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Monday, July 21, 2008

10 Mind-Boggling Psychiatric Treatments.

Nobody ever claimed a visit to the doctor was a pleasant way to pass the time. But if you’re timid about diving onto a psychiatrist’s couch or paranoid about popping pills, remember: It could be worse. Like getting-a-hole-drilled-into-your-skull worse. Or having-a-doctor-infect-you-with-malaria-to-cure-you worse. Think of it this way. After finding out what’s not going to happen to you, that couch is going to start looking a lot more comfortable.

1) INSULIN-COMA THERAPY

The coma-therapy trend began in 1927. Viennese physician Manfred Sakel accidentally gave one of his diabetic patients an insulin overdose, and it sent her into a coma. But what could have been a major medical faux pas turned into a triumph. The woman, a drug addict, woke up and declared her morphine craving gone. Then Sakel (who really isn’t earning our trust here) made the same mistake with another patient, who also woke up claiming to be cured.

Before long, Sakel was intentionally testing the therapy with other patients and reporting a 90 percent recovery rate, particularly among schizophrenics. Strangely, however, Sakel’s treatment success remains a mystery. Presumably, a big dose of insulin causes blood sugar levels to plummet, which starves the brain of food and sends the patient into a coma. But why this unconscious state would help psychiatric patients is anyone’s guess.

Regardless, the popularity of insulin therapy [wiki] faded, mainly because it was dangerous. Slipping into a coma is no walk in the park, and between one and two percent of treated patients died as a result.

2) TREPANATION

Ancient life was not without its hazards. Between wars, drunken duels, and the occasional run-in with an inadequately domesticated pig, it’s no surprise that archaic skulls tend to have big holes in them.

But not all holes are created with equal abandon. Through the years, archaeologists have uncovered skulls marked by a carefully cut circular gap, which shows signs of being made long before the owner of the head passed away. These fractures were no accident; they were the result one of the earliest forms of psychiatric treatment called trepanation [wiki].

The basic theory behind this "therapy" holds that insanity is caused by demons lurking inside the skull. Boring a hole in the patient’s head creates a door through which the demons can escape, and - viola! - out goes the crazy. Despite the peculiarity of the theory and lack of major-league anesthetics, trepanation was by no means a limited phenomenon. From the Neolithic era to the early 20th century, cultures all over the world used it was way to cure patients of their ills.

Doctors eventually phased out the practice as less, er, invasive procedures were developed. Average Joes, on the other hand, didn’t follow suit. Trepanation patrons still exist. In fact, they even have their own organizations - and websites! Check out the International Trepanation Advocacy Group at www.trepan.com if you’re still curious.

3) ROTATIONAL THERAPY

Charles Darwin’s grandfather Erasmus Darwin [wiki] was a physician, philosopher, and scientist, but he wasn’t particularly adept at any of the three. Consequently, his ideas weren’t always taken seriously. Of course, this could be because he liked to record them in bad poetic verse (sample: "By immutable immortal laws / Impress’d in Nature by the great first cause, / Say, Muse! How rose from elemental strife / Organic forms, and kindled into life"). It could also be because his theories were a bit far-fetched, such as his spinning-couch treatment.

Darwin’s logic was that sleep could cure disease and that spinning around really fast a great way to induce the slumber. Nobody paid much attention to it at first, but later, American physician Benjamin Rush adapted the treatment for psychiatric purposes. He believed that spinning would reduce brain congestion and, in turn cure mental illness. He was wrong. Instead, Rush just ended up with dizzy patients who were still crazy. These days, rotating chairs are limited to the study of vertigo and space sickness.

4) HYDROTHERAPY

If the word "hydrotherapy" conjures up images of Hollywood stars lazily soaking in rich, scented baths, then you probably weren’t an early 20th-centruy mental patient.

Building off the idea that a dip in the water is often calming, psychiatrists of yore attempted to remedy various symptoms with corresponding liquid treatments. For instance, hyperactive patients got warm, tiring baths, while lethargic patients received stimulating sprays. Some doctors, however, got a bit too zealous about the idea, prescribing therapies that sounded more like punishment than panacea. One treatment involved mummifying the patient in towels soaked in ice-cold water. Another required the patient to remain continuously submerged in a bath for hours even days-which might not sound so bad, except they were strapped in and only allowed out to use the restroom.

Finally, some doctors ordered the use of high-pressure jets. Sources indicate that at least one patient was strapped to the wall in the crucification position (never a good sign) and blasted with water from a fire hose. Like many extreme treatments, hydrotherapy was eventually replaced with psychiatric drugs, which tended to be more effective - and more pleasant.

5) MESMERISM

Much like Yoda, Austrian physician Franz Mesmer [wiki] (1734-1815) believed that an invisible force pervaded everything in existence, and that disruptions in this force caused pain and suffering. But Mesmer’s ideas would have been of little use to Luke Skywalker. His basic theory was that the gravity of the moon affected the body’s fluids in much the same way it caused ocean tides, and that some diseases accordingly waxed and waned with the phases of the moon. The dilemma, then, was to uncover what could be done about gravity’s pernicious effects. Mesmer’s solution: use magnets.

After all, gravity and magnetism were both about objects being attracted to each other. Thus, placing magnets on certain areas of a patient’s body might be able to counteract the disruptive influence of the moon’s gravity and restore the normal flow of bodily fluids. Surprisingly, many patients praised the treatment as a miracle cure, but the medical community dismissed it as supposititious hooey and chalked up his treatment successes to the placebo effect.

Mesmer and his theories were ultimately discredited, but he still left his mark. Today, he’s considered the father of modern hypnosis because of his inadvertent discovery of the power of suggestion, and his name lives on in the English word "mesmerize."

6) MALARIA THERAPY

Ah, if only we’re talking about about a therapy for malaria. Instead, this is malaria [wiki] as therapy-specifically, as a treatment for syphilis. There was no cure for the STD until the early 1900s, when Viennese neurologist Wagner von Jauregg got the idea to treat syphilis sufferers with malaria-infected blood. Predictably, these patients would develop the disease, which would cause an extremely high fever that would kill the syphilis bacteria. Once that happened, they were given the malaria drug quinine, cured and sent home happy and healthy.

The treatment did have its share of side effects -that nasty sustained fever, for one - but it worked and it was a whole lot better than dying. In fact, Von Jauregg won the Nobel Prize for malaria therapy, and the treatment remained in use until the development of penicillin came along and gave doctors a better, safer way to sure the STD.

7) CHEMICALLY INDUCED SEIZURES

Nobody ever said doctors had flawless logic. A good example: seizure therapy. Hungarian pathologist Ladislas von Meduna pioneered the idea. He reasoned that, because schizophrenia was rare in epileptics, and because epileptics seemed blissfully happy after seizures, then giving schizophrenics seizures would make them calmer.

In order to do this von Meduna tested numerous seizure-inducing drugs (including such fun candidates as strychnine, caffeine, and absinthe) before settling on metrazol, a chemical that stimulates the circulatory and respiratory systems. And although he claimed the treatment cured the majority of his patients, opponents argues that the method was dangerous and poorly understood.

To this day, no one is quite clear on why seizures can help ease some schizophrenic symptoms, but many scientists believe the convulsions release chemicals otherwise lacking in patient’s brains. Ultimately, the side effects (including fractured bones and memory loss) turned away both doctors and patients.

8) HYSTERIA THERAPY

Once upon a time, women suffering from pretty much any type of mental illness were lumped together as victims of hysteria. The Greek physician Hippocrates [wiki] popularized the term, believing hysteria encompassed conditions ranging from nervousness to fainting fits to spontaneous muteness. The root cause, according to him, was a wandering womb.

So, whither does it wander? Curious about Hippocrates’ theory, Plato [wiki] asked himself that very question. He claimed that is the uterus "remains unfruitful long beyond its proper time, it gets discontented and angry and wanders in every direction through the body, closes up the passages of breath, and, by obstructing respiration, drives women to extremity."

Consequently, cures for hysteria involved finding a way to "calm down" the uterus. And while there was no dearth of methods for doing this (including holding foul-smelling substances under the patient’s nose to drive the uterus away from the chest), Plato believed that the only sure-fire way to solve the problem was to get married and have babies. After all, the uterus always ended up in the right place when it came time to bear a child.

Although "womb-calming" as psychiatric treatment died out long ago, hysteria as a diagnosis hung around until the 20th century, when doctors began identifying conditions such as depression, post-traumatic stress disorder, and phobias.

9) PHRENOLOGY


19th century Phrenology [wiki] chart, with inscription "Discover yourself."
(Image Credit: Wikipedia)

Around the turn of the 19th century, German physician Franz Gall [wiki] developed phrenology, a practice based on the idea that people’s personalities are depicted in the bumps and depressions of their skulls.

Basically, Gall believed that the parts of the brain a person used more often would get bigger, like muscles. Consequently, these pumped-up areas would take up more skull space, leaving visible bumps in those places on your head. Gall then tried to determine which parts of the skull corresponded to which traits. For instance, bumps over the ears meant you were destructive; a ridge at the top of the head indicated benevolence; and thick folds on the back of the neck were signs of a sexually oriented personality.

In the end, phrenologists did little to make their mark in the medical field, as they couldn’t treat personality issues, only diagnose them (and inaccurately, at that). By the early 1900s, the fad had waned, and modern neuroscience had garnered dominion over the brain.

10) LOBOTOMY

Everybody’s favorite psychiatric treatment, the modern lobotomy [wiki] was the brainchild of Egas Moniz, a Portuguese doctor. Moniz believed that mental illness were generally caused by problems in the neurons of the frontal lobe, the part of the brain just behind the forehead. So when he heard about a monkey whose violent, feces-throwing urges had been curbed by cute to the frontal lobe, Moniz was moved to try out the same thing on his patients. (The lobe-cutting, not the feces-throwing.) He believed the technique could cure insanity while leaving the rest of the patient’s mental function relatively normal, and his (admittedly fuzzy) research seemed to support that.

The accolades flooded in, and (in one of the lower points in the Karolinska Institute’s history) Moniz was awarded the Nobel Prize in 1949.


Walter Freeman performing a lobotomy in 1949 at the Western State Hospital
(Image Credit: Shedding Light on Shadowland)

After the lobotomy rage hit American shores, Dr. Walter Freeman took to traveling the country in his "lobotomobile" (no, really), performing the technique on everyone from catatonic schizophrenics to disaffected housewives. His road-ready procedure involved inserting a small ice pick into the brain through the eye socket and wiggling it around a bit.

While some doctors thought he’s found a way to save hopeless cases from the horrors of life-long institutionalization, others noted that Freeman didn’t bother with sterile techniques, had no surgical training whatsoever, and tended to be a bit imprecise when describing his patient’s recovery.

As the number of lobotomies increased, a major problem became apparent. The patients weren’t just calm; they were virtual zombies who scarcely responded to the world around them. Between that and the bad press received in films and novels such as One Flew Over the Cuckoo’s Nest, the treatment soon fell out of favor.

Bonus: Father Hell Hath No Fury Like a Therapist Scorned

In the end, all 10 of these psychiatric treatments came under fire from critics and were shunned by the medical community. And the physicians involved usually went down with them. But not Franz Mesmer, the man behind mesmerism (see entry #5). He wasn’t going out without a fight - several, actually.

Mesmer’s career was plagued by various opponents, one of whom was a priest named Father Hell (Don’t worry. We had the name fact-checked, twice). Apparently, the good Maximilian Hell tried to take credit for Mesmer’s magnet-based psychiatric treatment. In response, a furious Mesmer replied by writing a dissertation explaining that the idea was his first. Unfortunately for Mesmer’s argument, he plagiarized much of said dissertation.

In the end, though, it didn’t matter much. Mesmer abandoned the practice in favor of his own personal magnetism. Somewhere along the way, he’d noticed that he could obtain equally good results by simply placing his hands on a patient’s affected body part and concluded that he himself must be giving off magnetic energy.

Many people, including Father Hell, worried about a placebo effect, and controversy erupted once again. And again, Mesmer took great offense to his critics and defended his practices vehemently.

At one point, he even wrote an open letter to Marie Antoinette that belittled the Austrian royal family. Bad move. This prompted an irritated Louis XVI to appoint two commissions to investigate the magnetism fad. (For the record, members included Benjamin Franklin and Dr. Joseph Guillotin, after whom the guillotine was named.) One report concluded that Mesmer’s results were likely attributable to the power of suggestion. That would’ve been bad enough, but another, confidential, report insinuated that Mesmer had a particular fondness for laying his hands on the bodies of young and beautiful women.

The article above, written by Dan Greenberg, is reprinted with permission from mental_floss magazine (May - Jun 2005 issue).

Don’t forget to feed your brain, subscribe to the magazine and visit mental_floss‘ extremely entertaining website and blog!


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Can Oxytocin Ease Shyness?

For centuries artists have tried to capture the essence of love, and now scientists may have found it in the brain. Known as oxytocin (from the Latin word for "quick birth"), the naturally occurring hormone is best known for controlling contractions during labor, but it also plays a key role in other fundamental human urges — including the desire to connect with others. "Somehow, the peptide increases trust, or alters the way individuals see each other," says Tom Insel, director of the National Institute for Mental Health.

Without oxytocin people would be far less inclined to seek social interaction, let alone fall in love and mate for life (or, as scientists call it, "pair bond"). The brain releases gobs of it during orgasm, mothers are awash in it during breastfeeding and, in clinical trials, a spritz of oxytocin has been shown to reduce anxiety, increase feelings of generosity and even ease the symptoms of shyness. Conversely, researchers are beginning to discover that low levels of the hormone — or the body's faulty response to it — may contribute to severe social dysfunctions like depression and autism.

Most previous research on oxytocin has focused on animals. (Prairie voles are famous for their oxytocin-inspired behavior: they're fiercely monogamous lovers and caring parents.) But more recently, scientists have begun to determine how oxytocin functions in the human brain — or, more specifically, how it malfunctions. Studies have shown that people with autism tend to have low levels of oxytocin, as well as hyperactivity in the amygdala, where most oxytocin receptors are located. The amygdala is also where memories are formed, and where our brains process and assign emotional meaning to sensory information — that is, where we turn perception (seeing someone smile) into "neuroception" (understanding the feeling of happiness that the smile reflects), according to Stephen Porges, a psychologist at the University of Illinois in Chicago. So, misfirings in the amygdala, in tandem with low oxytocin, may help explain why people with autism have trouble distinguishing between happy expressions and angry ones, making social interaction difficult and unpleasant.

Early studies of oxytocin's role in social interaction have yielded some interesting results. In a small 2006 experiment, Dr. Eric Hollander of New York's Mt. Sinai School of Medicine administered oxytocin and a placebo intravenously to 15 autistic adult patients; afterward, those who received oxytocin were better able to decipher emotions in tone of voice. Moreover, these improvements in social awareness lasted for nearly two weeks. In 2006, Hollander filed a patent for the use of oxytocin to treat symptoms of autism spectrum disorders; the request is still pending. Other investigators at Mt. Sinai have also found that oxytocin nasal sprays enhance autistic patients' ability to interpret facial expressions. Finally, in studies by Paul Zak, director of the Center for Neuroeconomics Studies in Claremont, Calif., small doses of inhaled oxytocin spray reduced anxiety and wariness of strangers in healthy volunteers; in one trial, the hormone made people feel more generous and trusting with their money.

For the oxytocin-deficient among us, the hormone is commercially available on the Internet in the form of a nasal spray — new mothers sometimes use it to trigger the release of breast milk (and nearly half of all women who give birth in the U.S. receive a synthetic version of the hormone, Pitocin, intravenously to induce labor). But some entrepreneurs are already touting oxytocin as a shyness cure. One website hawks a "trust elixir," an oxytocin-laced perfume that its manufacturers say will make its wearers seem more trustworthy to others — and vice versa.

There's no telling whether it works — products like these aren't classified as drugs, so they aren't evaluated by the FDA — but, at least in theory, it ought to make love or lust or trust bloom a little faster. That's not unlike the drug ecstasy, which triggers the release of serotonin, dopamine and oxytocin in the brain, and heightens users' feelings of trust and intimacy, even among complete strangers. Concerns that oxytocin might be similarly abused as a recreational drug seem unfounded, however, given that the hormone doesn't produce a high, says zoologist Sue Carter of the University of Illinois at Chicago, who pioneered oxytocin research in voles.

Oxytocin may be something of a wonder compound, spurring childbirth and creating love, but it's not exactly a performance enhancer and certainly not a cure-all — not for shyness or autism or any other social dysfunction. "The nervous system is not just oxytocin. There are many other hormones that might be just as important as oxytocin thathaven't been identified yet," Carter says. "A piece of social support is oxytocin. That doesn't mean that oxytocin alone equals social support."

But if a shot of oxytocin is what you want, there are other, more natural ways to boost the hormone's production. Massage, petting a dog, even eating food with a friend can trigger the chemical's release, says Zak. So can sensorimotor or "mind-body" therapies, like breathing exercises and yoga, which help people cope with their emotions by controlling their body's physical reaction to stress and fear. "We should look at other waysto juice the system without having to put two spoons of liquid up your nose every four hours," Zak says.

Preliminary findings may be intriguing, but most oxytocin researchers remain skeptical about its widespread clinical use. "If you feel safe and allow yourself to feel safe, you can learn, you can cooperate with others, you can build societies," says Carter. "Now does that mean we should runaround and spray everyone with oxytocin? I don't think so."

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Teens Get Drunk On Award-Winning Microbrew

EAST BRUNSWICK, NJ—The subtle interplay of the three varietal hops in MacTadcaster's Nut Brown Stout went tragically unappreciated Saturday when a group of high-school students got shitfaced on a case of the award-winning microbrew.

According to reports, Jared Rosenthal, Andrew Gobbola and Tracey Sheehan, 17-year-old seniors at East Brunswick High, obtained the beer from Rosenthal's refrigerator while his parents—bona-fide beer-lovers capable of fully relishing the subtle, hand-crafted taste of a MacTadcaster's—were away for the weekend.

Though none of the teens were able to comment on the Nut Brown Stout's chocolatey aroma or its surprisingly smoky almond finish, Rosenthal did say that it had "fucked him up majorly" and that he was "seriously payin' the price."

Added Gobbola: "Dude, I was ripped to the tits."

Despite consuming enormous quantities of the beer, the teens failed to detect the all-wheat malt that MacTadcaster's has developed over the years to give its beer "bottom." Further, none of them commented on the beer's uniquely dry, smoky hopping or the pleasant coffee highlights so often discussed among MacTadcaster's Nut Brown Stout cognoscenti.

Only the rich, robust texture of the beer drew any comment from the teens, with Sheehan overheard telling Rosenthal, "That beer is some thick shit."

Teens Get Drunk On Award-Winning Microbrew jump

MacTadcaster's Nut Brown Stout has won the Gold Medal for Best Small Batch Stout for three consecutive years at the Great American Beer Festival. John Winbourne, Chief Brewmaster at MacTadcaster's, said he was "shocked and disappointed" that the high-quality beer had wound up in the hands of unsophisticated, high school-age drinkers.

"Nobody the age of 17 can reasonably be expected to have the connoisseurship to detect even a fraction of the subtle complexities of our carefully aged stout," Winbourne said. "If they had guzzled our Honey Hefeweizen, a much simpler beer known for its plain, rumpled friendliness, the horror may have been muted somewhat."

"It's a tragedy, a real tragedy," said Steve Brauner, editor of Beer Aficionado magazine. "We're not talking about Bud Ice or Coors Light, or some mass-produced swill of a lager intended for crass high-school kids to get a cheap buzz off of. This is a complex, mature stout, whose creamy head alone is enough to overwhelm even the most experienced beer drinker."

"I can only hope those kids didn't drink it chilled," Brauner added. "Stouts are best enjoyed at room temperature."

According to sources within East Brunswick High School, the trio has previously been seen at night near the school's football field, drinking inexpensive domestic beers. "While such experimentation with alcohol is strongly discouraged," school principal Eileen Fleischer said, "at least these previous incidents only involved the three students getting wasted, as opposed to this senseless wasting of hand-crafted, award-winning beer."

Helmut Schildkraut is the experienced Bavarian farmer who harvested the hops in the MacTadcaster's twelve-pack at the peak of their mellow ripeness, then aged them in a oaken sherry cask for three months to maximally enhance their dignified flavor. Contacted at his home in the tiny German village of Gütbourg, he said: "Zis makes me very sad. Nein, der MacTadcaster's ist not fur der kinder. Ist fur der discriminating bier drinker only.
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Lawsuits Against Bloggers Seen Rising

When Christopher Grotke answered a late-night knock on the door, he did not expect to find the deputy sheriff on his doorstep serving notice that he was being sued. Nor was he prepared for the charge: libel.

Someone had posted a comment on his citizen-journalism Web site, iBrattleboro.com, stating that a woman in Brattleboro, Vt., was having an extramarital affair. The accused woman then sued Grotke and his Web site co-founder for failing to edit or delete the comment.

The blogging community increasingly is subject to lawsuits and threats of legal action running the gamut from subpoenas to cease-and-desist notices.

Since blogging became popular in about 2004, there have been 159 civil and criminal court actions involving bloggers, according to the nonprofit Media Law Resource Center (MLRC) in New York. Seven cases have resulted in verdicts against bloggers, with cumulative penalties totaling $18.5 million. Many more legal actions never result in trial.