During the 1960s and 1970s, patients at a small Sydney private hospital called Chelmsford were subjected to a treatment known as deep-sleep therapy.
Patients were kept in a comatose state for days or weeks by massive doses of barbiturates. They lay naked on beds and were fed through tubes and were sometimes administered convulsive electrical shock treatment while in a coma.
The treatment’s major proponent, Dr Harry Bailey, claimed deep-sleep therapy cured depressive illnesses and compulsive behavior such as drug and alcohol addiction.
There's a great fiction series called "The Regeneration Trilogy" in which the story of World War I is told from the perspective of W. H. R. Rivers, a real-life British psychiatrist who treated soldiers who returned from the front with "shell shock."
It's a great read on numerous fronts, and digs pretty deep into how soldiers were treated once they were back home.
It is a sad fact that combat stress reaction and subsequent PTSD among veterans was only taken seriously once the US armed forces began to have more deaths by suicide than by combat. The disorder causes immense personal suffering in individuals and communities that can take generations to heal. That psychedelic medicine is losing its stigma because of the long struggle to produce irrefutable evidence of its efficacy should inspire us.
> Obviously, the technique of psychoanalysis is out of the question in the [military] services and because of time and expense it is out of the question for most civilians as well.
That feels like the root cause of a lot of problems in psychiatry.
Taking a little bit wider context, and having the experience of going through almost four years of psychoanalytic psychotherapy, I would say that this might be one of the root causes, but the issue is more complex.
In my experience, for an analytical person, one of the challenges is that the analytic mind of the patient may be stronger than the analytic mind of the therapist. We humans appear to often be what may be called lopsided monstrosities. Our strength has become a weakness, in a way.
By this I mean that we tend to use our strengths to try to solve our problems even when another part of us would be more helpful in solving them. For instance, we may analyze, when would be more useful to connect to our feelings, or we may think -- i.e. procrastinate -- when it would be more useful to act.
The aim of the analytical psychotherapy does not appear to be to cultivate our weaker sides. So an analytical person might be able to access the trauma more quickly through these other paths than the analytical mind.
Therefore, it appears that while one of the issues is the aim to have a quick shortcut therapy, even when there are sufficient resources, one-size-fits-all approach might not be enough for a therapeutic process.
> we tend to use our strengths to try to solve our problems even when another part of us would be more helpful in solving them
This resonates.
I once worked with a coach who helped me realize this. It was the proverbial breakthrough moment. Many people probably could benefit from a similar realization.
Yes. I think it is very helpful to try to develop your weaker sides, in order to become a more balanced person. For me, partner dancing has been fruitful in developing my emotional and moving parts.
And, if you need to process some traumatic experiences -- and practically all of us probably could benefit from such work -- if psychoanalytic psychotherapy does not work for you -- I would suggest trying other kinds of therapy that works more through our emotional or somatic parts.
The literal shock to the adrenal system with trauma is this century’s cancer. We see it as decreasing expectancy of the last 30 years in the U.S. The fight for survival is a basic instinct that needs to be managed with holidays, nature, and recreational pursuits. With AIs will we learn to work and fight smarter? Even drone pilots get PTSD.
I think a big reason for the resistance of acknowledging trauma as injury is, arguably, because culturally so many of us are injured that we behave in a clearly traumatized manner towards actions of healing, ie. rejection/denial/lashing out. If we acknowledged all forms of trauma as trauma we would have a radically different society…
After all, beating children into bruising was normal just a generation ago. In many states it’s still legal to beat your children.
Another challenge is how we as a society view non-physical violence like emotional abuse, verbal abuse, gaslighting, and infidelity. Punch a person in the face and it leaves obvious physical markings. Yet cheat on your spouse with their best friend, and coordinate with your spouse's family and friends to gaslight your spouse into believing they're crazy and you're much less likely to be caught. I genuinely believe the psychopaths that live among us have a vested interest in ensuring that psychological abuse is very difficult, if not impossible to prosecute. And I would much rather be punched.
No there isn’t some conspiracy to leave it unprosecuted, just that people with psychopathic tendencies are good at sniffing out the areas where the victim is unlikely to hit back
From my experience, only way to really deal with those types is to always escalate and get more eyes on the situation
> only way to really deal with those types is to always escalate and get more eyes on the situation.
Want to echo this, and say that it is in the psychopath’s best interest to make you feel like you are overreacting. Bringing more eyes on the situation is not overreacting, and if someone who has power over you is trying to convince you of that, don’t trust them.
Thank you for reminding me of the game “Unmanned”. You play a drone operator who must make impossible decisions. The burden takes a toll, it is well worth a play for anyone interested in this subject of combat stress reaction.
> We see it as decreasing expectancy of the last 30 years in the U.S.
Is there any solid research showing this connection? It's not obvious that trauma has had a bigger impact over this period than e.g. sedentary lifestyles...
"91% percent of participants who did not perceive themselves to have had a warm relationship with their mothers (assessed during college) had diagnosed diseases in midlife (including coronary artery disease, hypertension, duodenal ulcer, and alcoholism), as compared to 45% of participants who perceived themselves to have had a warm relationship with their mothers. A similar association between perceived warmth and closeness and future illness was obtained for fathers.
82% of the participants who reported tolerant or strained relationships with their fathers had significant health issues in midlife, compared to 50% of those who had warm or close relationships with their fathers.
If participants had strained relationships with both parents, the results were startling: 100 percent had significant health issues, versus 47 percent of those who described their relationships with their parents as being warm and close.
Another study, conducted at John Hopins University, followed 1,100 male medical students for fifty years and found that cancer rates correlated closely with the degree of distance a participant felt toward a parent.
A LLM trained on the complete corpus of 19th century medical knowledge would be pretty useless (they had no infectious disease model). It's a fair argument that the state of modern psychological knowledge is comparable to early 20th century infectious disease knowledge (rather poor).
In terms of training corpus, I wonder how that is managed? Training LLMs on out-of-date scientific papers doesn't seem like a good idea. It might make sense to exclude primary research reports entirely and instead stick with current reviews and textbooks?
LLMs are great at producing “free undergrads.” By that I mean it’s now easy to train a model that can produce textbook answers to textbook questions, that is well-defined solutions to well-defined problems. Modern LLMs will not be able to replace or augment physicians much because so much of medicine comes down to understanding the patient’s context.
LLMs understand context pretty well, that's their magic, and one thing i've noticed is that they are much more thorough than a person: they won't forget the context in the next moment or the next month. A human doctor can do better but they have to really care a lot to do better. Also, they'll only be able to do some things without attending to all necessary tasks (for example one usually overlooked is communicating with caring words).
During the 1960s and 1970s, patients at a small Sydney private hospital called Chelmsford were subjected to a treatment known as deep-sleep therapy.
Patients were kept in a comatose state for days or weeks by massive doses of barbiturates. They lay naked on beds and were fed through tubes and were sometimes administered convulsive electrical shock treatment while in a coma.
The treatment’s major proponent, Dr Harry Bailey, claimed deep-sleep therapy cured depressive illnesses and compulsive behavior such as drug and alcohol addiction.