Life, Love, Long Hair, Weeping and Gnashing of Teeth, and other mysteries

All this and more, from a semi-Serbian, slightly sane, former editor for physicians and surgeons, who is the mother of seven kids.


Thursday 17 September 2015

A Facebook Convo With A Smart Friend



It has been a long while since I have posted anything in my blog, and even more of a while since I posted some banter sessions. Sometimes I just want to share the banters because I think they should be seen beyond the original audience, which is limited to those on the friend list of whoever it was who hosted the discussion on their Facebook wall.

Here is one that might interest those who like to read more than a paragraph or two of writing, between a Smart Friend (not to be confused with Smart Cars or Smart Phones, and not to diminish the smartness of any of my other friends who are not being quoted here, for I do have a lot of smart friends, but I needed to give this one a pseudonym) and me. I have known this Smart Person for several years and we have had enough interesting conversations to form a book, but this one will do for today. And I do have his permission to publish this here.

My Smart Friend's Facebook status said this:

I love science. I love research articles. I don't believe half of what I see claimed and headlined in popular articles -- especially on the Internet.

For good reason: Less than half of it is verifiable.

Try expressing such skepticism on Facebook. You will get passionate, even hostile, responses from those who have no idea how the research was conducted, and have read no more than a headline.

Yeah. People are that shallow in their impassioned beliefs -- that easily misled. I don't want to be. 

I am, therefore, thrilled to see yet another article taking on popular scientific notions in a non-political way. Of course, this applies to politically-charged science headlines as well.
Case in point -- near to my heart...

A few years ago, I was attending a multi-week seminar on a personality disorder which I was studying because someone I loved suffered from it. There was not even a diagnosis for it back when I studied psychology.

The seminar was run by psychologists who specialized in that disorder; yet, THERE WAS NO TREATMENT -- NO CURE. So, they relied on traditional "talk-therapy" to assist their patients in minimizing their symptoms, mostly by helping the patients become more aware of them. 

The results had only short-term results, and these professionals knew it. I admired them. They looked on the suffering and specialized in simply "being there" for their (often hostile) patients they knew could not be cured. 

To my surprise, they "hot-boxed" me after class one night. Asked me to consider going back to college for a semester or two and adding to my own professional degree to specialize in their work with them -- because of my significant experience in dealing with persons so suffering.

I said, "No" -- because I did not think I could last in a field when not even *I* had hope for a patient.

A few months ago, I saw a journal article indicating that that disorder now had a treatment -- with dramatic positive results! I was overjoyed! 

I was looking through local college catalogs for classes in that technique -- useful in treating many disorders, not just the one I had studied; and considering my budget for tuition.
It turns out, the headline and article had no, (zero, zilch, nada) substance. That was an expensive career move I was contemplating -- and for reasons which engaged all my passions. It turns out that the research was entirely subjective, and of such duration that no claims for "cure" could possibly be reasonable.

But you have to know how research is done, and know the subject well enough to even know when to be skeptical. I was, so I kept digging -- even though I hated the answer I ended up having to admit.

Still, just in writing this... I realize my passions remain stirred, and even if I cannot cure, maybe...

Anyway, a central point from the article:

"But the point is that a single finding should never be taken as evidence, full-stop, of a given phenomenon — especially findings that make us smile or nod. 

"Everyone is falling into that trap too often. There are reasons other than scientific worthwhileness that some studies find their way into our Facebook feeds, while others languish in obscurity or are never published at all. "


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My response:

Chirp....

Just kidding.

I read it. Good to see so many paragraphs on something about which you are passionate, even if you don't name the condition.

(I said "chirp" because we have this joke about writing things and not getting much, if any, response, other than crickets chirping.)

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His next comment:

And you lead to an important point!

If I have a friend who believes (as a made-up example) that giving up drinking coffee and instead drinking a quart of mango juice every morning will cure his cancer -- then I am not crying "Bunk!"

They need the hope, and it is not for me to take it away.

Besides, placebo effect is useful -- just thinking something will work can have some (limited) benefit-- but it won't cure cancer.

Yet, when I see that friend cancel radiation and/or chemotherapy treatments and throw out their coffee pot to make counter-space for the case of cranberry juice-- I get upset.

---

For those reasons, I won't mention the disorder, but the treatment -- which HAS shown effective for MANY other disorders -- may still be valid. First it was CBT, then it was DBT, but neither is showing any lasting value to the patient.

Frankly, the lack of lasting results makes sense to me, but I did hope it would be otherwise.

For another too-common disorder, I have been reading and hearing about EMDR (Eye Movement Desensitization and Reprocessing) -- but it just smacks of charlatan-ism to me -- yet some swear by it. I have read no compelling evidence.

Then there is LSD, MDMA, and psilocybin as potential *cures* for a common disorder -- when used clinically; yet studies are all but prohibited because of public fears of recreational uses.

The list of headlined promises based upon doubtful research is almost endless, (and that includes horses -- Yes, just being around horses). Pah-lease!

I am not sure if it is merely a desire to get noticed, and maybe to receive funding, or if it is the combined desperation of the therapists and patients to do SOMETHING.

But, for goodness sake, let's stick to the facts.

Because, leeches. ;)
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He added this next:

And with that said, I am off to another round of Physical Therapy where a blonde lady of about a hundred pounds will pounce on my shoulders to help heal my back.

[Sigh].

I feel like the only lab rat in a study.

(Back story: In a previous day's post, he told of an unconventional physiotherapy treatment he was receiving. Actually, just a sec... I'll post that conversation at the end of this one.) 

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My next comment:

Indeed! What works for some, or even one, doesn't necessarily work for others.

Because, Pfizer.

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His next comment:

That was the PERFECT response! 

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I then went on to have another comment that ended with a short paragraph that said: 

"Because, black momba."

But I won't print that here on my blog because I don't want to offend the person to whom I was covertly referring, who my Smart Friend knows via my stories, and about whom we have had some stress-relieving laughs behind the scenes. However, if you are curious about it, please email me and I may or may not fill you in.

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OK, as promised, here is not only the back story (no pun intended - you'll see what I mean) on the unconventional physiotherapy my Smart Friend is receiving, but also you get to find out a bit on the subject of crickets chirping.

An unusual afternoon. I just had my first Physical Therapy session for my sprained back this afternoon.

The kind, young, physical therapist could not have weighed even 100 lbs. Since I keep re-injuring it, I am a bit protective of my back, and not keen on being touched; but her slight size was hardly intimidating.

So, near the end, as I am beginning to trust her, she had me lie down, hold a position with my arms crossed and my tightly holding my own shoulders, and then asked me to close my eyes.

Close my eyes? Hmm.

The reason was so that I would not know (and therefore, not brace for it) that she was going to have to propel herself, in a standing leap, up over the table so that her entire mass could drop on me and force my back to do as she intended. 

It worked. A relaxing crackling sound cascaded from between my shoulder blades and down my spine. We both laughed at the sound-- and my surprise.

Very different, but I was reminded of a less intensive massage...

A joke shared between us back when I was married-- the one receiving a back and shoulder massage, at some point, would drowsily say, "I'll give you twenty minutes to stop that. Thirty minutes, tops." That joke just never got old. :) 

I don't think I would have enjoyed twenty minutes of what I got today. But I would pay money to have someone bear-hug me from behind, as she did, and lift my torso slightly from under my arms.

That was the best thirty seconds of my day.

A muscle relaxer, chased down with a beer, while chatting with a friend at a pub afterwards wasn't too shabby, either.

Next challenge: Since I always sleep flat on my back, I am under orders to sleep with a pillow under my knees to relieve the natural curve. I bet that pillow is kicked to the floor within five minutes of falling asleep. But, I'll give it a try.

Does anybody on the planet sleep that way? Sigh. 

I never understood how people sleep on their sides-- or for that matter, find sitting in chairs more comfortable than sitting cross-legged on the floor.

You Earthlings are weird.

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He then went on to do what he often does in his Facebook posts - he included an unrelated image, designed to draw people in to read, since it seems that photos get more attention on Facebook than prose.

I forgot to add an unrelated image. Here you go.

(Here, he posted a black and white photo of some big old ship.)

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I responded with this:

I respond with another unrelated image. I call him BeeFish.

Thank you for sharing yet another story to cause me to smile. I wish I could post stories about random daily events, but I hold back because I dread the crickets chirping.

(Here, I posted a picture of a toy plush fish that is yellow and black striped.)

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His response was this:

They do chirp! My images get about five or six times the likes and comments as my writing.

When someone posts an hour-long YouTube I am interested in, I often look for a transcript-- because it is faster for me to digest than watching a video.

I prefer reading-- and prefer paragraphs at a minimum. Call me weird, but I find complete thoughts to be engaging.

That is just more evidence that I am from another planet. :)

I would have called it BumbleFish, but BeeFish looks well used and well loved.

Thanks for tuning in, my friend.

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A comment of mine:

"I prefer reading-- and prefer paragraphs at a minimum. Call me weird, but I find complete thoughts to be engaging."

I totally relate. We might be from the same planet.

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In case you are eager to read more from my Smart Friend, here is one last bit with which I will leave you:

In a recent Facebook status, he posted a link for this article:

http://jonathanshedler.com/wp-content/uploads/2015/07/Shedler-2015-Where-is-the-evidence-for-evidence-based-therapy-R.pdf?utm_campaign=Clinical%20Department&utm_content=18135386&utm_medium=social&utm_source=facebook

And his comment beneath the article was this:

It is important for both patients and therapists.

Weekly, I read of a new therapy being heralded as the way to health.

I minored in statistics, my post-grad is in a field of psychology, I'm a Carl Jung fan, and I have continued my professional studies for twenty-five years -- so this hits the spot.

I am dubious of some therapies considered "Evidence Based." I am seeing them on Facebook as well as Psychology forums I read.

I believe my words concerning one such (very popular) claim last week was "On what planet and in what reality?" because I find the premise to be absurd.

A psycho-therapy based on acupuncture? Really? Or how you move your eyes while recalling an extreme trauma?

I'm seeing the VA approving stuff like this for PTSD patients -- and it looks like desperation -- science be damned.

Sugar-pills are cheaper -- and easier for the patient to dismiss as ineffective -- so that they continue the hard work that really does help.

Again and again, when I dig into one, I keep finding that the fad-of the-week has zero benefit without talk-based therapy and suspect they add nothing to that more common therapy beyond placebo.

So here is a man asking and answering some of the very questions I am asking --and anyone who stresses "footnotes" in analyzing research is someone who understands how it is done.

This is especially important in media reporting, when we know (or ought to know) that the reporter has no formal background in the subject -- and does not really care.

Or worse, YouTube videos and self-help books.

I want to help people. Charlatans want to make money pretending to help people. If I give advice, it is my job to know whether it is sound advice.

In a perfect world, someone in need of treatment ought to have access to data regarding effectiveness so they participate in the choice of a therapy that really can help.

This article is a primer in how to research a treatment or therapy.

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My comment:

As for this:

"A psycho-therapy based on acupuncture? Really? Or how you move your eyes while recalling an extreme trauma?"

Well, I just want to say that although EMDR - (I'm guessing this is the therapy of which you speak that involves eye movement while recalling trauma?) - helped me deal with some of my most painful trauma memories, I am not sure that my understanding of why it worked for me would be scientific: What struck me while I was in EMDR therapy sessions was that while focusing on the traumas, I actually came up with some of my own solutions, some of them seemingly simple, as in "Why did I not think of that before?" kinds of things.

But, of course, EMDR may or may not help others. (Refer back to my "Because, Pfizer" comment in our earlier conversation!)

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I will close with the sound of crickets (not to be confused with Buddy Holly and the Crickets, nor with the British game of Cricket), for all the people who are not reading this blog entry.





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