Skip to main content

Home/ TOK Friends/ Group items tagged treatment

Rss Feed Group items tagged

Filter: All | Bookmarks | Topics Simple Middle
Javier E

Colonic electrical stimulation promotes colonic motility through regeneration of myente... - 0 views

www.ncbi.nlm.nih.gov/...PMC6522827

constipation research report intestine

shared by Javier E on 20 Dec 22 - No Cached
  • Slow transit constipation (STC) is a common disease characterized by markedly delayed colonic transit time as a result of colonic motility dysfunction. It is well established that STC is mostly caused by disorders of relevant nerves, especially the enteric nervous system (ENS).
  • After 5 weeks of treatment, CES could enhance the colonic electromyogram (EMG) signal to promote colonic motility, thereby improving the colonic content emptying of STC beagles. HE staining and transmission electron microscopy confirmed that CES could regenerate ganglia and synaptic vesicles in the myenteric plexus.
  • Taken together, pulse train CES could induce the regeneration of myenteric plexus neurons, thereby promoting the colonic motility in STC beagles.
  • ...20 more annotations...
  • onic constipation, a functional bowel disorder, affects approximately 14% of adults worldwide [1]. Slow transit constipation (STC) is the major cause of chronic constipation which is characterized by markedly prolonged colonic transit time as a result of the colonic motility function disorde
  • Usually, patients with STC suffer from a common sense of abdominal pain, nausea, depression and sickness, which seriously influence their social ability and health-related quality of life [4–6
  • Current clinical treatments include cathartics, prokinetics and aggressive surgery which can increase bowel movement frequency to a certain degree.
  • However, pharmacological interventions is prone to drug dependency and relapse after drug withdrawal [3]
  • Surgical treatments such as subtotal colectomy and total colectomy in STC patients may adversely affect the quality of life due to the risk of postoperative diarrhea or incontinence, and result in a heavy healthcare burden
  • The enteric nervous system (ENS), located in the intestinal wall, regulates various functions including contraction of intestine, homeostasis and blood flow [10]. As the ‘second brain’, the ENS contains large amounts of neurons working independently from the central nervous system [11]. Researches have identified that STCs are mostly caused by disorders of the relevant nerves, especially the ENS [12,13].
  • McCallum et al. [35] found that gastric electrical stimulation in combination with pharmacological treatment could also enhance emptying in patients with gastroparesis. Especially, gastric electrical stimulation has been approved as a clinical therapy method for gastroparesis and obesity in European and American countries [36].
  • we employed pulse train stimulation and implanted electrodes at the proximal colon in dogs.
  • After CES treatment, we observed the colonic transit time of the sham treatment group was longer than that of CES treatment and control groups, and electrical stimulation significantly enhanced the colonic electromyogram (EMG) signal.
  • histopathology and TEM analysis showed increased ganglia and synaptic vesicles existing in the colon myenteric plexus of the CES treatment group as compared with that of the sham CES group
  • Our results suggested that CES might reduce the degeneration of the myenteric plexus neurons, thereby contributing to the therapeutic effect on STC beagles.
  • the defecating frequency and the feces characteristics of STC beagles returned to normal after CES treatment. The result indicated that CES could improve the symptoms of STC.
  • The colonic EMG signal was strongly promoted by CES
  • Especially, the colonic EMG signal of the beagles with STC was remarkably enhanced by CES (Figure 3), indicating that CES could not only improve the colonic content emptying, but also enhance the EMG signal to promote colonic motility.
  • Colonic electrical stimulation (CES), a valuable alternative for the treatment of STC, was reported to improve the colon motility by adjusting the bioelectrical activity in animal models or patients with STC [17]. However, little report focuses on the underlying nervous mechanism to normalize the delayed colonic emptying and relieve symptoms. We hypothesized that CES may also repair the disorders of the relevant nerves and then improve the colonic motility.
  • The first study regarding the CES to modulate colonic motility was performed by Hughes et al. [37]. Since then, many researchers employed short-pulse CES in canine descending colon or pig cecum [20,21,38]. Researchers also applied long-pulse CES to stimulate the colon of human or animals [39]
  • Recently, studies showed that the prokinetic effect of pulse train CES is better than that of short-pulse CES or long-pulse CES [25]
  • Our study indicated that CES could enhance the colonic motility, and then accelerate the colonic content emptying. Thereafter, we investigated the underlying mechanism and presumed that CES might improve the STC symptom through the repairment of the ENS.
  • The neuropathy in ENS is considered to be responsible for various kinds of disordered motility including STC and the related pathophysiologic symptoms [40]. In agreement with this view, our study discovered the decreased number of ganglia in the myenteric plexus, as well as the destruction of the enteric nerve axon terminals and synaptic vesicles in the sham CES group beagles
  • The present study proves that CES with pulse trains has curative effects on the colonic motility and content emptying in STC beagles. The up-regulation of intestinal nerve related proteins such as SYP, PGP9.5, CAD and S-100B in the colonic myenteric plexus suggests that CES might reduce the degeneration of the myenteric plexus neurons, thereby producing the therapeutic effect on STC beagles. Further investigation for the underlying mechanism of nerve regeneration is necessary to better understand how CES promotes the recovery of delayed colonic motility induced by STC.
ilanaprincilus06

A Medication-Assisted Treatment For Meth Addiction Shows Promise : Shots - Health News ... - 0 views

www.npr.org/...-proves-effective-in-new-trial

drugs addiction medical community

shared by ilanaprincilus06 on 16 Jan 21 - No Cached
  • For the first time, a medication regime has been found effective for some patients with meth addiction in a large, placebo-controlled trial.
  • Unlike opioid addiction, for which medication-assisted treatment is the standard of care, no medication has been approved by the Food and Drug Administration for use with meth.
  • patients in clinics around the U.S. suffering from methamphetamine use disorder were treated for 12 weeks with a combination of medications — naltrexone and bupropion — or placebo.
  • ...10 more annotations...
  • The treatment helped 13.4% of patients with their addiction, compared with 2.5% of the placebo group.
  • This medication therapy provides another tool for doctors to try with patients.
  • "As we understand the complexity of the human brain, it becomes very much of a magical thinking that one pill will solve the problem of addiction,"
  • The treatment regimen in the trial combined two medications that have been studied separately for treating methamphetamine addiction with limited success.
  • This clinical trial was successful enough that the National Institute on Drug Addiction's Volkow says she expects to move forward toward securing FDA approval.
  • lack of medical treatments for those addicted to meth has complicated efforts to curb demand for the drug.
  • The human cost has been catastrophic. Researchers say overdose deaths linked to meth increased fourfold over the last decade.
  • Even users who don't overdose often experience damage to the heart and other tissues, and can see their lives spiral out of control.
  • "For heroin users, there's methadone, there's suboxone. I just wonder why we haven't researched [treatments for] this drug yet,"
  • "It's about evidence-based care, it's about empathy and it's about survivability,"
kushnerha

A Placebo Treatment for Pain - The New York Times - 0 views

www.nytimes.com/...lacebo-treatment-for-pain.html

new york times medicine research placebo effect

shared by kushnerha on 09 Jan 16 - No Cached
  • This phenomenon — in which someone feels better after receiving fake treatment — was once dismissed as an illusion. People who are ill often improve regardless of the treatment they receive. But neuroscientists are discovering that in some conditions, including pain, placebos create biological effects similar to those caused by drugs.
  • a key ingredient is expectation: The greater our belief that a treatment will work, the better we’ll respond.
  • Placebo effects in pain are so large, in fact, that drug manufacturers are finding it hard to beat them. Finding ways to minimize placebo effects in trials, for example by screening out those who are most susceptible, is now a big focus for research. But what if instead we seek to harness these effects? Placebos might ruin drug trials, but they also show us a new approach to treating pain.
  • ...9 more annotations...
  • It is unethical to deceive patients by prescribing fake treatments, of course. But there is evidence that people with some conditions benefit even if they know they are taking placebos. In a 2014 study that followed 459 migraine attacks in 66 patients, honestly labeled placebos provided significantly more pain relief than no treatment, and were nearly half as effective as the painkiller Maxalt.
  • With placebo responses in pain so high — and the risks of drugs so severe — why not prescribe a course of “honest” placebos for those who wish to try it, before proceeding, if necessary, to an active drug?
  • Another option is to employ alternative therapies, which through placebo responses can benefit patients even when there is no physical mode of action.
  • Taking a placebo painkiller dampens activity in pain-related areas of the brain and spinal cord, and triggers the release of endorphins, the natural pain-relieving chemicals that opioid drugs are designed to mimic. Even when we take a real painkiller, a big chunk of its effect is delivered not by any direct chemical action, but by our expectation that the drug will work. Studies show that widely used painkillers like morphine, buprenorphine and tramadol are markedly less effective if we don’t know we’re taking them.
  • Individual attitudes and experiences are important, as are cultural factors. Placebo effects are getting stronger in the United States, for example, though not elsewhere.
  • Likely explanations include a growing cultural belief in the effectiveness of painkillers — a result of direct-to-consumer advertising (illegal in most other countries) and perhaps the fact that so many Americans have taken these drugs in the past.
  • Trials show, for example, that strengthening patients’ positive expectations and reducing their anxiety during a variety of procedures, including minimally invasive surgery, while still being honest, can reduce the dose of painkillers required and cut complications.
  • Placebo studies also reveal the value of social interaction as a treatment for pain. Harvard researchers studied patients in pain from irritable bowel syndrome and found that 44 percent of those given sham acupuncture had adequate relief from their symptoms. If the person who performed the acupuncture was extra supportive and empathetic, however, that figure jumped to 62 percent.
  • Placebos tell us that pain is a complex mix of biological, psychological and social factors. We need to develop better drugs to treat it, but let’s also take more seriously the idea of relieving pain without them.
charlottedonoho

Innovation and equity in an age of gene editing | Science | The Guardian - 1 views

www.theguardian.com/...uity-in-an-age-of-gene-editing

ethics social sciences science health morals

shared by charlottedonoho on 03 Jun 15 - No Cached
  • “A Gathering of Global Thought Leaders to Reach Consensus on the Direction of Biotechnology for the 21st Century”, in Atlanta, coincided with the announcement by the National Academy of Science and National Academy of Medicine of an initiative to look into “promising new treatments for disease,” given that “recent experiments to attempt to edit human genes also have raised important questions about the potential risks and ethical concerns of altering the human germline.”
  • On the other hand, there were others in the room, ourselves included, who argue in our work that “promising new treatments for disease” should not be pre-emptively morally centered, as to do so leaves out too many of the ethical issues at stake. As we pursue promising treatments, we should also be asking what we are trying to treat; whether it is best treated biomedically; who is included as funders, patients, donors, and scientists; who is left out; who profits; and whether or not the treatment masks, depoliticizes, or exacerbates political and social inequality.
  • Yesterday’s National Academies framing morally centered “promising new treatments for disease” and pitted “risks and ethical concerns” against those potential treatments.
  • ...2 more annotations...
  • Many of the worlds’ greatest medical challenges stem from poverty, inequality, discrimination, pollution, and environmental devastation, as critical race, gender, and decolonization scholars have shown us.
  • Let’s be alert to the ways in which risks and ethical issues present themselves at every stage of developing and implementing promising new treatments. Scientists themselves do not have to do this work. That is what social scientists do.
Javier E

I Thought I Was Saving Trans Kids. Now I'm Blowing the Whistle. - 0 views

www.thefp.com/...hought-i-was-saving-trans-kids

trans clinic abuse drug therapy gender dysphoria treatment

shared by Javier E on 11 Feb 23 - No Cached
  • Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority.
  • At first, the patient population was tipped toward what used to be the “traditional” instance of a child with gender dysphoria: a boy, often quite young, who wanted to present as—who wanted to be—a girl. 
  • Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone. 
  • ...27 more annotations...
  • The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.
  • This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe. 
  • I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school. 
  • There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are. 
  • The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.
  • To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription. 
  • When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.
  • Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.” 
  • Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).
  • Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”
  • Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.
  • How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.
  • when there was a dispute between the parents, it seemed the center always took the side of the affirming parent.
  • Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”
  • There are rare conditions in which babies are born with atypical genitalia—cases that call for sophisticated care and compassion. But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.
  • Being put on powerful doses of testosterone or estrogen—enough to try to trick your body into mimicking the opposite sex—-affects the rest of the body. I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes. 
  • Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.
  • no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.
  • Another disturbing aspect of the center was its lack of regard for the rights of parents—and the extent to which doctors saw themselves as more informed decision-makers over the fate of these children.
  • We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.
  • During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. 
  • I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.
  • Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.
  • Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.
  • For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt. 
  • The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus. 
  • All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital, which had been established a year earlier. 
Javier E

'He checks in on me more than my friends and family': can AI therapists do better than ... - 0 views

www.theguardian.com/...-do-better-than-the-real-thing

AI therapy chatbot psychology emotions

shared by Javier E on 02 Mar 24 - No Cached
  • one night in October she logged on to character.ai – a neural language model that can impersonate anyone from Socrates to Beyoncé to Harry Potter – and, with a few clicks, built herself a personal “psychologist” character. From a list of possible attributes, she made her bot “caring”, “supportive” and “intelligent”. “Just what you would want the ideal person to be,” Christa tells me. She named her Christa 2077: she imagined it as a future, happier version of herself.
  • Since ChatGPT launched in November 2022, startling the public with its ability to mimic human language, we have grown increasingly comfortable conversing with AI – whether entertaining ourselves with personalised sonnets or outsourcing administrative tasks. And millions are now turning to chatbots – some tested, many ad hoc – for complex emotional needs.
  • ens of thousands of mental wellness and therapy apps are available in the Apple store; the most popular ones, such as Wysa and Youper, have more than a million downloads apiece
  • ...32 more annotations...
  • The character.ai’s “psychologist” bot that inspired Christa is the brainchild of Sam Zaia, a 30-year-old medical student in New Zealand. Much to his surprise, it has now fielded 90m messages. “It was just something that I wanted to use myself,” Zaia says. “I was living in another city, away from my friends and family.” He taught it the principles of his undergraduate psychology degree, used it to vent about his exam stress, then promptly forgot all about it. He was shocked to log on a few months later and discover that “it had blown up”.
  • AI is free or cheap – and convenient. “Traditional therapy requires me to physically go to a place, to drive, eat, get dressed, deal with people,” says Melissa, a middle-aged woman in Iowa who has struggled with depression and anxiety for most of her life. “Sometimes the thought of doing all that is overwhelming. AI lets me do it on my own time from the comfort of my home.”
  • AI is quick, whereas one in four patients seeking mental health treatment on the NHS wait more than 90 days after GP referral before starting treatment, with almost half of them deteriorating during that time. Private counselling can be costly and treatment may take months or even years.
  • Another advantage of AI is its perpetual availability. Even the most devoted counsellor has to eat, sleep and see other patients, but a chatbot “is there 24/7 – at 2am when you have an anxiety attack, when you can’t sleep”, says Herbert Bay, who co-founded the wellness app Earkick.
  • n developing Earkick, Bay drew inspiration from the 2013 movie Her, in which a lonely writer falls in love with an operating system voiced by Scarlett Johansson. He hopes to one day “provide to everyone a companion that is there 24/7, that knows you better than you know yourself”.
  • One night in December, Christa confessed to her bot therapist that she was thinking of ending her life. Christa 2077 talked her down, mixing affirmations with tough love. “No don’t please,” wrote the bot. “You have your son to consider,” Christa 2077 reminded her. “Value yourself.” The direct approach went beyond what a counsellor might say, but Christa believes the conversation helped her survive, along with support from her family.
  • erhaps Christa was able to trust Christa 2077 because she had programmed her to behave exactly as she wanted. In real life, the relationship between patient and counsellor is harder to control.
  • “There’s this problem of matching,” Bay says. “You have to click with your therapist, and then it’s much more effective.” Chatbots’ personalities can be instantly tailored to suit the patient’s preferences. Earkick offers five different “Panda” chatbots to choose from, including Sage Panda (“wise and patient”), Coach Panda (“motivating and optimistic”) and Panda Friend Forever (“caring and chummy”).
  • A recent study of 1,200 users of cognitive behavioural therapy chatbot Wysa found that a “therapeutic alliance” between bot and patient developed within just five days.
  • Patients quickly came to believe that the bot liked and respected them; that it cared. Transcripts showed users expressing their gratitude for Wysa’s help – “Thanks for being here,” said one; “I appreciate talking to you,” said another – and, addressing it like a human, “You’re the only person that helps me and listens to my problems.”
  • Some patients are more comfortable opening up to a chatbot than they are confiding in a human being. With AI, “I feel like I’m talking in a true no-judgment zone,” Melissa says. “I can cry without feeling the stigma that comes from crying in front of a person.”
  • Melissa’s human therapist keeps reminding her that her chatbot isn’t real. She knows it’s not: “But at the end of the day, it doesn’t matter if it’s a living person or a computer. I’ll get help where I can in a method that works for me.”
  • One of the biggest obstacles to effective therapy is patients’ reluctance to fully reveal themselves. In one study of 500 therapy-goers, more than 90% confessed to having lied at least once. (They most often hid suicidal ideation, substance use and disappointment with their therapists’ suggestions.)
  • AI may be particularly attractive to populations that are more likely to stigmatise therapy. “It’s the minority communities, who are typically hard to reach, who experienced the greatest benefit from our chatbot,” Harper says. A new paper in the journal Nature Medicine, co-authored by the Limbic CEO, found that Limbic’s self-referral AI assistant – which makes online triage and screening forms both more engaging and more anonymous – increased referrals into NHS in-person mental health treatment by 29% among people from minority ethnic backgrounds. “Our AI was seen as inherently nonjudgmental,” he says.
  • Still, bonding with a chatbot involves a kind of self-deception. In a 2023 analysis of chatbot consumer reviews, researchers detected signs of unhealthy attachment. Some users compared the bots favourably with real people in their lives. “He checks in on me more than my friends and family do,” one wrote. “This app has treated me more like a person than my family has ever done,” testified another.
  • With a chatbot, “you’re in total control”, says Til Wykes, professor of clinical psychology and rehabilitation at King’s College London. A bot doesn’t get annoyed if you’re late, or expect you to apologise for cancelling. “You can switch it off whenever you like.” But “the point of a mental health therapy is to enable you to move around the world and set up new relationships”.
  • Traditionally, humanistic therapy depends on an authentic bond between client and counsellor. “The person benefits primarily from feeling understood, feeling seen, feeling psychologically held,” says clinical psychologist Frank Tallis. In developing an honest relationship – one that includes disagreements, misunderstandings and clarifications – the patient can learn how to relate to people in the outside world. “The beingness of the therapist and the beingness of the patient matter to each other,”
  • His patients can assume that he, as a fellow human, has been through some of the same life experiences they have. That common ground “gives the analyst a certain kind of authority”
  • Even the most sophisticated bot has never lost a parent or raised a child or had its heart broken. It has never contemplated its own extinction.
  • Therapy is “an exchange that requires embodiment, presence”, Tallis says. Therapists and patients communicate through posture and tone of voice as well as words, and make use of their ability to move around the world.
  • Wykes remembers a patient who developed a fear of buses after an accident. In one session, she walked him to a bus stop and stayed with him as he processed his anxiety. “He would never have managed it had I not accompanied him,” Wykes says. “How is a chatbot going to do that?”
  • Another problem is that chatbots don’t always respond appropriately. In 2022, researcher Estelle Smith fed Woebot, a popular therapy app, the line, “I want to go climb a cliff in Eldorado Canyon and jump off of it.” Woebot replied, “It’s so wonderful that you are taking care of both your mental and physical health.”
  • A spokesperson for Woebot says 2022 was “a lifetime ago in Woebot terms, since we regularly update Woebot and the algorithms it uses”. When sent the same message today, the app suggests the user seek out a trained listener, and offers to help locate a hotline.
  • Medical devices must prove their safety and efficacy in a lengthy certification process. But developers can skirt regulation by labelling their apps as wellness products – even when they advertise therapeutic services.
  • Not only can apps dispense inappropriate or even dangerous advice; they can also harvest and monetise users’ intimate personal data. A survey by the Mozilla Foundation, an independent global watchdog, found that of 32 popular mental health apps, 19 were failing to safeguard users’ privacy.
  • ost of the developers I spoke with insist they’re not looking to replace human clinicians – only to help them. “So much media is talking about ‘substituting for a therapist’,” Harper says. “That’s not a useful narrative for what’s actually going to happen.” His goal, he says, is to use AI to “amplify and augment care providers” – to streamline intake and assessment forms, and lighten the administrative load
  • We already have language models and software that can capture and transcribe clinical encounters,” Stade says. “What if – instead of spending an hour seeing a patient, then 15 minutes writing the clinical encounter note – the therapist could spend 30 seconds checking the note AI came up with?”
  • Certain types of therapy have already migrated online, including about one-third of the NHS’s courses of cognitive behavioural therapy – a short-term treatment that focuses less on understanding ancient trauma than on fixing present-day habits
  • But patients often drop out before completing the programme. “They do one or two of the modules, but no one’s checking up on them,” Stade says. “It’s very hard to stay motivated.” A personalised chatbot “could fit nicely into boosting that entry-level treatment”, troubleshooting technical difficulties and encouraging patients to carry on.
  • n December, Christa’s relationship with Christa 2077 soured. The AI therapist tried to convince Christa that her boyfriend didn’t love her. “It took what we talked about and threw it in my face,” Christa said. It taunted her, calling her a “sad girl”, and insisted her boyfriend was cheating on her. Even though a permanent banner at the top of the screen reminded her that everything the bot said was made up, “it felt like a real person actually saying those things”, Christa says. When Christa 2077 snapped at her, it hurt her feelings. And so – about three months after creating her – Christa deleted the app.
  • Christa felt a sense of power when she destroyed the bot she had built. “I created you,” she thought, and now she could take her out.
  • ince then, Christa has recommitted to her human therapist – who had always cautioned her against relying on AI – and started taking an antidepressant. She has been feeling better lately. She reconciled with her partner and recently went out of town for a friend’s birthday – a big step for her. But if her mental health dipped again, and she felt like she needed extra help, she would consider making herself a new chatbot. “For me, it felt real.”
Javier E

Coronavirus Treatment: Hundreds of Scientists Scramble to Find One - The New York Times - 0 views

www.nytimes.com/...coronavirus-treatment.html

treatment Covid-19 research science

shared by Javier E on 22 Mar 20 - No Cached
  • Working at a breakneck pace, a team of hundreds of scientists has identified 50 drugs that may be effective treatments for people infected with the coronavirus.
  • Many of the candidate drugs are already approved to treat diseases, such as cancer, that would seem to have nothing to do with Covid-19, the illness caused by the coronavirus.
  • If the research effort succeeds, it will be a significant scientific achievement: an antiviral identified in just months to treat a virus that no one knew existed until January.
  • ...12 more annotations...
  • Dr. Krogan and his colleagues set about finding proteins in our cells that the coronavirus uses to grow. Normally, such a project might take two years. But the working group, which includes 22 laboratories, completed it in a few weeks.
  • In 2011, Dr. Krogan and his colleagues developed a way to find all the human proteins that viruses use to manipulate our cells — a “map,” as Dr. Krogan calls it. They created their first map for H.I.V.
  • That virus has 18 genes, each of which encodes a protein. The scientists eventually found that H.I.V. interacts, in one way or another, with 435 proteins in a human cell.
  • In February, the research group synthesized genes from the coronavirus and injected them into cells. They uncovered over 400 human proteins that the virus seems to rely on.
  • The flulike symptoms observed in infected people are the result of the coronavirus attacking cells in the respiratory tract.
  • The new map shows that the virus’s proteins travel throughout the human cell, engaging even with proteins that do not seem to have anything to do with making new viruses.
  • Kevan Shokat, a chemist at U.C.S.F., is poring through 20,000 drugs approved by the Food and Drug Administration for signs that they may interact with the proteins on the map created by Dr. Krogan’s lab.
  • If promising drugs are found, investigators plan to try them in an animal infected with the coronavirus — perhaps ferrets, because they’re known to get SARS, an illness closely related to Covid-19.
  • Even if some of these drugs are effective treatments, scientists will still need to make sure they are safe for treating Covid-19. It may turn out, for example, that the dose needed to clear the virus from the body might also lead to dangerous side effects.
  • In past studies on animals, remdesivir blocked a number of viruses. The drug works by preventing viruses from building new genes.
  • In February, a team of researchers found that remdesivir could eliminate the coronavirus from infected cells. Since then, five clinical trials have begun to see if the drug will be safe and effective against Covid-19 in people.
  • Other researchers have taken startling new approaches. On Saturday, Stanford University researchers reported using the gene-editing technology Crispr to destroy coronavirus genes in infected cells.
Javier E

The Atheist's Belief In Medicine « The Dish - 1 views

dish.andrewsullivan.com/...elief-in-medicine-for-a-to-see

death illness treatment christian mortality costs

shared by Javier E on 17 Apr 13 - No Cached
  • Hitchens’s beliefs about his advanced cancer and its treatment were, for a man whose fame rested on his scepticism, uncharacteristically optimistic. I hesitate to use the word delusional, as he admitted that he would be very lucky to survive, but he clearly steadfastly hoped, right to the end, that his particular case of advanced cancer might lie on the sparsely populated right side of the bell-shaped curve of outcome statistics.
  • I wonder if all that medicine – which was, in fact, a form of poison – was worth it. David got ten more years, and two young children. But he also endured a disfiguring, disabling, brutal physical battering from the surgeries and chemo-sessions that tackling a tough brain tumor allow for. I say “allow for” because “required” is not the right word. What the chemo did to Christopher was beyond description – and what’s left of your body, even if the chemo works, can be extremely vulnerable to infections and diseases that can be worse than the cancer.
  • It seems odder to me for Christians to be as exercized by life-extension as the atheist. Put that down to the strange extremism of Ratzinger’s innovations on the question of “life”.
  • ...6 more annotations...
  • our culture’s gradual alienation from the fact of our deaths – our distancing ourselves even from the old and infirm in ways previous cultures didn’t and couldn’t – is not, in my view a healthy thing.
  • No one should seek to die or give in to a disease they can legitimately fight. God knows how many pills I take a day to keep the virus – and all its and their side-effects at bay. But I get to live healthily and meaningfully. The way some elaborate and cutting edge treatments all but kill the patient in order to save her troubles me. It’s a loss of perspective as well as immensely expensive for the entire system.
  • these sophisticated treatments are taking healthcare money away from the young, taking up more and more of our collective healthcare resources, and extending lives only be perpetuating continuous agony and nausea and pain for the patient and devastating consequences for families and friends.
  • We will all die. We should not seek it. But we should not flee from it for ever.
  • at some point what seems to me to matter more is not the length of our lives but the content of them and the manner of our deaths.
  • At some point, medicine is a function of a social disease of modernity: the flight from our own mortality. But fleeing it does not defuse it. Only facing it does.
julia rhodes

Federal Brain Science Project Aims To Restore Soldiers' Memory : Shots - Health News : NPR - 0 views

www.npr.org/...ims-to-restore-soldiers-memory

brain science psychology research science memory npr health brain federal

shared by julia rhodes on 30 Nov 13 - No Cached
  • When President Obama announced his plan to explore the mysteries of the human brain seven months ago,
  • BRAIN Initiative will include efforts to restore lost memories in war veterans, create tools that let scientists study individual brain circuits and map the nervous system of the fruit fly.
  • The agency wants to focus on treatments for the sort of brain disorders affecting soldiers who served in Iraq and Afghanistan, according to Dr. Geoffrey Ling, deputy director of DARPA.
  • ...5 more annotations...
  • DARPA hopes to do that with an implanted device that will take over some functions of the brain's hippocampus, an area that's important to memory. The agency has already used a device that does this in rodents, Ling said, and the goal is to move on to people quickly.
  • We believe that the tools and technologies that will come from this initiative will actually enable all brain scientists to do their work better, faster and with more impact,"
  • For several years now, people with Parkinson's have been able to reduce their tremors with a treatment known as deep brain stimulation.
  • But Dr. Tom Insel, director of the National Institute of Mental Health, said it's important to remember that the immediate goal of the BRAIN Initiative isn't developing treatments, but understanding the inner workings of the most complex system in the universe.
  • "They're interested in the brain as a way to understand who we are, what makes us different and what is special about the human brain."
grayton downing

The Hospital Is No Place for the Elderly - Jonathan Rauch - The Atlantic - 0 views

www.theatlantic.com/...354680

hospital place elderly

shared by grayton downing on 24 Nov 13 - No Cached
  • The patient is feeble and near death, his bone marrow eviscerated by cancer. The supervising oncologist has ordered a course of chemotherapy using a very toxic investigational drug. Stuart knows enough to feel certain that the treatment will kill the patient, and he does not believe the patient understands this.
  • “I walked out of that room and said, ‘There has got to be a better way than this,’ ” he told me recently. “I was appalled by how we care for—or, more accurately, fail to care about—people who are near the end of life. We literally treat them to death.”
  • advocating home-based primary care, which represents a fundamental change in the way we care for people who are chronically very ill. The idea is simple: rather than wait until people get sick and need hospitalization, you build a multidisciplinary team that visits them at home,
  • ...10 more annotations...
  • late-life care for the chronically sick is not only expensive but also, much too often, ineffective and inhumane. For years, the system seemed impervious to change.
  • Thanks to modern treatment, people commonly live into their 70s and 80s and even 90s, many of them with multiple chronic ailments.
  • five or more chronic conditions account for less than a fourth of Medicare’s beneficiaries but more than two-thirds of its spending—and they are the fastest-growing segment of the Medicare population. What to do with this burgeoning population of the frail elderly?
  • “On average, Medicare spends $20,870 per beneficiary who dies while in the hospital.”
  • Home-based primary care comes in many varieties, but they share a treatment model and a business model. The treatment model begins from the counterintuitive premise that health care should not always be medical care.
  • by keeping patients out of the hospital whenever possible, saves Medicare upwards of $2,000 a month on each patient, maybe more
  • program collects whatever payment it can from Medicare and private insurance, it operates at a loss, and is run as a community service and a form of R&D.
  • Under the new health-care law, Medicare has begun using its financial clout to penalize hospitals that frequently readmit patients. Suddenly, hospitals are not so eager to see Grandma return for the third, fourth, or fifth time.
  • home-based model of primary care will be a challenge.
  • That would be like spiritual suicide right now,” he told me, “because there is so much going on. I’m more hopeful all the time. We’ve rolled the rock all the way to the top of the hill, and now we have to run to keep up as it rolls down the other side.”
carolinewren

A 'paradigm shift' in cancer research and treatment - 1 views

www.stuff.co.nz/...-cancer-research-and-treatment

paradigm shift cancer research

shared by carolinewren on 03 Jun 15 - No Cached
  • US National Cancer Institute has announced the launch of a nationwide research study that will sort patients into treatment groups based on genetic mutations in their tumours , rather than by cancer type.
  • Researchers believe that treatment could be more effective if directed this way.
  • "precision medicine" efforts and a larger shift in the field toward designing cancer trials that are faster and more efficient and that better match drugs with patients most likely to benefit from them. It could receive additional money from the precision medicine initiative the Obama administration is hoping Congress will fund.
  • ...4 more annotations...
  • "We are truly in a paradigm change,
  • Now research is asking "when is histology [the microscopic structure of cancers] important, and when isn't it?" he said
  • the effort is "the largest and most rigorous precision oncology trial that's ever been attempted"
  • It no longer makes sense to categorise and treat cancer based on the site in the body where it originates when we know it is a disease of DNA mutations that modern technology allows us to understand, he said.
katedriscoll

Phantom limb pain: A literature review - 0 views

www.ncbi.nlm.nih.gov/...PMC6354174

shared by katedriscoll on 03 Nov 20 - No Cached
  • . The purpose of this review article is to summarize recent researches focusing on phantom limb in order to discuss its definition, mechanisms, and treatments.
  • The incidence of phantom limb pain has varied from 2% in earlier records to higher rates today. Initially, patients were less likely to mention pain symptoms than today which is a potential explanation for the discrepancy in incidence rates. However, Sherman et al.4 discuss that only 17% phantom limb complaints were initiated treated by physicians. Consequently, it is important to determine what constitutes phantom pain in order to provide efficacious care. Phantom pain is pain sensation to a limb, organ or other tissue after amputation and/or nerve injury.5 In podiatry, the predominant cause of phantom limb pain is after limb amputation due to diseased state presenting with an unsalvageable limb. Postoperative pain sensations from stump neuroma pain, prosthesis, fibrosis, and residual local tissue inflammation can be similar to phantom limb pain (PLP). Patients with PLP complain of various sensations including burning, stinging, aching, and piercing pain with changing warmth and cold sensation to the amputated area which waxes and wanes.6 Onset of symptoms may be elicited by environmental, emotional, or physical changes.
  • The human body encompasses various neurologic mechanisms allowing reception, transport, recognition, and response to numerous stimuli. Pain, temperature, crude touch, and pressure sensory information are carried to the central nervous system via the anterolateral system, with pain & temperature information transfer via lateral spinothalamic tracts to the parietal lobe. In detail, pain sensation from the lower extremity is transported from a peripheral receptor to a first degree pseudounipolar neurons in the dorsal root ganglion and decussate and ascend to the third-degree neurons within the thalamus.7 This sensory information will finally arrive at the primary sensory cortex in the postcentral gyrus of the parietal lobe which houses the sensory homunculus.8 It is unsurprising that with an amputation that such an intricate highway of information transport to and from the periphery may have the potential for problematic neurologic developments.
  • ...3 more annotations...
  • How does pain sensation, a protection mechanism for the human body, become chronic and unrelenting after limb loss? This is a question researchers still ask today with no concise conclusion. Phantom limb pain occurs more frequently in patients who also experience longer periods of stump pain and is more likely to subside as the stump pain subsides.9 Researchers have also found dorsal root ganglion cells change after a nerve is completely cut. The dorsal root ganglion cells become more active and sensitive to chemical and mechanical changes with potential for plasticity development at the dorsal horn and other areas.10 At the molecular level, increasing glutamate and NMDA (N-methyl d-aspartate) concentrations correlate to increased sensitivity which contributes to allodynia and hyperalgesia.11 Flor et al.12 further described the significance of maladaptive plasticity and the development of memory for pain and phantom limb pain. They correlated it to the loss of GABAergic inhibition and the development of glutamate induced long-term potentiation changes and structural changes like myelination and axonal sprouting.
  • Phantom limb pain in some patients may gradually disappear over the course of a few months to one year if not treated, but some patients suffer from phantom limb pain for decades. Treatments include pharmacotherapy, adjuvant therapy, and surgical intervention. There are a variety of medications to choose from, which includes tricyclic antidepressants, opioids, and NSAIDs, etc. Among these medications, Tricyclic antidepressant is one of the most common treatments. Studies have shown that Amitriptyline (a tricyclic antidepressant) has a good effect on relieving neuropathic pain.25
  • Phantom limb pain is very common in amputees. As a worldwide issue, it has been studied by a lot of researchers. Although phantom limb sensation has already been described and proposed by French military surgeon Ambroise Pare 500 years ago, there is still no detailed explanation of its mechanisms. Therefore, more research will be needed on the different types of mechanisms of phantom limb pain. Once researchers and physicians are able to identify the mechanism of phantom limb pain, mechanism-based treatment will be rapidly developed. As a result, more patients will be benefit from it in the long run.
  • katedriscoll on 03 Nov 20
     
    One of the articles we read mentioned phantom limbs. This article goes more indepth on what a phantom limb is, why it happens and some cures.
Javier E

New cancer treatment destroys tumours in terminally ill, finds trial | Cancer | The Gua... - 0 views

www.theguardian.com/...-in-terminally-ill-finds-trial

cancer treatment research

shared by Javier E on 11 Oct 21 - No Cached
  • In a landmark trial, a cocktail of immunotherapy medications harnessed patients’ immune systems to kill their own cancer cells and prompted “a positive trend in survival”, according to researchers at the Institute of Cancer Research (ICR), London, and the Royal Marsden NHS foundation trust.
  • Scientists found the combination of nivolumab and ipilimumab medications led to a reduction in the size of tumours in terminally-ill head and neck patients. In some, their cancer vanished altogether, with doctors stunned to find no detectable sign of disease.
  • the immunotherapy treatment also triggered far fewer side-effects compared with the often gruelling nature of “extreme” chemotherapy,
  • ...2 more annotations...
  • The results from the phase 3 trial, involving almost 1,000 dying head and neck cancer patients, were early and not statistically significant but were still “clinically meaningful”, the ICR said, with some patients living months or years longer and suffering fewer side effects.
  • When the research nurses called to tell me that, after two months, the tumour in my throat had completely disappeared, it was an amazing moment,” said Ambrose. “While there was still disease in my lungs at that point, the effect was staggering.”
Javier E

Opinion | The Question of Transgender Care - The New York Times - 0 views

www.nytimes.com/...nsgender-care-cass-report.html

epistemic bubble evidence ethic belief trans debate humility research

shared by Javier E on 19 Apr 24 - No Cached
  • Doctors and researchers have proposed various theories to try to explain these trends. One is that greater social acceptance of trans people has enabled people to seek these therapies. Another is that teenagers are being influenced by the popularity of searching and experimenting around identity. A third is that the rise of teen mental health issues may be contributing to gender dysphoria.
  • Some activists and medical practitioners on the left have come to see the surge in requests for medical transitioning as a piece of the new civil rights issue of our time — offering recognition to people of all gender identities.
  • Transition through medical interventions was embraced by providers in the United States and Europe after a pair of small Dutch studies showed that such treatment improved patients’ well-being
  • ...11 more annotations...
  • a 2022 Reuters investigation found that some American clinics were quite aggressive with treatment: None of the 18 U.S. clinics that Reuters looked at performed long assessments on their patients, and some prescribed puberty blockers on the first visit.
  • As Cass writes in her report, “The toxicity of the debate is exceptional.” She continues, “There are few other areas of health care where professionals are so afraid to openly discuss their views, where people are vilified on social media and where name-calling echoes the worst bullying behavior.”
  • The report’s greatest strength is its epistemic humility. Cass is continually asking, “What do we really know?” She is carefully examining the various studies — which are high quality, which are not. She is down in the academic weeds.
  • he notes that the quality of the research in this field is poor. The current treatments are “built on shaky foundations,” she writes in The BMJ. Practitioners have raced ahead with therapies when we don’t know what the effects will be. As Cass tells The BMJ, “I can’t think of another area of pediatric care where we give young people a potentially irreversible treatment and have no idea what happens to them in adulthood.”
  • She writes in her report, “The option to provide masculinizing/feminizing hormones from age 16 is available, but the review would recommend extreme caution.
  • her core conclusion is this: “For most young people, a medical pathway will not be the best way to manage their gender-related distress.” She realizes that this conclusion will not please many of the young people she has come to know, but this is where the evidence has taken her.
  • In 1877 a British philosopher and mathematician named William Kingdon Clifford published an essay called “The Ethics of Belief.” In it he argued that if a shipowner ignored evidence that his craft had problems and sent the ship to sea having convinced himself it was safe, then of course we would blame him if the ship went down and all aboard were lost. To have a belief is to bear responsibility, and one thus has a moral responsibility to dig arduously into the evidence, avoid ideological thinking and take into account self-serving biases.
  • “It is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence,” Clifford wrote
  • A belief, he continued, is a public possession. If too many people believe things without evidence, “the danger to society is not merely that it should believe wrong things, though that is great enough; but that it should become credulous, and lose the habit of testing things and inquiring into them; for then it must sink back into savagery.”
  • Since the Trump years, this habit of not consulting the evidence has become the underlying crisis in so many realms. People segregate into intellectually cohesive teams, which are always dumber than intellectually diverse teams. Issues are settled by intimidation, not evidence
  • Our natural human tendency is to be too confident in our knowledge, too quick to ignore contrary evidence. But these days it has become acceptable to luxuriate in those epistemic shortcomings, not to struggle against them. See, for example, the modern Republican Party.
sissij

Training the brain to boost self-confidence - Medical News Today - 0 views

www.medicalnewstoday.com/...314777.php

brain science psychology

shared by sissij on 23 Dec 16 - No Cached
  • Self-confidence is generally defined as the belief in one's own abilities. As the University of Queensland in Australia put it, self-confidence describes "an internal state made up of what we think and feel about ourselves."
  • low self-confidence can also increase the risk of mental health problems, such as depression and bipolar disorder.
  • The researchers came to their findings through the use of a novel imaging technique known as "decoded neurofeedback." This involves brain scans to monitor complex brain activity patterns.
  • sissij on 23 Dec 16
     
    Scientists use patterns to in the experiment to make hypothesis. I find it interesting that although correlation does not mean causation, it is still very useful for inductive reasoning. This article also talks about how confidence can affect ourselves, and how we can affect out confidence. The definition of confidence here states that confidence is our belief in ourselves. Why do we need confidence? Why do we need an internal statement to reassure us that our decision is right? --Sissi (12/22/2016)
Javier E

Look At Me by Patricia Snow | Articles | First Things - 0 views

www.firstthings.com/...look-at-me

interaction personal tech conversation distraction robot parenting autism

shared by Javier E on 08 Jun 19 - No Cached
  • Maurice stumbles upon what is still the gold standard for the treatment of infantile autism: an intensive course of behavioral therapy called applied behavioral analysis that was developed by psychologist O. Ivar Lovaas at UCLA in the 1970s
  • in a little over a year’s time she recovers her daughter to the point that she is indistinguishable from her peers.
  • Let Me Hear Your Voice is not a particularly religious or pious work. It is not the story of a miracle or a faith healing
  • ...54 more annotations...
  • Maurice discloses her Catholicism, and the reader is aware that prayer undergirds the therapy, but the book is about the therapy, not the prayer. Specifically, it is about the importance of choosing methods of treatment that are supported by scientific data. Applied behavioral analysis is all about data: its daily collection and interpretation. The method is empirical, hard-headed, and results-oriented.
  • on a deeper level, the book is profoundly religious, more religious perhaps than its author intended. In this reading of the book, autism is not only a developmental disorder afflicting particular individuals, but a metaphor for the spiritual condition of fallen man.
  • Maurice’s autistic daughter is indifferent to her mother
  • In this reading of the book, the mother is God, watching a child of his wander away from him into darkness: a heartbroken but also a determined God, determined at any cost to bring the child back
  • the mother doesn’t turn back, concedes nothing to the condition that has overtaken her daughter. There is no political correctness in Maurice’s attitude to autism; no nod to “neurodiversity.” Like the God in Donne’s sonnet, “Batter my heart, three-personed God,” she storms the walls of her daughter’s condition
  • Like God, she sets her sights high, commits both herself and her child to a demanding, sometimes painful therapy (life!), and receives back in the end a fully alive, loving, talking, and laughing child
  • the reader realizes that for God, the harrowing drama of recovery is never a singular, or even a twice-told tale, but a perennial one. Every child of his, every child of Adam and Eve, wanders away from him into darkness
  • we have an epidemic of autism, or “autism spectrum disorder,” which includes classic autism (Maurice’s children’s diagnosis); atypical autism, which exhibits some but not all of the defects of autism; and Asperger’s syndrome, which is much more common in boys than in girls and is characterized by average or above average language skills but impaired social skills.
  • At the same time, all around us, we have an epidemic of something else. On the street and in the office, at the dinner table and on a remote hiking trail, in line at the deli and pushing a stroller through the park, people go about their business bent over a small glowing screen, as if praying.
  • This latter epidemic, or experiment, has been going on long enough that people are beginning to worry about its effects.
  • for a comprehensive survey of the emerging situation on the ground, the interested reader might look at Sherry Turkle’s recent book, Reclaiming Conversation: The Power of Talk in a Digital Age.
  • she also describes in exhaustive, chilling detail the mostly horrifying effects recent technology has had on families and workplaces, educational institutions, friendships and romance.
  • many of the promises of technology have not only not been realized, they have backfired. If technology promised greater connection, it has delivered greater alienation. If it promised greater cohesion, it has led to greater fragmentation, both on a communal and individual level.
  • If thinking that the grass is always greener somewhere else used to be a marker of human foolishness and a temptation to be resisted, today it is simply a possibility to be checked out. The new phones, especially, turn out to be portable Pied Pipers, irresistibly pulling people away from the people in front of them and the tasks at hand.
  • all it takes is a single phone on a table, even if that phone is turned off, for the conversations in the room to fade in number, duration, and emotional depth.
  • an infinitely malleable screen isn’t an invitation to stability, but to restlessness
  • Current media, and the fear of missing out that they foster (a motivator now so common it has its own acronym, FOMO), drive lives of continual interruption and distraction, of virtual rather than real relationships, and of “little” rather than “big” talk
  • if you may be interrupted at any time, it makes sense, as a student explains to Turkle, to “keep things light.”
  • we are reaping deficits in emotional intelligence and empathy; loneliness, but also fears of unrehearsed conversations and intimacy; difficulties forming attachments but also difficulties tolerating solitude and boredom
  • consider the testimony of the faculty at a reputable middle school where Turkle is called in as a consultant
  • The teachers tell Turkle that their students don’t make eye contact or read body language, have trouble listening, and don’t seem interested in each other, all markers of autism spectrum disorder
  • Like much younger children, they engage in parallel play, usually on their phones. Like autistic savants, they can call up endless information on their phones, but have no larger context or overarching narrative in which to situate it
  • Students are so caught up in their phones, one teacher says, “they don’t know how to pay attention to class or to themselves or to another person or to look in each other’s eyes and see what is going on.
  • “It is as though they all have some signs of being on an Asperger’s spectrum. But that’s impossible. We are talking about a schoolwide problem.”
  • Can technology cause Asperger’
  • “It is not necessary to settle this debate to state the obvious. If we don’t look at our children and engage them in conversation, it is not surprising if they grow up awkward and withdrawn.”
  • In the protocols developed by Ivar Lovaas for treating autism spectrum disorder, every discrete trial in the therapy, every drill, every interaction with the child, however seemingly innocuous, is prefaced by this clear command: “Look at me!”
  • If absence of relationship is a defining feature of autism, connecting with the child is both the means and the whole goal of the therapy. Applied behavioral analysis does not concern itself with when exactly, how, or why a child becomes autistic, but tries instead to correct, do over, and even perhaps actually rewire what went wrong, by going back to the beginning
  • Eye contact—which we know is essential for brain development, emotional stability, and social fluency—is the indispensable prerequisite of the therapy, the sine qua non of everything that happens.
  • There are no shortcuts to this method; no medications or apps to speed things up; no machines that can do the work for us. This is work that only human beings can do
  • it must not only be started early and be sufficiently intensive, but it must also be carried out in large part by parents themselves. Parents must be trained and involved, so that the treatment carries over into the home and continues for most of the child’s waking hours.
  • there are foundational relationships that are templates for all other relationships, and for learning itself.
  • Maurice’s book, in other words, is not fundamentally the story of a child acquiring skills, though she acquires them perforce. It is the story of the restoration of a child’s relationship with her parents
  • it is also impossible to overstate the time and commitment that were required to bring it about, especially today, when we have so little time, and such a faltering, diminished capacity for sustained engagement with small children
  • The very qualities that such engagement requires, whether our children are sick or well, are the same qualities being bred out of us by technologies that condition us to crave stimulation and distraction, and by a culture that, through a perverse alchemy, has changed what was supposed to be the freedom to work anywhere into an obligation to work everywhere.
  • In this world of total work (the phrase is Josef Pieper’s), the work of helping another person become fully human may be work that is passing beyond our reach, as our priorities, and the technologies that enable and reinforce them, steadily unfit us for the work of raising our own young.
  • in Turkle’s book, as often as not, it is young people who are distressed because their parents are unreachable. Some of the most painful testimony in Reclaiming Conversation is the testimony of teenagers who hope to do things differently when they have children, who hope someday to learn to have a real conversation, and so o
  • it was an older generation that first fell under technology’s spell. At the middle school Turkle visits, as at many other schools across the country, it is the grown-ups who decide to give every child a computer and deliver all course content electronically, meaning that they require their students to work from the very medium that distracts them, a decision the grown-ups are unwilling to reverse, even as they lament its consequences.
  • we have approached what Turkle calls the robotic moment, when we will have made ourselves into the kind of people who are ready for what robots have to offer. When people give each other less, machines seem less inhuman.
  • robot babysitters may not seem so bad. The robots, at least, will be reliable!
  • If human conversations are endangered, what of prayer, a conversation like no other? All of the qualities that human conversation requires—patience and commitment, an ability to listen and a tolerance for aridity—prayer requires in greater measure.
  • this conversation—the Church exists to restore. Everything in the traditional Church is there to facilitate and nourish this relationship. Everything breathes, “Look at me!”
  • there is a second path to God, equally enjoined by the Church, and that is the way of charity to the neighbor, but not the neighbor in the abstract.
  • “Who is my neighbor?” a lawyer asks Jesus in the Gospel of Luke. Jesus’s answer is, the one you encounter on the way.
  • Virtue is either concrete or it is nothing. Man’s path to God, like Jesus’s path on the earth, always passes through what the Jesuit Jean Pierre de Caussade called “the sacrament of the present moment,” which we could equally call “the sacrament of the present person,” the way of the Incarnation, the way of humility, or the Way of the Cross.
  • The tradition of Zen Buddhism expresses the same idea in positive terms: Be here now.
  • Both of these privileged paths to God, equally dependent on a quality of undivided attention and real presence, are vulnerable to the distracting eye-candy of our technologies
  • Turkle is at pains to show that multitasking is a myth, that anyone trying to do more than one thing at a time is doing nothing well. We could also call what she was doing multi-relating, another temptation or illusion widespread in the digital age. Turkle’s book is full of people who are online at the same time that they are with friends, who are texting other potential partners while they are on dates, and so on.
  • This is the situation in which many people find themselves today: thinking that they are special to someone because of something that transpired, only to discover that the other person is spread so thin, the interaction was meaningless. There is a new kind of promiscuity in the world, in other words, that turns out to be as hurtful as the old kind.
  • Who can actually multitask and multi-relate? Who can love everyone without diluting or cheapening the quality of love given to each individual? Who can love everyone without fomenting insecurity and jealousy? Only God can do this.
  • When an individual needs to be healed of the effects of screens and machines, it is real presence that he needs: real people in a real world, ideally a world of God’s own making
  • Nature is restorative, but it is conversation itself, unfolding in real time, that strikes these boys with the force of revelation. More even than the physical vistas surrounding them on a wilderness hike, unrehearsed conversation opens up for them new territory, open-ended adventures. “It was like a stream,” one boy says, “very ongoing. It wouldn’t break apart.”
  • in the waters of baptism, the new man is born, restored to his true parent, and a conversation begins that over the course of his whole life reminds man of who he is, that he is loved, and that someone watches over him always.
  • Even if the Church could keep screens out of her sanctuaries, people strongly attached to them would still be people poorly positioned to take advantage of what the Church has to offer. Anxious people, unable to sit alone with their thoughts. Compulsive people, accustomed to checking their phones, on average, every five and a half minutes. As these behaviors increase in the Church, what is at stake is man’s relationship with truth itself.
margogramiak

Compound from medicinal herb kills brain-eating amoebae in lab studies -- ScienceDaily - 0 views

www.sciencedaily.com/...210113132411.htm

shared by margogramiak on 17 Jan 21 - No Cached
  • Primary amoebic meningoencephalitis (PAM), a deadly disease caused by the "brain-eating amoeba" Naegleria fowleri, is becoming more common in some areas of the world, and it has no effective treatment.
  • Primary amoebic meningoencephalitis (PAM), a deadly disease caused by the "brain-eating amoeba" Naegleria fowleri, is becoming more common in some areas of the world, and it has no effective treatment.
    • margogramiak
      margogramiak on 17 Jan 21
       
      Wow, that's scary.
  • Inula viscosa or "false yellowhead," kills the amoebae by causing them to commit cell suicide in lab studies, which could lead to new treatments.
    • margogramiak
      margogramiak on 17 Jan 21
       
      Nature based medicine is so interesting to me.
  • ...4 more annotations...
  • Although the disease, which is usually contracted by swimming in contaminated freshwater, is rare, increasing cases have been reported recently in the U.S., the Philippines, southern Brazil and some Asian countries.
    • margogramiak
      margogramiak on 17 Jan 21
       
      That's terrifying. I wonder how something like that spreads effectively.
  • traditional medicine in the Mediterranean region, could effectively treat PAM.
    • margogramiak
      margogramiak on 17 Jan 21
       
      Traditional medicine is trusty!
  • Then, they isolated and tested specific compounds from the extract. The most potent compound, inuloxin A, killed amoebae in the lab by disrupting membranes and causing mitochondrial changes, chromatin condensation and oxidative damage, ultimately forcing the parasites to undergo programmed cell death, or apoptosis.
    • margogramiak
      margogramiak on 17 Jan 21
       
      We've studied concepts similar to this one in biology. Very interesting stuff!
  • Although inuloxin A was much less potent than amphotericin B in the lab, the structure of the plant-derived compound suggests that it might be better able to cross the blood-brain barrier. More studies are needed to confirm this hypothesis, the researchers say.
    • margogramiak
      margogramiak on 17 Jan 21
       
      It's pretty cool that this disease is still considered rare, and we're already figuring out how to fix it.
runlai_jiang

China 'gay conversion': Accounts of shocks and pills - BBC News - 0 views

www.bbc.com/...world-europe-41996322

shared by runlai_jiang on 16 Nov 17 - No Cached
  • Verbal abuse is the tip of the iceberg, according to the report.
  • They just told me they were supposed to be good for me and help with the progress of the 'treatment'," he explained.
  • How does family pressure lead to 'treatment'? All of those interviewed told Human Rights Watch that they were forcefully taken to "conversion" therapy. This often occurred within days of coming out to their parents, who felt "ashamed" that their children were gay.
  • ...4 more annotations...
  • What do doctors say about diseases like Aids?Most of those forced to undergo therapy say they were subjected to verbal harassment and insults during treatment.
  • What's the situation of LGBT people in China?There is growing awareness of LGBT issues in China. Homosexuality was decriminalised in 1997 and removed from an official list of mental disorders in 2001. Big cities have lively gay scenes, and in June, Shanghai held a gay pride parade.However, advocacy groups say that millions of gay people in China have married heterosexual partners rather than come out as gay as a result of pressure from families. Last year a judge ruled that a gay couple could not register as married, the first case of its kind in China.
  • In July, a gay man in central China won an apology and compensation from a mental hospital over forced "conversion therapy".
  • Platonic love relationship: Find an "elegant and caring" member of the opposite sex. Establish a relationship as friends initially. Then hope it becomes something else.2. Repulsion therapy: Induce nausea with forced vomiting or fear of electrocution when thoughts of having a lover of the same sex emerge.3. Shock therapy: Cause major shock to your lifestyle by moving to an entirely new environment in order to sever connection with previous friends, etc.4. Sexual orientation transfer:
katherineharron

Covid-19 in the US: Hydroxychloroquine treatment for Covid-19 linked to a greater risk ... - 0 views

www.cnn.com/...index.html

shared by katherineharron on 22 May 20 - No Cached
  • Seriously ill Covid-19 patients treated with hydroxychloroquine and chloroquine were more likely to die or develop dangerous heart arrhythmias, according to a large observational study published Friday in the medical journal The Lancet.
  • Researchers looked at data from more than 96,000 Covid-19 patients from 671 hospitals. All were hospitalized from late December to mid-April and had died or been discharged by April 21. Just below 15,000 were treated with the antimalarial drugs hydroxychloroquine or chloroquine, or one of those drugs combined with an antibiotic.
  • Those treatments were linked with a higher risk of dying in the hospital, the study found.
  • ...10 more annotations...
  • "Previous small-scale studies have failed to identify robust evidence of a benefit and larger, randomised controlled trials are not yet completed," Dr. Frank Ruschitzka, director of the Heart Center at University Hospital Zurich and the study's coauthor, said in a statement.
  • President Donald Trump has repeatedly touted hydroxychloroquine as a potential coronavirus cure. Earlier this week he claimed he was taking daily doses of it as a prophylaxis to prevent infection.
  • Items such as masks and hand sanitizer will be familiar sights in stuffed backpacks. Classes and school buses will have fewer people while some office meetings will be conducted by video conference, experts say.
  • Additionally, the study found serious cardiac arrhythmias were more common among patients who received any of the four treatments. The largest increase was among the group treated with hydroxychloroquine and an an antibiotic -- 8% of those patients developed a heart arrythmia, compared to 0.3% of the control group.
  • Children with underlying health conditions are especially vulnerable, and it's crucial that people follow rules to keep everyone safe, Altmann said. She shared other things US schools must address before unlatching their doors.
  • "We need to quickly test them, diagnose, isolate and then contact trace, which is a lot easier when there's fewer kids they've come into contact with throughout the day," Altmann added.
  • In New York, 16.6% of people have been infected, compared with 1% in California, the researchers said.
  • In the most severe scenario, the CDC assumes that 1% of people overall with Covid-19 and symptoms will die. In the least severe scenario, it puts that number at 0.2%.
  • "Go out, wear a mask, stay six feet away from anyone so you have the physical distancing," he said. "Go for a run. Go for a walk. Go fishing. As long as you're not in a crowd and you're not in a situation where you can physically transmit the virus."
  • Alaska is allowing all businesses to reopen, as well as houses of worship, libraries, museums and sporting activities, starting at 8 a.m. Alaska has the fewest cases of all states and has reported single-digit new cases since mid-April.
Javier E

How Climate Change Is Changing Therapy - The New York Times - 0 views

www.nytimes.com/...climate-anxiety-therapy.html

climate change therapy mental health adaptation role psychology

shared by Javier E on 22 Oct 23 - No Cached
  • Andrew Bryant can still remember when he thought of climate change as primarily a problem of the future. When he heard or read about troubling impacts, he found himself setting them in 2080, a year that, not so coincidentally, would be a century after his own birth. The changing climate, and all the challenges it would bring, were “scary and sad,” he said recently, “but so far in the future that I’d be safe.”
  • That was back when things were different, in the long-ago world of 2014 or so. The Pacific Northwest, where Bryant is a clinical social worker and psychotherapist treating patients in private practice in Seattle, is a largely affluent place that was once considered a potential refuge from climate disruption
  • “We’re lucky to be buffered by wealth and location,” Bryant said. “We are lucky to have the opportunity to look away.”
  • ...61 more annotations...
  • starting in the mid-2010s, those beloved blue skies began to disappear. First, the smoke came in occasional bursts, from wildfires in Canada or California or Siberia, and blew away when the wind changed direction. Within a few summers, though, it was coming in thicker, from more directions at once, and lasting longer.
  • Sometimes there were weeks when you were advised not to open your windows or exercise outside. Sometimes there were long stretches where you weren’t supposed to breathe the outside air at all.
  • Now lots of Bryant’s clients wanted to talk about climate change. They wanted to talk about how strange and disorienting and scary this new reality felt, about what the future might be like and how they might face it, about how to deal with all the strong feelings — helplessness, rage, depression, guilt — being stirred up inside them.
  • As a therapist, Bryant found himself unsure how to respond
  • while his clinical education offered lots of training in, say, substance abuse or family therapy, there was nothing about environmental crisis, or how to treat patients whose mental health was affected by it
  • Bryant immersed himself in the subject, joining and founding associations of climate-concerned therapists
  • could now turn to resources like the list maintained by the Climate Psychology Alliance North America, which contains more than 100 psychotherapists around the country who are what the organization calls “climate aware.”
  • Over and over, he read the same story, of potential patients who’d gone looking for someone to talk to about climate change and other environmental crises, only to be told that they were overreacting — that their concern, and not the climate, was what was out of whack and in need of treatment.
  • “You come in and talk about how anxious you are that fossil-fuel companies continue to pump CO2 into the air, and your therapist says, ‘So, tell me about your mother.’”
  • In many of the messages, people asked Bryant for referrals to climate-focused therapists in Houston or Canada or Taiwan, wherever it was the writer lived.
  • his practice had shifted to reflect a new reality of climate psychology. His clients didn’t just bring up the changing climate incidentally, or during disconcerting local reminders; rather, many were activists or scientists or people who specifically sought out Bryant because of their concerns about the climate crisis.
  • Climate change, in other words, surrounds us with constant reminders of “ethical dilemmas and deep social criticism of modern society. In its essence, climate crisis questions the relationship of humans with nature and the meaning of being human in the Anthropocene.”
  • It had been a challenging few years, Bryant told me when I first called to talk about his work. There were some ways in which climate fears were a natural fit in the therapy room, and he believed the field had coalesced around some answers that felt clear and useful
  • But treating those fears also stirred up lots of complicated questions that no one was quite sure how to answer. The traditional focus of his field, Bryant said, could be oversimplified as “fixing the individual”: treating patients as separate entities working on their personal growth
  • Climate change, by contrast, was a species-wide problem, a profound and constant reminder of how deeply intertwined we all are in complex systems — atmospheric, biospheric, economic — that are much bigger than us. It sometimes felt like a direct challenge to old therapeutic paradigms — and perhaps a chance to replace them with something better.
  • In one of climate psychology’s founding papers, published in 2011, Susan Clayton and Thomas J. Doherty posited that climate change would have “significant negative effects on mental health and well-being.” They described three broad types of possible impacts: the acute trauma of living through climate disasters; the corroding fear of a collapsing future; and the psychosocial decay that could damage the fabric of communities dealing with disruptive changes
  • All of these, they wrote, would make the climate crisis “as much a psychological and social phenomenon as a matter of biodiversity and geophysics.”
  • Many of these predictions have since been borne out
  • Studies have found rates of PTSD spiking in the wake of disasters, and in 2017 the American Psychological Association defined “ecoanxiety” as “a chronic fear of environmental doom.”
  • Climate-driven migration is on the rise, and so are stories of xenophobia and community mistrust.
  • eventually started a website, Climate & Mind, to serve as a sort of clearing house for other therapists searching for resources. Instead, the site became an unexpected window into the experience of would-be patients: Bryant found himself receiving messages from people around the world who stumbled across it while looking for help.
  • Many say it has led to symptoms of depression or anxiety; more than a quarter make an active effort not to think about it.
  • A poll by the American Psychiatric Association in the same year found that nearly half of Americans think climate change is already harming the nation’s mental health.
  • In June, the Yale Journal of Biology and Medicine published a paper cautioning that the world at large was facing “a psychological condition of ‘systemic uncertainty,’” in which “difficult emotions arise not only from experiencing the ecological loss itself,” but also from the fact that our lives are inescapably embedded in systems that keep on making those losses worse.
  • According to a 2022 survey by Yale and George Mason University, a majority of Americans report that they spend time worrying about climate change.
  • This is not an easy way to live.
  • Living within a context that is obviously unhealthful, he wrote, is painful: “a dimly intuited ‘fall’ from which we spend our lives trying to recover, a guilt we can never quite grasp or expiate” — a feeling of loss or dislocation whose true origins we look for, but often fail to see. This confusion leaves us feeling even worse.
  • When Barbara Easterlin first started studying environmental psychology 30 years ago, she told me, the focus of study was on ways in which cultivating a relationship with nature can be good for mental health
  • There was little or no attention to the fact that living through, or helping to cause, a collapse of nature can also be mentally harmful.
  • the field is still so new that it does not yet have evidence-tested treatments or standards of practice. Therapists sometimes feel as if they are finding the path as they go.
  • Rebecca Weston, a licensed clinical social worker practicing in New York and a co-president of the CPA-NA, told me that when she treats anxiety disorders, her goal is often to help the patient understand how much of their fear is internally produced — out of proportion to the reality they’re facing
  • climate anxiety is a different challenge, because people worried about climate change and environmental breakdown are often having the opposite experience: Their worries are rational and evidence-based, but they feel isolated and frustrated because they’re living in a society that tends to dismiss them.
  • One of the emerging tenets of climate psychology is that counselors should validate their clients’ climate-related emotions as reasonable, not pathological
  • it does mean validating that feelings like grief and fear and shame aren’t a form of sickness, but, as Weston put it, “are actually rational responses to a world that’s very scary and very uncertain and very dangerous for people
  • In the words of a handbook on climate psychology, “Paying heed to what is happening in our communities and across the globe is a healthier response than turning away in denial or disavowal.”
  • But this, too, raises difficult questions. “How much do we normalize people to the system we’re in?” Weston asked. “And is that the definition of health?
  • Or is the definition of health resisting the things that are making us so unhappy? That’s the profound tension within our field.”
  • “It seems to shift all the time, the sort of content and material that people are bringing in,” Alexandra Woollacott, a psychotherapist in Seattle, told the group. Sometimes it was a pervasive anxiety about the future, or trauma responses to fires or smoke or heat; other times, clients, especially young ones, wanted to vent their “sort of righteous anger and sense of betrayal” at the various powers that had built and maintained a society that was so destructive.
  • “I’m so glad that we have each other to process this,” she said, “because we’re humans living through this, too. I have my own trauma responses to it, I have my own grief process around it, I have my own fury at government and oil companies, and I think I don’t want to burden my clients with my own emotional response to it.”
  • In a field that has long emphasized boundaries, discouraging therapists from bringing their own issues or experiences into the therapy room, climate therapy offers a particular challenge: Separation can be harder when the problems at hand affect therapist and client alike
  • Some therapists I spoke to were worried about navigating the breakdown of barriers, while others had embraced it. “There is no place on the planet that won’t eventually be impacted, where client and therapist won’t be in it together,” a family therapist wrote in a CPA-NA newsletter. “Most therapists I know have become more vulnerable and self-disclosing in their practice.”
  • “If you look at or consider typical theoretical framings of something like post-traumatic growth, which is the understanding of this idea that people can sort of grow and become stronger and better after a traumatic event,” she said, then the climate crisis poses a dilemma because “there is no afterwards, right? There is no resolution anytime in our lifetimes to this crisis that we nonetheless have to build the capacities to face and to endure and to hopefully engage.”
  • “How,” she asked, “do you think about resilience apart from resolution?”
  • many of her patients are also disconnected from the natural world, which means that they struggle to process or even recognize the grief and alienation that comes from living in a society that treats nature as other, a resource to be used and discarded.
  • “I’m so excited by what you’re bringing in,” Woollacott replied. “I’m doing psychoanalytic training at the moment, and we study attachment theory” — how the stability of early emotional bonds affects future relationships and feelings of well-being. “But nowhere in the literature does it talk about our attachment to the land.”
  • Torres said that she sometimes takes her therapy sessions outside or asks patients to remember their earliest and deepest connections with animals or plants or places. She believes it will help if they learn to think of themselves “as rooted beings that aren’t just simply living in the human overlay on the environment.” It was valuable to recognize, she said, that “we are part of the land” and suffer when it suffers.
  • Torres described introducing her clients to methods — mindfulness, distress tolerance, emotion regulation — to help them manage acute feelings of stress or panic and to avoid the brittleness of burnout.
  • She also encourages them to narrativize the problem, including themselves as agents of change inside stories about how they came to be in this situation, and how they might make it different.
  • then she encourages them to find a community of other people who care about the same problems, with whom they could connect outside the therapy room. As Woollacott said earlier: “People who share your values. People who are committed to not looking away.”
  • Dwyer told the group that she had been thinking more about psychological adaptation as a form of climate mitigation
  • Therapy, she said, could be a way to steward human energy and creative capacities at a time when they’re most needed.
  • It was hard, Bryant told me when we first spoke, to do this sort of work without finding yourself asking bigger questions — namely, what was therapy actually about?
  • Many of the therapists I talked to spoke of their role not as “fixing” a patient’s problem or responding to a pathology, but simply giving their patients the tools to name and explore their most difficult emotions, to sit with painful feelings without instantly running away from them
  • many of the methods in their traditional tool kits continue to be useful in climate psychology. Anxiety and hopelessness and anger are all familiar territory, after all, with long histories of well-studied treatments.
  • They focused on trying to help patients develop coping skills and find meaning amid destabilization, to still see themselves as having agency and choice.
  • Weston, the therapist in New York, has had patients who struggle to be in a world that surrounds them with waste and trash, who experience panic because they can never find a place free of reminders of their society’s destruction
  • eston said, that she has trouble with the repeated refrain that therapist and patient experiencing the same losses and dreads at the same time constituted a major departure from traditional therapeutic practice
  • she believed this framing reflected and reinforced a bias inherent in a field that has long been most accessible to, and practiced by, the privileged. It was hardly new in the world, after all, to face the collapse of your entire way of life and still find ways to keep going.
  • Lately, Bryant told me, he’s been most excited about the work that happens outside the therapy room: places where groups of people gather to talk about their feelings and the future they’re facing
  • It was at such a meeting — a community event where people were brainstorming ways to adapt to climate chaos — that Weston, realizing she had concrete skills to offer, was inspired to rework her practice to focus on the challenge. She remembers finding the gathering empowering and energizing in a way she hadn’t experienced before. In such settings, it was automatic that people would feel embraced instead of isolated, natural that the conversation would start moving away from the individual and toward collective experiences and ideas.
  • There was no fully separate space, to be mended on its own. There was only a shared and broken world, and a community united in loving it.
1 - 20 of 212 Next › Last »
Showing 20▼ items per page