🚀 go-pugleaf

David wrote:
> but suggesting that people ignore the advice of their
> doctors or other health professionals in favour of (idiosyncratic
> beliefs?) is irresponsible.

I, in no way, either said or implied this. I was referring to people I
know whose doctors insisted that there was nothing wrong with them, but
who persisted in getting tests done despite accusations of Munchausen's
Syndrome and the like because they "felt" wrong.

This is not unlike the Christian Scientist
> parents who refused their child a life-saving blood transfusion, believing
> that prayer would cure their child, resulting in an avoidable death (as
> had happened in 2 celebrated cases).

Cheap shot to my argument, Dave. Boo. Do you really think that this is
the argument I am trying to make. I'm sad.
>
> > David mentioned Carl Sagan's view of science over faith. Wierd
> > coincidence, because coming back to Buffalo (yuck!) yesterday on the
> > plane, I saw "Contact", the Jodie Foster movie based on his book. I
> > don't know how closely the movie portrays the book, but, it was focused
> > on the limitations of the scientific, positivist view. It might be
> > summed up as "experience overrides verifiability." Faith, in that movie,
> > is a most triumphant human quality.
>
> Didn't recall that ending in his novel. "Demon-haunted World" is
> non-fiction and argues that science, asking questions systematically,
> testing old and new ideas, is the only way we can escape superstition.
>
> > Anyone, including me, can imagine all kinds of extreme examples of
> > religious dogma or "faith" that involve human sacrifice, slavery, and
> > all manner of evil. But as far as I see it, we take most "scientific
> > facts" on faith. How many of us really critically read the literature on
> > the claims we make? Much research is appallingly bad. In many cases, the
> > conclusions and inferences are incredibly twisted from the actual data.
> > Science is as much faith as it is replicated fact.
>
> That's an argument for better science, not for throwing science out the
> window!

Total agreement here! I'm not for throwing science out the window, only
for dethroning it to being a mere earthly tool to enhance our lives.

> Critiquing the methodology and conclusions of that article is
> part of the scientific process. Write a letter to the journal. The best
> way to raise the quality of knowledge-gathering is to call people on bad
> science. Tossing the whole process and reverting to superstition would be
> a step backward.

I agree. Thanks for your encouragement. I'm thinking of writing the
letter.


> > I feel that your question skates dangerously close to a racist ideology.
>
>   I was suggesting that your statement (referring to "oreos" and "women's
> libber's"), carried to its logical conclusion, was clearly racist and
> sexist and I phrased it as a question in order to give you an "out."

Thanks; and I regret the counterattack. Sorry.
>
> > If Germans in the late 1930's were given Prozac and Xanax to help them
> > eliminate the symptoms of depression and anxiety associated with the
> > genocide of millions of people that was accomplished with their help, do
> > you think this "symptom elimination" would be "help" or "crap"?
>
> I find your reasoning questionable. Nazis actually did use airplanes and
> automobiles, does that make use of these technological developments
> "crap," too? Just because something can be misused, does not mean that
> they have no utility when used reponsibly.

Yes, but no such reckoning is done in many cases of treating mental
illnesses with drugs because the mental illness is reduced to being
understood as a brain disease, thus something to be treated with drugs.
Plain and simple. I stand by my analogy because just about anything can
be used responsibly (including assault rifles), but some of these things
are usually used irresponsibly. I don't like the latter class, of which
I think psychopharm compounds are a part.
>
> > I say that yes, taking drugs is "crap" to the individuals "helped"
> > because they are being sold on an ideology that somehow their problems
> > are beyond the power of human relationship and experience to resolve.
>
> By your reasoning, the same would hold true for prayer or other
> faith-driven interventions.

I'm not following you here. However, prayer and faith-driven
interventions (neither of which I'm into or have any explicit experience
with---I don't want to be reduced to a bible-thumper in an effort to
deflate my arguments) do wonders for some people. I can't believe you'd
doubt that such placebos are at times very powerful. One bipolar woman
wrote to me that she stopped taking her lithium, and was sick of not
getting better, and turned to God for help (she was extremely religious,
from what I could tell). That had been some time ago, and by her account
(for what that's worth) she was quite stable without the meds.
>
> I'm willing to bet you have treated very few clients with severe
> depression, schizophrenia or bipolar disorder.

True, but I have treated some in each category. More importantly, most
of those severely disordered patients I've treated without drugs have
gotten substantially better in a short amount of time. And I certainly
know other therapists with years of drug-free experience, as well. No
psychiatrist operating under the disease paradigm can say that, only
that s/he has successfully "managed" the symptoms of a chronic illness
until the patient becomes "treatment-resistant" and stops taking the
"life-saving" meds. Most importantly for your scientific position, there
is plenty of evidence (including large-scale multi-center studies for
the effective, non-biological treatment of severe mental disorders
(e.g., Karon & VandenBos's Psychotherapy of Schizophrenia). These
arguments shouldn't be reduced to comparisons of patient-hours. There's
enough empirical support to go around here.


 Stepping away from the
> hundreds of randomized, placebo-controlled studies (where objective
> support for the efficacy of various treatments should lie), I can relate
> that many clients subjectively report that their medications saved their
> lives. Here, psychological interventions (improving coping skills,
> stress management, etc.) may be an important adjunct to their medication.
> (e.g., studies suggest that cognitive behaviour therapy + antidepressants
> appears to make relapse much less likely than medication alone).

Other studies (e.g., meta-analyses cited in Karon and VandenBos; and
Antonuccio, Danton, & DeNelsky (1995)) show no appreciable effect of
combining drugs with psychotherapy over psychotherapy+placebo
conditions. You don't have to "step away" from the science. If you
search the evidence with a *different* filter, you'll find different
evidence. *This* is the point. The search for confirming data to fit
one's theory is not science, but it is what you and I do every day. We
can do it well, and we can wear the mantle of science to support our
claims, but in the end, the scientific method only generates a unified
ontology of mental illness by subverting undesirable epistemologies
(such as biopsychiatry is doing to competing epistemologies and
treatments of mental illnesses).
>
> Maybe another example would illustrate the absurdity of your argument:
> You wrote: "taking drugs is "crap" to the individuals "helped" because
> they are being sold on an ideology that their problems are somehow beyond
> the power of human relationships and experience to solve." Would you deny
> insulin to a diabetic because the medication wouldn't allow them to solve
> their problems themselves? Surely not.
Diabetes is not anything like a mental problem. Mental illnesses are not
diagnosable on the basis of a chemical malfunction. There are known,
stable, universal levels of "normal" insulin. Giving adequate insulin
solves the problem of diabetes (non-drug behavioral changes like diet
also work in some forms of diabetes). No such claim can be made about
any neurotransmitter or exogenous ligand for any mental illness.
Depression is not a "serotonin" problem now any more than it was a
"norepinephrine" problem 20 years ago any more than it was a phosphorous
problem in the 1860s.

Harrumph and Bah!
-Jason