Wednesday, January 14, 2009

More poison in the well

It seems about weekly that one can read about another scandal involving the manufacturers of psychotropic medications. It does not surprise me that companies will market their drugs in whatever way they can. It does sadden me that doctors in general, and psychiatrists in particular, seem to have been complicit in poisoning the well. I have prescribed zyprexa for schizopherneic patients for years and sadly watched some of them get fat. I have switched as many as I have been able to switch back to first generation medications, usually without difficulty or apparent harm. given how little trouble I have had over the years with tardive dyskinesia due to first generation medications and the amount of metabolic side effects I have observed with second generation medications, I would say that the profession has allow a great harm to occur. Why was this? It seems to me ironic that one of the reasons is the critique of psychiatry for neglecting the epidemic of tardive dyskinesia produced by first generation medications. That I believe made us quite uncritical of the marketing of second generation drugs like Zyprexa.

Tuesday, January 13, 2009

Reanimating Nature

As I was reading Steven Shapin's wonderful little book 'The Scientific Revolution,' and thinking about psychotherapy I came upon the following paragraph [p37]: "It must, however, be pointed out that there is nothing, so to speak, 'in the nature' of machines to prevent them from being regarded as mysterious, and a strand of thought going back to the Hellenistic period accounted machines something more than the sum of their material parts. Boyle, for example, wrote about the cultural variability of the appreciations of machinery. He related a --probably apocryphal-- story about the Jesuits "that are said to have presented the first watch to the king of China, who took it to be a living creature." Boyle himself accepted the adequacy of an account wholly in terms of "shape, size, motion &c. of the spring-wheels, balance and other parts of the watch," while recognizing that he "could not have brought an argument to convince the Chinese monarchs, that it was not endowed with life." A mechanical metaphor for nature meant, as all metaphors accepted as legitimate do, that our understanding of both terms changes their juxtaposition. The rightness of a metaphor is not subject to proof."
As someone who sees psychotherapy as fundamentally about trying to persuade people that they are not machines, but living creatures, this little story had great resonance. I realized that psychotherapy aims to reanimate nature, through whatever metaphors are at hand.

Sunday, January 11, 2009

The lingering presence of psychoanalysis

As I was reading C.U.M. Smith's "Brain and Mind in the 'Long' Eighteenth Century" I was thinking about psychoanalysis' lingering presence in the 21th century. Smith writes that "one important reason for the lingering of the old neurophysiology [ie. the one based on animal spirits] was the difficulty of knowing with what to replace it. The traditional understanding of the human being was at least a consistent system. Alexandre Koyré," Smith goes on to point out, said] "… the same of Aristotelian physics. … [Koyré] remarks that it '…forms an admirable and perfectly coherent theory which, to tell the truth, has only one flaw (besides that of being false)… that it is contradicted by the everyday practice of throwing.'"