggest CAUSALITY. It suggests vulnerability of certain genetic subgroups, who may have many other things in common, not a ‘schizophrenia gene.’ Causality figures would need to be in the 85-90% range. 15% says that at least 85% is NOT caused by genetics. So genetics is a secondary factor.
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Wow, you can make up a lot of stuff in one paragraph. Do you have even one citation for any of your claims?
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Abilify is an antipsychotic, most definitely prescribed frequently for “bipolar disorder.” It is only used as an adjunct for depression if regular “antidepressants” are judged not to work. Not sure where you’re getting this false information.
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At best, results are mixed. Read Irving Kirsch some time if you want to know the truth.
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The “low serotinin” theory of depression has long since been debunked. Additionally antidepressants are notoriously ineffective with youth and especially children. You are operating on faulty assumptions and criticizing others for not sharing them with you. Try reading some of the stories before you judge.
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Nobody is trying to take your medication away.
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You say a lot of things here you have repeated because you heard them somewhere, but most of the people on this site have a lot of direct experience with the system themselves and understand it’s not so simple. Clearly, Brittney’s life didn’t suddenly get all better when she got treatment, did it? Additionally, the issue of the guardianship was fraught with all kinds of conflicts of interest and personal agendas above and beyond any “mental health” concerns. You might want to read Anatomy of an Epidemic and get an idea why people have concerns about the “mental health” system instead of assuming everything you’ve heard is automatically true and people who don’t agree are irresponsible or ignorant.
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111 days – WELL DONE!
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POSTING AS MODERATOR: We are drifting over into areas of politics that transcend “mental illness,” largely because of the nature of this article. But we need to keep focused on the “mental health” themes and whether “mental illness” focus obscures structural violence. There are many other contexts besides Gaza to draw on.
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Way to go!!!!
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That sounds like your brother being put in danger by prejudice, not his own dangerous behavior.
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How would you know who genuinely “has” BPD?
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I “unapproved” the first one I could find. Is that the one you wanted?
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Posting as moderator: Which post, Beth? How does it start? I can delete it if you can help me identify it.
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