July 25, 2017

"Psychiatry group tells members they can defy ‘Goldwater rule’ and comment on Trump’s mental health."

The executive committee of the American Psychoanalytic Association emailed its 3,500 members, STAT reports.
The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. “We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

An increasing number of psychologists and psychiatrists have denounced the restriction as a “gag rule” and flouted it, with some arguing they have a “duty to warn” the public about what they see as Trump’s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead....

“In the case of Donald Trump, there is an extraordinary abundance of speech and behavior on which one could form a judgment,” [said Dr. Leonard Glass, a psychiatrist at Harvard Medical School]. “It’s not definitive, it’s an informed hypothesis, and one we should be able to offer rather than the stunning silence demanded by the Goldwater rule.”
Let them speak, and then the rest of us will speak about whether they are professionals deserving of deference or human beings like the rest of us who can't keep our political preferences from skewing whatever it is we might think about some pressing issue of the day.

Go ahead, expose yourselves. Let us see all narcissism, impulsivity, poor attention span, paranoia, and other traits that impair your ability to lead.

IN THE COMMENTS: David said:
The percentage of hacks, cranks and fools in the mental health "profession" is stunningly high. And many of them are in a position to make individual lives worse.
And Michael K (who is a surgeon) said:
I personally know several who went into Psychiatry to deal with their own mental health problems. One guy was a former surgery resident who went full psychotic and started to be treated by the chief of Psychiatry at a university medial center. That chief of Psychiatry then accepted him into the residency which he finished. He was brilliant but as crazy as anyone I've ever seen.

171 comments:

Darrell said...

Can we comment that their whole profession is bullshit?

Henry said...

Can we comment that their whole profession is bullshit?

Looks like it.

Henry said...

I'm guessing they also approved calling Chris Christie "fat".

Chuck said...

The same politically-loaded, arch-liberal, preening elites who, in 1973, and with no great new development in the science, determined to depathologize homosexuality in the DSM.

You are so right, Professor Althouse; it is bullshit from the APA. More bullshit, in fact.

Mike said...

Nothing says principled leadership like rewriting your own rules to allow unethical diagnoses!

David said...

The percentage of hacks, cranks and fools in the mental health "profession" is stunningly high. And many of them are in a position to make individual lives worse.

Michael K said...

Psychiatry and especially psychoanalysis, has disgraced itself in many ways since 1964.

We had a discussion at work last week about getting psych consults on problematic recruits. We agreed they are useless but another doc suggested they are useful for ass covering.

If the recruit goes postal (or Full Metal Jacket) in basic, we can say, "Well, we got a psych consult and they said he was OK."

What we are seeing in this country (and in these comments) is something similar to the day care center hysteria of the 80s.

Psychiatry disgraced itself in that hysteria, also.

LYNNDH said...

Prudence needs some prudence.

Michael K said...

The percentage of hacks, cranks and fools in the mental health "profession" is stunningly high

I personally know several who went into Psychiatry to deal with their own mental health problems. One guy was a former surgery resident who went full psychotic and started to be treated by the chief of Psychiatry at a university medial center. That chief of Psychiatry then accepted him into the residency which he finished. He was brilliant but as crazy as anyone I've ever seen.

David said...

My latest experience with the "profession" is a court appointed psychologist in family court of a relative. The psychologist's incompetence, unchallenged by the guardian ad litem and virtually unchallengeable by the litigants, has been adopted by the court, to the detriment of the minor children supposedly being protected. The law hands to he GAL and the voice of the children. Very little recourse when those are the voices of fools.

The Cracker Emcee Activist said...

Apparently they've learned nothing from the ongoing cratering of the MSM. Lemmings, indeed.

Ralph L said...

Transparency!

I'd like to see them treat someone else's TDS with more TDS.

traditionalguy said...

The restraint was to protect the practitioners. The conundrum was the false Honorarium "Doctor" added to the titles used by priests of Freud's talk therapy for wives of rich men that the rich men wanted out of the picture without a divorce. It was always a con by seeking money from whomever pays them the most.

Now it will be used to get the rich men a Divorce from Trump Populism.

Earnest Prole said...

If we can't enjoy Trump's wacky nuttiness then what fun is his presidency? Must everything in life be a slog?

David Begley said...

APA contracts TDS.

Hagar said...

Their whole profession is not bullshit, but a high percentage of it is.
A lot of them got into psychology because they were worried about their own mental state.

cubanbob said...

Considering the harm LBJ did it wasn't Goldwater who was crazy.

Oso Negro said...

And another step closer to civil war.

Michael K said...

"Considering the harm LBJ did it wasn't Goldwater who was crazy."

I am reading (via audio books) Caro's biography of LBJ. He was a weird and probably severely neurotic person. Until I began the first volume, I did not realize that his biographer did not like him.

sinz52 said...

"Psychological studies" are an ancient ploy, half a century old now, used by political activists against politicians they dislike. Usually Republican politicians and even Democratic politicians who were foreign-policy hawks.

No real mental-health professional would try to psychoanalyze somebody based on his policies and public statements, many of which have been prepped by his staff.

What they would be doing is "psychoanalyzing" the *Trump administration*, not just Trump. Because they have no visibility into how much of the Trump administration's actions and statements are Trump's alone vs. those of his staff and subordinates.

And that's entirely political.

Hammond X. Gritzkofe said...

Agreed. The psychiatric profession is on the cusp of beclowning itself and putting its irrelevance on display.

Are these "experts in human behavior" observant enough to notice recent changes in public attitude toward major news media?

Nick said...

This is the primary value of Free Speech. Not for our own vain expressions, but that idiots may declare themselves openly and thus more appropriately dealt with.

HoodlumDoodlum said...

A rule is a rule is a rule, until it's time to attack a Republican...

Pop culture reference: The Code is more what you'd call guidelines, than a rule

sinz52 said...

"The restraint was to protect the practitioners. The conundrum was the false Honorarium "Doctor" added to the titles used by priests of Freud's talk therapy for wives of rich men that the rich men wanted out of the picture without a divorce."

WRONG.
It was quite the reverse.

Freud discovered that a lot of female neurosis was caused by the fact that their husbands were lousy lovers. I remember one of Freud's cases. The wife was neurotic and depressed. It turned out that she was a virgin before the got married, and her husband was completely impotent. If she remained faithful to him, she would never lose her virginity.

Freud had to keep the real reasons for neurosis a secret from the husbands who paid him. He didn't dare tell the husband that he was the problem.

rhhardin said...

Psychiatry is the most anal retentive profession.

sinz52 said...

There were other solutions prior to Freud's talk therapy.

Electricity was state-of-the-art back then, and a lot of family doctors made a lot of money using state-of-the-art "electrical massage machines" on their female patients (especially wives) to relieve their nervous tension.

Today, we call those machines "vibrators."

The only difference is that today, they're available without a prescription and you can use it yourself.

tcrosse said...

Considering the harm LBJ did it wasn't Goldwater who was crazy.

Although LBJ came in for his share of long-distance mental health assessment in his day.

Unknown said...

My initial reaction was entirely different -- diagnosis without actually meeting the patient, the next step in health care reform.

Jim R. said...

Reminds me of those doctors giving out notes to protesters during the Walker repeal. "Ye shall know them by their fruits."

I Have Misplaced My Pants said...

Go ahead, expose yourselves. Let us see all narcissism, impulsivity, poor attention span, paranoia, and other traits that impair your ability to lead.

Pure gold. This is why I am addicted to the Althouse blog.

EDH said...

So the "rule" still applies to everyone but Trump, until the APA says so?

tcrosse said...

Nothing like having a chorus of frogs calling you ugly.

Michael K said...

"One guy was a former surgery resident who went full psychotic "

Greg was an attending surgery when he had his first psychotic break. He was getting therapy and could not practice so I used to have him assist me in surgery cases when I was a fourth year resident. He was still a terrific surgeon although crazy as a bedbug. We would be doing a case and he would be telling me how he could not be an astronaut because he couldn't stand to be inside all that machinery.

A couple of months later, he showed up on my ward one day with his head shaved (not well. there were a couple of bandaids on his scalp) and grabbed my junior resident, who was Chinese, to go with him to buy a Buddha. Psychotic again.

Great guy. Brilliant but crazy.

Michael K said...

"It turned out that she was a virgin before the got married, and her husband was completely impotent. "

Sounds like Salvador Dali.

LordSomber said...

Anyone who dated psych majors in college learned all this early on.

Roy Jacobsen said...

Funny how they never see fit to comment on the pathological behavior of someone with a D after their name.

And by "funny," I mean."predictable."

Danno said...

This should be the impetus for removing mental health treatment from the Obamacare coverage (essential benefits) mandate.

Roy Jacobsen said...

Jim R said...
Reminds me of those doctors giving out notes to protesters during the Walker repeal. "Ye shall know them by their fruits."

I see what you did there.

EDH said...

This is the psychiatric equivalent to a bill of attainder.

tim maguire said...

Good psychiatrists exist, but are few and far between. The problem with the profession is that it is very difficult to separate the wheat from the chaff. Incompetence had never been a bar to advancement. What really matters is recognition in the field and recognition turns on facility with the language and proper respect for certain idols.

Unknown said...

"Let us see all narcissism, impulsivity, poor attention span, paranoia, and other traits that impair your ability to lead."

We have already seen it. For 6 months now.

Birkel said...

In which Chuck reminds us that his objection to Trump is that he is not pure in his feeling about Obergefell.

Boo!

tim maguire said...

One way to tell the good from the bad: the bad see the Goldwater rule as a limitation on their ability to be of service to the public.

Hunter said...

This is one time I have to admit, the Scientologists might be on to something.

Fernandinande said...

David said...
My latest experience with the "profession" is a court appointed psychologist in family court of a relative.


I'm sorry to hear that. Really. Judges use them to offload decision making so it looks like it's not the judge's fault when they completely fuck up.

"I think the mistake a lot of us make is thinking the state-appointed psychiatrist is our 'friend'." -- J.H.

Drago said...

Leftists using psychiatry to "diagnose" their political opponents and then using those fake diagnoses to imprison them is very well established with examples abounding over the last 100 years.

What do you get when you cross a leftist and any profession?

A leftist.

What do you get when you cross a leftist and any political/social movement?

A leftist.

These are the little steps on the way to mass graves and lefty "Utopias".

And if you think Trump would be the last republican so diagnosed by these totalitarians, you should have your head examined.

Larvell said...

So the "rule" still applies to everyone but Trump

Kind of like "standing" -- there's the rule, and then there's the Trump exception.

dgstock said...

Suicide rate among psychiatrists five times that of the general populace. So what exactly did you have to say to me?

roesch/voltaire said...

It doesn't take a degree in psychiatry to figure out Trump has sociopath traits and seems to suffer from ADD, but so what there are many "successful" people like this. The question is not whether psychiatrists should comment on his mental health, I don't think they should publicly although, but when and if congress and others determine this behavior is harmful to the country.

Bay Area Guy said...

Psychobabble meets Leftist politics! What could be more fun!

sunsong said...

It's clear he's a bully and a liar, and he is obsessed with himself. He's not loyal...look how he's treating Seesions and now Price and he threw the entire House GOP under the bus with his comment that the vote they took in support of him was "mean"...

Susan said...

Sure let's make psychiatry openly political. What could possibly go wrong?

Every normal thinking person knows how many fingers I'm holding up, right Winston?

Mark Jones said...

"Oh my God! Rodney Dangerfield has joined the country club. It's inconceivable! Quick, there must be something we can do to disqualify him!"

Fernandinande said...

Susan said...
Sure let's make psychiatry openly political.


Psikhushka!

Matthew Sablan said...

This is grossly irresponsible.

Obama was *also* vastly different than other Presidents.

Way to completely let down an entire profession.

J. Farmer said...

The American Psychoanalytic Association is a very small group that includes a small fraction of mental health practitioners. I believe only graduates of a relatively short list of approved psychoanalytic institutes are even eligible to join. Very few actual working psychiatrists (MD's who do a residency in psychiatry) actually practice psychoanalysis, and it is not viewed as a particularly useful treatment by working clinical psychologists.

I have hired dozens of mental health practitioners for my business over the years, and I agree that it is a field that attracts a lot of unqualified people, and the qualifications have been weakened over the years as more people have flooded into the field. In my experience, the best clinical practitioners are Clinical Social Workers or licensed psychologists with a PsyD, a doctoral program that places a much greater emphasis on clinical practice than it does on the more traditional research-focused PhD. Psychiatrists, due to their rates, are typically pill pushers who see patients for 15-minute med reviews.

David Hampton said...

A Psych Doc from Chicago, Illinois? My advice, based on Psych 1 and 2 over a year is "Heal thyself." Freud is spinning in his grave, the ultimate Safe Space alone with his mouldering ID.

Michael K said...

"Psychiatrists, due to their rates, are typically pill pushers who see patients for 15-minute med reviews."

That is what the Psychologists say but the talk therapy, aside from good advice, is generally useless.

There are rare good Psychiatrists but I haven't run into many.

"Pill pushing" is probably the only thing that works.

In my second book I have a chapter on my own experience with one of the rare great psychiatrists. He treated only psychotics which is extremely unusual since they are almost all broke and uninsured.

whitney said...

I think every single person that's been to college or university or any post-secondary education knows that Psychiatry students are always just trying to figure out what's wrong with themselves. Everyone except the Psychiatry students of course

jacksonjay said...

What can be said about troll anxiety?

Levi Starks said...

I personally think it's great they've broken protocol, and given members the opportunity to confirm that Trump is just as normal and sane as the roughly 1/2 of the voters who elected him. Otherwise if all we had to go on was what we hear from the mainstream media we might be led to believe he's insane, like the 1/2 voters who voted for Hillary.

J. Farmer said...

In a more recent CT -ADM placebo-controlled comparison, 240 severely depressed patients were randomized to ADM (n=120), CT (n=60) or a (pill) placebo control (n=60) treatment.35 ADM involved paroxetine (an SSRI), augmented with lithium or desipramine as needed. The providers of both the ADM and the CT were experienced practitioners who received feedback and supervision throughout the period of the study. As shown in FIG. 1, both CT and ADM outperformed placebo at the 8-week assessment point (after which the placebo condition was discontinued). At the end of the 16-week treatment phase of the study, there were no differences in outcome between ADM and CT, with 58% of patients in both treatment groups meeting the criteria for ‘response’. Curiously, there was no indication that the two treatments affected different symptom clusters of depression: patients treated with either ADM or CT showed comparable rates of change of both cognitive and vegetative symptoms of depression.

CT=cognitive therapy, ADM=antidepressant medication

Cognitive therapy vs. medications for depression: Treatment outcomes and neural mechanisms

Obviously this is a single study, but this result has been replicated numerous times over the years. There is certainly good evidence that psychotherapy is not "generally useless."

deepelemblues said...

Do you want more Trump

This is how you get more Trump

When are people going to figure this out

Ron Winkleheimer said...

talk therapy, aside from good advice, is generally useless.

And generally not covered by medical insurance. I read somewhere that the first psychotropic drugs were the death blow to psychoanalysis. Because the psychotropic drugs actually work (though with bad side effects) and the talking cure, as it used to be called, does not.

Peter said...

Is The American Psychoanalytic Association truly "leading psychiatry group"? How many psychoanalysts are still practicing psychoanalysis?

"The rule states that it is unethical to offer a professional opinion about a public figure’s mental health, including the presence or absence of a disorder, without that person’s consent and without doing a standard examination."

I don't know if it's unethical, but it surely diminishes the profession. This relates to Tom Nichols' book, "The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters." People come to distrust experts when they express "in my professional opinon" opinions that are either outside their field of expertise, or simply beyond the field's capabilities.

So, psychiatrists are free to say, "The candidate's nuts!" (or some more dignified term for "nuts"). And the public is free to ridicule them for doing so. It's not as if the public is going to insist that candidates for high political office undergo and make public the results of a psychiatric examination by a "professional" who may be strongly biased against the candidate already.

Although the examiner could fall back on the old damning-with-faint-praise report, "No psychosis was observed in the candidate today" (thus leaving open the possibility that such existed but did not happen to manifest during the exam).

tcrosse said...

Bob Newhart's Talk Therapy.

Stop It !

Francisco D said...

Psychoanalysis is a cult with no empirical support. It always has been and will continue to be. Well trained psychologists and psychiatrists ignore them.

It continues to have some believers, but mostly among the whack jobs and the poorly educated. (Yes. Not all advanced degrees are created equally.)

J. Farmer said...
This comment has been removed by the author.
J. Farmer said...

@Peter:

Is The American Psychoanalytic Association truly "leading psychiatry group"?

Certainly not. Its membership is around 3,000, which would be less than 10% of all working psychiatrists in the country. Also, many of its members are not psychiatrists. They accept as members many people with graduate degrees in a mental health-related field who have also attended a psychoanalytic training program. The leading professional organization for psychiatrists is the American Psychiatric Association, which has over 36,000 members, more than ten times the membership of the Psychoanalytic Association.

Yancey Ward said...

Seriously, Althouse, this doesn't get the Trump Derangement Syndrome tag????

Martin said...

Back when I was in college ca. 1970, one year my roommate was a Psych major as was his GF. It was absolutely clear to me that they were both nucking futs (to use the technical term) and taking Psych to try and figure out their problems.

Some years later, in separate conversations I asked a couple of psychologists whom I knew and trusted about how common that was, and both responded that it is VERY common, everybody in the field know about it but of course doesn't go talking about it to outsiders. The questions, big ones, revolved around how successful those people were in resolving their problems, and how many with serious unresolved issues went into the field and started screwing around in other, unsuspecting people's heads.

As for this latest, yes, by all means let them speak, and let the rest of us judge them based on what they say. They are likely to do more public damage to the credibility of their so-called profession, than they are to Trump, b/c anyone who cares has already formed an opinion of Trump, while many people have yet to see how crazy and stupid a lot of shrinks are.

Martin L. Shoemaker said...

How Soviet...

exhelodrvr1 said...

Of course, we know what that nothing negative will happen to psychiatrists who stray off the reservation, and that this would only be done to Trump.

So we have that going for us ...

Roy Jacobsen said...

There are FOUR lights.

David said...

"m maguire said...
Good psychiatrists exist, but are few and far between."

The problem goes far beyond psychiatrists. The "profession" is full of mid level counsellors who have only undergraduate degrees (if that) and easy to obtain "certifications" that pass as acceptable qualifications with government agencies, courts, "clinics," and other organizations. There is no significant supervision once they get into the right (for them) sector of the mental health and counseling apparatus. They are highly influenced by their own prejudices, biases and personal experience. Yet courts and other institutions accept their analysis and opinion as nearly determinative in important cases. I have a well qualified and sensible friend who estimates that maybe 5-10% of the child therapists she encounters in her own practice know what they are doing. The rest are winging it, and being paid well to do so.

It is such a scandal that there has been a literature developing on the issue. But nobody does anything about it.

~ Gordon Pasha said...

You could spot the future psychiatrists with 100% accuracy by the 3d month of med school. Since they had money they were "eccentric".

Martin L. Shoemaker said...

My experience with social workers is limited, I'm happy to say; but when a friend was going through a custody battle, we saw three kinds of social workers:

1. Bitter victims who saw every case exactly like they went through themselves.

2. Burn outs who just went through the motions. They tried to help, but they had mostly lost faith.

3. Naive idealists who would someday become 1 or 2. Or quit.

But on a positive note: My friend was dealing with a 1 who eventually realized that she was misreading the case, and she couldn't trust her judgment. She passed the case to a 2, who eventually roused himself to do right by the child. So sometimes the system does work.

David said...

Fernandinande said...
David said...
My latest experience with the "profession" is a court appointed psychologist in family court of a relative.

I'm sorry to hear that. Really. Judges use them to offload decision making so it looks like it's not the judge's fault when they completely fuck up.

"I think the mistake a lot of us make is thinking the state-appointed psychiatrist is our 'friend'." -- J.H.


In the Judge's defense, he can only act on the evidence that is before him. The system gives the GAL and the psychologist status as neutrals, while the parties appear to he he said-she said even if one is right and the other is wrong. You can't question the GAL, and the psychologist's testimony is largely conclusory opinion that is hard impeach. Yes the Judges should be more aggressive with both the guardians and the mental health testimony, but the system is not set up that way. It's in significant part a systemic problem, and much of the system was created over time by the "professionals" who feed from it.

J. Farmer said...

@David:

I do not doubt that there are under qualified people in the field; that is true of many fields. But the primary problem is that psychiatric illnesses are themselves difficult to define and often vague in their symptom clusters. Differential diagnosis between say, Major Depression with Psychotic Features versus Schizoaffective Disorder can be difficult to determine, particularly on a single intake interview, and often require prolonged observation of behavior over time.

The "profession" is full of mid level counsellors who have only undergraduate degrees (if that) and easy to obtain "certifications" that pass as acceptable qualifications with government agencies, courts, "clinics," and other organizations.

Do you have data on this? Forensic psychology happens to be the area of my professional work, and the requirement for licensure as a mental health professional (in the state of Florida anyway) requires a graduate degree in a clinical specialty followed by a period of two years of supervision and a certain amount of hours of direct clinical work. Anyone who is not licensed is required to work under the supervision of a licensed clinician.

I am not saying there are not problems in the field; I witness them everyday. But consider the field of general physicians, who require a great deal of training and supervision before they are permitted to practice independently. And yet, despite these safe guards, thousands of people die every year in hospitals due to physician errors and mistakes. Now I think even the medical error number is inflated due to overly broad definition of error, but it is undeniable that physician errors kill, despite a high level of training and supervision.

Gusty Winds said...

Joiurnalism sold its soul and destroyed its reputation to fight Trump. So did the Charlie Sykes, Bill Kristol type never Trumpers. Pollsters blew their cover and now we know they don't measure public opinion; they try and shape it. What's to stop psychiatrists from catching Trump derangement syndrome?

Hop in, the water's warm!

FullMoon said...
This comment has been removed by the author.
Michael K said...

Farmer, I don't want to get into an argument with you.

"There is certainly good evidence that psychotherapy is not "generally useless."

One big problem is that clinical depression has changed definition radically over the past 25 years.

David Healy has written about this for years.

He has a lecture I have seen in which he shows anti-depression magazine ads from about 50 years.

They began with women with expressions of severe depression. By 2000, the magazine ads for the anti-depressants showed happy housewives.

The condition has changed so much since lithium was discovered that I have no doubt your study is correct. The trouble is that depression as a clinical entity has changed, too.

Michael K said...

Also,

But consider the field of general physicians, who require a great deal of training and supervision before they are permitted to practice independently. And yet, despite these safe guards, thousands of people die every year in hospitals due to physician errors and mistakes.

Few "general physicians" do any hospital work any more.

It's all "hospitalists" who may not be particularly competent but they are another group.

J. Farmer said...

@Michael K:

Farmer, I don't want to get into an argument with you.

A difference of opinion does not have to lead into an argument, which implies a heated or angry tone. Reasonable people acting in good faith can still hash out differences.

One big problem is that clinical depression has changed definition radically over the past 25 years.

What is your source for this? The DSM-IV was published in 1994, the same years that ICD-10 came into effect, and the fifth edition was published in 2013. I am familiar with both sections on depressive disorders, and I have not seen any radical change in the definition.

DanTheMan said...

Oh, I just can't wait for the diagnosis of Bill Clinton.

Oh, wait, the new rule is not retroactive? Surely that's just an oversight they will correct soon.

J. Farmer said...

@Michael K:

Few "general physicians" do any hospital work any more.

That's just clunky phrasing on my part. I just meant to differential between non-psychiatric physicians who have attended medical school and a residency with the much lower threshold of education and supervision for non-psychiatric mental health professionals.

Kevin said...

Yet another group where the values which have held them in esteem must be thrown out in the individual case of Trump.

Yet another group steps up to beclown itself in the service of stopping a duly-elected public official who has broken no law.

All is proceeding as I have foreseen.

Unknown said...

"And Michael K (who is a surgeon) said"

So, is the implication that Michael K is not cuckoo because he is a surgeon. Jeez.

It is well known from many long-term medical studies that people with high IQ's and usually male tend to have the most mental problems or disorders. This is not new information.

Michael K said...

" I am familiar with both sections on depressive disorders, and I have not seen any radical change in the definition."

I doubt the DSM has changed but I'm talking about the use of anti-depressants.

The Healy book is what I was referring to.

I don't know how strict the criteria were in the study you quoted.

We are a long way from the days when Lithium was discovered or when INH was discovered to treat depression.

it was noted that elevation of mood and euphoria were reported in the literature1 as side-effects when patients with tuberculosis were treated with isoniazid. Accordingly, plans were made to study the effect of this drug on a group of depressed but nontuberculous patients seen in private psychiatric practice.

Actually, isoniazid is not new, having been synthesized in 1912,2 but its recognized success against tuberculosis has been of but two years' duration. In addition to being a potent tuberculostatic agent, recently it has been used with increasing frequency in conditions other than pulmonary disease.


That was from 1953.

Michael K said...

I have decided to ignore all comments by the leftists here.

campy said...

I have decided to ignore all comments by the leftists here.

A wise decision.

Brookzene said...

The percentage of hacks, cranks and fools in the mental health "profession" is stunningly high. And many of them are in a position to make individual lives worse.

What percentage is that?

Paddy O said...

This stems from a repressed experiences with their mothers, who they secretly hated, but had to show love for the sake of propriety. Creating an exception for Trump allows their conscious loathing to give voice to their subconscious rage, transferring their childhood emotions into a socially acceptable critique. This also allows them to express power against a domineering authority figure who otherwise magnifies their sense of inferiority.

Swede said...

It seemed like most of the chicks in psychology class were there for self diagnosis.

I was there to meet the crazy chicks. I figured: crazy in the head, crazy in the bed.

Mixed results.

readering said...

Is it too early to say Merry Christmas yet? Unclear from last night's speech.

mockturtle said...

I've known several psychiatrists--socially, not professionally--and the younger ones, at least, are all about chemistry and neurophysics. The old Freudian psychoanalytic model is as dead as the proverbial door nail.

Left Bank of the Charles said...

But will they put both Trump derangement syndrome and Clinton derangement syndrome in the DSM? One would have thought afflicted people would have gotten over Clinton derangement syndrome, but it seems just as virulent as ever. I think the industry is missing a growth opportunity for treatment programs. They'd need to build two sets of rehab centers, as mixing the TDS and CDS patients would not be good.


BTW, Charles Krauthammer has been selectively ignoring the Goldwater Rule for years.

mockturtle said...

And please don't confuse psychiatrists--physicians--with psychologists.

mockturtle said...

Swede suggests: I was there to meet the crazy chicks. I figured: crazy in the head, crazy in the bed.

A good lesson was taught in the movie Fatal Attraction. ;-)

traditionalguy said...

The theory of Psychiatry started as dream interpretations and claimed it could divine the unseen minds divided into a conscious and awake mind and an unconscious mind in conflict with it. Throw in a superego to referee. Surprisingly these all came from Greek Plays written in 500BC. Throw in a mantra of a Learned Austrian Science and have a WWF Wrestlerama assigned State authority to destroy and imprison difficult people. It never worked. But it tortured and imprisoned many an innocent victim.

There are a few impossible psychotic people. And there are end of life syphilis cases. And after wars, there are many Shell Shocked PTSD cases. So someone has to attend to them. There are some Demonized people.

But Psychiatry cannot help. But there is some good in a Psychologist acting as a Life Coach for badly parented people who want help bad enough to work through their blind spots.

J. Farmer said...

@mockturtle:

And please don't confuse psychiatrists--physicians--with psychologists.

Other than the ability to prescribe psychotropics, there really is not that much difference. And in a few states, clinical psychologists have certain limited abilities to prescribe. The first two years of med school are usually medical science courses that do not figure into the day-to-day practice of most psychiatrists. On the other hand, most clinical psychologists are trained in administering and interpreting standardized tests, such as the WAIS and the MMPI, which most psychiatrists do not administer or interpret. A typical residency in psychiatry is 4 years, and it typically takes 4 to 6 years to complete a doctoral program in clinical psychology after which an individual often has to work supervised for two years before being granted a license.

heyboom said...

My father-in-law is a psychiatrist for the VA who diagnoses disability cases. He is a Trump voter and supporter.

Howard said...

Let them diagnose Trump and watch the Streisand Effect take place.

J. Farmer said...

@traditionalguy:

The theory of Psychiatry started as dream interpretations and claimed it could divine the unseen minds divided into a conscious and awake mind and an unconscious mind in conflict with it. Throw in a superego to referee.

First, modern psychiatry is no more beholden to Freud than modern biology is beholden to Darwin, who also got many things wrong. Also, the superego is not a referee but referred to the internalization of cultural rules. If anything, the ego could be called a referee, as Freud claimed it mediated our basic animal impulses (the id) within socially-acceptable cultural norms (the superego). So, for example, sexual impulses are biologically driven, but cultures have numerous rules for regulating the expression of these impulses.

Surprisingly these all came from Greek Plays written in 500BC.

Not exactly. Freud believed that the myths that inspired these plays were based on fundamental human nature. Jung expanded on this idea, but neither really "came from" the Greek plays. Freud's theory of psychosexual development came mostly from his observation of children. And again, the overwhelming majority of experimental or developmental psychologists today put little to no credence in Freud's sexual drive theory.

But Psychiatry cannot help.

Compare a schizophrenic on olanzapine with one on nothing, and I think you would see marked difference in behavior. Given a prevalence of schizophrenia of about about 1%, that's over 3,000,000 American people.

FullMoon said...
This comment has been removed by the author.
William Chadwick said...

Maybe next they can psychoanalayze "liberals." I've long wondered about the sadomasochistic streak in those people, and why so many of them remain yoked to the discredited State Cult.

Hammond X. Gritzkofe said...

Symptoms of a sociopath: manipulativeness, deceitfulness, callousness.

What would you call a person who habitually, knowingly, fails to keep to their promises? What would you call a person who does not accept responsibility for their actions?

I await the psyciatric profession to diagnose as a sociopath, individually and by name, every politician who has reneged on campaign promises, or who does not acknowledge the failure of legislation for which they voted.

Michael K said...

The first two years of med school are usually medical science courses that do not figure into the day-to-day practice of most psychiatrists.

That has changed a lot in the past 25 years. I've been teaching medical students in those two years since about 1998.

There is much more emphasis on "Health Belief Models" and frank psychiatric models.

We would run workshops in first years using actors and actresses. That has gotten to be quite common. A lot of it began 50 years ago with Howard Barrows, a professor of Neurology at USC who started using actresses to simulate neurological diseases.

Some of the workshops include a depressed patient who the students must get to talk about her problem, which is that she thinks she has cancer. Another workshop is an airline stewardess who is hyperthyroid and is self medicating with thyroid to lose weight.

The real Psychiatry experience is much less than it was when I was in medical school because there is no inpatient facility except one for psych patients with medical illness. I used to take my group to that several times a year.

Richard said...

Got a BA in psych half a century ago. The takeaway was that they don't know nearly as much as they want you to think they do.
Schools--psychotherapy, rogerian, behavioralism, come and go, in part based on the prestige of one or another proponent.
I recall when three to five years of depth psychotherapy was the scrip for schizophrenia. Kind of a come down when the initial treatment was a trip to the pharmacy.
Day by day, research finds neurological and chemical issues associated with mental illness. It's possible that continued stress caused by continually running into life's sharp edges causes adrenal hypertrophy or some other biochemical issue, but in reality, much of the neurology and biochem comes first.

jrapdx said...

Different subjects being discussed.

First, the issue of psychoanalysts changing their rules about "diagnosing" public figures shows the absurdity of psychoanalysis. Talk about pseudo-science, or as it's called these days "fake news". The scientific credibility of psychoanalysis is no better than CNN's.

Important to say "psychoanalysis" is NOT the same as "psychiatry". AFAIK the rules for psychiatrists belonging to the American Psychiatric Assn have NOT changed. Diagnosing without clinical relationship is still UNETHICAL.

In any case, let's give the creepy psychoanalysts a "diagnosis" of "pandering leftist sycophants, narcissistic type". Sounds like a accurate description to me.

J. Farmer said...

@Michael K:

I am not sure how typical it is, but the medical program I am most familiar with is University of South Florida's Morsani College of Medicine. In addition to the general science courses, first and second year students typically participate in a "doctoring" course half a day a week where the focus is on history taking, physical examination, differential diagnosis, etc. These are used to prepare students for third-year clerkships, where I think you would agree most of the real training truly begins. I think someone who has completed two years of a clinical psych doctoral program would be much further ahead on the issue of psychopathology than someone who has completed two years of medical school. I have employed psychiatrists and clinical psychologists, and nothing from my observation has led me to believe one is more clinically knowledgable or skilled than the other within the field, though a psychiatrist would generally have much more general medical knowledge and particularly psychopharmacology.

J. Farmer said...

@Richard:

Got a BA in psych half a century ago. The takeaway was that they don't know nearly as much as they want you to think they do.

That is true of any scientific field; scientists don't even fully understand how bees navigate. Nonetheless, a lot has changed in the last 50 years. Also, an undergraduate degree in psychology is much different than the training one received in a graduate clinical psychology program.

Day by day, research finds neurological and chemical issues associated with mental illness.

Given that pretty much all human behavior and internal mental states are a result of chemical reactions in the brain, this is obviously true in a sort of reductive way. But numerous findings have shown that cognitive-behavioral therapy, basically invented by the psychiatrist Aaron Beck, is as efficacious as psychotropic medication in treating depression and anxiety.

Jim at said...

"It's clear he's a bully and a liar, and he is obsessed with himself."

But enough about the last eight years .....

James Pawlak said...

The only "reliable and valid" tool for measuring psycho-pathologies known to me is the "Minnesota MultiPhasic Personality Inventory". I proclaim that the very far less reliable views of psychiatrists is here a political abortion of science.

I must wonder if the MMPI's "Lie Scale" could be "faked" by such "head shrinkers" who should be required to be so evaluated.

Gk1 said...

This seems like fake news to me in that the media is so desperate to find professional organizations that validate their belief system, that belittles or discredits trump. How big is this organization? Does it have the ability to speak for all members? Do they often make professional diagnosis remotely? I am kind of waiting for other members of this organization to speak up and try to protect their tattered reputations after their leaders have turned them into a laughingstock.

J. Farmer said...

James Pawlak:

If you're knowledgable of the test items, the MMPI's validity scales can be pretty easily gamed. That's why maintaining test integrity is an important part of standardized tests. It is generally good practice to use more than one assessment type. There are other good options, such as the Millon tests, the Beck inventory, Symptom Checklist, and the Structured Clinical Interview. The later is used frequently in research because it provides a standardized method of obtaining information that does not rely solely on self-report. Also, it is good practice to use multiple tests of validity, such as the Test of Memory Malingering or the Validity Indicator Profile, especially in populations where deception might be a high risk (e.g. forensics).

Francisco D said...

Richard wrote: "I recall when three to five years of depth psychotherapy was the scrip for schizophrenia. Kind of a come down when the initial treatment was a trip to the pharmacy."

That was when, 1952?

Guess which institution helped us better understand the causes of schizophrenia?

Richard said...

J. Farmer.
Point is, the knowledge is so ephemeral--you're as certain today as my behavioral profs were in the Sixties--that it's even more lame for partisan hacks to claim special knowledge of how Trump's mind works than if a bunch of mechanics were diagnosing the fuel economy of the POTUS limo by listening to a news clip of it going by.
And Trump isn't being accused of, (excuse me, diagnosed with) depression and anxiety.
I see a guy with a maddening inability to control his stupid mouth...and then I note that he sends the left down a bunch of empty rabbit holes and works behind the smoke screen. Is it purposeful? Is it working the way he wants?

Michael K said...

first and second year students typically participate in a "doctoring" course half a day a week where the focus is on history taking, physical examination, differential diagnosis, etc. These are used to prepare students for third-year clerkships, where I think you would agree most of the real training truly begins. I think someone who has completed two years of a clinical psych doctoral program would be much further ahead on the issue of psychopathology

Oh, I don't disagree.

But the third year clerkships pretty much are 100% medicine, not psych. The third year students these days are much more integrated into the treatment team than they were in my day. On the other hand we had a psych clerkship in the psych unit at county which no longer exists.

I'm not sure the PhD Psych students know that much about neurochemistry.

I have a daughter-in-law who has spent the last four years psychoanalyzing everyone in the family. She is a Psych professor at a college in the Bay Area.

I guess I am just prejudiced about Psychology with respect to psychosis.

Francisco D said...

"Got a BA in psych half a century ago. The takeaway was that they don't know nearly as much as they want you to think they do."

My takeaway is that you don't know enough with a B.A. to have an informed opinion about people with FAR more education and training.

I find the generalizations about the practice of psychology and psychiatry in this thread amusing. Only a few (e.g. J. Farmer) seem to know what they are talking about.

jrapdx said...

Second subject: depression.

A leading cause of disability in the US and world-wide, and a very complex condition (or set of conditions). Numerous body systems are involved. Alterations in the brain, hormones, and immune system are prominent. Also social, economic and cultural factors significantly affect onset and remission of depressive episodes.

A psychiatrist ought to be trained to understand the complex origins and be able to juggle the various tools to reduce the symptoms of depression. Applying the various medication strategies optimally requires a hell of a lot of experience and excellent judgement. Adding in other somatic treatments ups the ante considerably. These "physical" methods usually work best combined with the appropriate psychotherapy, but there are many kinds, knowing which is most suited for which patient is another judgement call that has to be made.

IMO not every clinician has the talent to optimally manage such responsibility. It takes someone with an ability to absorb a huge array of info, see the links among unordered data and use that "network" to synthesize a model that accurately reflects the patient's situation. People who can do that will have patients getting better outcomes.

Obviously those with the most comprehensive education and supervised clinical training experience have greatest potential to be effective practitioners. But the talent factor has to be there. Knowing who has it or not may well be the hardest thing in the world to figure out, yet is so crucial.

traditionalguy said...

J. Farmer is correct in that some one is needed to push the Thorazine and other drugs used to chemically perform virtual lobotomies on the dangerous people.

Michael K said...

If you're knowledgable of the test items, the MMPI's validity scales can be pretty easily gamed.

Interesting you bring that up.

I spent a summer in first year med school working in the VA psych unit in LA. I was hired to do physicals on 200 schizophrenic men.

Long story in my book.

Anyway, I did spend some time on other wards, one of which was the locked ward. Really locked.

One guy was very interesting. Black guy. Star USC football player in the 40s. Married a rich white woman of a famous family.

He had a psychotic break afterward and, as he was a vet, ended up in our hospital.

His Psych testing was read as not psychotic. It suggested he was as sane as I was but not being open with the staff,

It was a bizarre reading at the time when treatment was pretty primitive,. There was some suspicion that he was smart enough to game the whole thing.

Luke Lea said...

Psychoanalysis still lives? I thought it had been displaced by multiculturalism much as Marxism has been replaced by dogmatic believers in catastrophic global warming. In every generation it seems intellectuals fall "bigly" for some pseudo-scientific idea or another.

Francisco D said...

@Michael K.

Some of us have studied neurochemistry and neuroanatomy quite a bit. It seems to be increasingly emphasized in many research/University-based Psych doctoral programs.

Once again, I emphasize that not all psychologists are trained alike. The APA made a decision (The Boulder model) several years ago to swell the ranks of psychologists with Psy. D. training. They are worse than DOs and ARNPs in the medical field.

I have worked with many MDs in my life, in clinical settings, and in business consultation (mostly Pharma development). Some are very bright and well informed. Others have not kept up with the field and know more about current real estate investments than medical practice. As with all field, your results may vary.

J. Farmer said...

@Richard:

Point is, the knowledge is so ephemeral--you're as certain today as my behavioral profs were in the Sixties

I am not sure if the "you're" there is addressing me specifically, but I certainly do not approach the field with anything that could be called certainty. I think any knowledgable person working in the field would acknowledge that it is a field in its infancy and that there are huge gaps in our knowledge. That said, I agree that newcomers especially to the field have a know-it-all attitude that only experience can dissuade them of. But I think that is largely true of most professionals regardless of the field.

that it's even more lame for partisan hacks to claim special knowledge of how Trump's mind works than if a bunch of mechanics were diagnosing the fuel economy of the POTUS limo by listening to a news clip of it going by.

I do not deny that attempting to clinically diagnose Trump is foolish, and professionals should not attempt it. But also, we are talking about a very fringe group that does not in any way represent the field in its entirety.

@Michael K:

I guess I am just prejudiced about Psychology with respect to psychosis.

I agree that psychosis is a specific problem, and incidentally it is probably the psychiatric problem in which pharmaceutical intervention is clearly superior to psychotherapy. Psychosis seems to be the most closely "organic" psychiatric problem, but I still think psychotherapy is useful in the psychotic population to address the social disorgization that often accompanies psychosis and, more importantly, maintaining medication compliance. A lot of bipolar people have a hard time staying on mood stabilizers, because they don't like the flattening effect it has on their mood. Plus, the beginnings of a manic episode can often be very enjoyable, as it often includes a lot of euphoria and grandiosity. But I think Beck's work has shown that cognitive-behavioral interventions can be very efficacious in dealing with mood or anxiety problems.

J. Farmer said...

@Michael K:

It was a bizarre reading at the time when treatment was pretty primitive,. There was some suspicion that he was smart enough to game the whole thing.

Yeah, the validity items on standardized assessments can usually be identified by someone who is at least minimally sophisticated. The three main issues of validity are inconsistency (basically Christmas treeing a questionnaire), over reporting, and under reporting. Consistency items, for example, might include several items that ask the same question but in a reversed manner.

Michael K said...

I still think psychotherapy is useful in the psychotic population to address the social disorgization that often accompanies psychosis

I agree here. The experience I had at the VA was with a guy named George Harrington who had begun as an analyst and who had decided it was bunk. One of his UCLA residents wrote up his work in a book called "Reality Therapy" which is still in print. At one time the LA City schools adopted it but that was in the pre-union days and I'm sure it has been long discarded.

Harrington was the most impressive man I have ever met in Medicine. Sadly, he was almost unique.

Unknown said...

In college I started out in psychology. I read a big stack of the latest books: Freud, Adler, Rolf, you name it. I figured out that they all sounded convincing if you read them in isolation, but contradicted each other big time. On top of that, the students and professors seemed very neurotic (or worse). So I switched to a hard science.

Clyde said...

The jerkoffs didn't warn us about Barack the Narcissist, did they?

J. Farmer said...

@Unknown:

I read a big stack of the latest books: Freud, Adler, Rolf, you name it

When were you in college? Freud and Adler both died in the late 1930s. My mentor got his doctoral degree from the University of Michigan in the early 1970s, and neither Freud nor Adler were "the latest books" at that time.

J. Farmer said...

For those interested, Morton Hunt's The Story of Psychology is probably the single best history of the emergence of psychology as a discipline and its subsequent evolution over the 20th century. He does a particularly good job of covering two individuals who are much more important to the early history of the field than Freud--Wilhelm Wundt and William James.

Scientific Socialist said...

As an internist-and an off and on psychiatric outpatient-I have come to know many psychiatrists and lay psychotherapists well. With the exception of three practitioners, they are among the strangest and most socially awkward individuals that I've ever encountered. Several are genius-level brilliant but as crazy (to use a medically precise term) as their craziest patients. Generally speaking, I wouldn't regard their armchair psychoanalysis of the POTUS to be any more credible than that of the plumber who did work in my house last week.

veni vidi vici said...

Another group of the credentialed-but-useless is about to out themselves, I see...

Brookzene said...

The percentage of hacks, cranks and fools in the mental health "profession" is stunningly high. And many of them are in a position to make individual lives worse.

Reminds me of "my six-year old could paint better than this." Brilliant.

James K said...

So psychiatry goes the way of journalism. Is that what they really want to do? Have they looked at what has happened to the market value of MSM corporations?

J. Farmer said...

@James K:

So psychiatry goes the way of journalism.

The American Psychoanalytic Association is not psychiatry. It is a small fringe group that includes a smattering of people who have obtained psychoanalytic training.

Fabi said...

"I'm really good at killing people." -- BHO

Nothing to analyze in that statement! Lulz

Michael K said...

"Several are genius-level brilliant but as crazy (to use a medically precise term) as their craziest patients."

When I was a medical student I had a job doing histories and physicals on pre-op patients. They don't allow that anymore but it was legal then. One of the patients I worked up was a pre-op neurosurgery patient.

He told me that he and his psychiatrist would each take LSD and then have a therapy session when both were high, or whatever you would call the LSD experience. The guy told me he had the hallucination of being a fetus in utero. When he curled up in a ball, he became quadriplegic. Fortunately he was able to uncurl and it went away.

He was having surgery for the AV malformation in his spinal cord the next morning.

Smilin' Jack said...

Psychoanalysis is to psychology as astrology is to astronomy. Modern psychology texts do not even mention psychoanalysis, except perhaps in a historical footnote.

In that connection it is worth mentioning that much of feminist "theory" is based on psychoanalysis.

Francisco D said...

Smiling' Jack wrote: "Psychoanalysis is to psychology as astrology is to astronomy."

Exactly!

Unknown said...

The "why" is too obvious here. Repealing Obamacare means less taxpayer-financed income for these people, so they have a personal financial stake in declaring all Republicans evil.

James K said...

"It is a small fringe group that includes a smattering of people who have obtained psychoanalytic training."

So where is the real psychiatry group calling them out?

J. Farmer said...

@James K:

So where is the real psychiatry group calling them out?

It is not a matter of "real" or "fake." But the primary professional organization for psychiatrists is the American Psychiatric Association. They have no authority or responsibility to "call out" any other professional organization, and a big proportion of the Psychoanalytic Association are not psychiatrists and thus would not be members of the American Psychiatric Association.

gbarto said...

Let them diagnose Trump and watch the Streisand Effect take place.

This is the problem. There are people who genuinely need and benefit from psychiatric care. It is tantamount to malpractice to decide that riding your political hobbyhorses is more important to you than making sure people who need your services will trust you enough to seek them, regardless of their political persuasion. I strongly suspect most psychiatrists and a pretty fair portion of therapists could do without the jokers who run associations alienating their prospective patients. But, as has been noted, it's probably dangerous to speak up about this. Better to let a depressed Trump voter suicide than risk having your colleagues see you as impure.

Thurston said...

Dr. Drew Pinsky on Trump:
https://www.youtube.com/watch?v=_OncXf8eLfM

Michael K said...

It is tantamount to malpractice to decide that riding your political hobbyhorses is more important to you than making sure people who need your services will trust you enough to seek them,

Especially with people around who have, shall we say, a less than a firm grip on reality.

The fellow who drove to Virginia from Illinois to shoot Congressmen was organized enough to find the ball field.

The next one may not need to go that far. There have been half dozen so far arrested for threats or actual assaults on Congresspeople.

Crimso said...

"whatever you would call the LSD experience"

Tripping. "High" doesn't extend far enough to describe LSD. Or so I'm told ;)

Ralph L said...

organized enough to find the ball field.
It was next door to the Y's parking lot where he was hanging out/living in his van. But driving anywhere in the DC area does take some brain power and composure.

James K said...

'They have no authority or responsibility to "call out" any other professional organization'

No authority is necessary. If a group is giving the profession a bad name they should say something. Silence suggests approval.

Unknown said...

I've read that real doctors call the DSM (Diagnostic and Statistical Manual) a "voodoo book."

It's the one where the doctors get to vote on what's a "disease," what's only a "disorder," etc.


Yet hundreds of millions of federal dollars worth of spending gets steered by it every year.

mockturtle said...

Tripping. "High" doesn't extend far enough to describe LSD. Or so I'm told ;)

Yes, tripping better describes it, though there is a decidedly 'speedy' effect, as well.

Mary Beth said...

It must be disheartening to think that Trump has all of those negative personality traits and yet he still beat Hillary.

Disheartening for those who want to analyze him. Some of us are enjoying watching what he does (and enjoying the effect he has on all of his critics even more.)

bgates said...

It's clear he's a bully and a liar, and he is obsessed with himself.

You just don't like him because he's black.

J. Farmer said...

@James K:

If a group is giving the profession a bad name they should say something. Silence suggests approval.

That makes no sense. The American Psychiatric Association's "goldwater rule" is still in effect, and the APA members are ethically bound by it. That some completely unrelated group, who has many members not involved with the APA, believes the rule amounts to a "gag rule" is completely beside the point. Does the American Medical Association need to comment? The American Psychological Association? The American Counseling Association? The American Association of Marriage and Family Therapists? National Associations of Social Workers? National Association of School Psychologists?

J. Farmer said...

@Unknown:

I've read that real doctors call the DSM (Diagnostic and Statistical Manual) a "voodoo book."

It's the one where the doctors get to vote on what's a "disease," what's only a "disorder," etc.


I have never heard of the disease/disorder dichotomy, and the DSM makes no reference to such distinctions. At most, the DSM's most direct purpose to provided a standardized language and definition for certain disorders that will unify across the profession. There are numerous criticisms of the DSM, and many have been published by people working in the field.

Incidentally, psychiatry is not the only branch of medicine prone to vague diagnostic criteria. The non-psychiatric profession has a number of such diagnoses, from interstitial cystitis to irritable bowel syndrome to fibromyalgia to multiple chemical sensitivity to seronegative rheumatoid arthritis. Further, in some jurisdictions, political pressure is put on providers to address chronic lyme disease, which most physicians and professional medication organizations don't even recognize as a legitimate diagnosis.

Richard said...

Got a relation who's had a catastrophic interaction with mental health. Son was schizophrenic. Employed, committed, employed, jailed, employed, not employed, committed, jailed, etc. Commitments lasted maybe three days each. Killed himself in the last jailing, where, according to the sheriff, they couldn't afford the staff to watch everybody.
My relation belongs to a group which believes and advocates that mental health issues are...brain illness. Like any other illness. And should be fixed like any other illness. Or a broken leg or something.
Civil rights vs. prophylactic commitment...?
Some professionals they talk to support the near mechanical fix idea.
Some don't.
Both are pretty sure they're right.
You don't just take a pill. You take a pill until the voices stop, and then the liver metabolizes it differently and you have no thirst cues. Get that fixed and...
In the high and far off times, the psych and the philosophy departments were sometimes together. In addition to economizing on deans and various other hangers-on, this may have recognized that many mentally ill people are rational and logical to a fault. It's their premises that are mixed up. And philosophy is about (some) premises. Good an idea as any, so far.

Charlie Martin said...

This is misreported. The American Psychoanalytic Association said that. The American Psychiatric Association, which promulgated the Goldwater Rule, says "not so fast".

https://twitter.com/APAPsychiatric/status/889839330881130497

mockturtle said...

J.Farmer, there is at least a legal difference between psychosis and personality disorder. A psychopath [like Ted Bundy, Gary Ridgeway, John Wayne Gacy] would not get an insanity defense because he was not out of touch with reality.

mockturtle said...

PS: A psychopath/sociopath has a personality disorder and is not 'insane'.

J. Farmer said...

@mockturtle:

J.Farmer, there is at least a legal difference between psychosis and personality disorder. A psychopath [like Ted Bundy, Gary Ridgeway, John Wayne Gacy] would not get an insanity defense because he was not out of touch with reality.

I am not sure what I have said that this is a response to, so I'll just take it as a standalone comment and give my take. First, there is a difference between "pyschosis," which is a clinical term describing a loss of touch with reality and a psychopath, which is a personality disorder that has to do with antisocial behavior and a lack of remorse or empathy. "Psychopath," though is not a clinical term, and the Axis II diagnosis would be Antisocial Personality Disorder. Also, the two are not mutually exclusive. Psychotic features are typically observed in people with borderline personality disorder. As for the legal definition of insanity, the so called M'Naghten rule, someone could be psychotic and still not meet the criteria for legal insanity.

James K said...

That makes no sense.

It "makes no sense," yet from Charlie Martin we see that the APA in fact did take a stand. Good for them.

J. Farmer said...
This comment has been removed by the author.
J. Farmer said...
This comment has been removed by the author.
J. Farmer said...

@James K:

It "makes no sense," yet from Charlie Martin we see that the APA in fact did take a stand. Good for them.

The statement you linked to is dated March 16th, 2017 and was not a response to the Psychoanalytic Assocation's email. Also, the statement that was linked in the Tweet was from July 20th and was also not a response to the email. And let me just repeat, many members of the Psychoanalytic Association are not members of the Psychiatric Association and would not be bound by the APA's ethics rules for members

James K said...

Also, the statement that was linked in the Tweet was from July 20th and was also not a response to the email.

The tweet that Charlie Martin linked was from today, so evidently the APA saw the need to reaffirm the 'Goldwater rule.' The earlier statements were undoubtedly in response to other incidents of unprofessional behavior. There have been a number of incidents of psychologists and psychiatrists making pronouncements about Trump.

gadfly said...

Somewhere this train has gone off the rails. According to our hostess and all the Trumpists herein, those involved in the psychiatric and psychological professions are not psychics. But neither are Trump nationalists qualified to make judgments as to the maladies that have beset our obviously strange president. It can be anything from low mental capabilities to some form of dementia, perhaps enhanced by his extreme narcissism. Of course, it is a given that psychopaths are completely driven by their own hard-nosed self interests.

Oops, sorry, that no-no word "psychopath" just slipped in. As to whether or not Trump is legally insane, the American public will never find out. If impeachment happens, his mental state will never be mentioned. But whatever the diagnosis, the sickness that spins around Trump has been there for 30 years, at least.

But I'd shut my eyes in the sentry box, so I didn't see nothin' wrong.~Rudyard Kipling

J. Farmer said...

@gadfly:

But neither are Trump nationalists qualified to make judgments as to the maladies that have beset our obviously strange president. It can be anything from low mental capabilities to some form of dementia, perhaps enhanced by his extreme narcissism.

Because there is a world of difference between commenting on perceived personality traits or cognitive ability and making a clinical diagnosis. For example, there is a big difference between saying that someone looks underweight and saying that someone has an eating disorder.

@James K:

The tweet that Charlie Martin linked was from today, so evidently the APA saw the need to reaffirm the 'Goldwater rule.'

Yeah, because the issue was in the news thanks to the STAT report, and they were undoubtedly put on the spot. All they did was reaffirm a policy that's been in place for decades. They made no mention of the American Psychoanalytic Association, and they have no authority to determine what positions other organizations may take regarding their own members. This whole story is a giant nothing burger. The Psychoanalytic Associations' entire membership is about 3,000 people. That's .001% of the American population and a tiny fraction of the total number of mental health practitioners working in the country today , the overwhelming majority of whom have no involvement or membership in the Psychoanalytic Association.

Jonathan Graehl said...

psychoanalyze thyself, therapist

Rusty said...

This is goingto tell us a lot more about the professionals making the predictions and the people that support them than the subject of their interest.
This should be fun.

JAORE said...

If we must, just MUST, have ethics, let's make damn sure they are SITUATIONAL ethics!