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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Oddzilla on August 24, 2000, at 15:53:29
I just ran across this outstanding article and thought it deserved to be read here. It certainly provides food for thought!!! Do you know this guy Dr. Bob? It said he was from Chicago!!
Oddzilla
Psychiatric Medications as Symptoms
February, 1997
by David Kaiser, M.D.
--------------------------------------------------------------------------------
A middle-aged woman with a long history of chronic depression came to see me. She was taking Serzone at appropriate doses, and had experienced some improvement. At this visit she complained of frequently feeling angry. She felt her anger was extreme, and was caused by a "chemical imbalance," because "this much anger is not normal." It was obvious to me while talking with this educated and thoughtful woman, that she was experiencing rage toward a number of others, past and present. When I told her the anger was a reaction to people in her life and that she could use this anger to understand herself better, she remained unconvinced, saying she felt out of control and needed some kind medication for it. She was neither violent, nor out of control. She left unsatisfied and angry, as I did not change her medications.
For this patient, as in all patients, the medication she wanted functioned in her mind as a signifier. In other words, it had a meaning above and beyond its actual effect. For her, a medication represented perhaps a soothing other, a containing other, a form of love, a magical erasure of the past, or many other possible meanings. Only in speaking with her could this be elucidated. In my experience the signifying effect of medication is often more powerful than its real effect. Patients form complex and intense attachments to their medications more because of what they mean than what they do. This is why psychiatric patients often get on and stay on medications, often several at once, even though their actual benefit is questionable. All psychiatrists can relate to the experience of attempting to change medications in patients who are attached to them and resistant to change. Any change threatens some precarious equilibrium related to a complex set of meanings that their medications have taken on.Another way of saying this is psychiatric medications often become symptoms, in the sense of symptoms as signs full of meanings which function to cover over or fill in some lack in a person's life-whether it is a lack of love, desire, purpose or whatever. The psychiatrist, as the dispenser of these medications, is often acting to reinforce the patient's symptoms, further covering up of the patient's ability to see the true source of their discontent or unhappiness. As a result patients often need medications in the way they need their symptoms, as a substitute for what they really need from people. Medications lessen their pain, help them forget, provide a kind of substitute for love, and these substitutes are all the more powerful because they are sanctioned by modern medicine, authority and technology. So it is possible for modern biological psychiatrists to unwittingly act out symptoms and fantasies with their patients, leaving them more alienated from themselves and more dependent on false forms of gratification.
The true dimensions of this technologic catastrophe has yet to be learned. Today's patients, discontented, unhappy, fragmented and confused by an increasingly frantic, alienating and violent society, come to psychiatrists for help, only to have their illusions shored up by an increased dose of a technologic fix. They are told they have illnesses that are biologic and can be fixed, instead of being allowed to speak about their unhappiness, to speak about how difficult it is to be a human being, to speak about their suffering, because human beings have always suffered and always will. To believe that we can conquer depression, despair, anxiety with modern technology is the height of hubris and bad faith, a mere childish fantasy, unworthy of any thoughtful person who has their eyes open to human history and modern culture. Psychiatrists have become part of the problem. Perhaps they have always been so.
I can already hear the objections. Modern science is beyond such considerations, beyond good and evil, to coin a phrase of someone who knew better. We will go beyond subjectivity, which psychoanalysis depended on, to reach an objective science of human unhappiness. There is an epidemic of "depression," which is a medical illness, and we will stalk it and wipe it out like smallpox, given time, science and public health measures. Everyone with this illness called depression should be on medications. A bit of Zoloft in the water supply perhaps. Then we will all be content and productive. If I satirize here, it is only to bring out the absurdity of what is actually happening. An epidemic of depression? How about an epidemic of cozy relationships between academic psychiatry, pharmaceutical companies and managed care companies? How about an epidemic of psychiatrists who no longer think seriously about what suffering is? How about an epidemic of psychiatrists more interested in power and social legitimacy than in listening to their patients?
As a practicing psychiatrist, I often feel the pull of a patient's symptoms, a pull in fact to participate with them to cover up what is really going on. It is a seduction which should be resisted, because it is a seduction to enact a fantasy. Modern psychiatrists have been seduced wholesale, not only by patient's wishes, which are fantasies, but also by positivistic science and technology, which are as much based on fantasy. But it is a measure of how far this has gone that these words will seem extreme to today's psychiatrists, caught up as they are in multiple illusions, increasingly blind to the truth.
Please direct any questions or comments to Dr. Kaiser at Mental Health InfoSource.
--------------------------------------------------------------------------------
Dr. Kaiser is in private practice in Chicago, and is affiliated with Northwestern University Hospital.--------------------------------------------------------------------------------
Posted by Ant-Rock on August 24, 2000, at 19:52:05
In reply to WHY R U TAKING THOSE MEDS ANYWAY??, posted by Oddzilla on August 24, 2000, at 15:53:29
"further covering up of the patient's ability to see the true source of their discontent or unhappiness."
< Not True. What If someone goes through a traumatic event, and does not fully recover from it, goes to therapy to work through it, writes about it, understands the reasons that have brought him these years of suffering. In other words, "Seeing" and understanding the reasons that started ones journey into depression does not always mean they will get better. Does this mean one should give up and forgo every available option out there? >"not only by patient's wishes, which are fantasies"
< This is just plain insulting. Obviously the lady this Dr. spoke of didn't want to explore the reasons/cause of her anger. But to generalize that all patients only want a magic pill to fill some kind of emotional need is pure bull. >
Although I agree with parts of this post, especially about how Dr.'s don't listen enough to their patients, drug co.'s involvement etc., these two statements I responded to just generalize way to much. Still, very innteresting article.
Anthony
Posted by tina on August 24, 2000, at 21:47:51
In reply to Re: WHY R U TAKING THOSE MEDS ANYWAY??, posted by Ant-Rock on August 24, 2000, at 19:52:05
>Very interesting article Odd. Gives one pause.
Something to think about that's for sure.
I think the author was a little general in his assumptions but nontheless, these are valid arguments and worth exploring in further research.
> "further covering up of the patient's ability to see the true source of their discontent or unhappiness."
> < Not True. What If someone goes through a traumatic event, and does not fully recover from it, goes to therapy to work through it, writes about it, understands the reasons that have brought him these years of suffering. In other words, "Seeing" and understanding the reasons that started ones journey into depression does not always mean they will get better. Does this mean one should give up and forgo every available option out there? >
>
> "not only by patient's wishes, which are fantasies"
>
> < This is just plain insulting. Obviously the lady this Dr. spoke of didn't want to explore the reasons/cause of her anger. But to generalize that all patients only want a magic pill to fill some kind of emotional need is pure bull. >
>
> Although I agree with parts of this post, especially about how Dr.'s don't listen enough to their patients, drug co.'s involvement etc., these two statements I responded to just generalize way to much. Still, very innteresting article.
>
> Anthony
Posted by allisonm on August 24, 2000, at 22:20:05
In reply to WHY R U TAKING THOSE MEDS ANYWAY??, posted by Oddzilla on August 24, 2000, at 15:53:29
Dear Odd,
Thanks for the article. Very interesting. If this topic interests you, I recommend a book called "Of 2 Minds; The Growing Disorder in American Psychiatry" by T.M. Luhrman (Knopf).
Luhrman is an anthropologist who did a long study about how psychiatrists are trained in the U.S. The book deals a good amount on how drug therapy and talk therapy affect the way psychiatrists understand their patients (to borrow from the book cover). She watched residents, spent time with doctors on call, observed emergency rooms, sat through hundreds of hours of lectures that are a part of a psychiatrist's training. She even spent time counseling patients that were assigned to her as they would be to a psychiatrist in training at a clinic. She spent time in a community hospital that saw the same indigent patients come through over and over and she spent time in an expensive private psychiatric hospital. She talks about the differences between those programs and the effects of managed care on the whole system.I'm not all the way through it, but have found it pretty fascinating so far.
Allison
Posted by JohnL on August 25, 2000, at 6:11:08
In reply to WHY R U TAKING THOSE MEDS ANYWAY??, posted by Oddzilla on August 24, 2000, at 15:53:29
Hogwash in my opinion. Some interesting theories to ponder, but rather useless in reality. Unless an M.D. can propose a specific method with proven results for ending their patients' suffering, why even bother?It sounds like this M.D. has been impotent at ending the suffering of patients, and that this well thought out theory is a way to explain away those failures. I would rather see an M.D. put their time, energy, thought, and writings into getting people well, rather than just explaining away their own personal/professional failures.
Posted by Sigolene on August 27, 2000, at 6:47:09
In reply to WHY R U TAKING THOSE MEDS ANYWAY??, posted by Oddzilla on August 24, 2000, at 15:53:29
Even if I still take meds, I thing this psychiatrist is right.
I say that because I went to see many psychiatrists and therapists. But once, I met a therapist which suddenly took place of my medications in my mind. That is to say that I needed her as much as I needed my meds before. I understood then that there was something else behind my attachement to medications. I won't explain everything here, but still: he has right somewhere.
Even if I still have to take meds, it was of great importance for me, to understand the role of these meds in my psychological functionning. It also improved the way I could tolerate meds.
Sigolene.
> I just ran across this outstanding article and
thought it deserved to be read here. It certainly provides food for thought!!! Do you know this guy Dr. Bob? It said he was from Chicago!!
>
> Oddzilla
>
> Psychiatric Medications as Symptoms
> February, 1997
> by David Kaiser, M.D.
>
>
> --------------------------------------------------------------------------------
> A middle-aged woman with a long history of chronic depression came to see me. She was taking Serzone at appropriate doses, and had experienced some improvement. At this visit she complained of frequently feeling angry. She felt her anger was extreme, and was caused by a "chemical imbalance," because "this much anger is not normal." It was obvious to me while talking with this educated and thoughtful woman, that she was experiencing rage toward a number of others, past and present. When I told her the anger was a reaction to people in her life and that she could use this anger to understand herself better, she remained unconvinced, saying she felt out of control and needed some kind medication for it. She was neither violent, nor out of control. She left unsatisfied and angry, as I did not change her medications.
> For this patient, as in all patients, the medication she wanted functioned in her mind as a signifier. In other words, it had a meaning above and beyond its actual effect. For her, a medication represented perhaps a soothing other, a containing other, a form of love, a magical erasure of the past, or many other possible meanings. Only in speaking with her could this be elucidated. In my experience the signifying effect of medication is often more powerful than its real effect. Patients form complex and intense attachments to their medications more because of what they mean than what they do. This is why psychiatric patients often get on and stay on medications, often several at once, even though their actual benefit is questionable. All psychiatrists can relate to the experience of attempting to change medications in patients who are attached to them and resistant to change. Any change threatens some precarious equilibrium related to a complex set of meanings that their medications have taken on.
>
> Another way of saying this is psychiatric medications often become symptoms, in the sense of symptoms as signs full of meanings which function to cover over or fill in some lack in a person's life-whether it is a lack of love, desire, purpose or whatever. The psychiatrist, as the dispenser of these medications, is often acting to reinforce the patient's symptoms, further covering up of the patient's ability to see the true source of their discontent or unhappiness. As a result patients often need medications in the way they need their symptoms, as a substitute for what they really need from people. Medications lessen their pain, help them forget, provide a kind of substitute for love, and these substitutes are all the more powerful because they are sanctioned by modern medicine, authority and technology. So it is possible for modern biological psychiatrists to unwittingly act out symptoms and fantasies with their patients, leaving them more alienated from themselves and more dependent on false forms of gratification.
>
> The true dimensions of this technologic catastrophe has yet to be learned. Today's patients, discontented, unhappy, fragmented and confused by an increasingly frantic, alienating and violent society, come to psychiatrists for help, only to have their illusions shored up by an increased dose of a technologic fix. They are told they have illnesses that are biologic and can be fixed, instead of being allowed to speak about their unhappiness, to speak about how difficult it is to be a human being, to speak about their suffering, because human beings have always suffered and always will. To believe that we can conquer depression, despair, anxiety with modern technology is the height of hubris and bad faith, a mere childish fantasy, unworthy of any thoughtful person who has their eyes open to human history and modern culture. Psychiatrists have become part of the problem. Perhaps they have always been so.
>
> I can already hear the objections. Modern science is beyond such considerations, beyond good and evil, to coin a phrase of someone who knew better. We will go beyond subjectivity, which psychoanalysis depended on, to reach an objective science of human unhappiness. There is an epidemic of "depression," which is a medical illness, and we will stalk it and wipe it out like smallpox, given time, science and public health measures. Everyone with this illness called depression should be on medications. A bit of Zoloft in the water supply perhaps. Then we will all be content and productive. If I satirize here, it is only to bring out the absurdity of what is actually happening. An epidemic of depression? How about an epidemic of cozy relationships between academic psychiatry, pharmaceutical companies and managed care companies? How about an epidemic of psychiatrists who no longer think seriously about what suffering is? How about an epidemic of psychiatrists more interested in power and social legitimacy than in listening to their patients?
>
> As a practicing psychiatrist, I often feel the pull of a patient's symptoms, a pull in fact to participate with them to cover up what is really going on. It is a seduction which should be resisted, because it is a seduction to enact a fantasy. Modern psychiatrists have been seduced wholesale, not only by patient's wishes, which are fantasies, but also by positivistic science and technology, which are as much based on fantasy. But it is a measure of how far this has gone that these words will seem extreme to today's psychiatrists, caught up as they are in multiple illusions, increasingly blind to the truth.
>
> Please direct any questions or comments to Dr. Kaiser at Mental Health InfoSource.
>
>
> --------------------------------------------------------------------------------
> Dr. Kaiser is in private practice in Chicago, and is affiliated with Northwestern University Hospital.
>
> --------------------------------------------------------------------------------
>
>
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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