Canta, Canta Amigo, Canta


 Canta, canta amigo canta

Letra e música: António Macedo
http://www.youtube.com/watch?v=iLiCZCYon68

Canta canta amigo canta                                         Sing, my friend, sing
vem cantar a nossa canção                                     come and sing our song
tu sozinho não és nada                                            you alone are nothing
juntos temos o mundo na mão                              together we hold the world in hand.

Erguer a voz e cantar                                              Raise your voice and sing
é força de quem é novo                                           it is the strength of the young
viver sempre a esperar                                            to live always hoping that
fraqueza de quem é povo                                        the weakness of the people
Viver em casa de tábuas                                         Living in houses of sticks
à espera dum novo dia                                            in hope of a new day
enquanto a terra engole                                          while the earth swallows
a tua antiga alegria                                                   your ancient happiness

Canta canta amigo canta                                         Sing, sing my friend, sing
vem cantar a nossa canção                                      come and sing our song
tu sozinho não és nada                                             you alone are nothing
juntos temos o mundo na mão                              together we have the world in hand

O teu corpo é um barco                                           Your body is but a boat
que não tem leme nem velas                                  with neither helm nor sail
a tua vida é uma casa                                               your life is but a house
sem portas e sem janelas                                        with neither doors nor windows
Não vás ao sabor do vento                                      Do not tumble like a leaf in the wind
aprende a canção da esperança                             learn the song of hope
vem semear tempestades                                        come spread the seeds of change
se queres colher a bonança                                     if you want to reap the harvest

Canta canta amigo canta                                         Sing, sing my friend, sing
vem cantar a nossa canção                                     come and sing our song
tu sozinho não és nada                                            you alone are nothing
juntos temos o mundo na mão                              together we have the world in hand.

Já que me chamas amigo                                        Now that you call me friend
prova-me lá que o és                                                show me that you are.
vem para a ceifa comigo                                          come to the reaping with me
na terra sujar os pés                                                 and soil your feet in the earth.

Eu vou contigo pró campo                                      I will go with you to the battle
eu vou comer do teu pão                                         I will eat your bread.
Tu dás-me a força da vida                                       You give me inspiration,
eu dou-te a minha canção                                       I give you my song.

 

Posted in Art, Language | Tagged , , , , , | 1 Comment

Why Do Local Community Police Need Military Weapons?


Neighborhood Policing: The view from inside a
Mine-Resistant Ambush Protected (MWRAP) vehicle

MRAPcougar

I have watched new policing methods since Mayberry RFD, to the adoption of bullet-proof vests to SWAT teams. The adoption of these new methods were reasonable. What is happening today is that the police are suffering the progression of “mission creep.”

Less and less, many police are thinking themselves as protectors of the peace and more and more as a militaristic thick blue line. Small towns are ready to counter an insurgency of unhappy citizens.

Some act with impunity waylaying motorists on the interstate highways. They are empowered to confiscate cars and money as the possible fruit of fantasy trafficking conspiracies. Recovering confiscated property by transient workers or travelers may be impossible to recover because of time and cost. Many just move on lest worse might happen.

PoliceStateMARCH_13_190_wideThe police use controversial techniques like “stop and frisk,” or DWI (Driving while Irish, not to be confused with driving while black). This is nothing less than the notion that, if you stop everyone, statistically, someone will possess medicine (not in its original container), drugs, have a warrant, or be guilty of something. Even littering is a popular reason to pull someone over, or alleging a tail light outage. It is true that if you stop everyone on flimsy or absent cause, you will find someone in violation of something.

However, the presumption of innocence demands that people have a right to travel freely and unimpeded. Manufactured suspicions relying on how low one’s pants hang around one’s waist, whether a Mohawk haircut, tattoos, or skin color are clear and present indicators of criminality. Eccentricity is a normal part of the human condition. Even mental illness is part of the human condition. We are a free country and we have the duty to rein in police overreach.

To confuse mental illness and eccentricity with criminality is wrong. Criminality may be a form of mental illness. However, the difference between conscious deliberative criminality is different from the non-deliberative delusional or hallucinatory actions of those who have no control over their actions. There is some overlap in the continuum of those poles but the qualitative difference is huge.

PoliceCameraRialtodcd538da8f08ea99cd05df16307aaf1cToo often, the police see no difference between the mentally ill and the uncooperative venal criminal. Too we see the mentally ill beaten to death by police with no training or empathy. Too often “command presence” trumps compassion. Their promotions are based on the number and quality of arrests they make. The quality of arrests has to be “good” even if the facts of the arrest must be fudged a bit to allow the district attorneys to successfully prosecute.

Truly, the concept of neighborhood policing has been hidden inside the shatter-proof, mine-proof, wall of isolation as much as any foreign policy.

http://www.nytimes.com/2014/06/09/us/war-gear-flows-to-police-departments.html?emc=edit_th_20140609&nl=todaysheadlines&nlid=49429025

 

Posted in Law, Politics | Tagged , , , , , , , , , , , , , , | 2 Comments

In Support of e-Cigarettes


                               In Support of e-Cigarettes as a Substitute for                                     Tar-Containing Tobacco Cigarettes

C-rations, battle field necessities

C-rations, battle field necessities

As a recent convert to e-cigarettes I made a simple test to satisfy what I had known since I was a teenager.  If you inhale on a tobacco cigarette and exhale through a white paper towel you can see the brown tar residue on the paper.  If you do the same test with an e-cigarette there is no visible residue.

 I am pleased to know that what I inhale does not contain the carcinogenic tarry components of traditional cigarettes.  Non-filtered cigarettes, which I smoked for years, carry even more tar.  E-cigarettes are controversial because they are new, and – well, they are called cigarettes.  There is confusion about what e-cigarettes are.  This link should clarify what we are talking about.

That tobacco cigarettes are harmful is beyond dispute.  My grandfather played the French horn and smoked non-filtered cigarettes for over 50 years and died from a fall down steps.  Tobacco cigarettes are, then, mildly toxic with prolonged use (as opposed to highly toxic cyanide or Zyklon B).

Second-hand tobacco smoke has been shown to be harmful as well, although used tobacco smoke must be less toxic than freshly inhaled tobacco smoke, we must take into consideration of other sources of second-hand smoke.

Yes, I mean automobile exhaust, campfire smoke, the second-hand industrial contaminants that confound so many cities, and the second-hand artificial smoke that my local barbecued ribs shop puts in their exhaust as advertising.  Second-hand fumes are everywhere and it’s time to distinguish the harmful from the banal.

I have issues with the accompanying article primarily because it associates e-cigarettes and mental illness; this is a relationship I cannot fully support.  Smoking tobacco has for centuries shown itself to be addictive but comforting. It has been a source of wealth and trade.

A break in battle.

A break in battle.

It has been a symbol of friendship when communally consumed in a peace pipe, a calmative to soldiers suffering from the stress of battle, and to prisoners to counter the stress of captivity as well as a calmative for the mentally distressed.

In today’s anti-tobacco cultural wars little room is given to harm reduction because inhaling a misty vapor is conflated with harmful tobacco use. The truth is that the inhalation of a pure medication is superior to the natural tobacco product (CDC info).  Harm reduction should be the aim and if nicotine has any benefits let’s provide it in the least harmful manner.

Cats painted over time of personality disintegration

Cats painted over time of personality disintegration

- Carlos

 Here’s Why We Should Give E-Cigarettes to Mentally Ill People

Yes, smoking can kill. It can also ease stress.

By Helen Redmond, March 19, 2014  |   This article originally appeared in Substance.com:

“I want my cigarettes, I want my cigarettes, I want my cigarettes,” Charlie Cheswick, an enraged patient in a mental hospital, screams at the sadistically indifferent Nurse Ratched in the classic film One Flew Over The Cuckoo’s Nest. After several heartbreaking minutes, Jack Nicholson’s character, Randle P. McMurphy, breaks a window at the nursing station, grabs a carton of Marlboros and hands it to his deeply relieved comrade.

Gonzo author Thompson opining on life. - Carlos

Gonzo author Thompson opining on life. – Carlos

The history of psychiatric hospitals is one of abuse, neglect and copious amounts of cigarette smoking. Until the 1970s, hundreds of thousands of mentally ill people were warehoused for decades in state mental asylums. There was typically little to do, and going to the supervised smoking room every 15 minutes became an “activity” to break the tedium. Cigarettes rewarded compliant behavior or were taken away to punish noncompliance. The scene from One Flew Over the Cuckoo’s Nest played out daily in hospitals nationwide.

That almost 90% of people diagnosed with schizophrenia smoke—despite  tobacco’s well-known adverse health consequences—is a testament to the addictiveness of nicotine. But it is also evidence of nicotine’s power to chemically quell anxiety, depression and other upset. (The prevalence of smoking among people with bipolar and panic disorder, depression, anxiety and PTSD is also high.)

Hospital staff have long observed how smoking markedly improves the negative symptoms of mental illness, such as lack of motivation and pleasure, reduced emotional expression and deficits in attention and concentration.

“Whenever he runs out of cigarettes, he becomes highly agitated to the point where he has seriously injured staff and other patients. Providing a cigarette is generally much more effective at decreasing agitation than most medications I can provide,” Elizabeth Roberson, then a psychiatrist at Hawaii State Hospital, wrote to R.J. Reynolds in 2000, asking for free cigarettes for one of her patients.

The mentally ill remain the single-largest demographic of smokers, accounting for 44% to 46% of cigarettes sold in the US. This market earns the tobacco industry $37 billion annually. So it’s no surprise that the industry opposes smoking bans in psychiatric units. What may be surprising is that the National Alliance on Mental Illness (NAMI), a leading advocacy group for the mentally ill, collaborated with Big Tobacco in the 1990s to block smoking bans and to implement designated smoking areas. “It is inhumane to rob these patients of their autonomy and dignity by infringing on one of the few remaining freedoms historically allowed patients,” NAMI advocates said in 1995.

At the same time, the mentally ill also account for half of the estimated 400,000 Americans who die from a smoking-related health condition every year. The National Association of State Mental Health Program Directors reported in 2012 that people receiving public mental health services who have both an addiction and a mental illness die, on average, nearly 32 years earlier than others. Smoking is a major contributor to this premature mortality.

“The industry delivered carton-loads of cigarettes to psychiatric institutions. In some states, cigarettes were tax-free, “to be used for patient treatment.” R.J. Reynolds created “value” brands for “street people” and dispensed free samples to soup kitchens and homeless shelters.”

Given smoking’s many dangers and few benefits, for the “normal” person, whether or not to abstain is a no-brainer. But for the mentally ill, the risk/benefit analysis is more complicated. Their health-care providers know, on the one hand, that nicotine helps their patients cope with debilitating symptoms of mental illness and, on the other hand,  that smoking causes fatal illness. The debate has polarized the mental health community. But the recent introduction of e-cigarettes—a safe nicotine-delivery device—has the potential to shift the terms of the debate.

Expected Benefits, Exaggerated Risks

Research over the past decade or so supports the view of nicotine as a potential therapeutic tool. It is both a stimulant and a relaxant. A drag on a cigarette sends nicotine from the lungs to the brain in under 10 seconds; once in the brain, it saturates the nicotinic receptors, triggering an instantaneous release of a host of neurotransmitters—acetylcholine, dopamine, endorphins, serotonin and glutamate—that improve mood, memory and concentration. Anxiety and pain are lessened.

Nicotine may even have specific properties that “treat” symptoms of schizophrenia. The drug helps to mitigate “sensory gating,” the ability to make sense of stimuli in the environment. When this function is impaired, as is often the case for schizophrenics, all sensory stimuli seem to be equally important, inducing confusion and fear in otherwise harmless situations. Gunvant Thaker, MD, the director of the schizophrenia-related disorders program at the Maryland Psychiatric Research Center, said, “When schizophrenic patients smoke, or are given nicotine gum, this deficit of sensory gating is reduced or normalized.”

Pharmaceutical companies are investing big bucks in the design and development of potential drugs with affinity for the brain’s nicotinic receptors—they mimic the action of nicotine itself—in order to package and sell these positive neurochemical effects.

Yet nicotine’s deadly connection to smoking tobacco has made it difficult to think rationally about nicotine as a stand-alone chemical. Anti-smoking advocates have also done their part to promote the misconception that nicotine is a dangerous drug with no therapeutic value. Yet the danger lies exclusively in the fact that as a vehicle to transport nicotine, tobacco has to be burned. When a cigarette is lit, the tobacco is transformed into tar and other carcinogens.

Pure nicotine, while addictive, is not dangerous, which is why the FDA has approved nicotine replacement therapies (NRT) like gums, patches, sprays and oral inhalation devices such as Nicotrol. Clinical and observational studies of NRTs have long shown that nicotine is a safe drug.

The Mentally Ill as a Major Market

Big Tobacco identified the mentally ill and the homeless as critical to their bottom line in the early 1970s when health warnings against smoking were first gaining wide acceptance. The industry quickly turned this marginalized group into a lucrative, loyal and captive market, according to the so-called Tobacco Papers, millions of the industry’s internal documents made public as a result of hard-won lawsuits in 1998.

The educated and affluent began to quit in large numbers. The social acceptability of smoking waned and new restrictions on smoking prompted still more quitting. The customer loss cut into profit margins, and tobacco companies sought to reinforce marketing to the mentally ill and the homeless (two thirds of the severely mentally ill are homeless or at risk). The industry delivered carton-loads of cigarettes to psychiatric institutions. In some states, cigarettes were purchased tax-free and were “to be used for patient treatment.” R.J. Reynolds created “value” brands for “street people” and dispensed free samples to soup kitchens, homeless shelters and homeless service organizations.

The Tobacco Papers document the beleaguered industry’s many efforts to make the most of this market. Philip Morris ran an ad for Merit cigarettes that seemed to many mental health professionals to be targeted to schizophrenics themselves. The ad showed a double image of a pack of Merits and read, “Schizophrenic…For New Merit, having two sides is just normal behavior.”

Eager to “find” benefits of cigarettes, Big Tobacco left no stone unturned in funding research. A well-paid British psychiatrist promoted the idea that heavy-smoking schizophrenics were less susceptible to lung cancer. This notion was debunked only in the late 1980s.

Other research focused on the idea that the mentally ill were smoking to “self-medicate.” John A. Rosecrans, a psychopharmacologist currently at Virginia Commonwealth University, did industry-funded work on the therapeutic effects of nicotine for people with schizophrenia, anxiety and depression, ADHD and other neurological conditions. “The future for developing nicotine as a therapeutic agent…using a safe delivery system is relatively good,” he concluded. “One of the difficulties with a chemical such as nicotine is that it has been thought of as a ‘dirty drug’ or ‘demon drug’ like heroin, which makes people addicts. We first need to pull away from this concept of demonism and treat nicotine and its analogues like any other drug.” Rosecrans’s research was not based on junk science. Now, 16 years later, the nicotine’ potential benefits is being studied in all of the diseases he listed.

Will E-Cigarettes Change the Game?

Not tobacco smoke, mist

Not tobacco smoke, mist

The introduction of the e-cigarette dramatically alters the risk/benefit equation of nicotine by dramatically cutting the rate of smoking-related disease and death. The battery-powered device looks like a cigarette and is activated by drawing on the mouthpiece (like on a cigarette). A liquid nicotine cartridge is heated and turned into vapor, which is inhaled. There is no tobacco and no combustion.

Opponents of e-cigarettes say that they pose safety concerns, especially because the FDA does not currently regulate them.

But studies conducted in JapanItaly and the US suggest that e-cigarettes are a safe way to deliver nicotine. “Retailers all over the world have already sold millions of electronic cigarettes, yet there is no evidence that these products have endangered anyone and no indication that electronic cigarettes are any more of an immediate threat to public health and safety than traditional cigarettes,” the researchers of one study concluded. “E-cigarettes appear to be much safer than tobacco cigarettes and comparable in toxicity to conventional nicotine-replacement products.”

“Smoking provides “cover rituals for patients having psychiatric symptoms,” said a psychiatric hospital director. “You tamp the box, you play with the lighter, you can exhale and look into the middle distance and not look like you’re hallucinating.” E-cigarettes preserve these rituals.”

For smokers, the rituals of smoking are as powerful as the hit of nicotine: lighting the cigarette, the inhalation and exhalation of smoke, tactile and oral sensations. Nicotine patches, gums, sprays and medications eliminate these ritualistic aspects, and this may contribute to their high failure rates. For the mentally ill, smoking rituals help focus attention on one thing, alleviate boredom and experience pleasure. Socially, smoking provides “cover rituals for patients having psychiatric symptoms,” said Rona Hu, medical director of the acute psychiatric inpatient unit at Stanford Hospital. “You tamp the box, you play with the lighter, you can exhale and look into the middle distance and not look like you’re hallucinating.” E-cigarettes, because they preserve these rituals, may be more likely to be used consistently than other NRTs.

But anti-smoking advocates have mounted an effective campaign against electronic cigarettes. The response by CASAColumbia, an addiction and substance use think-tank affiliated with Columbia University, to e-cigarettes is representative of the advocates’ abstinence-only approach. In “E-cigarettes Seem to Be a Bad Idea No Matter How You Cut It,” CASAColumbia states its opposition to “the unregulated production, promotion and selling of e-cigarettes.”

CASAColumbia argues that nicotine is harmful simply because it is addictive. (The same can be said of caffeine, but there is no comparable campaign against coffee.) Its main argument is that young people could use them “as a bridge to other addictive substances including conventional cigarettes.” The group concedes that vaporized nicotine “could have therapeutic value,” but only if used for the purpose of complete nicotine cessation. There is no mention of the numerous, well-documented positive effects of nicotine.

David Nutt, the director of neuropsychopharmacology at Imperial College London and a former drug advisor to the British government, has endorsed e-cigarettes. “I’m totally in favor of this kind of harm reduction approach,” he said. “Electronic cigarettes should not be controlled as medicines—they should be controlled more lightly than cigarettes in order to encourage people to switch.”

Organizations that support the mentally ill remain on the fence. The National Alliance on Mental Illness’s director of media relations, Bob Carolla, said, “NAMI doesn’t have a position on electronic cigarettes. We are studying the issue and consulting with experts in the field.”

The FDA is in the process of making a ruling about how to regulate e-cigarettes, according to a January 2014 announcement. Mitch Zeller, the director of the Center for Tobacco Products, is reportedly meeting with e-cigarette manufacturers to gather data.

It is my view that, based on the well-established principles of harm reduction, e-cigarettes should be available to help smokers reduce their risk. They can also serve as a new approach to maintaining nicotine addiction, like methadone maintenance or buprenorphine for opiate dependency. Nicotine cartridges come in different strengths with which to taper down or quit.

For smokers who have chronic mental illness, the case for nicotine maintenance via e-cigarettes is even more powerful. Many are simply unable to remain completely abstinent. In a current JAMA study, Harvard researchers report that the decline in smoking, from 2004 to 2011, among people with mental illness was significantly less (from 25.3% to 23.8%) than among those without mental illness (from 19.2% to 16.5%). This is not only because of nicotine’s addictiveness but also because of its significant therapeutic benefits. Health-care providers should encourage their mentally ill patients to switch to e-cigarettes; psychiatric facilities should make them widely available and provide space for their use.

More research is needed on the long-term effects and safety of e-cigarettes. But we cannot wait indefinitely—until all the scientific evidence is in—while hundreds of thousands of people remain at high risk simply because they cannot, or do not want to, achieve total abstinence. Close to half of these people are mentally ill, a group for whom cigarette smoking has a special significance. It is unethical to deny them access to a nicotine delivery device that could save their lives.

18 COMMENTS

Helen Redmond is a freelance journalist and a drug and health policy analyst.

Posted in Mind | Tagged , , , , , , , , , , , , , ,

Crimea, The Charge of the Light Brigade, Ukraine, Historical Perspective


Ukraine_historical_vs_electoral_2010I think most people are confused about Ukraine, the horrible pogroms, Polish/Ukraine mutual ethnic cleansing and why Khrushchev amputated Crimea from the USSR only a few decades ago and why Putin is a little nervous at having the West move closer and closer to the Russian Federation’s border. And what’s up with all the Tatar descendents of the Mongol Empire.  One can’t make an informed opinion about the Crimea without understanding the history, including the Charge of the Light Brigade.  Does anyone remember how Kennedy got so incensed at having USSR’s missiles in Cuba? -Carlos
http://www.geocurrents.info/cultural-geography/linguistic-geography/tale-two-ukraines-missing-five-million-ukrainians-surzhyk?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+geocurrents+%28GeoCurrents.info%29

Posted in Politics | Tagged , , , , , , , , ,

Is the American Psychiatric Association Going Nuts? DSM-5 in the Eyes of the World.


I am not a psychiatrist,

DSM-5EndNearnor am I a chef.  However, it doesn’t take a chef to know when a container of milk has gone sour.  I won’t criticize the preparation of a béarnaise sauce, nor will I express an unschooled opinion on the APA’s DSM-5.    There are many whose opinions on the DSM-5 call its influence into question. The National Institute for Mental Health (NIMH) withdrew its support for DSM-5 based funding requests. – Carlos

The International Reaction to DSM-5

By Allen Frances, MD, April 23, 2013, original article at: http://tinyurl.com/meg223y

The intense level of international interest in DSM-5 is a great surprise. Although DSM has become a research standard around the world, it is rarely used by clinicians outside the US and therefore poses a much lesser threat to their patients.

So why all the prominent newspaper, magazine, TV, and radio coverage especially in Germany, the Netherlands, England, Belgium, France, Italy, Australia, Japan, and Brazil?

Partly, there is concern that the noxious effects of DSM-5 may spread beyond our boundaries. The excessive diagnosis of ADD and autism began in the US, but these false epidemics are catchy and have now become a worldwide phenomenon.

A great example: It was announced last week that a team from Cambridge University is going to China to hunt for autism and that they anticipate placing the label on 14 million Chinese. The power of facile labeling never fails to amaze and frighten me.

And beyond the obvious practical consequences, people everywhere wonder about the cultural implications of a suddenly expanding psychiatry that is so rapidly shrinking the realm of normal. What does it say about a society if all its members are defined as sick?

The one thing that is not at all surprising in all the media coverage is its consistent tone of heated DSM criticism. People living in other countries can no more understand the lack of common sense in DSM-5 than they can understand why it remains legal in the US to own an assault rifle.

Here is a telling excerpt from a story that appeared last week in a German national newspaper. The association DGPPN described in the article stands for German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology [the English-language website refers to it as the German Association of Psychiatry, Psychotherapy and Psychosomatics], whose annual meeting is the largest in Europe and almost as large as the one held by the American Psychiatric Association. Its views on DSM-5 will carry considerable weight in Germany and be influential far beyond.

“The specialist organisation DGPPN advises against overdiagnosis in the DSM-5. There is the danger of pathologising ordinary states of suffering as well as natural adaptation and aging processes,” says Wolfgang Maier, president of the DGPPN and director of the psychiatric clinic of the University of Bonn, in a statement on Monday.

“The statement names a number of examples, where the new catalogue shifts the boundaries between health and sickness in an inadmissible way,” according to the DGPPN. Thus, in the DSM-5, a sadness of over 2 weeks after a death shall be diagnosed as depression if it shows its usual symptoms: cheerlessness, lack of drive/energy, indifference, sleeping problems, lack of appetite.

“Such an overdiagnosis constitutes a threat, which is put up with by the APA authors with open eyes,” says DGPPN president Maier. “Their premise is, we prefer false positive diagnoses before we fail to see a real sick person.” But this is, according to Maier, a calculation that doesn’t work, alone for economical reasons, at least not in Germany. One should always take into consideration that a diagnosis entitles the person affected to a provision of medical care through the system, whose resources are limited. The consequence could be that for the psychically truly sick, there will be fewer possibilities for treatment.

The credibility of DSM-5 has been irrevocably compromised by the recklessness of its decisions; the weak scientific support; and the poor reliabilities in the failed DSM-5 Field Trials. I doubt DSM-5 will remain the international standard for research journals; it will almost certainly not gain any clinical following outside the US; and it will also probably lose its role as the lingua franca of American psychiatry.

What can be done now to restore credibility? If APA were really serious about DSM-5 being a living document and subject to correction, it would immediately commission a neutral Cochrane-type review of its changes to evaluate whether they stand up to real evidence-based scrutiny. I am convinced that none would (with the possible exception of autism).

Of course, it would have been far better had DSM-5 heeded much earlier the many calls for an independent review of its scientific justification. Psychiatry would have been saved much embarrassment had DSM-5 been either self-correcting or amenable to outside correction.

But, it is much better to do this far too late than not at all. Better to admit to mistakes and regain credibility, than to soldier on and be ignored.

We must protect against the real danger that all of psychiatry will be tainted by the folly of DSM-5. This would be unfair to clinicians and dangerous for patients. Psychiatry is an essential and successful profession when it sticks to what it does well. DSM-5 was an aberration—not a true reflection of the field.

There is only one possible good that can come from this unfortunate episode. Perhaps the concern over DSM-5 will generate a serious discussion on how best to correct overdiagnosis; overmedication; and the excessive authority that has been given to psychiatric diagnosis in school decisions, disability determinations, benefit eligibility, and in forensics. Psychiatric diagnosis has become too important for its own good.

Comments:

“Psychiatry often demonizes these “mental ills” by suggesting that persons “diagnosed” are an actual or potential danger, or threat to themselves and/or others, with no more evidence than the labeling description and (inadequate) process itself. It is also often asserted that these “illnesses” are incurable, justifying continued treatment (typically a drug oriented form), and offering no alternatives to drug treatment (or shock). This IS the stigma that tends to result in the conclusion (of those “diagnosed”, and others who know the person has been “diagnosed”) that people so diagnosed don’t get better and are “permanently” disabled.
AND, unfortunately long term psychiatric patients subjected to drug/shock oriented treatment often do become very physically ill, disabled, and possibly violent or suicidal as the result of the treatment, not as the result of a labeled mental illness, as those promoting psychiatric treatment often suggest. Current drug black box warnings evidence this as well as the facts about the mass shooters’ ‘mental health’ histories”- Jim Keiser

“Dr. Edward C. Hamlyn, a founding member of the Royal College of General Practitioners, in 1998 stated, ADHD is fraud intended to justify starting children on a life of drug addiction.”-unk

- ‘Modern psychiatry — with its Diagnostic and Statistical Manuals of non-existing diseases and their coercive cures — is a monument to quackery on a scale undreamed of in the annals of medicine.’ -Thomas Szaz

-“The problem with psychiatric diagnoses is not that they are meaningless, but that they may be, and often are, swung as semantic blackjacks: cracking the subject’s dignity and respectability destroys him just as effectively as cracking his skull. The difference is that the man who wields a blackjack is recognized by everyone as a thug, but one who wields a psychiatric diagnosis is. daisy @ Thu, 2013-06-27 16:17

The cost to people’s lives in the stigma of a diagnosis of “mental illness” is so encompassing that such a label shouldn’t be used except in exceptional cases.
If someone is accused of a crime there must be an investigation and there must be sufficient evidence; the case goes to trial and the person is listed as “innocent until proven guilty,” if they can’t afford one, a lawyer is appointed.
There are different levels of offense from petty crimes to murder 1. Even when found guilty the case can be appealed.
No such thing exists for people suffering mental distress or whose behavior is socially unacceptable.  daisy @ Thu, 2013-06-27 15:43:      

I’ve been a practicing psychiatrist and board-certified addictionologist for 20 years. I certainly concur that there are significant reasons to be concerned about DSM-V, as it is at present. For practicing clinicians, the courts, and the law enforcement community, the fact that there is no differentiation between different kinds of schizophrenics is quite problematic. To be more precise, paranoid schizophrenics are significantly different than other types of schizophrenics, and are likely to be far more dangerous. Therefore, it is inappropriate in my humble opinion for the American psychiatric Association and DSM-V to take the stance that they have.

MICHAEL @ Thu, 2013-06-27 11:56

Posted in Mind | Tagged , , , , , , , , ,

Sinister Predjudice


I am right-handed and have always suspended judgement of lefties much as I would a gap between one’s incisors.  I did not know that lefties were routinely excluded from studies much as one would exclude a statistical outlier.  The issue of handedness has been extensively studied (http://en.wikipedia.org/wiki/Handedness) so the exclusion seems to be unfounded. – Carlos

Call to scientists: Stop excluding left-handed people from scientific studies

Date:
February 13, 2014
Source:
Radboud University Nijmegen
Summary:
Left-handed people really do have different brains and genes from right-handed people. Yet left-handed people are almost never included as study subjects in scientific research. Therefore in a new article, a call is launched for more research into left-handed people.

Left-handed and right-handed people perceive actions in different ways. Left-handed people do that with the right half of the brain and right-handed people do that with the left half of the brain.
Credit: This figure is taken from the article that Willems and colleagues published in 2009 in Frontiers in Human Neuroscience.

Left-handed people really do have different brains and genes from right-handed people. Yet left-handed people are almost never included as study subjects in scientific research. Therefore in an article in Nature Reviews Neuroscience, Roel Willems and his colleagues from the Donders Institute and Max Planck Institute in Nijmegen call for more research into left-handed people. The article was published online on 12 February 2014.

Left-handed people are rarely included as study subjects for brain or genetic research because the differences with right-handed people cause noise in the final results. However, left-handed people form about ten percent of the entire population and their brains and genes contain interesting information about the functioning of both halves of the brain as well as about several psychiatric disorders. ‘Research into left-handed people is therefore interesting because of the noise they cause’, thinks neuroscientist Roel Willems from the Donders Institute for Brain, Cognition and Behaviour at Radboud University Nijmegen. With the opinion article he calls upon his fellow researchers to stop excluding left-handed people from studies.

Missed chance for the neurosciences ‘One of our studies from 2009 clearly shows why research into left-handed people is so vital’, says Willems. ‘According to the textbooks, facial recognition takes place in the right half of the brain. Our research revealed that the same process takes place in both halves of the brain in the case of left-handed people, but with the same final outcome. That is a fundamental difference. And left-handed people might process other important information differently as well. The minimal amount of research into this is, in my view, a missed chance for the neurosciences.’

Data from left to right According to Willems, the same applies to genetic research. Schizophrenic and psychotic patients are more likely to be left-handed. Up until now little has been done with that information to clarify the genetic links with the disorders concerned. ‘Databases without left-handed people are not representative for the population and in view of the large number of genetic databases currently being set up, ignoring left-handed people is not wise’, says Willems. In addition to the opinion article in Nature Reviews Neuroscience, Willems and his colleagues at the Max Planck Institute in Nijmegen are setting up the website www.mpi.nl/handedness, where left-handed people are encouraged to participate in research.

Story Source:  The above story is based on materials provided by Radboud University Nijmegen. Note: Materials may be edited for content and length.


Journal Reference: Roel M. Willems, Lise Van der Haegen, Simon E. Fisher, Clyde Francks. On the other hand: including left-handers in cognitive neuroscience and neurogenetics. Nature Reviews Neuroscience, 2014

Posted in Anthropology, Mind | Tagged , , , , , , , ,

Cruel and Unusual Punishment


Return to the Snake Pit

BedlamchainedtowallLong have we condemned the mentally ill in our society to counter-therapeutic residence in prisons.  Those unable to cope with living in society are subjected to dehumanizing captivity in prisons designed to punish the defenseless for psychiatric conditions beyond their control.  Yet our legal system holds them criminally responsible. Why? Certainly those with only a tenuous grip on rational behavior can only be marginally responsible if at all.  Confining them with career criminals is certainly cruel, but today it is not unusual.   http://www.nytimes.com/2007/01/15/opinion/15harcourt.html?_r=0

.

Jails That Masquerade as Psychiatric Hospitals

Douglas A. Kramer, MD, MS,  January 27, 2014

Out of sight, out of mind.

And we believe ours is a civilized society.

Listen to the description of Cook County Jail by Laura Sullivan of NPR (http://tinyurl.com/k7d4z3b).  Cook County is one of many large county jails that masquerade as a public mental hospital. At least one-third of the 10,000 inmates at Cook County have serious mental health problems. At Cook County, the mentally ill do receive psychiatric care. There are wards for men and for women. The NPR story reports that these struggling men and women, having truly “hit bottom,” go so far as to commit minor crimes to cause their own incarceration. They are that desperate to maintain access to their necessary psychiatric medications. At least they are taking responsibility—in the only way they know how.   The current societal approach to the treatment of psychiatric disorders cannot possibly be considered humane.

When did it become reasonable not to provide treatment to the people who suffer most in our society? When did homelessness become a compassionate alternative to hospitalization? When did serious mental illness, in essence, become a crime? There is no “liberty,” or “pursuit of happiness,” when people with serious mental illness are not provided good care and good treatment. Psychosis is not a civil liberty.

It is a misconception that most state mental hospitals of the past were “snake pits.” “One Flew Over the Cuckoo’s Nest was a fictional dramatization of a minority of such institutions. The majority provided humane care, even if effective treatment did not then exist. Those institutions at least provided “asylum.” Relatively effective treatment is now available, yet we now provide neither care nor treatment.

Out of curiosity, I went to the website of the Cook County Sheriff’s Office”(http://tinyurl.com/q9yf3k2). The home page emphasizes the Sheriff’s Mental Health Hotline—certainly ironic for a law enforcement agency in a big city. Sheriff Thomas J. Dart’s website, and NPR’s interview with him, make clear the compassion the Sheriff and his staff feel for the souls entrusted to them. It is our responsibility as a society to provide the resources consistent with such compassion.

“Out of sight, out of mind,” is a mechanism for personal and societal denial. It isn’t compassionate. It isn’t responsible. It isn’t consistent with a civilized society. It must not continue.

Further reading:
Kramer DA, Verhulst J. “Guns, Violence, and Mental Health: Did We Close the State Mental Hospitals Prematurely?(http://www.psychiatrictimes.com/trauma-and-violence/guns-violence-and-mental-health-did-we-close-state-mental-hospitals-prematurely)
Dr Kramer is Emeritus Clinical Professor of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. He is also Chair, Committee on Research, Group for the Advancement of Psychiatry; and a Distinguished Life Fellow, American Academy of Child & Adolescent Psychiatry. He writes a column for AACAP News, “The Biological Roots of Child Psychiatry.”
Original article: http://tinyurl.com/png57dj
Posted in Law, Mind | Tagged , , , , , , , , , , , , , ,