Until the main profession people see for these problems (the medical one) starts to see people as WHOLE creatures, not part creatures whose mental and physical health are completely separate, there is no fixing this problem. One must always care the for WHOLE person if one wishes to see better results.
The medical profession has so much improvement to make. I don't know how they could've gotten to a much worse position than where they are now.
So many people's problems would be because of drug interactions. Let alone a poor diet and lack of exercise etc. So what do the docs do? Give people MORE drugs.
Not only that, they also need to look at TRENDS in people's health. As an example, seeing a blood result in the 'normal' zone but not seeing that figure has fallen a lot over the past year or two is yet another example of how they are not dealing with the 'whole' person.
Plus GPs really don't know very much about mental illness. Unless they have done extensive studies in the area (unlikely), they are some of the LAST health professionals we should be seeing for mental illness!
Yes, yes, yes and yes to everything you wrote!!! We are human beings, not collections of organs and body fluids (mis)ruled over by a disembodied 'mind'.
I frankly don't have any confidence whatsoever that the medical profession is capable of improving. I think the vast majority of doctors will be replaced by AI and robosurgeons, and it will serve them right.
Ha ha, funny you should mention those robosurgeons. For many surgeries these days, robotics ARE being utilised! They're more precise than the docs... ;-)
Yes, I've heard about the da Vinci robotic surgical system for prostatectomy, and I'm sure there are other applications for this technology. Here's my concern: the majority of surgeons are probably pretty average if surgical skill follows the Pareto distribution (which it probably does). If the robosurgeon is trained on an AI algorithm informed by the practices of these average surgeons, rather than by the practices of the minority of truly gifted surgeons, it's going to deliver very average results. Case in point: Charlie Teo is a truly gifted neurosurgeon, which is why the other neurosurgeons hate him so much. I know a couple of people who would be dead or paralysed if it wasn't for him. But will the robosurgeon perform like him? Unlikely. It will be modelled on his jealous, inferior colleagues.
Of course, I'm hoping to never need the services of any surgeon :).
Thanks for another great article, Robyn. I'd like to share a conundrum of a situation.
My 37 year old daughter was unexpectedly diagnosed with bipolar disorder a decade ago. She is a musician and kinesiologist and yoga teacher. Diligent with diet and lifestyle, a meditator since her childhood (brought up in a yoga "cult" which, although I have long-since left, she chooses to regularly adhere to its practices). We have tried so many approaches, with excellent and committed practitioners including an integrative GP in Sydney (who incidentally advised agains the covid shots and wrote many exemptions - he was onto it in mid-2020), naturopaths, and a fantastic wholistic psychiatrist who uses supplements as well as judicious psychiatric drugs.
She has had every blood panel, hormone test, brain scan, genetic test we could find and we have done heaps of research. The most compelling explanation is that it seems there was some history of similar episodes in her paternal great-grandfather.
Despite all this, my daughter has had almost yearly relapses into mania and ended up in psychiatric wards in Sydney, Hong Kong, Amsterdam, London and more recently in rural Victoria. She doesn't have depression per se, but takes time to recover from the hospital admissions and the drugs administered to her there.
By and large my experiences with the more "allopathic" side of treatment and crisis teams etc have been good, and even interventions from the police have been reasonable. My daughter may not agree with this as she has been in the receiving end!
It has been a very difficult journey for her and our family. Mania is very hard for her to identify, as in the beginning it just feels like a very happy state, and can quickly build on itself. The most helpful protocol seems to be watching her circadian rhythms and prioritising sleep quality and quantity, regular lithium orotate (a "natural" and more bioavailable form of lithium), a heap of supplements, lifestyle management and occasional use of olanzapine. It appears that the olanzapine is vital to bring the mood down before it elevates, but is difficult for her to take as it does have side effects and she is very averse to allopathic medicine.
I'm sharing this as it can be very complex, and she doesn't fit into the typical patient profile. There is much less stigma around mental illness which is good, but we still come across the attitude from others such as "why doesn't she just stick to the meds?" Not helpful!
Thank you again, and I would be curious to hear your opinion.
I'm so sorry to hear what your family has been through. Obviously I can't offer any specific advice, but here is how I think about situations like this:
From the perspective of personality psychology, it's clear that your daughter has a propensity to this particular manifestation of psychological dysregulation that is labelled 'bipolar disorder'. I encourage you, and her, to read this article https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00248-y and then do a Big 5/NEO-FFI quiz to see where she lands. If she scores high on neuroticism/negative emotionality, Dialectical Behaviour Therapy (DBT) would be the best approach; mindfulness training may also be helpful. If she is excessively high in conscientiousness, exposure therapy may be helpful. If she is low in extraversion, once again, mindfulness training may be helpful.
Switching to an evolutionary psychology perspective, it's not hard to imagine that this particular cluster of psychological traits may actually have had some utility in a hunter gatherer setting. I think it's highly likely that people with your daughter's personality expression found their place in such settings as shamans or medicine men/women. This doesn't offer you much consolation in a modern setting, of course, but it does point to the importance of your daughter finding an ecological niche in which she flourishes. The strict adherence to sleep and circadian schedules that you mentioned is part of this, as is her work in occupations that allow her self-expression (musician), impose physical and mental discipline (yoga teacher) and get her attention focused on others rather than inwardly (kinesiologist).
Since she has already had extensive testing, I have nothing to recommend in this department. The one thing that I would suggest which she may not have tried yet is EFT, and in particular Matrix Reimprinting. There's a chance that if she is able to work through the events around her first (or possibly worse) episode of mania, and 'rewrite' this memory, that her threshold for subsequent manic episodes will be substantially raised.
Thank you so much for your generous and considered reply, Robyn. I will share the recommendations with her. You demonstrate a deep understanding of mental illness and I am very grateful you took the time to reply.
You raise some very interesting points.
I too dislike glib labels for complex conditions, but it is interesting that the symptoms of "mania" are so universal and consistent across race and sex. And regarding the historical role of shamans and priests etc, while there is comfort to be found in these ideas, the reality of mania at its height is as far from spiritual insight as one could imagine, although there is the uncharacteristic cutting observations and commentary as well as the extreme grandiose and fluid connectivity that occurs.
Her psychiatrist sometimes laments the "lack of insight", and here I think kinesiology can lay an interesting trap. Relying on body awareness and muscle testing is a useful tool, and she uses it to assist in decision making regarding food choices etc. My concern is whether this can override rational and sensible decisions - as an example, she travelled interstate recently and forgot her lithium orotate, and rather that call me to post it or see her psychiatrist for a script for a compounding pharmacist, she ordered some from iHerb and thought she could manage with her other supplements and a little bit of Olanzapine. She started to become unwell and it was hair-raising for all involved!
We are aware of EFT and I will look into Matrix Reimprinting, as it sounds fascinating. Familiar tropes emerge with each episode, and I imagine that good psychological help may assist. The first episode was significant, of course, and came not long after she appeared on that (awful) TV show "The Voice".
I don't mean to paint a grim picture as mostly she is an extraordinary young woman and the journey has been profound for us all.
I'm with you 100% that people in the grips of mania (or psychosis) are about as far from spiritual insight as you could get. I'm no expert on shamanism, but I suspect that part of the training of a young person who was identified as a candidate for this role, would have been learning how to ground themselves appropriately so that their extremely high openness and neuroticism didn't become a liability to them and their tribe.
It's that high openness and neuroticism, in my opinion, that makes people like your daughter susceptible to more 'fringe' ideas like muscle testing. I don't dismiss this practise out of hand, but I see huge potential for results to be gamed, either intentionally or unconsciously, by the practitioner's belief system.
Your daughter would need to do a lot of 'regular' EFT before moving onto Matrix Reimprinting, as the latter is more intense and could be risky in a person who isn't sufficiently grounded.
Josef spends a good amount of time talking about the decline in the American healthcare system. It is so much easier for the doctor to throw a pill at a patient rather than sit down and really listen to what is ailing the body. Doctors have almost no knowledge of the serious side effects of most drugs they prescribe.
Sadly, my experience as a provider trying to take a holistic/whole patient approach is that many patients don’t want to do the hard work of getting well. They too just want a pill to make it all go away.
That was one of my favourite Doc Malik interviews! Dr Josef is a rare bird - a doctor who is honest enough to admit that the way he was taught to practise medicine is harmful to patients, and antithetical to their healing.
Unfortunately, the same system that (mis)trains doctors has also trained the public to be passive recipients of so-called healthcare, rather than active participants in the process of self-healing. There is so much work to do to get our societies back on the rails.
I agree wholeheartedly. Drugs are the first port of call for anything and everything, the influence of the pharmaceutical industry appears to be wide spread and entwined with the medical schools. The medical profession used to be an honourable profession, then again, there was time before to get to know your patients and understand them. Health is now reduced to a microscope and a telephone call. Humans are social animals, we need contact, we need understanding. The present health crisis, especially mental health is at an all time low. Humans cannot be reduced to “parts” like a machine. You have to treat the WHOLE as you so rightly state. A cup of tea and a listening ear does work wonders, then again there is no money in this approach.
Couldn't agree more. I do long appointments with my clients (60-90 minutes), because it takes time to unpack a person's health history, understand their current problem in the context of all their life experiences, and explain each component of the treatment plan in a way that inspires them to commit to it. The medical system does not reimburse long appointments in a way that makes this approach financially viable for doctors.
You do know that the medical profession would burst at the seams if they actually started 'caring' for their patients?! I'm sure you do :-)
Financially they cannot afford the time! If they spent more than 5 mins per patient just doing the rounds in hospital, they'd be well over budget by the end of the week!
I'm like you - LONG appointments to unpack that health history and connect with the patient! The medical profession doesn't understand this concept, and they're not financially able to do that without their system completely breaking (which would actually be a good thing because it's such a broken system anyway!).
Dangerous talk! The last thing the pharmaceuticals want is a free market this would allow the witches of herbalism and homeopathic cranks in..........we must remember that they have done their upmost over the years to stop this. Then again there is some very unusual practice of “alternative” medicine out there which certainly raises my eyebrows......
I am fully in agreement that not everything in 'alternative medicine' is valid and helpful. But I don't think that government should be in charge of deciding what is, and what is not, legitimate. Would you trust the people who told you that COVID injections were 'safe and effective' to decide whether herbal medicine is voodoo? If government gets its snout out of it, the onus is back on the individual to take responsibility for investigating the bona fides of any practitioner or treatment that they're considering using. And I'm all for taking personal responsibility for ALL of one's life decisions.
The government should not be in charge, you just have to look at the UK health ministers to know this. I absolutely agree that the individual has to take full responsibility for their life decisions but how? Anything “alternative” has all but been removed. I worked as an alternative practitioner in the NHS, stumped at every level. Let in the free market as it cannot be worse than what we have at present. Encourage people to think for themselves, there is not a pill for all ailments, your health is an ongoing affair.
Except mentally ill people not on medications also have inflammation and commodities. Conversely those with autoimmune disorders can also get psychiatric symptoms because of the gut-brain axis. Bipolar is treated with lithium which is deficient in those with dysbiosis, serotonin is also manufactured by f gut flora. Schizophrenia is an autoimmune disorder and has been treated with autoimmune protocol
Until the main profession people see for these problems (the medical one) starts to see people as WHOLE creatures, not part creatures whose mental and physical health are completely separate, there is no fixing this problem. One must always care the for WHOLE person if one wishes to see better results.
The medical profession has so much improvement to make. I don't know how they could've gotten to a much worse position than where they are now.
So many people's problems would be because of drug interactions. Let alone a poor diet and lack of exercise etc. So what do the docs do? Give people MORE drugs.
Not only that, they also need to look at TRENDS in people's health. As an example, seeing a blood result in the 'normal' zone but not seeing that figure has fallen a lot over the past year or two is yet another example of how they are not dealing with the 'whole' person.
Plus GPs really don't know very much about mental illness. Unless they have done extensive studies in the area (unlikely), they are some of the LAST health professionals we should be seeing for mental illness!
Yes, yes, yes and yes to everything you wrote!!! We are human beings, not collections of organs and body fluids (mis)ruled over by a disembodied 'mind'.
I frankly don't have any confidence whatsoever that the medical profession is capable of improving. I think the vast majority of doctors will be replaced by AI and robosurgeons, and it will serve them right.
Ha ha, funny you should mention those robosurgeons. For many surgeries these days, robotics ARE being utilised! They're more precise than the docs... ;-)
Yes, I've heard about the da Vinci robotic surgical system for prostatectomy, and I'm sure there are other applications for this technology. Here's my concern: the majority of surgeons are probably pretty average if surgical skill follows the Pareto distribution (which it probably does). If the robosurgeon is trained on an AI algorithm informed by the practices of these average surgeons, rather than by the practices of the minority of truly gifted surgeons, it's going to deliver very average results. Case in point: Charlie Teo is a truly gifted neurosurgeon, which is why the other neurosurgeons hate him so much. I know a couple of people who would be dead or paralysed if it wasn't for him. But will the robosurgeon perform like him? Unlikely. It will be modelled on his jealous, inferior colleagues.
Of course, I'm hoping to never need the services of any surgeon :).
Thanks for another great article, Robyn. I'd like to share a conundrum of a situation.
My 37 year old daughter was unexpectedly diagnosed with bipolar disorder a decade ago. She is a musician and kinesiologist and yoga teacher. Diligent with diet and lifestyle, a meditator since her childhood (brought up in a yoga "cult" which, although I have long-since left, she chooses to regularly adhere to its practices). We have tried so many approaches, with excellent and committed practitioners including an integrative GP in Sydney (who incidentally advised agains the covid shots and wrote many exemptions - he was onto it in mid-2020), naturopaths, and a fantastic wholistic psychiatrist who uses supplements as well as judicious psychiatric drugs.
She has had every blood panel, hormone test, brain scan, genetic test we could find and we have done heaps of research. The most compelling explanation is that it seems there was some history of similar episodes in her paternal great-grandfather.
Despite all this, my daughter has had almost yearly relapses into mania and ended up in psychiatric wards in Sydney, Hong Kong, Amsterdam, London and more recently in rural Victoria. She doesn't have depression per se, but takes time to recover from the hospital admissions and the drugs administered to her there.
By and large my experiences with the more "allopathic" side of treatment and crisis teams etc have been good, and even interventions from the police have been reasonable. My daughter may not agree with this as she has been in the receiving end!
It has been a very difficult journey for her and our family. Mania is very hard for her to identify, as in the beginning it just feels like a very happy state, and can quickly build on itself. The most helpful protocol seems to be watching her circadian rhythms and prioritising sleep quality and quantity, regular lithium orotate (a "natural" and more bioavailable form of lithium), a heap of supplements, lifestyle management and occasional use of olanzapine. It appears that the olanzapine is vital to bring the mood down before it elevates, but is difficult for her to take as it does have side effects and she is very averse to allopathic medicine.
I'm sharing this as it can be very complex, and she doesn't fit into the typical patient profile. There is much less stigma around mental illness which is good, but we still come across the attitude from others such as "why doesn't she just stick to the meds?" Not helpful!
Thank you again, and I would be curious to hear your opinion.
I'm so sorry to hear what your family has been through. Obviously I can't offer any specific advice, but here is how I think about situations like this:
From the perspective of personality psychology, it's clear that your daughter has a propensity to this particular manifestation of psychological dysregulation that is labelled 'bipolar disorder'. I encourage you, and her, to read this article https://journalbipolardisorders.springeropen.com/articles/10.1186/s40345-021-00248-y and then do a Big 5/NEO-FFI quiz to see where she lands. If she scores high on neuroticism/negative emotionality, Dialectical Behaviour Therapy (DBT) would be the best approach; mindfulness training may also be helpful. If she is excessively high in conscientiousness, exposure therapy may be helpful. If she is low in extraversion, once again, mindfulness training may be helpful.
Switching to an evolutionary psychology perspective, it's not hard to imagine that this particular cluster of psychological traits may actually have had some utility in a hunter gatherer setting. I think it's highly likely that people with your daughter's personality expression found their place in such settings as shamans or medicine men/women. This doesn't offer you much consolation in a modern setting, of course, but it does point to the importance of your daughter finding an ecological niche in which she flourishes. The strict adherence to sleep and circadian schedules that you mentioned is part of this, as is her work in occupations that allow her self-expression (musician), impose physical and mental discipline (yoga teacher) and get her attention focused on others rather than inwardly (kinesiologist).
Since she has already had extensive testing, I have nothing to recommend in this department. The one thing that I would suggest which she may not have tried yet is EFT, and in particular Matrix Reimprinting. There's a chance that if she is able to work through the events around her first (or possibly worse) episode of mania, and 'rewrite' this memory, that her threshold for subsequent manic episodes will be substantially raised.
Thank you so much for your generous and considered reply, Robyn. I will share the recommendations with her. You demonstrate a deep understanding of mental illness and I am very grateful you took the time to reply.
You raise some very interesting points.
I too dislike glib labels for complex conditions, but it is interesting that the symptoms of "mania" are so universal and consistent across race and sex. And regarding the historical role of shamans and priests etc, while there is comfort to be found in these ideas, the reality of mania at its height is as far from spiritual insight as one could imagine, although there is the uncharacteristic cutting observations and commentary as well as the extreme grandiose and fluid connectivity that occurs.
Her psychiatrist sometimes laments the "lack of insight", and here I think kinesiology can lay an interesting trap. Relying on body awareness and muscle testing is a useful tool, and she uses it to assist in decision making regarding food choices etc. My concern is whether this can override rational and sensible decisions - as an example, she travelled interstate recently and forgot her lithium orotate, and rather that call me to post it or see her psychiatrist for a script for a compounding pharmacist, she ordered some from iHerb and thought she could manage with her other supplements and a little bit of Olanzapine. She started to become unwell and it was hair-raising for all involved!
We are aware of EFT and I will look into Matrix Reimprinting, as it sounds fascinating. Familiar tropes emerge with each episode, and I imagine that good psychological help may assist. The first episode was significant, of course, and came not long after she appeared on that (awful) TV show "The Voice".
I don't mean to paint a grim picture as mostly she is an extraordinary young woman and the journey has been profound for us all.
With gratitude,
Kate
I'm with you 100% that people in the grips of mania (or psychosis) are about as far from spiritual insight as you could get. I'm no expert on shamanism, but I suspect that part of the training of a young person who was identified as a candidate for this role, would have been learning how to ground themselves appropriately so that their extremely high openness and neuroticism didn't become a liability to them and their tribe.
It's that high openness and neuroticism, in my opinion, that makes people like your daughter susceptible to more 'fringe' ideas like muscle testing. I don't dismiss this practise out of hand, but I see huge potential for results to be gamed, either intentionally or unconsciously, by the practitioner's belief system.
Your daughter would need to do a lot of 'regular' EFT before moving onto Matrix Reimprinting, as the latter is more intense and could be risky in a person who isn't sufficiently grounded.
Fantastic article and it parallels well with the discussion that Dr. Malik had on his podcast with Dr. Josef Witt-Doerring. https://podcasts.apple.com/us/podcast/doc-malik/id1687952188?i=1000639970367
Josef spends a good amount of time talking about the decline in the American healthcare system. It is so much easier for the doctor to throw a pill at a patient rather than sit down and really listen to what is ailing the body. Doctors have almost no knowledge of the serious side effects of most drugs they prescribe.
Sadly, my experience as a provider trying to take a holistic/whole patient approach is that many patients don’t want to do the hard work of getting well. They too just want a pill to make it all go away.
That was one of my favourite Doc Malik interviews! Dr Josef is a rare bird - a doctor who is honest enough to admit that the way he was taught to practise medicine is harmful to patients, and antithetical to their healing.
Unfortunately, the same system that (mis)trains doctors has also trained the public to be passive recipients of so-called healthcare, rather than active participants in the process of self-healing. There is so much work to do to get our societies back on the rails.
I agree wholeheartedly. Drugs are the first port of call for anything and everything, the influence of the pharmaceutical industry appears to be wide spread and entwined with the medical schools. The medical profession used to be an honourable profession, then again, there was time before to get to know your patients and understand them. Health is now reduced to a microscope and a telephone call. Humans are social animals, we need contact, we need understanding. The present health crisis, especially mental health is at an all time low. Humans cannot be reduced to “parts” like a machine. You have to treat the WHOLE as you so rightly state. A cup of tea and a listening ear does work wonders, then again there is no money in this approach.
Couldn't agree more. I do long appointments with my clients (60-90 minutes), because it takes time to unpack a person's health history, understand their current problem in the context of all their life experiences, and explain each component of the treatment plan in a way that inspires them to commit to it. The medical system does not reimburse long appointments in a way that makes this approach financially viable for doctors.
You do know that the medical profession would burst at the seams if they actually started 'caring' for their patients?! I'm sure you do :-)
Financially they cannot afford the time! If they spent more than 5 mins per patient just doing the rounds in hospital, they'd be well over budget by the end of the week!
I'm like you - LONG appointments to unpack that health history and connect with the patient! The medical profession doesn't understand this concept, and they're not financially able to do that without their system completely breaking (which would actually be a good thing because it's such a broken system anyway!).
Yes, the system is broken and it ain't fixable, as far as I can see. I say, let the free market step in and offer the solutions that people want.
Dangerous talk! The last thing the pharmaceuticals want is a free market this would allow the witches of herbalism and homeopathic cranks in..........we must remember that they have done their upmost over the years to stop this. Then again there is some very unusual practice of “alternative” medicine out there which certainly raises my eyebrows......
I am fully in agreement that not everything in 'alternative medicine' is valid and helpful. But I don't think that government should be in charge of deciding what is, and what is not, legitimate. Would you trust the people who told you that COVID injections were 'safe and effective' to decide whether herbal medicine is voodoo? If government gets its snout out of it, the onus is back on the individual to take responsibility for investigating the bona fides of any practitioner or treatment that they're considering using. And I'm all for taking personal responsibility for ALL of one's life decisions.
The government should not be in charge, you just have to look at the UK health ministers to know this. I absolutely agree that the individual has to take full responsibility for their life decisions but how? Anything “alternative” has all but been removed. I worked as an alternative practitioner in the NHS, stumped at every level. Let in the free market as it cannot be worse than what we have at present. Encourage people to think for themselves, there is not a pill for all ailments, your health is an ongoing affair.
Except mentally ill people not on medications also have inflammation and commodities. Conversely those with autoimmune disorders can also get psychiatric symptoms because of the gut-brain axis. Bipolar is treated with lithium which is deficient in those with dysbiosis, serotonin is also manufactured by f gut flora. Schizophrenia is an autoimmune disorder and has been treated with autoimmune protocol
Yes, I specifically wrote about this in the article, mentioning the examples of glucose dysregulation and inflammation.