Sunday, April 29, 2007

"Utopia is the opiate of the people."

If V. Lenin were a little more reflective, he might have said that instead. I was thinking of this when I read the practice parameters for disruptive behavior disorders in the Journal of the American Academy of Child and Adolescent Psychiatry today. I reflected on my daughter's experience with her eighth grade class. Pretty clearly some of the kids revealed a need for (behavior) problem solving skills. Rather than approach this with any attempt at objectivity, the school was wont to deny that there was any need. The reason: the public law that says 'every child must be provided with the means to an education.' That legally makes the school system financially responsible. This leads to a political enforced standoff where the school will provide a nurse-teacher for autistic and MR children but do its best not to notice other problems. Such is state provided utopia.
Saw the Sunday Morning news shows today. George S. on ABC News is the cat that ate the canary. Boy, Stalin would be envious. In marketing terms, I could say they've got a point of view and a selection of facts and judgments that aren't mine. Makes me appreciate Instapundit; a cursory review of his recent posts would be a counterbalance to Stephanopolous.

Passing over the misundersestimating of G. Bush, the primary topic was how the top two Democratic candidates responded to the hypothetical bombing of 2 American cities. The emphasis was on being appropriately martial but to these people being warlike is the same as being antiwarlike; it's theater. One we've dispensed with the theatrical response, we go back to 'Desperate Housewives.'

Saturday, April 28, 2007

Wednesday, April 25, 2007

Dr. Helen has had a couple of recent posts dealing with the tension that ensues when one has a feeling that is not politically correct. I was particularly amused by the direction that the comments took where Dr. Helen said that she would rather be called a 'nappy headed ho' by whomever than "oppressed" by Hillary Clinton. That seemed to be a feeling that made Dr. Helen unsuitable as a psychological expert witness because her feeling was not objectively correct. This also ties into my recent 'Rank and Reality' post. Senator Clinton, somewhat in the tradition of the man from Galilee, has become the 'liberator of oppressed women' and any contradictory data is made null and void in the light of the rank of Senator Clinton who performs the miracle. This, of course, from people who might sneer at the childishness of religion.

Dr. John Meeks said that in family therapy with an adolescent an avenue of progress could be at going to the point where expressiveness could be framed in the form of "I feel that.." with the idea being that, regardless of an underlying truth of an 'allegation,' a person's 'feelings' could be true to the person experiencing them. In my time at university, the editor of the radical paper said that there was no 'objective reporting.' Chaos has not ensued in leftist quarters however because feelings rather than facts have become objectively correct. That makes Dr. Meeks' point of view, that one was allowed one's feelings, old school.

Thursday, April 19, 2007

Cho and Psychiatry, the issue of forced treatment

Dr. Helen has thought provoking comments and information about the mental health efforts made in regard to the VT killer. The facts given suggest that in January of 2005, a complaint was made that he had been spurned by 2 ladies that he appeared to be 'stalking' and that he seemed to have taken this very hard and might be dangerous. After review, a psychiatrist I presume seemed to be of the opinion that he had something of a depressive reaction to disappointment. He was given an antidepressant, probably an equivalent to Prozac as he 'got up in the morning and took his medication.' It appears as though a 'rambling composition (or speech)' was missed as a symptom of either a manic or schizophrenic illness, the speech process would likely be somewhat distinct characteristic of one or the other disorder. Also his sense of persecution and rage, exaggerating his ill treatment, were also missed and could have pointed to either illness. Thus he would seem to have been treated for Major Depression when his illness should have been categorized as a bipolar manic or schizophrenic illness.

No investigator, nor the manufacturers of Prozac or the like, have claimed that these drugs are effective in mania or schizophrenia. The serotonin reuptake inhibitors, Prozac etc., might be said to have the general psychological effect of helping a person 'let it go.' They are more effective than other antidepressants where self esteem is an issue because they help a person 'let go' of his self criticism. Mania and schizophrenia would likely have been benefited by the antipsychotic drugs or others with an FDA approved indication for these illnesses. The FDA indication means, at a minimum, that substantial and thorough testing has found the drugs to be effective for the indicated illness, here perhaps either a bipolar manic or schizophrenic illness.

One commenter raised the issue of 'enforcing the gun laws we have' and said that he should not have been able to buy a gun because of his having been committed. I believe that the question on the form is 'Have you ever been committed into a psychiatric hospital?' He would have answered truthfully, 'No' because he was ordered to outpatient treatment. If the symptoms reported after the mass murder had been present and recognized, the 'rambling speech' and unreasonable sense of persecution, during an earlier evaluation, dangerousness to others could have been seen as a potential consequence and a brief hospital stay with the appropriate medications ordered.

Thursday, April 12, 2007

Rank and Reality

'Muslim life is in part defined by who gets deference as the one who speaks the truth' (anon). I was thinking about this as I was reading The Quest of the Historical Jesus, and the outrage/ justice preserved story in the Duke non-rape case. One of the questions encountered for a modern reading the Bible is the issue of miracles. I think the 'Muslims' represent an old method of finding truth. In that frame of reference, the higher your rank the more you can define reality such that ultimately being able to define/make reality anything you want should be appropriate to G-d. thus finding miracles in a story about a G-d is like hearing 'Hail to the Chief' at a public ceremony involving the president; it is protocol. I suppose this is also related to why doctors are so 'trusted.' Life and death pass through our hands; so you wouldn't want to mess with us. True enough, clinical experience and science, which we represent, should also be respected. This also probably bears on the National Health Insurance debate. To an extent, the affirmative side seems to represent an insistence on outranking the doctor and other supply and demand forces that impact medical care. A rearrangement of deference is all that seems needed to get desired treatment in what is otherwise a status quo ante situation. Better count on being Jesus; Texas equivalent: 'Who in the Sam Hill do you think you are?' (Is there an etymologist in the house to explain the equivalence?)