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Wednesday, October 14, 2009

Make Of It What You Will

In response to Deb's comment about schizophrenics accepting the diagnosis or not

Here is the data I've compiled; make of it what you will. You may question the quality of the research, the method of analysis, and the logic of the conclusions. It is your choice whether to perceive it as your reality or not.

Your perception is yours alone to manage. Its a huge, unwieldy responsibility. There are certain default mechanisms available if you prefer autopilot. I wish you luck.

Hmmm. This seemed important enough for its own post at the time, but now it seems short and weird. This seems to happen to me frequently after I wake up


Debra said...

No... data, dink.
I had this argument yet again yesterday on my loony blog.
Two years ago or so a book came out in the U.S about... the particularly comfy relationship between... the pharmaceutical labos and the DSM4/5 or what you will.
That says it pretty well.
From an historical viewpoint, lots of people got so excited that they wet the bed when psychotrope/neuroleptic drugs were shown to have an effect on.. delusive outbreaks (bouffée délirante over here).
BUT... when the docs started fitting people with chemical straitjackets then the whole thing became a little more questionable, and problematic.
And... the old European clinical psychiatry has got swept away in the Pavlovian response, type : he is a schizophrenic BECAUSE he responds to anti-psychotic medication. Which promptly morphs into.... : he is a schizophrenic BECAUSE... he DOESN'T respond to antipsychotic medication.
Confused yet, dink ?
You SHOULD be.
The docs should be too.
Enough to have the good grace to say "back to the drawing board"...

Debra said...

I should have specified : I see NO REASON whatsoever why anybody should accept the diagnosis of schizophrenia at the moment...
Second point.
I also posted on my loony blog, and mentioned to my psychologist friend yesterday that one of the biggest, biggest problems with the DSM is that it bottoms out the diagnosis of hysteria.
Just... why and how does it do this ?
Well... the focal point of the hysterical structure is... questioning, and interrogating the all powerful, all knowing MASTER (of the universe, of the blog, of the factory, of the... you fill in what you like...
BUT... since the DSM has formally instituted and legitimized the MASTER'S PLACE in such a fashion as to cancel out any lateral vision of the fiction of this place (i.e. THERE IS NO MASTER).... the DSM CANNOT come up with a diagnosis of hysteria.
And... believe you me, that is a MEGA structural weakness of the DSM.
Are you following me ?

Thai said...

Deb, this guy does a pretty good job and I will hop over to his blog for a periodic read from time to time.

By definition, there is always a benchmark by which abnormal is defined.

The problem of course is normal can only be defined from one perspective.

From a practical standpoint this is not very useful since we all know what can happen when one perspective is not the right perspective... ;-)

And Dink, what data are you talking about?

Dink said...

" the DSM CANNOT come up with a diagnosis of hysteria."

Spychology/spychiatry have always seemed like incredible difficult fields to me. How can the DSM even hope to catagorize the range of human mental, um, thingees? In the end I guess the only hard-and-fast gauge is objectively "Can the person keep themselves alive and not harm others?" and subjectively "Are they satisfied with their emotional world?". If not, you try to match symptoms to treatments using the best info currently available.

"And Dink, what data are you talking about?"

Yeah, rereading it I definitely feel I didn't convey my thought well.

Anyone can give us their opinion; its up to us to decide if that opinion has any validity and should be incorporated into our reality model. If a Scientologist tells someone their "thetans" are out of whack, one would hope the person would do some critical thinking before taking the diagnosis as gospel. Its tough when one is presented with a judgment and doesn't even begin to know where to start the investigation. Such as various economic pundits spouting off predictions; where do you begin? Well I guess you start with Sudden Debt and start down the rabbit warren of Federal Reserve, national debt/deficit, and environmental sustainability.....;)

Thai said...

Oh, I think I may now understand

And re: "Are they satisfied with their emotional world?"

I once thought the same but now I have more of a "what works works" attitude.

Emotional satisfaction is nice but I don't think it is a requirement for life on any absolute perspective and for some people the absence of it is an advantage they probably forever wish they were not cursed with.

I think evolution can be a cruel mistress.

Dink said...

"for some people the absence of it is an advantage they probably forever wish they were not cursed with."

There was an interesting movie called "Mongol" a while back about the life of Genghis Khan. It didn't seem like a happy life, but genes were passed and fortunes/legends made. Individual torment for the benefit of the species? I try to remember evolution is unintentional and indifferent, but it does often seem intentional and cruel. In which case pleasure is the best revenge, I suppose. Donuts all around!

Thai said...

Sometimes interesting to see the way odd twists and turns that zero-sum plays out in life.

Debra said...

The problem is that normal goes with...
NORM, and stats, and the whole bit.
That is a BIG BIG problem.
There is a funny thing about the States, in my book.
Out in the street you can do just about every imaginable thing, dress the way you want, and it seems like you are invisible to people ; they just seem to look right through you (in the cities, at least...)
It was my brother last year who, when I told him that I wanted to take the Greyhound bus to Albuquerque almost had a hissy fit imagining that I was going to get axed by a schizophrenic...
And when I got back from Albuquerque, he promptly pulled out a newspaper article about some person who got his/her head sawed off with a pocket knife in a Greyhound bus in Canada while I was there.
Paradox time...
Do you realize HOW LONG it takes to saw somebody's head off with a pen knife ????
Long enough for ANYBODY with even a microscopic size of balls to overwhelm the other person (even better when people... COOPERATE, huh, Thai ???).
Incidentally, my bro spent an inordinate amount of time telling his kids just how weird everybody else by HE and his wife were.
It's called... instilling FEAR in the population, right ?

On a lighter note, my daughter has just introduced me to "Nodame Cantabile", a Japanese T.V. series set in a musical academy with very talented, complexed students.
It makes "FAME" look like... what can I say ?
What CAN you say about that American dream ?
"Fame" looks cheap, shoddy, and unimaginative next to "Nodame Cantabile", whose heroine is a 19 year old who plays piano by ear, without scores, has a hell of a technique, wants to be a school teacher, and marry the "beau ténébreux" (that means the Heathcliff type...) who is destined to become an orchestra conductor, but has a phobia of planes and boats due to PTSD. (When they do the flashback on his accident you see... a toy airplane crashing into the runway, and you hear the "Dies Irae" from the Verdi Requiem.
Seriously, seriously recommended for all you serious people.
Nodame is a doll. Her room is a mess. She is more... animal than human, but she is still a doll.
Lighten up. Get Nodame Cantabile (download).
End of commercial. Cheers.

Dink said...

I suspect they're counting the "Morning After" pill (or whatever its called) as contraception vs. abortion. Since no one is sure conception actually took place yet (or even will) perhaps its enough of a twilight area to be ignored by the prolifers?

Thai said...

Swine flu is simply kicking our butt

I was sick as a dog all last week at the ACEP conference in Boston. I spend lots of time in bed, etc... (when I am not at meetings) and I come back this week- bam!

I should have stayed in bed...

A 35 year old prisoner went into full cardiac arrest from swine flu today on me and I admitted another gentleman with it who I would only give 50/50 odds on.

I am really rooting for him.

It is certainly not the end of the world, but it is a nasty flu, no doubt about it, especially for the young and healthy.

Indeed an ED friends of mine in Texas has seen his ED volume double- i.e. 100% more patients/day- for almost 30 consecutive days in a row.

There is simply no way to staff for that kind of sustained capacity surge, the provider bodies are simply not there.

Fortunately we are only seeing a sustained 10% daily surge, which is still too in my opinion for a sustained surge.

It's totally different when it is only a single disaster and then over.

At least you get to go home.

Let's hope this thing burns out soon.

I am not looking forward to flu season in a few months.

How is swine flu in France?

Debra said...

Swine flu in France is yet ANOTHER occasion for people to get all paranoid about.
It gives rise to twenty commercials a day (which I don't see because we don't have telly..) and endless billboards and magazine spreads telling us to make sure we wash our hands like good boys and girls.
The powers that be are toying with the idea of making vaccinations MANDATORY if there is a pandemic in two European countries, but...
Don't count on it. I for one am extremely hostile to mandatory vaccinations in ANY form. (And since what I think is also thought by at least 1 mil other people, you get the picture, right ?)
More fear than actual harm here.
But... I thought that you would like to know that Freud had ALREADY picked up on "contagion", way back then. Translate : mass hysteria which leads to copycat behavior like the suicides at France Telecon I was telling you about.
Sometimes we are.. lemmings.
I'm disappointed you didn't say anything about Nodame, you guys...

Thai said...

Will look for Nodame (if I get a moment) on netflix

I am not paranoid fyi- just over worked

The Most Fabulous Objects In The World

  • Hitchhiker's Guide To The Universe trilogy
  • Lord of the Rings trilogy
  • Flight of the Conchords
  • Time Bandits