Tom Cruise, psychiatry, Matt Drudge, etc.

[DanS]

Here's an interesting back-and-forth between Tom Cruise and Matt Lauer on the Today Show.

http://www.drudgereport.com/flash3tc.htm

In short, even though I disagree with all of the scientology hocus pocus, I agree with Tom Cruise's dim view of psychiatry. It appears to me that it is a very immature science to put it in a charitable way and the brain is a black box that we don't know too much about.

Now don't get me wrong. In some cases, specific drugs can be helpful. I've known people who have taken lithium for being manic depressive and it has worked well, although the side effects are pretty bad. But in general, it seems that psychiatry is in the dark ages. I've known several people where it seems like the psychiatrist doesn't know what's going on at all and is just trying stuff (incredibly strong drugs) out randomly. It's almost the doctors of yesteryear using leeches.

There is some of this with traditional medicine. Doctors have a good idea about many illnesses, but they don't seem to understand some chronic illnesses that much. Perhaps those illnesses are more psychological than anything.

So what's your view?

Please note that I don't know why Tom Cruise is talking about this publicly. He's no expert on the matter and comes off pretty callously with regard to Brooke Shields and post-partum depression.

[Colon™]

I agree with your view. Call me prejudiced but I think psychiatry often results in people getting completely absorbed in their illness rather than "healing" them. And I don't like drugs at all.

[lord of the mark]

Re: Tom Cruise, psychiatry, Matt Drudge, etc.

Originally posted by DanS
Here's an interesting back-and-forth between Tom Cruise and Matt Lauer on the Today Show.

http://www.drudgereport.com/flash3tc.htm

In short, even though I disagree with all of the scientology hocus pocus, I agree with Tom Cruise's dim view of psychiatry. It appears to me that it is a very immature science to put it in a charitable way and the brain is a black box that we don't know too much about.

Now don't get me wrong. In some cases, specific drugs can be helpful. I've known people who have taken lithium for being manic depressive and it has worked well, although the side effects are pretty bad. But in general, it seems that psychiatry is in the dark ages. I've known several people where it seems like the psychiatrist doesn't know what's going on at all and is just trying stuff (incredibly strong drugs) out randomly. It's almost the doctors of yesteryear using leeches.

There is some of this with traditional medicine. Doctors have a good idea about many illnesses, but they don't seem to understand some chronic illnesses that much. Perhaps those illnesses are more psychological than anything.

So what's your view?

We actually have a much better idea about the role of brain chemistry in mood disorders than we did when Lithium was first used - however docs still dont have the ability to diagnose based on brain chemistry, or to select medications based on brain chemistry. Though theres a lot of research trying to go in that direction, IIUC. In any case its always going to be an art - mental health in general and mood disorders in particular have so many aspects that go beyond brain chemistry, into thought patterns, life patterns etc. I think good psychiatry will always be an "art"

But then im not sure a lot of the rest of medicine shouldnt be like that as well - fitting treatments into the patients personality and lifestyle, and using treatments other than medication.


For some thoughts on medicine as art, vs tradititional views of drugs, and the integration of organic brain conditions with the whole personality, i suggest any books by Oliver Sachs. Hes a neurologist, not a psychiatrist, but i think his insights are relevant to what you are asking.

For a specific discussion of mood disorders, I would suggest "A Mood Apart" by Peter Whybrow (sp?) That helped me a lot at a difficult stage in my life.

[Drogue]

I agree they're overprescribed, and I know they only mask the problem, but as Matt Lauer said, it works for some people. To say it's all bad is obviously false, as there are many cases of people getting better because of it.

It doesn't change the cause, and changing the cause is a better thing to do, but where that's not possible, or too hard, etc. andi-depressants can be valuable to help.

[lord of the mark]

Originally posted by Colon
I agree with your view. Call me prejudiced but I think psychiatry often results in people getting completely absorbed in their illness rather than "healing" them. And I don't like drugs at all.

Its a helluva lot better to be absorbed in the fact that you have depression, than to be absorbed in the fact that youre a total fVck up, that the world is evil, and that theres really no alternative to suicide. And of course a good therapist (who need not be shrink, but should work with a shrink) WILL try to get you focused on recovering, not on "wallowing".

[lord of the mark]

Originally posted by Drogue
I agree they're overprescribed,

im not even sure of that. There are certainly people who get SSRI's who dont need them, but I think there are plenty of people who do need them and dont get them for a variety of reasons, INCLUDING the stigma on admitting you have a problem and need meds. Which is the larger number, I dont know.

I would suggest that there more people who would benefit from good therapy than from meds - but that raises a couple of questions 1. Almost everyone, even the "mentally healthy" would probably benefit from some sessions with a good therapist, and given the cost, the potential for abuse forces insurance companies to be stingy about therapy (here in the wonderland of private health insurance, at least) 2. Really good therapists are not easy to find. You find a really good one, whos a match for your personality, who will go easy when its needed, but who will push you and not let you "wallow" - youve found a rare gem.

[DanS]

There was an excellent article in the Wall Street Journal the other day about drugs for illnesses that don't have a large enough market or are too risky in other ways for drug companies to develop, even though the basic research had been done by the government.

One example used was schizophrenia drugs. No new major drugs for schizophrenia have been introduced in the last half century. To me, that means that few, if any, double blind studies have been done with regard to drugs for schizophrenia, a sometimes severe condition or group of conditions that impacts over 1% of the population. That floored me.

I'm used to thinking that we live in a very scientifically advanced society. But some things go directly counter to my habit of thinking that way.

[DanS]

im not even sure of that.

In the first instance, I don't even know how we can know if the drugs are overprescribed.

[Nostromo]

I willing to bet that Cruise's lashing out on psychiatry is somehow motivated by Scientology.

I agree, we have to remain critical. But psychiatry and psychology remains our best knowledge on the mind and brain. To be blunt, psychiatry and psychology are less mature than, say, physics, in large part because the mind/brain is infinitely more complex than particles or solar systems. Throwing psychiatry and psychology overboard, because its allegedly pseudoscientific (like Cruise suggests in some interviews), is a dumb idea.

That said, there is a lot of room for improvement. Some conditions like ADD are overdiagnosed in some places, underdiagnosed in others. Some doctors don't even think ADD is a real disease, even though its in the DSM-IV. Diagnosing ADD isn't a simple matter, it takes time, the doctor has to review to childs or the adults history. But I read recently that some doctors prescribe Ritalin to children 10 minutes after meeting them... This is a problem. But is it a problem with our knowledge? No, its a problem with doctors, or with the medical system.

[Nostromo]

Originally posted by lord of the mark


Its a helluva lot better to be absorbed in the fact that you have depression, than to be absorbed in the fact that youre a total fVck up, that the world is evil, and that theres really no alternative to suicide. And of course a good therapist (who need not be shrink, but should work with a shrink) WILL try to get you focused on recovering, not on "wallowing".

[JohnT]

He's no expert on the matter and comes off pretty callously with regard to Brooke Shields and post-partum depression.

He and Brooke are having a pretty public tiff, which is why he made those comments. A couple of weeks ago she pwned Tom with the following line:

He should stick to saving the world from aliens and let women who are experiencing post-partum depression decide what treatment options are best from them.

That's a double-zinger because it takes a swipe at both:

1. Tom's "religion" (the big secret to scientology is that the world was once populated by aliens who are now living under some volcano somewhere (and no, I'm not making this up.))

2. Tom's well-publicized inability to knock up Nicole Kidman, despite 10 years of trying. At least Maury Povich had the excuse that his wife (Connie Chung) was 45 before she started wanting kids.

Go Brooke!

[JohnT]

Scientology's Core Beliefs

No, you are not being wooshed.

[boann]

Tom is arrogant as always. Assuming he knows more than anyone else about the subject. hes done research.. Well whoopdedoo... does he have a Ph.D. in it.
nooooo .. So hes not an expert on the topic. hes probably read a few papers on the topic at his scientology workshops.. or whatever he goes to.

Psychology is just like any other practice. Always evolving and changing with new research and with new methods of treatment. The way people are treated now is vastly different from even 10 years ago.
and massively different from 30 years ago..
Sigmund Freud was the king of therapy but now some of his ideas are thought to be outdated by current research.

[Nostromo]

Originally posted by lord of the mark


im not even sure of that. There are certainly people who get SSRI's who dont need them, but I think there are plenty of people who do need them and dont get them for a variety of reasons, INCLUDING the stigma on admitting you have a problem and need meds. Which is the larger number, I dont know.

I would suggest that there more people who would benefit from good therapy than from meds - but that raises a couple of questions 1. Almost everyone, even the "mentally healthy" would probably benefit from some sessions with a good therapist, and given the cost, the potential for abuse forces insurance companies to be stingy about therapy (here in the wonderland of private health insurance, at least) 2. Really good therapists are not easy to find. You find a really good one, whos a match for your personality, who will go easy when its needed, but who will push you and not let you "wallow" - youve found a rare gem.

Our folk psychology and scientific psychology are perpetually in conflict. A friend of mine suffers from anxiety disorder. We go see a movie and he leaves after a while. He sweats bullets when he has to go the barber... I heard some people call him a *****, a wuss. Not in his face, of course. But thats what they think of him. They can't seem to understand that its not under his control... The same goes with people who suffer from ADD. Peope say they're lazy, they're dumb...

[Nostromo]

Originally posted by boann
Tom is arrogant as always.

And you're being polite...