Re: [psychiatry-research] Understanding the biology of behavior: Psychology today
- Well, duh?! My problem was I was too open about having problems and taking Prozac as all my clients learned before they even signed our contract to work together. When I made the international media it was splashed all over in bold that indeed I was a practitioner as well as a consumer.You are very perceptive psychotic dogg.Being successfully treated oneself for depression/ptsd allows one to be especially tuned in to the issues and well aware of what works and does not; as have I since 1988. I am well acknowledged for my work w/depression/ptsd and Prozac and its kin. Not one of my clients has committed suicide nor killed another, been hospitalized for ideation/behavior for such while working with me, nor after continuing scrutiny by my oft disturbed licensing board folks or others (i.e. Church of Scientology & their ilk) have I been found to be any kind of factual (mythical-yes!) danger to my clients-in fact quite the opposite!Neener, neener... :-))PS Oh yes, and thanx for allowing me to sing my own praises periodically!From: Psycho Dogg <psychotic_dogg@...>
To: firstname.lastname@example.org; moaabsux@...
Sent: Friday, November 30, 2012 9:18 AM
Subject: Re: [psychiatry-research] Understanding the biology of behavior: Psychology today
sounds like the post's author's self-description to me.dogg --- On Thu, 11/29/12, Jim Goodwin <moaabsux@...> wrote:
From: Jim Goodwin <moaabsux@...>
Subject: Re: [psychiatry-research] Understanding the biology of behavior: Psychology today
To: "email@example.com" <firstname.lastname@example.org>
Date: Thursday, November 29, 2012, 5:21 PMYes, there are licensing boards in every US state. In my personal experience the problem is they are made up of folks with the very same mental health problems the rest of homo sapiens have but they are able to hide behind the letters behind their names and more importantly they are protected from treatment and/or prosecution by the laws of the state.From: Johan G <j_gunnarsson@...>
Sent: Wednesday, November 28, 2012 7:36 PM
Subject: Re: [psychiatry-research] Understanding the biology of behavior: Psychology todayDave,
Is there some kind of licensing of therapists in the US, telling the general public who has been assessed to know his job?
JG2012/11/29 David Schneider <sch@...>I'm no expert but I'm certain that there are no adverse legal consequences if a patient requests and receives conversion therapy, assuming, of course, that normal professional standards are observed. My sense is that it's likely to be ineffective, but lots of people waste lots of money on ineffective therapies (and obviously others spend money on therapies that help). I think that that most American therapists would strongly discourage such therapy (or at least the many I know would), but others on this list can speak to that better than I.There are at least four problems with centers and other organizations that exist primarily or exclusively to perform conversion therapy. The first, and to my way of thinking, most important is that there's nothing wrong with being gay, and therapy ought to help build a strong identity around that orientation rather than trying to destruct it. That's, of course, a value position, but one increasingly shared by Americans. The changes in attitudes toward homosexuality have changed dramatically over the past 10 years, perhaps the most radical change of a major attitude over such a short period of time. Most of the conversion therapies exist for teenagers who are forced by parents (although presumably some go willingly) to centers or camps with a strong Christian (some Jewish) orientation, and once there the kids are essentially told that they are doomed to hell unless they change. This is usually supplemented with other techniques, some quite obviously cruel and unprofessional. This might involve isolation for long periods of time criticisms and taunts from adults and fellow sufferers, and even physical punishment. The second problem is that many (probably most) of the so-called therapists are not professionally trained or licensed. I'm not sure how they get away with this, but my guess is that since they operate as religious organizations they get a pass. After all converting a gay person isn't all that much different from converting an atheist, or so it might be argued. Thirdly, these therapies are not only ineffective but often (and I suspect usually) cause great psychological harm to the kids. Imagine spending 2 weeks listening to someone you respect telling you that you're a bad person -- surely doomed to hellfire and damnation unless you change -- humiliated, etc. and then come to find out that nothing has changed but that you have to pretend to your parents that it has. And fourth, there are complex issues as to whether parents have the right to subject their children to such abuse. This is a difficult issue. Most of us, I suspect would not object to parents ending their sons or daughters to a center for treating substance abuse even though the kids might be fairly miserable while there, and even though the success rate of such centers is weak. And obviously parents often do know best. But for lots of reasons I won't get into there (but mostly because of my point #1 above), I think that conversion therapies are mostly not only unprofessional but ethically nasty. All that said, lots of kids are confused about sex, experiment with homosexual behavior (about a third if you believe the data), and don't necessarily turn out to be primarily gay. So some gentle guidance might not be amiss, but the conversion therapies centers are anything but gentle.<snip>
There are ‘normal’ people (especially the totally secular) who don’t condemn it. Granted these are usually academics, especially moral philosophers, but they are still a constituency. It is possible to consider, if you’re a radical libertarian at least, as I seem to be, that ‘ownership’ (I know the term is inept as life is not alienable property) belongs only to the person living the life, and if he doesn’t want to live any more, for whatever reason, even one you don’t understand, then nobody has the right to condemn him for deciding that life for him is crap and is better not there. And since the suicide is out of what he wanted to be out of, then any rejection of the act is purely selfish on the part of the rejector. I don’t think anyone who condemns a suicide does it for the sake of the suicide.
OK, i get what ur saying now. the quotes u provide, and the context, make sense to me. but most 'normal' people condemn suicide, and that was the point i was addressing. of course, i'm familiar with suicidal ideation from my personal perspective, and i would possibly agree with some of ur friends' opinions, depending on the case.
--- On Sat, 12/22/12, Roger Lass <lass@...> wrote:
Perhaps a little obscure. The ban may have different origins, not be hard-wired the way incest taboos nearly seem to be. Japan suggests that. What I meant is that in the context of suicides of friends I’ve often noticed a very different attitude, expressed in statements like ‘she really needed to do that’, or ‘it’s about time she did it, nobody could take that much crap for so long’. I must add too in fairness that a large part of my circle of friends consists of people with mood disorders or on the verge, and I’ve met suicide personally only in the context of at least suspected depression.
RL, i don't follow ur entire post, but i was speaking of the origins of the nearly world-wide ban on suicide (except in japan), not what suicidal people are thinking. but i'd bet that many of them think that life does indeed suck, at least their own. if they were loving it, they wouldn't end it.
why would the state put a death-row inmate on suicide watch? u raise a good point--that it wants to do the killing itself. but i could also hypothesize that (at least in the US, and probably nowhere else) with the endless appeals, the authorities might not want to be blamed for the death of a person who could have later been exonerated (by dna evidence, for example). just a guess.
--- On Fri, 12/21/12, Roger Lass <lass@...> wrote:
Interesting. It doesn’t however quite seem to match with the attitudes I’ve seen surrounding suicides of friends. On the other hand perhaps It’s not accessible to consciousness and doesn’t surface. There is also an oddity of a different sort in putting condemned prisoners on suicide watch: I should think that since we want them dead anyhow, that’s a waste of taxpayers’ money. Or it’s the State (as such organisations do) being sadistic and wanting to be able to show power.
RL, my theory about the taboo of suicide is the "lobster effect". It goes like this: "what happens when a lobster tries to climb out of the tank? The others pull it back in." The age-old proscriptions against suicide are basically saying: suicide is cheating--the rest of us have to put up with this life, and you can't bail out early just because it sucks.
--- On Mon, 12/3/12, Roger Lass <lass@...> wrote:
Very thoughtful and compelling, but I don’t agree. I think I am a much more radical libertarian than you, and in the case of suicide for instance, perhaps guided by different criteria. The reason for suicide I think is primarily that you don’t want to live any more. As someone who has suffered from unremitted (just partly controlled) bipolar disorder for 30 years and has been on the verge of suicide often enough, I consider that the most important human right. That and the ability to refuse to breed, and to show mercy, which are the only non-Darwinian criteria that define us as different from other organisms.
Yes I agree that suicide can be damaging to others, but why are others more important than you? I’ve never understood that notion. After all the life is mine, and if I inflict suffering on someone else that’s very sad, but in the end why me not them? It is of course better in the case of loved ones if you can agree on suicide and when it’s necessary in advance, as my wife and I did. We came to the conclusion that if one of us wanted to die then the other one might have a rational discussion with them, but ultimately the decision is only that of the owner of the life. My feeling about a suicide I hear of is generally ‘how lucky’. Needless to say I do not value human life very highly.
As far as social responsibility and paying for other people’s bad habits with your tax money, I can see the point. But I think from a libertarian point of view, which I value above all others, that’s just one of the things that a civilised society has to cope with. After all drug dealers (if they pay any) have to pay taxes for the police that capture them.
The problem with such "you're free to make your own choices" perspectives is that the harm one person does often has significant impact on the well-being of others. Relatives of those who commit suicide usually are guilty and otherwise miserable, sometimes more or less permanently. If you wish to smoke and kill yourself, that is, of course, your choice, but I don't see why I (through health insurance or my taxes, in a state sponsored health system) should have to pay for your increased health care costs. And it's not clear to me why I should pay for the added health care costs of drug addicts or alcoholics, not to mention whatever legal costs may be involved. Practically, of course, we have to pony up
The ethical, not to mention political, issues involved in this sort of thing are actually quite complex, or so it seems to me. Generally the older I get the more libertarian (god, I hope not conservative) I become. I happen to agree with you about assisted suicide and euthanasia, but only after prolonged consideration and, I would hope, consideration for the feelings of others. No matter how miserable a person is, committing suicide to punish others (which is often the case) seems to me to be just wrong. And despite what I've said about smoking, addiction, and the like, in the end I worry a lot about slippery slopes and how we might assign responsibility. Assuming that that you (and not I) should pay for your smoking related costs, I'm damned if I know how to make you pay up fairly and reasonably, and in the end I would not want you to die a horrible death because you could not pay those costs yourself. I surely don't want the Nanny government or anyone else (except my wife who is Nanny enough, thank you) tell me that I can't eat ice cream sundaes because they might make me fat and lead to health issues related to diabetes and obesity. So there is a balancing of moral considerations.
But I am clear that it won't work simply to say that you have the right to put whatever you want in your body. No man is an island, at least morally. I do, however, have very mixed feelings about whether the government (or a bunch of physicians, psychologists or psychiatrists for that matter) should have power to regulate everything that might be harmful, not that they could even if they tried. Beyond that we agree that somehow we need to improve the information that people have about the health benefits and costs of whatever medications or other substances they take. I just don't think it will be effective. But that's another issue.
I basically agree with everything here, except your views on a person’s right to kill themselves if they want to, or ruin their health. I am a strong advocate of suicide (and of course euthanasia – the two are often the same) when it’s appropriate, and do not think life is great enough so that it should be protected the way it is.
But I do agree that people should have the opportunity to consult whatever evidence base there is, and then choose to act on it or not. Informedness I think is important, but of course lots of people don’t care to be informed. I for instance smoked for nearly 40 years knowing perfectly well what the effects would be likely to be, and ended up as expected with emphysema. (Surprisingly not cancer, at least yet, but if that happens it will be part of the package of expectations that I took on knowing the likelihoods.)My choice, and the pleasure was worth it. Similarly for the past 25 years I’ve drink 2-3 liters of whisky a week, and know precisely what it does to my stomach lining, my mood, etc. But again, it’s too great a pleasure to give up, and I’m addicted, which is something else I think people have a right to be. I’m also addicted to benzodiazepines, have been for the past couple of decades, and wouldn’t think of giving them up because they’re too nice, and too medically effective. But I’ve read the literature, talked to good doctors, and know precisely what I’m doing. And in any case my liberartarian conscience, as you rightly call it, makes the individual’s life his total property.
I have no objection at all, and sorry if I implied I did, to pillaging nature (humanely) for medications. The point is testing them properly and controlling the contents of what’s sold. Anything can be dangerous or ineffective, and at least in the ideal world we don’t live in we should test properly. And (though it’s probably hopeless) to teach our children in school science programmes or somewhere how not to think anecdotally but always to be sceptical and ask for evidence. Doubt if this would work with the semiliterates who seem to be coming out of the schools and to some extent the universities in the English-speaking world anyhow these days, but probably worth trying. (I mention English-speaking because at least in the UK and South Africa the difference between the products of the state and private schools is stunningly huge, whereas the state systems i n places like Finland and Iceland really produce the kind of educated output that we had in the US and the UK in the 40s and 50s.)
Roger and others
I agree mostly. My only potential disagreement is with your statement that people should be allowed to treat themselves however they wish (as you imply only after sufficient information). I also am generally a libertarian on such matters, but I'm not sure that a mother who tries to cure her cancer by taking herbs rather than a potentially more traditional treatment which might save or prolong her life, and who then dies leaving 3 young children behind -- I'm not sure that she has that right. I know of 2 such cases, people I knew. But this is basically an argument about values, and I'm sure reasonable people would draw lines in different places.
In the US it is hard to regulate non-prescription med ications. The FDA (which more or less regulates prescription medications, often with great controversy) does not in general have oversight over herbal and other alternative medications. Given the spotty record of the FDA some might claim that is a good thing -- I wouldn't, but others surely disagree. There are, of course, some regulations over non-prescription over-the-counter medications such as aspirin, but I haven't a clue what these are. Most herbal and other alternative medications are classified as dietary supplements, and hence are essentially not regulated by anyone, or any more than salt or ginger would be. Manufacturers are not allowed to make specific claims about cures but are allowed to make more generalized ones, e.g. "helps the body's natural defenses". In the end none of this really matters because friends, Internet sites, and some medical people advocate the use of such "drugs" and everyday people take them without looking for side-effect s and potential dangers. Of course, people generally also do not explore potential dangers of prescription drugs either. If the doc prescribes it, it must be ok. So bottom line: I'm not sure that information about efficacy and dangers would really change people's behaviors. It certainly hasn't for cigarettes and alcohol. Some might argue that stupid and ill-informed people deserve their fates. Despite my first paragraph, there ought to be limits to the Nanny State.
In the US we have, as part of the National Institute of Health (the national umbrella for research and information dissemination), an agency called the National Center for Complementary and Alternative Medicine, paid for obviously by tax payers. Its charge is to investigate and evaluate alternative medications, but it does not do this effectively. For o ne thing it is under extreme pressure from influential politicians to avoid systematic clinical trials as taking too long and being too cautious. Also there are always claims of "it worked for me, and therefore it ought to be allowed." In the US congress people and Senators are, by and large scientifically illiterate, and work hard to stay that way. You gotta laugh to keep from crying. I haven't checked recently but as of a few years (maybe 3-5) ago, the clinical trials they had sponsored had not been able to demonstrate the effectiveness (compared to placebo) of any alternative medication. The NCCAM also, again because of political pressure, tend to act as hucksters for various herbal and other such remedies. So it's a bit of a scandal, but given the state of US politics pretty far down the list of problems to be solved.
Sorry to be so long-winded, but the take home message is that there are not only value issues concerning freedoms, but also issues about the extent to which things you put in your mouth or inject can or should be evaluated. And as usual politics and lobbying groups trump everything -- ignorance writ big.
I am, by the way, not hostile to the possibility that we have much to learn from alternative and folk remedies. It's worth spending some money to find out which have potential benefit. And there are lines to be drawn -- what about potential claims that eating 5 stalks of asparagus a day keeps colds away? I'm sure somewhere there are such claims on the Internet. Of course, it might be argued that eating veggies doesn't really harm anyone, but for all I know there are allergies to asparagus which might cause death.
An alternative view might be that ‘alternative’ remedies should not be able to be sold as medications, or make claims of efficacy that are not to some extent evidence-based. I agree that pharmaceutical companies selling for instance homeopathic remedies (if they are) should not be allowed to, as the best evidence appears to show that they are fraudulent. People should be allowed to damage themselves any way they want, or not get their illnesses treated, of course. But I think a case could be made that manufacturers ought not to be allowed to make fraudulent claims, and that labelling implying therapeutic effects ought to be made by law to be honest. Similarly alternative remedies that are potenti ally dangerous (like St John’s Wort, which interferes with ARVs, warfarin, oral contraceptives and many chemotherapy drugs) or Gingko biloba which as I recall is imp licated in brain bleeds, should be sold only with clear warnings, or taken off the market. There are also other issues, such as (as in the UK) the NHS spending taxpayers’ money on homeopathic drugs because some patients want to take them, which should certainly not be allowed. But some countries are peculiar: the Archbishop of York has advocated that the NHS furnish exorcism at taxpayers’ expense, because the health service ought to pay for ‘spiritual medicine’ too. I don’t see that that’s much difference than paying for homeopathy.