Re: Toxic/addictive thinking patterns

[Guest guest]

-- In ACT_for_the_Public , Darrell King wrote:

>

> Having said all that, I do agree with the spirit of your message

> but I think the delivery comes awfully close to over-generalizing

> therapists or psychologists into uncaring charlatans.

It's all a tangle. As you point out, neuroscience is not necessary for

speaking about human behavior or for doing something about it.

Let us leave the poor old brain alone for a while.

Beyond that I don't mean by any stretch of the imagination that all

therapists are charlatans. And I have sympathy for those therapists

who learned a style of therapy (e.g. any of the various psychodynamic

therapies) that is slowly falling out of favor, or who would prefer

to be the author of their approach to therapy rather than a mere

follower of things read in a manual. It must feel good to be able

to work creatively with clients & perhaps this is part of the appeal

of eclecticism.

Which makes me think that ACT ought to have an advantage

for anyone who does in fact want to work creatively; the support

of a strong model most likely allows for the invention of new

techniques, almost on an ad hoc basis, without the therapist

straying very far from the principles being tested in the research.

- R.

[Guest guest]

That scenario might be based on good science for SOME people, but certainly not most, and you were wise to decline. I have an adult nephew with severe bipolar disorder who cannot manage his life without medications. Currently, he is refusing to take them and his world is totally dysfunctional; he was forced to return home to live with his mother, who is pulling her hair out trying to deal with him. He is in therapy, but he really needs the meds, unfortunately. He got married in March and the marriage is now over. It was his new wife to convinced him to go off the meds - her religon doesn't "believe" in taking psychotropic meds.

Helena

To: "ACT for the Public" <ACT_for_the_Public >Sent: Monday, August 1, 2011 6:55:45 AMSubject: Re: Toxic/addictive thinking patterns

And the third scenario is: a young woman enters a psychiatrist's office seeking help for depression. She assumes that the psychiatrist has been trained to understand, value and use the latest science related to her disorder. The psychiatrist writes her out a script for anti-depressants and says "if you were a diabetic you would need to take insulin, look at this anti-depressant in the same way a diabetic looks at their insulin. Oh - and you may need to take it for the rest of your life". I declined.Kate > > >>> > >> I would even go so far as to say that some therapists don't really> > >> *like* the idea of science - certainly not evidence-based treatment - > > > > > > I think you carried your extrapolations a step too > > > far in this quote, Randy....> > > > > > D (a therapist who likes scientific method)> > > > Hi Darrell -> > > > Actually, it's not an extrapolation. I've personally met therapists> > who believe that they are the best judge of what works and what> > doesn't. Meaning they get to pick and choose.> > > > And even a quick Google finds concern in the literature about the> > difficulty in promoting evidence-based interventions, for this & > > other reasons. E.g. see Kratochwill, T. (2003), "Evidence-based> > practice: Promoting evidence-based interventions in school> > psychology" - here is a quick quote from that paper:> > > > "The challenges in EBI adoption go to the core of traditional> > problems surrounding the scientist-practitioner model and the hiatus> > between research and practice ... Some psychologists may be more> > influenced by clinical judgment than by research supporting EBIs> > when designing, implementing, and evaluating their own interventions> > (, 1996a, 1996b). , McMillen, and Pollio (2003) noted> > that 'evidence-based practice represents a paradigmatic break with> > authority-based and idiosyncratic practice methods that have> > historically characterized social service micro-, meso-, and> > macropractice interventions' (p. 239)."> > > > So it is a genuine issue out there in the wild.> > > > - Randy> >>

[Guest guest]

That scenario might be based on good science for SOME people, but certainly not most, and you were wise to decline. I have an adult nephew with severe bipolar disorder who cannot manage his life without medications. Currently, he is refusing to take them and his world is totally dysfunctional; he was forced to return home to live with his mother, who is pulling her hair out trying to deal with him. He is in therapy, but he really needs the meds, unfortunately. He got married in March and the marriage is now over. It was his new wife to convinced him to go off the meds - her religon doesn't "believe" in taking psychotropic meds.

Helena

To: "ACT for the Public" <ACT_for_the_Public >Sent: Monday, August 1, 2011 6:55:45 AMSubject: Re: Toxic/addictive thinking patterns

And the third scenario is: a young woman enters a psychiatrist's office seeking help for depression. She assumes that the psychiatrist has been trained to understand, value and use the latest science related to her disorder. The psychiatrist writes her out a script for anti-depressants and says "if you were a diabetic you would need to take insulin, look at this anti-depressant in the same way a diabetic looks at their insulin. Oh - and you may need to take it for the rest of your life". I declined.Kate > > >>> > >> I would even go so far as to say that some therapists don't really> > >> *like* the idea of science - certainly not evidence-based treatment - > > > > > > I think you carried your extrapolations a step too > > > far in this quote, Randy....> > > > > > D (a therapist who likes scientific method)> > > > Hi Darrell -> > > > Actually, it's not an extrapolation. I've personally met therapists> > who believe that they are the best judge of what works and what> > doesn't. Meaning they get to pick and choose.> > > > And even a quick Google finds concern in the literature about the> > difficulty in promoting evidence-based interventions, for this & > > other reasons. E.g. see Kratochwill, T. (2003), "Evidence-based> > practice: Promoting evidence-based interventions in school> > psychology" - here is a quick quote from that paper:> > > > "The challenges in EBI adoption go to the core of traditional> > problems surrounding the scientist-practitioner model and the hiatus> > between research and practice ... Some psychologists may be more> > influenced by clinical judgment than by research supporting EBIs> > when designing, implementing, and evaluating their own interventions> > (, 1996a, 1996b). , McMillen, and Pollio (2003) noted> > that 'evidence-based practice represents a paradigmatic break with> > authority-based and idiosyncratic practice methods that have> > historically characterized social service micro-, meso-, and> > macropractice interventions' (p. 239)."> > > > So it is a genuine issue out there in the wild.> > > > - Randy> >>

[Guest guest]

I agree. There is no proof of a deficiency. It would be impossible to measure the amount of any neurotransmitter in the brain, or to know if the drug actually works by making more serotonin or dopamine available to the neurons - such tests cannot realistically be done. So no one really knows how such meds work for those who actually need them and benefit from them, like my nephew. I've read that in the studies that have been done, the most severely depressed were not included in the trials, so the medication's efficacy in that population is not represented. They are definitely over prescribed, though, especially in children, which is appalling.

Helena

To: "ACT for the Public" <ACT_for_the_Public >Sent: Monday, August 1, 2011 7:50:50 AMSubject: Re: Toxic/addictive thinking patterns

I'm not anti meds and have actually taken anti-depressants a few times over the years since then and they have helped to some extent. But that psychiatrist's attitude and pronouncement made me feel so disempowered, like I was being handed a life sentence with only one hope for parole. I sure was REALLY depressed when I left her office.I believe that diabetes/insulin analogy is commonly used by those prescribing meds but I don't think it is scientifically very sound. As far as I know, it's never actually been proved that people suffering from depression actually do have any *deficiency* as such in serotonin or dopamine or whatever (unlike diabetics and insulin). And based on what I've read about the very limited (in length and scope) trials that are done with anti-depressants, the scientific basis for their efficacy is not clear either.CheersKate > > > >> > > > >> I would even go so far as to say that some therapists don't really > > > >> *like* the idea of science - certainly not evidence-based treatment - > > > > > > > > I think you carried your extrapolations a step too > > > > far in this quote, Randy.... > > > > > > > > D (a therapist who likes scientific method) > > > > > > Hi Darrell - > > > > > > Actually, it's not an extrapolation. I've personally met therapists > > > who believe that they are the best judge of what works and what > > > doesn't. Meaning they get to pick and choose. > > > > > > And even a quick Google finds concern in the literature about the > > > difficulty in promoting evidence-based interventions, for this & > > > other reasons. E.g. see Kratochwill, T. (2003), "Evidence-based > > > practice: Promoting evidence-based interventions in school > > > psychology" - here is a quick quote from that paper: > > > > > > "The challenges in EBI adoption go to the core of traditional > > > problems surrounding the scientist-practitioner model and the hiatus > > > between research and practice ... Some psychologists may be more > > > influenced by clinical judgment than by research supporting EBIs > > > when designing, implementing, and evaluating their own interventions > > > (, 1996a, 1996b). , McMillen, and Pollio (2003) noted > > > that 'evidence-based practice represents a paradigmatic break with > > > authority-based and idiosyncratic practice methods that have > > > historically characterized social service micro-, meso-, and > > > macropractice interventions' (p. 239)." > > > > > > So it is a genuine issue out there in the wild. > > > > > > - Randy > > > > >>

[Guest guest]

I agree. There is no proof of a deficiency. It would be impossible to measure the amount of any neurotransmitter in the brain, or to know if the drug actually works by making more serotonin or dopamine available to the neurons - such tests cannot realistically be done. So no one really knows how such meds work for those who actually need them and benefit from them, like my nephew. I've read that in the studies that have been done, the most severely depressed were not included in the trials, so the medication's efficacy in that population is not represented. They are definitely over prescribed, though, especially in children, which is appalling.

Helena

To: "ACT for the Public" <ACT_for_the_Public >Sent: Monday, August 1, 2011 7:50:50 AMSubject: Re: Toxic/addictive thinking patterns

I'm not anti meds and have actually taken anti-depressants a few times over the years since then and they have helped to some extent. But that psychiatrist's attitude and pronouncement made me feel so disempowered, like I was being handed a life sentence with only one hope for parole. I sure was REALLY depressed when I left her office.I believe that diabetes/insulin analogy is commonly used by those prescribing meds but I don't think it is scientifically very sound. As far as I know, it's never actually been proved that people suffering from depression actually do have any *deficiency* as such in serotonin or dopamine or whatever (unlike diabetics and insulin). And based on what I've read about the very limited (in length and scope) trials that are done with anti-depressants, the scientific basis for their efficacy is not clear either.CheersKate > > > >> > > > >> I would even go so far as to say that some therapists don't really > > > >> *like* the idea of science - certainly not evidence-based treatment - > > > > > > > > I think you carried your extrapolations a step too > > > > far in this quote, Randy.... > > > > > > > > D (a therapist who likes scientific method) > > > > > > Hi Darrell - > > > > > > Actually, it's not an extrapolation. I've personally met therapists > > > who believe that they are the best judge of what works and what > > > doesn't. Meaning they get to pick and choose. > > > > > > And even a quick Google finds concern in the literature about the > > > difficulty in promoting evidence-based interventions, for this & > > > other reasons. E.g. see Kratochwill, T. (2003), "Evidence-based > > > practice: Promoting evidence-based interventions in school > > > psychology" - here is a quick quote from that paper: > > > > > > "The challenges in EBI adoption go to the core of traditional > > > problems surrounding the scientist-practitioner model and the hiatus > > > between research and practice ... Some psychologists may be more > > > influenced by clinical judgment than by research supporting EBIs > > > when designing, implementing, and evaluating their own interventions > > > (, 1996a, 1996b). , McMillen, and Pollio (2003) noted > > > that 'evidence-based practice represents a paradigmatic break with > > > authority-based and idiosyncratic practice methods that have > > > historically characterized social service micro-, meso-, and > > > macropractice interventions' (p. 239)." > > > > > > So it is a genuine issue out there in the wild. > > > > > > - Randy > > > > >>