NYCOM Psychiatry Club

new template/format added. I did this because you couldn't tell in the old template where the links were. They looked just like regular words. Hope you like it. I'll restore comment functionality as soon as I iron out the bugs.

Extended Note: I think its interesting that 2 of our alternative medicine profs, both guest lecturers, one, Dr. Mehl-Madrona and Dr. Edward Shalts, were both psychiatrists, and then got additional training later, Dr. Mehl-Madrona in, uh, integrative medicine (actually Native American medicine), and Dr. Shalts in homeopathy. Also, Dr. Ballantine is a psychiatrist, too. The question arises, what, besides psychiatry, is the similarity between these three. Dr. Ballantine emphasizes change as the natural order of things, whereas modern medicine (osteopathy included) focuses on homeostasis. Psychiatry, before biopsychiatry (don't worry, I'll digest this site for you, later.), used to be psychodynamically oriented (not that I necessarily agree with that because it is an insight-oriented therapy, versus directive therapy, which focuses on changing some involuntary process or behavior, like CBT, Strategic therapy, or hypnosis and its derivatives (EMDR, NLP). These psychiatrists were broad minded, curious, and considered themselves to be treating the soul of the patient. So naturally they were attracted to Eastern-type medicine, which treats things along the same lines, i.e., they treat starting with consciousness. Biopsychiatry swept all that away.

My point is not that we should go back to the bad old days of psychiatry when the state simply warehoused patients. I think the current system of county-based mental health clinics, with halfway houses and all of that, is oodles better than the mental hospital system. My problem is that I don't want to be the type of psychiatrist I see in practice at these places, where their primary activity lies in doing 15 minute drug consults. If I have to get a whole nother bag of training, be it clinical psychology or TCM or whatever, then I will. I will not be a vending machine.

-Daniel

I've just had the inkling of an idea--a message from my unconscious. I was channeling my unconscious (read: drooling onto the keyboard listening to the Homeopathy lecture) and it suddenly struck me, like a bolt of lighting on a clear night, an epiphany, metanoia. A principle of Homeopathy, simila simibilis curantur,

"The theory held that the lesser symptoms brought on by the weak drugs replaced the stronger symptoms of the original disease and provided comfort for the patient"

sounds like a technique from strategic therapy called prescribing the symptom:

"One of the techniques used exquisitely by the hypnotherapist Milton Erikson was ‘prescribing the symptom’. So instead of preventing the patient doing or thinking X, the therapist may help the patient do or think X more effectively. For example, if a patient is anorexic or overweight, the therapist may demand that the anorexic lose even more weight, or the obese gain even more. How does this help? Often there are hidden feedback loops that maintain X, and restore X after any intervention designed to reduce X. This is as true of organizations as it is of individual personalities. Prescribing the symptom can have the paradoxical effect of destroying the feedback loop, thus allowing the individual or organization to escape a vicious circle or spiral. The technique also demonstrates that the subject has control over X."

This issue of control over seemingly involuntary processes is a central one in hypnosis:

"By hypnotic behavior we mean actions that an individual performs in response to suggestions made by a hypnotist. These actions are carried out without any sense of voluntary action on the part of the subject. The subject observes these actions as responses to suggestion that he or she did not initiate. The individual acts in a passive manner; there is no sense of initiating or inhibiting the action. The individual is aware of what is happening and has no desire to control the action. For example, if it is suggested that an individual's hand is becoming very light and will begin to float in the air like a gas filled balloon. To the disbelief of many subjects, this is what occurs."

Maybe this process is actually a physiologic one, where the patient subconciously notes that while they have an illness with a particular set of symptoms, and then when this particular set of symptoms is in fact replicated and enhanced by the pill, they realize that it is possible to change these symptoms and the body then restores homeostasis. A small change is all that is necessary because it has a snowball effect.

Man that looks awfully different in writing than it seemed in my head. I've got a head cold, so maybe its affecting my mental processes. Maybe I'm off my tree. In order to grok this, I will wait for fullness.

-Daniel Dexeus

I can't link to this because its behind a firewall, but I'll show the abstract, which explains the essential elements. During Dr. Chaudhry's final lecture on Laboratory medicine, called "renal profile," Dr. Chaudhry briefly mentioned that emotional stress can cause normovolemic hypnonatremia, as in the case of acute psychosis. I found a case report about acute psychosis and hyponatremia, here's the citation and abstract:

"Acute psychosis, polydipsia, and inappropriate secretion of antidiuretic hormone.
Source: Am J Med (The American journal of medicine.) 1983 Oct; 75(4): 712-4

Abstract: A relationship between acute psychosis, water ingestion, and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has been reported. This syndrome was observed in a psychotic patient who ingested massive amounts of water and became symptomatically hyponatremic with seizures. Although he had been taking haloperidol, the SIADH responded to fluid restriction alone. SIADH was clearly established, and a temporal relationship to his acute exacerbation of psychosis and polydipsia could be shown. This case illustrates that psychosis, polydipsia, and SIADH are often associated as a triad, and that psychiatric history must be considered in the evaluation of this syndrome."

There were some other titles, but they were mostly of the same theme: psychotic patient drinks too much water, and soon enough they don't have enough electrolytes to match the amount of water in their system. BTW, SIADH stands for Syndrome of Inappropriate Anti-Diuretic Hormone. I've heard this also happens with obese patients trying to lose weight by drinking eccessive fluids.

Also of note, this patient had been on haloperidol, a powerful anti-psychotic, yet he still had this problem. So was it the schitzophrenia? Did the medication not control the symptoms? Did it make him really thirsty (polydipsia= really thirsty link)? I'll get the article and let y'all know.

So why did Dr. Chaudhry's lecture refer to emotional stress as a cause? Wasn't the proximal cause polydipsia (drinking too much water)? If the polydipsia was a side effect of the drug, it would be a classic case of mistaking the side effects of the drug or the withdrawal of the drug for the disease; this type of mistake is rampant in psychiatry and represents a major practical and theoretical problem. More on this later. I'll email Dr. Chaudhry and ask him for a source on the emotional stress (acute psychosis)--SIADH connection. I'll see if "stress" makes you compulsively drink water.

--Daniel

Thanks to everyone who helped make the Psychiatry Club table a success, especially Jesse and Nga for reserving us a table. Thanks to Linda and the SGA for organizing such a smooth event.

Thanks to all who were interested in the Secretary E-Board position; we will announce our new Secretary next week.

Have a good weekend!

--Daniel

P.S. if you're looking for my email addy, here it is: gilgul1 [at] yahoo [dot] com

Okay so here's more about Peter Breggin. I will be sure to post a comment explaining the main points of each link. The antipsychiatry site encapsulates Breggin's (a practicing psychiatrist) ideas:

"Nothing has harmed the quality of individual life in modern society more than the misbegotten belief that human suffering is driven by biological and genetic causes and can be rectified by taking drugs or undergoing electroshock therapy. ... If I wanted to ruin someone's life, I would convince the person that that biological psychiatry is right - that relationships mean nothing, that choice is impossible, and that the mechanics of a broken brain reign over our emotions and conduct. If I wanted to impair an individual's capacity to create empathetic, loving relationships, I would prescribe psychiatric drugs, all of which blunt our highest psychological and spiritual functions." Peter R. Breggin, M.D., in the Foreward to Reality Therapy in Action by William Glasser, M.D. (Harper Collins, 2000), p. xi (underline added)." Notable Quotes

This is an excellent summary. I read "Toxic Psychiatry" by Breggin and its gripping. Like a novel, easy to read.
Amazon.com: Books: Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace the Drugs, Electroshock, and Biochemical Theories of the New Psychiatry

TTFN
-Daniel

I have added comment functionality. Hope it works.

For those of you second years who would like a second look at the eye movement paradigm introduced by Dr. Goldblatt at the Dr.-Patient relationship lecture--

www.nlpu.com/Articles/artic14.htm

For everyone else, it explains about eye-movements during conversations, and what they mean psychologically. Briefly, the way a person's eyes move indicate their thinking process (as opposed to content) at the time. Process versus content is very important in psychiatry. For instance, reading eye movements does not mean that you can read someone's mind, it simply tells you what type of information they are processing. For example, if someone looks up and left when you ask them "how's your wife doing?" then you know that they are remembering a scene visually. Why is this important? Because of a couple of things...1) you know they are really thinking about your question and not just answering "fine". 2) you know that the resulting output will draw on a visual memory (i.e. "she's happy about the new baby," then you know that he potentially remembered a picture of his wife being happy about the baby) and possibly 3) you can then use that information, like, whenever you get into an argument with your wife, remember that picture of how happy she was with the baby").

Also, check us out at the Club Carnival on Friday at the NYCOM park or whatever you want to call it. Hopefully we'll have a table.

--Daniel

UPDATE: Figgered out the hyperlinking problem. You have to type something in the field before the "/a" and after the "a href" part. Thanks to everyone who helped out!

Hey Every one! Check out our table at the Club Carnival, this Friday, Aug 22.

Also note, first link--> www.breggin.com

See you there!
-Daniel

this is a test post for NYCOM Psych Club