u/Hatrct — reddlx

Watch out for controlled opposition

The reason we have problems is that the vast majority have been brainwashed into not realizing this (that the Dems are controlled opposition).

There is a widespread belief by the vast majority that there is a significant and astronomical difference between Dems and Republicans. Those on the "left" think that Republicans are the cause of all problems on earth. And those on the "right" think the Dems are the cause of all problems on earth.

But the fact is, Dems and Republican politicians are far closer to each other than either are to the middle/working class. They are both radically neoliberal: this has been the case for the past half century. In fact, neoliberalism in both the US and UK started in the 70s with "left" wing parties (though Reagan + Thatcher did intensify neoliberal polices, but since then both Dems and Republicans and equivalent parties in the UK have continued neoliberal policies).

Unfortunately, the oligarchy, which the Dems and Republicans both serve/are practically a part of, own mass media. So for example CNN is pro-Dems and they try to run the narrative that all problems are caused by Republicans and that Dems are perfect, and vice versa for Fox news.

But all this does is prolong and strengthen the neoliberal anti-middle/working class oligarchy as a whole. Check out the site wtfhappenedin1971 dot com to see how both parties are neoliberal.

But the issue is that people continue to be brainwashed and keep actively and willingly voting for neoliberalism/voting against their own interests, by being divided+conquered.

I would say that on balance people on the left seem to be a little more against neoliberalism, but they keep being playing by Dems. Politicians like Obama and Mamdani are masters at this. They are put there by the neoliberal oligarchy to instill and maintain hope in the overall neoliberal oligarchy, to keep people flocking to the polls, which maintains neoliberalism and prevents any significant pro middle/working class changes.

But the fact is that the see-sawing between Dems and Republicans has not worked for the past half century: neoliberism has been maintained regardless of who is in power, and life continues to progressively become more difficult for the middle/working class, despite advances in technology and productivity. And the wealth of the super rich continues to disproportionately climb.

Obama's legacy is that he saved neoliberalism with his "yes we can" hope-instilling manipulation. All he did was buy 8+ years more for the oligarchy. He showed his true colors: people said he had his hands tied by congress, but since he left office all he has been doing is continuing to try to divide+conquer the middle/working class by pointing fingers at Republicans and getting people to keep flocking to the polls to vote for Dems vetted by the oligarchical pro-corporate Dem National Convention, such as Hillary/Biden/Kamala. Not once did he mention or criticize neoliberalism as a whole in this time. He remains responsible for crushing the 2011 Occupy Wall Street Movement: that was the only unified pro middle/working class movement in recent times, and he crushed it and Dems + Republicans then using their monopoly on mass media to try to divide+conquer the middle/working class along gender/racial lines + increasing polarization and cults of worship in terms of politicians and their politician parties, to try to make it seem like there is a significant difference between them.

This enables the middle/working class to focus on superficial differences and not unite and focus on the root of the issue: neoliberalism, which both parties are prolonging. They have successfully gotten about half of the population to be led by fear and believe the lies of the Republicans, and the other half to hate Republicans so much that this leads to emotional worship of Dem politicians. But all this does is keep people flocking to the polls to vote for either 1 of 2 neoliberal anti-middle/working class parties. They are trying to do this perpetually. Some people may argue that it still makes sense to vote for the "lesser" evil: but ask yourself, what did this strategy achieve for the past half century? Even if you assume that Dems are better, they were so bad that people literally had to be misled by someone like Trump and his lies of draining the swamp to seek refuge from Dems, and not once, but twice. So doesn't that show that the Dems had nothing of value to offer the middle/working class either? History shows us that even voting for the so called lesser evil just makes it more likely for the other party to get voted in the next time. This see-sawing between 2 neoliberal parties for the past half century has not helped the middle/working class: there is no plausible reason to expect it ever will. All it does is that it ensures in the mean time the Zuckerbergs, Trumps, Clintons, Musks, Bezos, Epsteins get richer, and the middle/working class becomes worse off.

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u/Hatrct — 1 day ago

▲ 0 r/ClinicalPsychology

censorship

Anybody else think it is messed up how there is a monopoly on science?

For all practical purposes, only professors/graduate students have the ability/means to conduct research.
Anything that is claimed and not backed up by research is dismissed as "non evidence based", and abiding by it can lead to consequences

So using these 2 points together, clinicians are forced to abide by existing/old research, and are not able to mention their own observations. Yet, throughout history, research can start with observations, and in many cases observations are later backed up by research. That is how science works: first there are hypothesis based on observations, then they are tested. And evidence is not always concrete: it can change/be upgraded over time. Ideally there would always be empirical studies, but the fact is this is not always practically possible, or not possible to be done within a timely manner. So a cost/benefit analysis will need to be done: if there is logical reason based on an observation based on a large sample size, and if informed consent is given and the course of action does not harm, then why not allow it?

I will use ADHD as an example.

For a long time I have observed that DSM has room for improvement. It lists certain hyperactivity, impulsivity, inattention symptoms as diagnostic criteria. Yet, the issue is that this is a neurobiological disorder. That means that its symptoms are stemming from a set of brain processes. But brain processes do not always uniformly manifest in the exact same symptoms in different people. So already a categorical diagnostic system for this type of disorder is problematic.

There have been 2 main brain findings in terms of ADHD: dopamine dysregulation and small brain size, in certain regions. So it logically follows that all symptoms follow from these.

This becomes problematic because not everybody has all or the same symptoms, but they will be likely to have a bunch of them.

Also, this blurs the line between "diagnostic criteria symptoms" and "associated features". For example, people with ADHD are significantly more likely to abuse substances, have emotional regulation issues, have excessive shopping/eating, and even depression/anxiety. The problem is that all of these issues can happen outside of ADHD as well/due to other causes. So looking solely at the superficial symptoms is problematic: it depends on why it is happening. For example, someone can abuse substances due to ADHD, but also due to trauma. And, obviously, people without ADHD can have depression/anxiety.

So why is it that the DSM solely has hyperactivity/impulsivity, and inattentiveness? Especially when not everybody with ADHD has all of these either (just like not everybody has all of the associated features/symptoms mentioned above)? So, given that A) all symptoms stem from the biological brain aspects B) not everybody has all the symptoms, should it not be that, if a categorical approach based on superficial symptoms is being used to diagnosed, the associated features/symptoms (e.g., substance abuse, emotional dysregulation, etc...) should also be listed as diagnostic criteria, or at least as "associated features to watch out for that can influence diagnosis" instead of being completely negated as they are now, because at the end of the day using a categorical approach like this is limited to associations altogether?

But the issue is that clinicians cannot say/do this: If they see an adult with no hyperactivity/impulsivity as per DSM criteria (remember, in adulthood hyperactivity tends to wane), and with some inattentiveness but just under the minimum number of DSM criteria for that category, yet with a bunch or all of symptoms from this list: substance abuse, depression/anxiety, impulsivity with shopping/eating, etc... and something like a history of being put on SSRIs and not responding (this is a thing in ADHD: serotonin and dopamine can have inverse effect, that is, raising serotonin can further decrease dopamine, exacerbating ADHD symptoms, and if the depression/anxiety is caused by the ADHD, then this will not help someone with ADHD) and then being put on an SNRI like Welbutrin by their family doctor (norepinephrine is somewhat implicated in ADHD, so it makes sense that an SNRI may work a little bit for someone with ADHD, at least better than an SSRI, but usually not nearly as well as a stimulant, which raises dopamine levels, which are low in ADHD and cause many of the symptoms), then the clinician still cannot diagnose, because they would be accused of not abiding by DSM/going against "evidence based practice". And then what would they have to do, become a professor and then do a research study to prove this, in order to be able to diagnose their patients?

This is further complicated by how many family doctors don't know much about ADHD: that is why they keep putting people who present with depression/anxiety on SSRIs, and then if they have ADHD that tends to not help, so then they switch to an SNRI. But they don't catch the ADHD. They instead treat the presenting symptoms in isolation: dep/anxiety: SSRI; weight gain: GLP-1 drugs. Substance abuse: referral to rehab, etc... Then the person comes to therapy, and the clinicians is unable to diagnose with ADHD, and without a diagnosis, they cannot get stimulants. And at the same time, the clinician is not allowed to talk about medication, so they cannot help the family doctor in terms figuring out that hey you might want to try stimulants. Unfortunately, many psychiatrists, especially older ones, are also not too aware about ADHD, and will often misdiagnose as bipolar or BPD. So the clinician is put in a tough spot. This is what happens when bureaucracy wins over common sense. The bureaucratic reason for all this is to safeguard "evidence based practice": so they say you need to go according to existing practice guidelines and existing research. While this is reasonable: everything has a point: when something does more harm than good/is too literal, maybe it is time to loosen up the rules. Because this will make clinicians' hands tied and unless they complete a research study themselves, which is not a practical possibility for most clinicians, they cannot do anything else about this.

And similarly, the bureaucracy is trying to protect patients by not having those without adequate relevant education talk about medication, but again, when this goes too far, it can hurt, not help patients. I mean is it really bad if a psychologist with their experience and seeing these patterns symptoms gently, without prescribing or telling anyone to take or get off a certain medication, says things like "given your history/symptoms you might want to try stimulants under supervision of a prescribing professional" or "yea, taking those benzos every time you feel anxious or panicky is kind of against the principles of exposure therapy... you might wanna bring that up with your prescribing professional who does not understand this". So the clinician has their hands unnecessarily zip tied, and who suffers is the patient.

For example I have been saying this stuff about for ADHD a long time. Now there is one study that backs it up:

https://www.psychologytoday.com/au/blog/brain-curiosities/202604/new-study-finds-that-adhd-has-9-categories-of-symptoms

Does this mean that if observations based on logical reasoning and seeing patterns after years of practice were automatically wrong and only become true once a study has been administered? What would have been the harm in trying stimulants quicker for someone on the suspected basis of ADHD?

u/Hatrct — 2 days ago

▲ 11 r/DeepThoughts

Market freedom paradoxically infringes upon most people's freedom.

We live in a neoliberal system. Basically, using the excuse of liberalism and freedom, it is said that there should be a free for all, and that anybody impeding this is against freedom.

But an important piece of the puzzle is missing here: start point. People start at different points.

The same politicians who claim they champion freedom and liberalism and women's rights for example, are the ones oppressing the middle/working class, aka the majority of the population, by giving unlimited freedom to the rich-born.

Would it be fair for a woman to face a man in a boxing match?

So why is it fair for those who are born into massive privilege to build on that privilege without any restraints? How can those who are not born into privilege get ahead like this?

The rich have an advantage in virtually all domains of life. They can afford better healthcare, education, shield themselves from problems using money, and even influence the outcome of elections. Is this freedom? For who?

So this all or nothing dichotomous definition of "freedom vs non freedom" is a simplistic notion that is not reflective of reality.

Some may argue that there will never be perfect equality. This may be true, but we passed the reasonable extent don't you think? There should be at least some solutions, such as increased taxes on the rich.

This concept has gone too far. For example, in the USA, there is a massive fetishization of the word "freedom". There is a huge crowd who fear the government and think we need to limit the power of government otherwise it will turn into a tyranny. But the paradox is that in doing so, you are building an even bigger tyranny: a society in which private capital practically has more control than the government and they have zero accountability to anyone. Even the most tyrannical governments have at least some accountability to people.

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u/Hatrct — 5 days ago