more on echo echo echo echo echo echo echo…

Posted on Monday 27 February 2012

an anechoic chamber...Dr. Roy Poses of Healthcare Renewal frequently mentions what he calls the anechoic effect in covering healthcare issues. It means exactly what you’d think it means parsing the word – no echo. He’s referring to the fact that big healthcare stories have a short shelf life – coming into the media, then quickly disappearing from sight. In this age of information overload, it happens everywhere – but it’s particularly noticeable in matters medical. Interestingly, Dr. Poses seems intent on keeping the term itself [anechoic] from suffering the same fate it defines by mentioning it 93 times since beginning to use it eight years ago [to his credit]. He also sends out periodic summaries of important issues covered by his blog. Certainly, you can’t follow these issues without noticing how all this works, watching scandalous stories just disappear as quickly as they arose. It’s pretty frustrating. I was commenting on Dr. Frances’ and his associates’ effectiveness in the campaign to bring the DSM-5 up to snuff [two lessons…], and one of the obvious reasons for that success has been recurrent articles, widely placed, that never allow the DSM-5 slink into the shadows while the revision is still underway.

I’m reminded of an old psychotherapy technique called flooding. When a patient is avoiding looking at something that badly needs looking at, they often bring up something else, some "shiny object" that tempts the therapist to skip merrily down another path. Such maneuvers are often unconscious – the mind can drift from potentially painful topics all by itself. So simply saying something like, "Are you trying to change the subject?" doesn’t meet the challenge because many times, the patient isn’t aware of their diversion. When flooding, the therapist acknowledges the new topic, but immediately returns. "I think <the new topic> is something important for us to look at down the line, but for the moment, let’s stick to <the topic being ‘left’>." I’ve never been much of a technique therapist [too artificial for my tastes], but this one has become an almost automatic response to a common defensive maneuver. So back to the anechoic effect, I do find myself reposting and reminding about issues here, like study 15 below [so maybe I’m more of a technique guy than I know]. I know I often sit down and remind myself what’s on the table that might get lost and Google® the news.

What’s in need of echoing just now? in danger of becoming another lost story? One thing is that trial I went to in Texas with some incredibly incriminating documents shown in open court. I’ve posted the testimony, but I’m still hoping to see a public source for the primary documents like after other trials. The recent flap over Dr. Ian Hickie’s review in the Lancet about Agomelatine has gone silent in the blogs and in the Australian news [a changing…]. It’s sure not ready to end. The data that goes with Dr. Gibbon’s assertion that the SSRIs are safe to use in children and adolescents is scheduled to be posted later this week [watchful waiting…]. And Dr. Healy’s book, Pharmageddon, is now being joined by his frequent blog postings that are pertinent to all of these topics. The one today is particularly enlighteninging [Mystery in Leeds] about the antidepressants and akathisia. Then there’s always the DSM-5 Task Force goings on, though Dr. Frances et al do a fine job of keeping that one front and center.

I have neither the illusion that it’s my task to keep stories from dying too soon, nor think that the readership of this blog is wide enough to keep stories from the anechoic effect, but I do believe in the simple premise that every little voice might count somewhere down the line. For what it’s worth, all those other little voices are what woke me up to how rotten things had become and how silence had allowed them free reign for much, much too long. I have had a recurrent fantasy of some centralized way of cataloging these examples of misadventures in psychiatry as they come along, not so much for commentary or comments like the blogs – more like an echo chamber to keep them fresh and alive, perhaps providing an antidote to the ravages of the dreaded anechoic effect

No, don’t comment, "why don’t you do it?" because I don’t know what to do either. But if anybody has some ideas, I’d be glad to hear them
    February 28, 2012 | 11:46 AM

    an echo

    The heterogeneity of the depressive syndrome: when numbers get serious

    S. D. Østergaard1,
    S. O. W. Jensen1,
    P. Bech2

    Article first published online: 13 AUG 2011

    DOI: 10.1111/j.1600-0447.2011.01744.x

    © 2011 John Wiley & Sons A/S

    Acta Psychiatrica Scandinavica
    Acta Psychiatrica Scandinavica

    Volume 124, Issue 6, pages 495–496, December 2011

    February 28, 2012 | 3:27 PM

    some centralized way of cataloging these examples of misadventures in psychiatry as they come along,

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