PhDwannabe

Holy Zenu you people are late to the party. I've been hating psychiatry for years.

I don't feel informed enough with regard to that side of the field to really register a solid opinion. I do, nonetheless, have an abiding suspicion of grand-explanatory neurological theories. It's a big mushy ball up there, and it's extremely difficult to compartmentalize it into regions and processes that make organizational sense to us. In many other fields, it's a safe bet that we'll know we were all wrong 50 years from now. In neuroscience, it's a safer bet that we'll know how dead-wrong we were 5 or 10 years from now.

To give you a half-informed state-of-the-science (I'm in psych, but not in the cog-neuro area): mirror neurons are a little like string theory. A good chunk of the field thinks they revolutionize our understanding of cognition and learning. Another sizable chunk think they're a fairly significant waste of time.

I took a couple of anthro courses in undergrad not too long ago, of course including intro. I just also asked two friends--an anthro major and anthro minor. None of the three of us has ever heard of such a thing. I'm not outright rejecting what you're positing here, Marat, but you may have to do a little better than that.

Makes sense to me.

Sounds like quite the just-so story to me. Aware of any evidence for it?

Dean, I commend your intellectual curiosity. But for crap's sakes, take a deep breath before you type something like this. A person may as well say, "there's no evidence for unicorns in the room, but I theorize that they're simply standing very, very still." What on earth does this mean? Suppose I have a sphere of radius 3 units, which makes its volume ~113 units3. And then I increase that radius to 4, making its volume ~268. Fascinating. What, exactly, is the "weight" of this sphere? What exactly is its "strength?" What studies? Point them out. And why on earth would common sense tell us this? This is precisely the sort of thing common sense wouldn't tell a person, for exactly the same reasons you yourself point out: it's happening so slowly. It isn't any more apparent to "common sense" than climate change or continental drift. If you'd bothered to actually read about it for ten minutes, you'd quickly find out a couple of general things. Namely: There is a persistent, near-mythical belief in the steady increase in height throughout history which is not supported by evidence. Ancient and pre-modern people were taller than we often tend to estimate. Yes, there have been significant jumps since the dawn of industrialized food production and public hygiene. But there have also been ups and downs as economies (and hence, diets and behavior) changed. For instance, average height in Europe fell a bit as the Roman Empire declined, as the economy simplified, peoples' diets became less varied, and basic public health facilities (think aqueducts and toilets) decayed. You raise kids 1) on diets of largely one or two staple carbohydrates, 2) under conditions where they have to spend a lot of energy working, and 3) with a load of pathogens and parasites that they have to essentially "donate" a lot of their calories to, they grow shorter. Change those things in the other direction, they get taller, and puberty hits earlier. It's not that complicated. You really don't even need evolution to explain most of it. I swear, look around for ten minutes, and you can find all of this. Or, go find the data that support the idea that we're evolving towards some point where we'll all fall over, and present them.

A fun little something to share with your friends/freaked-out relatives. As a somewhat-related side comment, the manager of my local food co-op (I live in Michigan, mind you--Michigan) said that she'd had several people coming in aiming to buy up all of the sea kelp supplements, with the intention of preventing radiation poisoning. She'd said a friendly e-mail had come across the national co-op listserv with some helpful information to provide such customers: to properly saturate your thyroid enough to prevent iodine uptake, you'd need approximately ten bottles of the stuff. Oh yeah, and also, the sidewalk concrete is currently flooding us here in f#%*ing Michigan with more radiation than the Fukushima nuclear facility is.

The "real" source material is going to be pretty arcane to the non-specialist. What Marat's talking about is pretty well-known, however. Proprioceptive and interoceptive sense is normatively contiguous with the bounds of the physical body, but it doesn't have to be. The brain's not that hard to trick. You can screw it up in one way by chopping off a limb. You can screw it up in the opposite direction with some easy induction techniques (one fun intro psych trick: you have someone put their hand under the table and stare at a fake hand above the table. You stroke both identically with feathers for a minute or two as they stare at the fake hand. Then, you pound your fist on the fake hand. They yell, engage in a withdrawal reflex, and often wince in pain.) My recommendation? Kick back and let the Indiana Jones of neuroscience, the great Vilayanur Ramachandran, explain things for you.

Random, let me start by saying that I am a psychologist in training, and not a psychopharmacologist. So this is miles and miles away from professional advice. Antipsychotics have side effects--that much is certain. Different antipsychotics, however, have different side effect profiles, and individual peoples' bodies interact with them differently. Please, please, please talk to a psychiatrist about what you're going through and what your experience with certain drugs has been in the past. He or she might have an idea, based on your specific symptoms, and reactions to specific drugs in the past, about what sorts of medications might be most effective and manageable for you. It is at least worth having the talk. Talk therapy can also be helpful for people dealing with what you're dealing with. A licensed clinical psychologist--preferably with a PhD in clinical psychology, and with training in empirically supported methods--can also be a useful place to go. (Psychology Today runs a nice therapist-finder service.) But it sounds like a psychiatrist might be a good place to start. I hope that is some help.

Show me your source. Actually, don't. It doesn't matter. Because no clinician I know cares about Freud, or practices a mode of psychology which would be remotely recognizable to him. Kindly demonstrate this assertion with evidence. Please cite the study, as well as some of the major responses to it. There is no such thing as the American Association of Psychologists. Please cite the study. That's fascinating. My cat, Punkin, has a friend named Charles, who's also a social psychologist, and heartily disagrees with you. I guess we're even on that one. I don't believe that. No clinical scientist I know does. Perhaps you could continue to attempt to demonstrate your assertions--here I'll repeat myself-- That'd be lovely.

This still going on? I can't wait to hear how clinical psychology is "a nonsense." Preferably, with references to: 1) the poster's understanding of what clinical psychology specifically is and does 2) specific empirical studies 3) the specific points laid out many months ago in the first several posts of the thread Or we could just leave it there and not defend our assertions. But that would be a stupid.

More neuroscientists (and journalists) wetting themselves about small-effect-size neurological differences between groups delineated by a social construct. For god's sake, people are different. Yes. Brain and behavior mirror one another--the brain is the grand mediator of all behavior. Behavior is the final output of the system. Why is it so beverage-spittingly shocking that people who behave differently have different brains? I'll tell you why--implicitly, there's this often-unspoken article of faith here that biology precedes psychology--that our behaviors are shaped by, limited by, or controlled by our brains. Well, of course they are. I could go burn out a little piece of it and you wouldn't be able to say anything but gibberish. Or laterally localize sound. Or make planful decisions. But things also go in the other direction. Neurochemical and neuroanatomical changes follow behavioral/environmental changes as well. If I raise you in a war zone or raise you in the suburbs, guess what? That organ will develop differently. Got OCD? It's somewhat recognizeable on certain forms of neuroimaging. Now, go through successful behavioral treatment for it, and the scans look different. Well, I'll be damned! We done gone change the whole thing! We are living in a biologically determinist age--we have been at least since Watson and Crick, and it's only accelerated with the development of high-quality neuroimaging and other biotechnologies. Somehow, someway, we've forgotten that things were real before we could see them on these scans. So, wait, depression looks to have neural substrates? Looks to be somewhat heritable? Oh blazes, it's real, then! Are you kidding me? It was real beforehand. So people find these cool things (and they are cool things, by the way) they start frothing at the mouth and yell "HARD-WIRED!" As if we're so neatly separable into hardware and software. The next time you hear the phrase "hard-wired" in the popular science media, put your hands over your ears, close your eyes, and scream at the top of your lungs.

So, literally, science would just... stop tomorrow if university physics departments stopped upgrading their equipment. How exactly do these scientists function between equipment upgrades, anyway? How do you even go about defending a claim like this? Did that seriously just... was that a... was that a joke? Are you honestly suggesting that we have two dichotomous options as a species: advancement to a "Jetsons" level of technology within 50 years, or extinction (of the species or of the civilization) within 50 years? Because, really, people get into trouble making predictions of this nature. Like, "the next time I go into the living room, it's either going to be on fire or everything'll be coated in two inches of ice." There's a bit of room between "Jetsons" and extinction. If you just categorically dismiss the enormous range of possibilities between these, you sound like a madman.

Since I'm actually looking at my hands right now and find myself unable to view any of the bones, muscles, or connective tissue, I'm going to go ahead and reject your claim, in its strong form, on empirical grounds.

That's pretty damned odd. You're right--it's definitely not your garden variety panic attack, I'll tell you that much. Derealization is possible during panic states, but it's not often prominent, and generally not accompanied by hallucinatory experiences. We're usually talking about people just feeling a bit unreal and disconnected. I'm also not familiar with status epilepticus being associated with so many positive symptoms (e.g., florid nuttiness) as opposed to predominant negative symptoms (e.g., stupor.) Certainly, pretty nutty-sounding delusional and psychotic states can be caused by a number of physiological conditions, but I guess I don't know enough about the metabolism of this particular substance (over what sort of timeframe do its mechanisms become manifest, most basically) to know whether hypovitaminosis would have such dramatic acute effects. I have heard of a relationship between B12 deficiency and a number of psychiatric concerns including psychosis, but not B6. The one thing that comes to mind is that pyridoxine is one precursor among many for the lengthy chains of reactions which synthesize all sorts of neurotransmitters--dopamine included. However, it's high dopamine levels that tend to be more implicated in psychotic states, not the lower ones we (might) expect to find when a component like this is missing. So, that's the opposite direction we want to go in, here. I guess we may be looking at some sort of more complicated causal series, whereby some other unknown state is depressing pyrodoxine levels as well as producing psychosis. I suppose a regimin of controlled and regularly-assessed supplementation would let you know if the pyrodoxine level was really causal here, depending on whether or not these "attacks" continued. If I know half of what I'm talking about: in general, such quick, transient psychotic experiences do typically have organic causes. The closest "psychological" thing I can think up would be a re-experiencing event in a pretty severe case of PTSD. Obviously, this isn't anything close to that. That said, we could always be looking at both: the substratum of a pathophysiological condition, twisted around into a very odd presentation by an accompanying psychological/psychiatric condition. People with something on the schizophrenia spectrum--schizotypal personality disorder comes to mind at the moment--can give some pretty odd symptom reports of physiological occurrences, since they often experience reality in a fairly odd way. Tangled web we weave, here.

I'll say. It's an interesting study in that it, on the face of it, doesn't seem to mesh terribly well with what has grown into a "muscular" understanding of self-control. In general: self-control is like a muscle--it can be strengthened in the long-term, and it fatigues in the short-term (what Tuk refers to as "ego depletion.") So, make people remember short number strings, and they then go into another room and patiently wait for people to finish talking, or go into a room and pick a healthy snack. Make the other group remember longer number strings, and they interrupt the people with greater frequency, and pick sweets and junk food. There are a bunch of cute studies like this, and they've gotten fairly consistent findings. I'm not entirely convinced by this automatic/unconscious vs. deliberate/conscious distinction to explain the strange results, though I'm not unconvinced by it either. Distraction, as Mr. Skeptic notes, may have something to do with it--that seems cogent enough to me. Pretty interesting.

Pfft. Like any of this is going to matter after May, anyway.

There are many elegant psychosomatic situations in which this is the case--glove paralysis is the classic one. However, this is not differentially diagnostic of symptoms of panic attacks or similar acute stress states. Several reasons: 1) Panic symptoms are often "real" symptoms, created by the cascade of stress hormones involved in a panic attack. 2) Many times, individuals' beliefs of what they "should" be feeling are more or less accurate--accurate enough to often sound indistinguishably similar to to the "real" symptoms. PD patients show up in ERs reporting chest pain, tightness, numbness down the arms, inability to catch their breath. Medical testing, not reliable differences in subjective reporting, sort out the cardiac events from the non. 3) People's subjective feelings of--and reports of--symptoms of "real" pathophysiological states are also often similarly clouded by expectation. It's all a big mess.

But, I would continue, enlightened individuals are not necessarily baked hams. And baked hams are not necessarily Phillips-head screwdrivers. And Phillips-head screwdrivers, as I'm sure you would agree, do not all qualify as globular clusters. And globular clusters, you know, are few and far between.

I hate to have-a-hammer-see-a-nail here, but when you put it that way, we could be talking about panic disorder. As any psychologist, psychiatrist, or ER doc can tell you, anxiety can mimic any physical symptom. Of course, with symptoms like these, you should be insisting on medical workups--probably a couple of blood tests, an EKG, and an echocardiogram are sort of standard front-line tests. That (in my admittedly nonmedical opinion) sounds more or less prudent for anyone with symptoms like this. Chest hurts? Get the heart checked out, early and well. That all goes without saying. However, it sounds like there has been at least one normal workup, and also that your symptoms are accompanied by some amount of anxiety. While continued medical attention is probably appropriate, I'd consider a referral to a psychologist as well, particularly if you think the anxiety is prominent or problematic for you. Panic disorder in particular has one very common presentation, something I've seen quite a few times: woman in early adulthood with a past-year history of what the ER docs often call "noncardiac chest pain." It's a very common way for things to initially present. Panic attacks can include chest pain, shortness of breath, parasthesias (weird physical sensations like numbness) and a lot of other physical, emotional, and cognitive experiences. They frequently occur in individuals who are more sensitive to their own internal sensations. Luckily, treatments for PD are really, really good. Try to find a psychologist who does cognitive-behavioral therapy which includes a treatment called interoceptive exposure. It's among the best interventions we have, with short-term and long-term success rates superior to antianxiety medication. That said, of course, keep seeing your physician! Talk to him or her about referrals to psychologists if you're interested. Nobody here can really give you medical advice appropriate to your specific condition. P.S.: If you're in the USA, ABCT's Therapist Finder is a good place if you're ever interested in finding therapists trained in the sort of techniques I'm talking about, and you're not sure where to start looking. Edit: Holy crap, just noticed the original post is from Summer 2008. Hope things are figured out/better by now. If not, uhhh, well, I guess all that still applies.

A strange and random copy-and-paste from your friendly neighborhood content farm: But with grammar and sentence structure like this: Who could complain? Also, looks like our robotic friend is also posting his thoughts about, err, online toy-purchasing in some places that make the Psych section of Science Forums look positively relevant.

Here's the actual story, easily Googled: OK, this is one of those claims that demand a little bit of scientific thinking and a little bit less, um, knee-jerk credulity. You don't really have to be an egg farmer to consider this reasonably. Just think to yourself: How would they even go about collecting this data?! So you're an egg farm. You put out a million eggs a day (or more than that--from the story, it's not clear how long the period is in which a million eggs are produced). Some percentage of those are going to be cracked eggs just because--they fall wrong, they're malformed, etc. Even if it's only one egg in a thousand, that's still a thousand cracked eggs a day. Of course, that's just a mean. There's going to be a lot of variance around that mean. Just because. Today it's 986. Tomorrow, 1055. (Oh, and whether or not machines or humans are doing the quality control, this thing called "cracked" isn't even a unitary construct--there's a more or less intact egg with a defined cracked seam running down it, and there's an egg broken in half with albumen falling out. Both of those are likely going to get tossed. So there's a range of egg appearances which would result in them getting tossed; they're not just "cracked/non-cracked" as if they were blue/red or something.) So on the day of the supposed earthquake, what do they do? Do they do some sort of count of all cracked eggs? So, suppose it's 1001. So what? That single egg is going to be well, well within the expected deviance from the mean. Not near enough, statistically, to claim that the earthquake had an effect. If you had a carton of eggs on your counter of known integrity, went through an earthquake, and saw one of them was cracked, you'd be in a pretty good space to make a reasonable inference about the earthquake cracking one of your eggs. But if you're putting out a million eggs. Continuously. The making of an inference about the earthquake cracking one egg, given the variances we can very charitably assume in a situation like this, is essentially impossible. So, guess what? It didn't happen. It's made up. Or it's sort of a joke. Or both. It is a fact that, nomologically, is unbelievably close to impossible to observe. A little bit of reason shows that very quickly. This is actually a really good example of how you can evaluate claims just by thinking about how they might be studied--I plan on using it with students!

I didn't even make fleeting references to studies--I made fleeting references to general findings. This isn't my area of psych--actually, this isn't really any area of psych I'm familiar with. It's sort of an oddly formed question that I'm trying my best to shoehorn into any area of psych. My thoughts are off the cuff, and moderately informed by literature and contact with academic psychologists. Those thoughts deserve all of the credibility and suspicion that sort of talk calls for. In general, I think I can tell you that most of us don't make this distinction so clearly anymore. I'm not going to give you specific citations, because 1) I'm not a cognitive psychologist, and 2) again, this is sort of an oddly phrased question that people in research wouldn't really ask, so I'm doing my best to interpret it. But in general, I think most academic psychologists would tell you that this conscious/unconscious distinction is a bit misleading. We talk a little bit more now about things being in or out of awareness, or somewhere inbetween. There is no thick wall with a tiny door. To temporarily use the metaphor I generally hate, these "unconscious processes" are not so much the deep mysterious processes buried in the operating system that you only find in the task manager, they're just the browser tabs you've got open that you don't happen to be looking at right at this second. It's not as if we've got a set of conscious processes which are "learned" and a set of unconscious ones which are "programmed." Of course a person's freely chosen actions are affected by cognitions which are occurring outside of awareness. But those cognitions do not inhabit a terribly special realm, they can often be dragged into awareness and tossed back out again. (Not to say that they're aren't plenty of heuristics and information processing tricks that we'd never know are going on with introspection. I'm not saying that the full machinery of perception is viewable to us.) Again, this is my feeling on the general state of the science. Many grains of salt, and all that. My ability to try to frame this in scientific terminology that is familiar to me has run out. Lemur, I'm really not trying to be an ass, and I've got nothing whatsoever against you, but I have no idea what the hell this means.

Don't drag us into this. We're not (exception: New Mexico, Louisiana) the ones prescribing drugs. Reply: Huh? I don't get it, dude--what are you talking about? OK, now that we've cleared that up, I'm going to hit a few things rapid-fire. I'm too lazy to throw in all of my damned references at the moment, which means I'm violating one of my more cardinal rules, but what the hell? 1. Henderman, for poop's sake, please, please, please, I'm begging you as much as one human being can beg another, please don't ground your opinions in what several people on YouTube seem to be saying. 2. The "drug companies are in bed with doctors" argument is as horribly tired as it is unnecessarily conspiratorial. There are more ways for systems and people to utterly suck and fail than to sit in a smoke-filled room full of all kinds of plotting and mustache-twisting. Look, a lot of psychotropic drugs suck. I tend to be pretty anti-calling-myself-pro-or-anti-things <giggle> but I'm very nearly "anti-drug." But I'm telling you, I also believe that this particular road to hell is paved with very good intentions. 3. Direct-to-consumer drug advertisements are indeed ridiculous. Their simplification of the etiology and treatment of mental illnesses is particularly egregious. Guess what? The serotonin hypothesis of depression rests on pretty thin empirical foundations. You wouldn't know it watching the ads. You can thank a Republican congress for all of it. 4. Biopsych studies tell you less about the etiology of mental illnesses than you think they do. So serotonin levels are low in depressed people. So what? Gasoline levels in the compression chambers are low when a car isn't moving very fast. That's cause the guy driving isn't pushing the pedal very hard. Biomarker does not suggest biological cause any more than behavioral marker suggests nonbiological cause. Nor do biomarkers suggest biological treatment. We're dealing with complex chains--no, webs, really--of causality, with factors moving in and out of fields that are amenable to an individual's conscious will, and fields that are amenable to biological/pharmacological manipulation. When I hear someone saying "[insert noun/verb here] causes [insert mental illness here]," I do all I can to stop myself from spitting out my drink. You may as well tell me that human beings have an average of one testicle. 5. Modern psych drugs don't perform terribly well. Part of this has to do with the fact that they have to compete against placebos, and placebos do really really well on their own. They're also less and less specific to disorder--if people knew the wide range of things docs try these meds for, both on-label and off--the drugs themselves would sound and seem a hell of a lot less impressive. Psychopharmacology is fairly significantly a game of trial and error. (Not that there's anything fundamentally wrong with that. A lot of physical medicine is too. That's, like, empiricism, right?) Of course, since people are wildly different, some of these drugs do work for some people. To dismiss every single one of them completely is an unwarranted injustice. 6. Mental illnesses are plenty real--a little more real than a unicorn, a little less real than a duck. They're generally not definable with single pathophysiological causes, but we're (I'm in psychology, not psychiatry, and I can't answer for Them) not a bunch of idiots out to pathologize anybody who looks different, either. I've known plenty of weird people; few of them are ill. Considerations of deviance, distress, and danger are all important in defining what a mental illness is. Some of these conditions are a little more taxonomic. Some, a little more continuous. People don't "have" depression like they "have" tuberculosis. We're talking about clusters of symptoms which hang together. In my experience, most psychologists tend to get this, and most psychiatrists tend not to. What do you expect? We're scientists. They're practitioners. Yeah. I said it. 7. Caveat on the last one: it's a shame, but there's a lot of stuff mixed up in the big book that does some amount of injustice to the differences between disorders. Remember how I said these diagnoses are realer than unicorns, less real than ducks? Well, take schizophrenia, for instance. That one's probably more or less a duck. (Not that there hasn't been a hell of a lot of historical difficulty in diagnosing it with high sensitivity and specificity. Not that it hasn't been cruelly used and manipulated by governments and other authorities for various nefarious ends.) 8. Psychiatrists and "mental health advocates" of the last two decades seem especially interested in screaming "IT'S A DISEASE!" It, of course, being depression, bipolar disorder, social anxiety, and so on. OK, fine, you've got a name for it. But what are you saying? Are you just trying to convince me that it's real? Well, my coffee table isn't a disease, and it's plenty real. Are you saying it's not my fault? Are you saying I can't do anything about it but battle it with pills? I could start eating cheesesteaks and doughnuts at every meal, and have diabetes fairly quickly. Diabetes is a disease. I could do behavioral things to make my influenza better or worse, or more or less likely to lead to poorer outcomes. Influenza is a disease. This shout of "DISEASE!" gets us nowhere. 9. Empirically supported psychological treatments for major mood disorders are pretty damn good. Most of the time, they show higher efficacy when compared to pharmacotherapy, lower long-term cost, longer maintenance of treatment gains, and lower drop-out rates (understandably, since psychotherapy doesn't typically pack weight on you, kill your erections, or make you sweat at night.) For the most common emotional nasties you and the loved ones are most likely to run into? Don't worry, babies. We got this. 10. As a (ahem, in a couple of years) psychologist, I don't really care about the Truth. I care about efficacy. I care about predictive validity. I want to classify people well enough to deliver to them the right sorts of treatments to improve their daily functioning and subjective well-being. Whether my classificatory scheme represents the real, beautiful, immanent Truth of the universe is borderline-pointless. Fun to argue about, of relatively minimal use to my patients. It'd be nice to improve upon it, but a few holes in it doesn't strangle what I'm able to do. Whether the theories behind my treatments are even correct is not even the issue of primal importance. Results are. And we have pretty good ones. Which has the greater effect size on its primary outcome variables: heart bypass surgery or exposure therapy for panic disorder? Since by now you already know my biases, I'll let you guess the answer.