PhDwannabe
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What are the common stress related disorders in psychiatry?
PhDwannabe replied to piterdisuja's topic in Medical Science
"Stress-related" is an interesting way of putting it--you're opening up a larger can of worms than you think you are. In general, most disorders have fairly solid evidence for a general model of etiology known as "diathesis-stress." To put it most simply: [insert disorder here] probably comes from some amount of heritable or nonheritable biological predisposition, which gets exacerbated or "set off" by some kind of chronic or acute life experience. The evidence for this is present, again, in nearly every mental illness you can think of, from depression to schizophrenia to eating disorders. What you may be asking about, however, are those disorders which seem to be more clearly touched off by distinct, acute events. PTSD is certainly one of those. Jake mentioned something about it: I might not go so far as to say "most common." PTSD is indeed relatively common--lifetime prevalence is between 7-8% in the United States. However, the plain-old psychiatric head-cold, depression, is also a common response to stressful life events. There used to be more of a distinction in psychology between so-called "endogenous" and "reactive" depression, but most clinicians are resigned to a diathesis-stress model which gives a fair amount of credence to both predisposing traits and stressful events in most cases. Given that the lifetime prevalence of depression is far higher (10-40%, depending on who you ask--this is really a much more complex question than you think), and that most cases probably have something to do with life stresses, I'd venture to say that we might even call depression a "more common" response to life stress. OK, so we're leaving a bit out, here. We do have to define "stress." PTSD is generally regarded as coming from "traumatic events" which usually involve things like threats to life and limb. So if we're talking about these sorts of things--traumatic stress--PTSD is substantially more likely when you make comparisons with more general life stresses, like a divorce or a bankruptcy. Depressive symptoms, however, are also highly common in combination with PTSD (we call this "comorbidity"), so they really show up all over the place. If we are, though, talking about plain old "stress," then, again: just about anything can come from it. Some people get anxious. Some people get sad. Some people break with reality. Why do they do one and not the other, or experience something rather than nothing? A million reasons. Part of it's due to their own temperament/personality/skills and deficits/beliefs and values. Part of it's due to the details of the stressful situation itself (does childhood bullying typically affect people different than a car accident? Of course). Part of it's due to more contextual variables like social support. So, take a look at any disorder you want. Browse the catalog of human madness knowing that all of them can come--in part--from "stresses" of some kind. Oh, and by the way: Post-Abortion Syndrome is more or less recognized by any serious scientist as a made-up attempt to emphasize horrible, destructive consequences of abortion, brought to you by pro-life advocates. Can abortion be stressful? Yes, just about anything can. Can it lead to psychopathological consequences? Yes, just about anything can. Are the supposed symptoms occurring after an abortion ubiquitous enough, severe enough, and internally consistent enough to justify calling it a specific mental illness? The data at this point seem to say no. Recent reviews tend to show that mood distress post-abortion is comparable to or lesser than mood distress postpartum. Abortion's affects on mental health appear to be relatively minimal. That part was just an afterthought; I had to get it in because it got mentioned. I hope nobody decides to pick up on this bit--I can't think of anything more profoundly annoying to argue about than abortion. -
Nobody is "programmed." Rather, we learn. Pop-psychological, self-helpy understandings of learning frequently use terms like "programmed," which often connote semi-magical powers others have over us, or those we might have over others (if only we'll spend $19.99 on this helpful book I've got right here). I tend to loathe anything which propagates this largely unhelpful modern metaphor of mind/brain-as-computer. Cognitive science has done much in the last two decades to elucidate the many ways that your mind does not function similarly to the electronic device you're currently staring at. So, at any rate, your question: In group dynamics (loosely a branch of social psychology), there's this general distinction between two large families of goals when people operate in groups: instrumental goals--getting concrete things decided or accomplished--and expressive/cohesive goals--keeping the group together, happy, and functioning. Sometimes, these goals assist one another; other times, they stand in opposition to one another. Most simply put, it seems like you're asking about why individuals choose to serve expressive/cohesive goals--particularly, at moments when these goals don't seem terribly useful. Well, there are many domains on which to interrogate nature as to why this occurs, and probably a million answers at each level. To be honest, it's kind of a fuzzy question--there are a lot of difficult-to-operationalize variables with hands in your inquiry. Inasmuch as this is the case, I'm afraid clear empirical answers are pretty lacking. To speak something to the question, however, one could look at things on the level of the conversational dyad: what sort of factors in the situation/related to the social partner/etc. would predict why people would do such a thing? The attractiveness of the conversational partner comes to mind! One could look at the level of traits: what sort of factors about a person would predict this behavior cross-situationally? "Agreeableness," one factor in the currently dominant and well-established Five Factor Model of personality, comes to mind. You could even ask about deeper attachment style issues or about differences in temperament (I know that word is used a lot of ways, but I'm talking about it in its technical sense: a relatively heritable psychobiological variable). Probably some halfway decent answers there too, but this actually strikes me as a behavior which is more substantially driven by more proximal, situational variables. That's just my social science spidey-sense about it.
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Extraordinary claims require extraordinary evidence. Why don't you start with the claims that seem to annoy the highest percentage of the thread responder population. Oh, and we're not proving them. Or disproving them. You're just supporting them. Or, trying to.
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It is. It doesn't.
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Let me tell you the very (very) general and simplified cognitive science view of deja vu. Typically important to explanations of deja vu is the concept of "inattentional blindness." Normally, we're reasonably attentive to our major sensory inputs (vision, particularly), but sometimes, we get distracted and end up profoundly unaware of our own processing. So, you process the red van as you speak to your friend in the parking lot, and a moment later, as your conversation winds down, you look again at the red van and have a memory of seeing it without a memory of encoding that memory. Very creepy, and unsurprisingly the cause of much superstition and magical thinking. In general, the principle of most importance here is the simple fact that the brain shares a lot of pathways between memory (which is mostly "created" on-demand, not "stored"), imagination, and perception (of the present). So much so that some throw up their hands and suggest that all of these things are almost entirely the same process. Once you get away from a homoncular view of the mind as a little guy up there looking at video screens and pulling up files on a big cognitive computer, it makes a little more sense.
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All of them. Nope. Yup. Oh? Rather not. I'll try to keep that in mind.
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Go ahead. Lay them out. Peer-reviewed papers. Make a specific, scientific claim, then make a citation. Then we'll talk about it. It's easy. Go ahead.
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Well, looks like I'm looking for different things. For me, there is a strong positive correlation between the general nutcasiness of the title and the chances I'll read it. Hmm. As if I didn't spend enough time around insane people all day?
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Heh. May be a little out of my area, man. Psych is a ways away from... what the hell is this, anyway? Fluid mechanics? The lighting is similar; I was paying attention to that today. Again, I strongly feel that I've observed this effect in a variety of different lighting and background conditions. (As somebody in psych, believe me, I'm well-aware of confirmation biases and other cognitive errors that interfere horribly with the process of drawing conclusions from these sorts of uncontrolled observations. So, while I strongly suspect something related to car exhaust is going on, I'm by no means screaming about how I know what's what.) Again: particulate matter. Nucleation sites. Nobody's gone there yet. Isn't that plausible?
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Again, the quality and direction of the light is certainly very important, but I feel like I've observed the effect fairly readily in a lot of different lighting and background contrast conditions, and there still seems to be a main effect difference driven by running cars. The street I was talking about crossing, for instance, is the same color as the side street I walk down to get to it (very gray, not blacktopped), so the surface remains constant--the difference is traffic.
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Participate in a social science study!
PhDwannabe replied to jdgew's topic in Psychiatry and Psychology
Just letting people know that this does NOT represent acceptable informed consent documentation. Acceptable documentation outlines the project's purpose, specific procedures taken to guard anonymity or confidentiality as well as data security, expected risks and benefits of a study, and perhaps most importantly, contact information for the principal investigators and the human subjects review board who approved the study. You don't call something science and fail to do this. Informed consent is not an extra, or a joke, or a technicality. It is part of a modern system of research ethics which grew from the abuses of the Nazis, and of dangerously ambitious medical and social science researchers around the world. Is this little survey likely to harm you? Of course not. That said, I would ask people to, as a matter of principle, not participate in studies which do not include an even halfway-decent informed consent. -
I swear I've seen this effect even without a black background (which, as I'm reading, could provide two very distinct effects: heat differences, and visual contrast differences), and running cars is the important difference. Isn't there some precedent for my best (uninformed) guess?: Don't clouds form more readily when there are a lot of nucleation sites available from the particulates in air pollution? Couldn't this be a very similar effect?
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OK, ignore the magical space fairies. Also, apologies: this may be posted in the wrong area, but I'll be damned if I can find the right subforum for it. So, I was walking to a meeting early this morning and, while crossing a busy street to walk onto campus, I noticed something that I think I've seen before and forgotten about. On a cold and bright morning like this, my breath is visible. I have a reasonably informed understanding of why that is. Here's the thing, though: when crossing the street, it is much more visible. Dramatically so. I recalled that I've seen this in parking lots, around major streets, and anywhere around running cars. So, what is it? I imagine it has to be a function of car exhaust--is the humidity just very locally higher? Is it a matter of local density of particulate matter, which provides for greater opportunity for condensation in the air? What are your guys' thoughts?
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The context of the joke was pretending to be an insane person who believes they've made a perpetual motion device, and, per thousands of years of Western intellectual tradition, posts news of it on this here forum. The deviation from this was the claim that I hadn't made a perpetual motion device, "merely" a "perfect vacuum." It's the equivalent of me claiming that I've built a probe which is orbiting Pluto, but I could never get the antenna screwed on entirely straight, so unfortunately I'm not able to download any of the images. This was a humorous way of presenting an article I saw--conveniently linked--about how friction in some sense would continue to exist in this "perfect vacuum." Thanks, Swansont, for getting the joke. COMEDY IS FUNNY, NO?
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This is one of the classic misapplications of probability. (This is kind of a philosophy of stats issue, here, and there's by no means a perfectly clear answer.) In short, probability is meaningful in reference to future or unknown events. It's not sensible when applied to past events whose existence is known. So, I'm going to throw ten nickels in the air a few minutes from now. What are my chances of getting ten heads? 1 in 2^10. About .1% of the times I'll do this in the future, I'll get those ten heads. However, just yesterday I threw ten pennies in the air and they all landed heads. What was the "probability that this happened?" 1. (Assuming, of course, I'm not lying to you, which of course, for pedagogical purposes, I am.)
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So, solipsism, essentially? You've invented the idea of solipsism? I'm going to have to alert Plato and the Arnofsky brothers immediately! Also, how did I already know the word for it? Damnit, nothing makes sense in this inescapable dream world of ours. Edit: Aww shucks, I'm sorry, Dean. I now look at your profile and see that you're a teenager. I shouldn't have been so reflexively snarky. You have little intellectual responsibility at your age to have taken a philosophy class and learned about something like solipsism, or even Plato. I don't mean to crush your philosophical curiosity. One of the great functions of a liberal education is to show you that 99% of your great ideas have been thought of already--chewed up, argued over, refined, dealt with, developed or discarded. Typically by people who know more than you'll ever dream about. The beautiful, liberating knowledge that you're more or less unimportant in the course of intellectual human events will come in time. Trust me. It's nicer than it sounds.
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I'll come out and say that I've never had lice, never known anyone with lice, and have never been checked for them to my recollection. The word creates no psychogenic pruritus or other parasthesia in me. I did, however, live in something of a substandard apartment building a few years ago at the start of grad school. Say "bedbug," and watch me squirm.
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Did, we, uhhhh... not see the joke, here?
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Is there not a "stoned" forum?
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...but I still didn't make a perpetual motion device. Damnit.
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What do we know about false memories?
PhDwannabe replied to random's topic in Psychiatry and Psychology
Like anybody else does: very poorly. Many people in the public have a perception that psychologists are dark sorcerers who can bore into your skull and tell what you're thinking. (Many of the same people think psychologists are worthless and stupid. It's a cute juxtaposition of beliefs that reminds me of 9/11 truthers: 1) the government's hopelessly incompetent, 2) the government perpetuated the most massive conspiracy in history and nobody's talking.) This really is far from the case. Whenever people question me, "how can you tell if somebody's depressed/been abused/secretly taking drugs? And I almost invariably answer: "You ask him." Clinically, it's asking the right questions that we're trained for and good at. Now, if you've done clinical work for a while, you get a halfway decent spidey sense. My clinical experience is training-based and thus minimal, but there are times when somebody says "it doesn't make me anxious at all" or "I'm not mad at her" that I know to raise an eyebrow, crack a little smile, and wait a moment for them to sigh and tell me the opposite. People with much more experience than me are yet better still. But that's a far, far way from lie detection. If people are really motivated to lie, however, I don't predict I'd be much better than a smart layperson at detecting it. If I was any better, the effect would be small. It's just not within the purview of my training to be a lie detector. Similarly, if people are convinced of something themselves, it's as good as if they were motivated to lie. Children (well, adults too) can often be experiencing a mix of both--really motivated to lie, and within a process of convincing themselves it's actually true. I'm going to be moderately defensive of my profession and claim that most to many of these cases were perpetuated by individuals with lower levels of training, although no echelon of the field is without guilt. In short, you're right. The 1980s were fraught with particular scandal as mental health workers became convinced that abuse was both unprecedentedly rampant, detectable through relatively simple observation of a person's symptoms, and almost completely credulous when reported. In short: tons of people have been abused, if they've got migraines or are depressed, that's a sign of past childhood abuse, and if they tell you so, you've just got to believe them. (Again, the vast majority of psychologists were never convinced by this.) Of course, the problems here are obvious: if the therapist believes it, a client who's not quite sure of it is going to become damn convinced, damn quickly. In the heroic narrative of my profession, this steaming turd of a professional practice continued in many quarters of the field until a psychologist named Beth Loftus came along and kicked it to hell. Her work on recovered memories systematically and beautifully destroyed these presumptions, convincingly showing that it's pretty easy to get people to believe ridiculous stuff that never happened to them, and completely constructed and uncorroborated memories of childhood are normative--almost all of us have several of them (sometimes quite cherished ones) that never happened. It was a big deal. Conferences were held, committees were formed, some people who got imprisoned on this testimony were released. If you've got journal access, you can get the Final Report of APA Working Group on Investigation of Memories of Childhood Abuse. It's in the Journal of Psychoanalytic Psychotherapy, vol. 14. Gives quite a bit of good info about the relevant state of the science. Skepdic has a good article on it, too. Many of the issues apply to not only recovered memories, but more to the point of what you're asking about, events being currently reported. More to that point: Good question. Let me tell you a little bit about how it works. Child psychologists can be pretty good at dealing with kids who are making these sort of claims. Professionals are typically good at taking a position of healthy skepticism, along with compassion towards the client. But here's the fact: the psychologist in this case, believe it or not, is not obligated to find the truth. Rather, the psychologist is required to tell someone else, so they can do it. As a mental health professional at any level, I operate under Mandatory Reporting laws found in every jurisdiction in the country. Generally, how it works is this: if a minor or a vulnerable adult reports to me anything reasonably suspicious of any kind of abuse or neglect (you say "accounts of his father which could be quite harmful," I'm going to make the assumption that's where we're going here), I've got to tell Child Protective Services, and damnit, I've got to tell them yesterday. (Yes, I have been involved in this in the past.) I am not the investigator--the state is the investigator. Although CPS is going to comprehensively interview me and is very interested in what I know already, it is often largely out of my hands from there. Statues do vary somewhat, but most of us understand that our duties as Mandatory Reporters extend to our entire lives once we work in a profession--it doesn't matter whether a client tells me this in a session, or some random stranger rings the doorbell and tells me right now. While it's difficult to define credulity by statue (i.e., exactly how sure of this do I have to be before I report, anyway?), most of us have a vivid picture in our heads of some judge or jury deciding that we ought to have been a good deal more credulous than we were, so we air greatly on the side of caution. Our failure to do so means possible civil penalties, criminal proceedings, and the very real potential of the end of our professional lives. It is taken, as you can imagine, extremely seriously. Psychologists do understand--perhaps better than most people--the factors which might cause a person to say something that's not true. Whether the kid in question is reporting truth or not, it seems to me that he'd see some use out of some visits to a child psychologist. But keep in mind: your friendly neighborhood shrink will not hesitate in reporting to the proper authorities claims of abuse which are even moderately credulous. And when he does, he will not be the one investigating them. These investigators themselves are pretty good, and are not throwing people in jail based on a child's claims--they need evidence. Bruises, pictures, siblings who corroborate. If the father in question here knows the claims to be false, and knows that there's no evidence to suggest they'd be true, he'd have little to hide. The price of such a "hassle" may be worth it to him if it gets his kid into decent therapy. Nobody can ethically make recommendations for people who aren't their patients. I can't and won't tell you what to do. But that's some information about how the system works. -
...What?
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Eeeehhh, not the greatest explanation. From the way Flow is proffered to work, you really need a more cognitively (or, sometimes, physically) demanding task and a higher frequency of reinforcement. Flow is often mistaken for states of mildly diminished awareness like "highway hypnosis," and I think that's the case here. Perhaps the street you live on has thousands of coins on it and it takes great powers of concentration and mental effort to find them. Perhaps the street is also roaming with heavily armed clowns who demand that you answer riddles and perform tricks in order to get at their precious coins. Then, umm, maybe it's Flow. We're misled by heuristics like these all the time. Our perceptions and memories are quite unreliable. This could very well be operating here. Awww mannnn, Occam's Razor's no fun. What about armed clowns?
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"Causally deduct?" That's a distractingly placed modifier if I've ever heard one. I'm just going to replace that with "predict," and the sentence then begins to make some parsimonious sense. I'll answer it that way. Before I do, though, a brief thought on scientific "laws" vs. "theories." Philosophy of science as I understand it still tangles about the distinction. "Theory" often seems to inhabit a continuum between loosely confirmed hypotheses and laws. I don't tend to make much of a distinction. Some people are fussy about laws, and demand that they must be absolute and universal in some way--in other words, they always predict everything about their subject matter. I don't tend to agree. Many of Newton's "laws" only work well in the comfortably nonrelativistic space around us--his understanding of gravity is, of course, just wrong. Einsteinian understandings replaced it. But that doesn't mean Newton's laws don't make really, really good empirical approximations if I, say, want to hit you with a cannonball or something. To me, they're still plenty good laws. There's some semantic and substantive debate about what these terms mean; I tend to throw up my hands a bit, and I'm going to use them interchangeably. Mostly just because I'm feeling snarky. (Nonetheless, I'd maintain even strictly defined "laws" aren't necessary for the scientific process--I'm not sold that biologists have them in a strict sense, and it doesn't make them any bit less scientists in my book.) Anyway, back to the question. You want a law? I'll give you something like it... Let's take operant conditioning, a relatively powerful way of describing a sizable range of behavior. The basics of these "laws" are that behaviors which are reinforced increase, while behaviors that are punished decrease. Reinforcement and punishment gain power by--among other variables--proximity to the behavior for which the consequence is applied. Negative reinforcement (which describes the reinforcing power of the removal of a noxious or unpleasant condition, as opposed to the more familiar positive reinforcement, involving a Scooby Snack) is extremely useful in describing the set of circumstances around, for instance, phobic and anxious behavior. In panic attacks, for instance, individuals characteristically avoid situations in which attacks might occur, and remove themselves from situations in which they do occur. Negative reinforcement paradigms predict this: avoidance is negative reinforcing, since it removes stimuli associated with the unpleasant attack. The behavior (that is, the attack itself) is thus made more likely. We can confirm this experimentally: when we more dramatically reinforce panic attacks by making avoidance behaviors easier, the attacks themselves become more frequent. Clinically, the most efficacious treatments fall under a paradigm loosely known as "exposure," in which we systematically restrict avoidance in the presence of the feared stimuli (for PD patients, those stimuli are often internal sensations which we have to deliberately induce for treatment--it's not the funnest thing in the world.) And then what happens? The panic behavior looses its reinforcement, and fades--a process we call "extinction." The specific treatment for panic disorder, Interoceptive Exposure, is one of the most efficacious in a clinical psychologist's repertoire. It works because its nitty-gritty details are so well-predicted and explained by relatively simple laws of behavior which have been verified experimentally for decades. In the usual inductive/deductive cycle of science, these procedures, informed by the law and theory, get translated into experiments which inform the theory with new empirical details, which thus lead to new hypotheses and new empirical work. There's nothing terribly distinct about psychology as a science in this process sense. I will say that our stats tend to be more complex, since the focus of our study is human beings, who carry along with themselves vast and irritating individual differences and free wills that rats, paramecia, jars of benzene, and globular clusters simply don't have in such abundance. The study of these ridiculous creatures is far from impossible, but it's statistically tricky. It also means that the certitude of our predictions is lower--I can't predict the outcome of mixing two people in a room with the same reliability as a chemist and predict the outcome of mixing two chemicals in a flask. Part of that's because some of my variables are stubbornly invisible. A lot of it's because I don't have the cash to measure all the variables necessary. When you're far away or limited in that way, your predictions have error (hear about any of those newly discovered extrasolar planets lately? You think they know the mass of them as precisely as we know the mass of earth?) That doesn't mean your predictions are meaningless, or you're not acting according to scientific laws, under the guidance of the scientific method. I'll say it all over again for the back row: the theory gets informed by empiricism, and guides further empirical work which goes on to shape it. Round and round. So, yeah, pretty mundane scientific method. Move along folks, nothing to see here. If you're curious, the family of exposure methods has been rigorously and carefully investigated, and has seen a flowering of applications (you need to be well-guided by behavioral law/theory if you're going to stretch it like this) for not only panic attacks but social phobia, PTSD, OCD, and even physical health conditions like Irritable Bowel Syndrome. In most cases, its efficacy is superior to that of psychopharmacological interventions in both short-term (sometimes we're on par with the pills there) and follow-up (we more or less run the table there). Sorry, psychiatrists. Better luck next time? I have learned never to doubt that deep, Linnaean urge deep in all of us to make cool-sounding hierarchies. That's a beautiful and arbitrary little list you've got there (and isn't the arbitrary often beautiful?) Can't say I haven't seen it about a thousand times. I do wonder if it means anything. N.B.: Pro tip.
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What do you know about the Waisseman method?
PhDwannabe replied to random's topic in Psychiatry and Psychology
I'll say something which I believe to be generally useful, even being completely naive of the Waissman Method. As a general rule, any sort of medical or quasi-medical procedure which suggests that it rids you of mysterious and devilish "toxins" is not to be trusted any further than you can crumple it up and throw it. It is not typically language that serious physicians and clinicians use. From late-night colon-cleanse commercials to cancer quacks and goofy autism treatment advocates, it all represents a pretty fuzzy/sad understanding of the way the body works, and the way we, physiologically, rid ourselves of noxious substances. Here's where I can speak with at least minor authority as someone in psychology: The medical and psychological treatment of addiction is an extremely difficult area. Most good, medium-to-long-term psychological (and medical) treatments for just about anything are predicated upon at least a modicum of motivation and adherence that addicts characteristically lack. It is hard as hell to do. Success rates are embarrassing. Anyone who tells you otherwise is selling you something.