Daily Archives: 22 Apr 05

Stewart Brand on the Coming Explosion of Urbanization.. and its Merits

Posted on by
A World Made of Cities: “At present there’s little awareness among environmentalists that growing cities are where the action and opportunities are, and there’s little scientific data being collected. I think a large-scale, long-term environmental strategy for urbanization is needed, two-pronged. One, take advantage of the emptying countryside (where the trees and other natural systems are growing back fast) and preserve, protect, and restore those landscape in a way that will retain their health when people eventually move back. Two, bear down on helping the growing cities to become more humane to live in and better related to the natural systems around them. Don’t fight the squatters. Join them.'” (radar.oreilly.com)

Married With Problems?

Posted on by
Therapy May Not Help: “Each year, hundreds of thousands of couples go into counseling in an effort to save their troubled relationships.

But does marital therapy work? Not nearly as well as it should, researchers say. Two years after ending counseling, studies find, 25 percent of couples are worse off than they were when they started, and after four years, up to 38 percent are divorced.” (New York Times )

I have conflicting thoughts about this news. First, I welcome the continuing trend toward recognizing that the emperor has no clothes in mental health care. I found it big news when research strongly supported the counterintuitive conclusion the critical incident debriefing and other emergency intervention techniques after traumas may not prevent survivors from developing post-traumatic stress. In fact, they may increase the risk. Similarly, we now learn that couples therapy may not save troubled relationships.

But is that evidence it is ineffective? In a great many cases, talking about a couple’s problems frankly may hasten the end of a doomed relationship, which is in my opinion as legitimate a purpose of couples therapy as saving a relationship at all costs. After all, the therapist is not making the decision about whether the marriage lives or dies; s/he is just facilitating the couple getting to what they really want.

F.D.A. Is Looking Into Epilepsy Drugs

Posted on by
“The Food and Drug Administration has begun a preliminary inquiry into whether epilepsy drugs may increase the risk of suicidal behavior in some patients, particularly those who use them for psychiatric illnesses.” (New York Times )

We in psychiatry use alot of anticonvulsant drugs for modulation of mood and impulses. I can see it now; they are going to make the same methodological mistakes they have made in concluding that antidepressants exacerbate suicide risk, about which I have written here in detail.