INdiana Systemic Thinking

February 19, 2008

Mental Health: Meds, Therapy, or Both?

In a story by the UPI, the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services in Washington, said consumers spent 17 billion dollars on Anti-depressants and anti-psychotic drugs.  Accounting for just over 13 percent of the 127 billion U.S. consumers spent on prescription drugs in 2005.

However, in another UPI story today;

In a speech at the annual meeting of the American Association for the Advancement of Science in Boston, Jason Robert of Arizona State University said that while understanding biology is crucial to the understanding of psychosis, “there is more to psychosis than mere biology.”

Robert said claims that genetics and neuroscience will revolutionize medicine and elaborate predictions about new diagnostic tools and new treatments are not being borne out “because they fail to grapple with the complexity of human beings — as brains, bodies, and, embedded in culture, steeped in history, and dynamically creating their own worlds. If we’re really going to have personalized medicine, we have to be focusing not just on the genome, but the person.”

Rather that having a caricature of culture in mind, “what’s really critically important is understanding cultures dynamically, as complex, historic, social and political structures that dramatically influence people’s lives.”

Ignoring all except biology may mean never having the capacity “to actually influence the well-being of the patient,” he said.

Mental health professionals have long known of their patients propensity to want an easy way out of their difficulties by just taking a pill to address their mental health needs.  However, while medication is a wonderful way to feel better and treat the biology of a disorder, almost no one recommends pharmacology alone in the treatment of mental health difficulties.

When I was in school, the prevailing thought about how one develops some of these biologically based disorders was some people are more than likely born with the predisposition to develop these disorders, BUT it was an individual’s life experiences that brought these predispositions out.  Of course, I’m not including things like adjustment disorders (where the environment, social and otherwise, are to blame) or Developmental Disabilities (which are entirely biologically based).

Medication does not address any of the underlying experiences leading to a disorder.  Nor does it help develop new coping mechanisms for situations affecting the disorder.  Americans need to see psychotherapy as they do physical, occupational, speech, and/or other therapies that work in conjunction with medicine.   For example, if one breaks their leg, they would see a physician to set the leg, then begin working with a physical therapist to teach them how to use the newly set leg now and in the future.  They would probably also address what may have happened in the past to cause the fracture.  If Americans used this same rationale with psychiatrists and mental health therapists, we would probably see dramatic “cure” rates for those afflicted with mental health issues.

However, because of stigma, time constraints, or whatever else, we see more people taking medications to feel better about what is going on in their life, which never really seems to change.  Conversely, we also see people who spend years in therapy never getting better either, because, for one reason or another, they don’t want to see a psychiatrist.  However, the people who, in my experience, seem to get better faster and go on to live well adjusted lives are those who employ the services of both professionals.


January 30, 2008

Autism and Vaccines: Pediatricians Speak Out

Filed under: autism,Disorders,Uncategorized — kurtglmft @ 8:41 am
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This from the Evansville Courier Press:

The nation’s largest pediatricians’ group on Monday said ABC should cancel the first episode of a new series because it perpetuates the myth that vaccines can cause autism.

ABC’s new drama, “Eli Stone,” debuts Thursday. It features British actor Jonny Lee Miller as a prophetlike lawyer who in the opening episode argues in court that a flu vaccine made a child autistic. When it is revealed in court that an executive at the fictional vaccine maker didn’t allow his own child to get the shot, jurors side with the family, giving them a huge award.

“If parents watch this program and choose to deny their children immunizations, ABC will share in the responsibility for the suffering and deaths that occur as a result. The consequences of a decline in immunization rates could be devastating to the health of our nation’s children,” Jenkins said in a statement.

Autism is a complex disorder featuring repetitive behaviors and poor social interaction and communication skills. Scientists generally believe that genetics plays a role in causing the disorder; a theory that a mercury-based preservative once widely used in childhood vaccines is to blame has been repeatedly discounted in scientific studies.

Remember folks, this is a fictional series. Sometimes the whole “bad things happen to good people” way of thinking is too much to handle. We look for reasons and people to blame because the real explanation is too difficult to accept. However, please don’t forgo vaccinating your child, as it is a proven way to make sure they will never develop a myriad of diseases, because of some theory that has little, if any basis in fact or research.

December 28, 2007

Indiana Eugenics: Past, Present, Future?

Dr. Eric Schansberg, in a guest editorial in the Fort Wayne News Sentinel, gives a history of eugenics in Indiana, and implications for today and the future.  When one reads the article, you are struck by how distasteful this was.  When he applies this to today’s science and political culture, it is just plain scary.

 We observed a dubious centennial this year. In 1907, Indiana became the first state in America to pass a eugenics law.

Eugenics can be defined as the study of the hereditary improvement of the human race by controlled, selective breeding. Because of what we now know about genetics, eugenics turns out to be a pseudo-science loaded with philosophical and ethical baggage.

One of the nation’s most prominent eugenicists was David Starr Jordan, a past president of Indiana University. Given the intellectual coherence of eugenics with the ideas of that time, powerful proponents like Jordan and Sharp’s extensive lobbying, the Indiana Legislature passed its eugenics law on March 9, 1907. It promised to prevent the “procreation of confirmed criminals, idiots, imbeciles and rapists.” The law was repealed in 1921 but reinstated in 1928 — after the U.S. Supreme Court upheld the constitutionality of Virginia’s similar law in 1927 (Buck v. Bell).

Oliver Wendell Holmes wrote the decision and penned this now-stunning quote: “It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. … Three generations of imbeciles are enough.”

Eventually, 30 states adopted sterilization laws. In all, more than 60,000 people were involuntarily sterilized in the United States. Beyond the United States, forced sterilization was practiced in many developed countries during the 20th century. But the most staggering legacy of such legislation is that it served as a model for the law adopted by the Nazi government in 1933. How does eugenics play out today?

A biological cause for homosexual orientation would allow for additional normalization of homosexuality because it would be seen as more “natural.” But ironically, such a biological link combined with modern technology and a eugenic reflex could lead to efforts to eliminate the trait or change a baby’s sexual orientation through treatment.

Blogmeister Note:  One could also throw in Schizophrenia, BiPolar Disorder, some forms of Depression and a host of other mental disorders shown to have a biological basis.

More broadly, the implications of a eugenics reflex include a broad array of issues within sexual and reproductive ethics (e.g., birth control), ethics within scientific research (e.g., cloning, embryonic stem-cell research) and, most broadly, in speaking to a “culture” of death or life (e.g., various forms of euthanasia). In each case, the same tension is at work: When is modern technology a useful way to improve life in an ethical manner? And when is it overly influenced by a eugenics reflex — with its desire to manipulate life in a god-like manner, through an overarching faith in the power of science.

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