Sunday, November 23, 2014

NYT -- old rules -- not to follow

It is a bit of an embarrassment to the professions of anyone who does psychotherapy that the NYT would publish this piece.  Perhaps, this happens only in New York, where people still follow Woody Allen into psychoanalysis.

Dr. Weiss is struggling by adhering to techniques that are a hundred years old and largely discredited.  It is good to see that as a psychiatrist she still does psychotherapy, as almost all psychiatrists outside of major cities only prescribe medications.  But if she is going to do therapy she should learn that things have changed.  That the relationship between the patient and therapist is very important and that, although it needs to be structured, and it is not a friendship, there certainly needs to be warmth and acceptance.  Then, there are many other approaches that have proven to be more successful than long-term psychodynamic treatment.
What I also find interesting is the wide range of comments that have been posted.  The differences in understanding the causes of depression are certainly very striking. Depression is a very serious condition, and a very complex one.  It often, but not always has some genetic component.  It also involves family history, job history, a history of loss or trauma, brain damage, illness, pain, unemployment, poverty, racism, and addictions.  It is not a “disease” with one clear cause.
Therefore the treatments have to vary accordingly, and should hopefully involve many disciplines, including, psychologists, geneticists, neurologists, social workers, and other branches of medicine if they are relevant.  Such treatments are very rarely available in our world of specialists who just do their own job.  That is why Dr. Weiss’s patient is still in treatment, and still suffering, many years later.

Sunday, November 09, 2014

Eating Health: Can't or Won't

Brain science keeps rolling along -- much faster that psychotherapy science I'm afraid. I rad a study this week about some researchers in Montreal found that both children and adults seek out high calorie foods, even when they understand the concept of obesity.

We are programmed to eat to stay alive.  We are programmed to grab what we can before it runs away or before winter sets in.  Perhaps that's especially true in Canada.

But what the study also makes clear is that we are hardly aware of all the factors that go into our decisions.  Our brains are wired to help us act quickly and in our best interest. Or at least in the best interest of where are way-back ancestors lived 200,000 years ago.  That was before Domino's had a pizza delivery app.

Eat healthy my friends, (and drink wisely too).

Sunday, November 02, 2014

ADHD in Today's NYT

            The lead article in today’s Review section of the NY  Times is by Richard Friedman, who is a professor of clinical psychiatry at the Weill Cornell Medical College.

            For a short piece he gives a good over-all look at what ADHD is and isn’t.  What I was most impressed with is the wide range of factors he cites, as well as all the new machines that are used in these studies.
            The studies he cites use things that were not available twenty, ten and in some cases even two years ago.  These include PET scans and fMris to look at brains, but also macines to examine genetic differences.
            Dr(?) Friedman also puts ADHD in a social and cultural context.  He talks about how schools now demand greater concentration and conformity.  He also mentions that video games are so stimulating and can seem so exciting compared to sitting in a class, trying to listen. You shouldn't blame or stigmatize a kid for something he can't do.

            With all of this new machinery we can now see differences in brains and genes that we couldn’t even imagine ten years ago.  But a different brain is not necessarily a bad brain. Differences can show the world how to improve and differences are what help humans evolve and adapt.
            But still, it’s not fun to have your four year-old rip apart everything in his room and throw his toys out the window.  There are multiple causes for that kind of behavior, not just fewer dopamine receptors.