The Role of Culture in Mental Illness

[lucie]

I recently read the following article in Atlantic Monthly (warning - this article is about the obsession with becoming an amputee and is not for the easily disturbed):

http://www.theatlantic.com/issues/2000/12/elliott.htm

(I really have two questions, but will put the second one in another thread.)

In the third part of the article, the issue of how culture may create or define a mental illness came up. An example used in the article is the sudden epidemic of multiple-personality disorder in the 1970's. By classifying this disorder, attaching it to the rising awareness of child abuse, developing a treatment, and especially by making it a high-profile disorder, did psychiatry and the popular culture create a niche, an environment in which a previously rare/unknown condition could spread? Did it merely bring an already existing condition to light? Did it create a new diagnosis that psychiatrists and other doctors could slap on a wide variety of pathologies? Did people find a new way to "go mad", developing symptons they would not otherwise have manifested if they did not hear of them?

I'd be interested in hearing from dopers in the mental health field or educated laypersons. I found this article fascinating and disturbing, and the conclusions made sense to me, but I have little education in field and would like to get other opinions.

[BunnyGirl]

I'm not making claims about being an educated layperson but my Psychology class I'm taking this semester (and yes, it is beginning Psychology) covered this to a small degree. The book we used felt it was a combination of both: those who are hungry for attention claiming a disorder and those who can be correctly classified. (This is my paraphrase).

It's been an interesting class.

[AHunter3]

did psychiatry and the popular culture create a
niche, an environment in which a previously rare/unknown condition could spread

Yeah, in the same sense that Jack the Ripper and Charles Manson "created a niche" in which murder "could spread".

[BunnyGirl]

Well, I just read most of the article and if I was a truly disabled person, the idea of someone actually wanting to become disabled would offend me to the core.

Reading through some of the stories, you've got to wonder if some of it isn't a conditioned response some how (behavioralism). I'm thinking of the guy in the story that said since the age of 17, he's been highly aroused by women's deformed feet. That's a very sexual age; I wonder what the circumstances are surrounding that experience.

Again, I'm no expert and make no claims to be. Our resident experts will confirm that! . Interesting article.

[Ptahlis]

In my mind there is some doubt as to the veracity of most claims of Multiple Personality Disorder. A pretty good article with links to articles on both sides of the debate can be found here:

http://www.skepdic.com/mpd.html

Much of what can be said about MPD sounds a lot like the criticisms that have been leveled against the repressed memory phenomenon. These, along with other "illnesses" give me a very dim view of psychology as a discipline. It is often extremely subjective, non-rigorous, and very liable to causing as much damage as it helps alleviate.

[AHunter3]

Phthalia:

It is often extremely
subjective, non-rigorous, and very liable to causing as
much damage as it helps alleviate.

You said that really well! Mind if I use that?

[lucie]

I wonder if there is a similarity to hypochondia. I've heard of (but not being in the field I cannot confirm) that a hypochondiac may hear about the symptoms of a new disease and claim to have the symptoms, and in extreme cases even develop the symptoms. I was intrigued by the idea of a vague, unnamed, free-floating interest or desire suddenly manifesting as a full-blown textbook case of some mental illness because it now has a name and a support group. Sort of like the sugar in a solution forming crystals around a piece of string.

[Ptahlis]

Originally posted by AHunter3
Phthalia:

You said that really well! Mind if I use that?

Be my guest AHunter3. Just change "causing" to "cause" so I sound better!

[Zenster]

Without having read the cite in the OP, I will venture to say that "culture" has had a lot to do with mental illness. Current American culture is only now emerging (and slowly at that) from many decades of totally dysfunctional mindsets. A quick glange at the wreckage due to the notion that; "If it doesn't hurt, it can't be love." is all that is needed to see why so many women continue to cling to abusive relationships.

This is but a small example of a much larger malaise. The lack of a rational philosophy, as taught both in schools and at home, not to mention the all too often total lack of a philosophy of any sort, has begat a society fraught with homicidal children. The money obsessed careerists whose lives ring with the cracked and hollow belltones of vacuous existence are a sterling example.

One look at generation X and it's almost total lack of inspiration or direction is all that is needed to affirm this notion. The recent uptick in self mutilation ("cutting") should sound a clarion blast of warning to the adults in this world that things have gone off the rails in a drastic fashion. Too often people are willing to turn away from such pathology solely because it does not seem to intrude into their lives in any substantial manner.

Yet, these same people complain of not being able to walk out at night anymore. The connection is not being made between the almost total lack of community in the inner cities and the amount of anonymity and impersonal attitude that prevails. Culture is supposed to enlighten. Yet, with the lowest common denominator broadcasting we have, instead, there has been brought about a culture of nihilism (if such a thing is possible).

The lack of personal responsibility shown by people who drive or walk past those in distress or need is a hallmark of the festering self-absorption that so many indulge in. Until culture unites in the pursuit of knowledge and liberation from the opaque void of unenlightened self interest we will continue to be plagued by so many of the evils that modern society has bred out of the cauldron of ignorance and intentional avoidance.

In a word, yes, culture is quite capable of becoming the breeding ground of mental illness. The schistic and duplictious nature of religions that simultaneously preach altruism and intolerance are but one example of the many fractures in the bedrock of our society. Parents whose children are mere trophies of their all consuming carreers should not be too surprised when those same children manifest severe antisocial behaviors. The all too frequent emotional vacuum of broken homes and cattle yard schools that our children endure inculcate them with a mentality of "me-first" and mind games that will haunt society for many years to come.

[mbh]

Culture often determines how behaviors get diagnosed. The AMA used to consider homosexuality to be a mental disease; now it's an alternate lifestyle. A kid with a gun used to be a disciplinary problem; now he's a psychosocial problem. The line between odd behavior and illness can be awfully blurry.

[They Call Me Sneeze]

hysteria.

that's what it is.

in class today (its a nonfiction writing class, taught by the head of the psychiatric department at the hospital - suffice to say that while the class might not know what is going on, the professor sure as hell does) the prof was talking about this.

there is no such thing as multiple personality disorder. instead, when a disorder all of a sudden gets in the spotlight (like MPD did after "the three faces of eve" and "sybil") some people start to manifest symptoms of the disorder. they claim they have multiple personality disorder, but in fact, they are hysterical.

hysteria is a behavioral disorder whereby sufferers unwittingly mimic (to use my prof's words) the symptoms of a disease, or what the imagine the symptoms of a disease to be. they're not faking it, per se - they are really convinced that they have, as an example, multiple personalitis swimming around in their head.

if the psychatrist/ologist 'ignores' the multiple personalties (by only recognizing the original person, for example) the other personalities will fade away into nothingness. this contrasts with a mental disorder like depression which, if 'ignored,' will most certainly not disappear.

another example of hysteria is found back in the old days, when people always thought they were being possessed by devils, or witches, esp. during the salem witch trials. because people who were possessed, and possession itself was receiving lots of attention, many, many young girls jumped forward as victims of possession, when, in reality, they were 'unwittingly mimicking' what the imagined possession to be like. [incidentally, almost all people who get hysterical in this manner are young girls. no one knows why.]


hysteria is not to be confused with hypochondria, however. in hypochondria, the person THINKS they are ill "doc, i think i have cancer." [doc does some tests, they come out ok, tells patient he is cancer free, and then] "thank you doc, thank you." then, of course, next week the same guy thinks he has arthritis, or something. with hysteria, the patient will be showing actual symptoms - if they say they are paralyzed, for example, they will not be able to move; self delusion can be a powerful thing.

anywho, yes, society can influence new pseudo mental disorders - whenever a new one comes into vogue, as it were, there will be people who become convinved that they have it.

[AHunter3]

There is no such thing as multiple personality disorder.
instead, when a disorder all of a sudden gets in the
spotlight (like MPD did after "the three faces of eve"
and "sybil") some people start to manifest symptoms of
the disorder.

Doctors as well as would-be patients are susceptible to this, and there is also no such thing as schizophrenia.

[They Call Me Sneeze]

except they have found physical abnormalities in the brains of people with schizophrenia, which kind of make it seem like schizophrenia is an actual disease.

one of the biggest problems facing psychiatrists/ologists is that many of the disorders they study and treat dont have a discernable pathology, and so by finding one (or, as in the case of schizophrenia, finding some physical element of the disease) they get a step closer to bringing the field of psychiatry up to the rest of the medical field.

not to say that some people who claim to be schizophrenic aren't suffering from hysteria, but schizophrenia is one of a very few mental disorders which they have actual physical proof of its existence.

[Geek Mecha]

Hysteria? Still hung up on Freud, are we? It's only been, oh, about eighty years...

There is such thing as multiple personality disorder. It was renamed a few years ago, and is now known as DID-- dissociative identity disorder. It's far less prevalent than movies would have us believe, but it does exist. A genuine case is simply rare.

And although I haven't read very much on the treatment methods for DID, it sounds incredible to me that any psychiatrist worth his salt would "ignore" any aspect of his patients' illness.


AHunter3-- I'm going to read your link more thoroughly in a second, but I will admit, it'll be tough to convince me that schizophrenia doesn't exist. As many types as there are, as long as it's been around and been studied and treated, and as frequent and widespread diagnoses of it are, it'll take one heck of an argument to get me thinking otherwise.

[AHunter3]

Sneeze:

except they have found physical abnormalities in the brains of people with schizophrenia, which kind
of make it seem like schizophrenia is an actual disease.

one of the biggest problems facing psychiatrists/ologists is that many of the disorders they study and
treat dont have a discernable pathology, and so by finding one (or, as in the case of schizophrenia,
finding some physical element of the disease) they get a step closer to bringing the field of psychiatry
up to the rest of the medical field.

Which is of course the goal.

[lesa]

Schizophrenia is not the same thing as Multiple Personality Disorder.

http://www.surgeongeneral.gov/librar...ter4/sec4.html - "schizophrenia is neither “split personality” nor “multiple personality.” Furthermore, people with schizophrenia are not perpetually incoherent or psychotic"

[BunnyGirl]

I believe the physiological aspect of schizophrenia is the difficulty of dopamine uptake/use at the synapses.

::checking notes::

Yup, that's what my class notes say.

They've also found a clear genetic link to the disease too (not necessarily a gene, per se, but a genetic link for the disease - did that make sense??).

Anyone read that book "I Know This Much is True"? Novel 'bout a guy whose twin brother is a paranoid schizophrenic. Got half way through and wandered away from it, but it was excellent.

[puddleglum]

I think culture has a big impact on mental illness. You can look into the history of psychology and find different illness proliferating at different times. The hysterias Freud was dealing with are almost unknown today while some of the disorders that are very common today, such as OCD, very virtually unknown in the past.
Here is an article that posits the explanation that all psychological disorders are all different manifestations of the same problems.
http://www.wglasserinst.com/chemistr.htm

[egkelly]

What about the so-called "alien abduction" phenomenon-how could any rational person believe this crap? yet a very respected harvard psychiatrist (Dr. mack)? was totally taken in by this nonsense.
I'd say a lot of what is called "mental illness" originates in the brains of psychiatrists!

[They Call Me Sneeze]

AudreyK said:

"And although I haven't read very much on the treatment methods for DID, it sounds incredible to me that any psychiatrist worth his salt would "ignore" any aspect of his patients' illness."

ok, maybe 'ignore' was a bad choice of words without providing an explanation. say a girl comes in suffering from anorexia and MPD/DID. she goes on and on about her different personalities, switching back and forth, and the doctors say to her 'well, the MPD is too hard for us to treat right now - we'll just concentrate on the anorexia.' so they do - they 'ignore' the MPD by, for example, like i said, only speaking to the original girl and not her other 'personalities,' and by claiming that they are only going to treat the anorexia.

so, as the weeks go by and the patient starts gaining weight, the claims of MPD slowly start to diminish until, finally, they disappear.

if no one pays attention to the MPD it goes away. that is what i meant by 'ignore.' like when you have a three year old throwing a tantrum, and you ignore it, you'll stop it a lot quicker than if you pander to it.

[lucie]

egkelly - you read my mind - I was going to bring up the alien abduction scenario. I'm sure there are a lot of dopers out there who have read Carl Sagan's "The Demon-Haunted World", a book which deal with (among other things) the whole alien abduction epidemic, and it's point-by-point similarities to demon possession, seeing elves & fairies, and other cultural phenomena. Same symptoms, different cultural interpretation. Once you get a bunch of people with degrees declaring it to be so (loudly, often, and in a news-worthy way), suddenly everyone who has had a similar, and apparently quite common and normal experience has been abducted by aliens.

[AHunter3]

Schizophrenia is not the same thing as Multiple Personality Disorder

Sorry, I should have realized that folks would think I meant to imply that it was. I mentioned schizophrenia specifically mainly because it is the oldest still-extand psychiatric diagnosis, and because I used it as the "example diagnosis" in the paper I cited in the link.

Admittedly, the topic of mental illness / psychiatric treatment is the one that gets me on my soapbox quickest loudest and for the longest time

::having said that::

I believe the physiological aspect of schizophrenia is the difficulty of dopamine uptake/use at the synapses.

Oh, is that once again a theory considered current and reputable? That was popular a couple decades ago, and then they switched their attention to serotonin. They are ALWAYS right on top of being able to make a physiological explication of schizophrenia (any day now, for the last 100 years), but it continues to be a very badly defined illness, diagnoses on the basis of behavior alone, for which sufficient reliable data is still lacking for being able to say with any certainty much more than "It would appear that the population of people who seem to have aberrant thinking processes have some small but statistically significant differences in their brains from those who do not." (well, duh!)

[Zenster]

The only coherent theory concerning schizophrenia that I have ever seen was covered in the book;

"The Origins of Consciousness in the Breakdown of the Bicameral Mind"

by Julian Jaynes. Has anyone else here read this? It is a superb treatise on the function and origins of consciousness and also gives an explanation of that other psych boondoggle, hypnosis.

Jaynes' theory that schizophrenia is merely a revision to an older form of non-conscious behavior is quite compelling and the evidence that he provides makes his case very well. If you read this book you will not look upon history or the human mind quite the same ever again.

[Dr.Pinky]

Originally posted by BunnyGirl
I believe the physiological aspect of schizophrenia is the difficulty of dopamine uptake/use at the synapses.

This is a popular theory, especially with people involved at the chemical dependency end of the spectrum. However, according to "The Biochemical Basis of Neuropharmacology" (p. 332) "Although there is a lot of data that supports the dopamine hypothesis, at present we have no direct experimental evidence of an excess of dopamine-dependent neuronal activity or an elevation of dopamine levels at central synapse in schizophrenics."

[BunnyGirl]

quote:

Originally posted by BunnyGirl
I believe the physiological aspect of schizophrenia is the difficulty of dopamine
uptake/use at the synapses.



This is a popular theory, especially with people involved at the chemical dependency end of the spectrum.
However, according to "The Biochemical Basis of Neuropharmacology" (p. 332) "Although there is a lot of data
that supports the dopamine hypothesis, at present we have no direct experimental evidence of an excess of
dopamine-dependent neuronal activity or an elevation of dopamine levels at central synapse in schizophrenics."

Well, told ya I wasn't an expert! It's all pretty interesting though, isn't it?

[Maeglin]

lucie, if you are seriously interested in this question, you should read Michel Foucault's Madness and Civilization.

[dal_timgar]

by the insanity it produces?

i would be inclined to wonder if warlike cultures would be more likely to produce this desire for amputation because a peaceful culture might have fewer amputees and no need to glorify heroism. didn't read the entire article but wonder now if more men or more women want amputations.

i southeast asia they have panics of men fearing their penis will be shrink into their bodies. read of cases of people having someone hold their penis while they slept.

a culture has to put wierd ideas into peoples heads in order for them to get ridiculous about it. can the american love affair with the automobile be included as a cultural insanity? no that's NORMAL.

Dal Timgar

[Dr.Pinky]

Random observations from an addled perspective:

EVERYBODY has multiple personalities. (I myself have 28.) It’s only a problem if it’s a problem (if you have conflicts integrating them on a day to day basis). A solitary, unifying "I" is a lovely fiction.

Brain chemistry is a part, but not the whole story. Environmental factors tend to be overlooked in treatment. The CIA has been studying was of inducing symptoms of mental illness in otherwise “healthy” people with rousing success for 50 years now. Also, people with equal genetic predisposition and brain chemistry deficiencies: one will develop schizophrenia, the other won’t. That’s a big riddle.

Originally posted by AHunter3

Admittedly, the topic of mental illness / psychiatric treatment is the one that gets me on my soapbox quickest loudest and for the longest time

Me too! lucie, be my sock puppet!

[lucie]

Okay, on the subject of my OP, talk to me about treatment. Should the desire to amputate a limb be regarded and treated as a mental illness with therapy alone, therapy with drugs, therapy with surgery (amputation, not a lobotomy)? Or should it be regarded as an identity issue (once a diagnosis of , I don't know, otherwise normal? is pronounced) and amputation permitted as cosmetic surgery?

If someone came to you and said their HMO referred them to you because they wanted to amputate both legs at the knee and would only do the surgery if you signed off on it, what would you do? How would you treat them?

The more I think about this issue, the fuzzier the lines seem, once over the initial yuck reaction. How different is wanting a limb removed (psycho alert!) from wanting a sex change (nature screwed up, we must fix this person)?

[Geek Mecha]

They Call Me Sneeze--

Wait a minute. You've complicated things with this example:

say a girl comes in suffering from anorexia and MPD/DID. she goes on and on about her different personalities, switching back and forth, and the doctors say to her 'well, the MPD is too hard for us to treat right now - we'll just concentrate on the anorexia.' so they do - they 'ignore' the MPD by, for example, like i said, only speaking to the original girl and not her other 'personalities,' and by claiming that they are only going to treat the anorexia.

so, as the weeks go by and the patient starts gaining weight, the claims of MPD slowly start to diminish until, finally, they disappear.

Are we talking about someone with only DID, or are we talking about someone with DID and another psychological problem on top of that? Granted, we were vague when we talked about ignoring "aspects" and "symptoms" of their illness, but I wasn't expecting you meant the symptoms of an entirely different illness altogether.

Furthermore, given how difficult it can be to treat anorexia, I don't think it's a good example of an compounding mental illness.

Anyway. I'm no expert in any branch of psychology, so I'm just guessing here. But I seriously doubt that even with patients with two distinct psychological conditions, that any doctor would ignore anything about that patient. If there was such an unfortunate patient who suffered from both DID and anorexia, my guess is that the illnesses would be tackled concurrently, and that more than one psychiatrist and/or psychologist would be involved. And although they'd be working together (communicating, exchanging notes, etc.), each would focus on one disorder.

if the psychatrist/ologist 'ignores' the multiple personalties (by only recognizing the original person, for example) the other personalities will fade away into nothingness. this contrasts with a mental disorder like depression which, if 'ignored,' will most certainly not disappear.

if no one pays attention to the MPD it goes away. that is what i meant by 'ignore.' like when you have a three year old throwing a tantrum, and you ignore it, you'll stop it a lot quicker than if you pander to it.

I still don't buy it. Are you saying that the only reason the disparate personalites existed before the person sought treatment for it was because he/she was paying attention to them? The problem I have with that is that it suggests that the person is an observer to his personalities at some root level. DID doesn't work that way.

Or do you mean that if other people (such as family, friends, and doctors) ignore the personalities, they'll go away and the person will be "themself" again? I don't accept that either. You're saying that the other personalities will simply dissolve out of feeling unwanted or from lack of use. I doubt that that will work either; my guess is that the person with DID would just walk away and cut you out of their lives. That treatment also approach doesn't address what may have caused the personalities to distinguish themselves in the first place, and it places no safeguards against relapse.


lucie--

In the third part of the article, the issue of how culture may create or define a mental illness came up. An example used in the article is the sudden epidemic of multiple-personality disorder in the 1970's. By classifying this disorder, attaching it to the rising awareness of child abuse, developing a treatment, and especially by making it a high-profile disorder, did psychiatry and the popular culture create a niche, an environment in which a previously rare/unknown condition could spread?

I think DID just became the hot diagnosis-of-the-moment. It caused doctors to re-examine their patients and patients to take a look at themselves and wonder if that disorder was what they had. Since it was early into DID's discovery and little was known about it, people could have been mistakenly diagnosed. (To know for sure, though, we'd need the numbers of how many people were diagnosed with DID, and then how many later had their diagnoses changed.)

Patient reactivity to DID could also be responsible for the sudden increase in diagnoses. It's not unheard of for people to read about the symptoms of an illness and start seeing those symptoms in themselves; this is called medical students' syndrome. Given that, I don't think it's too much of stretch to see how people could convince themselves that they have DID. The tricky part then becomes separating those who actually do have DID from those who just think they do.

Why would someone want to have DID? Because maybe for them it explains a lot of the things they're thinking or experiencing. Because it places a name on what problem it is they have, which is preferable to not knowing what's wrong with you. Because knowing what you have leads to a treatment and possibly a cure.

Did it merely bring an already existing condition to light? Did it create a new diagnosis that psychiatrists and other doctors could slap on a wide variety of pathologies?

Mistakenly, yes, but as I said, misdiagnoses could have/would have been corrected afterwards. I think DID always existed, but because of the rarity of a genuine case (a rarity which continues today), it was just not recognized as being different from other mood disorders or schizophrenia.

Did people find a new way to "go mad", developing symptons they would not otherwise have manifested if they did not hear of them?

If they did develop new symptoms after hearing of DID, then it's likely because of reactivity.

Okay, on the subject of my OP, talk to me about treatment. Should the desire to amputate a limb be regarded and treated as a mental illness with therapy alone, therapy with drugs, therapy with surgery (amputation, not a lobotomy)? Or should it be regarded as an identity issue (once a diagnosis of , I don't know, otherwise normal? is pronounced) and amputation permitted as cosmetic surgery?

Should it be regarded as a psychological problem? I say yes. I don't see how it could be normal (by any context or definition) to want to have part of your body removed or altered. For that reason, I don't think surgery to fulfill the desire to become an amputee should ever be carried out.

(I also would not consider it a "cosmetic" surgery, because that likens it to nose jobs and breast augmentations. For them to truly be the same thing, you'd have to come away from surgery with a nose that obstructs your breathing, or breasts so large they put a strain on your back and shoulders. Your ability to function and your comfort in doing day-to-day things would have to be reduced somehow.)

In order to figure out the best way to treat something, it helps to know what it is in the first place. I don't know where among psychological disorders apotemnophilia would fit; my guess is with somatoform disorders, such as body dysmorphic disorder. If that's so, then their treatment methods should be similar. BDD is treated with cognitive therapy. Anti-depressants sometimes help, but not really in treatment of the BDD itself. People with BDD are often depressed because of the perceived major flaws in their appearance.

How different is wanting a limb removed (psycho alert!) from wanting a sex change (nature screwed up, we must fix this person)?

Excellent question. The best I can do is this: Nature did screw up for transsexuals-- they were born into the wrong bodies. Nature, however, made no mistakes in giving someone two arms and two legs and ten each of fingers and toes.

Of course, why I can accept transsexualism and not apotemnophilia is something I should think about.

[Dr.Pinky]

AudreyK quote:
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But I seriously doubt that even with patients with two distinct psychological conditions, that any doctor would ignore anything about that patient.
--------------------------------------------------------------------------------

It happens all the time, especially with co-occurring diagnoses of mental illness and chemical dependency. (I’m not sure what the Surgeon General’s Report pegged that at – at least 20% of the mentally ill are dually diagnosed. What insurance covers is what gets treated. Welcome to managed care)

lucie quote:
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Did people find a new way to "go mad", developing symptoms they would not otherwise have manifested if they did not hear of them?
--------------------------------------------------------------------------------
AudreyK reply:

If they did develop new symptoms after hearing of DID, then it's likely because of reactivity.
--------------------------------------------------------------------------------

AK, have you ever studied suicide clusters? We are, unfortunately, uncomfortably, positioned in the culture we’re in. Waving away real deaths, over thousands of years (see Loren Coleman) under the cloak of “medical student’s syndrome” or “reactivity” isn’t really addressing the milieu both the doctor and the patient find themselves in. It’s real if you think it’s real.

[OT] You get to do this (psych research)? for a living? in Hawaii? First, let me direct you to the “What is the best job in the world” thread, and secondly, let me offer my services as, um, collator, blanket folder, grant writer, gadfly, banjo tuner… umm… Devil’ Advocate, bell hop, scorpion exterminator…shell sorter, carbuncle eliminator, expert on the fall of 1923 International Spanish surrealism artists who’s collaborator’s middle initial scores less than 7 no matter where you put it on the board in Scrabble. [\OT]

lucie quote:
--------------------------------------------------------------------------------
Okay, on the subject of my OP, talk to me about treatment. Should the desire to amputate a limb be regarded and treated as a mental illness with therapy alone, therapy with drugs, therapy with surgery (amputation, not a lobotomy)? Or should it be regarded as an identity issue (once a diagnosis of , I don't know, otherwise normal? is pronounced) and amputation permitted as cosmetic surgery?
--------------------------------------------------------------------------------

Well, AK completely misses the point here. When I got my ear pierced, back when Lincoln was president, my father made the same argument. That said, as a physician, the 1st rule is: do no damage. Someone wants their leg cut off, they got to go to the barber.

At work, they frown on me doing freelance counseling – unless someone is decompensating and violent, which I happen to be very good at. It’s not a billable activity, you see. And taking phone calls from delusional people. And re-engaging people from being hospitalized back into the community.

[Dr.Pinky]

Sorry! My third random personality is Boingo, the over- exuberant banjo tuner who has no social skills. My apo logies.

[Geek Mecha]

Originally posted by Dr.Pinky
It happens all the time, especially with co-occurring diagnoses of mental illness and chemical dependency. (I’m not sure what the Surgeon General’s Report pegged that at – at least 20% of the mentally ill are dually diagnosed. What insurance covers is what gets treated. Welcome to managed care)

Well now, that totally sucks.

In the case of anorexia with DID, I can see how anorexia would receive treatment first; it's a life-threatening illness. Even so, I can't see how any illness would be ignored in hopes that it'll just go away, as They Call Me Sneeze said.

Waving away real deaths, over thousands of years (see Loren Coleman) under the cloak of “medical student’s syndrome” or “reactivity” isn’t really addressing the milieu both the doctor and the patient find themselves in. It’s real if you think it’s real.

Tell me about suicide clusters. I haven't heard of them until now.

I didn't mean to say that people who exhibit symptoms because of reactivity aren't experiencing real problems or distress; my point was just that they could have increased the incidence of DID diagnoses.

Well, AK completely misses the point here. When I got my ear pierced, back when Lincoln was president, my father made the same argument.

I guess I need to elaborate:

I don't see how it could be normal (by any context or definition) to want to have part of your body removed or altered so drastically. Things like tattoos and piercings and brandings (I've seen it) excluded.


[OT]

You get to do this (psych research)? for a living? in Hawaii?

I'm a volunteer lab leader for four PSY 100 classes. I'm not paid.
_{(However, one of my students calculated that if I obtained the answers for all 4 variations of the quizzes for all the chapters, and then sold them to all my students for $1 each, I'd rake in $12,000 this semester.)}

First, let me direct you to the “What is the best job in the world” thread, and secondly, let me offer my services as, um, collator, blanket folder, grant writer, gadfly, banjo tuner… umm… Devil’ Advocate, bell hop, scorpion exterminator…shell sorter, carbuncle eliminator, expert on the fall of 1923 International Spanish surrealism artists who’s collaborator’s middle initial scores less than 7 no matter where you put it on the board in Scrabble.

Thank you.

You and Boingo can help me photocopy stuff and stare down evil library book-shelvers.

Is your random second personality named Oingo, by any chance?

[Dr.Pinky]

Originally posted by AudreyK
Is your random second personality named Oingo, by any chance? [/b]

Fnzbit! She's found me out.

[DocCathode]

I've had roughly 15 years of experience in the field.
I am currently on social security disability due to ongoing clinical depression. The most accurate diagnoses I've gotten to date is: bipolar affective disorder(manic depression to the lay folk), attention deficit disorder, and obsessive compulsive disorder (in the form of anxiety attacks over the same minor concerns. With out the proper medication I would be unable to sleep due to fear that a friend had borrowed a tape and not returned it.).

I began studying psychology at age 10. I realised that the doctors had quite a bit of control over my life. Almost immediately, I realised that some of them were completely wrong about me. I went on to major in Psychology at Penn state. I was a star pupil and in the honors program. Then in fourth semester, the medication stopped working. I've been unemployed and unable to return to school for the past six years. So I consider myself something of an expert on mental illness.

I have a close friend who has DID. They were subjected to serious abuse as a child. In case one of my friends finally takes my advice and joins the SD board, I'll call my multiple friend Lou. Most of the people in Lou's life do not know that he has multiple personalities. The shift in voice and body language that accompanies a shift in personality usually goes unnoticed. Thus, most people never address any of Lou's other personalities. Ignoring them has not made them go away. Lou was subjected to extreme abuse as a child. His father once threw him out of a moving car. Certainly some cases of any illness are attributable to medical student's syndrome, but Lou is a very genuine case of DID.

As for the original op, what is and is not an illness is definitely defined by culture. In many societies the carrying of talismans and the casting of spells is a normal part of everyday life. Psychology textbooks define this as "magical thinking". Diagnostic manuals list magical thinking as a symptom of some conditions and as something to be cured. To most psychologists, psychiatrists, and other shrinks a practicioner of Santeria, Voudoun, or Wicca is not some one with an active spiritual life but some one with delusions and megalomania.

There is a tendency to lump difficult cases under a condition that has been recently discovered or in which there has been a recent discovery. I was born in 1975, well before the media spotlight fell on ADD. My own resarch and my various problems when not on medication, have convinced me that ADD does exist and that I have it. Sadly awareness of ADD has caused many children who have other conditions or no condition at all to be misdiagnosed and given unnecesary medication. This is not confined to mental health however. When silicone implants were recalled many women claimed that they had caused a wide variety of symptoms. A few universities did research on this. They found that most of the complaints were unrelated to the implants. People want an answer to their problems. If the doctors have been unable to diagnose or help little Bobby, parents are happy to accept a diagnosis of ADD or DID because it is the first step toward getting help for their child.

[jab1]

Originally posted by AHunter3
there is also no such thing as schizophrenia.

Bullshit. I mean, pardon me for accepting the word of the Surgeon General and the Encyclopedia Britannica (to name just two) over yours.

You sound like some who, when they get cancer, refuse to believe that they have cancer, and may even declare there is no such thing as cancer, all to avoid accepting the uncomfortable, frightening truth.

You also sound like a creationist who, when hearing scientists say they don't know exactly how evolution works, will then pounce on the scientists and ask, illogically, "If you can't explain it, how can you say it exists?!"

I read most of "Witchpaper '97." You actually condemn psychiatric institutions for existing in order to protect society from the mentally ill, as if society had neither right nor obligation to protect itself.

You claim that scientists can't say there is schizophrenia because they can't agree on what causes it, whether it's "oversensitive dopamine receptors" or "interference in the uptake of serotonin."

That's like saying there is no such thing as cancer because we don't know everything about it. And that is bullshit.

It's unfortunate you have schizophrenia. I'm clinically depressed myslef, so I know what it's like to have a mental illness that may never be cured. But I learned one thing:

They can't help you if you won't let them.

[Dr.Pinky]

DocC is my new favorite poster. I'd like to write an essay to respond to issues raised in the last post. Instead, this.

Originally posted by DocCathode
In many societies the carrying of talismans and the casting of spells is a normal part of everyday life. Psychology textbooks define this as "magical thinking".

One of the things I do these days is fix computers for social workers. They push a button, it flails. I push the same button, it works. I have to ward against magical thinking, or they'll intake me (even tho that seems to be the most logical conclusion).

Yesterday was my 8 year anniversary in the mental health field... I've worked at the State, Municipal, & private non-profit level, doing everything except forging the Docs sig on ccccccccccc gvbbbhhhggfddedddddddddddddddddghbbb

[Dr.Pinky]

Originally posted by Dr.Pinky
ccccccccccc gvbbbhhhggfddedddddddddddddddddghbbb

Sorry. 1st hijack by Isadore, 2 years, 11 months.

I was going to list my credentials here, but I'm on Dada duty. I'll be back in about 18 hours.

[Helen's Eidolon]

Actually, I'm taking a class on this very subject this semester. An interesting book is Sanity, Madness and the Family by R.D. Laing and Esterson.

The book has some very interesting proof and discussion on how schizophrenia is socially intelligeable. Namely, the families of the girls in this book (randomly selected) are causing their symptoms. Truly fascinating.

[matt_mcl]

Originally posted by jab1 Bullshit. I mean, pardon me for accepting the word of the Surgeon General and the Encyclopedia Britannica (to name just two) over yours.[/b]

50 years ago, the encyclopedia said that homosexuality was a mental illness.

200 years ago, it said that drapetomania was a mental illness.

I'm not necessarily agreeing with AHunter3 about schizophrenia. But authorities are subject to error, just like us mortals.

[AHunter3]

Jab:

quote:

Originally posted by AHunter3
there is also no such thing as schizophrenia.


Bullshit. I mean, pardon me for accepting the word of the Surgeon General and the Encyclopedia Britannica (to name just two) over yours.

Appeal to authority. Spurious logic. I am not alone in my contentions.. But OK, I was being deliberately incendiary since it is no fun being on a soapbox without a "Them-representative" to square off against in front of the others, and I guess you'll do.


There are several levels of credibility you could assign to psychiatry's claims for the existence of "schizophrenia", or, for that matter, to my claim that there is no such thing as "schizophrenia". Does it completely fail to exist in the sense that unicorns fail to exist, and am I making that claim? Does it exist only in the same sense that "stress" exists, i.e., something that is so broadly defined that it is indistinguishable from that which is "ordinary" and "normative" (and is that the essence of my claim that it is a nonreal phenomenon)?

Or perhaps it exists in the same sense that PMS exists: within a continuum of experience that includes virtually everyone (or virtually every woman in the case of PMS) except to the matter of degree, but for those it affects to a greater degree it constitutes a genuinely disabling phenomenon; but still failing to constitute sufficient reason for denying its alleged sufferers the right to hold positions of responsibility, as some have claimed that it does. Is that the type of claim that I am making?

Or, with respects to the OP, perhaps I am saying that "schizophrenia" exists as a diagnostic and patient-identity phenomenon the same way "multiple personality disorder" exists, but that the diagnostic criteria are so sloppy that their reasonably objective application is impossible, and that the structure of myth that has grown up around it, e.g., the "typical history" of child sexual abuse ritualized in satanic practice followed by the splitting of the self into several "selves" with no recollection of experience if experienced by a "different self", etc? Is this closer to the claim that I am making?

To be sure, the allegory I use in the paper I cited above assigns "schizophrenia" to the same type of nonreality as "witchcraft". Yet at various times in my life and in various contexts I claim to be a schizophrenic and a witch.

One gets a large part of one's identity from one's social environment, and much of that through the process of having an identity attributed to you by others. And our culture tends to attribute negatively-tinged identities to those who are weird or disturbing or whose behavior cannot be readily understood and predicted by others. But science (and medicine, which distinctly seeks to be viewed as a science) attempts to focus on those things that can be said to have an objective existence. BECAUSE they are viewed as bastions of objective appraisal, their claims should be subject to much more skeptical inquiry, and in most cases, via the peer review process and the application of stringent research methological standards, they are. This is not the case for psychiatric research, though.

So in what sense might "schizophrenia" exist? Well, I think it is true that under certain circumstances, people's minds tend to go through a surrealistic (and disconcerting) phase in which the everyday meaning of things is confused with metaphorical and symbolic meanings; things take on great impact and import, a heightened drama; and as subsequent thought processes are built upon the existing structure when this is the existing structure, it is easy to end up embedded in a richly textured mental world that has a lot of emotion invested in it, but which is not coherent or comprehensible to other people. I also think that some people, by virtue of whatever factors make them up as an individual (perhaps including their genetic makeup, perhaps including variations in metabolic chemistry), are more inclined than others to slip into this type of mental state, or perhaps to be less able to re-integrate the fruits of this mental world into the everyday world and get their feet back on the ground, than other folks are. I think this is a genuine phenomenon, having been through it myself, and we could call it "schizophrenia" and perhaps could call folks who are more inclined than others to experience it "schizophrenics".

But it is not a disease. The metaphorical meanings and the dramatic impact of them on the person who experiences them are not merely "brain static" and do not lack real meaning. And it is not caused by "chemical imbalances in the brain". (If you had had the opportunity to check the brain chemistry of a sample of recently widowed and raped Bosnian women in Serbian concentration camps during the ethnic cleaning and mass rape venture of Slobodan Milosevic a few years back, you might find that their brain chemistry differed from that of a random sample of Baltimore Maryland shoppers. This does not mean that the differences in what they were feeling and thinking is caused by the difference in brain chemistry.)

The ability to point a finger and say "that's 'schizophrenia' does not mean that 'we can help you', which is another strand of the belief system difficult to untangle from the whole idea of "schizophrenia". Jab wrote:

They can't help you if you won't let them.

Generally speaking, they can't help you period. More to the point, I wish it were true that they can't HURT you if you won't let them. But because of the widespread belief in "schizophrenia" (defined as, and thought of as, THEY think of and define it, not as I've discussed it above), psychiatrists have been given the authority to impose treatment, and their treatment does not help "schizophrenics" cope with and integrate their schizophrenic experience. Their treatment does, however, damage people, and the institutional experience is devastatingly horrible overall.

[Helen's Eidolon]

200 years ago, it said that drapetomania was a mental illness.

What is drapetomania?

[DocCathode]

Dr Pinky is my new favorite poster! Now, I just have to figure out what it was in my post that generated such a positive response.

My grandfather was schizophrenic. I saw my first therapist in the third grade. I was diagnosed as schizoprhenic. I carried that label for six years. I have done a great deal of research on schizoprenia. I have reached two conclusions. It exists and I don't have it.

Like fingerprints, every brain is different. However, if I were to turn over a dozen brains to a good neurologist or researcher, they could determine if any of the brains were from schizophrenics. There are significant differences in chemical composition and structure between the brains of schizophrenics and "normal" brains.

It seems that the schizophrenia-does-not-exist-argument is this:
Not everyone can agree on a definition
Not everyone can agree on a cause
Not everyone can agree on symptoms

Lets look at Christianity:
Not everyone can agree on a definition (Our sect is the only true Christianity etc)
Not everyone can agree on symptoms (All Christians wear crosses. No! All christians go to church every Sunday etc)

So if I find a debate over the cause of Christianity, does it not exist?

It seems to me that many posters are against therapists, and Psychiatry in general. Did you have bad experiences with therapists? Then again there is a group whose members are against psychiatry and make frequent posts to discussions like this one. That's right folk's, we could be up against $cientologists!

[AHunter3]

I am not a scientologist. I am a member of a DIFFERENT group that is against psychiatry and psychiatrists: their prior victims, in the form of the psychiatric inmates' liberation movement.

I, like you (DocCathode that is), was once diagnosed schizophrenic. There does, of course, exist a logical position (in the Venn-Diagram sense) in which schizophrenics exist, but not everyone diagnosed schizophrenic is schizophrenic. My contention that they are a sloppy bunch of diagnosticians doesn't in any way refute that, although it indicates that the number of people diagnosed who aren't really schizophrenic is quite high. (It could also indicate that there is a large number of schizophrenics who have not been so diagnosed).

So I cannot rest my claim that schizophrenia doesn't exist on the sloppiness of diagnostic procedures alone.

Allan's corollary: If we stipulate that our ability to distinguish UFOs (whatever they may--or may not--be) from other explicable atmospheric phenomena is not good, that doesn't prove there are no UFOs at all.

Obviously, in the denotative sense of "does the DSM-IV description of 'schizophrenia' describe a pattern of behaviors and experiences that actually exists", there is schizophrenia. Just as there are, of course, Unidentified Flying Objects. As to what either of them MEAN, what they actually ARE, though...

Schizophrenia is conceptualized, popularized, discussed, treated, researched, and diagnosed AS A BIOLOGICAL DIFFERENCE OF THE BRAIN which is THE CAUSE OF disturbances of thought and feeling which, in turn, are conceptualized as ENTIRELY NEGATIVE, WITHOUT VALID MEANING, i.e., BRAIN STATIC. Just as the folks who "believe in UFOs" believe that they are ships piloted by intelligent extraterrestrial aliens who observe and manipulate affairs down here on earth.

As shorthand, many people on this board would probably say they "don't believe in UFOs", by which they do NOT mean that they do not believe that some flying objects are unidentified. In a similar vein, I say that there is no schizophrenia because in the sense that the field of psychiatry conceptualizes it, there isn't.

[Trout Mask Replica]

Originally posted by LaurAnge
What is drapetomania?

Drapetomania was a mental illness that induced slaves to run away from their masters.

[DocCathode]

So which of the things in capitals do you disagree with Hunter? And why? Do you favor a revision of the diagnosis of schizophrenia or eliminating shcizophrenia from the books completely?
I am not attempting to be adversarial, I simply want clarification of your positions.

In ADD A Different Perception, Thom Hartmann takes the view that ADD is not a handicap, but a condition that is not advantageous in our society. He argues that ADD characteristics are well suited for hunting. Our society is made up of "farmers". The book is well written and its points well argued. Hartmann also describes a meeting with a shaman in Uganda. A friend tells him that in America, the shaman would be diagnosed with schizophrenia and treated accordingly. Hartmann raises, but wisely avoids answering, the question are all the world's shamans schizophrenics or are the many schizophrenics locked in institutions and given pills shamans misunderstood in a technological society.

I agree with AHunter3, that the system has many flaws. Many of the therapists, psychiatrists and psychologists I've met should be fired, stripped of degrees and barred form ever working in the mental health field. But I've also met many people working hard to help their patients and willing to listen to them. We need reform, but if we get carried away we'll end up hurting more people than we help-exactly like the shrinks we're fighting.

[AHunter3]

Doc, for every 6-7 sadistic or uncaring shrinks or psych nurses, there is at least one totally devoted, compassionate psychiatric professional who does even MORE damage by trying to help, due to a failure to question the tenets of the medical model of mental illness.

I disagree with all of the parts in caps (in my post a bit up above): schizophrenia, if we are to speak of it as a thing that does exist, is not an illness; is not caused by structural or chemical differences in the brain (although differences may create a greater or lesser predisposition towards "schizophrenicity", if you will); and is not by any means entirely negative, at least not for all of us all of the time. (For most of us at least some of the time, yes; for some of us all of the time, also yes).

Insofar as it is a normative reaction or coping mechanism of the brain, the people who are (at any given moment) schizophrenic are schizophrenic at least in major part due to the context they are in, and that same context could cause a schizophrenic reaction in others so exposed.

For a variety of reasons--historical, financial, territorial (in the sense of academic and authoritative territory) and a slew of reasons pertaining to the social convenience of having a mechanism for removing inconvenient and disturbing people who haven't broken any laws--the psychiatric system's constituent professionals and contributing ancillary professions and industries are entrenched against change in the patterns we would need to change in order to have the system constitute a positive rather than a negative in our lives.

We would be happy to see the psychiatric profession drop its police powers (incarceration, forced treatment), divorce itself from the pharmaceutical industry, bite the proverbial bullet and discard the medical model of mental illness in favor of a holistic self/society interactive communication-and-coping model, focus on self-help and affirmative action and community building and group pride in identity politics, and cease to conceptualize the field as one ideally run by medical doctors. Even many of our opponents who DO believe fervently in the medical model and the wonders of forced treatment would love to see a huge influx of money sufficient to hire and keep competitively brilliant, dedicated, humanistic staff of sufficient size, create pleasant physical sites for community affairs and programming, facilitate individual job and social placement programming, pass laws protecting us from abuse and discrimination, and so forth.


None of that is gonna happen unless we--the folks so labeled--have and weild serious political clout. We are organized to that end as the beforementioned psychiatric inmates' liberation front.

Admittedly, my sense of "our" and "us" is heavily sculpted by my face-to-face conversations with other psychiatric inmates / ex-inmates who are opposed to forced treatment, opposed to lies and propaganda about the services and treatment psychiatry has to offer, and who have negative horror stories to tell about the "help" we personally have received. There is a large population of folks with psychiatric diagnoses who are users of the system and are dependent on it, either voluntarily or without the ability or opportunity to make the statement that they'd rather opt out. But most of them are not doing well and getting on with their lives and recovering with the aid and assistance of the treatments, therapies, and support of the psychiatric system, whereas those of us with far more critical perspectives on the Mental Health system tend to fall into one of these two categories:

a) Needed help, sought it or accepted it when it was offered, went through miseries of varying degree and duration at the hands of the psychiatric profession's "help", and ceased voluntarily accepting such "help". Often say that the "help" was significantly more traumatic than the original problem, whether the original problem persists or has been put behind them via other means; or

b) Wasn't seeking help, didn't consider themselves to have a problem (or at least did not agree with the psych profession that their problem lay within themselves and their ill brains), did not readily or completely accept the "help" but had it imposed on them anyway, to the detriment of their sense of self and personal liberty, and often much worse (including permanent brain damage, rape, bodily mutilation, and the creation of mood & thought disorders not present until after the psych profession's intervensions).

[Ptahlis]

Originally posted by DocCathode
It seems to me that many posters are against therapists, and Psychiatry in general. Did you have bad experiences with therapists? Then again there is a group whose members are against psychiatry and make frequent posts to discussions like this one. That's right folk's, we could be up against $cientologists!

Since I have stated that I find psychology a rather dubious discipline, I should perhaps elaborate lest someone suspect I have some sort of tie with Elron's loonies. FTR, I've never been diagnosed with any disorder or been treated by any psychological professional.

What I object to most of all is the faddish nature of psychology. Far too many "illnesses" become, for want of a better word, popular. MPD, repressed memories, ADD, co-dependency. I'm sorry, but lumping a set of subjectively judged behaviors together and slapping a label on it does not a disease make, yet psychologists are eager to classify and categorize patients into nifty little cubbyholes.

Do I realize that psychologists are trying to help people? Of course. And I realize that many in fact do help people every day. There are lots of very interesting studies, and fantastic work being done with respect to neurological disorders. I do not disagree that there are mental illnesses. (I have a cousin in New Jersey, diagnosed with schizophrenia, who hears voices all the time. She thinks she's telepathic, and she goes on dates with Jim Morrison in her mind.)

What really does chap my behind is the ridiculous Authority given to psychology and psychiatry, when much of it is based on subjective guesswork. In the eighties we had repressed memories of Satanic rituals and sexual abuse that were the cause of everyone's problems. People were sued, families torn apart, and lives ruined over events that demonstrably never happened. "Oops." Fifty years ago, merely being gay was a mental illness, even though it seems obvious today that the foundation for such a diagnosis was mere societal prejudice. "Sorry 'bout that folks." I won't even talk about lobotomies or electro-shock therapy except to say that it seems to be a whole lot easier to try out radical therapies if your patients are labeled as nutters. Simply put, "mental health professionals" have too much power built on too flimsy a foundation.

[Mr. Svinlesha]

There's actually a whole "branch" of psychiatry devoted to questions concerning the relationship between culture and mental illness known as Ethnopsychiatry. I guess the most well known name in the field is probably George Deverux, who wrote Basic Problems of Ethnopsychiatry and The Psychoanalysis of a Plains Indian. A fascinating topic, but unfortunately, I can't really recommend either book as I found Devereux's style of writing incredibly dry. But think about this:

"Devereux asks how one can determine if someone from an entirely different culture is emotionally ill. If a white, middle-class American male believes that he is possessed by witches and demons, then we would probably call him mentally ill. But if a member of a so-called primitive tribe in Africa holds such a belief, would we say the same thing? Presumably not. But does this mean that no member of this tribe may become mentally ill or is mentally ill only if he believes he is possessed by radar and microwaves (that is, forces that have no place in his culture)?" -- Alford, C. Fred, Melanie Klien and Critical Social Theory.

Devereux goes on from there to speculate about the structure of the unconscious (which isn't really relevant here) but I've always loved that quote as an example of how culturally relative the definitions of mental illness really are. Culture structures both the ways in which "mental illness" expresses itself and the ways in which it is conceptualized by the surrounding community. In point of fact, even the phrase "mental illness" is a missleading cultural construction, for who is to say that such-and-such behavior constitutes an illness? -- A point made amply clear by AHunter3.

My basic take on "schizophrenia", by the way, is also anti-psychiatric. I've worked in psychiatry a long time (8 years or so) and have to agree with AHunter3 that I've seen very little except abuse. I also think that "schizophrenia" has a meaning (admittedly difficult to figure out), and that it represents a coping mechanism in an extremely disturbed family situation. The "schizophrenic" is usually a family member chosen to carry the problems that nobody else within the family wants to deal with. In my opinion, the psychiatric community's insistance that schizophrenia is purely biological disorder consititues a massive denial of the real problem.

But it is, of course, a great boon to the pharmaceutical industry.

[DocCathode]

I think that AHunter3 and I agree to large extent
on the problems, but disagree on the solutions.
A great deal of the problems seem to be caused by the
culture of academia. Theories become enshrined, regardless of how ridiculous (the Oedepus Complex springs immediately to mind). Proffessors foster the attitude that degree holders are superior to all other human beings. Jargon has gone from a tool to make things easier, to a way to keep out outsiders (like patients.). I've found these problems throughout the medical field.

The first therapist I ever saw was a total Freudian. I could deny my urge to bed Ma and kill Pa for the whole session, it made no difference. Looking through my records, I was actually labeled "anal intrusive and phallic sadistic". I am familiar with Freud's stages of development-but what in the hell is anal intrusive?

All the labels followed me until I found a shrink who did something no one else had. He listened to me, read my file and decided that he trusted his own evaluation of me more than a file.

I have been committed against my will. There was an active group of patients who sold drugs. Some patients were raped, then intimidated out of reporting it. About the only rule that they managed to enforce was that patient's could not keep food in their rooms.

On the other hand, I need medication. The psychiatrist I have now wanted to be sure that my problems weren't actually caused by medication. For two months things got steadily worse. At the two month mark I experienced panic attacks, various OCD's and the most fun of all my death phobia returned. She put me back on medication. I still have problems, but there's no comparison.

AHunter3(I'll come up with a cute contraction of yer name when I'm less exhausted), are you saying that my brain chemistry is not the cause of my problems? If that were the case why would some medications help me and others not?

This post would be more ordered, but it's been a long day. I apologise for that long empty space in my last post. It's the result of an unrelated server problem.