Knowledge is a tree, not a conclusion, and it has been a tree for all of time. Sometime, however, it verboten in the Bible with a didactic “tale” apparently by oligarchs telling the average religious person to view the tree of knowledge and its information as verboten. This is the beginning of the limits and control of information necessary for oligarchic dominance, as opposed to capital-type control which is more commodity-based --though information is now a commodity as “intellectual property.” (With “intellectual” being a strong word for the slurry capital pumps into the population.)
The most important extension of this type of information control currently exists as academia with its early revival of control as the dialectic and didactic by academy founders Socrates and Plato in ancient Athens, and recently by Hegel to fit current capital. Important is that these instructors specifically used sexual abuse to control, which survived to our time as, for instance, the Aboriginal residence schools openly, and covertly elsewhere.
Causality is a rational reduction of the complexity of life saying that “if something happens in relation to something else, that something else caused the first thing.” As a rational reduction, it is a “dumbing-down” of all the highly sophisticade life-system that affect us. Knowledge is naturally structured both in society and in our minds in tree structures, also called “complex data structures” Personally, I have never been “causal” (I believe) because I have been influenced by aboriginal knowledge organization, and also abstract art and music early on as a child with access to all of New York’s museums and libraries (access has since been restricted to children.)
If I something is unavoidably causal, I say “simple math” --this causes that, w/o making a bid deal about it.
Empiricism is the scientific method (and system) built from causality and is considered the only (measurement) science, even by scientist who should know better. It suffers from being highly-fractured, as it is built from independent causal conclusions that also tend to be ego-vehicles from empiricist scientists. Another widely-misused term is “objective” as a synomym for “cruel” such that normal human thinking, such as the recollection of experiences, is excluded from empiricist conclusions; only empiricist numbers are used, often as an output of highly-purposed statistical systems. Dependance on statistics is such that statistics now often produce hypothesis and theory, that is validated by the same statistical systems. Information from other sources such as experience and observation, no matter how detailed, cannot test well against conclusive information produced specifically to test well by statistical systems. This statistical reality is most true for current control of the mind (both human and animal) in cognitive-behavioral strategies of CBT. Interestingly, in CBT, the dialectic method as the socratic method is also key for (as they say) “thought control.”
Objectivism, such as Ayn Rand’s and (current-capital’s) Adam Smith’s objectivism simply “objectify’s” people to make then inanimate numbers rather than feeling people to allow for capital exploitation. As it happens, capital-supporting empiricism, as info-oligarchic, also leverages this, and fills its capital-supportive role by defining and maintaining it as its own from of exploitation, originally sexual abuse.
Tuesday, January 18, 2011
Placebos in therapy
An attempt to lower the placebo effect is the use of a run-in phase, or test, to find and eliminate participants who respond to placebos (Hougaard, 2010). But a meta-study found that studies that used a run-in phase were not significantly different from those that didn't. Some find fault in the nature of antidepressant efficacy trials, showing that a majority of the depressed would not qualify to participate in the trials (Zimmerman, 2005). Eliminating factors include comorbid anxiety, previous episodes, a possibility of suicide, or social impairments.
Two likely explanations for the placebo effect are an expectation for improvement by participants (that may be supported by industry advertising), and that the interaction between participants and clinicians initiates a healing phase (Hagen, 2010). Explanations like these imply that efficacy trials themselves are therapy, and for this reason, psychotherapy should first be attempted, followed by medication. The greatest efficacy for depression combines counseling and medicine; the combination shows 15-20% improved efficacy for chronic severe depression. Counseling is the better long-term therapy as it helps prevents relapse.
There is temptation to use the placebo effect as it has fewer side effects than medications (Kirsch, 2002). But their deceptive nature inhibits their use. The best approach to the placebo effect is to attempt to understand why it is beneficial and to apply its components in ways that clients can accept.
DeMarco, C. (1998, June). On the impossibility of placebo effects in psychotherapy. Philosophical Psychology, p. 207. Retrieved from Academic Search Premier database.
Dimidjian, S., Hollon, S., Dobson, K., Schmaling, K., Kohlenberg, R., Addis, M., et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658-670. doi:10.1037/0022-006X.74.4.658.
Hagen, B., Wong-Wylie, G., & Piji-Zieber, E. (2010). Tablets or Talk? A critical review of the literature comparing antidepressants and counseling for treatment of depression. Journal of Mental Health Counseling, 32(2), 102-124. Retrieved from Academic Search Premier database.
Hougaard, E. (2010). Placebo and antidepressant treatment for major depression: Is there a lesson to be learned for psychotherapy?. Nordic Psychology, 62(2), 7-26. doi:10.1027/1901-2276/a000008.
Kirsch, I., Moore, T., Scoboria, A., & Nicholls, S. (2002). The emperor's new drugs: An analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration. Prevention & Treatment, 5(1), 23. doi:10.1037/1522-37220.127.116.113a.
Zimmerman, M. (2005). Generalizability of antidepressant efficacy trials: Differences between depressed psychiatric outpatients who would or would not qualify for an efficacy trial. American Journal of Psychiatry 162, pp. 1370-1372, July 2005. Retrieved October 24, 2010 from http://ajp.psychiatryonline.org/cgi/content/full/162/7/1370