View Full Version : Tourette’s Syndrome is Neurological: A Reply


Don S.
05-09-14, 12:15 PM
[The following is my response to someone who (most politely) disagreed with an article I wrote and had published on an online article service. Although I am not at liberty to post her response here, one can easily gather what her points were by my replies to them.]

Thank you for reading my article and taking the time to leave such a thorough, intelligent and polite comment. It is most appreciated. I shall try to address your points in contradiction to my views on Tourette's Syndrome ("TS").

In referring to your TS tics, you state: "Sooner or later it happens whether you want it to or not." Yes, I believe that is because tics are habituating, not unlike cigarettes. They are compulsive attempted defense mechanisms to obsessive thoughts. Many things can trigger such recurring, unpalatable thoughts (one of having been embarrassed, afraid or a range of negative emotions). The theories behind the behavioral therapies I endorse are thus basically variations of older habit-reversal therapies. They have evidenced very encouraging results (including a large study funded by TSA), though the process is difficult and often achieves a significant mitigation of tics rather than their complete banishment.

Dr. Weekes's method (in regard to the related "neurotic" affliction of acute anxiety) of learning to "float" through panic attacks (which are very severe manifestations of anxiety and are therefore at least as difficult to deal with as TS tics) is one I have personally greatly benefited from and is the advice an adult character gives to a boy with TS in my short story "Pride's Prison." This method takes persistence, patience and courage but it paid off handsomely for me.

You are the first person with TS I have encountered or read about who asserts that he or she tics during sleep. Your experience as stated implies more a state of waking, semi-consciousness than the unconsciousness that characterizes deep sleep. This implies at least a degree of volition, albeit habituated volition. In any event, even if you do tic in your unconscious sleep you would seem to be very much the exception rather than the rule.

I never concluded that TS is not neurological because certain "antipsychotic" drugs tend to mitigate tics. On the contrary, TS is most certainly not a psychotic affliction as there is no break with reality and TS sufferers are not a danger to themselves or others. What I have said is that the logic behind assuming that because TS symptoms respond to some extent to the usage of such medications then on an ipso facto basis there is a physical cause is not unlike assuming that one's hands are the source of one's compulsion to smoke because a pair of handcuffs would do wonders in addressing the issue. In that light, one might ask how does chemically restraining the brain prove there is a physical anomaly that causes TS? The same perverse philosophy is true for beta blockers and other medications used to reduce TS tics.

I most certainly never denied that the predisposition towards developing TS is genetic. My own personal hypothesis is that all anxiety afflictions are the result of an evolutionary process in which the will to survive has become so pronounced in certain individuals as to become counter-productive. Thus, they become "nervous-wrecks" from what I term to be "acute self-awareness" and -reflection. The nervous system of such an individual is like that of a car's engine in which the idle is set too high.

Your mention of neurotoxins interrupting nerve signals and thus mitigating TS tics in corollary once again is indicative of confusing cause with effect as illuminated by my previously mentioned handcuffs and smoking analogy.

For about forty-five years now, (I would imagine) millions of dollars have been funneled through the government and charities in order to fund studies and research designed to find the seemingly ever-elusive physical anomaly within the central nervous system that is allegedly responsible for TS. I maintain that the reason that all such efforts have failed is because they search for that which does not exist. It is time to abandon this absurd theory and focus resources on therapies that have shown true promise in improving the quality of life for those of us afflicted with TS.

Addendum: if anyone is interested and hasn’t read it yet, here is the link to the article to which the commenter was responding:

http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-11/4528703304

Stevuke79
05-09-14, 12:59 PM
Great post. It's fascinating that even after 45 years and millions of research dollars have failed to find a neurophyisical cause for TS, still mainstream research refuses to consider the obvious conclusion that perhaps none exist. Agumentum ad Ignorantiam. Favorite axiom! Can't refute it. If we could, they wouldn't call us Ignorantiamouses, would they?

Furthermore, these tics relate to otherwise voluntary and conscious actions such as speaking that are often associated with actual conscious thoughts and experiences which should imply the underlying cause is more psychological as apposed to neurophysical and neurochemical. If I had to choose a second favorite axiom: post hoc ergo propter hoc. No contest.

Wait, are those axioms? NOOOO!!! Those are fallacies. ;) Oops. :doh: .. our bad I guess ;) ;)

But now I'm being serious, there's a lot I like about your article even though you're wrong. (being right isn't everything :)) I agree that a more self aware and psychological approach can really help in these matters and it often gets overlooked. However, saying that thoughts or psychology are the cause of the tics is like saying that "stressors" are the cause of depression. In a sense that's true if we mean the "feeling" of being depressed. But when we refer to depression as an illness we're not referring to the feelings, we're referring to the brain's inability to self regulate as most people in the same circumstance do involuntarily.

Where you're right is that with TS as with many mental illnesses there is such a need to focus on the fact that these illnesses are neurophysical to counter the harmful stereotype that it's somehow within one's control. We are right to do so because so many people don't get that it's neurophysical. Where I agree with you is that we do so to a fault. However I think you too are going to a flawed extreme. It's neurophysical. So is smoking.

As far as not finding a neurophysical or biological marker for TS - we lack neurophysical markers for almost every neurological disorder. We know they're there and we continue to look but we hardly ever find. (Schizophrenia, Autism, Bi Polar, ALS.. ) Still, only an Ignorantiamouse would suggest that they therefore don't exist.

Don S.
05-09-14, 02:30 PM
Steve,

Thanks for the rather, er, whimsical reply.

I take it you’re not much of a fan of Betrand Russell. (Something about extraterrestrial teapots and burdens of proof.) I’m not resting my case merely on an argument from ignorance, but rather that combined with myriad empirical points that might be termed to fall within that virtue usually designated—for want of a better term—“common sense."

Reverting to TS, even TSA has apparently (perhaps reluctantly) come to endorse behavioral therapy (even funding a major study by a psychologist at UCLA) without, of course, deigning to explain that if TS is organic then how can any sort of talk therapy possibly have any efficacy. Steve, do you know of any oncologists who would advise a patient to become acutely aware that a malignant tumor is about to arise and then avert such through mental concentration?

Thank you for having taken the time to read my article. It’s most appreciated. Towards its ending, I list five criteria that apply to TS and ask what “other” organic illnesses would meet all of them. After over five years, I’m still waiting for someone to name just one.

By the way, I find your usage of the word “we” to be ambiguous as in: "As far as not finding a neurophysical or biological marker for TS - we lack neurophysical markers for almost every neurological disorder." Are you using the pronoun ubiquitously or are you implying some personal connection to the medical or mental heath fields?

Thanks again.

Lunacie
05-09-14, 02:56 PM
Questions posed by Don S. in his link above:

1) The disease cannot be identified and diagnosed (at least conclusively) by a blood test, X-ray or by any other physical means, but only by observation.

2) The symptoms of the disease vanish while the patient is unconscious.

3) The symptoms of the illness can be at least temporarily repressed by the sufferer, without any physical intervention, sometimes for an extended period of time. (Through “willpower,” can someone suffering with a severe toothache decide not to have it for several hours when not convenient?)

4) What exactly constitutes the disease cannot be objectively discerned, but only subjectively pronounced by “consensus.” (Such and such people have the disease because we say that they do.)

5) A significant percentage of those afflicted with the illness as children are cured, with or without medical intervention, simply by reaching adulthood.

As Stevuke pointed out, many of these are true of all the disorders listed in the DSM.
And all would seem to be true of ADHD as well.

Stevuke79
05-09-14, 03:24 PM
First and foremost, sorry if I was unclear. "We" just means mankind; I'm not implying that I'm a doctor.

Though he doesn't mention it explicitly it's implied that when we find Martian Chamomile Russell would then frown upon us rejecting they may have teapots as well. Kidding aside, to insist they have no teapots is just as much of a false dichotomy. Also, but Russel's teapot is about an existential assertion. If we had to prove such a thing to validate how we treat all mental illnesses, we would be treating basically none of them. I know you know this from your post - just saying.

We know that tics come from dealing with a neurochemical problem in an abnormal way. We don't know why, but to say that suggests it's psychological is not logic. My understanding is that most doctors agree with the idea of treating the psychological components as well and that this can ameliorate some of the symptoms. (I haven't checked - someone correct me with a citation if I'm wrong there.)

Let's make an analogy to ADHD. The media often publishes articles and people even come to this forum to tell us about diet, exercise, will power... and somehow then conclude that we don't need medication or accommodations - just more sunlight. And these people are morons. though most of us take meds and need meds, every single person on this forum knows that if they want any prayer of managing their symptoms they need a proper diet, exercise, environment, will power ..we obsess over these things as much as our meds.

Every single person who has TS knows that it is triggered and influenced by our emotions and even post experiences. But in most cases these are emotions and experiences that EVERYONE has but the genetic factor in the probability for developing tics is right in line with height and eye color. (ie. If a short stature non-TS parent adopts a child from tall and TS parents, adjusting for prevalence in the overall population, the child has as much chance of avoiding TS as he does of being short).

Don S.
05-09-14, 03:28 PM
Questions posed by Don S. in his link above:



As Stevuke pointed out, many of these are true of all the disorders listed in the DSM.
And all would seem to be true of ADHD as well.

Before I respond in more depth, may I please ask you for an example of an affliction that you consider to be strictly psychological? Do you believe such exist? If not, then why is there is an entire professional field (psychology) devoted to the study of that which does not exist? Until I understand your philosophy on this matter, I’m afraid we might be talking at cross purposes.

Thank you.

Stevuke79
05-09-14, 03:28 PM
Seriously, no one?

OCD, ADHD, Aspergers, Hypomania, ODD, GAD..

Who have you been asking?

Stevuke79
05-09-14, 03:34 PM
Before I respond in more depth, may I please ask you for an example of an affliction that you consider to be strictly psychological?

OCPD, PTSD, NPD, Borderlines, .. basically any acronym with a "P" in the middle.

And most of the neurophysical disorders have psychological components. For some of them a psychological" approach is the only way we have to treat them at all.

Lunacie
05-09-14, 04:21 PM
Before I respond in more depth, may I please ask you for an example of an affliction that you consider to be strictly psychological? Do you believe such exist? If not, then why is there is an entire professional field (psychology) devoted to the study of that which does not exist? Until I understand your philosophy on this matter, I’m afraid we might be talking at cross purposes.

Thank you.

There are at least two kinds of depression. One is situational, and eases when the stressful situation passes. One is neurobiological, not caused by any particular life event.

Anxiety is probably much the same, either situational or chronic and neurobiological.

Often the best treatment for mental illness is a combination of meds and therapy.

One reason for this is that there are often comorbid disorders like anxiety and depression.

Don S.
05-09-14, 04:39 PM
[quote=Stevuke79;1646583]
"We know that tics come from dealing with a neurochemical problem in an abnormal way."

—.Please exclude me from this particular “we.” Once again, this is a prime example of confusing cause and effect. As noted within my article, people suffering panic attacks are not victims of hyperactive adrenaline glands. Rather, the profusion of the hormone released during the event is the result of the psychological thought patterns of the person and not visa versa. It is undeniable that the mind can control the body to some extent. It happens during sexual arousal, frightful incidents, etc..

With TS, the mind is conditioned to respond to obsessive thought patterns in a compulsive manner which are attempted defensive measures to divert itself from the irritant. After while, the neural patterns within the brain become engrained (habituated) and tics becomes virtually involuntary (though never truly so). TS is nothing but a distinct variation of OCD; i.e., tics instead of bizarre rituals as compulsive defense mechanisms.

Don S.
05-09-14, 04:58 PM
Every single person who has TS knows that it is triggered and influenced by our emotions and even post experiences. But in most cases these are emotions and experiences that EVERYONE has but the genetic factor in the probability for developing tics is right in line with height and eye color. (ie. If a short stature non-TS parent adopts a child from tall and TS parents, adjusting for prevalence in the overall population, the child has as much chance of avoiding TS as he does of being short).

—Once again, I am most decidedly not denying that there is a tendency towards TS that is genetic. I think you are misunderstanding what I am saying. Is having extreme intelligence or musical ability an abnormality? Is there a difference in the construct of the brains between people with normal IQs and genius level ones? Perhaps. If this is what you mean by asserting that TS has a physical cause then I shall concede the point. I’d be foolish to do otherwise. I admit that if people with TS didn’t have brains and bodies then they wouldn’t suffer from TS…or anything else for that matter.

sarahsweets
05-09-14, 05:03 PM
I wonder how your theory would pertain to bipolar disorder?

Stevuke79
05-09-14, 05:04 PM
With TS, the mind is conditioned to respond to obsessive thought patterns in a compulsive manner which are attempted defensive measures to divert itself from the irritant.

You need research to prove that. It's already proven that it's genetic which until proven otherwise suggests that it's neurophysical. Until then this is all mere and highly unlikely speculation. But studies are contradicted and debunked all the time. Get to work ;) Come back when you have something.

Don S.
05-09-14, 05:08 PM
My understanding is that most doctors agree with the idea of treating the psychological components as well and that this can ameliorate some of the symptoms. (I haven't checked - someone correct me with a citation if I'm wrong there.)

The psychological components as opposed to what? Where is there any proof that there is any physical abnormality producing these psychological components? This is the meat of this issue.

Stevuke79
05-09-14, 05:09 PM
—Once again, I am most decidedly not denying that there is a tendency towards TS that is genetic. I think you are misunderstanding what I am saying. Is having extreme intelligence or musical ability an abnormality? Is there a difference in the construct of the brains between people with normal IQs and genius level ones? Perhaps. If this is what you mean by asserting that TS has a physical cause then I shall concede the point. I’d be foolish to do otherwise. I admit that if people with TS didn’t have brains and bodies then they wouldn’t suffer from TS…or anything else for that matter.

So what are you saying then? That TS has a psychological component and can be ameliorated psychologically? That's mainstream and we all know that. Tell me where you differ from the mainstream.

Mainstream ideas phrased as if contrarian and given incendiary titles. God those waste a lot of time!!

Don S.
05-09-14, 05:17 PM
You need research to prove that. It's already proven that it's genetic which until proven otherwise suggests that it's neurophysical. Until then this is all mere and highly unlikely speculation. But studies are contradicted and debunked all the time. Get to work ;) Come back when you have something.

Everything is genetic, from skin, hair and eye color to various aptitudes. So what is your point? But cancer, for example, can be treated (many times successfully) with physical interventions that might eradicate the abnormality permanently as opposed to simply giving the patient palliative drugs to mitigate the symptom of pain (which will do nothing to address the underlying problem). Exactly what physical intervention is going to eliminate TS permanently? Surgery? Chemo? Drugs? What physical intervention is going to address the underlying problem if it is organic in nature?

Stevuke79
05-09-14, 05:17 PM
—I am .. not denying a tendency towards TS that is genetic.

You agree.

Is having extreme intelligence or musical ability an abnormality? ..If this is what you mean by asserting that TS has a physical cause then I shall concede the point.

You agree again.

Where is there any proof that there is any physical abnormality producing these psychological components? This is the meat of this issue.

Then you disagree.

And I diagnose you with ODD. You contradict yourself. You don't have a point. You just want to win. Very well, you win. TS is rooted in a neurophysical "anomaly" and the condition itself is triggered and influenced by psychological and environmental factors. Can't believe you convinced me. Well done! Kaboom!!! <--- that was my mind. It's completely blown!!

Stevuke79
05-09-14, 05:25 PM
Don, I love you.

The next step in this debate is you telling me specifically where you differ from the mainstream. Because right now, you're like a breathing talking DSM manual.

Or maybe you can just say that you like your titles to be incendiary but not your ideas. I'll accept that. I might even empathize.

Don S.
05-09-14, 05:31 PM
So what are you saying then? That TS has a psychological component and can be ameliorated psychologically? That's mainstream and we all know that. Tell me where you differ from the mainstream.

Mainstream ideas phrased as if contrarian and given incendiary titles. God those waste a lot of time!!

What I am saying is that if there is no physical intervention even theoretically possible to address the substance of a condition (as opposed to simply mitigating symptoms) then that condition is not physical. If a cancer is too far advanced or too virulent in nature to be successfully treated, then it is still a physical affliction, albeit an untreatable one. With TS, there is never a physical intervention to eradicate it.

A significant amount of youngsters with TS “outgrow” it. What happens to this positioned physical anomaly? Does it simply vanish or does it remain and somehow loses its ability to produce the symptoms of TS?

Don S.
05-09-14, 05:41 PM
You agree.



You agree again.



Then you disagree.

And I diagnose you with ODD. You contradict yourself. You don't have a point. You just want to win. Very well, you win. TS is rooted in a neurophysical "anomaly" and the condition itself is triggered and influenced by psychological and environmental factors. Can't believe you convinced me. Well done! Kaboom!!! <--- that was my mind. It's completely blown!!


I asked you for proof of the existence of this alleged physical abnormality responsible for TS and this is how you respond! I’ll therefore graciously accept your sarcastic acknowledgment of defeat! Good night! (for now)

P.S. If you meant to type “OCD” (as opposed to “ODD”), then yes you can correctly diagnose me with such. That’s what I’ve been saying for years now. TS is simply a distinct variation of OCD!

Stevuke79
05-09-14, 05:52 PM
I accept!!

I can't identify the biological marker for TS.

You are 100% mainstream and DSM with regards to TS.

Perfect agreement. Congratulations again on a fine victory.

dvdnvwls
05-09-14, 06:02 PM
P.S. If you meant to type “OCD” (as opposed to “ODD”), then yes you can correctly diagnose me with such. That’s what I’ve been saying for years now. TS is simply a distinct variation of OCD!
ODD is oppositional defiant disorder, the symptoms of which include frequent pointless arguing, deliberately being annoying, and blaming others for own mistakes.

Lunacie
05-09-14, 06:04 PM
:goodpost: I was just going to add that Tourette's seems to be related to OCD and often comorbid with ODD.

Stevuke79
05-09-14, 06:11 PM
Dvd.. you're so awesome. but they wont let me give you more rep. :(

Stevuke79
05-09-14, 06:19 PM
But on the other hand, .. my arguing was no less pointless...

daveddd
05-10-14, 07:23 AM
i understand the relevance

i wasn't aware that familiar transmission proved a neurological problem

unless you're talking genetic neurological disorders with biomarkers (i.e. hunting tons)


like steve said most know that tics are related to suppressed emotion, but i don't agree this is the mainstream view

importance ! the disorders can be treated without gene therapy or brain surgery!


the dsm is not in line with that

Fortune
05-10-14, 07:31 AM
OCPD, PTSD, NPD, Borderlines, .. basically any acronym with a "P" in the middle.

Actually, I don't think current research supports that. Personality disorders describe a variety of behaviors that were thrown into the same category without necessarily being the same sort of thing, and PTSD has definite neurological impact.

I don't really think anything can be "purely psychological." The other guy's question about why we have psychology if psychology doesn't exist is just begging the question. Psychology was established as a field during the same period of time that scientists also seriously discussed the luminiferous ether.

daveddd
05-10-14, 07:37 AM
Actually, I don't think current research supports that. Personality disorders describe a variety of behaviors that were thrown into the same category without necessarily being the same sort of thing, and PTSD has definite neurological impact.

I don't really think anything can be "purely psychological." The other guy's question about why we have psychology if psychology doesn't exist is just begging the question. Psychology was established as a field during the same period of time that scientists also seriously discussed the luminiferous ether.

it seems to be accepted that nothing is purely physical and nothing is purely psychological

the separation of disorders with axis added to the confusion

Fortune
05-10-14, 08:04 AM
it seems to be accepted that nothing is purely physical and nothing is purely psychological

the separation of disorders with axis added to the confusion

This psychological/physical dichotomy is false, though. Like what we call "psychology" is a property of physical processes, not something that exists outside the physical neurology.

daveddd
05-10-14, 08:05 AM
explain further please

Fortune
05-10-14, 08:06 AM
I edited my response. The "mind" is not something separate from the "brain."

daveddd
05-10-14, 08:11 AM
This psychological/physical dichotomy is false, though. Like what we call "psychology" is a property of physical processes, not something that exists outside the physical neurology.

that i agree with

though its often taken out of context, like because our brain thinks, any faulty thinking must be a physical disease

like i drink to make problems go away

were my problems caused by a low blood alcohol level?

BellaVita
05-10-14, 10:06 AM
Well this thread has definitely entertained me.

Fortune
05-10-14, 10:08 AM
I think physical disease is kind of reductive, though. Esp. with stuff as subjective as neurological and psychological disorders.

Don S.
05-10-14, 12:03 PM
ODD is oppositional defiant disorder, the symptoms of which include frequent pointless arguing, deliberately being annoying, and blaming others for own mistakes.

Thank you for the clarification. I must confess that I do have trouble keeping up with the latest additions to the alphabet soup de jour of mental health afflictions. We had a thread awhile back about the contemporary tendency to pathologize personality traits to the point where virtually no one can be classified as “normal” any longer which is, of course, a contradiction in terms. That is, if there is no one deemed to be normal then it would seem that it is not possible for anyone to be abnormal. So why not declare victory over mental health afflictions and call it a day!

Don S.
05-10-14, 12:47 PM
There are at least two kinds of depression. One is situational, and eases when the stressful situation passes. One is neurobiological, not caused by any particular life event.

Anxiety is probably much the same, either situational or chronic and neurobiological.

Often the best treatment for mental illness is a combination of meds and therapy.

One reason for this is that there are often comorbid disorders like anxiety and depression.

You seem to be saying that clinical depression is an organic affliction while situational depression is psychological. Okay. We now have a starting point of agreement which is what I was after.

I presume you would acknowledge that there are some individuals better able than others to cope with adverse situations, such as the loss of a loved one. If so, then how would you account for this? Is there a difference in the construct between the brains of these two individuals? Since you just seemed to acknowledge that situational depression is purely psychological, then I gather you would say no.

As noted within both my response to someone else (in my OP) and in one of my TS articles presented on my website and on an online article service, my personal hypothesis is that those afflicted with all disorders within the chronic/acute anxiety spectrum of mental health afflictions are victims of evolutionary overkill. Their will to survive has become so pronounced as to become counterproductive as illuminated by their symptoms of panic attacks, bizarre rituals (akin to superstition) and tics.

Now, if you were to acknowledge (as I presume you will) that adverse circumstances affect different individuals to widely varying degrees—from: “I must get on with my life because that is what he would have wanted”; to: “I can’t live without her” (suicide)—while also stating that there is no physical difference in the construct of these two positioned individuals’ brains, then you would seem to be saying that it is possible for anatomically same-structured brains to produce dramatically different thought patterns, perhaps based on genetic tendencies. (“That’s just the way she is.”)

If so, that is all I am saying about TS…which is why various behavioral therapies (forms of talk therapies) have shown efficacy in treating the mental health affliction of TS, which they most decidedly would not if the individual were afflicted with cancer instead.

Don S.
05-10-14, 01:27 PM
I edited my response. The "mind" is not something separate from the "brain."

I adamantly disagree with you. You don’t think it possible for identical twins to have different reactions to the same stimulus? Can one be heterosexual and the other homosexual, for example?

The brain is analogous to computer hardware while the mind to software. Your train of thought strikes me as untenable on a reductio ad absurdum basis. It belies empirical evidence.

I responded to another poster here that I acknowledged that TS does indeed have a physical component. That is, if TS sufferers didn’t have brains or bodies then they wouldn’t have TS…or anything else for that matter. I’m afraid my somewhat less than subtle note of sarcasm eluded him as he seemed to take such as a concession on my part. Allow me to further the point by acknowledging that the same conclusion could be reached if oxygen did not exist.

About thirty years ago, I went through a period of extreme stress, and I developed panic disorder: grand mal panic attacks. After reading the works of Dr. Claire Weekes* and utilizing her techniques, I was completely free of symptoms and have been ever since. If brain = mind, then how would you account for this? Psychological?


*Dr. Weekes was a remarkable woman to whom I’m greatly indebted! She had been the first accredited female doctor in Australia. Although she was a medical doctor and not a psychiatrist, she began her career working with shell-shocked WWI veterans for the simple reason that that was one of the few fields she could get into (being a woman) because few others wanted to. From this experience, she formulated her theories on nervous illnesses and published many therapeutic books on the subject.

Unless you have ever experienced panic attacks, it is impossible to explain to you how terrible they are. (I’ll take TS over panic disorder any day!) I honestly thought I was going to die at any moment from a heart attack. After the dawn, I called her at her home in Australia; amazingly, she had had a listed number! The woman who answered the phone (perhaps her daughter or niece, I don’t known) most politely put me right through to her, presumably being used to this, no questions asked.

Although scrupulously polite, Dr. Weekes seemed more embarrassed than pleased when I told her of my deep gratitude to her. Her attitude seemed to be one of: “Well, thank you, but I’m not a humanitarian. This is my job.” Nevertheless, I honor the memory of this great woman! She was also a pioneer in behavioral analysis and therapy which has greatly influenced my thinking regarding TS and all illnesses in the anxiety spectrum of mental afflictions. Her analysis of what happens during panic attacks was right on the proverbial money as were her remedial techniques!

Stevuke79
05-10-14, 01:50 PM
As far as I'm concerned, we're all in agreement. I agree with DSM. I think most of the other members do. I know Don agrees with DSM 100% on this.

So we all agree. Until someone says where their thinking parts ways with DSM, I think this is just one big "patting each other on the back in agreement" party.

Don S.
05-10-14, 02:05 PM
As far as I'm concerned, we're all in agreement. I agree with DSM. I think most of the other members do. I know Don agrees with DSM 100% on this.

So we all agree. Until someone says where their thinking parts ways with DSM, I think this is just one big "patting each other on the back in agreement" party.

How do I agree with DSM (i.e., the APA) that TS is “neurological”? For that matter, why is TS even listed in DSM if it isn’t a psychological affliction? If you mean that you think I agree with Fortune that brain = mind, (rendering the distinction a moot point), then please read my last response to her!

Stevuke79
05-10-14, 02:10 PM
You agreed it was genetic and physiological. Like skin color, hair color.

As far as your post to fortune, you're just arguing. For most people, if they argue it implies they disagree. But you have yet to clearly state where you disagree. You agree there is a genetic physiological predisposition to Tourette's symptoms. The symptoms are triggered by environment and emotions assuming you have the predisposition. At most we have a difference in syntax: which to label cause.

Big hugs my DSM-brother.

Don S.
05-10-14, 02:29 PM
You agreed it was genetic and physiological. Like skin color, hair color.

As far as your post to fortune, you're just arguing. For most people, if they argue it implies they disagree. But you have yet to clearly state where you disagree. You agree there is a genetic physiological predisposition to Tourette's symptoms. The symptoms are triggered by environment and emotions assuming you have the predisposition. At most we have a difference in syntax: which to label cause.

Big hugs my DSM-brother.

I thought my response to Fortune was clear enough.

I don’t know if despite your obvious erudition you are incredibly dense or are simply being waggish to entertain the moderators here! My guess is the latter.

(You bring to mind a kid I used to baby-sit years ago. (The son of a lifelong friend of mine.) Despite being intelligent, even-tempered and well-behaved, he used to unnerve me as he was one of the few people I’ve ever encountered whom I couldn’t “read” (the hallmark of a good psychologist, writer of fiction or poker player). He was inscrutable. I never knew what he actually thought about anything.)

I’ll take one final stab at it. I agree that TS is physical only in the very broadest sense of the word; in the same way that I acknowledge that the ultimate cause of death is life.

daveddd
05-10-14, 02:39 PM
As far as I'm concerned, we're all in agreement. I agree with DSM. I think most of the other members do. I know Don agrees with DSM 100% on this.

So we all agree. Until someone says where their thinking parts ways with DSM, I think this is just one big "patting each other on the back in agreement" party.

oh come on steve

you know no one agrees with the dsm

not even the dsm agrees with itself

its for billing

in syndromic modeling of extremes of human behavior is almost laughable

daveddd
05-10-14, 02:45 PM
the tics themselves aren't physical

they're a learned behavior to cope with physical emotional hypersensitivity

Don S.
05-10-14, 02:50 PM
[quote=daveddd;1646901]"oh come on steve

you know no one agrees with the dsm

not even the dsm agrees with itself

its for billing

in syndromic modeling of extremes of human behavior is almost laughable"

My words off of your fingertips!

Lunacie
05-10-14, 03:05 PM
You seem to be saying that clinical depression is an organic affliction while situational depression is psychological. Okay. We now have a starting point of agreement which is what I was after.

... there are some individuals better able than others to cope with adverse situations, such as the loss of a loved one. If so, then how would you account for this? Is there a difference in the construct between the brains of these two individuals? Since you just seemed to acknowledge that situational depression is purely psychological, then I gather you would say no.

As noted within both my response to someone else (in my OP) and in one of my TS articles presented on my website and on an online article service, my personal hypothesis is that those afflicted with all disorders within the chronic/acute anxiety spectrum of mental health afflictions are victims of evolutionary overkill. Their will to survive has become so pronounced as to become counterproductive as illuminated by their symptoms of panic attacks, bizarre rituals (akin to superstition) and tics.

Now, if you were to acknowledge ... that adverse circumstances affect different individuals to widely varying degrees—from: “I must get on with my life because that is what he would have wanted”; to: “I can’t live without her” (suicide)—while also stating that there is no physical difference in the construct of these two positioned individuals’ brains, then you would seem to be saying that it is possible for anatomically same-structured brains to produce dramatically different thought patterns, perhaps based on genetic tendencies. (“That’s just the way she is.”)

If so, that is all I am saying about TS…which is why various behavioral therapies (forms of talk therapies) have shown efficacy in treating the mental health affliction of TS, which they most decidedly would not if the individual were afflicted with cancer instead.

I had to edit this to leave out all the guesswork on your part as to what I actually believe in order to see what you were saying about your own beliefs.



Actually, I have wondered if there is a difference in the wiring of brains that gives some people a "glass half full" outlook while others have a "glass half empty" outlook.

At this point, I don't believe anyone knows exactly why there is such a difference in outlook.



As far as "anatomically same-structured brains", we all do seem to have the same bits in the same places responsible for the same things.

However, the way those bits communicate with each other may be vastly different (the wiring I mentioned), and in fact, research has shown that they may be of different sizes which could have an impact on mental health.



Therapy actually does provide some benefit in treating and surviving cancer. Or in dealing with grief which you mentioned before, and in dealing with pretty much anything life throws at us.

Some find that therapy in friends, in family, or in a counselor's office. Some find it in nature, in drumming or music, or in prayer. Or any combination.


To save you further assumptions about my beliefs, I'll just tell you that I believe that contrary to what most Western medicine holds true, there is a very real connection between mind, body and spirit.

When we integrate care of all these together, the outcome seems to be better.

I also believe there is a heck of a lot that doctors and scientists and psychologists do not know yet about the way any of these bits works, much less understand how they work in concert with each other.

They are learning more every day, and that's a good thing.

Lunacie
05-10-14, 03:13 PM
How do I agree with DSM (i.e., the APA) that TS is “neurological”? For that matter, why is TS even listed in DSM if it isn’t a psychological affliction? If you mean that you think I agree with Fortune that brain = mind, (rendering the distinction a moot point), then please read my last response to her!

As I wrote in my previous response to you, much is being learned about these mental disorders or diseases.

At one time it was believed that they were all "sick thinking" or psychological.
Now it's known that there is sometimes a neurological issue causing the disorder.

Why is Parkinson's Syndrome listed in the DSM when it's clearly not a result of "sick thinking?"

Just because TS is included in the DSM does not mean it doesn't have a neurologic base. The fact is, no one really knows for sure what causes it at this time.

Lunacie
05-10-14, 03:20 PM
the tics themselves aren't physical

they're a learned behavior to cope with physical emotional hypersensitivity


I've had tics related to allergies, and to injuries to my eyes.

They can also be a sign of too much caffeine, neurological issues, or possibly signal a stroke or other brain injury.

Those are not emotional sensitivities.

namazu
05-10-14, 03:23 PM
If so, that is all I am saying about TS…which is why various behavioral therapies (forms of talk therapies) have shown efficacy in treating the mental health affliction of TS, which they most decidedly would not if the individual were afflicted with cancer instead.
Don,

I don't understand this line of argument.

I agree with you that talk therapies / behavioral therapies are ineffective for treating cancers themselves.

But I am not willing to make the leap with you when you suggest that because talk / behavioral therapies help some with TS, TS cannot be physical in nature and must be "psychological".

The reason talk therapy and behavior therapy cannot cure cancer is because the mechanisms underlying cancer are unrelated to the mechanisms by which talk or behavior therapy work. You cannot convince a wayward cell to stop proliferating by speaking to it calmly or suggesting it swap out maladaptive schema, or whatever.

But the brain is somewhat malleable; there are studies suggesting, for example, that monks who practice certain forms of meditation show evidence of changes in brain activity. Circuits can be strengthened with use (for better, in some cases, or for worse, in the case of anxiety that spirals out of control).

Would it not be within the realm of reason to consider that training, in the form of habit reversal therapy (e.g.), could likewise have an effect on the physical brain? Similarly, it seems plausible to me that exposure therapy for phobias, exposure and response prevention for OCD, and perhaps whatever methods you have used to mitigate panic attacks, could be effective because it selectively reinforces or degrades pathways in the brain that are responsible for those disorders.

Does this imply that all brain-based disorders (or psychological disorders, or neuropsychiatric disorders, or psychological conditions, or psychological tendencies, or whatever you want to call them) would respond to talk or behavior therapies? Not necessarily.

And certainly, not all forms of talk or behavior therapy would work for all types of mental disorders, because the form of the therapy would have to address and circumvent whatever specific mechanism(s) were producing the symptoms.

There may be some disorders that are far more amenable to such intervention than others because their cause is, for want of a better term, more "accessible" or "responsive" to the types of changes that can be brought about by targeted cognitive or behavioral therapy. (Perhaps this would, to you, imply that these disorders are "more psychological", but to me that is not a particularly useful or valid distinction.)

Likewise, some individuals may respond better than others to cognitive or behavioral or other "talk" therapies, despite having ostensibly the same diagnosis, because the underpinnings of the condition vary in nature and/or strength.

But in any case, I don't agree that the fact that "psychological" therapies are efficacious in many cases of TS obviates the possibility that TS (even in those HRT-treatable cases) has a neurobiological basis.

Stevuke79
05-10-14, 04:04 PM
Don - make a novel assertion that contradicts DSM.

Davidd - ok he doesn't agree with DSM. Take your pick:
1. He agrees with DSM to the extent that anyone can,
2. He has failed to disagree with DSM

Either way, the title of his article aside, his views are mainstream.

Stevuke79
05-10-14, 04:07 PM
the tics themselves aren't physical

they're a learned behavior to cope with physical emotional hypersensitivity

DSM is explicit about that. One's choice of tic is environmental, personal, .. Etc..

Don S.
05-10-14, 05:01 PM
I had to edit this to leave out all the guesswork on your part as to what I actually believe in order to see what you were saying about your own beliefs.



Actually, I have wondered if there is a difference in the wiring of brains that gives some people a "glass half full" outlook while others have a "glass half empty" outlook.

At this point, I don't believe anyone knows exactly why there is such a difference in outlook.



As far as "anatomically same-structured brains", we all do seem to have the same bits in the same places responsible for the same things.

However, the way those bits communicate with each other may be vastly different (the wiring I mentioned), and in fact, research has shown that they may be of different sizes which could have an impact on mental health.



Therapy actually does provide some benefit in treating and surviving cancer. Or in dealing with grief which you mentioned before, and in dealing with pretty much anything life throws at us.

Some find that therapy in friends, in family, or in a counselor's office. Some find it in nature, in drumming or music, or in prayer. Or any combination.


To save you further assumptions about my beliefs, I'll just tell you that I believe that contrary to what most Western medicine holds true, there is a very real connection between mind, body and spirit.

When we integrate care of all these together, the outcome seems to be better.

I also believe there is a heck of a lot that doctors and scientists and psychologists do not know yet about the way any of these bits works, much less understand how they work in concert with each other.

They are learning more every day, and that's a good thing.

You write well, most eloquently; almost poetically. But your response really doesn't contain much or anything of substance that I can discern. Rather, it is simply a rather verbose: “I don’t know.” That’s fair enough, but leaves little for me to respond to. This is not a philosophical venue. (Which I enjoy and find interesting, by the way, but such is simply not the issue here.)

Lunacie
05-10-14, 05:16 PM
You write well, most eloquently; almost poetically. But your response really doesn't contain much or anything of substance. Rather, it is simply a rather verbose: “I don’t know.” That’s fair enough, but leaves little for me to respond to. This is not a philosophical venue. (Which I enjoy and find interesting, by the way, but such is simply not the issue here.)

A response isn't necessary.

But I did say I know some things, and don't know others.


What I know: we have the same parts in our brains, but they aren't always the same size or shape.

What I don't know: how the wiring that connects them works or goes wonky.


What I know: therapy can be helpful, and it comes in many forms, and it works best when used with other things that are also known to work.

I don't see treating mental disorders as having to chose between things, but rather that what is helpful is cumulative with other helpful things.


If you still think that's saying nothing of substance, perhaps the lack is in your perception?

Don S.
05-10-14, 05:26 PM
Don,

I don't understand this line of argument.

I agree with you that talk therapies / behavioral therapies are ineffective for treating cancers themselves.

But I am not willing to make the leap with you when you suggest that because talk / behavioral therapies help some with TS, TS cannot be physical in nature and must be "psychological".

The reason talk therapy and behavior therapy cannot cure cancer is because the mechanisms underlying cancer are unrelated to the mechanisms by which talk or behavior therapy work. You cannot convince a wayward cell to stop proliferating by speaking to it calmly or suggesting it swap out maladaptive schema, or whatever.

But the brain is somewhat malleable; there are studies suggesting, for example, that monks who practice certain forms of meditation show evidence of changes in brain activity. Circuits can be strengthened with use (for better, in some cases, or for worse, in the case of anxiety that spirals out of control).

Would it not be within the realm of reason to consider that training, in the form of habit reversal therapy (e.g.), could likewise have an effect on the physical brain? Similarly, it seems plausible to me that exposure therapy for phobias, exposure and response prevention for OCD, and perhaps whatever methods you have used to mitigate panic attacks, could be effective because it selectively reinforces or degrades pathways in the brain that are responsible for those disorders.

Does this imply that all brain-based disorders (or psychological disorders, or neuropsychiatric disorders, or psychological conditions, or psychological tendencies, or whatever you want to call them) would respond to talk or behavior therapies? Not necessarily.

And certainly, not all forms of talk or behavior therapy would work for all types of mental disorders, because the form of the therapy would have to address and circumvent whatever specific mechanism(s) were producing the symptoms.

There may be some disorders that are far more amenable to such intervention than others because their cause is, for want of a better term, more "accessible" or "responsive" to the types of changes that can be brought about by targeted cognitive or behavioral therapy. (Perhaps this would, to you, imply that these disorders are "more psychological", but to me that is not a particularly useful or valid distinction.)

Likewise, some individuals may respond better than others to cognitive or behavioral or other "talk" therapies, despite having ostensibly the same diagnosis, because the underpinnings of the condition vary in nature and/or strength.

But in any case, I don't agree that the fact that "psychological" therapies are efficacious in many cases of TS obviates the possibility that TS (even in those HRT-treatable cases) has a neurobiological basis.

There is a clear distinction between TS and cancer and this point (that I am about to make) is critical in your fully understanding what I mean. Here it is: There is such a thing as asymptomatic cancer. However, there is no such thing as asymptomatic Tourette’s!

While cancer is in an asymptomatic stage, it still exists as cancer. It might be possible to detect it by various physical tests. However, if a person has no evidence of tics, then he or she will never be diagnosed with TS, neither by any physical test (which, by the way, does not exist) nor by observation. You see, the symptoms of TS and TS are one and the same! It is behavior which is why it can be treated with behavioral therapies. Without the presence of tics, there would be nothing to treat.

Regarding the mind being malleable, I hope you are not waiting for me to disagree! Demagogues and cult leaders of all stripes have proven that through the ages. Neural circuitry can be affected by environmental influences. No argument there. Please see my recent response to Fortune regarding her holding to the brain = mind theory in the brain/mind duality debate which I adamantly disagree with, and my analogy of hardware vs. software.

Fortune
05-10-14, 08:20 PM
the tics themselves aren't physical

they're a learned behavior to cope with physical emotional hypersensitivity

Citation needed.

Everything isn't reducible to emotions.

namazu
05-11-14, 12:03 AM
There is a clear distinction between TS and cancer and this point (that I am about to make) is critical in your fully understanding what I mean. Here it is: There is such a thing as asymptomatic cancer. However, there is no such thing as asymptomatic Tourette’s!

While cancer is in an asymptomatic stage, it still exists as cancer. It might be possible to detect it by various physical tests. However, if a person has no evidence of tics, then he or she will never be diagnosed with TS, neither by any physical test (which, by the way, does not exist) nor by observation. You see, the symptoms of TS and TS are one and the same! It is behavior which is why it can be treated with behavioral therapies. Without the presence of tics, there would be nothing to treat.
This is true, at present.

But I do not believe this is because of some fundamental difference between cancer-as-physical-entity and Tourette's-as-behavioral/psychological-entity -- it's a reflection of our limited understanding of TS and recent advances in our understanding of cancers.

I would argue that the distinction you note exists at present for a couple of reasons:
a) researchers/clinicians have not yet figured out how to detect "latent" TS, i.e. the underlying predisposition that I think we agree exists (though we likely disagree on the nature of said predisposition), and
b) because the underlying predisposition towards developing Tourette's appears to cause no problems when asymptomatic, and we do not understand why some people develop more severe tics than others, why age of onset varies, why some people have comorbidities such as ADHD and/or OCD and others appear not to, etc.

Bear in mind that many forms of cancer were, until recently (and some continue to be) undetectable (and thus undiagnosed!) until symptomatic (or worse).

Furthermore, some forms of cancers are slow-growing (e.g. some forms of prostate cancer), and some "pre-cancerous" states frequently resolve without intervention (e.g. some cervical hyperplasias). Even in the presence of a biological marker for cancer, there may be nothing to treat, or the risks of treatment may outweigh the probable benefits in a cancerous condition that may continue to be clinically asymptomatic for many years.

These "pre-cancerous" states or slow-growing cancers may be labeled as such because we currently define cancers by the presence of specific cellular abnormalities. But there are degrees of abnormalities, differences in prognosis, etc., even with cancers, such that they are not so black-and-white as the labels we give them might appear.

Now, it is true that at present, Tourette's is only diagnosed when symptomatic, by definition. But I can easily imagine that in the future, researchers and clinicians might discover some biomarker(s) or set of characteristics that could predict who may have "latent" TS (i.e., a predisposition towards TS that would likely become symptomatic without intervention) and pre-emptively teach such individuals ways of recognizing and managing urges to tic, such that the predisposition never manifests itself in the behaviors we now diagnose as TS. (Ditto OCD, anxiety, panic, etc.)

To me, this possibility seems analogous to any number of other medical conditions we are currently able to detect and treat while asymptomatic, in order to prevent deleterious consequences / clinical symptoms from arising.

Regarding the mind being malleable, I hope you are not waiting for me to disagree! Demagogues and cult leaders of all stripes have proven that through the ages. Neural circuitry can be affected by environmental influences. No argument there. Please see my recent response to Fortune regarding her holding to the brain = mind theory in the brain/mind duality debate which I adamantly disagree with, and my analogy of hardware vs. software.
No, I am not waiting for, nor expecting you to disagree with the mind being malleable. I, however, don't buy into strict separation of mind and brain, and your response to Fortune hasn't convinced me otherwise. Certain types of hardware can run only certain types of software, so in that sense, even if I were to accept your analogy, there would still be an inextricable connection between the brain and the mind. Furthermore, hardware can be upgraded, modified, degraded, inadequately vented, well-designed or not...and these conditions may all affect how well software runs on it.

In your response to Fortune, you made the point that identical twins may react differently to an identical stimulus. I agree that this happens, despite originally-identical genetic material. But the fact that twins may react differently, may develop differently, may experience different disease states, etc., I would argue, is related to the (subtle to significant) differences in conditions to which the twins are exposed, from the womb onward.

I imagine you would say the same -- but I suspect these differences (as they relate to behavior) aren't purely psychological, but also physiological in nature.

In the end, I suspect we would agree more than we would disagree on useful approaches for treating manifest TS, but I guess we may have to agree to disagree on the fundamental nature of TS. Frankly, I'm not so sure the fundamental nature matters as long as we make progress in helping people learn to deal with whatever hands they are dealt (whether the dealing is done more by genetics and neurophysiology, more by experiences and attempted coping strategies, or -- most likely, in my opinion, combinations thereof).

Don S.
05-11-14, 11:59 AM
This is true, at present.

But I do not believe this is because of some fundamental difference between cancer-as-physical-entity and Tourette's-as-behavioral/psychological-entity -- it's a reflection of our limited understanding of TS and recent advances in our understanding of cancers.

I would argue that the distinction you note exists at present for a couple of reasons:
a) researchers/clinicians have not yet figured out how to detect "latent" TS, i.e. the underlying predisposition that I think we agree exists (though we likely disagree on the nature of said predisposition), and
b) because the underlying predisposition towards developing Tourette's appears to cause no problems when asymptomatic, and we do not understand why some people develop more severe tics than others, why age of onset varies, why some people have comorbidities such as ADHD and/or OCD and others appear not to, etc.

Bear in mind that many forms of cancer were, until recently (and some continue to be) undetectable (and thus undiagnosed!) until symptomatic (or worse).

Furthermore, some forms of cancers are slow-growing (e.g. some forms of prostate cancer), and some "pre-cancerous" states frequently resolve without intervention (e.g. some cervical hyperplasias). Even in the presence of a biological marker for cancer, there may be nothing to treat, or the risks of treatment may outweigh the probable benefits in a cancerous condition that may continue to be clinically asymptomatic for many years.

These "pre-cancerous" states or slow-growing cancers may be labeled as such because we currently define cancers by the presence of specific cellular abnormalities. But there are degrees of abnormalities, differences in prognosis, etc., even with cancers, such that they are not so black-and-white as the labels we give them might appear.

Now, it is true that at present, Tourette's is only diagnosed when symptomatic, by definition. But I can easily imagine that in the future, researchers and clinicians might discover some biomarker(s) or set of characteristics that could predict who may have "latent" TS (i.e., a predisposition towards TS that would likely become symptomatic without intervention) and pre-emptively teach such individuals ways of recognizing and managing urges to tic, such that the predisposition never manifests itself in the behaviors we now diagnose as TS. (Ditto OCD, anxiety, panic, etc.)

To me, this possibility seems analogous to any number of other medical conditions we are currently able to detect and treat while asymptomatic, in order to prevent deleterious consequences / clinical symptoms from arising.


No, I am not waiting for, nor expecting you to disagree with the mind being malleable. I, however, don't buy into strict separation of mind and brain, and your response to Fortune hasn't convinced me otherwise. Certain types of hardware can run only certain types of software, so in that sense, even if I were to accept your analogy, there would still be an inextricable connection between the brain and the mind. Furthermore, hardware can be upgraded, modified, degraded, inadequately vented, well-designed or not...and these conditions may all affect how well software runs on it.

In your response to Fortune, you made the point that identical twins may react differently to an identical stimulus. I agree that this happens, despite originally-identical genetic material. But the fact that twins may react differently, may develop differently, may experience different disease states, etc., I would argue, is related to the (subtle to significant) differences in conditions to which the twins are exposed, from the womb onward.

I imagine you would say the same -- but I suspect these differences (as they relate to behavior) aren't purely psychological, but also physiological in nature.

In the end, I suspect we would agree more than we would disagree on useful approaches for treating manifest TS, but I guess we may have to agree to disagree on the fundamental nature of TS. Frankly, I'm not so sure the fundamental nature matters as long as we make progress in helping people learn to deal with whatever hands they are dealt (whether the dealing is done more by genetics and neurophysiology, more by experiences and attempted coping strategies, or -- most likely, in my opinion, combinations thereof).

Thank you for your considered response, but I’m afraid we are at an impasse on at least the basic point. What you seem to be saying is that although I am quite correct that there is no physical cause of TS evidenced to date (after forty-five years of trying to find it), “there still might be.” This despite, as I have laboriously pointed out, that every common sense (empirical) indicator points to the absence of any such physical anomaly.

I do not believe in the existence of fairies. If you were to respond that just because there is no proven evidence of their existence that doesn’t necessarily mean that they don’t exist and that evidence of their existence might be found at some unspecified point in the future, what could I do but shrug à la Bertrand Russell?

Yes, we agree that there is a genetic tendency towards TS (and towards a great many other things!), and yes, we probably disagree as to exactly what that means. To me, it simply means that a man and a woman with genius IQs are more likely to produce a genius offspring than would be a man and a woman of average intelligence. I have already stated my personal hypothesis of how such a genetic tendency emerged towards TS and all afflictions within the anxiety spectrum of mental illnesses. That, unlike my denial that TS has an organic cause, although logically tenable is pure speculation. I can produce no evidence for it whereas I can (and have) regarding my asserting that TS is strictly psychological/behavioral in nature.

But we do agree that we should continue to treat TS with effective treatments regardless of how the affliction is classified within DSM for political and economic reasons. If you and others want to continue to pay lip service to the organic paradigm while more and more TS sufferers find real benefit within the paradigm of behaviorism and related therapies, then so be it just as long as those afflicted with TS have that option. I do not condemn the judicious usage of medications to mitigate symptoms (by chemically restraining the brain) in severe cases, just as long as it is recognized that such is a mere expediency and should be discontinued if a significant mitigation of tics is achieved from behavioral therapies.

Thank you again.

daveddd
05-11-14, 06:57 PM
Citation needed.

Everything isn't reducible to emotions.

this is the problem with the school of "biological disease reductionism " , you haven't proven a single thing among things that should be easily provable in this day and age

yet you want scientific proof of unprovable things

people who are doing behavioral (preferably 3rd wave ) treatment are having excellent results , while the biological disease group is doing terrible , its a shame

and yes all psychiatric "diseases " are reducible to emotion, with rare exception

daveddd
05-11-14, 07:26 PM
I've had tics related to allergies, and to injuries to my eyes.

They can also be a sign of too much caffeine, neurological issues, or possibly signal a stroke or other brain injury.

Those are not emotional sensitivities.

stimulants and allergies can act on the same systems that are physiological signs of emotion

stimulants mainly- anxiety,fear , paranoia

Lunacie
05-11-14, 09:09 PM
stimulants and allergies can act on the same systems that are physiological signs of emotion

stimulants mainly- anxiety,fear , paranoia

I don't take stimulants ... never had a script.

I do realize that sometimes my allergies make me very emotional and anxious.

Can't tell you how many disapproving dentists thought I was being a cry-baby
when I was actually have a reaction to the numbing injection in the gums.
Yes, the tears were flowing, but I wasn't crying.

dvdnvwls
05-11-14, 09:10 PM
Thank you for your considered response, but I’m afraid we are at an impasse on at least the basic point. What you seem to be saying is that although I am quite correct that there is no physical cause of TS evidenced to date (after forty-five years of trying to find it), “there still might be.” This despite, as I have laboriously pointed out, that every common sense (empirical) indicator points to the absence of any such physical anomaly.
This argument assumes that all potential mechanisms for physical action inside the brain are well-known, documented, and understood already, and that a simple search for an anomaly in those well-known mechanisms would be all it would take. I don't think that's the case at all.

Lunacie
05-11-14, 09:21 PM
Thank you for your considered response, but I’m afraid we are at an impasse on at least the basic point. What you seem to be saying is that although I am quite correct that there is no physical cause of TS evidenced to date (after forty-five years of trying to find it), “there still might be.” This despite, as I have laboriously pointed out, that every common sense (empirical) indicator points to the absence of any such physical anomaly.

.

Very few believed in the possibility that germs and bacteria could be causing physical illness
... until someone figured out how to see the little buggers with a microscope.

Study of the physical causes of mental illness is still a very new frontier and we are learning
new things pretty often. Who knows what will be revealed in time?

Fortune
05-11-14, 09:37 PM
this is the problem with the school of "biological disease reductionism " , you haven't proven a single thing among things that should be easily provable in this day and age

yet you want scientific proof of unprovable things

If it's unprovable, then it's unfalsifiable, at which point it is a profoundly unscientific claim, and asserting it as fact is unscientific. And as such, it's probably not true.

people who are doing behavioral (preferably 3rd wave ) treatment are having excellent results , while the biological disease group is doing terrible , its a shame

Note that the article you've linked about this said that results have not been established on a larger scale, so it is too soon to claim that these therapies are quite the miracle you're touting them as - and even worse when you try to use this claim to shut discussion down (such as in the "be positive" thread a few weeks ago).

You are also profoundly mischaracterizing what I have said when you describe my opinion as "biological disease."

Also, even if those third wave treatments do turn out to be as successful as you believe, this does not reinforce a fake Cartesian duality between body and mind. It elaborates further on how the brain functions, but that is really all one can claim.

and yes all psychiatric "diseases " are reducible to emotion, with rare exception

You said yourself in the same post that this is unfalsifiable. This is at best an article of faith, not a known or demonstrated fact.

daveddd
05-12-14, 12:56 AM
yes and mental illness as diseases are proven facts:roll eyes:

any day now science will find the cause of the disease

until then everyone should sit by and helplessly suffer


like dizfriz says, proof is for math and booze, not psychology

ill take results

daveddd
05-12-14, 01:05 AM
I don't take stimulants ... never had a script.

I do realize that sometimes my allergies make me very emotional and anxious.

Can't tell you how many disapproving dentists thought I was being a cry-baby
when I was actually have a reaction to the numbing injection in the gums.
Yes, the tears were flowing, but I wasn't crying.

coffee that you mentioned is a stim

there will always be rare examples and personal anecdote

but the main focus is the what ?50% of americans with a diagnosable dsm disease

namazu
05-12-14, 02:47 AM
Thank you for your considered response, but I’m afraid we are at an impasse on at least the basic point. What you seem to be saying is that although I am quite correct that there is no physical cause of TS evidenced to date (after forty-five years of trying to find it), “there still might be.” This despite, as I have laboriously pointed out, that every common sense (empirical) indicator points to the absence of any such physical anomaly.
Thank you, as well, for your reply.

...But no, this is not what I am saying.

I disagree with your assertion that "every common sense (empirical) indicator points to the absence of any such physical anomaly".

There is empirical evidence of physiological differences in the brains of people with Tourette's.

(Whether those differences precede or follow symptoms, I could not say at this time, and that could be interesting fodder for discussion. But there is indeed empirical evidence that, at least at the population level, there are differences observed in the brain function of people with TS compared with individuals without TS. Differences have been observed even among drug-naive populations, lest you worry that prior use of medication might invalidate the inferences made from these studies.)

You may be interested in searching Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/?term=tourette)(a database of articles appearing in research journals) with terms like Tourette's + MRI (e.g. - but you can substitute other brain imaging or neuroanatomical terms) for a sampling of some of the research findings to date.

The research is indeed in its infancy, and there are some conflicting results, but that is the nature of scientific research.

Note that Pubmed also contains many citations to studies whose results support behavioral therapies such as HRT for TS, either alone or as an adjunct to other forms of treatment. I accept these as empirical evidence in support of the use of these behavioral therapies, just as I consider evidence of physiological differences to support the idea that there are neurobiological causes for TS.

I do not believe in the existence of fairies. If you were to respond that just because there is no proven evidence of their existence that doesn’t necessarily mean that they don’t exist and that evidence of their existence might be found at some unspecified point in the future, what could I do but shrug à la Bertrand Russell?
Nor do I believe in the existence of fairies. However, the possibility seems remote enough to me and unimportant enough to me that I will admit I have never bothered to look into the matter seriously...

In the case of TS, however, I have reasons to believe that neurobiology underlies the condition, and chief among these reasons is the extant empirical evidence provided by multiple research studies, such as those indexed in PubMed.

Yes, we agree that there is a genetic tendency towards TS (and towards a great many other things!), and yes, we probably disagree as to exactly what that means. To me, it simply means that a man and a woman with genius IQs are more likely to produce a genius offspring than would be a man and a woman of average intelligence. I have already stated my personal hypothesis of how such a genetic tendency emerged towards TS and all afflictions within the anxiety spectrum of mental illnesses.
And I find your hypothesis -- that genes may confer some tendency towards hyperreactivity or excess in traits that originally evolved to maintain safety/security -- to be plausible, broadly speaking, even if unproven.

However, a genetic tendency must be expressed through some physical mechanism, no? Genes are not magicians (or fairies!) who can wave a magic wand and say "Abracadabra!" and produce a psychological condition by fiat, after all.

That, unlike my denial that TS has an organic cause, although logically tenable is pure speculation. I can produce no evidence for it whereas I can (and have) regarding my asserting that TS is strictly psychological/behavioral in nature.
You have not provided convincing evidence (at least to my mind) that TS is "strictly psychological/behavioral in nature", particularly in light of the empirical evidence that physiological differences exist in the brains of people with TS.

But we do agree that we should continue to treat TS with effective treatments regardless of how the affliction is classified within DSM for political and economic reasons.
Yes, we certainly do agree on this point.

...Incidentally, if I had my druthers, I'd classify TS in a section with OCD-spectrum and/or anxiety disorders as well, in contrast to TSA's official position (which seeks to separate TS from "psychiatric" disorders). Although TS certainly does involve "movement", I believe TS has more in common with OCD than it has with, say, developmental coordination disorder (which I'd have placed with learning disorders...though there are plenty of cases of TS-dyspraxia comorbidity, too).

If you and others want to continue to pay lip service to the organic paradigm while more and more TS sufferers find real benefit within the paradigm of behaviorism and related therapies, then so be it just as long as those afflicted with TS have that option. I do not condemn the judicious usage of medications to mitigate symptoms (by chemically restraining the brain) in severe cases, just as long as it is recognized that such is a mere expediency and should be discontinued if a significant mitigation of tics is achieved from behavioral therapies.
Don, I do not see the "organic paradigm" as in any way incompatible with the use of targeted behavioral therapies, in part because I do not believe that the mind and brain are wholly separable entities.

(I can see why someone who does believe in mind-brain duality -- or, alternatively, someone who does not believe in mind-brain duality, but sees brain --> mind as a unidirectional process and does not believe that learned behaviors can affect the physical brain -- might consider them at odds, though.)

Nowhere in this thread have I mentioned medication as a treatment for TS, so I am not sure why you bring it up now as though I had advocated it as superior to other therapies for TS -- I have not.

I agree with you that when behavioral therapies are successful in mitigating symptoms, medications need not be used. Furthermore, they need not be used even if symptoms are not fully mitigated by behavioral measures; as you note, used judiciously, they are an expediency that helps some sufferers mitigate serious impairments resulting from uncontrolled tics.

Don S.
05-12-14, 10:08 AM
this is the problem with the school of "biological disease reductionism " , you haven't proven a single thing among things that should be easily provable in this day and age

yet you want scientific proof of unprovable things

people who are doing behavioral (preferably 3rd wave ) treatment are having excellent results , while the biological disease group is doing terrible , its a shame

and yes all psychiatric "diseases " are reducible to emotion, with rare exception

Exactly! Great post, succinct yet salient. Thank you.

Don S.
05-12-14, 10:32 AM
This argument assumes that all potential mechanisms for physical action inside the brain are well-known, documented, and understood already, and that a simple search for an anomaly in those well-known mechanisms would be all it would take. I don't think that's the case at all.

First of all, you might not be aware that it has only been since the late sixties that TS was thought of as an organic illness. Prior to that, it was accepted as a mental illness. So what I am arguing is not all that “off the wall.” And what was the reason for this radical transformation of TS from a psychological affliction into an organic one? The rational was that since haloperidol (Haldol) tends to mitigate tics that ipso facto there must be a physical agency causing the symptoms (because it responds to drugs). I believe my favorite analogy of smokers and handcuffs illuminates the bizarre logic upon which this (economically and politically expedient) paradigm shift occurred. What "other" evidence is there that it is physical? (Brain scans? Please see my forthcoming response to namazu.)

Even if you hold open the (dubious) possibility that at some unspecified time in the future a physical anomaly within the CNS will be located, why at this point in time should TS be classified as neurological? On what basis? On the basis that some evidence to that effect might be found in the future? What do you rest your case on as of now that TS is organic?

Don S.
05-12-14, 10:58 AM
Very few believed in the possibility that germs and bacteria could be causing physical illness
... until someone figured out how to see the little buggers with a microscope.

Study of the physical causes of mental illness is still a very new frontier and we are learning
new things pretty often. Who knows what will be revealed in time?

Until, if ever, this projected physical anomaly is discovered, then the default assumption should be that TS is psychological and tics are learned behavior which becomes habituated by reinforcement as empirical evidence suggests.

Since poor Pluto has been expunged by the powers that be in such matters from the canon of planets in our solar system, we now say that there are eight planets. We do not say that there are nine (or ten or eleven!) because someday one or more others might be discovered.

Don S.
05-12-14, 11:16 AM
Thank you, as well, for your reply.

...But no, this is not what I am saying.

I disagree with your assertion that "every common sense (empirical) indicator points to the absence of any such physical anomaly".

There is empirical evidence of physiological differences in the brains of people with Tourette's.

(Whether those differences precede or follow symptoms, I could not say at this time, and that could be interesting fodder for discussion. But there is indeed empirical evidence that, at least at the population level, there are differences observed in the brain function of people with TS compared with individuals without TS. Differences have been observed even among drug-naive populations, lest you worry that prior use of medication might invalidate the inferences made from these studies.)

You may be interested in searching Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/?term=tourette)(a database of articles appearing in research journals) with terms like Tourette's + MRI (e.g. - but you can substitute other brain imaging or neuroanatomical terms) for a sampling of some of the research findings to date.

The research is indeed in its infancy, and there are some conflicting results, but that is the nature of scientific research.

Note that Pubmed also contains many citations to studies whose results support behavioral therapies such as HRT for TS, either alone or as an adjunct to other forms of treatment. I accept these as empirical evidence in support of the use of these behavioral therapies, just as I consider evidence of physiological differences to support the idea that there are neurobiological causes for TS.

Namazu,

Regarding brain scans, the following reply (three pages, about five minutes reading time) at my website addresses the then theory de jour as to where exactly does this alleged physical anomaly responsible for TS lie within the CNS. Within it, I state what it would take to convince me that this organic paradigm is legitimate by way of a challenge:

http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-19/4539428707

I shall answer some other points you made later in your reply as soon as time allows.

By the way, what would it take for you to accept that there is no organic abnormality responsible for TS? Another forty-five years of futile searching?

Thank you.

Lunacie
05-12-14, 11:25 AM
Until, if ever, this projected physical anomaly is discovered, then the default assumption should be that TS is psychological and tics are learned behavior which becomes habituated by reinforcement as empirical evidence suggests.

Since poor Pluto has been expunged by the powers that be in such matters from the canon of planets in our solar system, we now say that there are eight planets. We do not say that there are nine (or ten or eleven!) because someday one or more others might be discovered.


If everyone makes such an assumption, then no one ever looks for any other reasons.

Meanwhile, the distinguished group of knowledgeable people who updated the DSM last year reclassified
Tourette's and tic disorders as motor disorders listed in the neurodevelopmental disorder category.

That has more credibility to my mind than someone who appears on this forum and begins to lecture us
on his opinion of the true nature of TS.

Dizfriz
05-12-14, 12:07 PM
I haven't been following this thread but today when I skimmed it, I got a feeling of Deja Vu.

Sure enough Don was here in 2009 pushing some of the same ideas.

http://www.addforums.com/forums/showthread.php?t=68348&highlight=Pride%27s+Prison

Just for information.

Dizfriz

Don S.
05-12-14, 12:16 PM
If everyone makes such an assumption, then no one ever looks for any other reasons.

Meanwhile, the distinguished group of knowledgeable people who updated the DSM last year reclassified
Tourette's and tic disorders as motor disorders listed in the neurodevelopmental disorder category.

That has more credibility to my mind than someone who appears on this forum and begins to lecture us
on his opinion of the true nature of TS.

You obviously have little knowledge of the political workings of DSM and the intense lobbying that goes on regarding classification. It was originally proposed that TS be classified within the “Anxiety and Obsessive-Compulsive Disorders” (exactly as it should be) if the previous mealy-mouthed classification was discontinued, but that was fought tooth and nail.

If you think this surprised me, then please read this which was written before a final determination was made:

http://wwwdnschneidercom.xbuild.com/#/ts-and-adhd-22/4541011721

Lunacie
05-12-14, 12:29 PM
I haven't been following this thread but today when I skimmed it, I got a feeling of Deja Vu.

Sure enough Don was here in 2009 pushing some of the same ideas.

http://www.addforums.com/forums/showthread.php?t=68348&highlight=Pride%27s+Prison

Just for information.

Dizfriz

Also in 2008.

Gotta admire the tenacity, but I'd be more admiring if Don was open to a less restrictive point of view.

Don S.
05-12-14, 12:45 PM
Also in 2008.

Gotta admire the tenacity, but I'd be more admiring if Don was open to a less restrictive point of view.

Yes, I post at this fine forum (which attracts people who are extraordinarily intelligent and well-versed in mental health matters, much more so than I have encountered on any other forum (I’ve even seen doctors post here!)) periodically under the assumption that the forum continues to attract new readers and participants. Is there anything objectionable about that? It’s not like I harp on matters day in and day out.

If you feel as thought I lack empathy for people with TS, then why don’t you do something radical and actually read “Pride’s Prison,” my free access, semi-autobiographical short story. The purpose of the story is to allow the reader to understand how such kids feel. By the time you get to the first few pages of the second half of the story (Part III), you will understand

.

Lunacie
05-12-14, 01:13 PM
Yes, I post at this fine forum (which attracts people who are extraordinarily intelligent and well-versed in mental health matters, much more so than I have encountered on any other forum (I’ve even seen doctors post here!)) periodically under the assumption that the forum continues to attract new readers and participants. Is there anything objectionable about that? It’s not like I harp on matters day in and day out.

If you feel as thought I lack empathy for people with TS, then why don’t you do something radical and actually read “Pride’s Prison,” my free access, semi-autobiographical short story. The purpose of the story is to allow the reader to understand how such kids feel. By the time you get to the first few pages of the second half of the story (Part III), you will understand

.

I don't understand why you think I may think that you lack empathy for people with TS? :confused:


I may read your story, my autistic granddaughter has a boy with TS in her class.
His noises drive her batty because of her autistic sensitivities.

Mostly I read about ADHD and Autism though, because these are the things that affect MY family.

Don S.
05-12-14, 01:50 PM
I don't understand why you think I may think that you lack empathy for people with TS? :confused:


I may read your story, my autistic granddaughter has a boy with TS in her class.
His noises drive her batty because of her autistic sensitivities.

Mostly I read about ADHD and Autism though, because these are the things that affect MY family.

The diagnoses of Attention Deficit Disorder and hyperactivity were not yet formulated when I was a kid. However, I can say without any reservation whatsoever that I could have been the cover boy for ADHD and it is mentioned within the story. In fact, looking back I think more of my problems in school were caused by ADHD than Tourette’s (which was relatively mild but still noticeable; I was diagnosed with that by a Navy psychiatrist). So it might be deemed curious as to why I have focused so much of my attention on TS and so little on ADHD. I really don’t know. But because I don’t believe in stating opinions from ignorance, I have rarely posted on the subject here.

As I said, what I so appreciate about this particular forum is the high degree of intelligence and education of so many of its members (present company not excepted!), so I don't have to tone down my writing. I’m sorry if I sometime come off as sounding pedantic.

Lunacie
05-12-14, 03:35 PM
The diagnoses of Attention Deficit Disorder and hyperactivity were not yet formulated when I was a kid. However, I can say without any reservation whatsoever that I could have been the cover boy for ADHD and it is mentioned within the story. In fact, looking back I think more of my problems in school were caused by ADHD than Tourette’s (which was relatively mild but still noticeable; I was diagnosed with that by a Navy psychiatrist). So it might be deemed curious as to why I have focused so much of my attention on TS and so little on ADHD. I really don’t know. But because I don’t believe in stating opinions from ignorance, I have rarely posted on the subject here.

As I said, what I so appreciate about this particular forum is the high degree of intelligence and education of so many of its members (present company not excepted!), so I don't have to tone down my writing. I’m sorry if I sometime come off as sounding pedantic.

Which doesn't answer my question, but only raises another one.

I did not write nor imply that you lack empathy for TS, yet you asked me if I felt that you do.
Where did you get that impression?

Neither did I write nor imply that you come across as sounding pedantic so there was no need to apologize.


The idea that ADHD was not diagnosed when you were a boy has been addressed by several posters
who were diagnosed with Minimal Brain Dysfunction when they were children.

The symptoms of ADHD have been recognized for over a hundred years, but with different labels at different times.

This is not a new disorder or a new diagnosis, merely a new label for something that was already known.

daveddd
05-12-14, 05:41 PM
Which doesn't answer my question, but only raises another one.

I did not write nor imply that you lack empathy for TS, yet you asked me if I felt that you do.
Where did you get that impression?

Neither did I write nor imply that you come across as sounding pedantic so there was no need to apologize.


The idea that ADHD was not diagnosed when you were a boy has been addressed by several posters
who were diagnosed with Minimal Brain Dysfunction when they were children.

The symptoms of ADHD have been recognized for over a hundred years, but with different labels at different times.

This is not a new disorder or a new diagnosis, merely a new label for something that was already known.

there was other names for adhd, but it was no where near as recognized when even i was a kid, and I'm 33

so the several posters with minimal brain dysfunction were lucky, thats all

Lunacie
05-12-14, 05:46 PM
there was other names for adhd, but it was no where near as recognized when even i was a kid, and I'm 33

so the several posters with minimal brain dysfunction were lucky, thats all

I do realize that ADHD has only become widely recognized and treated within the last 3 decades or so.

But it was known and diagnosed before that, just by a different name.

Don S.
05-12-14, 05:51 PM
Which doesn't answer my question, but only raises another one.

I did not write nor imply that you lack empathy for TS, yet you asked me if I felt that you do.
Where did you get that impression?

Neither did I write nor imply that you come across as sounding pedantic so there was no need to apologize.


The idea that ADHD was not diagnosed when you were a boy has been addressed by several posters
who were diagnosed with Minimal Brain Dysfunction when they were children.

The symptoms of ADHD have been recognized for over a hundred years, but with different labels at different times.

This is not a new disorder or a new diagnosis, merely a new label for something that was already known.

The perhaps perceived (by myself) lack of empathy on my part comes from my perception as to why so many people seem to respond negatively, even hostilely to my rejection of the organic, neurological paradigm in favor of a psychological/behavioral one. The party line goes that TS sufferers cannot control their actions (tics) because of an organic anomaly the same way epileptics (for example) cannot control their seizures. I might seem to be saying that since TS tics are voluntary that those afflicted with TS are engaging in bad behavior.

However, all too often I fear that my stating (over and over again!) that through practice and subsequent repetition tics become habituating and virtually involuntary is lost upon people wedded to the organic paradigm due to defensiveness. They fail to discern that it’s a point without a distinction regarding “fault.”

I—of all people!—understand that TS sufferers cannot help their tics. When I say that if this organic paradigm is factually incorrect (as I ardently maintain), I also assert that the true callousness towards those afflicted with TS is to have them believe that there is nothing they can do about their tics (since they result from an organic abnormality) and therefore they should simply take medications to mitigate them and learn to live with the condition.

Regarding my perception you might have thought I come off as pedantic, that comes from your previous post asserting that I come here to lecture people. That sounds like a fairly close definition of the word to me.

daveddd
05-12-14, 06:01 PM
The perhaps perceived (by myself) lack of empathy on my part comes from my perception as to why so many people seem to respond negatively, even hostilely to my rejection of the organic, neurological paradigm in favor of a psychological/behavioral one. The party line goes that TS sufferers cannot control their actions (tics) because of an organic anomaly the same way epileptics (for example) cannot control their seizures. I might seem to be saying that since TS tics are voluntary that those afflicted with TS are engaging in bad behavior.

However, all too often I fear that my stating (over and over again!) that through practice and subsequent repetition tics become habituating and virtually involuntary is lost upon people wedded to the organic paradigm due to defensiveness. They fail to discern that it’s a point without a distinction regarding “fault.”

I—of all people!—understand that TS sufferers cannot help their tics. When I say that if this organic paradigm is factually incorrect (as I ardently maintain), I also assert that the true callousness towards those afflicted with TS is to have them believe that there is nothing they can do about their tics (since they result from an organic abnormality) and therefore they should simply take medications to mitigate them and learn to live with the condition.

Regarding my perception you might have thought I come off as pedantic, that comes from your previous post asserting that I come here to lecture people. That sounds like a fairly close definition of the word to me.

i get this completely

i was relieved when i found out i wasn't bound by incurable brain diseases

but it seems to be insulting to many

oddly people who have been through terrible abuse (which leads to self blame) seem to be very attached to a biological model of mental illness

almost as an ultimate self blame outlet , its really upsetting , knowing how stuck they are (no one here that i know of)

Lunacie
05-12-14, 06:14 PM
The perhaps perceived (by myself) lack of empathy on my part comes from my perception as to why so many people seem to respond negatively, even hostilely to my rejection of the organic, neurological paradigm in favor of a psychological/behavioral one. The party line goes that TS sufferers cannot control their actions (tics) because of an organic anomaly the same way epileptics (for example) cannot control their seizures. I might seem to be saying that since TS tics are voluntary that those afflicted with TS are engaging in bad behavior.

However, all too often I fear that my stating (over and over again!) that through practice and subsequent repetition tics become habituating and virtually involuntary is lost upon people wedded to the organic paradigm due to defensiveness. They fail to discern that it’s a point without a distinction regarding “fault.”

I—of all people!—understand that TS sufferers cannot help their tics. When I say that if this organic paradigm is factually incorrect (as I ardently maintain), I also assert that the true callousness towards those afflicted with TS is to have them believe that there is nothing they can do about their tics (since they result from an organic abnormality) and therefore they should simply take medications to mitigate them and learn to live with the condition.

Regarding my perception you might have thought I come off as pedantic, that comes from your previous post asserting that I come here to lecture people. That sounds like a fairly close definition of the word to me.

I haven't seen anyone (least of all me) saying that medications are the only effective treatment for TS,
thereby fostering victim-based mentality for those who have tics.

Lecture = pedantic? Not at all what I meant to say.
I meant more in the form of a soapbox, [ broadly: something that provides an outlet for delivering opinions ]


I can't speak for others, but I find it very annoying when after reading a few of my posts here you make
the assumption that you know why I hold a certain opinion.
Such as saying that some who respond are "defensive" because they are "wedded to the organic paradigm."

Perhaps you are creating a strawman argument to joust against?

daveddd
05-12-14, 06:24 PM
I haven't seen anyone (least of all me) saying that medications are the only effective treatment for TS,
thereby fostering victim-based mentality for those who have tics.

Lecture = pedantic? Not at all what I meant to say.
I meant more in the form of a soapbox, [ broadly: something that provides an outlet for delivering opinions ]


I can't speak for others, but I find it very annoying when after reading a few of my posts here you make
the assumption that you know why I hold a certain opinion.
Such as saying that some who respond are "defensive" because they are "wedded to the organic paradigm."

Perhaps you are creating a strawman argument to joust against?

id say lunacie has a pretty good balanced view

although don was met immediately with incorrect defensive posts, so i can see how it can all come across as defensive

daveddd
05-12-14, 06:37 PM
"But when we refer to depression as an illness we're not referring to the feelings, we're referring to the brain's inability to self regulate as most people in the same circumstance do involuntarily."

steveuk

this is where the most important separation of disease and psychology needs to be made


where disease would be the brain self regulates involuntarily , psychology , in the words of russell barkley is "self regulation methods are self directed , conscious (the important part) acts " or voluntary acts

namazu
05-12-14, 09:24 PM
I also assert that the true callousness towards those afflicted with TS is to have them believe that there is nothing they can do about their tics (since they result from an organic abnormality) and therefore they should simply take medications to mitigate them and learn to live with the condition.
I remain baffled (and, I must admit, rather put-off) by your assertion that those of us who are willing to entertain an organic cause of TS "believe there is nothing [those with TS] can do about their tics...and therefore they should simply take medications to mitigate them and learn to live with the condition".

That a condition has an organic cause does not, to me, imply that said condition
- must always (or should, as a first approach) be treated with medications,
- cannot be remedied in a lasting way, or
- will not respond to behavioral treatments.

As I read you, you are setting up a false dichotomy (psychological = fixable, organic = immutable and tragic) and using this false dichotomy to label those who disagree with you (and even those of us who agree with you in part!) as misguided at best and callous at worst. I agree with Lunacie that this approach to discussion, and the (sometimes incorrect) imputation of others' beliefs/motives, more likely contributes to your perception that others see you as lacking in empathy than any belief that you are accusing people with tics of bad behavior; I have never seen you do the latter and would not have inferred such a belief from your posts.

You do seem to believe that buying into "the organic paradigm" essentially condemns sufferers to helplessness (other than pharmaceutical help and resignation).

I strongly disagree -- but please, if I'm mischaracterizing your belief, let me know.

Don S.
05-13-14, 09:21 AM
I remain baffled (and, I must admit, rather put-off) by your assertion that those of us who are willing to entertain an organic cause of TS "believe there is nothing [those with TS] can do about their tics...and therefore they should simply take medications to mitigate them and learn to live with the condition".

That a condition has an organic cause does not, to me, imply that said condition
- must always (or should, as a first approach) be treated with medications,
- cannot be remedied in a lasting way, or
- will not respond to behavioral treatments.

As I read you, you are setting up a false dichotomy (psychological = fixable, organic = immutable and tragic) and using this false dichotomy to label those who disagree with you (and even those of us who agree with you in part!) as misguided at best and callous at worst. I agree with Lunacie that this approach to discussion, and the (sometimes incorrect) imputation of others' beliefs/motives, more likely contributes to your perception that others see you as lacking in empathy than any belief that you are accusing people with tics of bad behavior; I have never seen you do the latter and would not have inferred such a belief from your posts.

You do seem to believe that buying into "the organic paradigm" essentially condemns sufferers to helplessness (other than pharmaceutical help and resignation).

I strongly disagree -- but please, if I'm mischaracterizing your belief, let me know.

I still do not understand how anyone can endorse both the organic paradigm of TS and behavioral therapy or any sort of talk therapy to treat it. If someone contracts cancer, then obviously situational depression will often follow which can be treated with talk therapy. However, it would do nothing for the cancer itself…or for a broken leg…or for a ruptured appendix, etc.. Anticipating a possible response from you, the behavioral therapy indicated for TS patients is not merely aimed at helping the patient cope with the condition (learning to live with it), but rather at attacking the affliction itself, teaching patients how to significantly mitigate the tics if not banishing them entirely.

When encouraging results were reported by Duke University in treating youngsters with TS with a form of behavioral therapy a few years back, some neurologists were reported in newspapers to have responded that the idea was basically nonsense and they would not advise their TS patients to try this approach. At least they were logically consistent.

Don S.
05-13-14, 09:30 AM
i get this completely

i was relieved when i found out i wasn't bound by incurable brain diseases

but it seems to be insulting to many

oddly people who have been through terrible abuse (which leads to self blame) seem to be very attached to a biological model of mental illness

almost as an ultimate self blame outlet , its really upsetting , knowing how stuck they are (no one here that i know of)

Thank you for your penetrating insights as evidenced within this most perceptive reply. It baffles me as well why many TS sufferers seem to rather think of themselves as having a physical abnormality which is currently untreatable (even if it does exist) rather than a psychological affliction which can be treated. Yes, people often believe what they want to believe, but why would they want to believe this in the absence of any compelling evidence whatsoever?

namazu
05-13-14, 09:32 AM
I still do not understand how anyone can endorse both the organic paradigm of TS and behavioral therapy or any sort of talk therapy to treat it. If someone contracts cancer, then obviously situational depression will often follow which can be treated with talk therapy. However, it would do nothing for the cancer itself…or for a broken leg…or for a ruptured appendix, etc.. Anticipating a possible response from you, the behavioral therapy indicated for TS patients is not merely aimed at helping the patient cope with the condition (learning to live with it), but rather at attacking the affliction itself, teaching patients how to significantly mitigate the tics if not banishing them entirely.

When encouraging results were reported by Duke University in treating youngsters with TS with a form of behavioral therapy a few years back, some neurologists were reported in newspapers to have responded that the idea was basically nonsense and they would not advise their TS patients to try this approach. At least they were logically consistent.
I am not those neurologists quoted in newspapers...or any neurologist, for that matter... Those who disagree with you do not have monolithic views.

Why do you consider it "logically inconsistent" to believe that a condition is based in neurobiology but can be changed with behavioral techniques?

If those behavioral techniques are designed specifically to extinguish certain behaviors while strengthening other pathways (the whole "competing response" part of HRT), which to me evokes neural plasticity, then there is no apparent contradiction... The reason I brought up the example of the monks meditating earlier was to indicate that I believe that behavioral training can change the brain in measurable ways.

As I mentioned earlier, the physiological mechanisms underlying cancer (...or broken legs, ruptured appendices, etc.) are not suited to direct targeting by behavioral therapy, whereas the mechanisms of TS, being (I believe) neurological, appear to be. (Note: this is not to say that all neurological conditions are necessarily amenable to behavioral therapy, but the pathways involved in TS seem to make it suited to this type of therapy.)

daveddd
05-13-14, 10:10 AM
Namazu

Just chiming in

I see a lot of people have a somewhat balanced view

But often and even in this thread it's viewed as insulting and offensive to suggest that these certain disorders can be fixed by psycological treatment

namazu
05-13-14, 10:39 AM
Namazu

Just chiming in

I see a lot of people have a somewhat balanced view

But often and even in this thread it's viewed as insulting and offensive to suggest that these certain disorders can be fixed by psycological treatment
I'm not sure I've seen anyone in this thread argue that the suggestion that psychological treatment can help with disorders like TS is insulting. ?

If someone had suggested that the treatment should consist of "trying harder", then I could see why many people would take offense. But that's not what Don S. is advocating; he's advocating mainstream cognitive-behavioral therapy for TS, which has been shown to be effective -- and no one, as far as I can tell, has objected to that.

daveddd
05-13-14, 11:02 AM
I'll stand corrected then

I got that vibe. But it could be wrong

Don S.
05-13-14, 01:01 PM
I am not those neurologists quoted in newspapers...or any neurologist, for that matter... Those who disagree with you do not have monolithic views.

Why do you consider it "logically inconsistent" to believe that a condition is based in neurobiology but can be changed with behavioral techniques?

If those behavioral techniques are designed specifically to extinguish certain behaviors while strengthening other pathways (the whole "competing response" part of HRT), which to me evokes neural plasticity, then there is no apparent contradiction... The reason I brought up the example of the monks meditating earlier was to indicate that I believe that behavioral training can change the brain in measurable ways.

As I mentioned earlier, the physiological mechanisms underlying cancer (...or broken legs, ruptured appendices, etc.) are not suited to direct targeting by behavioral therapy, whereas the mechanisms of TS, being (I believe) neurological, appear to be. (Note: this is not to say that all neurological conditions are necessarily amenable to behavioral therapy, but the pathways involved in TS seem to make it suited to this type of therapy.)

I do not discount the concept of neuroplasticity. Where I think we differ is that you seem (and please correct me if I am wrong) to be counting the construct of neural pathways as naturally fixed, genetically established agencies that can be altered (in some instances) through nonphysical means such as behavioral therapies or meditation. Before this alteration (correction?) occurs, a TS patient (for example) might be said to have a physical abnormality within the CNS.

If so, although I agree that the construct of neural pathways in some instances form without conscious effort (naturally) in line with genetic tendencies constituting, for example, hypersensitivity to perceived threats to survival resulting in chronic anxiety, this construct does not constitute a physical anomaly. Rather, I view this plasticity capability to be the result of metaphorical orders from the mind (via the brain) to so formulate themselves (to a hair-trigger degree) from repetition and conditioning.

By way of analogy, consider the matter of personal tastes. Very few people seem to like the taste of beer when they first try it. However, with persistence one can “cultivate a taste” for it and the pathways will signal pleasure rather than aversion. The initial construct of the applicable neural pathways were not abnormal and neither is the altered form.

The mind (the thoughts) that causes the neural pathways to alter their composition and resulting change in behavior (by nerve signals) is analogous to “software,” that which gives the marching orders to the metaphorical robot of the body/brain that is “hardware.”