Posted by ace on October 17, 2003, at 1:55:47
In reply to Re: What do GP's really know? ? ace, posted by EscherDementian on October 15, 2003, at 10:24:50
> Hi Ace,
> I have some 'bafflements' re: some of your statements in your answer to TonyIreland's question... could you address them please?
>
>
> > Huh...GP's don't know what they are talking about? That's a huge generalization. GP's can be far better than any psychiatrist. Just like a certain psychiatrist can be far better than a GP.
>
> Your claim 'far better' seems vastly general. The basis is unclear to me... please clarify?For some people a GP can provide greater service than a psychiatrist with regards to their mental health matters. A lot of people, including myself, have been mistreated by psychiatrists. This includes misdiagnosis, mismedication and outright verbal abuse. That being said I believe there is a MINORITY of vey good psychiatrists who provide their patients with support, both medication and emotionally wise.
> (And - 'ANY' psychiatrist?) It seems to me that you are comparing trunks and and branches. Both hold a postition in the whole: "tree". Could you define 'far better' in terms of the position of GP's and psychiatrists in the whole: "mental health"?
Whether it be a GP or psychiatrist I deem them 'far better' if they treat the patient with absolute respect, consider the patients suggestions for treatment.
> > I actually think psychiatry, as a medical speciality, should be no more. There is no blood tests, smears, xrays. Nothing.
>
> There are MANY medical tests existing in psychiatry: blood, hormones, xray (MRI), etc.etc.... many series of tests, both physical and psychological, are employed in the service of psychiatry. Are you unaware of these tests? Have you forgotten to research a point before using it as criteria for a value judgement? It may serve you to scrutinize your own assumptions before making such a statement.Sure, there are plenty of tests in psychiatry. But NONE of these tests can conclusively validate the existence of any mental illness. Actually, most tests that psychiatrists use are to rule out 'physical problems'. ie the psychiatrist has the patient take an MRI scan- this is to rule out the possibility of TLE. Psychometric tests also do not confirm the existence of any illness. They might show that the patient has a low IQ but the whole conception of what is intelligent is a social construct. In brief, most of the tests used in psychiatry look at the STRUCTURE of the brain. But the function of the brain is what psychiatrists are interested in. The brain is an electrochemical organ. All the current views on mental illness centre around biochemical imbalances. Yet we do not have the capability to measure the amount of neurotransmitter in the synapse. It is a hypothesis, NOT A FACT, that these problems have their genesis in biochemical imbalances.
What I was trying to say was this: DIAGNOSIS IN PSYCHIATRY IS, ULTIMATELY, BASED ON THE SUBJECTIVE IMPRESSION OF ANOTHER HUMAN BEING. THEIR IS NO BLOOD TEST OR SMEAR etc THAT CAN PROVIDE EVIDENCE OF ANY PSYCHIATRIC PROBLEM. Next time you go to your doctor, ask him/her to show you 'your biochemical imbalsance'. They can't do it. The best they have managed was to review suicides where their was seen to be a deficience of serotonin in Cerebrospinal fluid (CSP). But this is also no conclusive proof of a biochemical imbalance (in this case, one of a serotonin deficiency)
> > they represent unspecified shifts in brain chemistry. Labels don't do a great deal. Their can be an infinite amount of shifts in chemistry- which give rise to disorders which defy a neat diagnostic criteria.
>
> "Labels" as in names? What they "do" is describe and identify, somewhat like the names of parts of a machine that a mechanic knows and uses, or the names of instruments in an orchestra. It occurs to me that the "brain chemistry" that is responsible for disorders is specified in these same ways. Your overall generalization of them as "shifts" "giving rise to" is misleading as a blanket statement. Which is WHY we articulately specify not only categorizations, but dynamics.'WE'- are you a psychiatrist?
Let me illustrate: Someone who has 'OCD'- Now, I personally believe that for every person who has this label there is a differing biological aetiology. The same two people who have 'bad' thoughts and need to ritualize both, IMO, have two differing biochemical problems underlying this problem. For instance, one patient could have an excess of a neurotransmitter, but the other one could possess an excess of one, a deficiency in one, and a imbalance between another two.> Can you give me an example of what you mean by "a neat diagnostic criteria"?
Where the symptoms of the patient correspond exactly to DSM criteria. But they don't always: hense of the use of 'NOS'. People can not fit into these 'boxes'. People defy such limitations. We are too dynamic. Some disorders specify that a person must have been suffering from certain symptoms for 14 days or more. But what if they only had them for 12 days? They no longer fit the criteria? What do we do when a patient presents with symptoms which do not fit into any of the boxes?And also, what makes psychiatrists so supreme to diagnose "personality" disorders? Why is it inherently bad to be oppositional to everyone around you. Just because you annoy everyone around you, with eccentric behaviour, doesn't mean you have a 'disorder'. It simply means you are anomolous within the context of a society. Well, who says it's good to fit in with THIS society. This society is a real mess, IMO. People going around killing people, people having suicidal and drug-addicted rock musicians as their role models. But, again, that is just my opinion. And one could argue against me, 'why are these inherently bad things?'
>> > Psychiatrists typically start people on too higher doses and ween off too fast.
>
> Wow. What are your sources of information for this statement? Can you direct me to the specific proofs you found to support such a huge generalized conclusion?No I can't I'm afraid. That statement came from my own experience and many people who I have talked too. Also, many anecdotes. Infact, I believe one of the reasons antipsychotics have a bad rep simply because, a lot of the time, they are started at way too large dose, and knock the patients out.
> Or, if you can't, can you name at least 3 documented instances of this?I'll dig out some of those anecdotes I talked about.
> I'm very curious. Your statements contradict information that i 'know', so i am looking forward to 'knowing' your sources and proofs!
What is this information you 'know'?
Everything I have stated is my opinion. People are free to believe what they want. We are all seeing the world from our own 'lenses' and sometimes, we may get a bit lost in our own views, and forget others. I acknowledge your views and respect your right to have them. You have every right to them. Mine are just different. Which is great...what a boring world it would be if everyone agreed with everyone!
> Escher
>
>
Ace.
poster:ace
thread:269429
URL: http://www.dr-bob.org/babble/20031015/msgs/270088.html