Look, I am not saying that this stuff doesn’t exist either, but I do know that sometimes only YOU can fix your own problem. Sure, there are people out there that have a mental disease and they must have medication to prevent suicide or certain dangerous behaviors. That does not, however, lend credibility to the fact that just because you feel less that normal that you have a mental problem.
I am not a strong person by any means, but I have been able to deal with anxiety and depression and cure it without medicine. Yes, I get anxious and depressed from time to time but not like I used to. I keep my head up; think positive; talk to people and just go with the flow of life. Sometimes thinking you have a disorder, and handicapping yourself is 10x worse than the actual disorder.
I beg that some of you start trying to overcome things with willpower. Some might be able and some might not. It will mainly depend on how severe your illness is to begin with. I just hate pity parties that is all.
Requirements for certification as a practicing psychotherapist in Sweden currently include:
3 to 4 years of university study in a related field (psychology, social work, or [in my case] sociology);
Plus so-called “Step I” training, which usually involves 1 to 2 years of academic coursework plus at least 2 patients in supervised therapy for a year and a half, and at least 50 hours of personal psychotherapy under a “training therapist;”
Plus “Step II” training, which currently involves three additional years of academic coursework plus at least 2 patients in supervised therapy for at least 2 1/2 years, and an addition 75 hours of personal therapy.
Between “Step I” and “Step II” the candidate is required to spend a minimum of two years working within psychiatry or a closely related field.
I might add that thus far, the state provides certification exclusively for therapists trained in the “psychoanalytic” tradition, although this broadly includes the classical psychoanalysis (rare, these days), “object relations theory”, and Lacaninan flavors.
I was actually enrolled in a 5-year course (which has been subsequently phased out), so my entire period of training stretches over nearly a decade.
Psychotherapists do not have the right (or training) to prescribe medication, so I have no formal training in that. However, the DSM IV is used by all manner of folk: social workers, research psychologists, clinical psychologist, psychotherapists, etc. Clinical psychologists don’t have the right to prescribe medication either, at least not at the moment, although I understand that in the States they are lobbying for that right. Another caveat: I’ve not been formally trained to apply DSM diagnoses, since we use a different diagnostic system. But I nevertheless understand the diagnostic process employed with the DSM (or at least, I think I do).
Not at all. Ask away! Hentor:
Well turn that smile upside down!
Naturally, I’ve not scrutinized TVAA as carefully as I’ve scrutinized Bush, but on the other hand, he isn’t trying to start a war (is he?). What I’ve had trouble grokking, at least up till now, is the rancor. I completely agree with you that T has a tendency to overstate his case, that his posts contain numerous technical inaccuracies, and that he egregiously fails to support his arguments. Those are the down sides. But it’s not like everything he posts is complete shite – he also has some good points amid the dross. Important points, in fact, if you want my opinion. Standing as it were outside the debate, I see a polarization occurring that I don’t really understand: you, greck, and Primaflora (among others) ripping him a new asshole. Maybe he deserves it; maybe I’m just not seeing it.
I’ll give you my opinion, then, about the quotes you’ve posted from TVAA, beginning with this one:
I have no idea what he means with this.
To me, the question of whether or not one should consider a discipline to be “scientific” is old-fashioned and rather irrelevant. However, I suspect there is some merit to the accusation that in applying certain “scientific” methodologies to its object of study, clinical psychology risks “missing” important factors that are difficult, perhaps impossible, to “operationalize” in that manner. I also suspect there is some truth to the implication that these methodologies are applied in order to give psychology the appearance of a “science,” that is, as a means of legitimizing it. Statistics is the language of bureaucracy (and science); in order to qualify for financing, the findings of psychology must be expressed in that language.
Worse (perhaps) for TVAA, I strongly support financing types of research that he would in all probability label as “completely non-scientific.”
You are correct to point out that T hasn’t supported this statement, which may also be something of an overgeneralization. On the other hand, this approach is employed to this very day, in the sense that many children diagnosed with ADHD haven’t been properly evaluated. There’s a difference between the diagnostic practices advocated in the DSM and their practical application, one imposed by constraints on time, resources, education, etc. On the other hand, I can’t back that claim up either, except with my own anecdotal experiences. YMMV.
You reply, “Clinical psychology has nothing to do with pharmaceutical advertisements,” which is true as far as it goes, because at this point clinical psychologists aren’t allowed to prescribe medication. But (again, speaking from my own experience), there is a kind of “unholy alliance” between psychiatry and the medical industry (at least here in Sweden), in that it is to the economic advantage of both fields that psychological “disorders” are categorized/reduced to biological “illnesses.” And I react to the commercials I’ve seen in the States much in the same way T does. They are atrocious.
This is a judgement call, a matter of opinion. You and T disagree. It could be the substance of an interesting/enlightening debate, if each of you would quit insulting the other.
:shrug:
All scientific knowledge is arrived at by expert consensus. In that sense the DSM isn’t different from any other scientific report. Why apply standards to psychology that aren’t applicable to physics, chemistry, or any other field of research?
I would argue that T possesses a rather outdated understanding of the term “science.” He needs to read some Kuhn.
Okay, gotta go. Just a couple of quick final responses:
T contradicts himself when he first claims:
…and then goes on to state, regarding the correspondence level of inter-rater reliability (above zero, as you point out):
First off, it’s ridiculous for anyone to call you an idiot, which you obviously aren’t. When the polemics have reached this level, perhaps it’s time to pull the plug on the discussion.
Again, I agree with you that he’s overstating his case, but anti-psychiatry has always been a rather categorical protest movement. I understand you have some history with him on this issue, but from where I’m sitting it appeared that in couple threads TVAA expressed some rather innocuous, if slightly controversial, opinions, and was then struck by an onslaught of hostile responses, many of which were based on misreadings of his original argument (consider the OP, for example). Even you agree that there are problems with the DSM’s diagnostic categories, so the difference between the two of you seems to me to be one more of degree than kind. Not that it’s any of my business, really.
The “subjectivity” of psychology is not only a weakness. It’s also a strength. I rely on my own subjective impressions and responses to the patient every time I step into the consulting room. My data are all “subjective;” does that make me a “scientist” or a charlatan?
Kleptocracy, I tried just that. As a result, I wound up in a mental hospital close to catatonic. I am a strong person, and pretty much always have been. There are also, as far as I can make out, strong situational components to my problems, some of which I’ve alluded to on this message board. I’m not on medication and I’m not in therapy right now, but the therapy I have received for clinical depression during the last 18 months is the reason why when I was feeling very depressed after a brutal day at work this week, I did not beat myself up for being incompetent. This is a first for me.
I can’t speak for other mental disorders, only depression. When it’s at its worst, I genuinely and deeply believe that I am worthless, useless, and unworthy of life. I sincerely believe that I am a burden on my friends and family, and that they would be better off without me. This isn’t an exaggeration, and it is as real to me as this keyboard I’m typing on. Therapy has helped, both the initial therapy which was coupled with drugs 11 years ago, and the therapy I was in recently for about 14 months. The difference is evident not only to me, but to those closest to me, including my family, who weren’t big believers in psychotherapy originally. If I could “just snap out of it”, believe me, I would. I’ve certainly tried hard enough to. On the other hand, if I can’t do that on the spot, I will work to do it long term by getting treatment as needed and doing what I can.
I realize the effects and side effects of the drugs used to treat depression aren’t well known or understood – I’m the person who started an MPSIMS thread a year ago because Zoloft left me throwing up everything I even considered eating, and Wellbutrin, which did a great deal of good for a friend of mine, left me almost too jittery to type. I also know that the causes of depression aren’t well understood and that they will vary from person to person. As I said, in my case, there’s a great deal of external reasons I’m depressed, which may have done more damage than any internal quirks of brain chemistry. I am glad I was treated, however, simply because if I hadn’t been, I would be dead now.
This isn’t a pity party; it’s simply a fact of life for me, just as a friend’s diabetes is a fact of life for him. I’m strong, tough, and sensible, but part of being sensible tells me to seek help before I wind up unable to do so. There are also psychiatrists and psychotherapists out there who are first rant, incompetent twits. I don’t blame anyone for walking out on them, and I’ve done so myself, which is one reason I didn’t seek help when things were going bad. There are also ones out there who are genuinely good and who can do a lot of good. If I ever come up with a way to tell the difference before meeting them or during an initial phone call, I’ll let you know.
Siege, I’ve heard the “toughen up and get over it” bullshit that kleptocracy is preaching all my life, I believe him/her when he/she says they don’t have anything really wrong with them, or they probably wouldn’t say things like that, I think there is alot of overdiagnosis these days, mostly due to higher patient awareness, sees TV ad for zoloft, thinks “oh you know, I have felt rather sad lately,” goes to GP, diagnosed with major depression, perscribed zoloft. I also know that if you have a real condition, let it slide for years and try to “just get over it”, they WILL eventually take your fucking belt away when your wife hauls you into the ER after you won’t get out of bed for days on end. I don’t want a badge, its not something I discuss IRL, except with family, it sucks. Why would I make up something that is detrimental to my marriage, family relationships, and career? Oh yeah, cause pity is so underated compared to those things. :rolleyes:
For what it’s worth, I’m never sure to what degree I agree or disagree with TVAA – he has a written style that seems framed to obscure the elemental semantics therein.
Nevertheless, I kind of like him.
And, pertinently, on the subject of the inherent difficulties and pitfalls of the diagnosis and classification of mental disorders, I think he has a point. It’s just so hard to tell.
The Great Unwashed, that poem struck a chord with me, and made me chuckle. You are a poet, if one with a rather poor sense of hygiene.
As for kleptocracy - he has a valid point, but that only extends to some. Some people just can’t “get over” whatever they have. It’s pretty much impossible. A friend with clinical depression, however, is the most level-headed and philisophical person I know, through the use of willpower, aided by no medication whatsoever. It took her awhile, but she’s happy with herself.
Mr. Svinlesha, thanks for your courtesy in responding and for encouraging me to “ask away.” What is your experience (work-related) with psychiatry?
I am unware of a lobbying effort (on the part of psychologists in the U.S.) to be allowed to perscribe medications. That is a rather scary thought! I would think that most of them would no better than to open that can of worms for themselves.
I’m glad to see that Sweden has such high standards for psychotherapists.
There are several kinds of clinical depression and I’m certainly not a psychiatrist – just a long-term patient who tried too many times to handle it on my own.
Kleptocracy, I admire your courage in pulling yourself out of your funk and finding solutions to whatever was bothering you.
But please remember that there are lots of kinds of depression. Sometimes depression is not clinical depression or a mood disorder. Sometimes it is not a matter of a chemical imbalance in the brain. Where does will power come from? I would think it starts in the brain – right? What if your brain is damaged and unable to perform and muster any will power? What may be possible for you may not be possible for someone else.
I agree that people should try to do things to make themselves feel better. (Exercise, attitude adjustment, etc.) But if it doesn’t work, they shouldn’t fault themselves. And if it becomes even impossible for them to try, then that is not a character flaw either.
Do a little research on the relationship between Parkinson’s and clinical depression. You wouldn’t insist that a Parkinson’s patient could use will power to stop shaking, would you?
Seige, I hope that you never remain silent on these issues. I know that you know.
Siege- I understand what you mean and it is obvious that you have tried. That is all I am trying to get across to some people. They never try and expect medication to just pull them right up. Good luck in your continuing battle.
labmonkey- I have had to be checked into a hospital on three different occasions for my depression and anxiety. I was under treatment for several years and on medication. I didn’t start feeling better until I stopped feeling better for myself and said I didn’t want to feel that way anymore. It didn’t matter what happened anymore but I knew I didn’t want to be depressed. I am not always happy but I am not depressed anymore. Occasionally, I will get down again but I just remember my philosophy and it gets better when I use it. I didn’t go to my GP when I was diagnosed but I did see two psychiatrists and two psychologists and they both agreed with each others diagnoses. What do you want me to say? You want me to say that it was just a misdiagnosis because I am not feeling sorry for myself anymore? I won’t do that. Good luck with your battle too if you have one.
Zoe- Yes, I do realize some of it is an unfortunate chemical imbalance. I thought I had alluded to that in one of my prior posts, but if I didn’t state it explicitly then sorry. To be honest with you… I faintly recall a study on Parkinson’s that stated people were achieving results by willing the shakes a way. I will try to find what I am talking about or maybe it was just a trick of my mind. I want to say it was some kind of treatment that Michael J. Fox was using.
** Cognitive psychologists study the nature and structure of the mind by analyzing people’s performance on laboratory tasks and responses to certain kinds of sensory stimuli.
There aren’t many legal issues that arise when someone claims to be a cognitive psychologist.
** People are not claiming to have certain symptoms – they’re saying they have some disorder and implying that it’s a specific physical problem.
That is not an “ancedotal self-report”: it’s just an unjustified claim.
This will absolutely be my last exchange with you, TVAA. I have wasted far too much time. I wish I had the patience of Mr. S, but I simply do not.
Given that one of the measures was the CBCL, simply one of the most frequently employed questionnaires that has been involved in many empirical tests of its performance, I know that the authors never said this. I have repeatedly asked you to quote the authors. Tell me where they suggest that the Child Behavior Checklist has never been empirically evaluated before. For once, cite!, silly person!
At long last, however, I thought TVAA was starting to understand the methodology employed in the paper. Until…
Tell me, then, how do you employ a control group or “baseline” in a factor analysis? Were the population sampled children’s data used or not used in the analysis? If they were used, how, pray tell, were their data distinguished in a factor analysis from the other children in any way that would allow for a baseline or control comparison. If their data were not used, why did the authors bother to even make mention of the data, going so far as to include the n’s and descriptive data regarding these various samples?
The answer is that multiple samples are included in the study to represent a variety of children, some with and some without psychopatholgy, and make a compelling confirmation of the DSM theorized model. Parent and teacher ratings of all the children were included in the analyses. There is no baseline or comparison group, because the associations between variables (in this case, behaviors) is the focus of the analysis.
While none of my published papers have used factor analyses, I have used the technique in other capacities. Have you ever used it? If you have no expertise or even any apparent familliarity with the technique, how in hell are you able to come to different conclusions than the authors who actually conducted the study? You simply don’t understand what they did. For example,
makes absolutely no sense given the nature of the analyses. Match with what? In confirmatory factor analysis, one indicator of the strength of a model is it’s comparison to other models, including an unspecified model. In this study, the DSM model was statistically significantly superior to the other models tested.
Why don’t you bone up on the analytic technique before continuing to make an ass out of yourself, particularly the interpretation of goodness of fit and the testing of models in CFA? Or you know what? Don’t bone up on it. You and I both know you aren’t interested in actually understanding what was done, and I couldn’t care less.
Your ability to expound on a subject you have not a whit of knowledge about is the very reason why you have been pitted here. You remain an unrepetent twit.
Regarding any future nonsense you might spew, nobody should take silence from me as assent. I quote Ted Knight, as Judge Smails from Caddyshack: “The man’s a menace!”
You see, I think the first of these says that you are “out of this thread” – that’s not a general rule, but this thread actively seeks to engage TVAA, if you decline to do so, what could be left to say? Of course you could claim that you were merely providing a factual answer to a factual question, fair enough, but then, why would you be reading the thread?
And thank you, Gadfly, but can I assure you that my hygiene is considerably better than my poetry.
Kleptocracy, so basically, are you trying to say that a person has to WANT to help him or herself? Because if you are, I agree-you can’t force someone to go to therapy.
And no, medication is NOT a magic cure all. It’s an aid, but without some therapy and actually trying to get better in addition, it won’t cause your troubles to just go away automatically.
I don’t follow - is Computer GuruTVAA? Seems a bit nit picky to me. I said I would choose not to respond to TVAA. I said nothing about not talking about psychology and mental health, especially since its the one area I can actually contribute some expertise on the boards. So why not read the thread and respond to others? Or does it follow that if I read the thread I will have to respond to TVAA? Hmm. I am left wondering what your point is.
** The whole point of the research was to examine the degree to which theory-driven standards matched actual associations between certain variables. The authors state that there’s been little work establishing the relative validity between clinical and psychometric standards. Though they did not state that the CBC had never been evaluated before, their research was being conducted in order to evaluate it and other instruments in a particular empirical way.
Obviously.
My interpretation and discussion of this study hasn’t changed since you first brought it up. Perhaps the problem isn’t that I don’t understand it, but that you don’t understand what I’m saying about it.
** Not quite.
The authors clearly state that they compensated for the inherent correlation between the items. How can they determine that other than examining the general population? It’s like the MMPI: if you don’t compare the clinical population with the baseline, you might end up with an instrument that responds not only to some underlying disorder but to perfectly “healthy” people as well.
If you want to test the hypothesis that depressed people are more likely to head straight for the comics section of a newspaper, you need to look at both depressed people and non-depressed people. If you want to test the hypothesis that symptoms are associated with each other in a way consistent with an underlying disorder, you need to screen out the associations they might have in normal people.
Twit.
** Merely superior – it provided the best explanation for the variance they saw. Its compatibility still wasn’t statistically significant, as the authors pointed out repeatedly.
You’ve also repeatedly ignored the extremely obvious conclusion (of the authors themselves) that the research failed to find at least one very important finding that they’d hoped to find.
