{"id":11913,"date":"2011-08-12T12:00:21","date_gmt":"2011-08-12T16:00:21","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=11913"},"modified":"2011-08-12T12:12:23","modified_gmt":"2011-08-12T16:12:23","slug":"reflections-i","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/08\/12\/reflections-i\/","title":{"rendered":"reflections I&#8230;"},"content":{"rendered":"\n<ul>\n<div><a target=\"_blank\" href=\"http:\/\/en.wikipedia.org\/wiki\/Subjectivity\"><strong><font color=\"#200020\">Subjectivity<\/font><\/strong><\/a>: <\/div>\n<p>      <\/p>\n<div align=\"justify\"><em><sup>Subjectivity may refer to the specific discerning interpretations of  any aspect of experiences. They are unique to the person experiencing  them, the qualia that are only available to that person&#8217;s consciousness. Though the causes of experience are thought to be &quot;objective&quot; and available to everyone, [such as the wavelength of a specific beam of light], experiences themselves are only available to the subject [the quality of the color itself].<\/p>\n<p>       Subjectivity frequently exists in theories, measurements or concepts,  against the will of those attempting to be objective, and<strong><font color=\"#990000\"> it is a goal  in most fields to remove subjectivity from scientific or mathematical  statements or experiments<\/font><\/strong>. Many fields such as physics, biology,  computer science, and chemistry are attempting to remove subjectivity  from their methodologies, theories and results and this is a large part  of the process of experimentation in these fields today.<\/p>\n<p>       Despite this, subjectivity is the only way we have to experience the  world, mathematically, scientifically or otherwise. We share a human  subjectivity, as well as individual subjectivity and all theories and  philosophies that dictate our understanding of mathematics, science,  literature and every concept we have about the world is based on human  or individual perspective. Subjectivity is within itself the only truth  despite assumptions about subjective &quot;truths&quot; we make. The creation of  philosophies is within itself subjective, along with the concept of  discovery or creation of ideas.<\/p>\n<p>       This term contrasts with objectivity,  which is used to describe humans as &quot;seeing&quot; the universe exactly for  what it is from a standpoint free from human perception and its  influences, human cultural interventions, past experience and  expectation of the result.<\/sup><\/em><\/div>\n<\/ul>\n<div align=\"justify\">I became interested in psychiatry much later in the game than most. The trajectory of my own life had been driven by the pursuit of objective medical science. But when I was in the situation of practicing medicine beyond training, it was apparent to me that much of the suffering I saw in patients was located in their own subjectivity. I could easily see that a lot of my patients were depressed, viewing the world in a distorted and depressive way. But seeing that or telling them what I saw didn&#8217;t often help. And giving them the antidepressants of the hour [tricyclics] rarely made much difference. I started asking about their lives and their experience of their lives, and it was if a whole new body of data appeared that I knew very little about except from my own perspective. So I moved to psychiatry and then psychoanalysis to learn more about human subjectivity [including my own].<\/div>\n<p align=\"justify\">I enjoyed learning about what I thought of as the <em>diseases<\/em> of psychiatry &#8211; schizophrenia, manic-depressive illness, melancholia, the various brain syndromes. I learned to recognize them, how to treat them with the tools available at the time. Like many, I marveled that antipsychotics, lithium, even the tricyclics had a therapeutic effect in certain situations. I read with real interest the theories about how they worked. Psychiatric neuroscience was fascinating to this now older hard scientist, but I had come to learn about human subjectivity, and that&#8217;s where my focus remained to the present.<\/p>\n<p align=\"justify\">When the DSM-III came out and psychiatry changed abruptly, I just didn&#8217;t understand. I had moved <em>from<\/em> medicine proper because of the limitations of medical thinking, and suddenly there was a move to <em>medicalize<\/em> psychiatry &#8211; to move to <em>objectivity<\/em>. I had no complaint about <em>objectivity<\/em> &#8211; I&#8217;d lived there for most of my life. But I&#8217;d discovered that mental illness was properly named, many people hurt in their <em>mental<\/em> &#8211; in their minds. For the post-DSM-III psychiatry, what I had come to psychiatry to learn was declared mumbo-jumbo, unscientific, n=1 speculation, something to be forgotten.<\/p>\n<p align=\"justify\">I wasn&#8217;t unaware that the psychoanalysis of the 1980s had its problems. Psychoanalysis and related psychotherapies are useful in certain situations, certainly not all. Long term therapy requires motivation and is more in the range of choice than necessary. People were using medical insurance to pay for long term therapy or analysis and that was not right. I must&#8217;ve known that because I didn&#8217;t use my own insurance to pay for my own analysis to the surprise of my classmates. It didn&#8217;t feel right. And the psychoanalysis of the 1970s deified formal analysis rather than psychoanalytic psychotherapy. My interest was in the latter. But those problems didn&#8217;t change the fact that my patients hurt in their minds, and psychoanalysis was the only <em>mind-science<\/em> around, so I took from it what helped, and stayed away from the problems.<\/p>\n<p align=\"justify\">The new academic psychiatry of the 1980s wasn&#8217;t for me [and vice versa], so I left. I was naive then. I didn&#8217;t know about the growing invasion of the pharmaceutical companies, the effect of managed care, hospital corporations, or the insurance industry. I frankly thought that the new psychiatry was not so medical it thought. People seemed to be talking about their dreams of future discoveries rather than the subjective realities of our patients. Symptoms like depression became the target rather than step one in figuring out what was wrong. What I had seen as the <em>diseases<\/em> of psychiatry became all there was, and the DSMs progressively added to the list. It felt to me that the specialty had redefined itself based not on its patients, but by its methods. That was a loud complaint that had been justifiably aimed at psychoanalysis and psychotherapy previously, but it seemed like the complainers were doing the exact same thing themselves.<\/p>\n<p align=\"justify\">Whatever was happening, it was too big for me, so I retreated to practice what I had come to learn &#8211; and that was a good place for me to be. A mile from my new office, Dr. Nemeroff built his empire in the department I had left. I stayed on the faculty teaching in the analytic institute that survived in the department &#8211; functioning autonomously on the side. Over the years, psychoanalysis has adapted to its new reality, found its place, and we now teach people from a variety of mental health specialties [including psychiatry] to do primarily psychoanalytic psychotherapy &#8211; the thing I was drawn to from the start.<\/p>\n<div align=\"justify\">This blog isn&#8217;t about any of that. The world of psychiatry came to this blog [that had focused on something else entirely] when I made a new discovery, at least new for me. The problem that I had assumed was a difference of opinion about objectivity and subjectivity had another dimension that I had not really considered. It wasn&#8217;t about science or the subjective discomfort of our patients, it was about money. My specialty, psychiatry, had become corrupted. ..   <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Subjectivity: Subjectivity may refer to the specific discerning interpretations of any aspect of experiences. They are unique to the person experiencing them, the qualia that are only available to that person&#8217;s consciousness. Though the causes of experience are thought to be &quot;objective&quot; and available to everyone, [such as the wavelength of a specific beam of [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-11913","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/11913","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=11913"}],"version-history":[{"count":26,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/11913\/revisions"}],"predecessor-version":[{"id":11974,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/11913\/revisions\/11974"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=11913"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=11913"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=11913"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}