Qi-Gong Psychotic Reaction: DSM-IV [Archive]

GLW

06-20-2006, 04:18 PM

you need to keep the DSM in perspective.

It serves several basic functions.

One is to give a similar diagnosis foundation for mental health professionals across different countries, cultures, etc...

However, if you are talking about its uses in the US....

The BIGGEST use and important aspect of the the DSM is its use in diagnosis for patients being seen in a professional setting where INSURANCE or 3rd party copay is involved.

Basically, the therapist/doctor will always choose a DSM disorder that (A) fits the patient's complaints the closest and (B) is one that the patients 3rd party payer as in Insurance, Medicare, Medicaid, or whatever - will cover and pay for.

You will NEVER see a patient in a psychiatric facility with a disorder from the DSM that is NOT one that the insurance company pays for.

Putting it into perspective :

Adolescent Adjustment Reaction - a VERY common diagnosis for just about any adolescent in any treatment facility.

Defined as :

"An adjustment disorder is defined as an emotional or behavioral reaction to an identifiable stressful event or change in a person's life that is considered maladaptive or somehow not an expected healthy response to the event or change. The reaction must occur within three months of the identified stressful event or change happening. The identifiable stressful event or change in the life of a child or adolescent may be a family move, parental divorce or separation, the loss of a pet, birth of a brother or sister, to name a few."

Now, if the adolescent in question has insurance or a family with money and insurance, they are diagnosed as having Adolescent Adjustment Reaction and spend time in a treatment facility.

If they don't have the insurance, have a family that is loathe to use psychiatrists, or don't have money, AAR all of a sudden becomes delinquent or some such behavior and the kid ends up in front of a judge and then in juvenile detention.

Amazing how money works :)

So, is there some politics in a Qi Gong Psychosis - yes. It CAN be families trying to get a person out of a cult...but it can also be families trying to get the strange one that got stranger some help.

Every instance is different. But....at the same time, keep in mind that if you have gotten drunk TWO times in the past year, according to the DSM, you may have an alcohol abuse problem. (the two times do NOT exclude New YEar's and Labor Day)

alquimista

06-20-2006, 07:30 PM

well ... i can see by your reply that you dont take DSM-IV very serious but ... did any of you read the "Qi-Gong Psychotic Reaction" chapter? Even if they exagerate i would like to know what are the symptoms ... i dont want to buy the book just to read that chapter ... so if anyone knows what are the symptoms in the book i will appreciate very much if you share the information.

thank you all for the reply,
enjoy,
Jorge

Scott R. Brown

06-20-2006, 09:51 PM

Hi alquimista,

I'm still looking for a better link, but try this one for now:

http://www.spiritualcompetency.com/dsm4/lesson3_5.html

alquimista

06-21-2006, 05:04 AM

Thank you Scott ... It´s a very interesting link with a lot of symptoms that can happen during meditation http://www.spiritualcompetency.com/dsm4/lesson3_5.html
It doesnt say much about the DSM IV-Qi-Gong Psychotic Reaction but i guess its should be very similar.
I conclude that those symptoms are all related to a "Yang Rising" TCM syndromes that happen because the meditation focus to much on the "heaven" and too little on the "earth" or because a person has a lack of Yin energy. I feel in my body some of this Yang Rising symptoms when i practice meditation for long periods. One day i realized that the symptoms decreased when i meditate and breath also with my legs and feet or when i meditate in grounding stance (tree stance) with my feet in the grass and with the palms of my hands turning down to get the Earth Yin energy.
Some of the symptons described on the link can be very serious mental psychotic disorders ... i think that can only happen if someone is not ready (balanced) to practice meditation like schizophrenics or other serious unbalanced persons who insist to meditate.
I think that a person with a balanced body/mind (Yin/Yang) and with a good Earth relation during the day activities should not feel any "Yang Rising" symptoms during the meditation practice (even when your kundalin awakes).

Thank you all for cooperating in this thread,
Jorge

Scott R. Brown

06-21-2006, 04:15 PM

Hi alquimista,

I am trying to locate the actual DSM entry. I thought I had a copy of it at work, but I can’t find it right now! I’ll keep looking.

I really don’t consider it having anything to do with Chi or Chi Kung. The vast majority of people suffer no ill effects from Chi Kung even when they practice it in what may be considered by some the “wrong” way.

All things may be abused and all things affect each individual a little differently. IMO the individuals who suffer psychotic symptoms had a lack of basic emotional maturity or psychotic tendencies in the first place. Chi Kung practice is nothing more than a stimulating event. If an individual is emotionally unstable to begin with or does not have the tools to correctly handle and interpret the resultant experiences they may experience negative effects, but it is not the fault of Chi Kung. Destabilizing events can be anything from substance abuse to acute or deep seated traumas. People with delusions of grandiosity generally have deep seated insecurities to begin with.

Some who drink alcohol become alcoholics; some who drive cars get in accidents. In America over the recent holiday we had a BASE jumper fall to her death when her parachute didn’t open. I can step outside tomorrow and get struck by lightening. Life is full of risk and nothing is ever guaranteed. Is it alcohols responsibility that someone becomes an alcoholic, is the parachutes responsibility the BASE jumper died, is it the cars responsibility someone crashed it? Individuals are responsible for their own actions, not the inanimate objects that were the means of their undoing.

GLW

06-21-2006, 04:16 PM

It is not that I don't take the DSM IV seriously... it is just that I was in the mental health field (back when it was the DSM III) and before I went into engineering.

The ONLY time a therapist or a psychiatrist pulled out the DSM was to get the approved code for a patient to make sure their insurance would pay for hospitalization or sessions. In the academic world, it was pulled out to classify a subject into the right bucket for statistical analysis.

It DOES have a good broad brush of what the various basic disorders are - classes and such.

If you are an MD (psychiatrist with prescription drug privileges), you can get an idea as to what drugs to give.

But, if you are a therapist, you still have to do the work to devlop a relationship and work through the issues.

Psychosis is one of those things that requires drugs and then therapy. Very often, the therapy ends up centered around how to live with the drugs.

Then, you have drugs to counteract the side effects of the anti-psychotic drugs - like Haldol as an anti-psychotic and Cognetin for the EPS (side effects). Problem is, the side effect drugs can often produce psychosis too.

Qi Gong Psychosis -- then TCM ideas....this can get really messy since you would be using a western diagnosis modality and then switching to a TCM treatment modality...and they rarely map easily.

alquimista

06-21-2006, 08:24 PM

Scott ... i will apreciate very much if you can find the DSM chapter about the ChiKung Psychotic Reaction ... thank you

cjurakpt ... thank you for the links ... i get a lot of information about Qigong Psychosis in the 2nd link

GLW ... i didnt know that psychiatrists in US use DSM only because of the insurances ... maybe they do the same in Europe ... interesting ... but i really want to know what DSM says about "Qi-Gong Psychotic Reaction" ... are you a TCM student or a TCM therapist ?

thank you all,
Jorge

mawali

06-22-2006, 10:18 AM

"Devil running fire" is the translation of the term associated with adverse experiences in qigong circles. It has many manifestations like moderate to severe anxiety, heart palpitations, self harm (manifesting as cutting off one's hands, arms, legs, etc) or psychoses, schizophrenia and delusional behaviour.

DSM-IV is a Western coding tool relating for reimbursement for insurance and doesn't say much on the matter. Only that it has a potential code.
Many of the 'devil running fire' group may have undiagnosed mental health issues (Mainland China does not believe in mental health per a Western framework) but with modernization, they will see a 100 fold increase due to rapid societal shakeup that will point to the less vulnerable.

GLW

06-22-2006, 01:20 PM

Mawali pretty much got it.

The entry in the DSM was probably made so those treating Chinese patients could put a diagnosis to something. It is doubtful that any insurance or third party copayer would accept that particular diagnosis (at least in the west...no telling what would happen in someplace like Singapore).

But what you do get from having it is a nice place for the mental health professionals in China to get hooked in to the whole DSM process - statistcs, tracking...and eventually coopting them into the western view of psychiatry.

while this may sound weird, in the PRC, anti-psychotic drugs are expensive and not readily available. They also tend to prescribe lower doses for similar patients than do their western counterparts.

The main mode of treatment is to use the drugs to get a level of normal functioning and then switch into the "Long Discussion" ---or some such phrase which basically means very deep one on one sessions with a therapist (or lay-therapist) - and this tends to be closer to reality therapy than strange things like...oh...Freudian analysis :)

But, western psychiatric treatment is more geared to the 45 minute hour, pills, and not spending the depth of time needed with each patient. In a western setting, if the patient hits on something that is a breakthrough at 44 minutes into the hour, the therapist is winding down and talking about picking up there next time (meaning that it takes that much longer).

In the Chinese version, they tend to keep going and actually accomplish something. Part of this is the culture and philosophy. The other part is that it is of no advantage in China for a therapist to drag treatment out for years or to have a relapse. They don't have the insurance/get rich on the patient approach.

When you see a psychiatrist come into a hospital where their patients are and hit one floor after another...starting at the top and working down...and then having the nursing staff round up their patients on each floor and herd them in one at a time...for 5 minutes max....and then realize that each patient was charged for a 45 minute hour PLUS the charge for hospital treatment from the shrink, you begin to see how the mental health field has a big racket going on.

And the really good therapists are the ones that get burned out and leave the field

I have studied some TCM and follow my Qi Gong teacher who is a TCM doctor and was a founding teacher of the Shanghai College Of TCM....before he retired. - to answer the question...

alquimista

06-22-2006, 03:55 PM

Mawali ... some translated also has "Mislead the fire and enter the devil", in PiYin is "Zou Huo Ru Mo". I know already a lot about Qigong deviations by Chinese and TCM point of view but im looking now for the western point of view. I dont want to discuss if DSM is good or bad ... i just want to know what does it say about "Qi-Gong Psychotic Reaction". You say "DSM-IV is a Western coding tool relating for reimbursement for insurance and doesn't say much on the matter" ... have you read it? What does it say about "Qi-Gong Psychotic Reaction" ?

GLW ... i think everybody got it ... i agree with everything you say ... the point is that anyone here knows for sure what DSM says about "Qi-Gong Psychotic Reaction" ... do you know?

The point in this thread is not to discuss about DSM or Qigong deviations, but about what DSM says about "Qi-Gong Psychotic Reaction". Maybe we can start another thread so we can share what we know about qigong deviations or discuss about DSM and learn more about it. For now i would like to know what DSM says exactly about "Qi-Gong Psychotic Reaction" and ... since you all know so much about DSM ... maybe you can help me to find out ...

thank you a lot for your effort and patiente in helping me with this question,
Jorge

Scott R. Brown

06-23-2006, 01:07 AM

Hi Jorge,

Apparently the DSM-IV really doesn’t say much about Qi Gong psychotic reaction. Here is the listing I have found it is only from citations of the DSM-IV. I cannot find the DSM-IV at work yet.

DSM-IV Appendix I:

This appendix lists cultural specific disorders and there quite a number of them. There is no diagnosis number that I have been able to determine and all the DSM really says is:

Qi Gong psychotic reaction:

A time-limited episode characterized by paranoid and other psychotic symptoms. Can occur after participating in the Chinese folk health-enhancing practice qi-gong.

This is basically what has been cited in many of the above links.

I have 4 years experience with acute psychotics in nursing, running the daily programs and participating in therapies and groups as well as Doctors interviews and I can confirm that everything that GLW and cjurakpt have said is accurate about the Western or at least American Psych system.

dwid

06-23-2006, 04:10 AM

Wow, sounds like people have seen some bad psychiatric care.

At the hospital where I work, there are treatment teams. Each patient is assigned a psychiatrist, a social worker, an occupational therapist, and a nurse. Of course, the nurses rotate through, according to the shifts they work, but we chart pretty thoroughly so the docs and residents and everyone else on the team can follow a relatively seamless description of day to day changes.

In my experience, it is not the psychiatrist's role to treat with therapy. Psychiatrists are there for medication management and to direct the overall treatment goals. To be honest, psychiatrists, being MD's are simply too expensive to rely on to conduct therapy. There is no reason why someone needs to be an MD to conduct therapy, and further, acute inpatient care isn't really the time to begin therapy anyways. The only reason for a patient to be in inpatient psychiatric care is that they are in some kind of crisis, so on some level they are a threat to themselves or someone else. Once they're stable enough to leave, then they are in a good position to benefit from therapy, and if someone wants therapy, regardless of their ability to pay for it, their social worker can probably find something that is available to them. The fact is, many if not most patients would rather just take a pill. In adult inpatients, there is an extremely high comorbidity of substance abuse and psychiatric illness, and many of these patients refuse to take responsibility for themselves, so they will not follow up with any treatment that, like therapy, requires a great deal of effort on their part.

As far as the DSM, it is mainly a reimbursement tool, and there's nothing wrong with that. Psychiatric illness is by its very nature more nebulous than physical ailments. The DSM allows for people in the position to make a clinical judgment about a patient's need for care to make that judgment. Any other way and you are likely to exclude from treatment people who really need help.

The mental health system in the U.S. is flawed for sure. Thank Ronald Reagan and de-institutionalization for one thing and the tendency of people (within the medical community as well as without) to not really respect psychiatric medicine as a valid branch of medicine. Still, the idea that it is some kind of racket is somewhat ludicrous to me. Most people involved in mental health are overworked and underpaid. Nurses are paid the same salary in our facility as in the regular hospital, which is as it should be, but psych nursing does not command the respect that other nursing positions do, and you can see how it slowly wears away at the people who do it. As far as psychiatrists, in the hospital setting you are seeing fewer and fewer residents who want to go on to be psychiatrists because the earning potential is not nearly what it is in other areas of medicine. Maybe it's different in other places or in private practice. Further, psychiatric units as parts of large hospitals often barely get by, or even operate at a loss. The types of patients that are in need of acute care often do not have insurance, so you're talking Medicaid (at best).

Scott R. Brown

06-23-2006, 04:21 AM

dwid

06-23-2006, 05:18 AM

Hi dwid,

I did not intend my comments to be taken in a negative respect. My clinical experience is very similar to the one one you have outlined, with the exception that mine took place in a Correctional setting. To be honest with you I have somewhat of a knack for Psych nursing so I did not find it stressing in the least. Most of my stress was caused by fixing the problems caused by inept or immature staff.

I didn't really take your comments negatively, I just wanted to add my perspective to the mix. I've actually given thought to going to work in the Correctional system myself once I finish school. The pay is very good for NPs, and I think you probably see a broader spectrum of diagnoses than you do almost anywhere else. In the private sector, most psychiatric professionals compartmentalize and just treat a particular level of acuity, type of patient, etc..., but in Corrections you have acutely ill people and also people suffering from a mental illness that is subacute and requires treatment.

I agree with you about about the Psychiatrist, it isn't their job to spend a great deal of time with the patients. That is left to the many others in the therpeutic team. I must also admit that many or maybe even most of the Psychiatrists I have worked with were as nutty as the patients, mostly neurosis though rather than psychosis, but some psychotic controled with meds, LOL!!

LOL, I think it helps to be a little nutty in this field. And it takes a particular type of person to be suited to the environment. As far as the shrink with more severe mental illness, I think that's what gets some people into psychiatric work in the first place, just trying to figure themselves out

alquimista

06-23-2006, 05:19 AM

Ok ... i found it ... this is what DSM-IV says:

“Qi-Gong Psychotic Reaction: DSM-IV General Information: Appendix I, Outline for Cultural Formulation and Glossary of Culture-Bound Syndromes:
qi-gong psychotic reaction A term describing an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms that may occur after participation in the Chinese folk health-enhancing practice of qi-gong ("exercise of vital energy"). Especially vulnerable are individuals who become overly involved in the practice. This diagnosis is included in the Chinese Classification of Mental Disorders, Second Edition (CCMD-2).”

There is a new edition of CCMD-2 (CCMD-3) and say this:

“42.1 Mental disorders due to Qigong [F43.8]
In the tradition of our country, Qigong is a way to keep healthy and cure the sickness. The method is usually to keep special posture or practice some exercises, and keep concentration on some points, pondering and reading silently, relaxation and regulating respiration.
Mental disorder due to Qigong refers to the phenomena that an exerciser is kept in a state of Qigong for so long as not to stop because of improper operation of Qigong (e.g., excessive exercise), the manifestations include symptoms of thought, emotion, and behavior, loss of ability of self-control.
A. Symptom criteria:
(1) Directly caused by Qigong exercise;
(2) The symptoms are closely related to the content of Qigong books and periodicals, and exercise of Qigong. The patients show abnormally mental symptoms repeatedly and continuously, without self-control;
(3) With at least 1 of the following:
psychotic symptoms, e.g. auditory hallucination, delusion;
hysteria-like syndrome;
neurosis-like syndrome.
B. Severity criteria:
Impairment of social function;
C. Course criteria:
The course is transient, patients may recover immediately by being out of spot, stopping exercise and proper treatment.
D. Exclusion:
(1) Excluding similar manifestations regarded as tricks to cure the sickness for oneself or others, or tricks to obtain money or attain other goals, excluding similar manifestations that can be involuntarily self-induced or self-ended;
(2) Excluding any kind of other disorders, especially hysteria or stress disorder due to psychological trauma.”

I got the answer for my question, the symptoms for Qi-Gong Psychotic Reaction by western psychology in DSM and CCMD are:
. Directly caused by Qigong exercise
. an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms
. symptoms of thought, emotion, and behavior, loss of ability of self-control
. abnormally mental symptoms repeatedly and continuously, without self-control
. psychotic symptoms, e.g. auditory hallucination, delusion
. hysteria-like syndrome
. neurosis-like syndrome
. Impairment of social function
. Excluding any kind of other disorders, especially hysteria or stress disorder due to psychological trauma

I think it will be better to start a new topic if you want to continue changing information about psychology so more people in the the forum will be able to share also they experiences

Thank you for helping me ... cjurakpt, GLW, mawali and Scott

Enjoy,
Jorge

GLW

06-23-2006, 07:59 AM

Thanks to Scott for posting that listing of the DSM description.

It was something I had read earlier and my take was "Typical DSM IV - falls into the category of that's nice, but so what"

The description doesn't tell you much and can be used to even describe a person who might describe seeing lights as brighter or haloed...or seeing auras after practicing Qi Gong. That does not mean that it WOULD be used that way.

However, I HAVE seen such vague diagnosis areas used to keep people committed under a psychiatric warrant based upon ulterior motives in the family (like the rich male patient who didn't get along with his wife, left and spent all of his time living on his docked sailboat, drinking beer and fishing....and she would have him committed about once a year to try to get a power of attorney over his assets. He MAY have had a drinking problem but he was sharp as a tack and was still making money....and the only person he ever had an issue with was his wife.)

Wouldn't it be just fine if such a diagnosis was also used by a husband to get his wife committed so then he could divorce her and keep custody of the kids? In such an instance, if the wife got upset and argumentative about being incarcerated, the nursing staff would log it as inappropriate behavior. If the wife were to take things in stride and then continue practicing Qi Gong, the doctors and nursing staff would probably mark that as "strange behavior" and still, it would be used to keep her hospitalized.

Not that far fetched.

For Qi Gong side effects, I would say it would be more valid to examine the things that are listed in TCM and totally ignore the DSM IV.

dwid

06-23-2006, 10:54 AM

The point is really moot from the perspective of practice here in the U.S. No psychiatrist would ever use that diagnosis for inpatient documentation. At least from my perspective, most psychiatrists rely on the DSM as little as possible. Someone with psychotic symptoms and no history of schizophrenia or other psychotic illness would simply by written up as Psychosis NOS and that would be their diagnosis until a more useful or valid diagnosis could be obtained.

As far as the other stuff re: commitment with ulterior motives. That's some wild stuff. I'm sure it happens, just like wives falsely accuse husbands of domestic violence to gain leverage, etc... A good staff would figure out the game pretty quick though. We don't just watch people and take copious notes on their behavior. We talk to the patients and try to understand what's going on from their perspective. In acute care, you can separate the people who belong on the unit from those who don't pretty easily in most cases just by spending some time with a person.

mawali

06-23-2006, 01:51 PM

Jorge,

The Western medical professional will probably see this as foolish (qigong psychotic reaction) and at best, that the individual is a nutcase. It will be a useless designation and the indiviudal will probably committed or undergo counselling!

alquimista

06-23-2006, 04:31 PM

i know that mawali ... i just wanted to know how western psychology classifies a Qigong Deviation ... just as simple as that ... i dont want to use it ... i dont care if its foolish or not ... i dont care if it´s useless ... but now i know what it means if someone come to me with a "Qigong Psychotic Reaction" from is psychiatrist ...

Enjoy,
Jorge

Scott R. Brown

06-23-2006, 05:43 PM

In America or at least California it is for the most part illegal to lock someone up in a hospital against their will. They must be documented to be a clear danger to themselves or others. It is not illegal to be nuts!!

GLW

06-24-2006, 01:02 PM

It is typical that the proof required for a mental health warrant for committment is "dangerous to themselves or others"

However, that is pretty broad and open to interpretation. I have seen the dangerous part applied - in rality the danger was to the bank book or stocks...or that the family member was going to be cut off due to the 'crazy' one...and I have also seen those that were truly dangerous or suicidal NOT be committed because of having a lawyer or just flat out no one would start the process.

It is a horribly flawed system.

But, the benefit of the doubt lies with the psychiatrist and such when the hearing comes off. The judge issues a committment warrant, the person is put in the hospital for observation, there is then a committment hearing and the person is either released or committed for a period of time (usually 90 days in Texas..and then a re-examination takes place at those intervals).

But once in the hospital - such things as anger, despondency over being in there, bewilderment over bieng there, feelings of betrayal for their family member that had them committed - are all taken as proof of needing to be there. While this may be true, In 5 years in the field...before I left it, I only saw TWO Patients come in on warrants and leave directly from their hearing. One was due to insurance and no bed space at the county ward - strange how he was deemed not so dangerous when they had no space in county and no way to pay for him otherwise. The other had a good lawyer and his wife had done this thing repeatedly. He was most pleasant and simply refused to talk with the staff about much of anything...on his lawyer's advice.

I saw several asian patients come in for depression...and NONE of them had therapists that knew jack about their culture or how important their family would be in treatment.

mawali

06-28-2006, 12:22 PM

One point of view

pincha aqui:
http://www.hkjpsych.com/Culture_bound.pdf#search='qigong%25pdf'

Judge Pen

06-28-2006, 02:41 PM

At least from my perspective, most psychiatrists rely on the DSM as little as possible. Someone with psychotic symptoms and no history of schizophrenia or other psychotic illness would simply by written up as Psychosis NOS and that would be their diagnosis until a more useful or valid diagnosis could be obtained.

I've been told, at least informally, that it's because of the difficulty to distinguish between actual illness and pre-established personality disorders. What's your perspective on that?

alquimista

06-29-2006, 12:56 PM

One point of view

pincha aqui:
http://www.hkjpsych.com/Culture_bound.pdf#search='qigong%25pdf'

thank you mawali ... its a good link

Enjoy,
Jorge

dwid

06-29-2006, 03:56 PM

I've been told, at least informally, that it's because of the difficulty to distinguish between actual illness and pre-established personality disorders. What's your perspective on that?

Well, in the strictest sense, "personality disorders" are an axis 2 diagnosis in the DSM, while disorders such as Depression and Schizophrenia fall on Axis 1. But if I understand your question correctly, you mean the difference between what a person has become through his or her environment, upbringing, choices, etc... vs. what he or she is predisposed to biologically. In the current mental health system, it is particularly difficult with adult patients to differentiate what nature gave them and what lifestyle has given (or exacerbated) due to the extremely high comorbidity of mental illness and substance abuse. It turns into a kind of chicken and egg thing, though for the purpose of acute inpatient treatment, it's a largely academic point. Treatment is the same regardless of causal factors. Ultimately, you want to refer them for further substance abuse treatment following discharge, and it will effect some of the supplemental meds you give (you don't want to throw a lot of ativan at a junkie). However, the diathesis stress model has been widely accepted for a long time, and it suggests that biology combines with life stresses to create active mental illness in many cases. Stresses can be a bad childhood, substance abuse, homelessness, any number of things.

Anyway, I think a big part of the reason why people tend to utilize the DSM in a limited fashion is because its greatest diagnostic clarity is in regards to the more commonly seen illnesses, such as Bipolar, Major Depression, Schizophrenia, and the Anxiety Disorders. A lot of the other stuff, the stuff you see greater changes in from one iteration of the DSM to the next, is maybe more to get you thinking of possibilities when you have a wtf kind of case. But this is largely conjecture on my part, just my thoughts based on my observation and experience.

mawali

06-30-2006, 09:54 AM

Another link
Abuse of government authority in political way to intimate opponents.
Psychiatric abuse:

haga click:
http://www.jaapl.org/cgi/reprint/30/1/126.pdf

Christopher M

07-03-2006, 05:23 PM

...acute inpatient care isn't really the time to begin therapy anyways. The only reason for a patient to be in inpatient psychiatric care is that they are in some kind of crisis, so on some level they are a threat to themselves or someone else. Once they're stable enough to leave, then they are in a good position to benefit from therapy, and if someone wants therapy, regardless of their ability to pay for it, their social worker can probably find something that is available to them. The fact is, many if not most patients would rather just take a pill...

On the other hand, medication compliance, particularly with psychotic populations, can be extremely low. And this idea that it is the patient's responsability to put forth the effort to attend and benefit from therapy is part of a particular culture of therapy rather than a necessary principle of therapy in general. It's possible to do extremely beneficial therapeutic work with inpatients, it just takes a different mindset than therapists are typically trained to have.

In my experience, it is not the psychiatrist's role to treat with therapy.

Right, but the problem is that it isn't clearly anyone's role any more. Which is probably why active therapeutic approaches, such as that mentioned above, are so rare. Even clinical psychologists are largely abandoning psychotherapeutic roles for strictly psychodiagnostic ones. Good therapists typically have training as therapists alongside whatever profession they have, but this is preventing the development of 'therapist' as a professional identity, along with the benefits that this would bring.

dwid

07-04-2006, 10:44 AM

On the other hand, medication compliance, particularly with psychotic populations, can be extremely low. And this idea that it is the patient's responsability to put forth the effort to attend and benefit from therapy is part of a particular culture of therapy rather than a necessary principle of therapy in general. It's possible to do extremely beneficial therapeutic work with inpatients, it just takes a different mindset than therapists are typically trained to have.

Well, part of it may be mindset. Part of it is that if you are only keeping a person in inpatient care until they are no longer a threat to themselves or others, then by definition, they are in a state in which they are not equipped to attend to or benefit much from therapy. This is not to say that they cannot benefit at all, just that if thereapy is to be conducted, it must have very specific, simple, and short-term goals. Further, it may be sad to accept, but the system for the most part is just not set up for this. The people in the best position to conduct therapy in an inpatient unit are the nurses, and they simply have too much to do to be able to work with each patient in this way. I know of one hospital in Columbus in which they actually do some inpatient therapy (conducted by the psych nurses), but that hospital is selective about what patients it takes. When all your patients are insured or can pay for their care, and are not mainly substance abusers with behavioral issues (but rather legitimately ill people), you can afford to reduce the patient to nurse ratio somewhat and can actully get some therapy done.

Regarding the whole patient's responsibility to engage therapy, I'm not saying we should write off patients that are unable or unwilling to actively participate in therapy, but in my opinion it is simply a fact that until someone accepts that they are ill and takes an active interest in getting better, no therapy is going to be an effective long-term solution. Therapy=work. The therapist can try to help a person to understand why the work is worthwhile, medication can help clear a person's thoughts so they can start to make decisions that are in their best interests, but ultimately, I can't think of a therapy that works with patients who are not actively participating. If there is such a therapy, please refer me to some resources/research.

Right, but the problem is that it isn't clearly anyone's role any more. Which is probably why active therapeutic approaches, such as that mentioned above, are so rare. Even clinical psychologists are largely abandoning psychotherapeutic roles for strictly psychodiagnostic ones. Good therapists typically have training as therapists alongside whatever profession they have, but this is preventing the development of 'therapist' as a professional identity, along with the benefits that this would bring.

As someone who is training to ultimately prescribe and conduct therapy, this comment strikes close to home. The whole chaotic nature of the professional environment for people like myself (who see the value of therapy and want it to be a large part of what they do) makes me very nervous about my future. There are big problems with the system right now in terms of poor continuity of care within mental health and the absence of mechanisms to help people stay on track when they have the will but sometimes lack the cognitive or financial resources to do so.

Christopher M

07-04-2006, 02:47 PM

Part of it is that if you are only keeping a person in inpatient care until they are no longer a threat to themselves or others, then by definition, they are in a state in which they are not equipped to attend to or benefit much from therapy. This is not to say that they cannot benefit at all, just that if thereapy is to be conducted, it must have very specific, simple, and short-term goals.

I'm not sure this is necessarily true. Certainly therapy in this venue will have elements of 'crisis management' but unless crisis management is understood as antithetical to the goals or methods of long-term therapy, there's no reason why one couldn't be working on both at once. Although inpatient stays are so short these days that perhaps we should be talking about 'post-psychiatric' patients rather than inpatients.

Further, it may be sad to accept, but the system for the most part is just not set up for this.

This is definitely true, but again I think it's part of the problem of there being no professional identity and not really much support for therapy.

Regarding the whole patient's responsibility to engage therapy, I'm not saying we should write off patients that are unable or unwilling to actively participate in therapy, but in my opinion it is simply a fact that until someone accepts that they are ill and takes an active interest in getting better, no therapy is going to be an effective long-term solution.

I would suggest that "accepting you are ill and taking an active interest in getting better" is part of the progress of therapy rather than a pre-requisite. To the extent that it's treated as a pre-requisite, severe mental illness is in principle excluded from therapy, and the therapeutic goals in cases of less severe mental illness become restricted to initial complaints (which are what gets defined as the illness and as what the patient has an interest in affecting, but which, from a long-term therapeutic perspective, are not infrequently defenses in themselves that need to be addressed).

dwid

07-04-2006, 08:09 PM

I'm not sure this is necessarily true. Certainly therapy in this venue will have elements of 'crisis management' but unless crisis management is understood as antithetical to the goals or methods of long-term therapy, there's no reason why one couldn't be working on both at once. Although inpatient stays are so short these days that perhaps we should be talking about 'post-psychiatric' patients rather than inpatients.

I understand where you're coming from here, and, like I said, I can see there being a point to very short-term goal-oriented stuff, but the lack of continuity of care (a systemic problem) ultimately precludes getting very much done. I agree that there's no reason to not "work on both at once," but without a mechanism for a smooth transition/continuity from the acute setting to the outpatient one, a lot of whatever progress can be made in therapy stands to be lost in this transition.

I would suggest that "accepting you are ill and taking an active interest in getting better" is part of the progress of therapy rather than a pre-requisite. To the extent that it's treated as a pre-requisite, severe mental illness is in principle excluded from therapy, and the therapeutic goals in cases of less severe mental illness become restricted to initial complaints (which are what gets defined as the illness and as what the patient has an interest in affecting, but which, from a long-term therapeutic perspective, are not infrequently defenses in themselves that need to be addressed).

Well, severely acute patients suffering from a psychotic episode or a manic episode, in my opinion, cannot benefit much from therapy until they transition out of the acute phase of their illness. Further, therapy alone is highly unlikely to help someone suffering from a severe illness such as schizophrenia. Without medication, all the therapy in the world is not going to do a whole lot. Therapy in such a case is a great supplement to meds, but is no substitute. Further, while the goals in less severe illness may initially be restricted to "initial complaints," an individual who is sincere in seeking help will likely be receptive to the initial complaint representing a symptom rather than the illness itself. Most modern therapies aren't really built around the idea of digging all that deep from an initial complaint anyway, and some of the more modern therapies, such as cognitive and cognitive-behavioral therapies, have pretty stong support in the research for their efficacy.

Christopher M

07-04-2006, 08:44 PM

...but without a mechanism for a smooth transition/continuity from the acute setting to the outpatient one, a lot of whatever progress can be made in therapy stands to be lost in this transition.

Right, which is another reason why I think we need a clearly identified professional role of 'therapist' so there is someone to provide this continuity.

Well, severely acute patients suffering from a psychotic episode or a manic episode, in my opinion, cannot benefit much from therapy until they transition out of the acute phase of their illness. Further, therapy alone is highly unlikely to help someone suffering from a severe illness such as schizophrenia. Without medication, all the therapy in the world is not going to do a whole lot. Therapy in such a case is a great supplement to meds, but is no substitute.

Well, I'm not suggesting an either-or situation, but in my experience valuable work can be done both with and without medication, and also in acute stages; although, again, methods and experience specific to this situation are needed. From one point of view, as I mentioned above, medication compliance can be an issue in the therapy, and so therapeutic work with nonmedicated patients can be part of an overall progress towards the patient's involvement and interest in their treatment (including, here, psychopharmachological treatment). Again, this important contribution is foreclosed if medication is considered a prerequisite for psychotherapy.

dwid

07-05-2006, 07:19 AM

Well, I'm not suggesting an either-or situation, but in my experience valuable work can be done both with and without medication, and also in acute stages; although, again, methods and experience specific to this situation are needed. From one point of view, as I mentioned above, medication compliance can be an issue in the therapy, and so therapeutic work with nonmedicated patients can be part of an overall progress towards the patient's involvement and interest in their treatment (including, here, psychopharmachological treatment). Again, this important contribution is foreclosed if medication is considered a prerequisite for psychotherapy.

I can agree with you there. I think we're pretty much in agreement, I just had maybe a more rigorous definition in mind of what constituted therapy.

Researcher

07-13-2006, 03:51 PM

What is Qi Gong Psychosis?

It is a time limited psychotic mental break. The classic case often quoted from China involved a house painter, self-taught in Qi Gong, that began to believe he could speak to beings from another dimension. It is included in the DSM as a Culture Bound Syndrome.

Most sites agree that the event happens when too many Qi Gong sessions are performed in a compact time frame. But they believe the mental break is caused by miss-handling universal life energy, Chee. Some claim performing the Kata incorrectly is the cause. One site blames demons.

The actual cause is much simpler but it reveals how Qi Gong actually works and contradicts the beliefs of those who practice Qi Gong. (Sometimes there is a price for advancing knowledge.)

In the 1960’s designers building new close-spaced office workstations encountered a problem when knowledge workers using them began to have mental breaks. The problem was investigated and psychologists determined that Subliminal Sight and Peripheral Vision Reflexes had acted in the “special circumstances” those workstations created to cause the mental events. The Cubicle solved the problem by 1968.

It is difficult to see at first but performing Qi Gong in-groups also creates those “special circumstances.” Concentration in the form of eyes-open meditation substitutes for the mental investment to perform knowledge work. The movement of others close beside you provides detectable movement in peripheral vision to trigger repeating attempts to cause a peripheral vision reflex.

One way to look at the problem is that the constant subliminal appreciation of threat, movement in your Subliminal Peripheral Vision, eventually colors thought and reason creating paranoia, fear, and the psychiatric outcomes. (Google the "Awakening of Kundalini.")

Your brain does not identify the nature of the moving object it just reacts to the movement. It is a warn first identify second system. The reaction is a startle and sudden gut wrenching apprehension which forces you to look and identify the detected movement. You will learn to ignore safe movement but that does not turn the system off. That means you can also be exposed to visual Subliminal Distraction in many places. The additional exposure during Qi Gong performances would push you past the threshold of exposure and cause the mental break.

Low level long-term exposure for some users of Qi Gong and Kundalini Yoga creates fixed altered mental states in which the user begins to believe they have superhuman strength and supernatural powers. One such belief is that a Qi Gong master can cast Chee from his fingertips to strike an opponent. For Kundalini Yoga users these beliefs include the ability to levitate, walk unharmed through solid objects, dematerialize - become invisible, and read other’s minds and control their actions by mental telepathy. These beliefs are usually called “psychotic-like.”

This means that the actual reason you have health and mental state improvements by performing Qi Gong is operant conditioning.

VisionAndPsychosis.Net is a private psychology project, which includes Qi Gong deviation as evidence that visual Subliminal Distraction is an unknown and unevaluated cause of mental illness.

One of the first mistakes investigators make is to believe that the disorders of the DSM actually exist. They are observed then grouped and named behaviors. The names are given based on the length of the acute phase and the content of the behavior. Authors of the DSM openly admit they do not know what causes any of the disorders. Trauma is the latest theory. Most of the theories involve a belief in the fragility of the human psyche.

http://visionandpsychosis.net/QiGong_Psychotic_Reaction_Diversion.htm Start by performing the psychology demonstration and scanning the Everquest Connection page.

Illustrations will be added to facilitate communication later this summer.

One of the first symptoms is "hearing voices." This is shown through investigation of other Culture Bound Syndromes.

If you suspect you are beginning to have the epidode stop performing Qi Gong and search your daily activities for other places of exposure. It is not necessary to eliminate them all. We each have exposure daily. Most of it is harmless.

GeneChing

06-16-2009, 03:15 PM

...well, not really. I just wanted to post this somewhere.

Global Update
Mental Illness: Far More Chinese Have Mental Disorders Than Previously Reported, Study Finds (http://www.nytimes.com/2009/06/16/health/16glob.html?_r=2&nl=health&emc=a4)
The New York Times
By DONALD G. McNEIL Jr.
Published: June 15, 2009

The burden of mental illness in China has been seriously underestimated, the authors of a new study say. More than 17 percent of Chinese adults have a mental disorder, the study concluded — far more than the 1 to 9 percent reported in studies done between 1982 and 2004.

To do the study, published in the journal Lancet last week, researchers at Columbia University and major psychiatric hospitals in Beijing, Shandong, Zhejiang, Qinghai and Gansu screened 63,000 adults with questionnaires, and psychiatrists interviewed more than 16,000 of them, often in local dialects. The research was financed by the World Health Organization, the Shandong provincial health department and the China Medical Board of New York, an independent medical foundation begun in 1914 by the Rockefeller Foundation, which supports medical education and research across Asia.

The most disturbing aspect of their research, the authors said, was that, among those who had a diagnosable mental illness, 24 percent said they were moderately or severely disabled by it. But only 8 percent had ever sought professional help, and only 5 percent had ever seen a mental health professional.

People from rural areas were more likely to be depressed and have alcohol problems than urbanites, the study found. Mood and anxiety disorders were more common in people over 40 and among women, while alcohol abuse was much more common among men.

Although the authors did not reflect at length on the role of China’s economic rise, which has led to mass migrations of poor people to the cities, they acknowledged that they were measuring some effects.

uki

06-16-2009, 06:39 PM

The research was financed by the World Health Organization, the Shandong provincial health department and the China Medical Board of New York, an independent medical foundation begun in 1914 by the Rockefeller Foundation, which supports medical education and research across Asia.this is the meat of the article...

i believe the practice of qigong and other forms of energy-work activate encoded sequences of DNA - thus we get the concept of being filled with light(energy) aka en-light-enment. the more our dormant DNA sequences are turned on and fired up, the more our mental, spiritual, and physical bodies transmute and evolve... naturally to those outside this line of thinking will view the manifestations of this inner wisdom and sense of peace as being a mental disorder of sorts that impairs our ability to function in the world marketted to us to live in. finding your center and bringing harmony to the mind, body, and spirit, is NOT what the controllers of the world want you to do... any attempts to shed light on this understanding will invite the judgement of the witch hunters. :)

Sifu

06-18-2009, 09:22 PM

Seriously, are any of the practitioners here free from experiencing phenomenon that might be hard to explain to a psychologist? If we start calling everyone who feels the chi spin, accumulate or flow, crazy, then silk winding is a dangerous tool to make people psychotic. Heaven forbid anyone start to actually see any of this energy flowing.

It is pretty easy to find people on youtube that are pretty far gone in their practice, but, in general, I believe that the perceptions that qigong tends to give are a more natural state of being. That said, I do think great care should be taken. Finding a constructive teacher with high ideals is a good idea.
.

Bob

Researcher

06-19-2009, 12:11 PM

The information you posted on mental illness in China is interesting. It contradicts information that has been replicated for about a hundred years around the world.

There is more mental illness in cities than in rural areas every where else.

Why is this reversed for China?

I doubt it has anything to do with Qi Gong or Kung Fu.

Low income rural areas in China may still use too-small single-room living arrangements. It would be interesting to investigate this.

That situation would allow Subliminal Distraction exposure.

Around the world where these living arrangements are used there are mental events called Culture Bound Syndromes. Qi Gong Psychotic Reaction is a CBS. Jumping Frenchmen of Maine was a CBS of the northern United States and Canada. I happened when groups of men lived in single room bunkhouses in lumber camps. It disappeared when modern logging equipment replaced those camps.

If you want to see an example of this go to YouTube and search George Dilman. He was featured in the National Geographic Channel program Is It Real? "Superhuman Powers."

Dilman believes he can throw Chee energy from his hands to strike opponents.

He has those beliefs from years of instructing one student while others move around him in his peripheral vision. That's Subliminal Distraction exposure.

I have a link to his YouTube video on my First Psychotic Episodes page but it is under a rewrite and I may move the link to another page.

This is not considered psychotic because he functions normally in his every day life. It is usually referred to as psychotic-like.

The danger is that if you have enough exposure to create one of these mental breaks you will have a fatal accident by acting out the delusions of the episode.

The Virginia Tech shooter created the circumstances for SD exposure, had the psychotic episode, and killed 32 people. Remember his paranoid psychotic rant? That was Subliminal Distraction exposure.

The symptoms of the episode can be shown to be fear, paranoia, panic attacks, depression, and thoughts of suicide.
visionandpsychosis.Net

mawali

06-20-2009, 06:27 AM

Gene,

I do agree that the mainland has undercounted the millions who have psychological problems and it is made worse by the refusal to diagnose or even consider it a problem. Modernity will even create worse problem because China does not recognize psychiatry as a 'real' field in that the population looks to demons, spirits and such as the cause and no real solution will be found.

The present solution is to blame qigong for such ills and this is made worse by political ideology compounded by socioeconomic distress.

Researcher

06-20-2009, 12:12 PM

In primitive societies those with psychiatric symptoms such as hearing voices are revered as having supernatural powers.

Qi Gong has been noted for causing psychiatric symptoms for about 3000 years. A supernatural force, chee, is believed to be the source of these behaviors.

Although explained in first semester psychology very few people are aware of Subliminal Distraction. No one else has noted that performing Qi Gong in group exercises creates the circumstances for SD exposure.

Just because there is a belief in mainland treatments for mental illness does not mean that that modern treatment is either helpful or effective.

There is no "testable credible objective evidence" that these modern western treatments do anything.

Experts admit they don't know what causes any psychiatric symptom. Worse yet there is no test for effectiveness for drugs used. Patients get better while taking them and that is used to claim effectiveness.

The mentally ill improve on placebos then relapse when told their drug was a placebo. Suggestion was enough for recovery in those test groups.

It has been known for about 500 years that those with mental illness have spontaneous recovery. They get better with no treatment. Without viable testing for drugs it is not possible to state that the improvements while taking drugs is not just spontaneous recovery coincidental with treatment.

(If you read the prescribing instructions for these drugs, quoted on my site, you learn there is no knowledge of how or if they work. They only have to beat random chance or placebo to be sold as safe and effective. Some sources quote rates as low as 20/30% for drug effectiveness. )

There have been studies and articles showing that placebo often beats drugs in testing. You would never know that without an FOIA filing with the FDA. Drug companies dismiss the failed testing.

Learning about Subliminal Distraction and avoiding it will prevent psychiatric symptoms. There is no cost, nothing you must do, no special diet, or treatment.

Just learn about it and avoid situations that would cause exposure.

uki

06-21-2009, 03:47 PM

Seriously, are any of the practitioners here free from experiencing phenomenon that might be hard to explain to a psychologist?it is definitely difficult to tell a psychologist that one understands the nature of the way... they tend to think you are crazy - then again, that is not my problem. :D

Scott R. Brown

06-22-2009, 07:58 AM

I spoke to a Psychologist once who could not believe I understood so much about the human mind without a formal Psychology degree.

I couldn't believe that it isn't common knowledge and that everyone doesn't understand that same stuff!

"Know yourself, and you know the world!"

taai gihk yahn

06-22-2009, 09:20 AM

I spoke to a Psychologist once who could not believe I understood so much about the human mind without a formal Psychology degree.
talking to a life-size poster of Freud hardly counts...

I couldn't believe that it isn't common knowledge and that everyone doesn't understand that same stuff!
all information is a lie; the truth lies with Xenu!

"Know yourself, and you know the world!"
I must be a really messed up person then...

uki

06-22-2009, 12:49 PM

I spoke to a Psychologist once who could not believe I understood so much about the human mind without a formal Psychology degree. i am enjoying my custody counselling(psychotherapy) for this reason... he pretty much just stares at me with his jaw dropped to the floor every time i speak on the issues surrounding my daughter and my ex.

I couldn't believe that it isn't common knowledge and that everyone doesn't understand that same stuff!that would put psychologists out of work... can't have that - paper brain's or bust is the way of the world. :D

"Know yourself, and you know the world!"forget your self and you'll forget the world.

I must be a really messed up person then...if you weren't messed up, life would be rather boring.

andyhaas

06-23-2009, 10:58 AM

Basically, the therapist/doctor will always choose a DSM disorder that (A) fits the patient's complaints the closest and (B) is one that the patients 3rd party payer as in Insurance, Medicare, Medicaid, or whatever - will cover and pay for.

You will NEVER see a patient in a psychiatric facility with a disorder from the DSM that is NOT one that the insurance company pays for.

Uhhh ... you forgot the doctor function. (A) makes the doctor the most money and (B) gets the doctor the most $$$ from Insurance, Medicare, Medicaid, etc.

GLW

06-24-2009, 08:04 AM

Nope. Didn't forget it . It is just a GIVEN.

Back in the day when I worked in Psych hospitals and then as a counselor, I actually ran into only two honorable psychiatrists.

One would only admit a patient to the hospital when they were truly dangerous to themselves or other people. Her patients came in and were always in the locked ward for being dangerous or were on suicide watch. She used drugs in those cases liberally...so she could get them stable enough to go home and then did all of her real therapy in one on one sessions and group therapy...and she did her own groups.

We saw about 2 or 3 patients for her in a year and none were ever hospitalized for more than 2 weeks...and the amount of drugs she used decreased to a level that kept them safe but also left them lucid.

The other worked mainly with adolescents. He used the hospital to mainly keep the kid from becoming a run away statistic and living on the street. He rarely had a patient who was in locked ward - unless it was a kid who got into a fight and the hospital rules required the transfer.

Two out of 30+ - not a good percentage.

Researcher

06-24-2009, 10:09 AM

GLW,

The therapy you write about is the best treatment for mental illness. Your doctor had found it possibly accidentally.

Once the acute phase is complete just changing the patients daily activities will cause a remission.

Another good therapy is exercise like running. That takes the subject away from potential Subliminal Distraction exposure.

GLW

06-24-2009, 11:04 AM

To clarify...not MY doctor...one of the ones who had admitting privileges to the Psych hospital I worked for.

I am not sure how both of them came up with their therapeutic approaches...but they were the only two I really respected...and the only ones who had a decent rate of actually HELPING the patient.

The others...well, one had a majority of patients that had X number of days where the insurance would pay for treatment. Then Y number of days the patient had to be out of the hospital before they could be re-admitted. Funny how their progress to discharge followed that calendar. If they had 60 days of treatment and then 60 days out, they could be totally divorced from reality with acute paranoid schizophrenia at 48 days....and be absolutely well enough to go home at 58 days...and back in at 61 days after that.

I actually had to assist on a number of Electro-Convulsive Therapies (ECT of shock treatment) - and the typical ECT patient was a paranoid schizophrenic. Now, at the time ECT was ONLY indicated for extreme cases of depression where suicide was highly likely...sort of a method to buy time for drugs and therapy to work...but I NEVER saw it used that way. Shocking a schizophrenic was the standard....and KNOWN to not really work anyway.

The mental health providers - psychiatrists and psychiatric nurses - were often part of the problem. I personally got out of it when we had a patient commit suicide by hanging himself with a necktie from his shower curtain rod...he was known to be a suicide risk...and should never have been in a room with a shower curtain rod and definitely no necktie.

The staff on that ward liked to sit behind the desk instead of mingling with the patients and keeping up on what was going on in the day areas, their rooms, etc...

Patient died on a Tuesday. I had Wed and Thur. off. Came back on Friday and the same staff were on duty...doing EXACTLY the same things - staying behind the desk...doing rounds once an hour on the hour....and I went down and resigned effective the end of my shift that day.

Researcher

06-24-2009, 09:44 PM

GLW,

The wording "your doctor" should have been 'that doctor' or 'the doctor.' My mis-wording. I did understand that you worked with the doctor.

You are exactly correct in your observations. Going back to my original post, "There is no 'testable objective evidence' that any current treatment for mental illness does anything."

That includes ECT! Shocking the patient does cause a temporary remission but when the brain repairs that damage the symptoms return.

My mother had ECT when I was about eight years old. She lived a normal life span but never recovered her memory. She had severe problems from that ECT treatment most of her life.

I did not learn about what should be done until I began to investigate Subliminal Distraction after my wife had a psychotic break in the pay roll office of the University of Alabama. It happened thirty days after her office was changed eliminating Cubicle Level Protection.

I thought everyone knew why the cubicle was created. I was stunned to learn this phenomenon, discovered and solved forty years ago, is unknown in any area of mental health services.

GLW

06-25-2009, 07:36 AM

It is amazing to me how such things can affect our lives.

In my case, my father had a "nervous breakdown" - as they called it in the 60's when I was in 4th or 5th grade. He went from a private hospital to a VA hospital to private one and so on. They tried barbaric medications. The psychiatrist then asked to see everyone in the family group and individual to 'help' deal with things.

At one point, he prescribed ECT for my father. There were 6 or 7 treatments over a period of around 2 months. After each one, my father's personality was different. He was still him...but different aspects of his personality came out as being the predominant one. Now, mind you, his original diagnosis was borderline schizophrenia and adult adjustment reaction (some elements of depression were probably also thrown in). At no time was he ever suicidal..but he DID have a temper and could lose control over his anger and impulses.

The doctor went a couple of treatments too far with virtually no counseling therapy. And I saw my father's personality dimmed with those last two treatments.

He was then put into the state hospital. It was then that I left to go to the National Asthma Center residence school - asthma can be a real life threatening thing. While in Denver, the FINALLY had a neurological consultation on my father. A simple Babinski reflex test told the tale. That is the test where they run the stick or something on the bottom of your bare foot. In an normal infant and adult with neurological problems, the toes fan out one way. In a normal adult, they go the opposite way.

This is a typical test that any GP should do...and any competent psychiatrist should have verified had been done.

My father's was abnormal. Further tests led them to surmise Alzheimer's - presenile dementia - rare to have an onset in the late 30's early 40's..but not unheard of.

The ECT probably shortened his functional time by years. He deteriorated and ended up in a nursing home. The time from first symptom to death was 18 years....totally atypical. The autopsy showed it was NOT Alzheimer's but rather MS. Whereas MS USUALLY attacks the muscles and associated nerves, in this case, the deterioration was the myelin of the nerves in the central nervous system and cerebral cortex.

The original psychiatrist did not even do the basic "let's rule out physical causes first" type of tests...and then went on to violate the first rule of his Hippocratic oath - "First, do no harm"

I originally went into the psych field to see if I could make a difference due to my experience with growing up. However, after working with the loons who were the caregivers, I left the field, went back and got an engineering degree...and developed a major distaste for psychiatrists.

Scott R. Brown

06-25-2009, 12:12 PM

Patient died on a Tuesday. I had Wed and Thur. off. Came back on Friday and the same staff were on duty...doing EXACTLY the same things - staying behind the desk...doing rounds once an hour on the hour....and I went down and resigned effective the end of my shift that day.

I understand your feelings on the matter.

I worked for 4 years under similar, but different circumstances. It was within a prison environment. I have observed the same staff behaviors. There are few Psychiatrists I respect, but a few more Psychologists.

I tried not to worry about what others did and focused more on developing a beneficial relationship with my patients. You can't save everyone, but you can make a difference with some and that made it worthwhile for me.

andyhaas

06-30-2009, 02:50 PM

I recently had a psychologist friend who is trying to earn her masters try to assess me as mentally disabled (I have a habit of when I think of a kata sometimes trying out the movements with my hands a little bit -- I don't do it at work but sometimes I do it when I'm watching a fight sequence on T.V. or lounging around when I'm bored). I tried to explain to her what I was doing, but she got weird, and wouldn't listen.

I tried to explain to her that the psychologist that I was seeing for stress reduction (helping me be less stressed out) seemed to think that I was okay.

So I asked a psychologist what the requirements were for actually being disabled this way -- if I could get social security or something -- I asked kindof like a joke.

She basically said that if I can function in a class, function on a job, function in society, and talk to her cogently like I was doing.

I don't qualify as mentally disabled! (Egads ... no social security and free money for me).

GLW

06-30-2009, 03:02 PM

andyhaas

06-30-2009, 03:16 PM

I know of a number of therapists who have not made this distinction...and virtually all that do not end up with many problems from it.

I have found that in the end, I lost ALL my friends that turned psychotherapist.

They just couldn't help analyzing me and other people. It got annoying, so I went away.

They ALWAYS try to find some problem with the person. This wasn't the first case. This was the first time anybody tried to compare me to a crippled retard, though. I must be slipping up somewhere. LOL

taai gihk yahn

07-01-2009, 04:38 AM

and there you have a line that many therapists like psychiatrists, psychologists, and other types of psychotherapists cross all too frequently.

You can be a person's friend and you can be a person's therapist. However, you can't be both at the same time.

If you are a therapist and try to make your patients friends, you often lose the ability to do the confrontation or to have the objectivity that is required.

If you have a friend and try to be their therapist, you very often lose a friend.

I know of a number of therapists who have not made this distinction...and virtually all that do not end up with many problems from it.

this concept should be tattooed onto the foreheads of EVERY therapist, psycho- or otherwise; PT's especially need to be very clear in their boundaries, as we are often doing hands-on work for extended periods of time, and it can be very intense sometimes - I still find it risible that in PT school NO ONE talked about transference / countertransference, which absolutely can happen in a non "talking cure" setting!

my "golden rule" is that once you become a formal patient of mine, that is the defining relationship for life - meaning no socializing, romancing, doing business, doing favors, etc.; a bit harsh, perhaps, but in the long run, much cleaner for everyone...

and if you ever meet a patient in public, don't say hi - acknowledge them, but let them be the one to say hi first; if you have to think about why, you should be in another field...