What do you mean by coping skills?
What are they trying to cope with?
And what causes individual differences in coping skills?
Those 2 things make peoples coping skills worse.
How, and what makes them better?
How?
Obviously if the therapy is terrible or they’re given the wrong meds, you’ll have problems, but otherwise, I don’t see how they make coping skills worse.
How compassionate. :dubious:
You are ignorant. Deeply ignorant. I’m thinking ‘‘UFOs are real’’ levels of ignorance here so I don’t think educating you is a real possibility. I must weigh this reality with the fact that there are other people out there reading this who may be corrupted by your bizarre view of things.
The DSM-V is a research tool. A bunch of mental health professionals and scientists got together and said, ‘‘Hey, there are a lot of people out there who need mental health treatment, but we’re going to have to figure out a way to define mental illnesses in order to do the research necessary for effective treatment.’’ That is what the DSM is - a way of operationally defining mental illness. Over time it has come to be known as the gold standard diagnostic tool, but it is far from the only diagnostic tool, nor is it the ultimate word on how mental illnesses should be defined or treated.
There are some valid criticisms of this textbook and the political and social factors that impact what ends up in there. It is subjective, by definition, because there is no real objective way to measure mental illness. We don’t know enough about the brain to run a blood test or something. Those criticisms are the subject of fierce debate among mental health professionals even as we speak. Each successive version of the DSM is an attempt to resolve as many of those issues as possible. So you aren’t really saying anything revolutionary about it when you talk about its flaws, and you sure as hell aren’t doing as much to fight it as the psychologists and psychiatrists hacking these issues out behind the scenes. I guarantee you there are already psychologists and psychiatrists engaged in fierce debate over how the DSM-VI should be written. I know you would like to believe otherwise, but many mental health professionals actually give a shit about their clients and tirelessly work to improve the quality of their lives on a regular basis. You, matt strike me as a person who is completely disconnected from the reality of psychology as a profession, and you also seem to lack an understanding of the scientific rigor that many psychologists apply to this field.
I will defend the DSM because despite its flaws, it has been able to point the way to many revelations about mental illness. We know, for example, based on randomized controlled trials, that people who the DSM defines as clinically depressed experience a significant reduction in those symptoms when treated with cognitive behavioral therapy. If we had no operational definition of clinical depression, we wouldn’t very well be able to figure out if CBT was effective, would we? If it weren’t the DSM, it would have to be something else. There’s no way of getting around the inherent subjectivity of diagnostic tools, at least not yet.
Second, there is another dimension of this debate which A Hunter alludes to, and that is the fact that there are many mentally ill people out there who feel they were taken advantage of, used or otherwise coerced by the mental health system. This is where we get into tricky territory. These abuses certainly do happen, and unfortunately they happen more commonly to people more likely to be entrenched in the system - like schizophrenics and individuals with bipolar disorder. However, we have to balance this with the consideration that one of the hallmarks of schizophrenia is paranoia and non-compliance with treatment. If I had to choose one group of people who would be most likely to feel persecuted regardless of the actual situation, it would be schizophrenics. I am lucky enough not to have schizophrenia, my uncle does, and I am deeply saddened by his suffering. I want to find a way to honor the reality that some people are mistreated by the system while at the same time recognizing that schizophrenics have a flawed perception of reality. And I can’t even tell you how to resolve this problem - feel free.
And I have my own set of axes to grind with the mental health system, particularly with regard to how my mental illness was initially treated. I was 18 years old and utterly clueless about the system. The truth is that a person seeking mental health treatment is vulnerable and often quite ignorant about what treatments have been proven to be most effective, and we have a right to be fully informed of the scientific rationale, risks, and potential consequences of any treatment we receive. Too often we just trust the authority figure to do what’s best for us and end up burned as a result. This has happened to me. I am not unsympathetic, and in fact I would be in favor of revoking the license of any therapist not using evidence-based treatments with their clients, or in the very least not informing clients when they are basically pulling their treatment out of their ass rather than using the best available evidence. We are in the middle of an ideological war on how psychology ought to be practiced, and I think I’ve stated my side clearly enough.
However, the lack of evidence-based treatment is hardly unique to psychiatry. It is a problem common across the entire field of medicine. As much as we would like to believe that our GPs and other doctors are using the best available evidence, the chances are good that they’re actually just doing what they believe works regardless of the evidence. There has been plenty of research into this and it’s clear there is a massive disconnect between research and the actual implementation of treatment in all of medicine. So don’t even try to pretend that psychiatry is some special case.
You don’t seem driven by compassion for the mentally ill at all - rather you have chosen to negate the awful experiences of every mentally ill person, to render them invalid, and to present some vague and uncompelling reasons why those of us with mental disturbances should not have access to the best treatment available at this time. This is what I find hard to swallow. If you were just a Mad Pride advocate like A Hunter, this wouldn’t be so problematic. Instead you are telling people who have spent years struggling with mental illness that their suffering is not real. This is incredibly cruel. If I gave your ideas any credibility at all, it might actually hurt.
And you have the audacity to say it’s because they don’t have the ability to cope. Utterly fucking ridiculous. The purpose of mental health treatment is to help people to better cope with mental illness, and the transmission of certain coping skills have proven effective in study after study. I probably owe my life to CBT. However, you can’t just erase a biologically based mental illness. You can learn better ways of coping, but it’s never going to go away, any more than arthritis or any other chronic illness can go away.
Just be clear,** A Hunter**, Mad Pride is not an insult. I am all about the Mad Pride movement, and I think if real change is to happen, it will have to be change facilitated by experienced, empowered members of the mental health community who will not stand for these abuses any more. I just don’t want to throw the baby out with the bathwater, you know? Bad stuff happens, but good stuff happens too.
all good points Olive!!! as the thread found legs it became clearer the goal for him was not to debate his claims but to dangle carrots in front of those who actually thought they were engaged with someone who gave a shit. Feels like **Matt ** was more interested in building a page count instead of promoting intellectually honest discussions. Not just manipulative, cleverly premeditated.
Thanks.
I believe that if there is going to be change, it needs to involve two factions that have been sadly polarized against each other: those who for their own reasons have sought out mental health services, who want help, but whose experiences as a psych services recipient give them ideas for how things could be made a whole lot better; and those who have been the victim of unwanted psychiatric interventions and mostly just want to be left alone, want the right to tell the psychiatric profession to go to hell.
The old Mad Pride movement did incorporate both and it’s sad that we became so split.
A commitment to self-determination and consumer choice (including the right to refuse) is key here, just as it is with nearly all areas of medicine.
People seeking help deserve to be fully informed and should be educated about how the doctors see their situation, what the offered treatments involve, how other folks have experienced those treatments (good and bad), what the alternatives are, and so on.
I have come to wish I’d been less adversarial and militant on this issue overall on this board and perhaps allied with instead of antagonized those who do consider psychiatric services a net positive in their own lives.
Be all of that as it is, I have to say that I do agree with some of what matt357 is saying. And I’d urge the rest of you to consider it and not just reject him as someone who denies essential truths and can therefore be dismissed as a kook.
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I agree that all the worries about “well what are you going to do about dangerous mental cases” are best addressed by treating us the same way as dangerous violent people who aren’t considered mentally ill. That means DO NOT use the ways in which you feel sorry for us as ground for “protecting” us from criminal law enforcement. We cannot have it both ways. Neither can you. We should not be involuntarily locked up without either losing a full-blown competency hearing or else committing a crime that would get anyone else locked up. Reciprocally, we should indeed be locked up like anyone else if we do those illegal things. You do us no favors by saying, in essence, “How can you propose that this poor unfortunate confused nutcase be arrested and jailed? He needs HELP!”
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It is true that the DSM-IV / DSM-V categories of mental illness, with its implication of narrowly defined and specifically understood clinical ailments, is based on smoke. We don’t have that kind of specificity of understanding. I understand why the profession would like to be seen as one that did, but they don’t and aren’t and it isn’t. So in a broad clumsy sweep-of-hand sense, yeah, that shit doesn’t exist. Not as they pretend that it does. What we have instead are some fuzzy patterns of behavior that cluster in certain ways when we study mental / emotional / behavioral problems. We dont’ know what causes any of it. We have some sense of how it is likely to develop over time but that’s about it. We don’t even know for sure if it has a true physical component, twin studies besides the point.
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It is also true that the scope of what is defined as a mental illness has been expanded several times, starting with the DSM-III or thereabouts. More human behaviors are at least hypothetical symptoms of a mental illness than ever before. Given that psych diagnoses depend on observed behavior and self-reported experiences that themselves may be interpreted through those lenses, that IS a viable concern, it really is.
The new DSM-V lists fewer disorders than DSM-IV. Perhaps this has already been mentioned and I just missed it.
People can say what they will about psychiatry. But no one can say it is resistant to change.
The characterization of DSM categories as fuzzy, broad and based on smoke is not accurate.
The casual dismissal of behavioral genetics (such as twin studies) displays an ignorance of science.
I see this people saying this sort of thing all the time.
How do you think this happens? I work for a drug–excuse me, pharmaceutical–company, and I’m curious which of my colleagues to suspect of unethical/illegal behavior. Do you suppose that we pay physicians to prescribe our drug? Offer kinky sex with our most attractive chemists? Threaten their friends and families?
Are the insurance companies, who are the ones actually paying nearly all of the costs for the drugs that are prescribed, in on this? I’ve always heard that insurers are eager to pay for drugs that patients don’t actually need; maybe it’s like that?
What about the physicians themselves? Are all of them unethical? Only most?
And within the companies themselves, who is it, exactly, that doesn’t care if the drugs are needed or taken? Everyone I work with seems to care about that a lot. But it seems most of them are liars… do you have any suggestions how I can identify which? The chemists? The clinical operations leads? Medical writing? Formulation? Drug supply? Medical? Biostatistics? Or is it just the executives? But there are so few of those, and so many doctors to bribe or blackmail… maybe there’s a black ops team.
Well, you all *used to be able *to cater us lunches and give us coffee mugs! I miss those days.
I wrote out a nice long post and then my webpage just refreshed and everything disappeared, so let me try to summarize what I meant to say from memory. 
Actually, I’m not in the mood to rewrite it all over again but I’ll go over some quick points:
I started to read this debate and then added a third prong because of my own strong emotional feelings about psychiatry. But these feelings are not “anti-psychiatry.” It’s a branch of medicine that means well and does well. However, I think there is over-medication and, from a personal perspective, that annoys me for the simple reason that whenever I asked to try to get off of meds, I was told no. When it comes to being “forced” to take medication, this is indirectly true. That is, no one’s forcing it down your throat but you essentially are being forced to take them because the only other option is to leave the doctor entirely. The only other option is to stop taking them on my own, to taper off on my own, and I’d rather do that with a professional. But they won’t work with me.
Some people need to be on meds for the rest of their lives. But not everybody. Maybe I might survive off of meds. I think I at least deserve the chance. But there’s this attitude in psychiatry that people need meds, forever, that I have an issue with. Meds are prescribed when they shouldn’t be too often and patients are expected to be on meds forever when, perhaps in some cases, they might do well off of them eventually.
Meds are an important part of the arsenal but I’d prefer they were more last resort. Not in all cases. Some people who are very sick might need them earlier, but too often, I think, the prescription pad comes out too soon.
And as for ECT, that too has a place, but it should be the last resort of all, after everything has been tried.
Let me his REPLY before I get all this erased too. No time for proof-reading!
I’m sorry to hear that.
No, I don’t think that’s right. I don’t think we fully understand what causes these problems and the result is that medication is hit or miss at best, but I don’t think all of these drugs are just placebos.
Pedantically speaking, they couldn’t simultaneously be a placebo, and make you fat/kill your libido/etc.
I’m not sure the evidence offered (one medication didn’t work for one patient) is sufficient to support the conclusion drawn (no medication works for anybody).
I’m not going to argue with you saying it didn’t work for you, and I’m not going to say you weren’t failed by the system – it didn’t and you were. But all that proves is that humans aren’t machines
All you people who think you’re mentally ill? Well, matt357 has some good news: you’re not ill at all, you’re just a failure.
Also, a question I’m not sure I’ve seen answered yet: People who seem to exhibit the constellation of apparent symptoms labelled – let’s narrow this down to one thing – “agoraphobia,” what’s actually going on there?
Should anything be done about it?
If not, why not? If so, what?
And nobody can help you, so suck it up and stop being so weak. matt357 has been kind of stingy with the details but he doesn’t seem to have any other advice or opinions on people with problems.
Good news, everyone. The voices have conferred, and have concluded that I do not have schizophrenia. Sadly, they have informed me that I do have poor coping skills, for which there is no intervention.
Just a sec… there has been some miscommunication. Apparently I have poor copying skills. They’ve given me some tracing paper.
Glad that’s resolved.
If I understand you correctly exactly what’s going is a subject of debate
Nothing needs to be done until a disorder starts interfering with a person’s life.
What should be done then is a subject of even more debate. Should the person go into therapy? If so, exactly what kind? Should they be medicated? If so with what and how much?