• Posty McPostface
    I regard the idea is not so much anti-psychiatry as taking a step back to ask what the context is.mcdoodle

    Then by definition, this would be anti-psychiatry. This is because (due to the economics of the situation and the prevailing idea and mainstream thoughts in psychiatry) psychiatry can't address the context and only considers the resultant behavior or symptoms arising in the individual.

    What I think may be more enlightening is considering why do people choose psychiatry over psychological therapy?
  • unenlightened
    This brings me back to the pragmatics of said therapy device. There's little hope that despite how effective this therapy might seem, it will never take any hold in countries where the mainstream narrative or course of action is to refer a schizophrenic or bipolar to the psychiatrist and prescribe the pills.Posty McPostface

    It's being trialled in the UK by the National Health Service, and there is a training course.

    I don't know where the US is a the moment, and from the pov of one seeking help, it's going to be a very slow process rolling it out, because of the need to properly train and also adjust the institutions. But in the longer run, I am quite confident that if it is as effective as it is claimed to be, it will be taken up everywhere, because although it is expensive in terms of commitment of resources, if it gets people off drugs, out of hospitals, and working and contributing, who would otherwise be sucking up resources for a lifetime, then it is an absolute bargain. Money will convince even a scientist. ;)

    Edit: In the meantime, there is apparently other stuff going on in the US of A ...
  • mcdoodle
    Quite frankly, many therapists hereabouts and psychiatrists would call this homeopathy. Sadly enough.Posty McPostface
    There do seem to be initiatives in north America. Like this one: http://www.dialogicpractice.net
  • Posty McPostface
    The rollout will probably not come from the top down. Hope private practices are able to roll it out within a reasonable price.
  • Wosret
    The documentary sounds pretty full of shit to me. I look up their claims and can't find any actual support for them, but can find information that suggests that much of it clearly isn't true, and what may be simply hasn't even been properly investigated.

    The documentary seemed pretty wild and slanted, so I couldn't help but look for some support for its claims, of which there is nothing substantial, and things that indicate that their results are not different at all for schizophrenics, and half as good for psychotics as the standard treatment.

    I thought that it was about just mental illness is general, and talk therapy is definitely great with respect to that, I didn't realize that the claim was that it was revolutionary for even the most extreme of psychotic disorders as well...
  • Metaphysician Undercover
    The relation of parent to infant necessarily begins as a person-object relation, in which the parent is the author and authority, and the infant is a dependent object. The task is to conjure from this relation a new relation between individuals, by invoking the interiority of the infant, just as God created man in His own image.unenlightened

    Fee fie fo fum
    I smeel the blood of an Englishman.
    Be he alive or be he dead
    I'll grind his bones to make my bread.

    The rejection of the parent as authority is a necessary part of the process of individualisation, just as the Fall is a necessary part of the creation of humanity.unenlightened

    See, the stories that the parents tell are intended to make the child reject the parent as the authority. But that's how authority generally works, no one wants to take that responsibility, so it's passed off, and someone else is the author of that.
  • MikeL
    I probably am describing neurosis in general. I agree that language is very dominant in human relations, but it is the least effective tool you have if building trust and rapport is your goal. These group sessions seem to have a heavy trust focused bias. Sorry, I only watched the first couple of minutes and then skipped through so maybe I missed something.

    Language is good for misleading people too and creating false impressions and the person with the fast tongue can frustrate the person without, causing all sorts of expressive bottlenecks.

    I have interacted with a lot of different personalities over the years, but not in a clinical setting.

    From my experiences it seems that people often aren't looking for solutions to their problems when they come to me. They are wanting to tell someone their problems and are wanting to know that the world hasn't changed for having told them. The world goes on and they are still accepted in it despite the trauma they have faced. They are still part of the pack. (They also often want justice)

    I find when dealing with people that are extremely upset for instance a big key is to not show a lot of emotion. To listen closely and nod- to show you are listening. Once they have told me their problem they almost invariably look me very strongly in the eyes to watch my reaction to what they've said. If I react like its all under control and in the scope of my everyday experiences (regardless of how much it is not), they relax almost immediately.

    You can tell them of course things like, "well that is horrible", or "well let me see if I can do something to make that right for you" (justice), but without too much emotion. You can isolate them with a strong focus of attention, causing them to believe they really do have a problem. - Just you and them in a psychiatrists office for example - they know before they even go in they have a problem, they just don't know how big it is yet. They'll wait for your reaction before they make their mind up on that one.

    I love studying animal relations. We all use the same gestures and the same pattern of gestures.
    Sounds are important in conveying intent - warm intent or hostile intent, as much as gestures are. Language may explain it a little clearer, may allow you or them to pop the blister of pain.

    If I go out into my backyard and there is a bird there, I will look at it- show it that I see it - and then look away and show no interest. All animals do it, including humans. Animals do this to establish you can share a domain with them and vice versa. Its a mutual non-aggression pact: They yawn, lick themselves, scratch themselves and look away - these all show awareness of your presence and a disinterest in threatening you or seeing you as a threat. Tensions are immediately dissolved. Proximity is of course important, but it's never a direct approach unless you know the animal. Smiling and tongue lolling works.

    Of course, when they don't do that stuff, you know you're in trouble.

    In what I saw of the group therapy session there was a high level of general awareness and disinterest. They responded to each other initially and then showed little interest. The patients would be free to express themselves, be heard and then blend into the group without thinking they have singled themselves out for scrutiny. There is a mutual non-aggression pact in a group dynamic, so, many social disorders would benefit enormously from this approach I would think.

    But, I am not trained in psychiatry.
  • unenlightened
    but can find information that suggests that much of it clearly isn't true, and what may be simply hasn't even been properly investigated.Wosret


    This is the basic claim:
    In the 1980s psychiatric services in Western Lapland were in a poor state, in fact they had one of the worst incidences of the diagnosis of schizophrenia’ in Europe. Now they have the best documented outcomes in the Western World. For example, around 75% of those experiencing psychosis have returned to work or study within 2 years and only around 20% are still taking antipsychotic medication at 2 year follow-up.

    If this is substantially true, it is remarkable, and if it is false, it should be very easily falsifiable.
  • unenlightened
    It doesn't look like there's going to be much discussion of intersubjective consciousness. :(
  • Wosret


    That's what I read. Why I find it persuasive is because those numbers are remarkable, and if it were true why isn't it quickly becoming the standard treatment? Why it is not even really being substantially investigated? The article suggests that it's simply because the results aren't nearly as remarkable as that documentary claims. Not in fact as good as the standard treatment from what it looks like.

    I was attempting to discuss it in a wider fashion. I of course was attempting to find points of disagreement, as that is where views are honed. Nodding in agreement isn't the super bestest path to refinement in my view. My basic idea that that talk therapy is unquestionably great, definitely the best kind (though I was thinking generally, and not in the most extreme psychiatric cases.), but it just isn't the same thing as peer to peer dialogue, and probably can't be. What I saw you suggesting is a narrowing of the gap between kind of teacher and pupil. Doctor and patient, and I wished to explore exactly how harrow that gap could get, while being skeptical that it could be closed.

    If that makes sense.
  • unenlightened
    If that makes sense.Wosret

    Yeah, it makes sense. But this makes a tad less sense.
    those numbers are remarkable, and if it were true why isn't it quickly becoming the standard treatment? Why it is not even really being substantially investigated? The article suggests that it's simply because the results aren't nearly as remarkable as that documentary claims. Not in fact as good as the standard treatment from what it looks like.Wosret

    If the remarkable figures were true, it would have become standard practice.
    If the remarkable figures were true, they would have been investigated.

    They haven't been investigated, therefore they are not true.
    It is not standard practice, therefore it does not work.

    There is an open-ended scepticism, and then there is a closed-minded scepticism. Well there is enough hope that this...
    if we assume that they were the ones with schizophrenia then only 53 per cent of those with schizophrenia were medication free. And this is roughly consistent with the Merck Manual and the definition that outcomes for a simple psychosis are better than for schizophrenia. — your link
    ... is overly pessimistic an assumption, especially taken in conjunction with the fact that we are talking about early intervention and a diagnosis of schizophrenia requires that, "Continuous signs of the disturbance must persist for at least 6 months, during which the patient must experience at least 1 month of active symptoms (or less if successfully treated), with social or occupational deterioration problems occurring over a significant amount of time.", to justify some replication elsewhere and further trials.

    It's odd, that. It almost seems to define schizophrenia as incurable - if it got cured, it wasn't schizophrenia. Kind of like death - if you come back to life, you can't have been dead.
  • Wosret
    If the remarkable figures were true, it would have become standard practice.
    If the remarkable figures were true, they would have been investigated.

    Firstly those two propositions are not accurate representations of what I said, and clearly the second should come first to bring them even close. Why would I have some deep investment in the antithesis anyway? Like a closed-minded adherence to the standards?

    I don't think that it's fair to reword what I said to sound sillier, and then call me dogmatic as a response. Furthermore, to go on to undermine the definition of schizophrenia seems silly. Also consider that it is genetic, and highly heritable. People that have never even met their parents, or had socialization problems still manifest the condition, from what I understand. I read an article about a dude that discovered that he was part of a eugenics project that tried to foster genius progeny, and his father ended up being a paranoid schizophrenic that lied about his credentials, and background (when the programs creator couldn't get Nobel laureates he shot a little lower in seedy hotels), and he had fostered many children. The article was about his experience as his condition began to manifest itself in his twenties.

    Not that I know a lot about it, but I just noticed that the success rate claimed is nearly twice that of what should be expected. That ought to get a lot of attention. Why hasn't it? Because they cure them so fast that their condition becomes undiagnosable? The mainstream are all too dogmatically attached to the standard treatments and closed minded to care?

    There isn't much I can say to any of that. The claims are apparently both unconfirmable, and denied out of closed-mindedness...
  • Wosret
    And because that hurts me feelings, I'll name call back, only I'll actually be right. What you're doing just looks like motivated reasoning to me: "The processes of motivated reasoning are a type of inferred justification strategy which is used to mitigate cognitive dissonance. When people form and cling to false beliefs despite overwhelming evidence, the phenomenon is labeled "motivated reasoning". In other words, "rather than search rationally for information that either confirms or disconfirms a particular belief, people actually seek out information that confirms what they already believe".[2] This is "a form of implicit emotion regulation in which the brain converges on judgments that minimize negative and maximize positive affect states associated with threat to or attainment of motives"."

    Your justifications for not accepting the criticisms, and maintaining the position seems clearly motivated. Whereas, I don't give much of a fuck at all about this, and just like you, and reading and interacting with you. That's my motivation. I may even be motivated to argue with you, but I'm not particularly invested in any positions of this subject.
  • Posty McPostface
    I have even be motivated to argue with you, but I'm not particularly invested in any positions of this subject.Wosret

    Why does this topic have to be about 'me'?
  • Wosret

    I didn't make it about me... I was clearly discussing only what I understood to be the topic, although my first post was indeed a passing comment about me, and then I was asked to engage the topic, which I did without talking about myself.

    Then my motives were questioned, so it seems fair to address them. How else am I supposed to respond to the accusation of investment, and close-mindedness? If it was merely goading, then I'm immune, if it was sincere, then I'm entitled to defense. Entitled like a princess.
  • Posty McPostface
    I didn't make it about me... I was clearly discussing only what I understood to be the topic, although my first post was indeed a passing comment about me, and then I was asked to engage the topic, which I did without talking about myself.Wosret

    It is just that the whole purpose of this therapy is to not get the individual to conform to their diagnosis, accept the meds, and live on disability, speaking as a paranoid schizophrenic myself who is doing all three. Changing the mindset of your closest ones (family) about your diagnosis and what that means can lead to greater outcomes in therapy in terms of living a more fulfilling life.
  • Wosret
    The diagnosis isn't like mean, or meant to keep you down or something. Treatment is about improvement at the very least, and ideally cures. Most everyone involved I'm confident really wants to help. It's easy to stay on disability though. Right now with my shitty job, I make less than the people on disability, and have to work for it. Everyone in my family is on some kind of assistance, or disability, and have legitimate concerns, but I never have been. I also have crippling disorders, and experience psychotic breaks from time to time, which would almost certainly get me disability if I wanted it. I have a hard time accepting any help in general though, besides that I would decay with nothing to do, and no schedule. Not one is forcing me, or twisting my arm.

    Ideally I'll go undiagnosed with anything until I'm forcefully committed, and plan to only stay on this job until I can get unemployment, and then go back to school (not the same thing, as I'm paying for that). I have to avoid stress though, as my control is always precarious.
  • Posty McPostface

    I used to try and medicate and alleviate my boredom myself. I'd take a bunch of research chemicals online and try my best to solve my issues myself. Nothing good came from that despite being a decently functioning individual myself. Now, I'm waiting for my first welfare check and trying to figure out what to do with my life. The figuring out phase is kind of over and I intend to go to back to college while on disability, which thankfully is possible here in the states. I didn't know I could go to college AND be on disability at the same time, but that combination of affairs is really relieving, as I don't have to live as if on early retirement on a measly monthly pension is now out of the doors. I have some future to look forward to, which brings me back to Open Dialogue.

    It seems to me that half of the battle is due to social circumstances. In places like Finland where welfare isn't stigmatized, people are allowed to freely live on some form of disability and go through the necessary therapy and other life lessons, like not taking drugs and adhering to what's good for you instead of what you think is good for you. Here in the states, the welfare isn't as great as in some Scandinavian countries, but the quality of therapy is quite high, so that makes up somewhat for the difference. My mother, who now understands my situation, doesn't treat me as someone who should be the bread winner, and instead views me affectionately as a person with a problem who is in the process of trying to get better, which helps tremendously with how I view myself also due to the fact that I live with my mom. Things are getting better than worse, and that's important to know. People are predominantly unaware of their circumstances in life and knowing your place in the grand scheme of things is a relief. Getting better isn't anymore defined in terms of how well I feel (say due to how much I make or what drugs I want to take) but instead obtains an objective sense once engaged in dialectical therapy or therapy in general. So, yeah. I'm not complaining. Only times, I feel bad is when I have cravings and urges for the feel better drugs, like Ritalin or Adderall. Pot helps as a stopgap measure, also. But, I try to limit that. I haven't had a psychosis in a while, so that's a benefit, as psychosis kind of retards psychological development.

    So, all in all, I'm happy there's a social safety net that grabbed me, and I feel safe in my environment. Things, which I am grateful for and combined with the fact that I desire some positive change in terms of educating myself and building up my human capital, well then I have no complaints.
  • Posty McPostface
    I should also mention that places like this forum and the old PF, have given me a sense of stability. Listening to what a fictional Marcus Aurelius would say in my mind also helped. Philosophy itself is a dialectical art that began with the dialogues of Plato and Socrates, and if you take a harder reading, then all philosophy is a sort of dialectical art according to Hegel.

    So, philosophy has been also a safety net for me, that has helped me stay afloat in times of distress. Keeping my thoughts in check, which I think many people feel that sense of relief for overactive or sensitive minds, to engage in philosophy and be entertained endlessly. I plan to become a subscriber once I can financially.
  • Wosret

    Safety? Comfort? Lack of negative stigmatizing judgement? Sounds awful.

    I don't much believe in mental illness beyond the functional kinds. You can talk, and walk, then you're pretty much fine. Not like everyone else is perfectly connected to reality. Not like everyone else maintains perfect control, or has deep insights into their emotions and motivations. All that matters is that they're able to get the job done. If they want a sandwich, so walk outside and maw the lawn, then something is up, but if a sandwich comes to them as a result then things are working smoothly.

    I don't want to have other people pay my way, or take care of me. I don't want sympathy, or pity. I want respect, and high regard, which for the most part, I definitely get. Get less making less money, but it was never where I got my self-respect from in the first place. I was just using the extra money on recreational drugs, and helping people that were unwilling to help themselves, and ultimately resented me for it anyway. I couldn't take the competitive stress, or needy attention anymore, and minus those expenses, and I don't really have less. Bills are paid, food in the fringe, new games in the console, what more could I want? I can't afford too bad of habits now, which is better for me.
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