{"id":15996,"date":"2011-11-15T19:12:20","date_gmt":"2011-11-16T00:12:20","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=15996"},"modified":"2011-11-15T19:19:40","modified_gmt":"2011-11-16T00:19:40","slug":"dissonance","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2011\/11\/15\/dissonance\/","title":{"rendered":"dissonance…"},"content":{"rendered":"
Cognitive Dissonance<\/font><\/strong><\/a> is a discomfort caused by holding conflicting ideas simultaneously. The theory of cognitive dissonance proposes that people have a motivational drive to reduce dissonance. They do this by changing their attitudes, beliefs, and actions. Dissonance is also reduced by justifying, blaming, and denying. The phrase was coined by Leon Festinger<\/font><\/a><\/strong> in his 1956 book When Prophecy Fails<\/font><\/a><\/strong><\/u>, which chronicled the followers of a UFO cult as reality clashed with their fervent beliefs. It is one of the most influential and extensively studied theories in social psychology<\/span>. A closely related term, cognitive disequilibrium, was coined by Jean Piaget to refer to the experience of a discrepancy between something new and something already known or believed.<\/em><\/div>\n

The name and formal sounding definition don’t really convey the level of discomfort that comes with Cognitive Dissonance. I had a patient once who had a term for the way her mother was that comes much closer – crazy making<\/font><\/strong><\/em>. You think you know something that’s just part of your being, and suddenly you’re confronted by another thing that shows you unequivocally that you were wrong. The conflict undermines the mind and you feel as nutty as a fruitcake<\/font><\/strong><\/em> as they say.<\/p>\n

I was raised in the South, luckily in a home where racial segregation was seen as a bad thing, an unfortunate piece of history that needed to be righted. But I was a proud southerner too. The impossibility of the world around me wasn’t that apparent to me as a child. It was just the world I knew. When the Civil Rights Movement came in the mid-1950s, it was something that was happening that I was somewhat involved in. But then one Monday [September 16th, 1963], I was eating at a lunch counter and picked up a loose newspaper and read about the 16th Street Baptist Church being bombed in Birmingham killing four little girls, and whatever Cognitive Dissonance means hit me like a ton of bricks. I went back to work in a fog. My world had been turned upside down and I couldn’t ever see the South of my childhood the same way again. I had a similar experience when one evening in the early 1980s I was looking at the news and saw a colleague that I had known and worked with for several years, someone I considered a friend, plastered on the television set as a longtime pedophile who had finally been busted that day. It took days to regain my equilibrium. I had Cognitive Dissonance in 2005, when I realized that our Invasion of Iraq was based on nothing and unrelated to 9\/11. In each of these instances, the effect was like what traumatized people describe – the experience changed me. I became a Civil Rights Activist. I’ll never look at a kindly older religious man helping children without my radar going to DefCon 4. I started this blog in 2005 and became obsessed with the Iraq War and related matters. I don’t know if I have a Cognitive Dissonance Sensitivity Disorder<\/font><\/strong> or if it’s that way for most people. It’s obviously that way for me.<\/p>\n

The massive changes in psychiatry after 1980 had a huge impact on my personal life, but there was no Cognitive Dissonance that I can recall. I guess I felt like an official who had been voted out of office after only one term. I left academia peacefully, I hope gracefully, and found something else to do with myself. It wasn’t what I wanted or planned, but I made the best of it and life continued. I saw the devastating impact of Managed Care on psychiatry and my colleagues, but I was insulated in a number of way so it didn’t bother me much personally. I saw the rise of psychopharmacology, neuroscience, the dramatic changes in our literature, but I just avoided meetings and the general psychiatry journals. Back then, we got CME credit for teaching which I did a lot of, so that’s how I filled my requirements – that and some psychoanalytic meetings. In my mind, I could see why the insurers were down on paying for long term therapy. I could also see why the were pointing to the lowest bidders – not psychiatrists. I was on no insurance panels, and didn’t charge very high fees. I guess I coasted at a time when many were living out the Myth of Sisyphus. The chairman of the department I was associated with was Charlie Nemeroff who I rarely saw, and then only from afar. I thought he was puffed up guy riding the waves of a psychopharmacology boom – an opportunist. I didn’t know about the "boss of bosses" thing or the layers of deceit. I felt sorry for my colleagues reduced to being medication doctors and attributed it to the evils of managed care. I retired at the end of 2003 and built a small barn.<\/p>\n

After Dr. Nemeroff got defrocked as editor in 2006, I got a re-interested in the goings on in psychiatry. When he got busted by Senator Grassley in 2008, I got much more interested. After he stepped down, I began to learn more and began to blog about what I was learning. I had two Cognitive Dissonance moments. The first was when I reviewed Seroquel’s trip through the FDA and realized that Dr. Richard Borison had authored one of the articles that came from a trial that got Seroquel approved. I had met him in the 1980s and heard him speak. He was a crook from a football field away. He had just come to the Medical College of Georgia and gave a Grand Rounds for us in Atlanta. When I realized that our new chairman wasn’t as outraged as I was that Borison’s talk was such an obvious infomercial, I first started thinking about leaving. When Borison got thrown into prison in the 1990s from the position of Chairman for massive fraud in Clinical Trials, I thought "finally! good riddance!" But when I saw that he’d authored that Seroquel article, it went from an isolated event to an "Oh my god!" and it changed my whole perspective. I began to realize that things were globally awry.<\/p>\n

There was another such Cognitive Dissonance moment. I had read Allen Jones<\/font><\/strong><\/u><\/a> narrative about TMAP and his experiences discovering the level of fraud in TMAP. But when I got hold of the Rothman Report<\/font><\/strong><\/u><\/a>, a document prepared for the coming trial, I walked around feeling moderately dazed for a day or two. It was crazy making<\/font><\/strong><\/em>. By then, I’d become aware of the magnitude of the pharmaceutical invasion of psychiatry and was getting kind of used to rethinking my whole history and the history of my specialty. But the details of the Rothman Report<\/font><\/strong> took things to a new level. It was days after I first read it that I was able to reread it. They say "the devil’s in the details" – certainly true in this case.<\/p>\n

Apparently it had the same impact on Alison Bass<\/font><\/strong>, a veteran of devilish details from researching her book, Side Effects: A Prosecutor, a Whistleblower and a Bestselling Antidepressant on Trial<\/font><\/strong> about an earlier version of a similar debacle. Her recent post [Allegations of fraud and extensive ghostwriting form core of upcoming Texas case against Johnson & Johnson<\/font><\/strong><\/u><\/a>] is a fine summary of the highlights of that document. She concludes:<\/div>\n
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Rothman’s report on J&J is painfully reminscent of what companies like GlaxoSmithKline, Eli Lilly, Pfizer and Forest Labs did to make their antidepressants blockbuster drugs [which I wrote about in Side Effects<\/font><\/a><\/strong><\/u>]. I suspect Rothman’s detailed findings are part of what led a South Carolina Judge earlier this summer to call J&J’s actions in deceiving the public about Risperdal “detestable” in his $327 million ruling against the company — see Pharmalot<\/font><\/a><\/strong><\/u>. Even so, Rothman’s 86-page report makes for disturbing reading. It is an indictment not only of J&J but of academic psychiatry and all the doctors and patient advocacy groups who were all too willing to sell their soul for money.<\/font><\/strong><\/div>\n<\/blockquote>\n
Who ever knows how these things will end in advance or how much will be public? But there’s already enough information in Allen Jones’ Statement<\/font><\/strong><\/u><\/a> and the Rothman Report<\/font><\/strong><\/u><\/a> to make your eyes move independently in their sockets for a day or two if you’re not already desensitized. <\/div>\n