engaging with actual human beings is much better. Quicker? maybe not. But hey, spend 20 minutes actually dealing with a human being who suffers from a disorder, you might actually learn something of value.
There are subtleties that the camera just doesn’t catch, particuarly if you’re interested in something as intangible as “mien.” How are you operationalizing that btw?
Anyway, my point was that this quote of yours leads me to believe that you have no (or very little) first hand knowledge of people who suffer from ADD, ODD, or any other disorder. This was the only reference to actual human beings (with any disorder) in any of your posts in this thread that I could find.
Without that, you really can’t know much about the disorders themselves.
Go back and look at your first post in this thread. Are you really trying to tell me that you regard that as an intelligent and meaningful contribution to this thread?
No one suffers from those “disorders”, because there aren’t any disorders to suffer from. ‘Disorder’ refers to the lack of harmonious functioning between the individual and his environment; presuming that the fault for this lies in the individual is the basic fallacy of pathologization.
For the psychiatric disorders (as opposed to known neurological disorders), there is simply no proof whatsoever that they’re distinct physiological or even psychological diseases.
What are you talking about? What is a psychiatric disorder as opposed to a psychological disorder as opposed to a physiological disorder?
Are you talking about ADHD? are you saying that there is no neurological basis for psychological/psychiatric disorders? Please read this re ADHD, at least, and this re ODD, it might prove enlightening for you.
Physiological disorder: something is wrong with the hardware of the body.
Psychological disorder: something is wrong with the software of the mind.
Psychiatric disorder: anything the psychiatric community views as a pathological condition worthy of treatment.
Do you have someway to test the scientific validity of those definitions? You know a lab test, something to prove that they correlate with something real or even that different observers would say the same thing about each disorder.
Or is it just nonscientific claptrap?
Please tell me where exactly you draw the line between hardware and software in the brain? Reversibility? Gross anatomic as opposed to receptor or transmitter or wiring pathways based? Because if you know there’s a Nobel that’ll be waiting for you. Because the scientific community understands that there are different levels of analysis but that real physical changes underlie such concepts as “Drives” and “Sensory Representations” etc.
The concepts themselves require no empirical justification (or very, very little). Now, applying them to actual people and situations does require empirical justification, or at least an awareness of the lack thereof.
For example, psychiatrists were once convinced that pellagra was a psychological disorder. The same for neurosyphilis. Now we know better: those are purely physiological conditions whose symptoms are (partly) psychological.
The belief that the natures and causes of these conditions were known was incorrect; more importantly, it was reached without sufficient evidence in a completely non-scientific manner.
** Now, this is a really, really difficult question; it’s also an incredibly interesting one.
Anyone with more than a rudimentary background in cognitive psychology or applied neurology knows that the distinction between hardware and software in the brain is fundamentally arbitrary: all mental events are the results of physical changes in the brain. Nevertheless, there are ways to make meaningful distinctions between behavior that occurs because of stored data and behavior that takes places because of the physical properties of the nervous system.
I was merely trying to “cut” the thickness of your skull, apparently I need a much bigger blade.
Maybe you aren’t able to discern the the contribution my posts make because you simply don’t recognize them as anything already existing in your rigid thinking. Perhaps your mentality is rocky soil where these seeds will take no purchase.
Just cause something makes you uncomfortable doesn’t give you the right to deny it’s existance. I mean, deny it to yourself all you want, but don’t try to stand in the way of those who might be more enlightened.
No one suffers from them because there aren’t any disorders to suffer from.
OOOOOOOH! I get it now. I’ll tell my client tomorrow he’s got no problems, see how it works out.
I think you’re forgetting that there’s a little something that we in the mental health profession refer to as “reality” here. Call it psychobabble, call it what you will, but we believe this “reality” to be quite important. In this “reality” there are people. These people tell me they’re suffering, their teachers and parents tell me they are too. I believe them. They back up their statements with proof.
You don’t.
I’ll go along with your “lack of harmonious functioning…” part of the definition, it’s workable.
But could you show me in the DSM, or any other diagnostic manual where fault is assigned? Could you also show where it states that presumptions should be made? NAMI website? Magazine?
Shame on you. I believe you set up your own strawman with that “presuming the fault…” line there.
[That’s the first time I’ve ever called someone on a strawman, did I do it right? A strawman argument is where you make up something another person didn’t say as though they said it and then refute that statement right?]
I think you might be making that one up based on your distaste for the profession; but if you’d like to cite it somewhere I’d be glad to consider it (I won’t hold my breath on that one).
I’m sorry, but I have no proof for you. There is no proof for a person with no willingness to believe. There is strong enough evidence, but no sufficient proof for you.
Although, could you point to the part of the DSM that claims ODD is a physiological or neurological disease? Even a disease at all?
But I’ll tell ya what, I’m a sporting fellow, and since I have access to someone who knows it all here; let me ask you.
A kid gets suspended from school for repeatedly pestering other kids, often leading to fights. He’s been to time out, detention, stayed in from recess, sent to another classroom for the day, nothing seems to faze the kid. He simply won’t take responsibility for doing any of the things the teacher and other students say he does. He usually blames someone else for his indiscretions, even when confronted with eye witnesses and overwhelming logic. He argues with the teacher over things he feels are unjust, although none of the other students have a problem with these injustices. He’s flunking school. He’s smart enough, his IQ is average, but often he doesn’t do his homework and doesn’t learn the material for tests. His mom says that getting him to do anything around the house is a major battle.
He’s the kind of kid who won’t let anything go. If another student bumps into him, even if by accident, he seems compelled to shove that other student back. If he bumps into another student, he won’t apologize and when shoved back, of course, he hits the other kid and reports feeling justified in doing so because the kid pushed him.
Sometimes he does it seemingly on purpose by the teacher’s report.
He sits out of about half the P.E. activities because of this type of behavior, and P.E. is his favorite class.
Since data is stored because of physical properties and changes to those physical properties I’d enjoy hearing how, other than an arbitrary level of analysis distinction, you make that meaningful distinction.
What is “neurologic” and what is “psychiatric” are matters of historical happenstance, not scientific reality. Neurology has staked out the turf with more easily quantified data. Seizures, strokes, etc. Psychiatry staked out harder to quantify behaviors that include socio-emotional dimensions. As understanding of brain function has advanced it is realized that the socio-emotional and the cognitive systems are intertwined. Disorders like schizophrenia, autism, depression, ADD, etc. are complex and as yet not well understood. It is well established that they have clear components of biologic predisposition in the inate hardwiring of the brain even if the exact nature of those differences are not well worked out in all cases. For some of these disorders changes to the physical structures that occurs as a result of experience or environmental insults also may play a factor to some greater or lesser degree.
I think that you are trying to declare as “psychologic” those changes that occur as a result of experience, but it is impossible to seperate out the inate structural predispositions of different brain systems to react to experiences in certain ways from the effects of experience alone.
Which doesn’t answer the question of whether you know the distinction.
** Conceptually? That’s easy. A psychological disorder would be a function of the data stored in the brain and not problems with the biological mechanisms by which the brain operates. A physiological disorder would be a function of the biological operating system of the brain.
How can we distinguish between the two with today’s technology and understanding of the brain? We can’t. That’s my point. The claim that we understand mental disorders – how they arise, what they are, how their treatments actually work – is not based in scientific evidence, and as such is invalid.
** I’m not even sure how to interpret this rather incoherent set of claims. The distinction between psychiatry and neurology was initially that neurologists were medical professionals with degrees while psychiatrists were not. Some have suggested that the resulting “physics envy” has persisted to this day.
** No. You’re confusing physiological association, genetic predisposition, environmental predisposition, hardwiring vs. learning, and our ability to identify physical anomalies in the mentally ill.
** We have no idea what the factors are, or even what the conditions are. We have no grounds for stating that potential physiological causes are more important than potential environmental or cultural causes. Your claim is invalid.
Again, I would recommend that you read Blaiming the Brain by Elliot S. Valenstein. It’s thorough, relatively easy to understand, and without gross bias. It also examines the history of clinical psychology and psychiatry – a subject you clearly need to bone up on.
Well versed enough to claim that psychiatrists were not professionals with degrees. Buddy, from the start psychiatrists were MDs. From Philipe Pinel in the 1700’s to Emil Kraepelin in the late 1800s who first attempted to classify mental disorders according to symptomology couse and prognosis to Freud and beyond.
Just in keeping with your level of being well versed so far demonstrated.
I dont know, I dont understand why everyone is coming down so hard on TVAA when all he’s really been doing is pointing out the obvious; many if not most of the criteria to date for a dignosis of ADD or ODD or whatever has been largely subjective and subject to cultural/social opinions as to whats normal or not. What gets me is people asking him for cites to that effect!
Ive read through the whole damn thread and none of the experts here has offered proof otherwise. The first post offering any sort of objective, or attempt at an objective test/diagnosis, was by auliya in her post above; it only took 5 pages. But since NeuroSPECT imagery tests are not in any way a requirement for an ADD/ADT or OPP dignosis, at least currently, its kind of irrelevent.
It seems clear that ritalin and other drugs do not treat the disorder, but treat the symptoms. Thats fine in and of itself, but no one here from the industry has come out and stated ‘well its a temporary way to deal with the symptoms until we can define/isolate the actual causes’. Im sorry but treating the symptoms is not the same as treating the disorder.
Really, most of what Ive read here from those in the industry amounts to ‘we dont know the root causes but ritalin/drugs makes sufferers feel better and makes them less annoying to those who have to be around them’. I mean, on a certain level, thats fine, but just come out and say it. Ritalin and other drugs are not a cure, so much is clear; they are a lid. Treatment is not aimed at a cure, but at an accomodation.
All TVAA has really been doing is pointing out the very obvious danger in letting things be diognosed in such obviously and by-their-nature subjective ways, and all he’s gotten is flak. Rather than argue the logic he has presented, too many (for my comfort) industry people have demanded to know his qualifications. The first sign of not being able to refute an argment is to call into question the person making it. Its almost as if some people in the industry are of the opinion that only others in the industry may question the industry, which is of course absurd.
TVAA keeps making statements about practices in the profession as though they were fact. For facts you need proof.
I see you too have been duped into thinking ritalin has anything to do with ODD (directly, I mean, it’s used to treat the symptoms of ADD, and a high percentage of kids with ADD develop ODD) that distraction seems to come courtesy of TVAA as well. I agree, BTW, treating the symptoms doesn’t mean treating the disorder.
Medications (In my opinion) should be used as a starting point, a supplementation of treatment, something we use to allow the kid a moment to consider the consequences before acting. Treatment entails helping the client use that moment. For some people, medication is all that’s needed. Most need to know what to do now that they no longer have the physiological aspect of the problem.
Well, if one purports to speak as if an expert while providing no proof of assertions we’re left to rely on that person’s expertise alone. Without even qualifying one’s expertise, we’re left with no reason to take that person seriously nor treat them with respect, especially if that person is insulting.
TVAA seems to be insulting the practice of psychiatry/psychology without fully understanding it, or even trying to do so. It’s as much art as it is science. Without appreciating the context of the manifestation of a disorder in an actual human being, one cannot seriously claim to understand the disorder.
It would truly be absurd for those in the profession not to hear criticism, I agree. I personally am unwilling to conceede any point to TVAA because I don’t believe that such a concession could be looked at objectively.
That is really a poor reading of the assertions that TVAA has been making. He has been arguing far more than that. I don’t think that anyone has argued against there being some subjectivity within some symptoms. However, this varies across symptoms and disorders. In regards to ODD, this really comes down to a consideration of what “often” means.
Ive read through the whole damn thread and none of the experts here has offered proof otherwise. The first post offering any sort of objective, or attempt at an objective test/diagnosis, was by auliya in her post above; it only took 5 pages. But since NeuroSPECT imagery tests are not in any way a requirement for an ADD/ADT or OPP dignosis, at least currently, its kind of irrelevent.
It seems clear that ritalin and other drugs do not treat the disorder, but treat the symptoms. Thats fine in and of itself, but no one here from the industry has come out and stated ‘well its a temporary way to deal with the symptoms until we can define/isolate the actual causes’. Im sorry but treating the symptoms is not the same as treating the disorder.
Really, most of what Ive read here from those in the industry amounts to ‘we dont know the root causes but ritalin/drugs makes sufferers feel better and makes them less annoying to those who have to be around them’. I mean, on a certain level, thats fine, but just come out and say it. Ritalin and other drugs are not a cure, so much is clear; they are a lid. Treatment is not aimed at a cure, but at an accomodation.
All TVAA has really been doing is pointing out the very obvious danger in letting things be diognosed in such obviously and by-their-nature subjective ways, and all he’s gotten is flak. Rather than argue the logic he has presented, too many (for my comfort) industry people have demanded to know his qualifications. The first sign of not being able to refute an argment is to call into question the person making it. Its almost as if some people in the industry are of the opinion that only others in the industry may question the industry, which is of course absurd. **
[/QUOTE]
That is really a poor reading of the assertions that TVAA has been making. He has been arguing far more than that. I don’t think that anyone has argued against there being some subjectivity within some symptoms. However, this varies across symptoms and disorders or “whatever.” In regards to ODD, this really comes down to a consideration of what “often” means. The diagnostic criteria are not subject to cultural/social opinions. The question is how useful the diagnostic criteria are among different cultures. Within the United States, they appear to be equally valid across cultures. The ICD-10 organizes the symptoms of ODD and CD a bit differently, but essentially the items are the same. I know of several studies that find ODD symptoms to have utility in different countries, such as China and Turkey. I think there was one study that found some reliability concerns with the diagnosis in a sample in New Zealand, or Australia, but I would have to find the reference for that. Is there any particular information you have regarding variance across cultures?
Well, first you were talking about subjectivity within the symptoms and cultural variation, and now you are talking about biological or physiological indicators. These are two different issues. No reliable markers for the disorders have been found, meaning that they would not serve as reliable ways to identify the disorders. This does not change the fact that the 8 symptoms of ODD identified in the DSM have been found to be useful in identifying a subgroup of children who share common risks and similar courses.
As a nitpick, it’s really more of a profession than an industry. I took pains to cite review material that suggests that medications are not considered particularly effective in treating ODD. And I think it has been repeatedly said that we are trying to move forward to better identify, with greater precision and reliability, the disorder. We try to identify the best interventions that are most reliably associated with a decrease in symptom related impairment. If we can do this, I am less concerned with whether we are addressing symptoms or causes (although again the most precise diagnostic criteria are still the goal).
Then you have not been reading very carefully at all.
Again, you seem to have skipped over a great many assertions of TVAA. Now, I agree that he is all over the board with his arguments, but even a casual read through the thread would have found arguments about whether psychology/psychiatry are sciences, whether ODD reflects mere coercion and/or pathologizing of healthy defiance, and a host of other tangents, side tracks, red herrings, gross mischaracterizations and flat out errors (psychiatrists not being MDs being only the most recent). His qualifications are the least relevant argument that has been put to him. I don’t really care about one’s qualifications if they can present evidence to support an argument. Wild ass accusations on the other hand…
** Nice try. Pinel was not a psychiatrist. Neither was Kraepelin – although he’s now considered the Father of Psychiatry, his work was ignored throughout much of the twentieth century because of Freud. Freud wasn’t a practicing physician, and Freudian psychotherapists were generally not doctors.
** No, that is not what it comes down to, and cultural/social opinions are vitally important! The problem is that the “culture” in question is that of the psychiatric profession.
** And they’re nevertheless quite vague. How are we to determine when a child is unreasonably disobedient?
** Yes, but is that distinction meaningful? Do children who fit the ODD criteria (subjective as that is) behave significantly differently than a child who only fits some or most of the criteria?
** But first we must justify the claim that there is a disorder to be reliable about!
I said the first were not, and they weren’t. Quit distorting my statements.
