was the meaning - which you should have realized from the very beginning.
The fact is that you evade the DSM standards, and discussion of the process, and particularly evaded the question of identifying the threshold diagnostic standard.
You're just evasive, and now you're frustrated that you haven't frustrated me.
That would be your personal problem. I will not accept responsibility for your weaknesses.
But if you want to do me a personal favor, you can watch the way you bugger the English language. It hurts my eyes to read your posts.
there is indeed a DSM category for "Personality Disorder not otherwise specified".
No, folks, there are no independent organic markers for any of these things. Psychs look for behavior patterns (eg ADHD calls for 12/18 behaviors that are entirely conclusory) and they do not have the resources, training nor inclination to confirm or investigate the context of those behaviors; and indeed, the dx threshold is that somebody complains - the standard of care does NOT require independent confirmation. So what happens is that if a teacher or parent says Johnny is more inattentive than she wants him to be, the psych does NOT ask, well, what percentile does that put him in? They do not ask, well, are you a nut yourself? Nope, it's time for the Ritalin.
Here is the epiphany: they are not diagnosing any sort of organic condition. They are dxing the social relationship between the patient and the complaining party, and trying to adjust that by experimenting with meds.
And THAT is where we come up with statistics that one-third of all civil servants are being treated for depression. The fundamental hypothesis is that nobody is "normal", it's just a matter of how much and what way you are fucked up. It's pretty wonderful for business to be able to CYA in every direction, isn't it?
Personally, I love this line: "Doc, how do you know the patient isn't lying to you." "Oh, that's impossible, we have ways to figure that out, we know it all the time." "Well Doc, what about this patient who lied to you resulting in a false dx? (I see it pretty often, and the effect was written up by a shrink in 73 in the Rosenhan experiement.) "SPUTTER!! He lied to me! That could happen to anybody!" "Well, no. You just got thru saying you could detect lies."
Now, this sort of thing is the core of special ed. Because of the absence of objective standards makes it possible for anybody WHO CAN FINANCE A COMPLAINT to get special attention, and as my original point, it is a hole in the money bag that has no obvious way to repair, apart from fixed limits.
Bizzaro, you are NOT off the hook. You (and most people) could find the answers in SECONDS, and if you make ANY prgress, I will nurse you thru it until we get there. If you make NO progress, I will mock you mercilessly until you do.
A diagnosis in most physical illnesses depends upon what the patient tells the doctor. It's less so now that you have scans of various sorts, MRIs, advanced blood tests, and such. But just 30 years ago, it was totally dependent on the patient telling the doctor where it hurt. When the doctor pressed here, he asked if that hurt.
In my own experience and because of my family experience, you can't convince me that these illnesses don't have an organic basis so far undetected. No need to spam about this. You can't convince me. No argument will do it. Nothing you say whatsoever will negate my personal experience about this. If you mock, I'll simply take a vacation from the board. I won't read mockery, and I've seen your arguments, repeatedly.
Though I'll add that there is a lot of mis-diagnosis, and that over-diagnosis is made and rewarded too much. For almost any condition, however, the drug companies have made drug treatments into consumer market. However, there might be another phenomenon besides over-diagnosis: that our minds are falling to pieces for much the same reason that our teeth are becoming crooked and our eyes less sharp: civilization protects defective genes.
alternative views - and I find many people are violently conscious of this, and probably/possibly because it affects them emotionally, so deeply that they are aware they are not open to consider other views.
But of course other people may be interested, and the dialogue (if you can call it that) is the point.
Before I invest effort in trying to explain something on your terms, I need to understand your terms. It is a LOT OF EFFORT to adjust to a person who is close-minded, but at least you are sharp enough to recognize your close-mindedness.
I find very often that people who have these issues are very sensitive. Most people can discuss a medical condition fairly dispassionately, but psych is not one of those things.
People seem to be open to the possibility that their doc may have made mistakes when they're talking about something organic, but when you're talking about their head and emotions, it's rarely something they can consider dispassionately.
So your comment about mockery here is pretty much like the perennial criticism of "the media" that usually comes down to the fact that somebody thinks presentation of an undisputed fact is unfair personal criticism, ie the messenger is the one responsible for the news.
Of course, all that killing the messenger does is hide from the news. Everybody has thrown away bills at one time or another, but the person who thinks it's sensible does indeed need help adjusting.
So how about defining "mockery"?
where you are headed. And Z is open to new ideas and concepts. ON more than one occasion he has posted to others that he is open to a new view. However, your failure to limit your own view of this topic to YOUR specific experience - on what? one or two episodes? Some of us - and specifically Z, have multiple experiences to draw upon....
In short, you're so impressed by yourself that you fail to measure up to your own standards. RTFM concerning Z - I did, it is enlightening.
asshole
If you could follow a thread, you could find out.
But I haven't seen you follow one steadily for more than 2-3 posts yet.
You wander around until you tire everybody, yourself included, then cry, piss & whine about anybody that isn't as tired as you.
You've been offered private affirmative action, but you seem too disabled to be able to take up the offer.
My diagnosis is, pretty fucking pathetic.
On the internet, anybody can be Jesus, and I really just don't give a shit.
What I am interested in - and you should be if you knew shit about science - would be the logic of what this Jesus says.
I don't care if it's Jesus Garcia if he can explain himself; and I don't care if it's Jesus Christ if he can't.
I suggest that you come back and talk when you have the attention span for a couple dozen paragraphs, and show you are willing to put some effort into explaining your thinking, instead of this endless rambling bullshit that eventually comes down to claiming your resume is longest. Right. So why can't you explain yourself?
Do you just have to say something?
Or do you want him to beg for you to bless him with your words?
Who's doing the mocking here? Looks to me like you might be mocking yourself.
Just saying, you know.
You said you can't let it pass, but I don't see anything here except your notifice that you aren't going to consider any other views.
So if that's what you have to say, I guess I need to say, "THANKS FOR SHARING!!"
is not given the correct info by the patient. (and that has been done also). I gave you the preferred diagnostic algorithm about 1/2 a page below...
ANY diagnostician who depends on a single test to affirm the existance or absence of any disease is waiting for a malpractice law suit - but you know that, don't you?
As far as the diagnostic end of things go - there are very few "single" markers for any medical condition or disease.... My fave? diagnosis for any autoimmune disease... or something like "Chronic Fatigue Syndrome..." Now there is one that is a bit of a challenge.
That the individual in question sought aid and assistance and found it necessary to file a complaint - I'll go right back to my original statement - sometimes it is NOT about the frickin $ but rather specific aids that the school can provide - if the kid is categorized.
At first, for my kid I was opposed to the categorization - but after my kid was, and I saw what assistance consisted of, I wished to keep said kid categorized... but alas the kid grew out of the need for assistance. Happily said kid is doing very well, but I've no doubt that had the kid not been categorized the kid would not have had as good a start academically as was provided. You should also know that my ex and I fought for the categorization.... Schools do not wish to hand them out.... So - been there, done that.
As far as the advancement of psychiatric science... it too has advanced from '73 as has every other branch of medicine. With PET and MRI scans providing a full 3-d image of brain activity - and specific metabolite utilization we do have a better understanding of metabolic abnormalities.... and how to detect them - Granted - we are a long way off from definitive objective diagnostics for many psychiatric disorders... just as we are a long way off from definitive objective diagnostics for many cancers, and autoimmune disorders.... Whats the diff for MGUS vs Multiple Myeloma? both can be assiciated with specific service in Nam!
Sheese, ya make it all sound so easy.... if it was that easy - we could all skip going to the doctor.
Dude, teachers are NOT qualified by anyone - to make the diagnosis! RTFM linked to the previous post below yourself.
-- Modified on 10/21/2007 2:59:32 PM
(1) consciousness is the subject matter, and shrinks represent themselves as specialists in mental abnormalities; (2) it is critical that a psych should be able to judge truthfulness, and psychs will always tell you that they can ID pt lies - until of course a pt actually lies; and (3)
the psych depends on the pts' description of his mental state, when in fact the pt is only there because there is good cause to doubt his mental state and perceptions?
The last time I saw a pt sucker a shrink was last month, and this is a shrink I have worked with for years, and regard as good and thorough. But I've also learned that detailed attention to facts will trump the judgment of any psychrink, and my own judgment is usually better, because I am OCD about facts and evidence.
The reason the Rosenhan experiment has not been reproduced is it's already been done, and nobody really thinks the result would be any different.
In cases where results can be objectively measured (eg criminal recidivism) shrinks have been found nominally worse than the average layman, and substantially worse than people directly involved with the facts. And how could that be? Professional/institutional bias.
I'll tell you something I have heard from several psychs, and that is that competence and volition are legal issues that they are not qualified to judge. And yet, you would think those should be critical to their work.
But it's not. What they are doing is, as I have pointed out, judging a person's social adaptation, and trying to ID problem areas. And in that respect, they are really no better than anybody else.
Now, people say, "why did it work for me?" and of course there are as many answers as there are people. 2 common and obvious ones are variations on the placebo effect, that they would have gotten better on their own anyway, and/or that paying attention to them, or diddling with the obvious (like brush your teeth to minimize halitosis) often works wonders.
I am not making it sound easy. I am pointing out fundamental misconceptions. Of course this is complicated, and from listening to you cry piteiously in the past, I doubt you can handle this much, in one post or several. You're probably just a lightweight.
And I agree with your assessment - however, when I look at the profession, I do know that in specific instances when the Dx is made correctly - and the appropriate therapeutic course charted and followed, significant benefit can be achieved. Have seen it, in more than one instance- and particularly in education.
But I have also seen psychological influence on therapeutic benefit derived from "Belief" in a therapeutic treatment or therapeutic agent. We are only now finding out "why" this is (actually goes back to the 80's). And that is fascinating.
Your hang up on a specific reference demos just how little you actually do know. As I said earlier, I was "the diagnostic expert" for a category of disease... along with 5 other labs in the US and about 10 total labs in the world... for a period of time. (yea - really and we all traded data, tissues and histopath slides etc.). Were we in a standardized HICFA code? No, we were not. Docs simply called us, provided a tissue sample to us and we performed a couple of lab tests for the Dx. This was prior to the tests being standardized and commercialized by outfits such as Quintiles or other CLIA certified outfits.
Who recommended us? The NIH.... of course. Or a state testing laboratory... heck - even had calls from the INS folks! - no shit! How do you think laboratory tests go from discovery to practice in the commercial world anyway?
as far as non-specific... that is how most diseases or disorders start... non-specific. and that is historical.
Your confusion might be that you deal with the failed cases. and not the successes... and they are there.
As far as truth telling - you run with a very different crowd than I. Most that I know - well, they go the investigative route... and not the "you're telling me the truth, right?" route. Few people, who are rational, really expect that if they put someones back to a wall, will tell them the truth. after all, our prisons are filled with innocent folk - right?
Sheese.... ya gotta meet a better breed of psychologists and psychiatrists... cause most I know would just not go down the path you do. and I do not even support the ones I know! as they are mostly academics! Bwahahaha!
getting reimbursed for his kids' spec ed dx, and my comment that we couldn't know about the facts of that specific case,
BUT the POINT WAS that the lack of objective standards makes this a hole in the spec ed/HMO budget; because anybody who can cry loud & long enough can almost always get a psych dx, and the public will almost always pay for it.
Do you disagree with that?
HarryJ & a couple others called that pinko liberal backfire, which is of course whiskey talking, but they have a point, even if its too broad to be useful.
"The student's parents had insisted that public schools were unable to meet the child's needs. His learning disabilities were diagnosed after he was enrolled in private school..... a lower court said tuition reimbursement is available to the parents under the Individuals With Disabilities Act.
The New York City board of education had asked the justices to take the case after a lower court said that tuition reimbursement is available to the parents under the Individuals With Disabilities Act. Lawyers for the boy's parents said the special education program proposed by the public school system was inadequate to meet the child's needs....
...challenge inappropriate proposals and obtain reimbursement for the costs of placement in private school."
Don't kid yourself.... if I found that assistance to my kid was inadequate by the local school district - I would do same. by the by - the parent lost his job.
that is not the key point; and as I said to begin with, we can't know about that case (without reading the transcript).
The ISSUE (as I stated) was that the totally subjective standards left a big hole in the SpecEd and HMO budgets, because anybody can claim them, if they are so inclined.
My PERSONAL view is that it will probably eventually be plugged by dollar limits, which gets back to what I said, open ended programs get pimped by the people wealthy enough to finance a complaint.
My observation is that the state SpecEd programs (in CA) tend to bog themselves down in bureaucracy until they are next to fucking useless.
But psych claims in nationalized insurance (which I tend to regard as inevitable) could easily come down to lonely old folks going down and talking to their doc for company, when the should be pitching in helping raise their grandkids, to minimize the number of swarthy babysitters and handymen we need.
Hell, if their doc is as good looking as mine, I'd go down and hit on her every damn week until she put out!
finds you as distateful as I do. Read my story of the psrink who told the parents that their kid is an asshole.... disappoint diagnosis, but one that I think should be used more.
in the lobby if that were true, BUT she's doubtless too careful. I will have to take another tack if I really want into her panties, but there are too many other better options for now. For now I just like to have good-looking babes around.
I did not see your story about the shrink telling parents their kid was an asshole, but it sounds good as far as it can be believed.
IMHO, it's far more likely that the parents were the assholes, because it's either nature or nurture, and they're responsible for both, correct?
The larger question is, what to do about it, and a dose of reality therapy is better than nothing.
I'm really grateful you find me distasteful, because then I won't have to worry about you going all queer on me.
my type... well, they differ - but mostly I go for strippers.... they are really fun.
and mostly they take kindly to an old geezer like me! Doctors? Well, hee hee - Been there - done that! lol! Divorced now, and I feel much better....
I have a real hard time feeling sorry for people who lose their jobs as corporate directors, especially one as small as Viacom.
Lost his job my ass. Chances are he doesn't need to work at all, unless he wants to buy Ferrari.
-- Modified on 10/21/2007 6:31:25 PM
loose your job. ya won't laugh. No matter how rich you are.
stop hijacking threads and then complaining about the results.
Dude they don't exist - for any disease or disorder - except for some limited genetic diseases... Gave you a few of those... most are multiple systems involvement. Particularly the neurological ones....
was the meaning - which you should have realized from the very beginning.
The fact is that you evade the DSM standards, and discussion of the process, and particularly evaded the question of identifying the threshold diagnostic standard.
You're just evasive, and now you're frustrated that you haven't frustrated me.
That would be your personal problem. I will not accept responsibility for your weaknesses.
But if you want to do me a personal favor, you can watch the way you bugger the English language. It hurts my eyes to read your posts.
why, in ADHD and many other dx, do the clinical dx stds only ask for 'more or less' instead of the very easy alternative of estimating a fraction or percentile?
algorithm that is recommended as well as a link to the NIH (NIMH) page. Clearly you have a bug up your ass about something. as for my part - what is there is there. and you know damn well it is. Don't follow the recommended Dx protocol and go to Rx. then you will probably have issues.
DSM? yea, it is there. as far a Rx goes... does it EVER occur to you that for the most part, when inverventions are called for by EITHER The school or the parents - that Rx is listed as an option.... but so are things like giving the kid a rubber band to place on his / her foot to remind them to remain seated during class? there are so many tools... that can and are tried. But if the kid is not place properly in the school, they won't be. And that might be the bene of an active parent demanding that the SCHOOL Do its job. Which is how I read the original post.
Guess you did not.
ducking and weaving to avoid simple questions
http://www.theeroticreview.com/discussion_boards/viewmsg.asp?MessageID=52677&boardID=39&page=1
Just for one starter, a repeated question you've never tried to deal with is identifying the diagnostic threshold of significant impariment.
Just for minimal documentation of your bullshit, you know?
Bizarro, you're lame. And I don't mean physically.
-- Modified on 10/22/2007 1:19:20 AM
the psychrink is in no way obliged to medicate the kid, and in fact can suggest any one of the things you did - ??
But they don't, and IMHO their failing is medicating without investigation.
I do not believe that medication is wrong per se, nor that kids should never be medicated.
The bug up my ass is that psychs and indeed the institutions mislead parents and teachers into the "chemical imbalance/disease" bullshit (which I will elaborate when asked) when in fact they should be investigating the environment and asking if there are less intrusive options that would acknowledge the individual, like telling the parents to buy the kid a big dog, or telling the housewife to volunteer to help people who have real problems instead of feeling sorry for herself. (These are NOT general prescriptions, but typical suggestions for typical patterns.)
Another BIG BUG up my ass is the high proportion of times I have seen shrinks ignore or twist evidence to get to a result, or say things like, "even if it wasn't true, I'd have to make the dx for the insurance".
You see, there are lots of people who regard that as dishonest, and I'm one of them.
BUT they are too fucking busy making money, which is another story.
The original post was not about a father demanding the school do its job, but that the SUBJECTIVITY of the definition of the job left a hole in the HMO/SpecED budget; and that what was going on here was not medicine, but politics.
The reason there are no objective standards is simple: behavior is NOT medicine, it is politics; but the demand for glib answers, and the attraction of power is simply irresistible for the HMOs and psychrinks. Those who have a big problem with it are not practicing, but the most biting critiques are in fact written by psychrinks, who are notoriously not as oriented to factual detail as lawyers are.
-- Modified on 10/21/2007 5:41:05 PM