Psychology/Psychiatry

[speed]

Does Psychology/Psychiatry work? Has either discipline made important advances in how the brain works? In understanding behavior and psychological "disorders"? Are there even psychological "disorders"? Do the psychological theories even work? And have the many brain-altering drugs psychiatrists have prescribed over the last 20 years helped at all?

I contend, that psychology and psychiatry have harmed more than they have cured; have labelled numerous patients with disorders they probably dont have, and prescribed them drugs they dont need; have taken the community and family out of psychological health, and have replaced such needed supports with drugs and theories; have generally harmed society and contributed much to many of our societal ills.

Of course one of the most obvious examples of all of this is how much of Freudianism has since been proven wrong. All of those hidden sexual urges explaining our behavior that were force-fed to patients to explain their own behavior, have been tossed out the window. Then we have the named psychlogical disorders themselves. Are they truly correct? Are they always correctly prescribed? And that leads us to the drugs prescribed to treat the disorders. Are these drugs even effective? I recently read a couple of reports that claimed prozac is only slightly more effective in treating depression as a sugar pill, yet it does alter the brain's chemistry. And its seems everyday there are reports about the side-effects of these anti-psychotics and depressants--including extreme agitation and violence.

I am also concerned with the idea that mental health is entirely a personal problem. Travels far and wide, including studies show that all but America, Japan, Britain, and Northern Europe have very very low instances of psychological orders (and all, of these aforementioned countries are capitalist or incredibly individualistic). Many, if not all, of other countries and cultures around the world, place a emphasis on family, community, and culture over the individual--a safety net if one will in which all the burdens of the world and life are not pinned on one person.

Or is madness perhaps a societal or cultural construct as Foucault postulates? Surely there are truly mad people, but perhaps most are not mad? Perhaps most who are labelled with a disorder or need drugs, are actually lashing out at a injust and repressive society, at work, at stress, or at the incredible lack of creativity allowed but in a few money-making fields?


I'm just a normal late 20's white guy living in middle class America whose never been on any drugs apart from the occasional aspirin (and Im not a Scientologist either). And I am surrounded by drugged up and depressed people. Everyone is on some anti-depressant of some sort; everyone seems in a haze or a drug induced stupor. Some seem on edge--as if the drugs do something to them; bring out some anger deep down inside. My passion for a posteriori reasoning, compels me to conclude there is a direct relation between these drugs and this bizarre and cloudy behavior.

 

[Norsemaiden]

Does Psychology/Psychiatry work? Has either discipline made important advances in how the brain works? In understanding behavior and psychological "disorders"? Are there even psychological "disorders"? Do the psychological theories even work? And have the many brain-altering drugs psychiatrists have prescribed over the last 20 years helped at all?

I contend, that psychology and psychiatry have harmed more than they have cured; have labelled numerous patients with disorders they probably dont have, and prescribed them drugs they dont need; have taken the community and family out of psychological health, and have replaced such needed supports with drugs and theories; have generally harmed society and contributed much to many of our societal ills.

Of course one of the most obvious examples of all of this is how much of Freudianism has since been proven wrong. All of those hidden sexual urges explaining our behavior that were force-fed to patients to explain their own behavior, have been tossed out the window. Then we have the named psychlogical disorders themselves. Are they truly correct? Are they always correctly prescribed? And that leads us to the drugs prescribed to treat the disorders. Are these drugs even effective? I recently read a couple of reports that claimed prozac is only slightly more effective in treating depression as a sugar pill, yet it does alter the brain's chemistry. And its seems everyday there are reports about the side-effects of these anti-psychotics and depressants--including extreme agitation and violence.

I am also concerned with the idea that mental health is entirely a personal problem. Travels far and wide, including studies show that all but America, Japan, Britain, and Northern Europe have very very low instances of psychological orders (and all, of these aforementioned countries are capitalist or incredibly individualistic). Many, if not all, of other countries and cultures around the world, place a emphasis on family, community, and culture over the individual--a safety net if one will in which all the burdens of the world and life are not pinned on one person.

Or is madness perhaps a societal or cultural construct as Foucault postulates? Surely there are truly mad people, but perhaps most are not mad? Perhaps most who are labelled with a disorder or need drugs, are actually lashing out at a injust and repressive society, at work, at stress, or at the incredible lack of creativity allowed but in a few money-making fields?


I'm just a normal late 20's white guy living in middle class America whose never been on any drugs apart from the occasional aspirin (and Im not a Scientologist either). And I am surrounded by drugged up and depressed people. Everyone is on some anti-depressant of some sort; everyone seems in a haze or a drug induced stupor. Some seem on edge--as if the drugs do something to them; bring out some anger deep down inside. My passion for a posteriori reasoning, compels me to conclude there is a direct relation between these drugs and this bizarre and cloudy behavior.

I agree with a lot you have said - but have a slightly different view on some things.

The study of psychology has brought many useful insights into human behaviour. Psychology is not primarily about treating mental illnesses and psychologists are not medically trained. Psychiatry is concerned with such matters.
Psychiatry has a history of being flawed in many ways. Recently the consensus seems to be coming around to the realisation that drugs do not work nearly as well as they should, and that they often cause more harm than they aleviate.
The extent to which genes or environment (and a combination of the two) play a part in the development of mental illness is still not firmly established. However the envionment appears to be the critical factor, even when there is also a genetic component.
Children born to women who had previously seriously considered aborting their pregnancy have been found to have four times the risk of developing schizophrenia. This condition is now thought to be triggered by parental negligence or abuse in most cases.
http://www.guardian.co.uk/comment/story/0,,1598133,00.html

More general evidence of the crucial role of environment comes from sociological studies. Schizophrenia is around 12 times more common in children of West Indian immigrants to Britain. Increased rates have been found for immigrants to other countries. Poor people are several times more likely than the rich to suffer schizophrenia, and urban life increases the risk.

Rates of schizophrenia vary as much as 16-fold around the world, as does its course. It is less common in developing nations and tends to last much longer and be more severe in rich, industrialised nations compared with poor, developing ones (even so, about 20% of schizophrenics in developed nations recover completely without taking anti-psychotic drugs). In fact, if you become ill in a developing nation where hardly anyone is treated with drugs, you are 10 times less likely to have any recurrence of the illness - a huge difference, also nothing to do with genes.

One in four westerners now supposedly suffers some form of mental illness in their lifetimes.
A lot of this must be caused by the stresses of modern life and by unhealthy lifestyles with poor nutrition and lack of excercise. A daily half hour walk in a green area is more effective than prozak.

The most common mental illnesses are:
Severe depression, anxiety, schizophrenia, Bi Polar Disorder (manic depression), phobias, obsessive-compulsive disorder, and eating disorders.

 

[Scourge of God]

I'm skeptical overall about the efficacy of psychotherapy. Pharmacological solutions are generally more effective, but often applied indiscriminately.

I tend to agree that for many people, the dissonance of modernity tends to exacerbate underlying psychological conditions, but I don't think we can look at modern life as the causative agent.

 

[Scourge of God]

In any event, I doubt mental illness is radically more prevalent today than in the past. The apparent increase in prevalence has more to do with an increase in diagnosis (and the willingness of Westerners to seek psychiatric consultation). More sensitive diagnostic tools are part of it: behavior patterns that used to get you labelled a fucking jerk now earn you sympathy and prescriptions.

 

[derbeder]

@speed: You seem to be thinking primarily about abnormal psychology and applied psychology, which includes clinical psychology and counseling. Psychiatry is related to these fields of psychology. Yet, much work in psychology involves research into human and animal perception and cognition which do not have any clear connection to matters about personality and psychological disorders.

 

[speed]

@speed: You seem to be thinking primarily about abnormal psychology and applied psychology, which includes clinical psychology and counseling. Psychiatry is related to these fields of psychology. Yet, much work in psychology involves research into human and animal perception and cognition which do not have any clear connection to matters about personality and psychological disorders.

True, both you and Norsemaiden have made good points about that. Pardon my faux pas.

 

[CatwomanEarache]

In any event, I doubt mental illness is radically more prevalent today than in the past. The apparent increase in prevalence has more to do with an increase in diagnosis (and the willingness of Westerners to seek psychiatric consultation). More sensitive diagnostic tools are part of it: behavior patterns that used to get you labelled a fucking jerk now earn you sympathy and prescriptions.

I agree,today it is just more acceptable to admit that one is suffering stress or depression without the social taboo or stigma that it once carried. However the pyschiatrists and even general practioners are dishing out way too many pills, when sometimes all that is needed is counselling or maybe stress management. I used to believe that Cognitive Behaviour therapy was very effective, but now read that maybe it is not all it was cracked up to be.

 

[Seditious]

the pyschiatrists and even general practioners are dishing out way too many pills, when sometimes all that is needed is counselling or maybe stress management. I used to believe that Cognitive Behaviour therapy was very effective, but now read that maybe it is not all it was cracked up to be.

They're useful as a combo, one-two punch, rather than throwin all your effort into the cross blindly, the pills are the jab that set CBT up to land most effectively. It would be disconcerting to the patient if such therapy was a hail mary swing n' a miss because of a neurological bias, and thus they lost hope in the future and giving the treatment another go a second time with drugs. Given how long these therapies can take, it's worth going with a strong approach from the outset. "Dishing out way too many pills" shouldn't be measured in terms of how many people take one kind of medication, but in how many they use or how high their dosage is. Giving someone a minimal (10-20mg a day) dose of an average SSRI is pretty negligible, it's not exactly something to be concerned about as if we're all on 100grams of heroin a day or some shit, doped up to hell like getting a girl drunk to lose her inhibitions...

 

[JoeVice]

psychology and its methods are an answer to needed support. a struggle though, is the subjects' dependency on practiced methods vs. self-supressed honesty.

its kind of like someone who depends on alcohol to get laid, all the while being conscious of the fact in a self-defeating manner. when the child is born, the parents' unease that created it will be passed down. the child senses it from the very moment of conception, contemplates the inherited insecurity throughout his adolosence, wises up, and chooses not to take drugs. but, in the process, dies of prostate cancer because his sacral chakra is out of whack. in the end, what goes around, comes around.

psychiatry helps some, and doesn't others. the field is a passion that people pursue, and its patients are part of what is given back. sometimes it works, sometimes it doesn't.

third world countries don't have the luxury of becoming mentally ill. their dis-ease effects them on a more immediate level, none the less psychologically related, but one that isn't as much psychologically concsious.

 

[Norsemaiden]

Many people have a tendency to expect, almost as a right, to be happy and to be confident and socially successful, and if they feel they are failing in any of these respects, they get the idea that they should get treatment - as if someone can just fix them. Even parents send their teenagers for treatment if they are quiet and unsociable, even though the teenager may be completely content himself. They can't just accept that not all personalities have to be the same.

Criminals and feckless irresponsible people like alcoholic wife-beaters typically won't take responsibility for their own short-comings and try to behave themselves - instead they blame their behaviour on a condition they think can be remedied by pills or some quick therapy where the onus is entirely on the therapist to transform them, and not on themselves to get a grip. They won't even take responsibility for their harmful behaviour, suggesting that "my head went", "it wasn't the real me" and "my head needs sorting out" - when really they are congenitally scum.

 

[derbeder]

The question whether there really is such a thing as mental illness is not just a theoretical question. It is immediately relevant to our daily concerns. For instance;

Who should pay for psychotherapy?

One might say the client or the patient should be paying, but most medical treatment today is paid for by insurance companies or the government, and questions arise about whether psychotherapy should be included in third-party payment plans. Some clinical psychologists and psychiatrists hold that there is no such thing as mental illness, and thereby conclude that there is no such thing as psychological therapy. Hence, on their view what goes under the name of "psychotherapy" should not be covered by third-party payment plans. Medical therapy for disorders of the nervous system (such as endogenous depression) could be covered. In practice, however, most therapists recognize that if psychotherapy costs had to be borne by clients, their practices would bring in a lot less income. Psychiatrists and clinical psychologists therefore agree that third parties should pay for psychotherapy, but they disagree about who should be paid.

Squabbles over insurance and managed care, and the increased marketing of health care like any other product, raise the nasty question that was potentially embarrassing to psychiatrists and clinical psychologists alike: Does psychotherapy work? Private and public health plans do not pay for quackery, so treatments must be proven safe and effective. The first person to actually investigate the outcomes of psychotherapy was the English psychologists Hans Eysenck, in 1952. He concluded that getting therapy was no better than just waiting for therapy for the same amount of time - the cure rate for spontaneous remission was as good as for therapy. This implied that psychotherapy was a fraud. Since then, psychotherapists have challenged Eysenck's conclusion, and hundreds of psychotherapy outcome studies have been done. Naturally, mainstream clinical psychologists eagerly argue that psychotherapy, or at least their kind of psychotherapy, is effective, but the evidence is, at best, extremely mixed. There is consensus that psychotherapy is probably better than doing nothing for a psychological problem, although the magnitude of improvement is not very great. However, many studies have concluded that professional psychotherapy with a trained therapist may be no more effective than amateur therapy or self-help. It is also not clear whether psychotherapy is safe. Some studies have concluded that many clinicians are not competent and describe cases made worse by therapy.

(Much of this is taken directly from Thomas Leahey's A History of Psychology, 5th ed., 2000. I suppressed some details and any references to studies.)

 

[zabu of nΩd]

Psychotherapy is probably useful for a small proportion of people who actually have some debilitating mental disorder which warrants medication, but for most people it's basically the equivalent of having a "professional conversation partner".

My parents took me to see a psychotherapist for a few months while I was in high school. It wasn't really a life-changing experience or anything, but it came at a time when I didn't have many friends, and thus little opportunity to discuss away my various personal problems and insecurities, so I'd say it helped to make that period of my life a bit easier.

There really isn't a whole lot of 'treatment' involved in psychotherapy, besides the occasional drug prescription. For the most part, it's just an alternative form of social interaction for people who are lacking a meaningful form of that in their lives.

 

[speed]

The question whether there really is such a thing as mental illness is not just a theoretical question. It is immediately relevant to our daily concerns. For instance;

Who should pay for psychotherapy?

One might say the client or the patient should be paying, but most medical treatment today is paid for by insurance companies or the government, and questions arise about whether psychotherapy should be included in third-party payment plans. Some clinical psychologists and psychiatrists hold that there is no such thing as mental illness, and thereby conclude that there is no such thing as psychological therapy. Hence, on their view what goes under the name of "psychotherapy" should not be covered by third-party payment plans. Medical therapy for disorders of the nervous system (such as endogenous depression) could be covered. In practice, however, most therapists recognize that if psychotherapy costs had to be borne by clients, their practices would bring in a lot less income. Psychiatrists and clinical psychologists therefore agree that third parties should pay for psychotherapy, but they disagree about who should be paid.

Squabbles over insurance and managed care, and the increased marketing of health care like any other product, raise the nasty question that was potentially embarrassing to psychiatrists and clinical psychologists alike: Does psychotherapy work? Private and public health plans do not pay for quackery, so treatments must be proven safe and effective. The first person to actually investigate the outcomes of psychotherapy was the English psychologists Hans Eysenck, in 1952. He concluded that getting therapy was no better than just waiting for therapy for the same amount of time - the cure rate for spontaneous remission was as good as for therapy. This implied that psychotherapy was a fraud. Since then, psychotherapists have challenged Eysenck's conclusion, and hundreds of psychotherapy outcome studies have been done. Naturally, mainstream clinical psychologists eagerly argue that psychotherapy, or at least their kind of psychotherapy, is effective, but the evidence is, at best, extremely mixed. There is consensus that psychotherapy is probably better than doing nothing for a psychological problem, although the magnitude of improvement is not very great. However, many studies have concluded that professional psychotherapy with a trained therapist may be no more effective than amateur therapy or self-help. It is also not clear whether psychotherapy is safe. Some studies have concluded that many clinicians are not competent and describe cases made worse by therapy.

(Much of this is taken directly from Thomas Leahey's A History of Psychology, 5th ed., 2000. I suppressed some details and any references to studies.)

Yes, I concur with this. So many--if not all--of the social sciences (which psychology is part of) have been proven wrong. Now with psychiatry and neuro-psychiatry, etc, thats still up in the air. It seems many of the drugs dont work that well or are incorrectly prescribed.

Obviously, Foucault is the big inspiration or source for much of my thought on this matter. I wonder whether psychology (and its drug prescribing sibling psychiatry) have any real basis. Is the concept of sane merely a bourgeois modern one? Is the idea of eternal happiness a modern one? Is it okay to be a bit melancholy and different?

 

[Norsemaiden]

The question of whether mental illness actually exists is an interesting one. I would say that it does, but that most prescribed conditions of mental illness are not infact insanity at all, but merely aspects of personality.

The sentence below is supposed to cover all "mental illness" but that seems to be going too far.

"mental illness" is simply deviance from what people want or expect in any particular society. "Mental illness" is anything in human mentality greatly disliked by the person describing it.

http://www.antipsychiatry.org/exist.htm

What about schizophrenics who hear voices in their heads, as clear as if someone was really talking to them - and these voices torment them and urge them to murder or self-harm? What about if they are sure that they are being watched and listened to by all sorts of people who are secretly laughing at them? What about the man who went past a schoolyard and thought the children were laughing at him (when they were merely playing and not interested in him at all) and attacked them?
How about a schizophrenic woman who usually is very happy and a loving wife, but becomes convinced first that her husband has stolen her womb and then that he is in fact an imposter, and she tells his parents how badly she misses him and wishes he would come back (even though he never left)? What if drugs seem to get her back to thinking normally once again?
Wouldn't you say she was mentally ill and that psychiatric drugs helped her? I would - but I am not sure how much help such a person should receive considering that she can't have children nor do any work.

 

[speed]

What about schizophrenics who hear voices in their heads, as clear as if someone was really talking to them - and these voices torment them and urge them to murder or self-harm? What about if they are sure that they are being watched and listened to by all sorts of people who are secretly laughing at them? What about the man who went past a schoolyard and thought the children were laughing at him (when they were merely playing and not interested in him at all) and attacked them?
How about a schizophrenic woman who usually is very happy and a loving wife, but becomes convinced first that her husband has stolen her womb and then that he is in fact an imposter, and she tells his parents how badly she misses him and wishes he would come back (even though he never left)? What if drugs seem to get her back to thinking normally once again?
Wouldn't you say she was mentally ill and that psychiatric drugs helped her? I would - but I am not sure how much help such a person should receive considering that she can't have children nor do any work.

True, true. There are some truly psychotic people. If drugs can help them, so be it; if not, I suppose a long stay in a prison or mental institution is necessary if they are harmful to society.

 

[Norsemaiden]

One of my relatives used to work in an asylum for the criminally insane. He told some interesting tales about the inmates. Once one attacked a mental nurse with the emergency axe and killed him. Another time one (who had Berserker strength) ripped out a toilet and hurled it through a window. One woman was convinced she had rats living in her stomach. Another compulsively swallowed inappropriate things like needles.
My relative was friends with a few of the characters. One of them wrote little stories and poems and was thrilled if he was praised for doing so. Here is one of his poems.

It was a dark and rainy night
The streets were black and clean
And I was walking backwards
To the place where I had been

When suddenly, I saw a noise!
I smelt a noise!
What could it be?!

I threw my arms around myself
And I clung tight of me

I did the splits
Had a thousand fits
And left myself with me.

 

[zabu of nΩd]

It was a dark and rainy night
The streets were black and clean
And I was walking backwards
To the place where I had been

When suddenly, I saw a noise!
I smelt a noise!
What could it be?!

I threw my arms around myself
And I clung tight of me

I did the splits
Had a thousand fits
And left myself with me.

Dude, that's awesome. I'd love to know some insane dude who wrote poetry.

 

[Norsemaiden]

Dude, that's awesome. I'd love to know some insane dude who wrote poetry.

It's especially entertaining when you know it came from someone who is officially insane. They should get people in mental hospitals to be more creative like that. Then they could do something fairly worthwhile. I suppose they might have to censor out anything that might have a disturbing effect, but then a lot of what supposedly sane authors write is really disgusting and disturbing anyway, so it's not as if it would be any more objectionable than that.
But we're not laughing at what that guy wrote in a mean way, only in an appreciative way imo. The trouble is, the insane person might be totally offended and want to strangle anyone who didn't show the right response.

 

[Silver Incubus]

I would just like to say that if you hypnotize a schizophrenic and say if, like my friend Stu, they hear voices in their head, you can tell them to turn the voice so low that they don't hear it anymore.

The thing most people with real mental illness need are options for response. Obsessive compulsives are just stuck in a loop, created my mental images of something bad happening and a associated anxious bad feeling. Give them a way out of the loop that feels better and they will take it. Same with phobics. Have them feel relaxed and do some double dissociative, where they watch themselves watching themselves in a phobic situation. Then as they step into the situation, they stay calm , and learned a new response which can be kept.

If you know someone with anxiety, tell them to toss a ball or something, back and forth. Anxiety is just a buildup of one side of your brain.

the thing is that there is no one who isn't mentally ill, its just some people can control it and others can't. We hallucinate in daydreams, or when doing math, etc. The problem people have is that they don't know how to control their thinking.

I'm sure you can imagine anyone's voice in your head, Even hear one when you read. Does that make you a schizophrenic? No, its the lack of control over those voices. The lack of options.

 

[CatwomanEarache]

Many people have a tendency to expect, almost as a right, to be happy and to be confident and socially successful, and if they feel they are failing in any of these respects, they get the idea that they should get treatment - as if someone can just fix them. Even parents send their teenagers for treatment if they are quiet and unsociable, even though the teenager may be completely content himself. They can't just accept that not all personalities have to be the same.

Criminals and feckless irresponsible people like alcoholic wife-beaters typically won't take responsibility for their own short-comings and try to behave themselves - instead they blame their behaviour on a condition they think can be remedied by pills or some quick therapy where the onus is entirely on the therapist to transform them, and not on themselves to get a grip. They won't even take responsibility for their harmful behaviour, suggesting that "my head went", "it wasn't the real me" and "my head needs sorting out" - when really they are congenitally scum.

So true, I wish I had more time at the moment to reply, especially the part about parents taking their teenagers for "treatment" when they are probably quite content, and would never open up anyway to a total stranger, let alone someone who appears to be analysing them, especially if it is in an uncomfortable hospital type environment.