Psychiatry – the medical speciality that combines empathy and science

Indigophoton

Indigophoton

Senior Member (Voting Rights)
An article in the Guardian, paid for by the Royal College of Psychiatrists.
What drives trainee psychiatrist Dr Mary-Ellen Lynall is “seeing people get better who have been in a very dark place”. Mental health problems such as depression affect one in four adults and their only hope may be a talking therapy or a prescription for antidepressants. In future, says Lynall, a simple blood test could lead to an entirely different course of treatment.

“Research shows that brain inflammation may be a cause of depression and in five or 10 years we could have a blood test to detect whether that inflammation is present,” she says. “Talking therapies are always going to be a mainstay because they’ve been shown to work incredibly well, but neuroscience research will mean that we have more tools in our box as psychiatrists.”

Lynall, who has a neuroscience background and combines psychiatry with research at Cambridge University, argues that understanding the physical basis of psychiatric disorders could be the key to better mental health. She is a prime example of the new wave of young doctors that the Royal College of Psychiatrists (RCPsych) hopes to draw into the profession, partly to make up for historic shortages but also to meet the government’s £1bn pledge to transform mental health services and treat an extra 1 million patients by 2020/21.

The college is running a Choose Psychiatry recruitment drive for psychiatric training – 20% of places are unfilled every year – and one aim is to dispel myths about the profession, for example, that patients never recover or that it is unscientific. RCPsych dean Dr Kate Lovett says the beauty of psychiatry is that cutting-edge neuroscience is interwoven with a psychosocial approach to patients.
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https://amp.theguardian.com/royal-c...speciality-that-combines-empathy-and-science?

 
"Psychiatry – the medical speciality that combines empathy and science"

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Jonathan Edwards said:
We used to think that people went into psychiatry because they were nuts themselves.
I now tend to think that people go into psychiatry because they don't understand other people and think it will tell them how to. It doesn't. So they still don't.
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My friends who studied psychiatry fall into one of two categories: Those who have trouble getting a grasp on life and think psychiatry will help them (and others) correct this, and those who think they have really figured life out and just need a diploma that will allow them to use all this wisdom to ‘help people’.
 
When you don't understand the problem solutions will work like crap.
Uppers or ignore your problems. Psychiatry already knows the answers (as if they are gods) so they won't listen when you say these options both suck.
 
Jonathan Edwards said:
We used to think that people went into psychiatry because they were nuts themselves.
I now tend to think that people go into psychiatry because they don't understand other people and think it will tell them how to. It doesn't. So they still don't.
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andypants said:
My friends who studied psychiatry fall into one of two categories: Those who have trouble getting a grasp on life and think psychiatry will help them (and others) correct this, and those who think they have really figured life out and just need a diploma that will allow them to use all this wisdom to ‘help people’.
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I think there's a certain esoteric aspect of it. That it contains transcendental wisdom passed down from gurus like Freud, Lacan et al. - the red pill that allows you to see and manipulate the matrix of the psyche. Analogous to the way some people study Aikido (or whatever) thinking it's an effective martial art but it's really just a nice dance and bit of exercise of little use in a truly dangerous situation.

Heres the slogan - Keith Geraghty was close:
Psychiatry: we're not getting society's best; they're sending us their charlatans, sociopaths, and bullshit artists. And some, I assume, are good people.
(I forget who I adapted that quote from, but I do recall a strong resemblance to that Michael Sharpe chap)
 
Andy said:
Lol, really. Please explain your level of knowledge about it that allows you to make such a sweeping statement.
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If we must.

I actually think it's a pretty fair analogy in some ways for things like the lightning process, CBT, or even 'mindfulness' as applied to illness.

It's a sort of self-referential theory and practice that projects esoteric wisdom and power but, when it comes down to it, doesn't stand up to reality testing.

How so? Well, it is suggestive that nobody in mixed martial arts - no, not even Japanese fighters - incorporates Aikido in their style. Sure, MMA is contrived to an extent but it provides the truest test of what actually works in unarmed combat between two people. Aikido was rapidly discarded because it is not effective.

...Analogously, it is suggestive that ME patients virtually universally reject GET.

I don't mean to dump on Aikido in particular, I'm sure other styles could be substituted, but Aikido is quite well-known and you can find all sorts of goofy demonstration videos of it so I used it. I don't think anybody is wrong or stupid to do and enjoy it - it looks like great exercise and won't damage your brain in contrast MMA. If sold as such I have no problem. But it is misleading and unethical when people profiting from teaching it mislead students into thinking that it is effective in the way we would expect a martial art to be. Now substitute 'martial art' with 'treatment for illness'. Does that make sense?
 
James Morris-Lent said:
If we must.

I actually think it's a pretty fair analogy in some ways for things like the lightning process, CBT, or even 'mindfulness' as applied to illness.

It's a sort of self-referential theory and practice that projects esoteric wisdom and power but, when it comes down to it, doesn't stand up to reality testing.

How so? Well, it is suggestive that nobody in mixed martial arts - no, not even Japanese fighters - incorporates Aikido in their style. Sure, MMA is contrived to an extent but it provides the truest test of what actually works in unarmed combat between two people. Aikido was rapidly discarded because it is not effective.

...Analogously, it is suggestive that ME patients virtually universally reject GET.

I don't mean to dump on Aikido in particular, I'm sure other styles could be substituted, but Aikido is quite well-known and you can find all sorts of goofy demonstration videos of it so I used it. I don't think anybody is wrong or stupid to do and enjoy it - it looks like great exercise and won't damage your brain in contrast MMA. If sold as such I have no problem. But it is misleading and unethical when people profiting from teaching it mislead students into thinking that it is effective in the way we would expect a martial art to be. Now substitute 'martial art' with 'treatment for illness'. Does that make sense?
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Yes we must, because you yourself use it as an example, surely you should be able to defend it?

And you haven't answered my question, so I'll ask it a slightly different way. Do you have any substantial direct experience of aikido? Yes or no? My informed guess given your answer is not.

Your definition of it not being an effective martial art is that you haven't seen it being used in MMA - a highly artificial sport situation.

In my 20+ years of aikido practice, I've been fortunate not to have to use it in an off-the-mat situation, but many of my training partners, who have included doormen, security personnel and ex-armed forces, as well as ex-bikers who were, at times, all too keen for a fight, have and found it to be more than effective, thanks.

What you seem to be doing is making a lot of assumptions from a position of very little knowledge - analogously, something we see the psychs doing a lot of about ME.
 
James Morris-Lent said:
I actually think it's a pretty fair analogy in some ways for things like the lightning process, CBT, or even 'mindfulness' as applied to illness.
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To me, the way these things are applied seems to be a misunderstanding of what they are and how we tend to approach them in contemporary culture.

You used the example of aikido - but a true master of any martial art will have taken decades to get to where they are - 10s of 1000s of hours of training. By that stage, the practice of aikido is probably highly effective. But once you start to dilute it with other things, probably less so, unless you spend a similar amount of time to produce a definitive style.

I'm highly suspicious of any therapy like CBT or mindfulness that claims it can be effective after just a weekend or even 12 sessions of practice. That's why I think all the studies focus on the superficial gains, the immediate subjective experience, and why in the long-term, any gains are lost as those superficial effects wear off. But that's not to say that the things they are based on are not useful - but to be truly useful, they need to be practised and understood over a very long time, and need to work with individual needs, and not against them (as GET tends to do). If psychotherapy really wanted to be useful, it would be to enhance the practice of pacing. Maybe some are beginning to realise this.
 
Lucibee said:
But that's not to say that the things they are based on are not useful - but to be truly useful, they need to be practised and understood over a very long time, and need to work with individual needs, and not against them (as GET tends to do).
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Are you sure you are not being too charitable @Lucibee? What horrifies me about psychotherapy is that to a first approximation we do not even know if it ever does more good than harm. My limited experience of sitting in on three therapists' sessions is that they either were useless or harmful. I have good evidence of harm in another case (the break up of a family based directly on ideas put in the patient's mind by the therapist).

For the martial arts expert at least we have an objective outcome - the opponent on the mat - and convincing evidence of causation. With psychotherapy it is often very unclear which of all sorts of outcomes is most important and rarely clear that any improvement was actually caused by the therapy. For the great majority of psychotherapists I suspect there is no solid evidence available to them throughout their careers as to whether they are doing things right or wrong or getting better at it. It could well be that trainee therapists make people happier than old hacks - I suspect nobody knows.

In short, nobody knows anything much.

The audit on the FINE trial brings this out. The 'supervisors' assume that they know how to do the therapy and that the nurses are making beginners mistakes. But nobody has shown this therapy works in any circumstances so how can the supervisors know?
 
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