View Full Version : An alternative view of TS


Don S.
03-18-11, 10:03 AM
Someone wrote me to inquire if I had any insights regarding neuropsychiatric disorders. He or she was particularly interested in schizophrenia due to a personal consideration. The following is my response which advises that, unfortunately, I have none. The reply does, however, explain (as a synopsis) why I hold that TS is neither a neuropsychiatric or neurological disorder.

If any would like to explore an alternative view of TS and related conditions, then I invite you to read my articles at my website, which are all free access.

(I sell nothing. I am only interested in helping others overcome the obstacles I have faced throughout my life, and hopefully at a much younger age.)

My second two articles at my website present the core of my arguments supporting my views, while the first offers remedial advice for parents of youngsters with TS and/or ADHD. My entirely free access website can be found at:

http://wwwdnschneidercom.xbuild.com/#

—Don S.
____________<WBR>_________<WBR>____

Dear —:

Thank you for inquiring concerning my views on neuropsychiatric disorders. However, my field of interest is afflictions that once were—or would have been had not the terminology been discontinued prior to the formulation of certain diagnoses—characteri<WBR>zed as "neurotic," and are now, in some cases, officially characterized as "neuropsychiatric.<WBR>" These would include Tourette's Syndrome, Obsessive-Compulsiv<WBR>e Disorder, Anxiety Disorder (panic attacks) and ADHD; all of which, I hold, are related and stem from the same underlying cause: chronic anxiety caused by acute self-awareness.

The entire thrust of my arguments is that none of these afflictions are in fact neuropsychiatric (or neurological<WBR>) disorders, which connotes that the affliction is caused by an organic (physical) disorder of the central nervous system which manifests as an apparent mental illness. I hold that these afflictions are simply inherited personality traits that through repetition and subsequent habituation become hyperbolic and cause impairment in regard to functioning at an optimal potential.

None of these afflictions involve any true mental impairment, such as delusions. People suffering from these afflictions retain complete control over their intellectual processes but have lost the ability to completely control their actions, while fully understanding and realizing the aberrant nature of their behaviors (symptoms). This is no different than, for example, being a compulsive smoker while understanding that such behavior is potentially detrimental to one's health.

Therefore, I hold that people who suffer from these afflictions can ultimately cure themselves (or at least significantly mitigate their symptoms) through the processes of their own minds by invoking corrective mechanisms inherent within one's mind. I strongly advocate behavioral therapies, which have already demonstrated effectiveness in treating such disorders, as well as breathing and relaxation exercises.

(I also believe that in some cases hypnosis might be of benefit, though I am less certain on that point having had no personal experience with it.)

I fail to see how any sort of talk therapy could have any efficacy regarding an affliction caused by a physical abnormality (such as, for example, cancer).

With true neurosychiatric disorders—which is what you are interested in—, such as schizophrenia and clinical depression, there does indeed appear to be an organic (physical) basis for these afflictions which manifest as mental illnesses and can cause delusions, as well as violent and suicidal tendencies. It is apparent that innate chemical imbalances within the central nervous system of some nature are the causative agencies for the severe symptoms often associated with such afflictions.

All my work is geared toward disproving that certain mental afflictions are truly neuropsychiatric (as opposed to psychological in nature). I know little about true neuropsychiatric illnesses such as schizophrenia, and the methods I advocate within my articles for the former afflictions I mentioned would, I'm afraid, have little or no utility regarding the treatment of neuropsychiatric illnesses.

Thank you for your most kind interest, and I wish your family and you all the best in regard to dealing with the obstacles that might present themselves regarding neuropsychiatric afflictions.

Cordially,

Don S.

m1trLG2
03-18-11, 01:32 PM
What exactly is your field? Is this independent research you are conducting or is this for some thesis? If it's for a thesis I suggest you look more closely at the words you are using and what your saying. You are contradicting yourself. Plus, you can not separate Psychology from the brain.

I strongly disagree with what your trying to prove and am curious about your background. What training, education, or knowledge have you had to support your claims other than superficial readings about these disorders?

I can tell you a couple of things. First of all, personality is innate and it is widely accepted that personality disorders are not 'curable' or even always treatable. Second of all, ADHD has organic differences in the brain that register both on PET and MRI scans of the brain. There are different areas of activity for various tasks and ADHD specifically has had the pre-frontal cortex identified as it's place of abnormality.

More over, true anxiety disorders are probably the farthest thing from a simply "psychological disorder", as you put it. It is a malfunction in the sympathetic nervous system. Some people with anxiety disorders have attacks just watching TV. They are not always stimulus based, it's an overactive sympathetic nervous system.

My field of Psychology is cognitive behavioral therapy. My focus is on personality disorders, specifically oppositional defiant/conduct disorder/antisocial personality disorder and how the progression from one to the other takes place. I also look at the comorbitity between these disorders and ADHD. In my education I had to study not only "classical psychology" but also neuropsychology and the generalizations that you are making are inconsistent with what is known about both psychology and the brain. The DSM breaks down disorders basically by whether they are organic or if they are more psychological. Personality disorders for sure are considered permanent and organic.

So I'm confused. You are suggesting that most disorders are not organic and that therapy doesn't help?

Do you suffer from any of these disorders that are simply psychological? How do you explain that the diagnostic criteria for some of them requires the symptoms to be present from birth? Do you think mental retardation is simply psychological too?

I would suggest doing some research to make sure your theories haven't already been disproven because from what I am understanding some of them have.

m1trLG2
03-18-11, 01:39 PM
Another word of advice after viewing your website. Provide a proper 'works cited' page. You are incorrectly citing things and technically plagiarizing.

I think you need to look into how research is done and make sure you understand what the articles are talking about too. You mention the sample size being too small when in reality those sizes are average for most studies in general. What would you consider a "comfortable" or "reliable" number? Also, do you understand how significance levels work in research? It's a lot more than, "Oh, 8 out of 10 people have this so it's significant." It is not only the number of people who are displaying symptoms but also the degree to which they are, etc.

You may have an interesting idea, but your disorganized approach to presenting it makes it sound very unprofessional and therefore unappealing to consider. If you really are serious about this, take the time to do it right. Find research that both supports and contradicts your theory and cite it properly so you don't go to jail for stealing people's hard work.

Don S.
03-18-11, 02:18 PM
Dear M1

You seem to be latching on to something specific in one of my TS articles, and to address your criticism it would be helpful to know to what you are actually referring. In my article “Is Tourette’s Syndrome a Neurological Disorder? — A Dissenting Viewpoint,” not only do I cite direct quotes but actually link to my online sources.

I know for a fact that one psychologist I cited is aware that I quoted him and made no complaint to me concerning the manner in which I used it. Since many people do periodically “Google” their own names, if anyone else I quoted has a grievance with me, none have yet voiced such.

In regard to the size of medical studies, yes, I concede that a study I referenced (which is probably what you are referring to) is typical (if not greater) than the amount of subjects in most such studies. That is the problem. I am not the only one who has questioned the adequacy of the quantity of study participants in various epidemiological studies. Witness the recent fiasco over the now infamous study (published in Lancet!) concerning vaccinations and Autism.

(The paper was exposed, by the way, not by a medical professional, but rather by a tenacious reporter (who was not in the medical field)).

Nevertheless, in the article I think you are referring to (“Tourette’s Syndrome and Alleged Structural Abnormalities Within the Basal Ganglia”), I continue to argue from the standpoint that the studies indicating the link I am questioning are indeed adequate.

Since my views challenge the status quo within the TS establishment today, I hardly think anyone would want to assert that I am plagiarizing their work in support of my views. Historically, when anyone challenges the status quo hostility inevitably follows. I could cite numerous very famous cases where the views of the one who made such a challenge are now accepted as orthodox, with Einstein perhaps being the most salient contemporary example.

Indeed—and most ironically in this context—, Dr. Arthur K. Shapiro (from NY), who first established the prevailing paradigm which I am now challenging, faced such a reaction. He published his landmark paper in a British psychiatric journal because it had been rejected by American ones.

My papers are intended for a popular readership and do not purport to be works appropriate for scholarly journals. I have never asserted otherwise, and I state clearly in my first TS article that I am not in the medical or mental health fields. My views are predicated upon my own experiences and supplemented by my readings. That fact does not necessarily mean that my views are wrong, especially in light of the fact that a great many have a vested interest in maintaining the status quo, which is always the case when one challenges such.

<O:pYou are, of course, perfectly free to accept the current orthodoxy. If you would care to give your reasons, I would be glad to debate the issue with you: but only in a civil manner.

Best regards,

Don
<O:p

Don S.
03-18-11, 02:39 PM
What exactly is your field? Is this independent research you are conducting or is this for some thesis? If it's for a thesis I suggest you look more closely at the words you are using and what your saying. You are contradicting yourself. Plus, you can not separate Psychology from the brain.

I strongly disagree with what your trying to prove and am curious about your background. What training, education, or knowledge have you had to support your claims other than superficial readings about these disorders?

I can tell you a couple of things. First of all, personality is innate and it is widely accepted that personality disorders are not 'curable' or even always treatable. Second of all, ADHD has organic differences in the brain that register both on PET and MRI scans of the brain. There are different areas of activity for various tasks and ADHD specifically has had the pre-frontal cortex identified as it's place of abnormality.

More over, true anxiety disorders are probably the farthest thing from a simply "psychological disorder", as you put it. It is a malfunction in the sympathetic nervous system. Some people with anxiety disorders have attacks just watching TV. They are not always stimulus based, it's an overactive sympathetic nervous system.

My field of Psychology is cognitive behavioral therapy. My focus is on personality disorders, specifically oppositional defiant/conduct disorder/antisocial personality disorder and how the progression from one to the other takes place. I also look at the comorbitity between these disorders and ADHD. In my education I had to study not only "classical psychology" but also neuropsychology and the generalizations that you are making are inconsistent with what is known about both psychology and the brain. The DSM breaks down disorders basically by whether they are organic or if they are more psychological. Personality disorders for sure are considered permanent and organic.

So I'm confused. You are suggesting that most disorders are not organic and that therapy doesn't help?

Do you suffer from any of these disorders that are simply psychological? How do you explain that the diagnostic criteria for some of them requires the symptoms to be present from birth? Do you think mental retardation is simply psychological too?

I would suggest doing some research to make sure your theories haven't already been disproven because from what I am understanding some of them have.

—I'm sorry, but I originally missed your first response to me, which is far more substantive than the one I have responded to already. I shall try to reply in a few hours. For now, however, if you are a behavioral therapist, then it is most ironic that you should be hostile to my views as I am a strong supporter of this approach in treating TS and attendant conditions, while many supporting the current orthodoxy have been hostile to that proposition.

Don

m1trLG2
03-18-11, 03:16 PM
I question whether you understand what behavioral therapy involves. I am also a cognitive behavioral therapist... not just a behavioral therapist. The differences in treatment approach are significant. Taken from your above post:

"Therefore, I hold that people who suffer from these afflictions can ultimately cure themselves (or at least significantly mitigate their symptoms) through the processes of their own minds by invoking corrective mechanisms inherent within one's mind. I strongly advocate behavioral therapies, which have already demonstrated effectiveness in treating such disorders, as well as breathing and relaxation exercises.

(I also believe that in some cases hypnosis might be of benefit, though I am less certain on that point having had no personal experience with it.)

I fail to see how any sort of talk therapy could have any efficacy regarding an affliction caused by a physical abnormality (such as, for example, cancer)."

This is not behavioral therapy, and especially not cognitive behavioral therapy. True therapy involves spending A LOT of time talking and identifying thinking errors. When it comes to organic disorders we do even more talking so that the client can fully understand how their thought process is different and ways in which they can actively work to overcome these differences. We identify thinking errors. As to your cancer comment, there is loads of research supporting the idea that support groups have been found to help prolong life and improve quality... all through talking. If you are suggesting that all psychologically based disorders can be fixed with Pavlovian behavior modification then I think a lack of experience becomes undeniably evident.

In my opinion, you can read all the psychology writing and theories that there are out there. It's not going to help until you have experience working with people that have these disorders. There is no one "right" way, you must understand in depth all the theories in order to choose the best approach for each client.

My issue with what you are writing is that you are making claims that aren't supported. Yes, you have cited a few things (though incorrectly) but you have also made these claims with nothing to back it up. For example, I cut and paste this from your blog:


I read on a website devoted to the topic of school bullying that "seventy percent of all kids report having been bullied at some poInt at school." This is absurd and serves to cheapen the problem.

I see no website linked or listed. Are you simply using this statement for effect and no website exists? You use quotes indicating that you are copying something from this website verbatim but there is no link or direction as to how I can view this website for myself. This is plagiarism.

You have a website that appears to strive towards academic conversation but you present it in a way that does not uphold academic standards.

My professor for a political science course once said something to the effect that in order to effectively argue one must know their opponent like the back of their hand.

You can say whatever you want on your website, all I'm saying is be careful. First of all, the plagiarism. Secondly, if you truly are interested in this and want to be taken seriously you must be able to argue intelligently about your topic. To me it seems to don't really fully understand the terms that you are throwing around. Most fundamentally you fail to explain the existence of 'psychology' apart from nueropsychological influences. The brain is essentially a large computer. It sends impulses as varying rates and to various areas thus triggering additional actions. There is no consciousness without an underlying organic structure. This statement is especially confusing:

None of these afflictions involve any true mental impairment, such as delusions. People suffering from these afflictions retain complete control over their intellectual processes but have lost the ability to completely control their actions, while fully understanding and realizing the aberrant nature of their behaviors (symptoms). This is no different than, for example, being a compulsive smoker while understanding that such behavior is potentially detrimental to one's health.

Live one day with ADHD and tell me this is true. This is an opinion. You have NO facts that I have seen to support this statement. I can cite studies that show organic brain differences in various disorders. Can you cite anything supporting your opinion? If so, it would help your credibility.

All in all, if you want to come on a forum and act like you are pursuing this theory you should do so properly. Coming to a forum like this to tell people that our problems aren't real, that we are in control of our minds and just have lost our ability to control our bodies is bold. You better have the information to back it up.

And because I always have to hammer the last nail. Check your little smoking example for scientific fact. Smoking is a CHEMICAL DEPENDENCY. Ever heard of nicotine? Do you understand it's effect on the brain? This is not a 'behavior' issue.

Don S.
03-18-11, 03:51 PM
M1:

If you really want to intelligently discuss my views with me (and you are indeed under no obligation to do so), then you must read my second and third articles regarding TS. The third one in particular spells out my personal struggles regarding a period of my life when I was afflicted with severe panic attacks, something I have not experienced now in well over twenty-five years. I attribute this complete recovery to an Australian physician (not a psychiatrist or a psychologist) who had been both a pioneer as a woman in the medical field in her country and in the field of nervous illnesses. She advocated behavioral therapy in her books which forms the basis for my views.

From quickly (for now) reading your last reply to me, it sounds that you are basically arguing that you are a credentialed mental health professional while I am not; therefore, nothing I have to say could possibly be an informed opinion. In response, I would like to paraphrase Herman Wouk in his The Winds of War:
</O:p
“There are worse ways to learn war than by serving in the trenches.”

By the way, yes, I suffer from TS.
<O:p</O:p
Don

Don S.
03-18-11, 04:08 PM
"And because I always have to hammer the last nail. Check your little smoking example for scientific fact. Smoking is a CHEMICAL DEPENDENCY. Ever heard of nicotine? Do you understand it's effect on the brain? This is not a 'behavior' issue."

—I’m afraid I challenge the orthodox view on this point as well. Labeling smoking as “addictive” flies in the face of every common sense indicator of the subject. It is habituating, exactly as every surgeon general prior to that anti-smoking fanatic C. Everett Koop classified it. Whenever zeal enters the picture, science is orphaned.

We live in an age of agenda-driven “science.”

But let's save that debate for another day.

m1trLG2
03-18-11, 05:04 PM
I am not arguing superiority here. I'm simply saying you make comments that over simplify the situation. Do you know about feedback loops? Smoking is habituating, I'm not taking that away... but it's because of the effects of nicotine on receptors in the brain. You smoke, it pours chemicals onto your "feel good" nerves, you associate smoking with a good feeling, you do it again...

I'm glad you had a life changing experience but again, you don't say what this magical doctor did to make you better. Your arguments are incomplete. I don't want to argue though, just be weary. Not because you are an unorthadox thinker but because you do so in a confrontational manner and without evidence that one can mull over themselves. This is a bad combination if one hopes to be taken seriously.

"The Art of War" by Sun Tzu speaks of military strategy that focuses on being able to make quick decisions. When you get behind a topic and are ready to present it to the world you should be able to anticipate and converse about the counter point of view. This is how you defend your thesis in grad school. You don't just get to do research on the things you believe... cause they are going to try and shred you.

Therefore my issue is that, whether or not it's true, you do not seem to be aware of the true mechanics of the human body at all. How can you argue something organic or not when it feels like your are unaware of what organic implies or means?

There is much to be said about meditation and holistic approaches to things. But to write off an entire category of diagnosis as "not real" or "not organic" and put the person at fault is a huge statement. You are not backing this up with anything.

I have spend the better part of 6 years focusing almost exclusively on ADHD and Personality disorders and I am by no means an expert in that field and I study only 3 disorders. For you to pretty much take every Axis - 1 diagnosis and deny it's 'real' causes me to question your understanding. Especially with lacking evidence.

Just caution my friend. What you believe is your thing... don't try to speak it as truth though. At least not yet. Like I said, if you want to be heard, take the time to back it up without flaw. Be able to scientifically explain doubts.

The best advice I ever got in my life was to not use personal experience as examples of things that contradict the norm. So if I want to say that ADHD people can be graduate from college. I need to look outside of my personal experience for proof of this. If I am the only person with ADHD to ever graduate then I am an exception to the norm... not an example of success.

To better organize your statement I would ask that you state the specific behavioral therapy you recieved. Was it shock therapy? Because this has been studied and found in some cases to work because of the release of chemicals it triggers in the brain. The way you talk about behavioral therapy makes me think it was some sort of reinforcement schedule.

You should also be aware of the fact that anxiety disorders can be outgrown... perhaps your timing with this doctor happened to coincide with you outgrowing the problem.

This is why you telling me things like specific therapy as well as citing other cases in which similar therapies worked would help your argument a lot.

Take it with a grain of salt I guess.

m1trLG2
03-18-11, 05:34 PM
http://www.youtube.com/watch?v=cnV4RnWcmWo&feature=player_embedded

worth investigating

Don S.
03-18-11, 06:28 PM
"I question whether you understand what behavioral therapy involves. I am also a cognitive behavioral therapist... not just a behavioral therapist. The differences in treatment approach are significant. Taken from your above post:

"This is not behavioral therapy, and especially not cognitive behavioral therapy. True therapy involves spending A LOT of time talking and identifying thinking errors. When it comes to organic disorders we do even more talking so that the client can fully understand how their thought process is different and ways in which they can actively work to overcome these differences. We identify thinking errors. As to your cancer comment, there is loads of research supporting the idea that support groups have been found to help prolong life and improve quality... all through talking. If you are suggesting that all psychologically based disorders can be fixed with Pavlovian behavior modification then I think a lack of experience becomes undeniably evident."

—I am referring to the Comprehensive Behavioral Therapy (CBIT) which is used to treat TS children under Dr. John Piacentini of UCLA, as well as the cognitive behavioral therapy used to treat TS patients at the Duke University Medical Clinic. My second article on TS links to a newspaper article discussing the latter.

In regard to the former, you can read my brief article entitled “Behavioral Intervention Therapy” at my website which has a link to the website for the Tourette Syndrome Association (TSA). Many within the TS establishment have resisted recognizing the efficacy of behavioral therapies in treating TS for exactly the reason I have indicated. That is, how can a physical affliction be effectively treated with talk therapy? Behavioral therapies have been derided as merely “replacing one tic with another.”

On one hand, I am disappointed that Dr Piacentini appears to be willing to maintain what I* consider to be the transparent fiction that TS is a “neurological disorder,” but on the other I am very happy to see that he is on the cutting edge of bringing this treatment into the mainstream and apparently securing its acceptance by TSA, the most important charitable institution regarding the affliction.

(*Note: I am not implying that Dr. Piancentini agrees with my characterization of the prevailing orthodoxy.)

For forty years, TS sufferers were told that their tics are inevitable and that they should learn to accept such while God knows how much money have been thrown at researchers searching for the elusive physical anomaly within the central nervous systems of those afflicted with TS that has been alleged to exist. After all this time, are they any closer to finding it? I say no: for the simple reason that it does not exist!

Dr. Pianectini and the mental health therapists at Duke are making a profound difference in the field and are helping to dispel the aura of passivity that the current paradigm has cast upon TS sufferers for all too many years now.

Don S.
03-18-11, 07:15 PM
"I see no website linked or listed. Are you simply using this statement for effect and no website exists? You use quotes indicating that you are copying something from this website verbatim but there is no link or direction as to how I can view this website for myself. This is plagiarism."


óYou are referring here to my assertion that I read at some website regarding school bullying that seventy percent of all kids reported they have been bullied in school (which I label as absurd). M1, from reading your posts (which I am afraid I cannot keep up with!), you are obviously a person of high education and blistering intelligence. However, I donít think you are all that well acquainted with the field of popular writing, whether it be fiction or nonfiction.

An offhand remark such as this on a personal website hardly requires a citation. Even journalists often make such remarks. I donít even remember what website I had been at a few years back when I wrote this article. If youíd care to do some very elementary research via search engines, you will see myriad similar claims at websites devoted to the issue of school bullying.

Don S.
03-18-11, 07:30 PM
"I can tell you a couple of things. First of all, personality is innate and it is widely accepted that personality disorders are not 'curable' or even always treatable. Second of all, ADHD has organic differences in the brain that register both on PET and MRI scans of the brain. There are different areas of activity for various tasks and ADHD specifically has had the pre-frontal cortex identified as it's place of abnormality."

—Personality is innate? Who has ever argued otherwise? I certainly don’t. We at least agree here.

In regard to your assertion that “it has been documented that ADHD specifically has had the pre-frontal cortex identified as its place of abnormality," I ask the same question regarding this claim as I do for the same claim regarding TS. That is, can this condition be diagnosed from various brain scans on a blind basis using (perhaps) one hundred subjects diagnosed with ADHD against those with no history of such a diagnosis? If not, why not? If this has been done, please provide a citation.

Don S.
03-18-11, 07:46 PM
"I can tell you a couple of things. First of all, personality is innate and it is widely accepted that personality disorders are not 'curable' or even always treatable. "

—I have never denied that TS has a genetic basis. What about our bodies and brains does not have a genetic basis? What I have argued is that, at least in some cases, we can learn to control behaviors engendered by innate personality traits. Knowledge is power, which as a cognitive behavioral therapist, I would think you would readily agree.

Don S.
03-18-11, 08:02 PM
M1,

Iím afraid I shall have to call it a night. I am getting too fatigued to continue right now, and I shall try to answer more of your points Saturday and/or Sunday. I see where too many typos are beginning to creep into my posts, and I am especially mortified to see how I have misspelled the name of the (very) good Dr. Piacentini in more than one usage

I would call you a worthy antagonist, except I donít see why our views on this subject should be antagonistic since you are a cognitive behavioral therapist. Those who hold to the prevailing paradigm regarding TS have derided your field in regard to its efficacy in treating TS, while I have extolled it!

Whatever. More later!

Thanks for your time.

Best regards,

<O:pDon S.

Don S.
03-19-11, 12:11 PM
M1:

In your responses to me, you make many assertions without being very specific. Therefore, it is difficult to answer you directly. Your replies seem more geared to discrediting me in readers’ minds than disproving or directly addressing my arguments.

(And once again, it is a mystery to me why you would want to discredit my views on TS when they advocate the very therapy that you practice professionally, while many who adamantly disagree with my views also deride your therapy regarding its usage and efficacy in treating TS!))

You more than once admonish me to be careful of “plagiarism,” without (that I can see) citing any specific examples beyond stating (accurately) that in the beginning of my first TS article I stated that I read on a website a claim that seventy percent of all kids say that they have been bullied in school, which I then counter by asserting that such a claim is absurd and serves to cheapen the problem.

As I responded previously, an offhand remark like this on a personal website article hardly requires a citation, and even if you disagree on that point, that is not an example of “plagiarism.” It would be an example of failing to cite an asserted source in an attempt to establish a straw man argument.

(As I said previously, you can do some simple search engine research to establish in your mind that I was not engaging in such a rhetorical ploy. Many anti-school bullying <NOBR>websites make (http://www.addforums.com/forums/newreply.php?do=postreply&t=99219##)</NOBR> such hyperbolic claims).

To spell it out, not only am I not asserting that it was my assertion (presumably based upon a <NOBR>study (http://www.addforums.com/forums/newreply.php?do=postreply&t=99219##)</NOBR>) that seventy percent of all kids are bullied at school, I am contesting such an assertion!

You state that my articles are “disorganized,” without indicating why you make that assertion. I think my articles are very organized and logical.

My third article on TS (“Is Tourette’s Syndrome a Neurological Disorder? — A Dissenting Viewpoint”) was <NOBR>translated into Spanish (http://www.addforums.com/forums/newreply.php?do=postreply&t=99219##)</NOBR> and German by an online health publication. They did this on their own volition. Not only did I not pay them to do so, I didn’t even request that they do so or bring the article to their attention.

Therefore, they apparently disagree with your characterization of my work to have gone to the trouble and the expense to have the article translated into two foreign languages. On the other hand, your attempted rebuttals to my views seem to be all over the place. You jump from one thing to the next and, as a result, this thread has lost coherency and I find it difficult to keep up with your machine gun-like approach casting aspersions upon my work with reckless abandon.

You accuse me of using terminology without understanding what it means. Once again, you are not specific in such a criticism. How can I respond to such a general criticism?

In my next post or posts, I shall lay out my analysis and corresponding views regarding TS in a very coherent and easy to follow manner for the benefit of all interested in following this thread. If you disagree with anything I write, please address the point or points likewise.

Thank you.

Best regards.

Don

P.S (file://p.s/). By way of correction, I previously said that the behavioral therapy practiced under Dr. John Piacentini of UCLA used to treat youngsters with TS is called “Comprehensive Behavioral Therapy.” It should be “Comprehensive Behavioral Intervention Therapy” (CBIT). I apologize for the error.

Imnapl
03-19-11, 01:08 PM
Don S.: are we advised to view anything written on your website as personal opinion only?

Don S.
03-19-11, 01:28 PM
Don S.: are we advised to view anything written on your website as personal opinion only?

Yes. In my first TS artcile.

Don S.
03-19-11, 01:35 PM
M1:

You also counsel me that one should attempt to anticipate all criticisms of one's views and proactively respond to them, I agree and I assert that I have done so within my several TS articles published on my personal website and elsewhere online. Anyone interested in the subject can read my articles and draw their own conclusions independently from you and me.

Prior to the late 1960s, TS was thought of primarily as a psychiatric condition and psychoanalysis was a common recommended therapy utilized in the treatment of TS. This all began to change when Dr. Arthur K. Shapiro (who ironically was a psychiatrist himself) from the NYC area began to treat a TS patient with Haloperidol (Haldol). Because the patient’s symptoms (tics) responded favorably, Dr. Shapiro appears to have concluded that TS must have an organic basis (which manifested as a psychiatric illness, thus: “neuropsychiatric"). After the predictable period of skepticism and criticism, he eventually managed to convince many within the mental health community to accept his new paradigm which remains the orthodox interpretation to this day.

To me, this was a quantum leap of an assumption. My favorite analogy in countering this assumption is that handcuffs will do wonders in keeping smokers from indulging in their habit. That does not mean, however, that we can conclude that the source of their urges to smoke is their hands. In a like fashion, chemically restraining the brain does not prove that there is a physical anomaly within the brain or elsewhere within the central nervous system. Yet, this seemingly absurd logic has been accepted by many within the TS establishment: medical and mental health practitioners; medical researchers; charitable and advocacy groups, many of whom have quite a vested interest in maintaining the status quo.
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The only other real assertion of proof that TS is organic that I know of is the one claiming that anomalies have been detected within the brains of TS patients. As I countered in my article regarding this subject, then diagnose TS by using such brain scans. Take a hundred brain scans of those diagnosed with TS and a hundred more of control subjects with no history of tic disorders, and see how much above chance experts in reading such scans can achieve on a blind basis. It they can diagnose TS sufferers with a significantly above chance level of accuracy, then I shall publicly retract my views. Why hasn’t this been done? Why is “observation” still the only way to diagnose the affliction?<O:p></O:p>

Against these alleged proofs that TS is organic (as opposed to psychological), I put forth in my third TS article the following five criteria that apply to TS and ask what other physical illnesses would meet all of them:

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.

I then state

“In regard to the minority of TS sufferers afflicted with coprolalia (shouting obscene words or racial epithets), what language do they use? The one they speak, of course. If he or she does not speak French, then he or she will not shout such words in French.

"Language is learned behavior that must be consciously applied; to speak a language is a volitional act, not an involuntary one. Although such sufferers feel compelled to shout such words and feel helpless to prevent themselves, it is still a conscious, volitional act that does not (generally) occur in a state of unconsciousness (when volition is not possible).

"It has, however, become virtually involuntary through repetition and subsequent habituation as an attempted defense mechanism to dispel repetitive (obsessive) thought patterns that the mind finds objectionable. The same scenario is true in regard to other vocal and non-vocal tics which are either attempted defense or concentration mechanisms in accordance with obsessive-compulsive pathologies.”

Do you have a response? Can you name another physical illness that would meet all the criteria that I listed? Can you explain how coprolalia can be accounted for by any physical mechanism?
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Don S.
03-19-11, 02:20 PM
The last subject I want to touch upon is related to something you said tangentially regarding panic attacks.

(By the way, I can’t believe that you would assert that perhaps I had “outgrown” panic attacks rather than having had been cured by the behavioral therapy used by a physician and author I had read. For one thing, I had been around thirty at the time. For another, panic attacks, unlike TS, are not usually (if ever) a childhood onset affliction. The sympathetic nervous system becomes hypersensitized, usually as a result of some stressful event within a person's life and his or her dwelling upon such.

Therefore, the “fight-or flight” defensive mechanism kicks in at the slightest provocation (of stress) due to reinforcement and habituation. The individual has lost control of his or her nervous system in much the same way TS sufferers have lost control of certain bodily functions due to the repetition and subsequent habituation of vocal and physical movements. They are related conditions and, in my opinion, caused by chronic anxiety generated from acute self-awareness (an innate evolutionary process.))

Because brain scans show elevated levels of dopamine (and perhaps other hormones suggested as possible causative agencies for tics), many have concluded that there must be some physical anomaly causing the elevated level of the hormone (or neurotransmitter).

If one were to take a blood test of a person in the grip of a panic attack, one would discover a greatly elevated level of adrenaline. Does this indicate that panic attacks are caused by adrenaline or is it the other way around? Of course it is the other way around. Elevated levels of adrenaline are caused by the patient’s panic and not by any physical anomaly within the person’s central nervous systems which periodically and arbitrarily releases huge amount of adrenaline.

Therefore, theorizing that an elevated dopamine level causes TS rather than being a symptom of it seems specious reasoning at best. Dopamine is known to play an important role in motor activity. Therefore, the TS sufferer’s compulsion to tic invokes the release of dopamine, in my opinion, and not the other way around. In other words, the current paradigm regarding TS confuses cause with effect.

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Don S.
03-19-11, 02:50 PM
The very subjectivity as to what TS is attests to the fact that it is not a disease, but rather is the culmination of personality traits carried to an extreme via repetition and subsequent habituation. This is one reason why I believe that even if TS were an organic affliction, brain scans could not be used to diagnose it because of the wide range in the severity of manifested symptoms that are now accepted as constituting the condition. Such would be analogous to detecting inherent great musical ability within a person’s brain and differentiating it from that of a person with some minimal musical aptitude

One either has cancer or one does not. Physicians or scientists do not sit around debating and deciding such. It is the disease itself that makes that decision.
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Don S.
03-19-11, 02:56 PM
On a final note, implicit in much of this consideration is the long running brain-mind duality debate. My position on this question, which is very much relevant to TS and related conditions, can be found within my second TS article at my website regarding the Duke behavioral therapy to treat TS. In summary, I hold that the brain is analogous to computer hardware, while the mind is the software that such generates. TS is very much a software problem and not a hardware one.