{"id":45644,"date":"2014-04-17T09:00:44","date_gmt":"2014-04-17T13:00:44","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=45644"},"modified":"2014-04-17T07:38:02","modified_gmt":"2014-04-17T11:38:02","slug":"three-wishes","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/04\/17\/three-wishes\/","title":{"rendered":"three wishes&#8230;"},"content":{"rendered":"\n<div align=\"justify\">It&#8217;s been over a hundred years since Freud suggested that our wishes can color the workings of what he called the <em>mental apparatus<\/em>. Think what you will about the old <em>guy<\/em>, but he was onto something with that wish thing. Here are three personal examples:<\/div>\n<ol><span class=\"small\">                <\/p>\n<li>\n<div align=\"justify\">In my last post [<a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/04\/16\/reason-enough\/\" target=\"_blank\">reason enough&hellip;<\/a>], I interpreted the theme of this year&#8217;s APA meeting [Changing the Practice and&nbsp; Perception of Psychiatry] as some recognition that psychiatry&#8217;s reputation is in the tank. But, alas, <a target=\"_blank\" href=\"http:\/\/www.psycritic.com\/\">Psycritic<\/a> gently informed me that I&#8217;d missed the boat:<\/div>\n<ul>\n<div align=\"justify\"><em><font color=\"#200020\">I don&rsquo;t want to a total downer, but when the APA says  &ldquo;changing the practice and perception of psychiatry,&rdquo; with the  &ldquo;practice&rdquo; part they are referring to increasing use of evidenced-based  treatments and integrated care, and the &ldquo;perception&rdquo; part is wanting the  public, other doctors, and med students to see psychiatrists as &ldquo;real  doctors&rdquo; and scientists. Alas, it has nothing to do with the the reasons for change that most of us reading this website believe are important.<\/font><\/em><\/div>\n<\/ul>\n<div align=\"justify\">Alas indeed! I could perhaps blame the pollen count, but that&#8217;s not the only time that my wishes have overwhelmed my rational thinking recently. To wit:                 <\/div>\n<\/li>\n<li>\n<div align=\"justify\">In early March [before the Spring pollen came], the APA published a preliminary schedule for this year&#8217;s meeting. Looking through it, I ran across this:<\/div>\n<div align=\"center\"><img decoding=\"async\" vspace=\"5\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/apa-2014-1.gif\" \/><\/div>\n<div align=\"justify\">That was about a month after Dr. Kupfer&#8217;s Conflict of Interest with this company became clear. I thought maybe this had been put together before and they might need alerting, so I wrote the program chairs:<\/div>\n<ul>\n<div align=\"justify\"><em><font color=\"#200020\">Drs. Muskin and Carter,<\/font><\/em><\/div>\n<div align=\"justify\"><em><font color=\"#200020\">I&#8217;m a retired Psychiatrist and Psychoanalyst who blogs as <a href=\"http:\/\/1boringoldman.com\">1boringoldman<\/a>.           Looking over the preliminary APA Annual Meeting Program, I ran           across this:<\/font><\/em><\/div>\n<div align=\"center\"><em><font color=\"#200020\">[above graphic]<\/font><\/em><\/div>\n<div align=\"justify\"><em><font color=\"#200020\">The presenters are shareholders in a commercial venture [<a target=\"_blank\" href=\"http:\/\/www.adaptivetestingtechnologies.com\/\">Adaptive Testing Technologies<\/a>]               marketing these very CAT tests. The details are well               documented:<\/font><\/em><\/div>\n<div align=\"center\"> <em><font color=\"#200020\">[<a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/01\/21\/open-letter-to-the-apa\/\">open letter to the APA&hellip;<\/a>,<\/font><font> <a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/03\/01\/credibility-2\/\">credibility&hellip;<\/a>, <\/font><font><a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/03\/03\/ludicrous\/\">ludicrous!&hellip;<\/a>] <\/font><\/em><\/div>\n<div align=\"justify\"><em><font color=\"#200020\">Is it really appropriate for them to be               presenting their products in an educational forum like               this? Did they declare this obvious Conflict of Interest               to your program committee? Don&#8217;t we have enough Conflict               of Interest problems already?<\/font><\/em><\/div>\n<\/ul>\n<div align=\"justify\">And was answered the same day:          <\/div>\n<ul>\n<div align=\"justify\"><em><font color=\"#200020\">All presenters disclosed.<\/font><\/em><\/div>\n<div align=\"justify\"><em><font color=\"#200020\">Thank you for your message, I will consider the matter closed.<\/font><\/em><\/div>\n<div align=\"justify\"><em><font color=\"#200020\">Philip R. Muskin,MD<\/font><\/em><\/div>\n<\/ul>\n<div align=\"justify\">And sure enough, when the definitive <a href=\"http:\/\/annualmeeting.psychiatry.org\/File%20Library\/Scientific%20Program\/2014_APA_Program.pdf\" target=\"_blank\">program<\/a> was published, the disclosures [and symposium] were there:<\/div>\n<p align=\"center\"><img decoding=\"async\" width=\"480\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/apa-2014-2.gif\" \/><br \/>      [reformatted to fit screen] <\/p>\n<p align=\"center\"><img decoding=\"async\" width=\"350\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/apa-2014-3.gif\" \/><br \/>      [reformatted to fit screen]<\/p>\n<div align=\"justify\">So it&#8217;s listed as NIMH Research [Gibbons grant to develop his tests]. It&#8217;s disclosed as a coming commercial product. But at the APA convention, it&#8217;s a session. How that&#8217;s anything but a huge conflict of interest <u>and<\/u> using the APA meeting to roll out a new commercial product disguised as an educational symposium is beyond my understanding. But back to the wish it was a clerical error &#8211; no cigar there.   <\/div>\n<\/li>\n<li>\n<div align=\"justify\">The third wish interfering with my judgement should be obvious. I apparently still wish the APA would stand up and firmly acknowledge the problems and make some kind of ethical stand about COI, or just about anything else. So I keep acting as if that&#8217;s possible. But I&#8217;m afraid that&#8217;s the most irrational wish of all. They&#8217;re not going to do that. They didn&#8217;t do it through the DSM-5 process, or at the time of the Grassley investigations, or any time since or in-between. And my continued attempts to view the American Psychiatric Association as anything but a big part of the problem is going to have to accede to Freud&#8217;s Reality Principle &#8211; and fade away. <\/div>\n<\/li>\n<p>   <\/span><\/ol>\n<div align=\"justify\">I guess <a target=\"_blank\" href=\"http:\/\/www.psycritic.com\/\">Psycritic<\/a>&#8216;s right, the APA plans to barrel ahead with &quot;<em>increasing use of  evidenced-based  treatments and integrated care<\/em>&quot; and to get &quot;<em>other doctors &#8230; to see  psychiatrists as &#8216;real  doctors&#8217;.<\/em>&rdquo; It&#8217;s hard for me to see how moving ahead without addressing the tsunami of the academic&middot;pharmaceutical fusion and its attendant conflicts of interest and scientific misbehavior is going to achieve those goals. But what I do see is that my wish for some kind of coming clean and reappraisal emanating from the APA is a just fanciful dream I had&#8230;<\/div>\n","protected":false},"excerpt":{"rendered":"<p>It&#8217;s been over a hundred years since Freud suggested that our wishes can color the workings of what he called the mental apparatus. Think what you will about the old guy, but he was onto something with that wish thing. Here are three personal examples: In my last post [reason enough&hellip;], I interpreted the theme [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","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_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-45644","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/45644","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=45644"}],"version-history":[{"count":32,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/45644\/revisions"}],"predecessor-version":[{"id":45676,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/45644\/revisions\/45676"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=45644"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=45644"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=45644"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}