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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 35 to 59 of 85. Go back in thread:
Posted by noa on February 24, 2002, at 16:57:54
In reply to You won't believe this! » OldSchool, posted by spike4848 on February 23, 2002, at 18:50:28
See, to me, it didn't sound like the therapist is asking you to "trash" psychotherapy---it sounds to me like he is asking you to join the two forms of treatment for stronger effect!
I also am starting to wonder about how geography plays into this. I find myself wondering where y'all live that you are meeting psychiatrists who only like to do therapy! That is very different from my experience! Sure, there are some here and there who do therapy and very little medication, but most psychiatrists I've heard of are doing a lot of psychopharm and very little therapy. Has been this way for about a decade.
Or therapists who have had their heads in the sand for the past few decades and have a bad attitude about depression being a medical illness??? Not in my experience! On the contrary, most I've encountered see their role as providing what is often part of a total treatment plan that involves medication when indicated.
Every so often, I hear about therapists who do have a bad attitude about meds. A friend of mine extricated herself from a bad therapy situation in which the therapist's philosophy was that if you take medication you are avoiding the real issues and if you need medication you should be seeing a psychiatrist instead of her. She even communicated this philosophy in her printed literature. Personally, I think it is malpractice, but the way she actually worded the statement in print can be defended legally.
But for the most part, I think that therapist is not the norm in today's mental health world, at least as I've experience it. So that is why I asked about geography.
Posted by noa on February 24, 2002, at 17:11:12
In reply to Re: You won't believe this!, posted by OldSchool on February 23, 2002, at 19:32:49
>>I just cannot believe with the severe symptoms I have had that some people honestly believe that talking will make things better...
You are right. With my symptoms, too, talking would NOT make it better. Not without medication, anyway. But with medication, for me, the medication makes it better, but not better enough in the sense that there are things that medication cannot help me accomplish in the process of recovering from depression that therapy can and does.
But if you have had what sounds like an incredibly frustrating experience of working with professionals who suggested that therapy would suffice for you, then I understand the anger that I sense in your posts. That kind of thing can really be maddening, as though people are telling you that the incredible pain you are suffering will go away if you would only just work harder in therapy. That kind of thing is crazy making, to be sure. (but, per my previous post, don't discount the value of therapy just because you've had the misfortune of this kind of crazymaking treatment by some therapists).
The truth is that while I strongly believe that therapy can be a powerful healing part of treatment for some people, I know that for many of us, it is impossible to find it useful without establishing some kind of minimum "floor" of neurochemical functioning. For many of us, when we are very depressed, talking is pretty useless except to establish basic safety and support structures to get us through the low-functioning time. As successful as I believe therapy has been for me, it would not be so without my medication (and vice versa).
And it sounds like you are having a rough time finding the right formula of meds. I know from experience how frustrating and demoralizing that process can be. Many times, I thought it impossible to find something that would work for me, and it took a long time, but it did happen. For whatever that's worth. I guess I'm trying to be encouraging--keep the quest going.
Posted by Dinah on February 24, 2002, at 17:13:05
In reply to Re: To each his own...., posted by noa on February 24, 2002, at 16:43:46
That was a wonderfully articulate and well thought out post, noa.
Thanks!
Posted by noa on February 24, 2002, at 17:18:59
In reply to Re: Psychiatrists are Lazy .... again!, posted by OldSchool on February 24, 2002, at 14:44:58
Where is the brain science?
It is there! Brain science is in its infancy, is hte problem---whether you are talking about a psychological approach or a psychopharmocological/neurological approach (Andrew Solomon's "dart board"). But what is beginning to finally emerge is that the brain science IS showing that it is a two-way street between experiences/feelings/thoughts and physiology/neurochemistry.
Posted by spike4848 on February 24, 2002, at 20:36:52
In reply to Re: You won't believe this! » spike4848, posted by noa on February 24, 2002, at 16:57:54
> See, to me, it didn't sound like the therapist is asking you to "trash" psychotherapy---it sounds to me like he is asking you to join the two forms of treatment for stronger effect!
Quite the opposite. Most of his patients have been stuck in therapy for years without improvement. Now he has seen myself and one other patient who were aggressive with finding the right meds and now are back to normal. So he wants me to talk to these individuals who have been brainwashed into thinking "meds are bad/they just cover the problem" and "therapy is the only way to improve" and try to get them to get the meds they *NEED*.
I mean it is common sense. Your not going use *TALK* therapy for a diabetic to get his or her blood sugar back to normal and get them out of a diabetic coma! No, you going to give them insulin!
> I also am starting to wonder about how geography plays into this. I find myself wondering where y'all live that you are meeting psychiatrists who only like to do therapy! That is very different from my experience! Sure, there are some here and there who do therapy and very little medication, but most psychiatrists I've heard of are doing a lot of psychopharm and very little therapy. Has been this way for about a decade.
Actually quite the opposite again! I am from the north east USA were freudian therapy still is alive and well. Forunately, people are realizing *IT DOESN'T WORK* and get the help they need with medication.
Frankly, I think you and others by supporting the notion that "therapy is important" are prolonging the suffering of patients who listen to this crap.
Of course this is just my option as a physician and a patient.
Hope this helped.
Spike
Posted by spike4848 on February 24, 2002, at 20:41:23
In reply to Re: To each his own.... » noa, posted by Dinah on February 24, 2002, at 17:13:05
> That was a wonderfully articulate and well thought out post, noa.
> Thanks!I disagree. As I mentioned in my prior post, I think by supporting "talk therapy" you inadvertly prolong the suffer of other patients who listen to this crap. Are you going to treat a patient with asthma or diabetes with talk therapy .... of course not!
Hope this helped.
Spike
Posted by Dinah on February 24, 2002, at 21:08:22
In reply to I think that was CRAP! » Dinah, posted by spike4848 on February 24, 2002, at 20:41:23
My goodness, Spike.
You know, my post was directed to Noa, who obviously put a lot of effort into a very reasonable post backed up by a lot of science. I appreciated the thoughtfulness, and wished to tell her so. In fact, I wanted to post again after her other replies to compliment her for her compassion and empathy as well. I am quite impressed.
She explained her reasoning very clearly, did not use obscenities even once, and didn't resort to shouting down the people she was conversing with. Now that is what I call a dialogue. What is that commercial - something about "raising your voice when you should be reinforcing your argument"?
Now mind you, I am not a bit put off by your language. And you didn't insult me. I wish you had. I would have found that merely amusing. But now the Don Quixote in me is stirred. I do believe that you owe Noa an apology. In fact I find myself quite exercised over the entire matter.
I shall post no more about this. But if you have anything further to say to me, kindly say it about me.
Posted by Shar on February 24, 2002, at 21:35:02
In reply to Re: To each his own...., posted by noa on February 24, 2002, at 16:43:46
I think your first line here is invaluable, Noa. There is hardly any place where either-or, black-white thinking is useful or helpful. It must be the polar opposite of 'thinking outside the box.'
Shar
> And I think there is something wrong with either-or thinking.
>
> Our brains and the illnesses we have, are complex. Each of our brain illnesses, though called the same thing, might be quite different. What we call "depression" might in fact be a heterogeneous group of illnesses yet to be understood. And our brains are certainly quite complex and unique.
>
> The relationship between "nature" and "nurture" is only beginning to be understood, but there IS enough knowledge at this point in time to lead us to not think of it as either-or.
>
> Nature and nurture, psychological/emotional experience and physiology/neurology are constantly interacting and mutually influential. For each of us, the degree to which our psychology or our neurology is the most reasonable point of entry for intervention, is going to be different.
>
> The science/art of therapy is inexact for sure, but so is the science/art of psychopharmocology (The author of Noonday Demon likens it to a game of dart board).
>
> For some, medication only is the treatment of choice. For others, therapy only is the treatment of choice. For others still, a combination of the two is the treatment of choice. And there are many reasons for choosing one approach or another--all based on the needs of the individual.
>
> And, a comprehensive plan of treatment isn't just limited to therapy/and or medication. There may be other aspects to the treatment, like exercise, diet modifications, developing more social support, practicing meditation, etc. What works for me isn't necessarily going to work for you and vice versa, just as this is the case with our choice of which medication to take and how much.
>
> The recent PBS special on the brain (The Secret Life of the Brain) did a good job, imho, in its 4th episode, of illustrating just how intricately connected are feelings and thoughts and psychological experiences and physiology. They used PTSD to illustrate this--how the interplay between physiology and psychology lead to symptoms and how the interplay between the two can be harnessed in treating the symptoms.
>
> We are complex creatures and the complexities of our our brains function is something we are only beginning to understand. For me, the either-or approach just doesn't fit. It is true that I am so grateful for my medications--without them I would be dead. But if I were just on medication and not in therapy, I'd probably be dead too. And without therapy, I certainly would not be able to work through just how much this illness has caused me to suffer. Or to be able to take better charge of my life. Both forms of treatment have been essential for me in my recovery process. But I recognize that what works for my treatment may not be the thing that works for your treatment, and I fully respect that--we are each so unique that it would be impossible for me to assume that what works for me would necessarily be what works for you. I hope that you will be able to recognize that, too, and not dismiss the value of what has been valuable in my treatment, just because it is not necessary or valuable in your treatment.
Posted by OldSchool on February 24, 2002, at 21:41:43
In reply to I think that was CRAP! » Dinah, posted by spike4848 on February 24, 2002, at 20:41:23
> > That was a wonderfully articulate and well thought out post, noa.
> > Thanks!
>
> I disagree. As I mentioned in my prior post, I think by supporting "talk therapy" you inadvertly prolong the suffer of other patients who listen to this crap. Are you going to treat a patient with asthma or diabetes with talk therapy .... of course not!
>
> Hope this helped.
>
> SpikeSpike, unfortunately I hate to say this talk therapy/psychology mindset is so well lodged into mental health that it might take another hundred years to overcome. Too many people just cant comprehend what real mental illness is, too many people just cant deal with the fact everything you are originates in your brain. Your whole entire personality, thoughts, moods, emotions, feelings, SLEEPING, EATING, SEX AND COGNITION...its all CNS (brain) based and controlled.
Talk therapy and psychology has been romanticized in the past. Mental illness has been "intellectualised" going all the way back to Freud. Ive noticed women in particular go for this sort of thing, maybe because women just like to talk about themselves, I dont know.
I get frustrated too by it. I swear if I ever get better, Im going to do something about it. I might form my own lobby group or something, dedicated towards formally merging psychiatry into Neurology and ending this sick lie called psychiatry that masquarades as a branch of medicine.
Old School
Posted by Dinah on February 24, 2002, at 22:22:34
In reply to Re: I think that was CRAP!, posted by OldSchool on February 24, 2002, at 21:41:43
> Spike, unfortunately I hate to say this talk therapy/psychology mindset is so well lodged into mental health that it might take another hundred years to overcome. Too many people just cant comprehend what real mental illness is, too many people just cant deal with the fact everything you are originates in your brain. Your whole entire personality, thoughts, moods, emotions, feelings, SLEEPING, EATING, SEX AND COGNITION...its all CNS (brain) based and controlled.
>
> Talk therapy and psychology has been romanticized in the past. Mental illness has been "intellectualised" going all the way back to Freud. Ive noticed women in particular go for this sort of thing, maybe because women just like to talk about themselves, I dont know.
>
> I get frustrated too by it. I swear if I ever get better, Im going to do something about it. I might form my own lobby group or something, dedicated towards formally merging psychiatry into Neurology and ending this sick lie called psychiatry that masquarades as a branch of medicine.
>
> Old SchoolNow spike, here is an example of someone who is trying to be civil - a bit sexist perhaps, but civil. Thank you old school.
Now I really do love to talk about myself. You are right there. And I love to learn everything there is about myself. I find myself endlessly fascinating.
BUT, it would be a gross generalization to say that all women like to talk about themselves as much as I do. Just as it would be a gross generalization to say that all men like to compare the size of their..... suffering.
Other than that little point, I thought Old School's post was quite civil.
Posted by Zo on February 24, 2002, at 22:23:12
In reply to Re: I dont relate well to the mental health commun, posted by OldSchool on February 23, 2002, at 11:07:54
Wait a minute!
I was just over on Admin posting to your popping off at Judy1. .. only to find you'd already posted to me here in the same disrespectful way.
It will not do, Old School. It just will not do. You went off on a rant not only in ignorance of my usage of the word psychic, which is one thing, but--I find this more offensive--in order to do so, you had to ignore the thought behind the whole post. As if I had no meaning to convey at all. Just flapping my gums in the breeze. You manufactured something to disagree with, and you ran--in the exact wrong direction--in response to a post that was only underscoring your own.
A move I now regret. Get a grip.
Best,
Zo
Posted by spike4848 on February 24, 2002, at 22:28:11
In reply to Re: I think that was CRAP! » spike4848, posted by Dinah on February 24, 2002, at 21:08:22
Dear Noa/Shar/Dinah/PsychoBabbleMembers,
I apolized for the my choice of words. My posts are not intended to insult or offend anyone. I am truely sorry if I did insult or offend you. I really enjoy reading others views on things, I learn everyday on this board.
I am trying to voice my opinion to help others as well. But after reading your post, I realize my language was inappropriate. Sorry.
Please keep the dialogue going. I really do learn from everyone here.
Spike
Posted by spike4848 on February 24, 2002, at 22:30:15
In reply to Sorry for My Language Noa/Shar/Dinah!, posted by spike4848 on February 24, 2002, at 22:28:11
Posted by Dinah on February 24, 2002, at 23:08:41
In reply to Sorry for My Language Noa/Shar/Dinah!, posted by spike4848 on February 24, 2002, at 22:28:11
Well, as I said, you didn't insult me at all. And I can't speak for anyone else.
But it would be ungracious of me to refuse to accept such a gracious apology. It takes a big man to admit when he is wrong.
I'm not sure that I have anything further to offer this conversation, but I will read it with interest. And if I feel I can contribute in any way, I will be happy to throw in my $.02.
Posted by kiddo on February 24, 2002, at 23:21:47
In reply to Re: I think that was CRAP!, posted by OldSchool on February 24, 2002, at 21:41:43
> Spike, unfortunately I hate to say this talk therapy/psychology mindset is so well lodged into mental health that it might take another hundred years to overcome. Too many people just cant comprehend what real mental illness is, too many people just cant deal with the fact everything you are originates in your brain. Your whole entire personality, thoughts, moods, emotions, feelings, SLEEPING, EATING, SEX AND COGNITION...its all CNS (brain) based and controlled.
>Here we go again....since 'real' mental illness is a medical condition I don't understand why it's being discussed here...(you say it's medical) I reiterate, psychological issues can CHANGE things in the brain.
> Talk therapy and psychology has been romanticized in the past. Mental illness has been "intellectualised" going all the way back to Freud. Ive noticed women in particular go for this sort of thing, maybe because women just like to talk about themselves, I dont know.
>
Maybe by some it's been romanticized and intellectualized, but women bashing is a little extreme don't ya think? If that isn't a stereotype I don't know what is...seems to me there are plenty of men in therapy, plenty of others that should be, and still plenty others that like to talk about themselves, but, of course, maybe this is just one woman's view of hearing herself talk :-)> I get frustrated too by it. I swear if I ever get better, Im going to do something about it. I might form my own lobby group or something, dedicated towards formally merging psychiatry into Neurology and ending this sick lie called psychiatry that masquarades as a branch of medicine.
>
> Old SchoolI think it's great you want to stand up for what you believe in. What I don't understand is why you frequent a Psychiatrist's site for support if it's a sick lie. I'm surprised you haven't started your own discussion board about it. Care to enlighten me?
Kiddo
Posted by Dinah on February 25, 2002, at 0:50:27
Old School,
I am going to say now what I was trying very hard not to say in my early posts, because I thought, rightly or wrongly, that saying it might hurt you. I based that conclusion solely on my experience with my father, and you really do remind me of him. So if I'm wrong, please forgive me for being mistaken. And if I'm right, please forgive me for saying it.I hear the pain behind your anger and it saddens me that you have to feel it. I know the pain that both results in and results from either/or thinking and it is very deep. And I know the pain that results from alienating those who want to reach out to you and I wish sincerely that I could stop you from making that mistake. There are very kind people on this board, people who have in fact, said this more plainly than I have, since oddly enough I was trying to spare you my compassion. But I do have compassion for you and your very real suffering. It must hurt so bad to be so full of rage.
So I really did try to explain the real benefits people find in therapy. And I really did understand your need to vent your frustration. And I really was happy when I "heard" you laugh on the admin board.
And I really do hope that neither you nor Spike think that I was being hurtful or sarcastic to you. I was really just trying to protect you.
That being said, I also have very real compassion for those who are hurt by your assumption that their pain is not equally real and deep. I'm not sure you understand that that is the message they are getting from you.
Now if I'm right, and you are like my dad, I'm guessing you'll be very angry by this post and go on the offensive. And I want you to know that that's OK with me. I really do understand where that anger comes from. No one likes to be vulnerable. Just target it at me, please.
And if I'm wrong, and you are nothing like my dad, perhaps we can lower the tone a bit and have a real discussion.
And this is an interesting exercise in complete and total honesty.
With all sincerity,
Dinah
Posted by spike4848 on February 25, 2002, at 7:15:22
In reply to For Old School (and Spike too), posted by Dinah on February 25, 2002, at 0:50:27
Hey Dinah,
Thank you so much for your concern. That was a beautiful post.
I realize some of my posts have the undertones (or overtones for that matter) of angry. This stems from my first depression in medical school. I was told by a pdoc that I needed to talk out my problems and that medication was harmful. So I tried therapy without any meds for a year. I suffered so much and my condition worsened.
I finally switched doctors, and once I started nardil, I was back to normal .... no therapy needed.
I see this everday in my office as well. Patients who are endure years of therapy without benefit and worsening of there disease. Some of these patient actually give up hope and commit sucide. Once I properly medicate them, and I am an internal medicine doctor-not a pdoc, they are so much better.
So my anger does not stem from personal pain, because I feel good on nardil. It stems from frustration of see other suffer.
Thanks again.
Your Friend (I hope),
Spike
Posted by noa on February 25, 2002, at 7:42:55
In reply to Re: To each his own.... » noa, posted by Dinah on February 24, 2002, at 17:13:05
Posted by noa on February 25, 2002, at 7:43:17
In reply to Re: To each his own.... » noa, posted by Shar on February 24, 2002, at 21:35:02
Posted by Dinah on February 25, 2002, at 7:44:41
In reply to No, thank you so much! » Dinah, posted by spike4848 on February 25, 2002, at 7:15:22
Hi Spike,
I really appreciate that you took this post in the spirit it was intended. I hope Old School did as well. It is really scary to be so open.I'm sorry you and your patients have had such bad experiences with therapists. For what it's worth, my experience and the experience of many many others is much different. My therapist referred me for medications almost immediately, seeing clear signs of OCD, although the possibility had never occurred to me. And when I fought the idea of medication, he was the one who convinced me to take it. Perhaps we can all agree that there should be a pox on all bad therapists.
In reading your posts last night on Admin, I was struck by what a good friend you were trying to be to Old School.
Gee, I feel the need for a group hug. But I guess that's because I'm a girl. (That was a joke by the way.)
Best wishes,
Dinah
Posted by noa on February 25, 2002, at 8:03:22
In reply to Re: I think that was CRAP!, posted by OldSchool on February 24, 2002, at 21:41:43
Your post suggests that I and others who disagree with you don't really understand mental illness. Just because I disagree with your all or nothing stance, must you dismiss me as somehow ignorant? The implication is that we who have different views are ignorant both of the science and of the firsthand knowledge of what it is to suffer with mental illness, both implications being wrong.
Posted by jane d on February 25, 2002, at 9:38:07
In reply to No, thank you so much! » Dinah, posted by spike4848 on February 25, 2002, at 7:15:22
Spike,
I'm curious about this. Statistically it seems likely that some of the professionals I deal with probably share a few meds with me but none of them has every said so. I would think that it would make patients feel a little less stigmatized. Of course, I'm not making general announcements to my co workers either.
Jane
Posted by NikkiT2 on February 25, 2002, at 10:27:57
In reply to Sorry, but that is plain *NONSENSE*! » noa, posted by spike4848 on February 24, 2002, at 20:36:52
I think you're taking this a little too far.. i agree whole heartedly that talk thereapy won't help me.. I don;t have issues...
BUT, I do have ingrained behaviours from dealing with my crap for so long, so I do believe a behavioural therapy such as CBT will help me...
i saw a therapist for one appointment, and she was sooo freudian she made me want to shout and scream at her.. how dare she blame my upbringing and my parents care..
Only got one appointment on the wonderful (!!) National health Service in the Uk though!!!I'd give therapy a try if it was offfered to me now, as I am so bloody desperate I will try anything.. i believe that if you've lived with it all long enough, and feel desperate enough, you will try ANYTHING... Don;t rule something out before you've tried it just cos you don;t think it will help.
Nikki
Posted by NikkiT2 on February 25, 2002, at 10:31:37
In reply to Re: I think that was CRAP!, posted by OldSchool on February 24, 2002, at 21:41:43
"Ive noticed women in particular go for this sort of thing, maybe because women just like to talk about themselves, I dont know. "
WHAT THE FUCK???????????????????????????? Now, I ahve been supporting you in this, but please, do not make your argument count for nothing with pathetic statements like this.
It makes you look a pointless, young, idiot with nothing good to say.
Nikki
Posted by OldSchool on February 25, 2002, at 11:13:36
In reply to For Old School (and Spike too), posted by Dinah on February 25, 2002, at 0:50:27
> Old School,
> I am going to say now what I was trying very hard not to say in my early posts, because I thought, rightly or wrongly, that saying it might hurt you. I based that conclusion solely on my experience with my father, and you really do remind me of him. So if I'm wrong, please forgive me for being mistaken. And if I'm right, please forgive me for saying it.
>
> I hear the pain behind your anger and it saddens me that you have to feel it. I know the pain that both results in and results from either/or thinking and it is very deep. And I know the pain that results from alienating those who want to reach out to you and I wish sincerely that I could stop you from making that mistake. There are very kind people on this board, people who have in fact, said this more plainly than I have, since oddly enough I was trying to spare you my compassion. But I do have compassion for you and your very real suffering. It must hurt so bad to be so full of rage.
>
> So I really did try to explain the real benefits people find in therapy. And I really did understand your need to vent your frustration. And I really was happy when I "heard" you laugh on the admin board.
>
> And I really do hope that neither you nor Spike think that I was being hurtful or sarcastic to you. I was really just trying to protect you.
>
> That being said, I also have very real compassion for those who are hurt by your assumption that their pain is not equally real and deep. I'm not sure you understand that that is the message they are getting from you.
>
> Now if I'm right, and you are like my dad, I'm guessing you'll be very angry by this post and go on the offensive. And I want you to know that that's OK with me. I really do understand where that anger comes from. No one likes to be vulnerable. Just target it at me, please.
>
> And if I'm wrong, and you are nothing like my dad, perhaps we can lower the tone a bit and have a real discussion.
>
> And this is an interesting exercise in complete and total honesty.
>
> With all sincerity,
> DinahDinah, the above post is exactly what Im complaining about. It is full of these psychological concepts about "pain" and blah blah blah. I read your post and it made me want to yawn. Its full of these vague psychological ideas that have nothing to do with mental illness. You arent listening to what Im saying in my posts. I mean what I say. You are overanalyzing my posts and reading psychological stuff into it. All Ive been saying is that I cant relate well to the usual mental health spiel because these sorts of problems are typically not thought of as "real" physically based problems. And from my perspective its a very real and very physical illness.
Im just saying I dont understand why mental illness isnt being treated by Neurology instead of psychiatry. I dont understand why others cant see the simple fact that this stuff is basically a disease of the nervous system. Not psychobabble.
We have all been brainwashed into thinking these problems are psychological or emotional issues, when in reality its pure Neurology stuff. Again, poor sleeping that goes hand in hand with severe depression is not caused by "issues" its caused by some physical Central Nervous System process run amok and is broken and needs to be fixed medically. Who studies sleep? Neurologists. All sleep labs are run by Neurology. Duh.
Please dont analyze it like you are doing and put all these psychobabble terms into it. Im just saying that maybe, just maybe if the doctors who treat serious mental illness were more well versed in Neurology and the brain rather than psychobabble, maybe more patients would recover.
Old School
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