Tuesday, December 12, 2017

Comments by irishrover777

Showing 3 of 3 comments.

  • Sure, we need psychiatry to evole, to have a revolution. The good people featured in this article identify valuable paths of inquiry to pursue. Meantime, we live in our real world where imperfections reigns supreme. Really few folks worked in psychiatry hospitals during the time before first generation anti-psychotics. Many patients were shackled in one way or another, Their living agony was apparent to most. Hardly anyone has worked with lobotomy patients. Insulin shock and iced baths, etc. Straight-jackets seemed the least of the evils.

    Thorazine was experienced to be a godsend by most everyone. Now, it was obvious patients were unnecessarily snowed or zonked. The “side-effects” (as Laing explained the “side effects” were main effects of the medicine that we deemed unwanted) were troublesome and longer term “side effects” even more so. Truthfully, there have been very few advances in psychopharmacology since first generation of antipsychotics, mood stabilizers, antidepressants, anxiolytics, etc. That said, psychotropics have helped a tremendous number of people.

    Extremism in any form is ultimately transgressive and self destructive. R.D. Laing was never “anti-medicine” and refused the anti-psychiatry label. When a patient requested medicine to manage terrible anxiety or insomnia or psychosis he wasn’t resistant to giving a prescription. He made clear he hoped a psychiatrist would offer him medication to quell extreme symptoms of this or that. His beef was that so much of what happens in psychiatry is involuntary and/or absent informed consent.

    Dr. Peter Breggin bragged that he’d never prescribed a single medicine in his psychiatric career. When asked how he would treat a patient who’d returned from combat suffering from symptoms consistent with PTSD he boasted he wouldn’t give them medicine even if they asked or begged. When pressed he said he’d refer the patient while suggesting this rarely happened. This frightens me every bit as much as a traditional psychiatrist mindlessly ordering medication.

    We are quite fortunate to live in a time where psychotropics are available. Armchair critics have opinions though none that strike note with me. Old-timers who worked in patient psychiatry pre 1960, family doctors and psychiatrists working in settings they understand to be less than ideal, patients and their families suffering with severe problems tend to be more measured in their take on psychiatry in 2017.

    Let’s not throw out the baby with the bathwater.

  • As a late comer to this community I am heartened and unsettled at the same time. Prior to graduate school I was bothered by an apparent abundance of “Job’s Comforters “. Helping professionals with an excessively anti-medicine bias, need to replace patients (one who suffers…how is that demeaning ?) frighten me a bit. During one workshop given by Dr. Peter Breggin, at a conference devoted to the life and work of R, D. Laing, I was stunned to hear Dr Bregger brag that he had never given a single patient any medicine in his entire career. Dr. Breggin wasn’t working any admissions units with mostly indigent and often dually diagnosed patients with schizophrenia, bipolar illness, profoundly depressed folks, and so on. To refuse to offer patients medicine that they actually request or beg for to ease their torment seems cruel, irresponsible, wildly arrogant, and indefensible. Some clinicians know too much about the outrageous ways anti-medicine folks can get. Unless you have had a loved one and/or personally been through some psychiatric impairment, and have logged years working on admissions units with largely unmedicated, agitated, and combative folks, it might be best to demonstrate a wee bit of humility. All the “anti ” fervor is the luxury of only the naive virulent form of utter disconnection from the real world, with loved ones who beg for medicine, when a clinical psychologist becomes so profoundly depressed that ECT and aggressive psychopharmacology are experienced as gifts. Too many non physician therapists routinely fail to refer patients to physicians for assessment of psychiatric symptoms caused by frankly medical problems. Brain tumors are missed, patients with serious thyroid dysfunction, some with stunningly low testosterone, or medical problems that present with psychiatric symptoms. It only takes a bit of education in medical psychology and humilty to refer our patients for medical work-ups. I have heard too many times about therapists who literally beg patients who want to try a medicine not to take it. WTF……Too many times I saw patients who had been in 10 years os “psychotherapy, never referred to a physician for work-up or psych meds. 10 years of suffering until they receive anxiolytcs to treat crippling panic and sustained panic, and maybe effexor (we love to hate effexor unless our lives were saved by it. Whatever the case, it is hell to taper of it for sure. But, maybe all of us could be a bit more humble-people who do every thing they can not to become “Job’s Comforters”. Yes, Big Pharma is evil, etc etc. But guess what—-thorazine and haldol were true godsends to patients chained to poles in basements of hospitals, full of urine and defecation, and just the worst conditions. These patients don’t give a damn what we preach about the evils of drugs, they beg for the treatment. The terribly inhumane and horrific warehousing of crazy folks vanished once thorazine rescued these foks real hell. Dr Breggin said with pride that he would deny a vet tormented by PTSD and panic and dread–who was begging for some relief from awful torment. In my mind that smacks of an inability to exercise compassion and common sense. Let these people have some xanax to to quell torturous anxiety and torment. Give them the medications known to help PTSD not become the brutal destoyer of a man’s soul. So when Dr. Breggin boasted that he’d deny them medication I became frightened and more than a little angry. Laing was NEVER one to deny a patient some humane relief from torture that could be lessened a great deal by some medicine. Of course, it requires very close monitoring, and lots of care when it appears a patient can taper off a medicine. Let them decide not the arrogant mental health professional who insists they need to come off all medicine pronto. Then we become exactly what we hate or detest–a Job’s Comforter. Sometimes judicious use of medicine is a truly healing experience. Anyway, I will stop. I see lots of very caring people here wanting to do right by our patients. Actually, it was Freud that said “Psychoanalysis is in essence a cure through love. Laing spoke of creating a sense of community and solidarity, allowing patients to experience communion with their doctor, and move into a transpersonal realm mostly best not talked much about. This way of attending to suffering souls works and that medicine is also used for a bit and this is okay. Lets not “other” clinicians different from our overly anti medicine blah blah, blah. It can nhever hurt to be humble and serve our patients and ourselves with the care we need to heal.