Friday, March 19, 2010

Strange double standards

A top health website invited me to subscribe to other blog feeds on their site that share my interests. My interests are really only singular (schizophrenia) but I am willing to stretch myself so I included bipolar as a second interest.

The site then suggested some treatment options that might further interest me in both these categories.

Aside from a long list of nearly identical meds in each category, beginning with Abilify and ending with Zyprexa, the other "help" targeted to these pharmaceutically very similar conditions was interesting, or rather "telling."

In the complementary/alternative medicine category, bipolars apparently benefit from crying, holistic health, marijuana, meditation, music, pets, running and yoga while their identical twin, the schizophrenic, can only take advantage of music and pets!

Under the treatment program category, bipolars may benefit from not only psychotherapy, but cognitive behavioral therapy, dialectical behavioral therapy and group therapy, while their "twin" only is thought to benefit from mere psychotherapy.

Apparently this website doesn't think that people with schizophrenia will benefit from diet and vitamin support, because they get zilch here, while their bipolar twin is thought to benefit from taking fish oil. Wow, fish oil!

Music and pets while ignoring everything else except drugs? Sounds like this website sees schizophrenia as hopeless and chronic.


  1. Of course it sees "schizophrenia" as hopeless and chronic. It sees "bipolar" in the same light and to the extent that it advocates any adjunct treatment it also acknowledges that medication by and large does not work. If it worked why would one need to add anything else?

    It floors me that any site would suggest marijuana as having any benefit recognizing it is a proven catalyst for psychosis.

    More clueless quacks!

  2. Yes, I, too, am floored that marijuana is suggested. Maybe I shouldn't be as it is now being legalized in certain jurisdictions for "medical" treatment. Watch out!

  3. I don't know. I've heard of people who've had some benefit from marijuana in their recovery. There are different kinds of, with slightly different effect. I think, it depends both on what kind you choose, and whether you know when not to smoke any (the really difficult part).

    If it wasn't for that I do have less favorable experiences with "the leaf" (yes, it can trigger "psychosis", especially if you don't know when to stop smoking), and that I today don't believe it to be a good idea to mess with consciousness at all, I'd clearly prefer marijuana to anything from the list of FDA-approved substances.

    Madness Radio-interview with Dr. Mitch Earleywine on marijuana

  4. Another thought: I couldn't agree more that it's clearly an expression of prejudice and double standards to insinuate that "schizophrenics" aren't helped by anything but music and pets, maybe, while "bipolars" are thought to benefit from a whole lot of other things too. I wouldn't even venture to neither limit nor standardize the range of possibly helpful things/activities to a certain number and a certain kind, like it's obviously done by the creators of the site you quote. on the one hand, emotional distress is emotional distress, no matter how exactly it's labelled, and there's only one thing that can be done about it: face it, accept it, and come to terms with it.

    On the other hand, "schizophrenia" is not "schizophrenia", "bipolar" is not "bipolar", etc. How somebody experiences their emotional distress, and how they react to it is entirely individual (which is why, IMO, there's little if any validity to the labels; a broken leg is a broken leg, and everybody knows what precisely it needs to heal it; in order to have just as valid labels for emotional problems there would have to be either an individual label for each person, who experiences these problems, or only one single label that can be applied to everybody alike; the latter being something along the lines of "being human"... ), and so is what they experience as helpful.

    People have their individual experiences with what was helpful for them, and those experiences can be an inspiration for others, but IMO no one has the one and only answer to how exactly to deal with emotional distress.

    On another note, I am surprised that the site only mentions psychotherapy as helpful for "schizophrenics" without further specifying what kind of. "Psychotherapy" is an umbrella term for all kinds of therapy, be it cognitive behavioral, narrative, existential, humanistic, analytical, systemic, or whatever else. The currently prevalent opinion is that CBT (and to a certain extent DBT) is the one and only (sic) efficient kind of therapy, no matter what the problem. Without having seen the site myself, not further narrowing down which specific kind of therapy can be of help also in my view seems to be an expression of a view of "schizophrenia" as chronic and hopeless ("It doesn't matter what kind of therapy. It won't really help anyway."). At the end of my own therapy experience my therapist made the, to me at least, unexpected statement that even though she as being specialized in CBT would like to attribute the outcome to this specific kind of therapy, she couldn't do so, and that in her opinion any kind of therapy could have brought about the same outcome. It's not the technique, the method, that is important. It's the quality of the relationship between therapist and client. And this quality depends widely on the therapist's qualities as a human being, rather than on his/her professional qualities/qualifications.

  5. The categorization of treatment options for schizophrenia and bipolar on this website showed how dumbed down the thinking is in general on what makes people get well. I agree that the tone is just give someone with schizophrenia psychotherapy (any kind will do!)'cause it probably won't work anyway. What helps people get well is other people not freaking out and not treating the person as if he/she were diseased. Time and empathy, and the quality of relationships is so important.

  6. I agree it is the quality of the relationship between therapist and patient that matters most. The brand merely provides some structure within which that relationship is nurtured. The risk is if the therapist is too academic and focuses on process rather than relationship the therapy will be ineffective. Too many do this and the intellect of the "schizophrenic" patient in many cases outweighs that of the therapist. As a consequence when this occurs the patient plays games.

    Freud was of the opinion that "schizophrenics" could not form a transference with their therapist thus psychotherapy with this group was useless. A skilled therapist, perhaps few, can successfully catalyze transference based on the authenticity of their interest in establishing the relationship. From there recovery begins.

  7. Anonymous: They focus on progress, yes. But more often than not it is their own idea of how this progress should look like they focus on. That is a expression of not seeing the client. A good example are therapists who define progress as the consolidation of "insight" and "compliance", and the acquisition of "coping strategies", while they have little or no interest in working with trauma issues. To be focussed on progress isn't the worst thing, if it is the progress the client has defined him-/herself to be progress that is focussed on.

    About a year and a half ago, a Norwegian blog neighbour of mine had an ad in the Norwegian Psychological Association's journal where she's looking for a therapist to work on her trauma issues with her. She hasn't got any reply yet. Not one. At least, you might say, they're honest. She's also tried to be in therapy for several years with someone who'd initially agreed to work on her trauma issues with her. After a few years where she felt, she didn't get anything out of therapy, actually felt increasingly miserable, she brought up the matter in a session, and was told: "Oh, but, you know, I don't do that." Imagine!

    Concerning transference, I don't think it is as much the problem as simple trust is. Here I think, it applies what Darby Penney concludes in her article "The Recovery Dialogues": "Communication is only possible between equals." One of the reasons why Soteria had the success it had, the staff mostly being non-professional, young people, and actually not practising therapy.


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