![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Dr. Bob on February 21, 2004, at 16:35:28
Hi, everyone,
I'm pleased to announce that Mr. Grimes, author of the book, "WILL at epicqwest.com: A Medicated Memoir", has agreed to be our guest from Monday 3/8 through Friday 3/12. He says:
> I've dealt with, and have thought a lot about, the effects of medication and mood disorders on creativity. Like, um, right now, I should be writing my novel, but my head's been a little fuzzy the past couple of days.
>
> Anyway, how this all figures into our lives, and our culture, is what WILL at epicqwest.com is about, so I'm happy to talk about it. Readers at least will find it pretty funny, amidst all the anxiety and searching for the right meds.
>
> My publisher has a web site for the book:
>
> http://[email protected]
>
> There are reviews, and on the subsequent page, which pops up after a few seconds, there's an interview with me, and a link to chapters 1-4.I guess the online equivalent of reading excerpts is posting them, so take a look at the above site. Or just buy the book. :-)
http://www.amazon.com/exec/obidos/asin/0971341575/drbobsvirte00-20
I think this should be interesting!
Bob
PS: Discussion about the how this works -- or doesn't -- is welcome, but should take place at Psycho-Babble Administration.
Posted by noa on February 22, 2004, at 10:44:34
In reply to Psycho-Babble Books Guest Author: Tom Grimes, posted by Dr. Bob on February 21, 2004, at 16:35:28
This sounds great. I found the amazon link but the link to his publisher's site doesn't work.
Posted by Tom Grimes on February 22, 2004, at 11:01:29
In reply to Re: Psycho-Babble Books Guest Author: Tom Grimes » Dr. Bob, posted by noa on February 22, 2004, at 10:44:34
Hi. I just checked in and noticed the message about the link to my publisher's site. It works for me, and that is the correct address.
If you have trouble, a web search for [email protected] also takes you to my publisher's site.
But Dr. Bob's link works from this end.
Best, TG
Posted by Dr. Bob on February 26, 2004, at 1:32:41
In reply to Re: Psycho-Babble Books Guest Author: Tom Grimes » noa, posted by Tom Grimes on February 22, 2004, at 11:01:29
Posted by shar on February 22, 2004, at 23:02:19
Sorry, this has me totally confused. I went to the site and saw there were Texas reviews (a good thing imho), but somehow I thought there would be an interview with Dr. Bob. Maybe the way the message from D.Bob is worded could be improved? Or, perhaps not.
Shar
Posted by Dr. Bob on February 26, 2004, at 1:37:13
In reply to Re: Guest Author: Tom Grimes « shar, posted by Dr. Bob on February 26, 2004, at 1:32:41
> > Mr. Grimes ... says:
> >
> > > There are reviews, and on the subsequent page, which pops up after a few seconds, there's an interview with me, and a link to chapters 1-4.
>
> somehow I thought there would be an interview with Dr. Bob. Maybe the way the message from D.Bob is worded could be improved? Or, perhaps not.You thought it would be me that was being interviewed? Or that I would be interviewing him? Sorry if I presented that in a confusing way!
Bob
Posted by tom grimes on March 8, 2004, at 17:34:55
In reply to Psycho-Babble Books Guest Author: Tom Grimes, posted by Dr. Bob on February 21, 2004, at 16:35:28
Hi. When I give readings, there's always this silence as people wait to ask the first question. So, I'll start with a thought. If you've read [email protected], you'll notice that the main character, Will, goes through several diagnoses. There's lot of information out there, which in the book becomes Information Sickness, or IS. As in -- is. To be. But one of the thing that has perplexed and interested me is the trends in diagnosis. Do they precede medication, or does medication define the illness by making it more treatable. For instance, right now I'm considering Trileptal. It isn't, of course, an FDA approved treatment for bi-polar I or II. And BP I/II are vanishing categories. Now it's more or less all bi-polar if there is any cycling at all. And Trileptal, which is an anti-convulsant, seems to work in terms of diminishing the cycles in both intensity and frequency. So, depression with normal or up periods seems to be on the wane. And my book asks the question, what if you're not able to figure all this out on your own? What if you're 19, or can't read all the literature? What if you can't understand all the information being thrown at you? I also just wanted to be funny. And while I'm thinking of it, if any of you live in LA, I have a short play going up on the subject of medication and despair in April/May. It will be performed with a new piece by Sam Shepard and several other playwrights. Anyway, feel free to ask me anything. Best, Tom
Posted by Phil on March 9, 2004, at 8:27:08
In reply to Re: Psycho-Babble Books Guest Author: Tom Grimes, posted by tom grimes on March 8, 2004, at 17:34:55
Tom, I haven't been reading nearly as much(actually, no books at all, lately)as I did pre-meds; especially before depression DX 20 years ago. I will read your book, though. Okay, I'll try. ALRIGHT, I'll at least read the jacket.
Timely post you've made. I was diagnosed with depression for all these years. A few weeks back, I presented with bipolar symptoms and find it hard to believe that pdocs far and wide have missed the ups and downs along with PTSD beacons I was sending. Maybe the DSM 'XII' will be one page before it's all over.
I think about the old souls(chronologically young)
that will travel the path many of us have. Although our conditions are 'gaining acceptance'(BS) according to many authorities, I see, hear, and experience as much discrimination as ever. Actually more discrimination because I don't 'hide' my illness. I won't get into the parity issues...grrrrrr. I will send up a prayer for the young.I'm kind of random today so I'll close this post.
I am glad you are here. Congrats on the play and the book: A bittersweet congrats.Phil
ps...Questions? Do you have a particularly embarrassing, ie. funny story that stands out in your mind in relation to a med SE manifesting itself publicly? I have a few and will share if you will.
pss...I 'will' read your book and good luck w/ the play. Peace
Posted by DSCH on March 21, 2004, at 9:28:20
In reply to Psycho-Babble Books Guest Author: Tom Grimes, posted by Dr. Bob on February 21, 2004, at 16:35:28
I have to say the synopsis of this book sounds eerily like my abortive graduate school experience, just without the sex and the James-Bond-villian. ;-) That would have at least made it viscerally exciting. :-p
Posted by Tom Grimes on March 21, 2004, at 14:03:33
In reply to Life imitating art imitating life » Dr. Bob, posted by DSCH on March 21, 2004, at 9:28:20
Sorry. Didn't mean to bring up any scary graduate school memories. The book didn't start out with any particular intent. I was just trying to make sense of my own loss of self. To me, Prozac seemed at the time to be just more information, more of the world's unorganized, or barely organized, chaos.
And I don't think psycopharmacology has answered this question of the self. If anything, it may have confused it. For eg, look in any pill book and for any drug like Prozac or Trileptal or Lamictaal the phrase "exact mechanism unknown." There are, say, eight to ten mood stabilizers currently on the market. It's guess work to say which one will work best for your if your BP. And then, if one works, exactly how it works is unknown.
So, the book came out of my thinking about the self. Am I more me before the pill, or after the pill? More me without it, or with it?
And I saw this, and felt it, as another aspect of information sickness, the melancholia that comes of having too many choices. No necessity, no truth.
PS: Phil, if you're reading this, I did send a long response to your post. Not sure why it didn't go through, and I didn't notice until some time afterward.
I'm happy to answer any posts that continue to come through.
Best, TG
Posted by DSCH on March 21, 2004, at 19:52:55
In reply to Re: Life imitating art imitating life, posted by Tom Grimes on March 21, 2004, at 14:03:33
>To me, Prozac seemed at the time to be just more information, more of the world's unorganized, or barely organized, chaos.
You might be surprised to learn that highly respected physicists have postulated that abstract information - bits or qubits (quantum-bits) - is the deepest ontological level, more fundamental than fields/waves/particles and space-time.
John Wheeler, "It from bit", in Sakharov Memorial Lecture on Physics, Volume 2, eds. L. Keldysh and V. Feinberg, Nova Science, New York, 1992
Holger Lyre, "C. F. von Weizsaecker's Reconstruction of Physics: Yesterday, Today, Tomorrow", http://arxiv.org/abs/quant-ph/0309183
> And I don't think psycopharmacology has answered this question of the self. If anything, it may have confused it.
Heh. Of course not. But nobody who's not a pseudo-scientific crackpot or an adherent of some religion is claiming that they have, no?
>For eg, look in any pill book and for any drug like Prozac or Trileptal or Lamictaal the phrase "exact mechanism unknown." There are, say, eight to ten mood stabilizers currently on the market. It's guess work to say which one will work best for your if your BP. And then, if one works, exactly how it works is unknown.
Biological systems are horrifically complex. If they were not they would not "be alive". If you throw out the notion of vitalism, you need to address the idea of how any living thing can "act on its own behalf".
http://www.edge.org/3rd_culture/bios/kauffman.html (cool video interview!)
> So, the book came out of my thinking about the self. Am I more me before the pill, or after the pill? More me without it, or with it?
You are you. Just different than before. ;-)
I believe most of what we refer to as consciousness is an illusory seemless screen over what is actually a very decentralized process. The purpose of the screen is to prevent us from being transfixed with the complexity of our inner perspective, seeing as we needed to hunt and gather/fight or flight rather than meditate for most of our history as a species.
H.R. Pagels, "Dreams of Reason"
M. Minsky, "Society of Mind"> And I saw this, and felt it, as another aspect of information sickness, the melancholia that comes of having too many choices. No necessity, no truth.
Life is good...
"Yes, but good for what? Power to do what?"
- Tom Wolfehttp://www.projo.com/words/story930.htm
Posted by Tom Grimes on March 21, 2004, at 21:24:21
In reply to Re: Life imitating art imitating life » Tom Grimes, posted by DSCH on March 21, 2004, at 19:52:55
Dear DS,
I'll check out the Kaufmann video; it wouldn't load at the moment. Thanks.
As for "exact mechanism unknown" you say:
Biological systems are horrifically complex. If they were not they would not "be alive". If you throw out the notion of vitalism, you need to address the idea of how any living thing can "act on its own behalf".
Granted. Hence, information sickness. Like chaos theory. A butterfly flaps its wings in Buenos Aires, there's a tsunami three days later in Tokyo.
Our psychological complexity may be our undoing. And, at the speculative/philosophical level, the loss of the Cartesian and Englightenment sense of self -- that it's a single, coherent, personalized structure -- may simply be the beginning of our cultural undoing. Maybe we're the pioneers!
Philosophy, of course, is no consolation on the down days of the BP cycle.
But doesn't vitalism -- the ability of any living thing to "act on its own behalf" mean that a living thing can act destructively, to the point of destroying itself. Why does the mind attack the mind? Of course, an answer may be that the mind is made up of discrete, competitive parts, one attacking the other w/o any sense of unity. Our minds may be subject to Darwin's law just as everything around it is.
As for this exchange:
> So, the book came out of my thinking about the self. Am I more me before the pill, or after the pill? More me without it, or with it?
You are you. Just different than before. ;-)
This could be rephrased: you are no longer you.
Difference itself implies a prior state or stability.
Notice that our political/military language is about stability. We want to stabilize a region. Same with BP. We want stability.
We don't treat the degree of cycling, say, just the nature of it. A little or a lot. Doesn't matter. Let's stabilize it. Which, of course, is another attempt at coherence, unity.
But, if I'm different than who I was before, then I'm different. Not a different me. Just different.
Finally,
I believe most of what we refer to as consciousness is an illusory seemless screen over what is actually a very decentralized process. The purpose of the screen is to prevent us from being transfixed with the complexity of our inner perspective, seeing as we needed to hunt and gather/fight or flight rather than meditate for most of our history as a species.
Right, we're mostly gaps. I don't believe there's a little Cartesian homunculus in our heads, like a driver behind the wheel of a car. More like, our head is the interstate. It's all those zillions of cars, each one a neuron. 90% function OK. 10% crash. Each goes its own way, if and when possible.
I think it's the idea of treating gaps that comes back to the phrase "exact mechanism unknown." If there's no unity, then the chances for predicting how adressing one gap, or one car crash, will effect the overall "system" becomes exponentially more difficult.
We all like CNS depressant meds for a simple reason -- they do something very simple, they depress the CNS in a pretty simple way. .75 mg of Xanax and, as Tom Wolfe said, "Life is good."
But it may be that the number of gaps in our psychological make up are breaking up the clarity of our "illusory seamless screen." As the world around us disintegrates -- the Englightenment saw its integration, in cultural/philosophical terms; we see terrorism, chaos theory, qubits of ontological information -- our notion of the human mind may as well.
Best,
T
Posted by DSCH on March 21, 2004, at 23:10:09
In reply to Re: Life imitating art imitating life, posted by Tom Grimes on March 21, 2004, at 21:24:21
> Granted. Hence, information sickness. Like chaos theory. A butterfly flaps its wings in Buenos Aires, there's a tsunami three days later in Tokyo.
Not really. That's an exaggeration.
Classical "chaos" breaks down into a simple concept: sensitivity to initial conditions.
If you can specifiy the phase space of a system at a time, t=0, with infinite precision, then you can both predict *and* retrodict the trajectory the system takes through phase space indefinately, and also with infinite precision.
Naturally, nobody - even with a classical system - is able to play the role of Laplace's daemon and accomplish this in practice. When nonlinear behavior is present, this means eventually the prediction and retrodiction from t=0 into the future and the past will diverge from behavior of the system as it gets/got measured.
However, the cool and interesting thing is that this doesn't mean the *prediction* for the system will always go berserk all over phase space, like the name "chaos" would suggest to the layman. Rather it can often be confined to a geometric figure of limited extension. This is called the attractor.
The system does what is going to do. Our predictions can be way off the mark as far as what the state is at a given time, but we can capture an overall picture of system's behavioral bounds through the mapping of the attractor.
Let's leave Werner Heisenberg out of this for the moment. ;-)
> Our psychological complexity may be our undoing. And, at the speculative/philosophical level, the loss of the Cartesian and Englightenment sense of self -- that it's a single, coherent, personalized structure -- may simply be the beginning of our cultural undoing. Maybe we're the pioneers!
Weren't the exisentialists already there in the 19th century? And Hume and Kant certainly demolished notions of having everything come together all hunky-dory via just a priori reasoning.
> Philosophy, of course, is no consolation on the down days of the BP cycle.
Yes.
> But doesn't vitalism -- the ability of any living thing to "act on its own behalf" mean that a living thing can act destructively, to the point of destroying itself.
That's not vitalism. That's the idea of living systems as autonomous agents. Perhaps someone would have a problem over whether that notion is really compatible with pure materialism or not. I won't go there now.
This idea of autonomous agents crops up in simulations of market behavior and other such things. The thing about these agents is that they always go for min-max behaviors on the assumption of rationality, minimize (risk, pain, etc.), maximize (profit, pleasure, etc.).
Needless to say this doesn't quite square with the human world yet.
>Why does the mind attack the mind? Of course, an answer may be that the mind is made up of discrete, competitive parts, one attacking the other w/o any sense of unity.
If the source codes (parental DNA) are bug-free (no predispositions to psychiatric disorders) and come through the duplication and publication process (sexual procreation) alright, and the system running the new code isn't subjected to treatment not covered by the warranty (illness, injury, extreme stress) we can expect it to not crash (engage in extreme self-damaging behavior).
>Our minds may be subject to Darwin's law just as everything around it is.
That's the whole idea behind evolutionary psychology (what Wilson would rather call sociobiology). A pretty self-evident one if you ask me, but it's politically radioactive.
> As for this exchange:
>
> > So, the book came out of my thinking about the self. Am I more me before the pill, or after the pill? More me without it, or with it?
>
> You are you. Just different than before. ;-)
>
> This could be rephrased: you are no longer you.Yeah, you got me there. But I don't see this as necessitating an identity crisis.
You can never step into the same river twice as they say. Does this then mean the concept of a river is thrown into crisis?
> Difference itself implies a prior state or stability.
Yes, the systems view again. A new attractor? Some EEG work shown in later editions of Sacks' "Awakenings" raises this possibility.
> Notice that our political/military language is about stability. We want to stabilize a region. Same with BP. We want stability.
Heh.
> We don't treat the degree of cycling, say, just the nature of it. A little or a lot. Doesn't matter. Let's stabilize it. Which, of course, is another attempt at coherence, unity.
Static systems are dead systems. So are random systems. Chaos is the knife edge where interesting things happen.
Look what happens when you become over-vigilant in preventing forest fires. The fuel load builds up and eventually a fire breaks out that cannot be maintained and you have a monster fire.
When you put a political situation into a pressure cooker and weld the safety valve shut things will eventually blow up. French revolution. WW1. Collapse of the Soviet Union.
This is another notion like "sensitity to initial conditions", it's called "self-organized criticality". Look up Per Bak on the Edge page for more on that.
Systems that survive for the long haul do so by adapting to changes rather than trying to prevent them.
> But, if I'm different than who I was before, then I'm different. Not a different me. Just different.
You have long-term memory. As long as that keeps functioning you have a certain amount of continuity as a human being, I would think. And there are other qualities too that are quite ineffable (more Sacks case studies I'm thinking of here).
> Right, we're mostly gaps. I don't believe there's a little Cartesian homunculus in our heads, like a driver behind the wheel of a car. More like, our head is the interstate. It's all those zillions of cars, each one a neuron. 90% function OK. 10% crash. Each goes its own way, if and when possible.
I am amazed it is as robust as it is though. It takes quite a lot to knock it off the knife edge altogether.
Anyway, macroeconomic activity does take place through such decentralized systems. Indeed decentralized ones work much, much better!
> I think it's the idea of treating gaps that comes back to the phrase "exact mechanism unknown." If there's no unity, then the chances for predicting how adressing one gap, or one car crash, will effect the overall "system" becomes exponentially more difficult.
Heh. Prediction. But the prediction is not the reality, is it? Anyway, we can get places by knowing how the global patterns can change.
> We all like CNS depressant meds for a simple reason -- they do something very simple, they depress the CNS in a pretty simple way. .75 mg of Xanax and, as Tom Wolfe said, "Life is good."
I'm not sure if I would feel that way about Xanax at all. Me being one of those people who function better on *stimulants*. ;-)
> But it may be that the number of gaps in our psychological make up are breaking up the clarity of our "illusory seamless screen." As the world around us disintegrates -- the Englightenment saw its integration, in cultural/philosophical terms; we see terrorism, chaos theory, qubits of ontological information -- our notion of the human mind may as well.
Certainly, we didn't evolve to be information-age city dwellers, and for many individuals this can lead to misery. On the scale of societies, it is clear that things will keep evolving and we can't predict where it will go exactly. That's the uncertainty that bears worrying about.
Posted by Tom Grimes on March 22, 2004, at 10:13:49
In reply to Re: Life imitating art imitating life » Tom Grimes, posted by DSCH on March 21, 2004, at 23:10:09
God, I've lost a really long response to your post. So, maybe just the end of what I can remember.
I agree with much of what you said. I do believe that chaos theory -- which as Lorenz would say finds "order masquerading as disorder" can help us find a new image for the "river" of long term memory, the "stream of consciousness" that seems to masquerade as our "self." Hume and Kant atomized Cartesian unity. Yet, we cling to the image of the unified self.
Who wouldn't? It's our illusion of security. And to bring this back to simple human suffering I mentioned that in the novel my character Will realizes when he can't save his mother's life that we're all essentially contingent, that we're here by chance, and that we're powerless to do anything about it.
And the sad and dispiriting thing about mental illness is that we have to observe our powerlessness as we lose, or tentatively hold on to, the one thing that gave us the illusion of power, that is, our sanity, our sense of self, our sense of inner continuity, stability, and familiarity.
And that's why it's so unnerving. We have to comprehend what's being lost, with what has been lost or eroded.
T
Posted by DSCH on March 22, 2004, at 10:56:49
In reply to Re: Life imitating art imitating life, posted by Tom Grimes on March 22, 2004, at 10:13:49
> God, I've lost a really long response to your post. So, maybe just the end of what I can remember.
:-)
> I agree with much of what you said. I do believe that chaos theory -- which as Lorenz would say finds "order masquerading as disorder" can help us find a new image for the "river" of long term memory, the "stream of consciousness" that seems to masquerade as our "self."
Yes. This could be a very fruitful way of looking at things. Maybe you should introduce yourself to the folks at the Santa Fe Institute (of which Kauffman is one of the Mandarins)? I'm sure they would love to converse with a novelist who has a philosophical bent and an interest in psychophrmacology, chaos, complexity, and non-linear systems.
>Hume and Kant atomized Cartesian unity. Yet, we cling to the image of the unified self.
How many people bother to digest anything at the level of say, Aristotle or Plato, let alone Kant? The vast majority of people absorb themselves utterly in polite society, religion, work, politics, or frivolous distractions that parade themselves today as media, news, and entertainment. To take the plunge into serious philosophy (and not the New Age obscurantist poppycock that is yet another form of comforting escape) marks one out as a rara avis. And guess what? You're a natural for visiting a psychiatrist eventually!
I love Hermann Hesse's description of the "Age of the Feuilleton" in the Glass Bead Game. It hits contemporary western culture dead on.
I recoil at the majority of what is called music today. For my own sense of self I have retreated into Haydn, Mozart, Beethoven, Bruckner, Mahler, and Shostakovich (hence the forum handle 'DSCH'). In them I see the balance one needs to strike between the static death (too much order) and the random death (not enough). Most pop music is random death.
> Who wouldn't? It's our illusion of security. And to bring this back to simple human suffering I mentioned that in the novel my character Will realizes when he can't save his mother's life that we're all essentially contingent, that we're here by chance, and that we're powerless to do anything about it.
Check out Lenny Susskind's video interview "The Landscape" on Edge too. Physics is starting to wrestle with the notion of inevitability vs. contingency. The traditional view (expounded most publicly by Hawking) has been the universe is the way it is because there just is not any other way for it to be. M-theory suggests an infinite number of possibilities out which we happen to just have this one we call our own.
I'm no big fan of string or M-theory however. "My little finger" tells me otherwise; if I can be allowed the temerity to cop a quote of Einstein's. ;-) Wheeler, Weizsaecker, and others strike me as more provacative.
However, if you stick with the Newton-Laplace-Einstein view of the universe, you are simply embracing a materialist version of Calvinism and free will and time are illusory sense constructs.
If you allow nature some stochastic wiggle-room, these things come back into the picture! Heh, now Heisberg may re-enter the room! :-)
> And the sad and dispiriting thing about mental illness is that we have to observe our powerlessness as we lose, or tentatively hold on to, the one thing that gave us the illusion of power, that is, our sanity, our sense of self, our sense of inner continuity, stability, and familiarity.
Mental illness is pernicious for striking at the root of the will and the self!
> And that's why it's so unnerving. We have to comprehend what's being lost, with what has been lost or eroded.
Having had a good treatment response, I believe things can be regained.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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