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Boston: Familiarity Breeds Contempt
April 23, 2013 | 36 comments
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Secretary Kerry’s Maiden Voyage
March 5, 2013 | 40 comments
Special Report
Ordering More Disorders
As it discovers new “disorders,” the DSM guidebook for psychotherapists should dispose of Post-Traumatic Stress.
In the early 19th century Samuel Butler wrote a quasi-utopian novel called Erewhon. It was startlingly prescient. Those who committed crimes were considered to be ill. Those who were ill were considered guilty of a crime. Society objected to facing the pains of others. In the following century Aldous Huxley expanded the same envelop in Brave New World. Joy was the order of the day; unhappiness was unacceptable self-indulgence. Depression, feelings of unworthiness, and similarly common strains were unnecessary, rendered so by pills Huxley called soma. (Sex was for fun exclusively and procreation was a crime; babies were made in the laboratory — that’s why God made petri dishes and test-tubes.)
Butler and Huxley would not be at all shocked by the current contretemps over what should go into the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the proximate cause being the proposed inclusion of bereavement as a disorder. The DSM is a guidebook for psychiatrists and psychologists, akin to the user’s manual that comes with your appliances and vehicles, that standardizes the human psyche and renders it susceptible to tinkering along suggested lines. Equally important (well, maybe more so), it determines what tinkering will be covered by insurance. Ah ha!
Put baldly, the more tinkering is suggested in the DSM, the more money there is to be made by those who purport to plumb the human mind. (“And how did that make you feel, Shirley?”) It surely is true that being listened to can be therapeutic. But if listening required professional attainments, bartenders would have to be board-certified.
According to a January 25 New York Times article addressing the issue, depression as defined by the current DSM does not include bereavement (i.e. what one feels when a loved one dies). The community is divided over whether it should. The dispute comes down to whether it is inappropriate to be unhappy when, say, your child dies. Some in the profession appear to feel this is “normal,” while others feel that it is a pathology that should be treated, no doubt with a little help from Medicaid.
Feeling bad about a death is not the only potential DSM inclusion on the table. Other favorites are “binge eating disorder” (can “binge drinking” be far behind?), and “premenstrual dysphoric disorder” (what are comediennes to do when PMS “jokes” aren’t funny anymore?). It is statistically verifiable that once a behavioral condition, however transitory, is labeled a “disorder” the number of people diagnosed with the “disorder” goes zooming up the charts. Suddenly tens of thousands of people who formerly were reduced to having to pull up their socks and get on with their lives can now lie back on the couch and indulge a “disorder” they didn’t previously know they had. That is very gratifying for some personalities and very lucrative for the person who “diagnosed” their disorder.
If all this were restricted to low-lit rooms, couches, boxes of Kleenex, and someone murmuring “Hmmm, and did your uncle remove his hand when he realized you were uncomfortable?” it would all be relatively harmless quackery.
But it doesn’t stop with the session on the couch. The pharmaceutical industry gets into the act as well. There are pills (soma?) to be popped, such as those, e.g. Paxil, Prozac, Zoloft, implicated in the suicides of people, chiefly those of a youthful age, being “treated” for various adolescent angsts. These episodes may match up with the high number of American soldiers committing suicide.
The unhappy (and largely unexamined) fact is that the military does not have a sufficient number of troops to fight the protracted wars now slowly grinding to an inconclusive halt (and so has to keep re-using the troops it has), and it does not have enough doctors to treat those who are dealing with the consequences. So, in order to get the stressed trooper back up on his or her feet and into the fight, out comes the pill bottle. The result, as I personally confronted during my brief tenure as Deputy Undersecretary of Defense for Wounded Warrior Care and Transition Policy, is soldiers too addled to assemble a simple sentence.
Which brings us to another revision to the DSM to be prayed for, this one not an addition but a deletion. The DSM currently characterizes Post-Traumatic Stress as a “Disorder.” U.S. military medical personnel confronting a soldier’s reaction to trauma, usually manifested as some greater or lesser degree of stress, commonly seize on the DSM definition in addressing the reaction. This produces one or a combination of the following results, sometimes depending on whether the soldier means to stay in the service or leave it:
The soldier who intends to make a career of the military is loath to have a “disorder” on his or her (inexpungible) military record. The military culture is one that penalizes anyone suspected of emotional weakness. The military is trying to change this, with little success. Commanders may urge people to report themselves if they are experiencing symptoms of stress, promising there will be no penalty, no stigma, attaching to those who ask for help. By and large, soldiers do not trust the leadership, at least on this point. Accordingly, soldiers who need help are likely to resist seeking it.
The soldier who intends to leave the military is equally reluctant for his or her medical record to have the pejorative term “disorder” permanently inscribed as they try to find employment in the civilian job market. For some professions, e.g. law enforcement, the associated stigma can be an absolute bar to employment.
Post-Traumatic Stress is a condition associated with warfare for as long wars have been fought. It is freighted with euphemisms that can be found in accounts of conflict going back to the Iliad, but there is little more understanding of how to manage it today than there was when Achilles slew Hector, despite mountains of monographs, studies, and theoretical therapies. The one conclusion that clearly can be drawn is that reaction to trauma differs from one person to the next and is not susceptible to the kind of standardization implied in the Diagnostic and Statistical Manual of Mental Disorders.
Whatever becomes of “bereavement” as an accouterment to depression in the next edition of the DSM, the term “Disorder” must be detached from Post-Traumatic Stress if our military personnel are to have a fair shot at surviving the consequences of their hard service to our nation.
Appleby| 7.13.12 @ 6:40AM
Clinical depression is an illness. It has nothing to do with "feeling sad", the feelings attendant upon it are caused by a chemical imbalance in the brain, for which there is treatment available. People who have never suffered from it think an order to "cheer up!" is all we need. People who suffer quite often end up in the hospital. I am now able to sort out what belongs to the illness and what I can really solve by changing my environment and my life.
On the other side of the coin are the "grief counselors" rushed into schools every time some really hard reality bites the students, e.g. one of them shoots a number of others or a fellow student is killed or seriously injured in a drunken or binkie-driven car crash, along with his passengers who were not wearing seat belts, or a rock star or Princess dies. Students are encouraged to "let it all out" -- that is, to engage in screaming hysterics and manufacture drama so that others can shower them with attention and sympathy -- and incidentally teach them that only the government can cure what ails them, as the appointed Grief Counselors replace their families and their church, and their God, as the author of consolation. No wonder they are trying to make bereavement a disease! Sooner or later Reality will be a disease, and a misinterpretation of the Declaration of Independence wil convince everyone that we have a right to be Happy, and someone else has the duty to make it so...
c. j. acworth| 7.13.12 @ 7:03AM
Of course, these days at least half of the boys and an increasing number of the girls in any given school are already doped for their ADD or ADHD or whatever it is we call what used to be called high spirits in my day. Teachers used to know how to deal with a cut-up or class clown. Nowadays they march the unfortunate child to the nurse for a sedetive because they don't want to be bothered.
Mike G| 7.13.12 @ 9:12AM
Many school districts require that untruly students receive "due process" before they can be disciplined. This "due process" usually takes 2-3 months. The reason for this is because administrators don't want to deal with the unruly students or their parents, hence the teachers must put up with it.
In my day, unruly students received swift and sure punishment, sometimes with a baseball bat that was cut in half, but usually something less painful.
Wonder why so many students are ignorant when they get out of high school? It's that teachers don't have time to teach because they are so busy correcting unruly students who can't be punished.
Appleby| 7.13.12 @ 6:12PM
In one of her Little House on the Prairie books, Laura Ingalls Wilder describes how a teacher once routed a gang of bullies -- with a blacksnake whip. Try that one today.
TLP| 7.13.12 @ 7:11AM
They should add one more to their ever growing list. The one that afflicts The Pointy Headed among us, who find themselves with Too Much Time on their hands. Sometimes a Cigar, is just that. A Cigar. Even when it's Bill Clinton's.
Let's remember who we're talking about, here.
They pretty much, sit around all day, looking for sh*t to do. They spend Years and Years, in School, and when they finally get out? Now what?
I gotta believe that being a Shrink isn 't like being an Orthadontist, or a Pediatrician, or a Veterinarian.
Being NUTS is a pretty Exclusive Club. Take HERE, for example - Out of everyone writing comments, there are just a select few - Ya got Purp, of course. That Canadian Broad who thinks she's American. Ya got DRed, RCV, Alan Brooks, and everybody on this site who's Nomde Plum begins with "Doctor". It's not like Teeth. Or Babies. Or Dogs and Cats. They're more like 5 Leaf Clovers. Leprechauns. And "Friends" of Doctor Right.
They're practically Nonexistent, except in the case of the last one, which, I think we can all agree, is always running a Zero Balance.
Not exactly a target rich environment in which to Set Up Shop.
Instead, they have to INVENT their Clientele. Make Up new Ailments of the Psyche. Convince EVERYONE that EVERYTHING is a Mental Disorder, and not just Liberalism.
It's called: Drumming Up Business.
It's called: The Americans with Disabilities Act.
It's called: Follow the Money
Can you Blame them?
Doctor Right| 7.13.12 @ 9:14AM
Severely repressed anger, expressed as rudeness, vulgarity, and braggadocio (ie, your supposed "smoking hot wife" whom you insisted on identifying as "Asian," as if that somehow further elevates your coolness) is also a sign of underlying mental instability...
...and you're a text-book example.
Your long-winded, inane posts (generally the first on each topic every morning - got a life? Isn't your "smoking-hot" wide keeping you busy, or did you run out of Viagra?) are written more to impress yourself than anyone else on this board.
Sorry, but those of us who read beyond the 4th-grade level aren't impressed. We find your deep-seeded insecurity issues to be totally boring.
As I've said in the past, if you had any actual insight then your bloviating might be tolerable - but you don't.
You're a tiresome Master-of-the-Obvious.
A bore.
A clown.
And a cry-baby.
TLP| 7.13.12 @ 9:33AM
Smoking Hot, obeys her Husband - ME - and makes Big Bucks.
House.
Kids.
White Picket Fence.
Dog.
Big Back Yard.
Lots of Friends.
(Why do I feel like I'm teasing the dog?)
Doctor Right| 7.13.12 @ 11:48AM
Maybe you think if you keep saying it over and over then others will believe it as much as you do?
MK48| 7.13.12 @ 10:36AM
Gee......DOC for someone that has TLP sized up and criticizes his opinions and thinks that his bloviating is "off the mark" maybe you should sit in front of a mirror when posting, Iv'e read some of your comments and think WTF.
You are missing Tim's......passion and by the way if you don't like what he says find another site to hover over.......oh if forgot your a lib "no free will" just FOLLOW. Mark Levin writes about that in his latest book maybe DR you should read it.
If you don't mind me asking just what does Dr. Right mean. Are you a doctor ? of what ?
Tim....brother.... love your passion I just wish more had it.
Doctor Right| 7.13.12 @ 11:46AM
"Passion" is swell.
However, passion + ill-informed opinions + rude, vulgar comments + preening narcissism + obnoxious attention seeking = stupid.
You love it?
Your choice. It's a free country.
And if you think I'm a Lib because I think TLP is a pathetic bore, then you must be as dumb as he is.
There's all kinds of Conservative voters. Not all of us are hopeless bores...
Doctor Right| 7.13.12 @ 11:55AM
BTW...
As far as leaving this forum is concerned, I've considered it.
The level of intellectual discourse has hit an all-time low.
And frankly, half the articles aren't that interesting, either.
Lots of folks from the old days have disappeared, too.
Heck, for all his anti-Semitic leanings at least "Jack in Wi" could string two sentences together into a coherent thought.
You...not so much.
TLP| 7.13.12 @ 4:29PM
Don't let the door hit ya on the way out.
I hear The Onion is looking for commenters.
You, and The Onion.
Perfect together.
Doctor Right| 7.13.12 @ 5:18PM
I'd love to write for the Onion. That's serious satire, so it's no wonder you don't get it.
MK48| 7.13.12 @ 6:07PM
Hey doc....you didn't answer my question doctor of what ?
Bob Grant| 7.13.12 @ 9:06PM
All things right.
Doctor Right| 7.13.12 @ 11:41PM
That's because I don't suffer fools.
Stephanie| 7.13.12 @ 7:22AM
Now THIS kind of capitalism we could do without. And how sad for our soldiers.
JD| 7.13.12 @ 1:55PM
Capitalism? You call it capitalism when an entire industry is built out of government's willingness to shovel tax dollars at anyone who can snag a diagnosis?
Bumr50| 7.13.12 @ 7:27AM
I am currently coming off of SSRI antidepressants for the first time in 15 years (I'm 36), and titrated off myself after not being able to get any REAL answers from professionals as to why if I missed a dose of my medicine, strange, REAL, and truly frightening things would happen to my nervous system.
These meds are routinely prescribed to kids.
I'm not one of these "anti Big Pharma" people. I'm just a guy who feels that the effects of this class of medicine were NEVER explained to me satisfactorily. If they work for some people, great. But NOTHING that makes you feel like this for weeks and weeks after discontinuing use should be prescribed as flippantly (IMHO) as Paxil, Zoloft, etc. are.
Even worse is having a doctor give you a big "Hmmm" and look at you like you're crazy when you describe symptoms that you're having a month after discontinuing treatment, and explaining to you that the medicine is out of your system after two weeks and that somehow these symptoms aren't physical in nature. BS.
TLP| 7.13.12 @ 8:17AM
Ya know? I gotta tell ya, for your own good.
Ya sound crazy. You sound like you are Wound Up tighter'n Appleby's sphincter, during one of those Canadian Blizzards that they get up there WHERE SHE LIVES.
Not for nothin, but, the next time you see one of these guys?
You might want to avoid having the words - "I'm not Crazy" - be the first ones outta your Mouth.
That'll always get the finger pressing the Red Button, under the table, quickly followed by the Burley Assistant.
I'm just saying. You know. Like in the Movies. I don't have any Life Experience in this, because I'm not Crazy.
Ask any of my Therapists.
They'll tell ya.
inxy| 7.14.12 @ 1:10PM
Either you are joking or you're pretty stupid. Me thinks pretty stupid.
TLP| 7.14.12 @ 8:25PM
I'm joking.
And, actually, I don't really care what "methinks".
Doctor Right| 7.13.12 @ 11:41AM
Ignore the dolt called "TLP."
I GUARANTEE you that he is now, or has been at one time in his life on anti-depressant medication.
TLP| 7.13.12 @ 4:36PM
Ignore the dolt called "Doctor Dumb@ss".
I GUARANTEE that he is now, or has been! at one time in his life, hiding in his Mom's closet, watching her undress.
You can't beat me.
I Sh*t bigger'n you.
Always have.
Always will.
If you weren't such a POS, I think that I might even FEEL SORRY for you.
IF you weren't such a POS.
Doctor Right| 7.13.12 @ 5:20PM
What a witty reply!
Oooooh,, my feelings are soooooo hurt!
...snicker...
Occam's Tool| 7.13.12 @ 6:34PM
A few comments: one, the military (or at least the VA, as I know from personal experience having been trained through it) tends not to cover the latest medications, such as Abilify, which have relatively low sedative properties. Secondly,modern warfare can do tremendous things to nerves and bones not seen in the wars of the Illiad.
Third, the kids that I have taken care of with ADHD did NOT tend to be medicated for convenience---it tended to cause tremendous learning and behavioral difficulties. I am as tired of that slur as I am of the Obama administration implying that I would wait for a patient to decompensate so that I could make more money off of him.
Fourth, Koch, you ignorant Obama administration swine, I have treated plenty of Vets with PTSD successfully.
PTSD DOES get overused as a disorder, but patients suffering from traumatic brain injury as well as seeing their friends get blown up by a roadside IED have suffered in ways that REMFs may not be able to understand.
Occam's Tool| 7.13.12 @ 6:41PM
A point that may not apply to you---coming off of SSRIs can give one a Serotonin withdrawal syndrome if done too rapidly, worse with Paxil than with others, least problematic with Prozac.
The symptoms would be physical in nature and would genrally be flu like symptoms. The treatment is usually to withdraw more slowly. Another piece of information that is necessary is that the risk of recurrent depression goes up tremendously if you have had more than one two week episode, and staying on meds reduces that risk considerably. (70% for two episodes, 90% for three. I usually tell my patients that if you've had three episodes, it is a lifetime condition)
One should always come off and on these under an MD's supervision. It should also be pointed out that depression symptoms can come back and come on, quickly.
For good explanations of psychotropic medications, I always recommend going to the University Psychiatric Department of the local medical school in your nearest big enough city to have one. Psychiatric residents tend to have more time.
But don't taper yourself off without your MD's guidance, and G-d Bless and Good Luck.
Appleby| 7.13.12 @ 7:29AM
TLP, you are a Syndrome all by yourself. People will study you for generations.
I hereby cut TLP out of my loop and will no longer respond to anything it says.
C'mon Man!| 7.13.12 @ 7:50AM
I like TLP - he may come across a little harsh, but the time for niceties is long past. I think Appleby has good things to say, but she should in no way participate in our elections, since she has no skin in the game.
There you have it!
THKrupp| 7.13.12 @ 10:11AM
TLP has some good points as does Appleby. I dont agree with everything either one of them say. I dont agree that Appleby shouldnt participate in our elections though. I dont know the circumstances of why she lives in Canada...thats really none of my business. By limiting voting rights to only citizens that live inside the borders of the USA you mean that you wouldnt let servicemen and women deployed overseas to vote? What about businessmen and women who work overseas? There are many expatriates who reside outside the country for one reason or another. Would you deny them all the basic right of voting?
TLP| 7.13.12 @ 10:37AM
There's a HUGE difference between Soldiers Deployed Overseas, Businesspeople who are TEMPORARILY working Overseas for their Company, and Greta Garbo, up there, by CHOICE, and of her own Free Will.
She's not at a Red Roof Inn.
She's in her HOME, in CANADA.
She LIVES in CANADA.
Am I coming through, out there?
Letting her vote, is no different from letting any other Illegal Alien, vote.
THKrupp| 7.13.12 @ 10:52AM
Theres many business people that live...their home is outside the USA...for many years. I know a lot of people in Caterpiller that are overseas for 10 years or more. They are still citizens. They still vote. They still have "skin in the game". These people arent living in hotels. They arent on some kind of temporary assignment. Theres also many people who retire to Mexico and Central America. Are they to be denied the right to vote as well?
TLP| 7.13.12 @ 4:39PM
Please enlighten us on how Miss Canada, living in her HOME, in CANADA, has ANY Skin in the Game.
Please.
THKrupp| 7.13.12 @ 6:09PM
To be honest I dont really know anything about her situation, but it isnt any different than other expatriots.
What is interesting is that you both agree on most issues. I dont understand your level of animosity towards people that basically agree with you for the most part. The only reason I speak up is that some of what you say is uncalled for. You make some good points but they get lost in the vitrol.
Ive been in situations where there are people that shout everyone down and immediately go to personal attacks. It takes the conversation to the level of children. Ive noticed that the only reason it continues is that no one says anything to the people doing this. I dont know anything about you personally and I dont really care. I just get tired of people that browbeat everyone around them. It just gets old.
THKrupp| 7.13.12 @ 6:26PM
I realize I didnt answer your question of why she in particular should be allowed to vote. Shes a citizen and therefore has the right to vote. If you want to deny people the right to vote due to geographic location then you have to change the Constitution.
THKrupp| 7.13.12 @ 6:44PM
Sorry just did some research and its not the Constitution, its the Uniformed and Overseas Citizens Absentee Voting Act which allows her to vote.
TLP| 7.13.12 @ 7:20PM
She has made her HOME, in CANADA.
For all intensive purposes, SHE'S CANADIAN.
WHEN SHE LIVES HERE?
I will support her effort to vote for her Stupid Write-in waste of time
TLP| 7.13.12 @ 7:56PM
I want you to know that I don't mean these things as an attack on you.
I'm just trying to make the point that SHE DOESN'T LIVE HER, by HER OWN CHOICE.
Let her Vote, up there, WHERE SHE LIVES.
That's all I'm sayin.
THKrupp| 7.13.12 @ 8:17PM
No worries, youve always been decent with me even though we probably disagree on a few things.
MK48| 7.13.12 @ 10:47AM
She is also a traitor...........I heard she's comming back across the border because she can't get her legs in stirrups for 9 mo. and needs her oil checked asap. Ya come back to this den of iniquity when you can get something free.
Most illegals do.........maybe Jane Fonda will get you a geern card.
TLP| 7.13.12 @ 4:39PM
Exactly.
TLP| 7.13.12 @ 8:01AM
Have you been responding to me?
I didn't even notice.
Evidently, you were writing in your native Canadian.
Doctor Right| 7.13.12 @ 11:31AM
He can't help it.
Trying to make other people feel bad is how he makes himself feel good.
It's a char ate rustic common to the narcissist, along with poor self-esteem.
Cobalt| 7.13.12 @ 8:00AM
To paraphrase what has been stated before; depression is not a moral weakness, flaw, or failure. Depression can have a biological basis.
There is no shame in being diagnosed with depression.
JimH| 7.13.12 @ 8:24AM
Medicine follows the laws of economics like everything else. If you subsidize something you get more of it. As government pours more and more tax payer money into treating disease, in this case mental illness, lo and behold the profession finds more mental illnesses to be treated.
Occam's Tool| 7.14.12 @ 6:57PM
Jim: I make beaucoup money treating Depression, mania, and psychosis. My patients are doing obvious things like arguing with cops telling them to step away from the gun, threatening to jump off bridges, or running into traffic. In 19 years, I have made excellent money keeping people from killing themselves or others, or keeping them from having the screaming voices preventing their sleep.
I haven't had to make up any "illnesses." At one time, 1/4 of ALL Hospital beds were occupied by mental patients, we now have a shortage of beds. Walk the streets of LA sometime. As I tell my patients now: "pal, I wasn't out there chasing you with a butterfly net. I actually make less per unit of work now that you are here. I am keeping you here, and treating you, because anyone with an ounce of brains would want one treat someone who did (fill in the blank from the choices above; feel free to think of anything humanly possible except that I have never, ever, treated someone who thought he was Napoleon.)"
Incidentally, I have NEVER, EVER seen a TV Show or Movie that shows what I do for a living accurately. Not ONE goshdarned one. It's not "What's up Pussycat?", it bears NO RESEMBLANCE to "Analyze This," or "The Sopranos." The closest thing I have ever seen to accurately capturing the anguish that psychiatrists get to feel routinely is "What About Bob?" But even that bears no resemblance to the pressure cooker I get.
JimH| 7.15.12 @ 8:21AM
Occam, I am not questioning the ethics of you or your profession. I am just pointing out then when an incentive is provided for something you get more of it. What is happening here is that certain behaviors and symptoms are being are now being diagnosed as mental illnesses where in the past they hadn't been. I leave it to you as the professional in the field to decide if all these conditions had existed in the past and just not been labeled as mental illness and why they should be so now. BTW, I am not questioning the reality of mental illness just the apparent eagerness to label non standard behaviors as such. Unfortunately I too know the reality of mental illness.
Cobalt| 7.15.12 @ 10:28AM
The next time we see a homeless person, there is a fair chance that we are looking at someone who is suffering from mental illness.
A disporportionate number of homeless people are mentally ill. Certainly not all of the homeless are mentally ill, but many of them are, especially in large cities like New York and Los Angeles.
It's a sad situation. Those of us who have a home, job, decent life, etc., and the free time to entertain ourselves by posting on blogs are truly blessed.
I can only imagine how the mentally ill are treated, and how they must suffer in places like Russia, China and third world countries.
Occam's Tool| 7.15.12 @ 8:52PM
The problem with the homeless is a confluence of interests from both Liberals and Conservatives. Liberals wanted deinstitutionalization, and Conservatives wanted to cut state budgets. Voila!
Completely correct, Mr. Cobalt.
Occam's Tool| 7.15.12 @ 8:51PM
Well, Jim, you are a nice guy. I just get my hackles up on this, as you can well understand. Hey, criticize my politics all you want, and I certainly undrstand some people misusing the PTSD diagnosis for a lot of foul purposes. But when someone is sick, they are sick, and pretending that subnormal functioning is not a problem is ridiculous.
The DSM-V, by the way, is TIGHTENING the criteria for diagnosis of autism (I, myself, have NOT seen the explosion of autism on the psychiatric units that I work on, and if there has really been an explosion of this over the last 7 years, some of the earlier cases should be coming onto the adult units by now), which I think may be useful. There are also diagnoses I believe are crocks, such as the dissociative identity disorder, which if it happens at all, I believe is very rare.
Usually, real psychiatric diagnosis are as subtle in their failures as a Cubs' season. It's not hard to pick up. I think Deputy Undersec Koch showed a remarkable lack of concern for the suffering of his men as evident in this article, which is probably the reason that even the Obama administration had to can him.
Mimi | 7.13.12 @ 8:25AM
Psychic PAIN is part of LIFE....We all endure painful experiences...UPS & DOWNS !
The whole trick is to not kill this pain with temporary quick fixes...ETOH & DRUGS...Go thru it let it rise up and go out...each time you become stronger and your ability to endure is a lifelong protection. Once you try to kill it the quick way..your natural ability decreases your endurance and you could end up with a problem of addiction.
Genuine psychiatric illness Schizophrenia, Manic Depressive etc does respond to treatment.
Most of us are not mentally ill but we are never immune to heartbreak and sad events....BUCK-UP!
TLP| 7.13.12 @ 9:55AM
You couldn't be righter, Mimi.
Every time I see one of Doctor No Friends comments, I feel Anger and Disappointment. I feel Pity and Rage. I feel Sadness, for anyone who reads one of his Idiotic Sops, by accident. And I feel Regret, that he wasn't ABORTED, when they had the chance.
That's life.
It truly is, filled with painful experiences.
Mimi | 7.13.12 @ 10:49AM
I would expect you had the confidence, and self respect to ignore un-asked for criticism.
We are never liked by all...enough of us love the heck out of your posts they inform and right on....you've got the "O" NAILED !!!
TLP| 7.13.12 @ 4:44PM
The Confidence, Mimi?
Really?
This has never been a case of anything, but the fact that I DON'T LIKE HIM.
He started all of this Bullsh*t.
And I aim to Finish It.
He's not worthy of your Pity.
Doctor Right| 7.13.12 @ 5:26PM
Oh, you're gonna "finish it"?
And how are you gonna' do that, L'il Timmy?
And yes, you lack confidence; it's evident from each and every post.
False bravado doesn't hide that. The only person you're fooling is yourself.
TLP| 7.13.12 @ 7:28PM
This is what I'm talking about.
He's a Pathetic Waste of Oxygen.
And, as long as he seeks to pull my chain?
I will, Joyfully, put him in his place, like the Wothless POS that he is.
I've never taken any Sh*t, from Anyone, in my life.
And, I ain't about to change, now.
Doctor Right| 7.13.12 @ 11:44PM
But you're takin' it now, aren't ya' tough guy?
How's it feel to not be in control?
LOL!
Occam's Tool| 7.13.12 @ 6:44PM
Mimi: Psychic pain IS part of life---but Major Depression and PTSD go beyond mere pain, and psychiatric medications do help prevent suicide. Koch is a former Obama administration guy. Nuff said.
Doctor Right| 7.13.12 @ 11:36AM
Really?
Because every time I see one of your posts, I snicker.
Why??
Easy. You're funny, but not in a "Ha-Ha" way, more like in a clueless, pathetic dolt kind of way.
You have NO idea how readable you are. There's nothing original about you. You're a cliche'.
But the FUNNIEST thing of all is how you whine like a baby when I reply to your posts, but THEN you go out of your way to mention me!!!
LOL!
You're like a little boy desperate for attention from his daddy.
You're funny!
Doctor Right| 7.13.12 @ 5:31PM
So much pent-up emotion...maybe you should see a psychiatrist?
MK48| 7.13.12 @ 6:15PM
Hey DOC............are you a doctor and of what.....gee this is the 3rd. time Iv'e asked.
You sound like you have some smarts....just curious.
My nephew is a Dr. sounds a lot like you.
THKrupp| 7.13.12 @ 10:36AM
Yes I agree pain is a part of life. Some people have no problem bouncing back from trauma some people dont. To just tell people to buck up is no answer at all. When I was in my 20s I was farming with most of my income from raising hogs. In 98 the hog market completely fell apart. I was losing money every day..buckets of cash. I was selling hogs for only slightly more than what it cost to ship them to market. It was the worst period of my life. I owed the bank quite a bit of money and there really was no relief in sight as far as the market was concerned. I started having panic attacks. My heart would start racing for no reason and I would almost faint. I went to the Dr and he could find nothing wrong with me. My heart then started skipping a beat every 4 beats during these attacks and I managed to get to the Dr while one of these attacks was happening. He still could find nothing.
THKrupp| 7.13.12 @ 10:36AM
I was put through many different tests which I could not afford because they were all out patient procedures and my insurance only covered major things that required hospitalization. I was in my 20s so I didnt expect there to be anything truely wrong with me. Finally I was telling a neighbor about what was happening. His wife was a psychiatrist she offered to get me a script for zoloft. It made all the difference in the world. I was on it for maybe a year till I got things financially squared away. I was able to think much clearer and make better decsions because of it. I was not crazy or mentally ill other than constant stress in what seemed to be an impossible situation that was destroying my life. I dont believe you truely understand. My natural ability to deal with stress didnt decrease and I didnt end up with an addiction problem. You are fortunate if you have never had issues like this. You simply dont understand.
Mimi | 7.13.12 @ 11:00AM
Glad the Zoloft worked for you , to calm things down and give you the opportunity to sort it all out....thats the purpose and I hope things are better now.
I am a retired R.N. in ETOH/DRUGS please forgive ....one fix doesn't serve all we are all unique and different...hope my advice is taken generally!
THKrupp| 7.13.12 @ 11:19AM
Yes quite better, thanks. In some ways it was the best thing that ever happened to me. I do agree that drugs are over prescribed in many cases. Rather than using them as a means of last resort many are prescribed much too easily.
Doctor Right| 7.13.12 @ 11:39AM
Are you speaking from experience?
So you're an expert on psychiatric disorders?
Please...
TLP| 7.13.12 @ 4:47PM
Yes.
And I have determined that you suffer from a Severe Case of Male Inadequacy.
You're nobody, you've got nothing, and you should do yourself, and everybody else, a Favour, and Pull The Trigger, next time you put that Gun in your Mouth.
Doctor Right| 7.13.12 @ 5:27PM
It's funny how easily I figured you out...
TLP| 7.13.12 @ 7:29PM
Yeah.
You're a freakin genius.
Bob Grant| 7.13.12 @ 9:13PM
Guys,
Any psychic hated aimed at anyone other than obama right now is unpatriotic. You guys need to aim your venom at 1600 Pennsylvania.
Capiche?
TLP| 7.14.12 @ 7:39AM
I'm Multitasking.
Doctor Right| 7.13.12 @ 11:45PM
You're an open book.
Kind of like "See Spot Run," but an open book, nonetheless.
fmm| 7.13.12 @ 9:46AM
At first I took exception to your sub-title as I took its meaning to be post traumatic stress should not be recognized as a problem requiring treatment. However, the details of your article clarified your meaning as people who have this problem should not be stigmatized by naming it a disorder. I totally agree with this approach as long as people truly suffering can gain access to professional help. I personally underwent a transition from thinking PTSD was simply an emotional issue to understanding that it often has a physical damage component beyond the control of those affected. My concern stems from my son's experiences in Iraq which left him with quite a few problems, some of which the doctors explained as being related to a partial separation of the brain stem due to concussions from explosons. This area apparently provides some automatic dampening of aggresive reactions to aggravating stimuli. Once he was made aware of this, his ability to consciously control his reactions improved markedly to the point that he has been taken off medications. I am very grateful to the medical personnel who have been able to learn so much and translate this into actions which help our soldiers.
MRD| 7.13.12 @ 11:14AM
Mr Koch has a point. That said in fact PTSD is a "real disorder" There are structural & functional changes in brains of patients with the symptoms of PTSD, ( based on MRI imaging) . Chronic exposure to stress produces biologic effects. There is a stress induced heart damage, Takotsubo's cardiomyopathy. Stress may injure the brain producing mental ills. Mental illness is really brain illnesses. Human beings are a combo of body and soul. It should be obvious that our "soul" can not be "ill" As the source of our free will, it interacts with and through our bodies (specifically our brain) to produce our behavior, thoughts & emotions. If our brain is disordered we can have disordered behaviors, thoughts and emotions ( what we think of as "mental illness" but we can have similar bad behaviors, thoughts, etc because we choose disordered things, that is we are morally flawed . A man can commit murder because he is a bad man, or he can commit murder because he is in a drug induced paranoia. Hence the confusion when observing "mental illness" It depends on the specifics of the case and we need to remind ourselves of both the philosophical tradition that talked about the moral truths, the soul , God etc as well as understand modern neurobiology that shows our behavior can be altered by changes in the brain, in and in fact our behavior and enviornment can alter our neurophysiology.
J.C.Eaton| 7.13.12 @ 12:04PM
With due respect to the professions of psychiatry/psychology, the DSMs are fundamentally a crock. In the mid-70s I was cross-examining one who claimed to have c0-written or contributed in some utterly indispensable way to the original volume. I asked him if homosexuality was listed as a disorder in DSM-1 and then, by a majority vote of the membership[in Las Vegas, of all places] removed as such in 1974.He admitted that that was true."So", I asked," by a majority vote, all the homosexuals were cured of their disorder." He opined that I made the process sound silly. Well, I responded, How do you think the jury sees it? How seriously can one take the legitimacy of that kind of diagnostic tool?
MRD| 7.13.12 @ 3:56PM
I am not a psychiatrist but am a physician (pulmonary critical care with a few years doing neurocritical care.) Most psychiatric disorders are defined by their symptoms, their is no specific test for them. This is not a lot different then some clinical disorders about which little is known, for example fibromyalgia is mainly defined by clinical criteria as is migraine. DSM was an attempt to make the clinical criteria uniform and consistent to facilliate research. In concept if you understood it you would not call it a crock. Thats not to say that the discipline of psychiatry has not been wrecked by its shameless left wing politicization. It has. That has led to the ongoing corruption of the DSM process, but the original idea to have uniform diagnostic criteria for such real mental disorders as Tourettes syndrome, paranoid schizophrenia, and major depression was a sound one. This is common across medical disciplines as often a clinical syndrome is described ( The Adult respiratory distress syndrome for example) this leads to better understanding of its biology and ultimately more objective diagnostic testing.
J.C.Eaton| 7.13.12 @ 4:11PM
Oh thanks, but I understand the formuation and the concept. That's why I said what I said. Is there anything in my post, either anecdotally or historically untrue? No, there isn't. The APAs define what is and what isn't by a majority vote. They classify as diseases and disorders based on simple democracy....that sir, is a crock. They attempt to make emprical what is not empirical. Cancer, brain lesions, broken vessels etc. ARE observable and definable. The "stuff" of the APA is not. I do agree with your aside that the disciplines the APAs represent have been politically prostituted[my term, not yours]. They have degenerated into testimonial hookers and damn us lawyers, we let them. Finally, if you want to see how this outfit sees its'own 'expertise", with respect to predicting dangerousness, read their [APAs'] friend of the court brief in Tarasoff v. Board of Regents[U of Cal.] What a hoot.
Occam's Tool| 7.13.12 @ 7:57PM
Uh, no they don't do that by simple vote anymore. No one is proposing that for Schizophrenia, Depression, Bipolar disorder, Tourette's, or PTSD. Eaton, there was a major sea change in diagnosis in going from DSM-II to DSM-III.
You annoy. The diagnoses for the major disorders are as reliable and predictable as those for cardiac disease. Our view of our expertise in predicting dangerousness is that there are too many variables to be accurate beyond, say, 72 hours now. It was the Supreme Court that ruled like idiots in Tarasoff, not the APA's position.
Why can't you believe that predicting human behavior can be as complex as forecasting the Earth's climate? The brain, in non-attorneys, is the most complex thing that we know of. Might I remind you that there have been advances inother areas of medicine since 1974? Your quoting comments from a professor made when this 49 year old psychiatrist who has been practicing for 19 years as of today was 12 years old is about as sensible as discussing heart transplant surgery today based on the technology available in 1974---the first transplant was done in 1968.
Incidentally, the criteria for depression from DSM-IIIR have held up pretty well with only minor changes since 1984, when I started medical school. The criteria for major disorders are field tested for diagnostic viability and replicatability between examiners.
In short, you don't know what you are talking about, Mr. Eaton. I am calling you a moron to your face.
Doctor Right| 7.14.12 @ 8:50AM
Like! Like! Like!
Occam's Tool| 7.14.12 @ 5:38PM
If you had my experience with scumbag attorneys, you would want them staked out in the desert to die, as well, Mr. Eaton.
To continue:
Occam's Tool| 7.14.12 @ 5:42PM
Simply because we cannot predict when bombs are going to explode, we do have a good idea of the concept of bombs, better than attorneys. Ever have to wait for a judge to come back from a softball game (no pager on, of course) to have to get a violent psychotic involuntarily hospitalized? That's the way it works in Alabama. It's moronic.
We can do a decent assessment, and predict obvious things, and should act on these, as I do. But how can anyone tell when an addict is going to use and have a bad trip?
As for my attitude and manners, yeah, they suck. I cry about my manners many times. But, sir, you were the one who started out with the term "crock," and I'm the one who unfolded my Adamantium claws. STUPID to get in a fight about dangerousness issues from a man who received his training from the head of Forensic Psychiatry at UCLA, and moreso with a man who was the Psychiatrist for the Alabama Chain Gang and has forgot more about dangerousness and prevention of it than you will ever know. And STUPID to get into an argument with a man whose wife nicknames him "Wolverine."
Occam's Tool| 7.14.12 @ 5:43PM
This is MY area of expertise, Eaton, and I'm brilliant and very well paid for it. Shove off, puppy. (My recert score in 2005 was 92%)
My disagreement is that your knowledge of psychiatric nosology and treatments ended in the year 1974, when I was 12. Your ignorance and arrogance are typical of most attorneys I know, most of whom are poorly educated wannabees with a severe sense of inferiority (very well deserved) towards the medical profession. This is due to the fact that ANY MD could have gotten easily through law school, whereas almost no attorneys could do the reverse. I've slept with enough Law Review lady attorneys to realize this.
Occam's Tool| 7.14.12 @ 6:02PM
Thank you as usual, Dr. R. I also have more comments for Mr. Eaton, and King.
You know, Dr. R, this article and Eaton's comments--- it's like the time I was on call taking care of severe psychotics one night at UCLA, and the Ann Landers column has Ann blasting the psychiatric profession. My response, from the depths of my exhaustion and physical pain was, "what the hell?" Then along comes Mr. Eaton, who calls me a "crock," based on his experiences in 1974 (hey, the Medical profession also did the Tuskeegee experiments, and the Legal profession argued against basic Civil Rights for Free Blacks in the 1950s. What the hell?), 19 years before I got into the profession.
I tire of rolling the boulder up against the hill of human stupidity. I'm going to go to work now and round on and take care of severely mentally ill people so they can be released safely back into the community so I can take care of the next set of severely mentally ill people I need to stabilize so that they can go safely back into the community...
skeptical red| 7.15.12 @ 12:00PM
Occam's Tool seemingly has Narcissistic Personality Disorder, forming the basis for his mental disorder regarding attorneys. One guesses that, far from "eating their lunch", they have eaten his a sufficient number of times that he is filled with rage because they don't share his extravagant self concept.
Actually, the best reason to abolish the DSM is that it is a tool for obviously dysfunctional people like Occam to "diagnose" and "treat" others.
Get help, man.
Occam's Tool| 7.15.12 @ 8:54PM
You haven't worked with enough attorneys, skeptical. Either that, or your brain is filled with mush.
Review Reise versus St. Mary's in detail, and come back to me. Most attorneys that I know would be doing the world a favor if they were staked out on an anthill with honey spread on their privates.
Occam's Tool| 7.13.12 @ 7:47PM
DSM-III, 1980, was the first attempt at evidence based atheoretical diagnostic nosology.
I freely admit that the decision around homosexuality as an illness was handled poorly. I, myself, don't believe that it is an illness for reasons that are too detailed to explain here.
But, JC, considering that it was legal clowns that set up the concept that people could be hospitalized for being dangerous to themselves and others and then refuse treatment necessary to stabilize them so they could leave safely (Reise v. St. Mary's---by the way, punk, you are the type of attorney I EAT FOR BREAKFAST ON THE STAND), you have no place to comment from a superior moral position. You are a bit behind the Diagnostic times, as well.
Kingofthenet| 7.13.12 @ 12:34PM
PTSD, or even Bereavement can certainly rise to the level of a mental disorder, it all depends on the severity and length of time.IF you aren't 'stressed' after nearly getting killed in an Ambush, than your crazy right there. now if your 'low crawling' around your neighborhood and checking for IED's on Route 66, please seek help.
Occam's Tool| 7.14.12 @ 7:00PM
King: Your 7/13/12 1234 PM post was exactly, completely, certainly correct and on the ball.
Savor this moment, pal. Feel free to bring it up in the future when I berate you.
JD| 7.13.12 @ 1:58PM
The goal is to be diagnosed with an illness so you can get tax dollars lavished on you and have an excuse in life.
Democrats make sure that this is possible and encouraged, for two reasons. First, more dependents means more votes. Second, soon only the proud, independent conservatives will NOT have mental illness diagnoses. You'd think that be a good thing for us, but not in liberal bizarro-world. In their world, it means only we are responsible for our actions, which means we get blamed for all problems in the world. No one else is responsible for anything, because they have mental illnesses. Nothing is their fault!
TLP| 7.13.12 @ 4:49PM
I salute you, Sir.
You absolutely get it.
Thank You.
Who Knows?| 7.13.12 @ 6:52PM
I was going to comment about the freedom I chose when quitting cable TV---I can’t get dish TV---and putting up this adequate antenna I got over the Internet.
However, this article sparked the thought---
There already IS a mass delusion disorder, called watching TV.
Where’s Newton Minnow---TV is a wasteland.
Nowadays, it’s bread and circuses, almost 24/7!
Over eat AND be over entertained---by no means, DO anything, yourself.
Like, read a book. Or, even, a newspaper---which, with few exceptions, is not very edifying, these days.
Me—I’ve been more and more succored by rereading my book about Madhyamika Buddhism, and its foremost instigator, Nagarjuna. I earned an MA in math in ’66, so I took some amazingly difficult classes—and passed them.
But, in 1970, at UCSB, auditing a class on Buddhism, when I tried to read the required book, it was filled with so many Sanskrit words, and Eastern Religion ideas, I couldn’t believe it. I’ve continued to absorb it, though, and the “getting it” moments still come.
Yes, go for challenges that last a lifetime, and don’t be JUST a loser, by settling for TV, etc.
Who Knows?| 7.13.12 @ 7:00PM
Example from “The Central Philosophy of Buddhism”, by T.R.V. Murti, 1955---
“Paramartha Satya or Absolute Truth is the knowledge of the real as it is without any distortion. Categories of thought and points of view distort the real. They unconsciously coerce the mind to view things in a cramped, biased way; and are thus inherently incapable of giving us the Truth. The paramartha is the utter absence of the function of Reason, which is therefore equated with samvrti (appearance). Absolute Truth is beyond the scope of discursive thought, language and empirical activity; and conversely, the object of these is samvrti satya. It is said: “The paramartha is in fact the unutterable, the unthinkable, unteachable, etc.”
Devoid of empirical determinations, it is the object of the innermost experience of the wise. It is so intimate and integral that we cannot be self-conscious of it. ”Page 244
“Paramartha satya, as the unutterable ultimate experience wherein the real and the intellect cognizing it are non-different, does not admit of differentiation and degrees. Knowledge could be different on two grounds principally: because of the difference of objects or the cognizing agent. As both these differences are absent in the paramartha, it is of one uniform, undifferentiated nature.” Page 245
Occam's Tool| 7.13.12 @ 7:08PM
To Mr. Eaton: Yes, we psychiatrists carefully explained to the Supreme Court that our ability to predict middle time range violence was impossibly difficult, and the court ignored us, stating that we needed to be able to do what we told them we scientifically couldn't.
For example, take a schizophrenic who drinks a bit and gets violent when he drinks and refuses treatment for his every couple of months binge drinking, but will take his antipsychotics. I go for a commitment to force him into CD treatment and get laughed out of court because "you have done your job too well, the patient looks quite stable.")
I month later, after being discharged against medical advice, the patient whose risk I said was obvious and apparent, but which I could not predict precisely because no one knows kills someone while drunk. But I couldn't get him committed because I could not be precise down to the week when he would relapse.
Sir, the Law is an ASS. Joe Biden was accepted into an upper third American Law School (Syracuse) with grades in the bottom quarter of his class from University of Delaware (not an academic powerhouse). Give me a break.
Koch, by the way, was asked to step down under duress from his position from the notoriously clubby Obama administration.
Kingofthenet| 7.14.12 @ 1:41PM
I actually feel sorry for you Occam, it must have been hard having a ticking time bomb out there, that you know is going to go off, but not exactly when.
Occam's Tool| 7.14.12 @ 5:26PM
Thanks, King. Yeah, it sometimes is. The best I can do sometimes is ameliorate. But it is interesting to look at Catch-22s that the ACLU has put the psychiatric profession in.
What's worse is watching the money being wasted having to wait for court approval to start obviously indicated treatement for a patient in the hospital involuntarily until the court approves. Look up Reise versus St. Mary's.
I spend my time treating people who are dangerous to self/others, not ego-syntonic homosexuality---I disagree with gay marriage due to the need to keep marriage sacrosanct, but have never believed that it was a disorder---unless it is ego-DYSTONIC and uncomfortable to the person to have the urges. Then it is like every other obsession.
Therefore, this concept of "crock" etc. being bandied about is meaningless to me. the people I treat are sick, and their illnesses look the same in NW Minnesota and Rotorua, New Zealand. And they hurt like hell, and we should be kind.
Kingofthenet| 7.15.12 @ 4:29PM
Dr. Sam Loomis: I met him, fifteen years ago. I was told there was nothing left. No reason, no conscience, no understanding; even the most rudimentary sense of life or death, good or evil, right or wrong. I met this six-year-old child, with this blank, pale, emotionless face and, the blackest eyes... the *devil's* eyes. I spent eight years trying to reach him, and then another seven trying to keep him locked up because I realized what was living behind that boy's eyes was purely and simply... *evil*.
Occam's Tool| 7.13.12 @ 8:00PM
I gues I should have left off that close parenthesis. Otherwise, pretty good.
The patient I discussed in the example above does not exist; he is an amalgamation and theoretical example, but a very real type familiar to any psychiatrist.
J.C.Eaton| 7.13.12 @ 10:45PM
Occam, Your stating that I'm a "punk" and a "moron" doesn't really do you any good and doesn't do me anything at all. You agreed with me that the early methodology used in creating the Manual was no way to run a railroad. Secondly, you acknowledge that the APA handled the homosexual debate badly. I honestly fail to see how your agreement signals either my punkishness or moronicism. But enough. The point of the Tarasoff position was that the APA was denying they had the ability to predict dangerousness any better than the average layman.. It was psychiatry that either wilfully inserted itself into the business of civil committment law and perforce, the criminal code, or willingly allowed themselves to be co-opted. Either way, they vouchsafed they had the expertise, sometimes to bad effect. The tragedy of Tarasoff was that a human being died, amid the assertion that a psych-type should have foreseen and warned. We agree that the law horribly complicated the committment regimen, alternatingly making treatment far more difficult to obtain and giving the mentally ill the chance to act out to their detriment. But again, who acted in complicity with the movement.You have a chronic low opinion of lawyers, I have a chronically ambivalent attitude toward shrinks. I've seen the venal and incompetent ones. But I believe that buried in the detritus are very good ones. Perhaps you are one. the vituperativeness needs work, tho :-]
Occam's Tool| 7.14.12 @ 6:48PM
The vituperation is due to the fact that the majority of attoneys I have worked with are witless asses. Sorry. By the way, you OVERRATE my opinion of lawyers. What's the difference between lawyers and Vent Crabs lying near the vents of the Mariana Trench?
One lives lower than Whale Dung on the bottom of the ocean, and the other is a crab. I need to work on my vituperation; granted. You, sir, need to work on your Intellectual Arrogance---DSM FIVE is about to be released---arguments about DSM-I (which has NO diagnostic areas of agreement with FIVE, since FIVE is based on a non-psychoanalytic theory model, but simply on observable/ easily reportable symptoms, as all DSMs since II have been) are fooish.
Incidentally, another place where Koch goes wrong is in his disagreement with "disorder." I know plenty of vets who have been in the shit who have no signs of PTS DISORDER, and I've treated plenty who do. If you have enough of the cluster of symptoms and they interfere with normal functioning, it's a disorder. Trying to ignore reality to avoid "stigma" is not the correct approach, minimizing "stigma" is. having to go to see a psychiatrist to get depression treated is different from being hospitalized due to suicidal/homicidal urges too strong to be controlled (and that's the only way to get into the hospital these days).
It's no wonder Koch was canned.
Occam's Tool| 7.14.12 @ 6:48PM
Sorry---"foolish."
J.C.Eaton| 7.15.12 @ 10:44AM
Just rose and scanned your successive posts. Glad I missed them 'til now. A good sleep does wonders to lessen stress. Thanks for staying with this. I stipulate to your charge of intellectual arrogance on the topic and pleased to hear you no longer rely on a "crock" methodology[DSMI and II ]to try to find out what's wrong. As for lawyers, well, I'm afraid there are very good ones and some who, as you so charmingly put it,are scumbags. In a long career I jailed three lawyers and no doctors. But you certainly have your share of shitbirds too. Truth be told, we have lots in common, had you been my expert, we would have spent days together going over your resume, testing, diagnosis, basis, prior trancscripts. I would have prepared you for cross "til Hell wouldn't have it. We would have looked at the same for your opponent too. Finally, I've got the same decorations you do, maybe more.[two wartime active duty stints].Get more rest Doc; I'll do more research! BTW, I was a 24/7 judge. Best, P.S. Who you slept with is relevant towhat!!???
Occam's Tool| 7.15.12 @ 8:56PM
One learns much by sleeping with the enemy, Mr. Eaton.
Occam's Tool| 7.15.12 @ 9:17PM
And perhaps, Mr. Eaton, I learned more because the purpose of my profession is to listen. One can seduce women more successfully by listening to them, you see. Beautiful women are used to be objectified for what exists below their neck. When they are listened to as human beings, they tend to be grateful.
And, in this fashion, I learned about judges and lawyers before I had to deal with judges and lawyers. I bedded a very successful corporate attorney who represented drug companies and graduated from Michigan on Law review. She was also a bitch, which served her profession well.
skeptical red| 7.15.12 @ 11:52AM
All Mr Koch says is true, but he overlooks one thing: after a veteran is discharged, he can make a claim for disability benefits from the VA, based on PTSD. A 100% disability pays over $30,000 per year, tax-free. See va.gov
David| 7.15.12 @ 1:30PM
Wow, the vitriol in these comments!!!
Allow me to speak as neither a doctor (of any type) nor a lawyer.
What I can bring to this discussion between Eaton and Occam is that I spent 22 years as a trial paralegal. I have been in trial with some of the most well-known and respected lawyers on both the plaintiff and defense side. The last nine years, we defended doctors at Baylor College of Medicine in Houston.
It is a most amusing experience to sit through the questions and testimony of expert witnesses (both attorneys and doctors). One can literally SEE the huge egos of both the attorneys posing the gatcha questions and doctors with their smart ass answers in attempts to make the attorneys look foolish.
I thoroughly enjoyed it. I learned a lot listening to experts in medical and legal malpractice cases.
I think everyone reading Eaton's and Occam's posts can SEE exactly what it is that I experienced in listening to docs and lawyers in the courtroom.
As to psychiatry or psychology in general, in my opinion, any mental help that a person gets should be Christ-centered. Twelve step programs are so successful precisely because they acknowledge the existence of a Supreme Being. That's my two cents on the subject.
Cobalt| 7.15.12 @ 3:46PM
Good advice on twelve step programs.
However, in my ignorant opinion these programs can't help everyone.
Some poor souls, like those who have been diagnosed with schizophrenia or bipolar disorder, are suffering in a way that we can't imagine, and need medical attention that often can only be found in a mental hospital.
Occam's Tool| 7.15.12 @ 8:59PM
Not arguing with the benefit of 12 step programs and G-d helping. I have found them to be very helpful with my patients. (A reason for me being a teetotal all my life--well, I did drink on 12/31/99.)
Occam's Tool| 7.15.12 @ 9:10PM
Yes, David, you got it exactly.
However, I am not always glum. My longterm view is this: On 11/24/2028 I will hit 20 years exactly with the State of Minnesota and be 66 years old. My kids will be through with college, my house will be paid off, and I will have a pension of $80,000 a year and $3 million in investments (assuming a 5% rate of return on investments). I then plan to quit the state job, continue my Suboxone clinic to earn an extra $40K a year or so, and retire to a condo in Grand Forks, ND. Six years after that, at age 72, I plan to retire, so I can sit in a coffehouse in the college town of Grand Forks all day long, eying College Coeds "with bad intent," even if I no longer have the physical skills to seduce them, much as my neutered declawed cat looks at birds on the porch from his place on the hardwood floor in the sun. Man, there is nothing like Scandinavian coeds.
Best of luck and future to you, Mr. Eaton. And if anyone takes my comments regarding "bad intent" seriously and writes a missive slapping me and doesn't recognize that I stole the line from "Aqualung," well, joke you if you can't take a ...
J.C.Eaton| 7.15.12 @ 10:20PM
Et cum spiritu tuo, Occam. Couldn't agree more with you with respect to listening. That was the sine qua non of my work as well. Stay in there.
J.C.Eaton| 7.15.12 @ 2:19PM
David, you sell your comments short; I found them worth a lot more. They serve as a useful reminder. Especially your inclusion of Our Savior.
J.C.Eaton| 7.15.12 @ 2:22PM
David, BTW, did you ever have the chance to see the late John O' Quinn? We met and became pals in Houston.
callmeishmael| 7.15.12 @ 4:51PM
A surprisingly lightweight article. Author dismisses psychotherapy as quackery but gives no evidence. He dismisses psychopharmocology out of hand. He poo poos PTSD, again offering no evidence. I guess author must be another career bureaucrat genius.
Occam's Tool| 7.15.12 @ 9:11PM
Thank you, callme...you skewered the author more effectively than I did, with much more brevity. Kudos to your brilliance.
David| 7.16.12 @ 2:57PM
J.C. Eaton, yes sir, I did have the occassion to be on the opposite side of Mr. O'Quinn two times: Once in a binding arbitration that lasted two weeks before a three judge panel. We represented the Plaintiff, a named partner in a well-known law firm in Houston, that involved the division of the contingent fee in a billion dollar settlement. It was known as the Red Hill case, our client's law firm represented the Plaintiff in that case. Once the case was settled, while our client was in the hospital, the 3 other partners distributed the monies and shorted our client about 5 million dollars. O'Quinn represented the managing partner of the firm and two other attorneys represented the other partners. We settled our client's case for about 1.75 mil if I correctly remember.
Next case in next posting.
David| 7.16.12 @ 3:20PM
J.C., I had been a paralegal only about 3 years at the time of the arbitration. O'Quinn was very impressive - very smooth in both direct and cross-examination - non-combative in cross, but could get witnesses to agree with his statments.
That all changed by the next time we had a case against him about 17 years later. He had lost it all and was even incoherent at times. He had uncontrolled diabetes and that no doubt took a toll on him.
We defended Ford in a 5 and 1/4 rollover case in Bay City, Texas. Mother and and son survived and father was thrown out and killed. O'Quinn claimed the dad was buckled in and the seat belt was defective along with the Explorer itself.
Get this, a black lady got on the jury who had a cousin who was killed in an Explorer rollover. The scene: Small town, everyone knew and liked the decendent who was an exterminator who provided free service to poor folks. He regularly had coffee with all of the pastors, ministers, and priests in town. We did not think we had a chance.
The jury poured-out the Plaintiffs in a 10-2 vote. The black juror voted with us. O'Quinn was pissed. It was the first time he ever lost a personal injury trial. He filed motion after motion accusing jurors of misconduct, etc. After 11 months from date of jury verdict, the judge set a hearing to enter final judgment. O'Quinn had his fatal accident just a few days before the hearing.
J.C.Eaton| 7.17.12 @ 11:56AM
Thank you for the feed-back, David. Ifound it extremely interesting. I suppose his representation of Anna Nicole Smith's mother in Florida was not too far removed from your last go-round. Met him in the warehouses he stored all those cars. I was turned off by the excess, but enjoyed my time with O'Quinn and his engaging manner. You've seen some interesting stuff. Thanks again.