Saturday, October 25, 2003
Food for thought:
You can tell a good person because their anxiety manifests as "I haven't done enough". Case in point: Schindler's List.
Talk amongst yourselves.
--Daniel
UPDATE: case in point: I lost my wallet in Manhattan on Halloween, at the Greenwich Village parade. Two days later, a guy calls, saying he found my wallet, and would I like it if he mailed it to me? That's heart.
You can tell a good person because their anxiety manifests as "I haven't done enough". Case in point: Schindler's List.
Talk amongst yourselves.
--Daniel
UPDATE: case in point: I lost my wallet in Manhattan on Halloween, at the Greenwich Village parade. Two days later, a guy calls, saying he found my wallet, and would I like it if he mailed it to me? That's heart.
Friday, October 24, 2003
NYCOM Psychiatry Club
Don't forget to check the archives if you're a newcomer--good stuff in dere.
-Daniel
Don't forget to check the archives if you're a newcomer--good stuff in dere.
-Daniel
WHAT HAPPENS IN PSYCHOTHERAPY?:
"This is what I think Keats meant when he said that Shakespeare must have been able to tolerate negative capability, that is when a man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reason. ' How tolerant are you with not knowing what is going on in your patients?"
...
Here's some of the rest of the quote, by Keats:" This pursued through volumes would perhaps take us no further than this, that with a great poet the sense of Beauty overcomes every other consideration, or rather obliterates all consideration."
negative capability letter
I think this is an important principle, negative capability, both in therapy and in life. How do you handle silence, emptiness, without "irritable reaching after fact and reason".
Sometimes, when I have a difficult problem, I sit back, and ask myself a question. Often it goes like this: "What do I want?" Then I SIT STILL. I do not grab the pen and write. I do not spew social platitudes, I do not recite trite bullshit. I simply wait for the answer to come, then I commit myself to that.
This can help in transactions, too. When faced with FUD (fear, uncertainty, doubt), ask yourself, "well, what do I think?/how do I feel?" And then WAIT. Then commit yourself to the answer that the small, still voice provides. It's asking your unconscious a question.
If nothing else so far has grabbed you, try this on for size:
"Don't just do something, STAND THERE!"
--Daniel
UPDATE: The Wikipedia entry is illuminating:
"Keats believed that great people (especially poets, whom he considered to almost be on another level to the rest of humanity) had the ability to accept that not every thing can be resolved - being capable of remaining negative on something. Keats was a Romantic and believed that truth does not lie in science and philosophical reasoning, but in art. In art the aim is not to find a solution, as in science, but to explore the idea, so accepting that there might not be an answer is important to artists."
"This is what I think Keats meant when he said that Shakespeare must have been able to tolerate negative capability, that is when a man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reason. ' How tolerant are you with not knowing what is going on in your patients?"
...
Here's some of the rest of the quote, by Keats:" This pursued through volumes would perhaps take us no further than this, that with a great poet the sense of Beauty overcomes every other consideration, or rather obliterates all consideration."
negative capability letter
I think this is an important principle, negative capability, both in therapy and in life. How do you handle silence, emptiness, without "irritable reaching after fact and reason".
Sometimes, when I have a difficult problem, I sit back, and ask myself a question. Often it goes like this: "What do I want?" Then I SIT STILL. I do not grab the pen and write. I do not spew social platitudes, I do not recite trite bullshit. I simply wait for the answer to come, then I commit myself to that.
This can help in transactions, too. When faced with FUD (fear, uncertainty, doubt), ask yourself, "well, what do I think?/how do I feel?" And then WAIT. Then commit yourself to the answer that the small, still voice provides. It's asking your unconscious a question.
If nothing else so far has grabbed you, try this on for size:
"Don't just do something, STAND THERE!"
--Daniel
UPDATE: The Wikipedia entry is illuminating:
"Keats believed that great people (especially poets, whom he considered to almost be on another level to the rest of humanity) had the ability to accept that not every thing can be resolved - being capable of remaining negative on something. Keats was a Romantic and believed that truth does not lie in science and philosophical reasoning, but in art. In art the aim is not to find a solution, as in science, but to explore the idea, so accepting that there might not be an answer is important to artists."
Monday, October 06, 2003
Have You Ever Tried To Sell A Diamond? - 82.02
Many people disbelieve me when I tell them I do own a television, and in fact really dislike it. They say, "well, what else am I going to do when I want to come home and veg out?" And I think, well, what do I do? Well, I blog, send email, play around on the net. In short, the computer is the new TV and DSL is the new cable. I tell them that teevee rots your brains. I tell them that it takes more energy to sleep than it does to watch television. I don't tell them it brainwashes them, because, hey, that's insulting.
I don't watch television because I understand the power of advertising. Modern-day U.S.-style capitalism works by creating a market for your product. This started happening when all of the markets for things that people need were saturated. The degree that American culture is based on this, cannot be overstated.
For example, the above link takes you to a history of the diamond business. I was shocked-Shocked! to find out that diamonds had not been considered really valuable until the 50's! And that the custom of giving diamond engagement rings did not begin in earnest until then either, and then only in Amelika. And it was all engineered by De Beers, an international cartel of diamond mines and merchants, through an ad campaign that used a "series of lush four-color advertisements in magazines that were presumed to mold elite opinion, featuring reproductions of famous paintings by such artists as Picasso, Derain, Dali, and Dufy. The advertisements were intended to convey the idea that diamonds, like paintings, were unique works of art."
What has this got to do with psychiatry? Everything. For advertising and marketing has everything to do with how we treat mental illness, even to how we describe mental illness. From dinners and conferences for psychiatrists to samples and magazine advertisements for patients, advertising is creating the market for psychiatric medications as the preferred method of treatment.
I don't want to be a vending machine. I don't want to be a drug dealer. I don't want to pimp for the drug companies. For as we have seen, doctors control both the supply and the demand for psychiatric medications; all prescription medications, actually. Jewish ethics (Pirke Avot) emphasizes that judges should not take gifts, because it will blind them and prevent them from judging without bias. It is the same in medicine--we make important life-and-death decisions, so our judgement should be unclouded.
I'm talking about taking gifts from drug companies. Pens, pads, little plastic organs, trips, dinners, donuts, electronics, (I hesitate at research grants-debatable), all kinds of things--serve to distort your judgement. Maybe the patient does not need medication at all. Perhaps the patient would be better served with an old generic standby. But take the drug companies presents and poof, you have become an Agent of the Machine. Your decisions, your mind, is paroxysmally not your own. You give Prozac despite the suicides, despite the alternatives.
You recoil from touching your patients, you reduce your discussions with them to 10-minute medication adjustment appointments, you lose any interest in anything remotely resembling therapy, you disempower them by shouting "Brain disease! Brain disease!" instead of giving them the responsibility and the opportunity of an incipient change in their life, you prescribe the latest and most expensive drugs, you abstract any problem the patient brings to you as an "adverse drug reaction", you render to therapists and social workers as inferior to you because of your prescribing power, you stop wondering about the social setting of the problems, and you lose your belief in the power of free choice, and ultimately, you lose your faith in humanity.
So, children, don't get bought by the drug companies! Make your own decisions based on the need of the patient and what will make them better in the long run as well as the short run. I beg you.
Many people disbelieve me when I tell them I do own a television, and in fact really dislike it. They say, "well, what else am I going to do when I want to come home and veg out?" And I think, well, what do I do? Well, I blog, send email, play around on the net. In short, the computer is the new TV and DSL is the new cable. I tell them that teevee rots your brains. I tell them that it takes more energy to sleep than it does to watch television. I don't tell them it brainwashes them, because, hey, that's insulting.
I don't watch television because I understand the power of advertising. Modern-day U.S.-style capitalism works by creating a market for your product. This started happening when all of the markets for things that people need were saturated. The degree that American culture is based on this, cannot be overstated.
For example, the above link takes you to a history of the diamond business. I was shocked-Shocked! to find out that diamonds had not been considered really valuable until the 50's! And that the custom of giving diamond engagement rings did not begin in earnest until then either, and then only in Amelika. And it was all engineered by De Beers, an international cartel of diamond mines and merchants, through an ad campaign that used a "series of lush four-color advertisements in magazines that were presumed to mold elite opinion, featuring reproductions of famous paintings by such artists as Picasso, Derain, Dali, and Dufy. The advertisements were intended to convey the idea that diamonds, like paintings, were unique works of art."
What has this got to do with psychiatry? Everything. For advertising and marketing has everything to do with how we treat mental illness, even to how we describe mental illness. From dinners and conferences for psychiatrists to samples and magazine advertisements for patients, advertising is creating the market for psychiatric medications as the preferred method of treatment.
I don't want to be a vending machine. I don't want to be a drug dealer. I don't want to pimp for the drug companies. For as we have seen, doctors control both the supply and the demand for psychiatric medications; all prescription medications, actually. Jewish ethics (Pirke Avot) emphasizes that judges should not take gifts, because it will blind them and prevent them from judging without bias. It is the same in medicine--we make important life-and-death decisions, so our judgement should be unclouded.
I'm talking about taking gifts from drug companies. Pens, pads, little plastic organs, trips, dinners, donuts, electronics, (I hesitate at research grants-debatable), all kinds of things--serve to distort your judgement. Maybe the patient does not need medication at all. Perhaps the patient would be better served with an old generic standby. But take the drug companies presents and poof, you have become an Agent of the Machine. Your decisions, your mind, is paroxysmally not your own. You give Prozac despite the suicides, despite the alternatives.
You recoil from touching your patients, you reduce your discussions with them to 10-minute medication adjustment appointments, you lose any interest in anything remotely resembling therapy, you disempower them by shouting "Brain disease! Brain disease!" instead of giving them the responsibility and the opportunity of an incipient change in their life, you prescribe the latest and most expensive drugs, you abstract any problem the patient brings to you as an "adverse drug reaction", you render to therapists and social workers as inferior to you because of your prescribing power, you stop wondering about the social setting of the problems, and you lose your belief in the power of free choice, and ultimately, you lose your faith in humanity.
So, children, don't get bought by the drug companies! Make your own decisions based on the need of the patient and what will make them better in the long run as well as the short run. I beg you.
