Psychiatry : The Infallible Profession

[KFG]

Just accept that you're Psychiatrically ill. These people know what they're talking about. Don't they ?

http://en.wikipedia.org/wiki/Rosenhan_experiment

Well, you've gotta laugh.....​

 

[Bob]

Yes, that's fascinating isn't it KFG... I've read about that before... It really does demonstrate how undeveloped our understanding of psychiatric diseases is... Basically, we are still in the dark ages when it comes to psychiatry.

I was watching Newsnight tonight, and they had an item about psychiatry, in which they were talking about how they are hoping that advances in technology will massively improve our understanding of psychiatry.

They said that, in the future, psychiatry will be more like other branches of medicine, in which doctors will be able to diagnose a condition using technology.

Technologies such as brain scans and rapid genetic analysis have changed everything. At last, those treating mental disorders have the tools they need to apply a more systematic approach, and it's already changing they way patients are treated.

http://news.bbc.co.uk/1/hi/programmes/newsnight/9631964.stm

Overall, it wasn't a particularly interesting news item, but one interesting thing they were talking about is how they are using brain scans to show changes in the brains of people with depression, and to predict how severe a patient's psychosis is likely to be in the future.

In groundbreaking research seen by Newsnight, a London team taught computer software to recognise patterns in brain images. Those patterns predict which patients will go on to develop the most serious forms of psychosis.

http://news.bbc.co.uk/1/hi/programmes/newsnight/9631964.stm

This all made me think about a recent article by Margaret Williams, in which she says: "...the Wessely School psychiatrists persisted with their 5 million PACE study that was designed and intended to re-structure patients alleged aberrant illness beliefs that they were physically sick."

This whole psychiatric approach to ME contrasts so much with the enlightened comments about psychiatry, in the quote boxes above. The ridiculous psychiatric approach to ME looks like it's out of the dark ages, even when (or especially when) compared to proper fields of modern psychiatry as discussed in the quote boxes above. The text in the quote boxes seems enlightened compared with the nonsense that W et al make up about ME, even though the psychiatrists in the Newsnight item admit that they understand very little about the proper disorders in psychiatry.

The term "maladaptive illness beliefs" and "maladaptive avoidance of activity" suggests we have a personality disorder, in which case, the psychiatrists have labeled us with possibly the least understood psychiatric label.

Whatever the psychiatrists actually believe (i.e. we have a personality disorder), I think that they like to say that we have a "psychosomatic disorder".

I wonder what other supposed psychosomatic disorders are supposed to exist these days?
I know that the psychiatrists like to believe that IBS is a psychosomatic disorder, just as stomach ulcers were once to believed to be the same.
And they like to think that high blood pressure and back pain are psychosomatic disorders.
But ME and IBS are nothing like blood pressure and back pain.
It seems quite obvious that back pain and blood pressure can react to stress.
Asthma can also react to stress (I know that for a fact because relaxation techniques can sometimes reduce my asthma symptoms), but I don't think that asthma is classified as a psychosomatic disease, probably because it is successfully treated with medication and can obviously be a very serious and even a fatal disease.

To put ME and IBS in the same category as blood pressure and back pain just seems obviously inappropriate.
Basically the psychiatrists will just grab any disease that they can get their claws on if they don't get much resistance from other fields of medicine.

Anyway... Just some thoughts.

 

[CBS]

<snip>
Wow. I managed a long post on Psychiatry without using the word "f*ck" ! That's your friendly influence, Bob.

Just wanted you to know that I really appreciated the laugh at the end of your post.

Having done graduate work in a related field, I'm always pleased to see when someone draws attention to the Rosenhan study - one of the most enlightening studies ever done in (or on) the field of psychiatry.

 

[Bob]

I make no apologies for giving Psychiatry a very hard time indeed with respect to CFS - their involvement thus far is a shocking story and their contributions have been extremely negative. Outside of CFS, Psychiatry has some really challenging and devastating conditions to tackle. I have a friend whose son has received a diagnosis of schizophrenia in the last few years and the illness takes its toll on the entire family, not just the poor lad.

Hopefully the use of new technology will see Psychiatry move further towards accurate diagnosis and therapy, based on solid data. And this should also benefit CFS - allowing the removal of current CFS-diagnosed patients from the CFS wastebasket. If your scan matches the template for a somatisation disorder then that will be the diagnosis. Those of us, like many here on PR, who have some form of immune-related neurological disease, will not ( I would assume ) match any of these newly developed templates and would therefore not be diagnosable under a Psychiatric banner. Assuming they get it right, of course.

There certainly does seem to be a contingent among the Psychiatric profession who are only too willing to get their claws into any illness which isn't satisfactorily explained with current medical technology. The whole "mind/body" duality thing especially irritates me. This is of course a very interesting and generally relevant area, but it's entirely inappropriate to foist it on an illness which has never had the "body" side of things thoroughly investigated.

I totally agree with everything you've said KFG.
You've made really interesting observations.

Wow. I managed a long post on Psychiatry without using the word "f*ck" ! That's your friendly influence, Bob.

lol, congrats KFG! Is that a first?! lol

I hope you won't be having feverish nightmares and screaming "f*ck" in your sleep tonight because you've suppressed your feelings and not had a proper rant?!?!

If you suppress your feelings then you might develop some sort of psychosomatic disorder... ... Oh, hold on... ... ...

 

[Enid]

I've not gone through all of this but it seems "hoping advances in technology will massively improve understanding" away from maladaptive behaviours of the Stone Age has to be welcomed. Latching onto real science and advances in medicine as opposed to wild ideas and theory is the only way to improve their credibility and image (somewhat).

 

[redo]

Just accept that you're Psychiatrically ill. These people know what they're talking about. Don't they ?

http://en.wikipedia.org/wiki/Rosenhan_experiment

Well, you've gotta laugh.....

+1 KFG. That was just a great read!

 

[alex3619]

I have an hypothesis. There is no hard evidence that the biopsychosocial illness claims are valid. We can't find evidence in blood tests or MRIs or EEGs or anything. Some people in various studies have ticked options on forms indicating they feel this approach works. This is clearly psychotic behaviour. People who believe in though induced psychosocial behaviour clearly have a biopsychosocial problem. This is testable - all we need to do is find a universal biomarker for biopsychosocial illness and we can track progress under various treatments with hard evidence to back our claims. Hmmm, that could be hard. Have they found any biomarker for any of them?

Sarcastically yours,
Alex

 

[alex3619]

I have an hypothesis. There is no hard evidence that the biopsychosocial illness claims are valid. We can't find evidence in blood tests or MRIs or EEGs or anything. Some people in various studies have ticked options on forms indicating they feel this approach works. This is clearly psychotic behaviour. People who believe in thought induced psychosocial behaviour clearly have a biopsychosocial problem. This is testable - all we need to do is find a universal biomarker for biopsychosocial illness and we can track progress under various treatments with hard evidence to back our claims. Hmmm, that could be hard. Have they found any biomarker for any of them?

Sarcastically yours,
Alex

 

[Enid]

Couldn't find biopsychosocial in my blood tests - are we taking a poll ?

(That's a bit of a cunning ploy adding the "bio" bit in - trying to make it look respectable - or did it fall off the table in all the useless b..... produced still trying to grasp some basis in the real)

 

[sianrecovery]

I spent years in the health service working in addiction and managing services and pyschs. I worked with some excellent doctors, and some who were not fit to practice. In terms of ME, don't hold your breath waiting for a breakthrough to demonstrate its reality to the British medical establishment - you cant force open closed minds, and the political context of this is of course money and control. Can you imaagine what it would cost the NHS if it actually started treating ME patients - ACTUALLY treating? As Kuhn wrote in The Structure of Scientific Revolutions, the paradigm doesnt change until it reaches the right tipping point, and until then, all the contradictory evidence is ignored, as with the Newtonian/Einstein transistions in physics. Frankly, I feel pretty lucky they're not putting us into insulin comas as they used to in the 40's, or using ECT on us to rid us of our 'aberrant beliefs'. I cling on to the idea that what goes around comes around - yeah, Wessely, I'm thinking of you.....

 

[Waverunner]

I spent years in the health service working in addiction and managing services and pyschs. I worked with some excellent doctors, and some who were not fit to practice. In terms of ME, don't hold your breath waiting for a breakthrough to demonstrate its reality to the British medical establishment - you cant force open closed minds, and the political context of this is of course money and control. Can you imaagine what it would cost the NHS if it actually started treating ME patients - ACTUALLY treating? As Kuhn wrote in The Structure of Scientific Revolutions, the paradigm doesnt change until it reaches the right tipping point, and until then, all the contradictory evidence is ignored, as with the Newtonian/Einstein transistions in physics. Frankly, I feel pretty lucky they're not putting us into insulin comas as they used to in the 40's, or using ECT on us to rid us of our 'aberrant beliefs'. I cling on to the idea that what goes around comes around - yeah, Wessely, I'm thinking of you.....

You made a good point about Kuhn and I agree to 100%. As long as we don't reach that tipping point, some psychologists will use even most aberrant explanations in order to keep their wrong worldview.

 

[max]

Psychiatry and Psychology = lethal injection with a friendly smiley face concealing the shringe.


I wrote a great deal more, but decided not to post.

We have to end their involvement.

Withdraw your consent and refuse all shrink involvement in treatment.

However, I am biased because I have witnessed the devastating effects.

 

[Enid]

Sian at post 11 - I much appreciated a view from the inside so to speak - just hope the tipping point is well on the way now with all the latest research and findings. And "gods of the gaps" finally put in their ridiculous place.

 

[biophile]

I wanted to chime in with a limited defense of the involvement of psychiatry in ME/CFS, perhaps they have achieved something positive despite the negative? However, after spending some time thinking about it, I couldn't really come up with anything significant. Nothing that wasn't already known or couldn't have been done by any other mediocre epidemiologist or lab technician or psychologist. Can anyone seriously think of anything useful? I'm willing to listen, credit where it is due and all that. Routine psychiatric management that could be applied to any other medical patient experiencing psychological distress does not really count, I mean specific to CFS, what have CFS psychiatric researchers really achieved to warrant the persistent smugness despite that pillars of their models are looking increasingly questionable? Then we have to factor in the negative impact it has had.

 

[Enid]

I think the important concern is any notion of being "infallible" - 4 Docs in my own family (various specialities) who all accept we learn - we don't know everthing yet. And yet the psychiatric world lacking science finds itself full of certainty.

 

[max]

Hang on ....... there is this pearl of wisdom that was presented as part of the advice given to the MRC in 1992 - they still believe this apparently.

Shrinkage at its very best I would say.

.......... "Why is chronic fatigue so appealing to patients and their doctors? One factor must be that fatigue is difficult to disprove. There is a desire among patients and doctors to upgrade their symptoms in order to stay abreast of science. Virology and immunology are dynamic, progressive branches of science, and patients are irresistibly drawn to them in order to explain the mysterious origin of their symptoms. This is evidence of a somatization disorder, in which patients believe their symptoms, which are psychogenic in origin, are evidence of organic disease. Many patients and their support groups aggressively deny that CFS has any psychological component."

Priceless.

 

[Bob]

I think the important concern is any notion of being "infallible" - 4 Docs in my own family (various specialities) who all accept we learn - we don't know everthing yet. And yet the psychiatric world lacking science finds itself full of certainty.

Good points Enid. They have certainty and arrogance, even in the face of contradicting evidence.
If there was a little more humility, honesty, intellectual curiousity, and a genuine concern for the patients, then our lives would be a lot easier.