Last year as I was reading research trying to understand the suicide rate in schizophrenia as part of my ongoing personal work. The suicide rate is why the drug clozapine can be justified for use. This is the most dangerous licensed narcotic. It kills. The antipsychotic is also the most effective at 'treating' schizophrenia.
I've been on antipsychotics for diagnoses of bipolar with paranoid features and schizoaffective: bipolar type. I've also smoked herbal cannabis for the same disorders, drugs which are as effective but unregulated. Users get to chose what they use and it doesn't need the dogma of psychiatry to get a prescription.
Skunk has been the best treatment for treatment resistant depression I've tried. I've tried sodium venlaflaxine. That's the best of what psychiatry has to offer for depression. The drug works with other neurotransmitters....the one that nicotine releases if I remember right. When I say tried I mean took it for 3 years along with massive doses of antipsychotics and mood stabilisers.
Had I gone psychiatry's way i'd have been dead inside and outside. Now I live an internal experience as well as an external one which would break a person's ego. I still hang out with old friends, friends who are successes in many ways. I'm sure I am too but in that coy way that isn't associated with success.
It's irrelevant of course. My journey was about change. I could have been one of those conventionally successful people who earn money but contribute minimally, or at least actively. For all my madness I could be a corporate tosser. For all my madness I am, but only to serve my ends.
My madness ripped me from a career path to success but it expanded my mind in a way i'd resort to drugs to do before. My madness brought about change, change to become someone old friends would be uncomfortable with but true friends still recognise.
An open mind is a quality far too rare in our world. Thanks to fucking psychiatry.
Anyway...causality and individual experience.
Well bear with another tangent. How we become, and how we become mentally ill. All psychiatry does in its highest scientific sense, the reliable judgement of reduced life outcourse (without psychatric treatment of course...) based on the existence of enough of a few symptoms (the operational cluster of symptoms approach) which is basically using science to attempt to tell a person's future (DSM, which is the American system) badly (Thomas szasz and the Myth of Mental Ilness and Richard Bentall Madness explained. Please google.) but better than any other system ever (Bentall in his award winning book madness explained though in a bad intepretation because he didn't quite convey the significance of the increase in reliability and validity through the better application of positivistic scientific methods).
And with all that the poor science forgets casuality too frequently. What is cause and effect is what I'm talking about.
The current science, the operational cluster of symptoms aligned with prognosis studies of the reduced life course of the mentally ill (as defined by the reference diagnostic criteria used in these studies rather than what happens in clinical practice), is flawed like chemistry is without a periodic table of elements.
There is limited understand in what is considered good evidence to support the cause. There is little reasoning which is supported by strong evidence which can withstand the onslaught of positivitic science which survives. Some might consider what I'm sort of rambling about as a quantitative evidence versus qualitative thing but it isn't because I understand why qualitative evidence is at the bottom of the tree. A systematic review disregards all bias and is evidence based. A good one at least. They are sadly ineffective and this is where qualitative research wins but this is not a reliable methodology. For example it seems to eschew both evidence and replication.
I might be wrong about those failings but it is regardless of what I'm saying. Both techniques can, to quote Chef in South Park, suck on my chocolate salty balls. Just put them in your mouth and suck them.
Before I suck on anyone else's balls of coca goodness I might stop to think. Causality and individual experience. I perhaps should have refined my language to lived experience but I'm a bit drunk and stoned.
If I can refer back to my chemistry example, one which refers to 'real' science then I can suggest that current techniques don't have anywhere near the predictability which comes from understanding cause an effect.
I know if I strike a match it will ignite. If it doesn't then I can try again but I need more force. Sounds like psychiatry?
No. Psychiatry understands what happens as a reaction of empirical things. Stuff as I might also describe it but perhaps here I'll be precise and write a rapid oxidation reaction which requires kinetic energy to overcome the potential energy barrier which creates the reaction from two solids striking rapidly enough to generate the friction required for the mixture of elements and compunds to ignite to produce an exothermic reaction which creates gases andincandeasent semi-gaseous solids (fire).
Sorry for the long sentence. I just had to explain what precision of definition is achieveable and what isn't in psychiatry.
Here, in this example, I've explained the future. Here's the present. We still need to understand cause and effect.
Who knows cause and effect? The psychiatrist can judge upon present symptoms as well as their own (non-scientific) judgement. The psychologists can guess and win awards for poor science. Sadly I'm a huge fan but only becausee I've come to ...another unsubstantiated theory?
Yeah. Kind of. If science can't perform then let the people, the mentally ill, decide. Many people upom hearing this statement might think I'm the master of lunacy (a reference to a title of a member of the UK court of protection until 2005 but I use to make a salient point about lunacy and sense).
Someone smarter than me must have said this. I think it might be Prof Richard Bentall in his book Madness explained. I'm not sure. Got halfway through and bored. He's meant to be going on about a complaints-based model and that's fair play and stuff but I haven't read it. If the person who relayed this information about the latter half of his book is correct then he's talking about an unevidence based distress continuum model having significantly challenged the psychopathology continuum which is generally percieved to be based on positivistic science.
I'm even less evidence based but have a better source of evidence. Bear with me please. I am bearing the burden of many organisations and concepts sucking on my chocolate salty balls.
The evidence is what is, in practice, the highest of the evidence hierachy. It is one which is off the published scale but so obvious. It is personal experience.
I've laboured at length in this long piece on the precision of science. But it barely exists in mental health. I'll use Bentall's technique to explain that no outside judger of your mental health based on the current state of science in the area is valid...
So am I talking shit? Perhaps...but I espouse a change in the dogma. The problem is I espouse a change in the established hierachy and, fundamentally, the hegemony of psychiatry. That sentence in proper communication means I value lived experience highly and consider those without worth of supping on my chocolate balls. At least when it comes to understanding me and my people, or the mentally ill as you would pathologise or perjoratise my very being.
You get me?
No comments:
Post a Comment