Monday, 22 September 2008

Joseph Biederman is a wanker (although that's just my personal opinion)

I was just reading this piece - not because I'm particularly interested in bipolar, harvard, psychiatry, or the quality of the Globe's coverage, but rather because I'm fascinated by the myth of Joseph Biederman.

"I think a pharma person would not dare to tell Joe what to say," wrote Dr. Jerrold Rosenbaum , chief of psychiatry at Mass. General, in an e-mail. "And if they made that mistake, it would be only once. . . . For Joe, it is his ideas and mission that drive him, not the fees."

Well, thank goodness for that! This is Rosenbaum's perspective, of course, not Biederman's, but let's assume it's accurate.

Which begs the question, I think, as to what ideas Biederman has, and what his mission is. He perceives that "these children... are in a desperate state," and he assumes that the reason for this is that they are mentally ill, in some sense. However, as the piece points out, rightly, I think, assuming that the issue lies with the individual allows Biederman to ignore the environment in which that individual operates.

I'm skeptical about what Rosenbaum says, mind you: if one is included in a club (and pharma has surely included Biederman in its club), then one is inclined, generally-speaking, not to act against the interests of that club, especially if one is receiving a benefit, by dint of membership. I wonder what Biederman's stance would be, if pharma were prevented from giving him money? Would he start to see the solution to childhood bipolar (assuming it exists - there appears to be some doubt about that), as lying somewhere else? Is Biederman that superficial? Are we all that superficial?

Who knows? And who cares? Well, I'll tell you who cares, actually. The people who care are the ones for whom Biederman's solutions don't work, and who are left bearing all responsibility for the fact that they don't work.

You're a charlatan, Biederman. Your piddling little ideas have never fixed anybody, and the idea that you should be paid millions of dollars for failing is a fucking travesty. But only in my opinion, obviously.

Matt

Addendum:
Jesus, this is one secretive bunch! This is Biederman's official homepage, in which he's only mentioned as one of the 650 faculty members. Nothing about his ideas, nor his "mission" (am I the only person to find that word disturbing, although I'm not quite sure why?).

17 comments:

Fiddy said...

Joseph Biederman is a wanker (although that's just my personal opinion)

I'll ditto that.

Fid

susan said...

nice article Matt.

Funny how "wanker" means something totally different over here than it does over there.

Stephany said...
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Stan said...

Dearest Matt:

When does hunting season open for these pesky Wankers anywise? I would love to mount one of those heads on my wall to throw darts at during times of frustration.

Great post by the way! I love that shoot straight from the hip approach with sarcasm working at it very best.

Yours truly
Stan

Radagast said...

Cheers, guys. You know, the funny thing is, for a guy who's had such a massive impact on the dubious prescribing of drugs to children, he's almost completely anonymous. Do a Google, and there's very little there, as far as I could see.

But he's never fixed anybody, as far as I know (I stand to be corrected on that point, obviously), or if he has discovered some extraordinary secret, then he really ought to be sharing that with others, given his apparent concern for children. His one contribution of note appears to be the discovery of a new illness, which manifests itself in a series of behaviours that people don't like the look of (whether or not the patient has an issue with them isn't clear). How he knows it's an illness is unclear to me, seeing as he hasn't, to my knowledge, explained the cause, at any point.

Hmm, that sounds like coercive treatment, which probably fits in nicely with the patients' experience of life...

Matt

Radagast said...

BTW, Stan: I couldn't find any information on the status, protected or otherwise, of the wanker (masturbatus regularis). You should probably check the bye-laws, local to you.

We're pretty strict on bloodsports, in the UK, so they're probably protected, unless it can be shown that they carry bovine TB, or something, in which Defra's hitsquad will move in!

Matt

Stephany said...
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Radagast said...

Stephany wrote:
"He refuses public interviews."

I'll just bet. Can you imagine some sharp bastard putting the same questions to Beetlejuice that I put to TF? He'd fucking implode!

Matt

Radagast said...

OK. I've just had a quick look at one or two pages of results - all the papers assume that mania/bipolar/ADHD/etc are genetic, or otherwise fixed in the individual - none of the papers looks at causation, or even the possibility that a child's environment has led to the symptoms exhibited.

All behaviour is learned - in microscopic detail, quite often - and then a person seeks to improve on the model placed before them. The confusion arises when they perceive the model is flawed, but are not permitted to make it better.

This is obviously a massively generic analysis, but it's true for me, and I've tested it on others, too. Most people don't realize that they operate like that, though. What do people think they are? We're fucking robots - we have to work on some form of logic...

Spiderman's paradigm is founded upon a model of the human mind that is so incomplete that it doesn't work. That's all there is to it.

Matt

PS I was dismayed at how many of these academic papers, having assumed that the presenting illness of children was there to stay, were just looking at drug and drug combos.

Matt

Stephany said...
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Stephany said...
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Radagast said...

Stephany, Bottlejam's wrong, and that's all there is to it. All these diagnoses are symptomatic of the same malaise: everybody knows the whole fucking (human) world's gone to fuck, and humanity seems determined to take the rest of the planet with it. But nobody is willing to acknowledge that.

The people who are trying - the one's trying to rationalize the crap that comes out of people's mouths with the violence that's just around the corner, are the mentally ill. The "sane" are the people who've decided that the best way to deal with stuff is to ignore it, whilst the mentally ill know exactly what's wrong, but keep being told they're talking shite.

I know exactly what happens when I acknowledge them, validate what they're saying, and show them a way out. Unless they ask me my opinion, I tell them nothing of my perspective, so I know that we're only dealing with the information that they've given me. And given the effect that simple thing has, I know that Biederman's got it wrong, and he's got it wrong, because he can't look at his patients and say to them "you know more about you than I do - I can only seek to understand, and maybe have you understand a little better, too."

I don't live in my own private world, Stephany: I've never been allowed to. I've been obliged to live in others' worlds, even though, when they drag me in there, they won't talk to me.

Matt

susan said...

Umm. Ok... My two cents for what it's worth.

First of all September 23 is one of my favorite days. My grandmother's water broke and my mom was born early in the am on the 24th.


Secondly- and not as nice as my mom.....Biederman. Never met the guy, though did meet a lot his disiples from the ex. (Matt, PM me for who that is, or ask Stephany or Philip).

The DBSA chapter that I belong to has an advisor, as set up by our by laws. This advisor trained under Biederman in medical school. When he came back to Princeton, (where he had gone as an undergrad) to set up practice, his practice was influenced by Biederman.

After a couple of years he grew disanchanted, and saw a lot of flaws in what was going on in his practice. The more he saw, the more he started disagreeing with Biederman. and his teachings. His practice evolved, and he became a damn good shrink. He has cut all ties with Biederman, and currently spots a sign on his door "NO sales reps allowed". If one gets in, he tells them to get lost, not come back again.

I cannot afford him, but he saw me for free last week to help me deal with my friend's suicide.

So- there is one good Eastern shrink. And I live on the East Coast and I am nice!

I hope your head doesn't explode tomorrow am!

Radagast said...

I'm sure that there are people who disagree with Biederman, but the trouble is, those guys have been indoctrinated with what is believed to be "the state of the art," when they were in med school. But that stuff doesn't work - why can't somebody be honest about that?


Do you know how I came to the conclusion that I have? I spent years, nearly forty of them, fully believing that there was a form of words that I needed to adopt, which would cause people to treat me as though I were a decent human being - yes, I was quite convinced that people could tell that I wasn't one of "them," owing to some giveaway mistake that I might make. Oddly enough, I think I may have been closer to the truth than I knew.

And so I spent those forty years working out what it was that people wanted to hear. A fucking feat of mathematical impossibility. It can't be done, so I decided that if one made a mistake, and the other person got upset, there was stuff that one could do, that would rectify the situation, and so on. Except, it's quite evident that nobody else was wasting their time with this kind of thing. I know this, because people very rarely apologize to me. And people are happy to clarify that they mean me ill, not realizing that that gives me carte blanche to return the favour, according to their own rules.

Human beings have created so many different ways to communicate, and they've fucked them all up. Every last one. Nobody knows what the fuck is going on, any more, nor what they should be doing, and most importantly, why they should be doing it.

I may be a freak, by some people's estimation; but can you imagine how everybody else looks to me? If I saw somebody like me, I'd acknowledge them - that's how I know that other people are not like me, because most of them won't even take the time to find out.

Matt

Radagast said...

"I hope your head doesn't explode tomorrow am!"

You know, that's the kind of bizarre non secitur that used to trouble me, as I pored the possibilities. I went through a period when I'd ask people to clarify. And now... well, I'm not really listening anymore, anyway, so it doesn't really matter. I don't model people closely enough, nowadays to be impacted by their stuff.

There is only really one course that interests me, these days, and that is the course that benefits me, before all others (because I understand that that's the game that everybody else is playing). If something happens outside of that, I'm not interested.

Sorry to be brutal, but you'll be aware by now, I imagine, that there's nobody looking after my interests...

Matt

susan said...

Matt, I meant I hope you don't have much of a hang over when you wake up tomorrow, if you were drinking tonight.



Sorry..... for the confusion.
I meant no disrespect....

Radagast said...

Apology accepted, although not really necessary - I have my "triggers," too, although I'm trying to work through them, one by one, as I find them. I don't have anybody to listen to me, either - a not uncommon problem, I think.

Matt