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Nederlog

September 14, 2012

B12-Protocol | Psychologist with M.E. | Statistics and medicine


Sections
Introduction
1. M.E. + my eyes
2.


Introduction:

This is a copy from the orginal to NOTEBOOK. I insert the copy here for ease of reference - the idea being that Nederlog 1012 continues after August with NOTEBOOK, which is easier to maintain for me, because of the problems with my eyes that started in May 2012.



1. On my eyes and the B12 protocol and M.E.

My eyes are still not worth much, as before. I have stopped my B12 protocol now for 5 days, for which see Nederlog of 2012, but it does not seem to make a noticeable difference.

The diagnosis in my case is keratoconjunctivitis sicca, as part of Sjoegren's Syndrome, for which see the internet. There is some help with Duratears, but so far no cure.

Incidentally,
Sjoegren's Syndrome is prevalent in M.E. but then both are diseases or syndromes of unknown cause, in real medical science. In psychiatric pseudoscience at least  and probably indeed like any disease, ailment or problem is declared to be a psychiatric ailment: "psychosomatic", "somatoform disorder", etc. and especially so when the disease is not in the medical handbooks, or not quite clear, or the patient is not absolutely average in almost all respects.

2. On being a psychologist with M.E.

As it happens, I am a psychologists who fell ill on Jan 1, 1979, with Epstein-Barr, in real medicine the most common precursor of
M.E., as did my then wife. We remained both together and ill till 1984, when we divorced so as not to go both to pieces from no help and medical discrimination. Nevertheless, eventually we both finished our studies (psychology) with an M.A. degree, which in my case was excellent.

What conceivable reason did she or I have to claim we are ill?!.

We were very happy, we lived together only since 5 months, having a student flat for couples; we were in the first year of our university studies; we were both very intelligent and could expect an excellent career; and being ill, in any way, was very much against our interests and desires.

In brief: There was no rational empirical reason whatsoever for us to pretend to be ill or to falsely believe to be ill, other than that we really fell ill - eventually with a disease that real medical science does not have bio-markers for.

Thhen again, such bio-markers do exist for Epstein-Barr, which is what started our problems, that then never disappeared - indeed as if we both got stuck somewhere between being quite ill with Epstein Barr and recuperating from it, for some reasons medical science has not found, and will never find unless and until it starts to take people with M.E. serious and scientifically  researches their problems - and not by the pseudo-science that is psychiatry, but by real medical science.

What
conceivable reason do psychiatrists or medical doctors have to claim she and I were not ill with a real disease but ill with an imagined disease, namely one due to our "dysfunctional belief systems"?!

Firstly, psychiatrists have an obvious monetary motive, they always refuse to discuss, even if it is THE reason they are in medicine as professionals: It adds patients to their kind of heallth professionals or to themselves, and thereby incomes, and also easy and safe incomes, for people with M.E. are much easier to (mis)treat and much safer to deal with, than are schizophrenics, melancholics, manic depressives and almost any other kind of clearly insane, difficult but physically healthy  people. There is not much of a danger in telling a really ill person he is not really ill: He can't beat you up for behaving like a cruel bastard! He lacks the energy to go to court for medical malfeasance!

Besides, medical folks in general seem to find it hard to admit that they simply do not know things, quite unlike Hippocrates, who literally said:

and quite unlike the principle "First do no harm", or as he himself put it literally and even better:

"The physician must...have two special objects in view with regard to disease, namely, to do good or to do no harm" (Bk. I, Sect. 11, trans. Adams, Greek: ἀσκέειν, περὶ τὰ νουσήματα, δύο, ὠφελέειν, ἢ μὴ βλάπτειν).

that is in dire need of the supplement "Second do not pretend to know when you do not know":

Most medical doctors seem to like to label one's complaints somehow, by some label in their textbooks, rather than honestly and simply admit "sorry - I don't know" - which in fact is in very many cases, also outside medicine, the most rational answer to many questions and also often is the most honest and most moral answer.

Secondly, note that - effectively - the claim by anyone that you are insane or malingering or incapable of rational thought (viz. you are a "hypochonder", "neurasthenic", "psychosomatic", "somatoformer") is slander, defamation and character assassination, and an offense against one's human and personal dignity, especially if all the evidence there is for it, as was true for of my ex and me, was that we claimed to keep feeling ill - muscle aches, very little energy, unable to walk for more than a few hundreds of meters, not being able to stand for more than a quarter of an hour, always tired - while there were no standard tests that revealed a known illness. Also we did that in a situation - students on a loan - in which being ill had no advantage for us whatsoever, and very many problems, such as being unable to attend lectures, examinations and practica. (In fact, we did these nevertheless, but indeed with great difficulties, and not always at the first or second opportunity, because we then were too ill to do so.)

Now it ought to be obvious, although many doctors behave and speak as if they pretend to themselves, and certainly to others, that they have both a very firm claim on great personal moral integrity and on almost perfect medical diagnostic skills, that this can't be really true in general, and that, besides there are good reasons to assume that if the person who is slandering and defaming one looks, talks and behaves as an arrogant medical doctor that he or she may have started to study medicine because that is precisely the one profession that much appeals to conscious, half-conscious and unconcious intelligent sadists


Claiming persons who are ill are only mentally diseased provides the psychiatrists with income with promises to cure; it provides other medical doctors the flattering delusion that they are omniscient, and can positively diagnose any complaint they do not know how to diagnose from their textbooks as if "therefore"  it "must" have a psychiatric cause, and then to proceed letting the patient get socially and financially destroyed.

For one of the most easily foreseeable common social consequences of medically labelling a patient as a "somatoformer" is that, therefore, all sorts of help ill people do get will be denied to them, by bureaucrats, health insurances, and indeed also often friends and family: "The doctor says you're mad - who are you to presume to know better?!"

And as I said, it gives persons with a medical or psychological degrees who very well may have a - possibly unconscious -
sadistic inclination all the joys of hurting and harming others, and of getting paid for it as well, and of not being found out and not being contradicted because they are supposed to be medical or psychological authorities, what with their degrees.

This is the more plausible as an explanation for the behavior and opinions of quite a few (though certainly not all) medical folk I have seen because of my M.E. since the followng alternative is or ought to be obvious to anyone with any rationality, and any decent morality, such as any medical doctor and any psychologist fit to practive must have:

Either say one does not know the cause of the patience pains and lack of energy, if that patient is not manifestly insane, as the vast majority of persons with M.E. - there are estimated to be more than 15 million of them - is not, or else do some serious reading, e.g. in the material in my  M.E.-resources, do a proper medical and personal diagnosis of a patient with the symptoms of M.E., and not one consisting of 10 minutes of mere talk, and make a medical diagnosis to the effect that either that the patient is really ill but of an unknown disease or
that the patient has M.E. and indeed is ill.

That is realistic, rational moral medical science, that conforms to the medical and moral principle of "First do no harm".

Any
other medical diagnosis of persons with the symptoms of M.E. (<- medical diagnostic tools in pdf, by 14 medical doctors) and without evident known psychiatric ailment (and indeed possibly with: There even are psychiatrists with M.E. (<-a book in pdf by such a one) is bound to be sadistic, consciously or unconsciously, and especially so since the  person making the diagnosis (i) should know and usually does know that it will do much harm the patient, and (ii) is clearly on the medical and financial principle of "We're only in it for the money", while (iii) it is  clearly not behaving as a good and moral medical doctor should - "First do no harm" - but as a fraud, who pretends positive knowledge where he or she has none, and who abuses a medical degree, for money, for kicks, or because of indifference to the predictable and occurring suffering of patients.

For a real medical scientist who is moral and who is not out to harm people, and who is not out to denigrate them, or to pretend knowledge where he or she has none, and who is not somehow compensating secretly for harm done to him or her, has no intellectual or moral reason to abuse his or her medical authority to slander and denigrate persons, and to stick rationally unfounded psychiatric labels on them that trivialize their suffering and that make it socially impossible to get the help ill people are entitled to.

Whoever labels a person with the symptoms of M.E. or fibromyalgia, who does not show evidence of serious delusions or socially dangerous  practices  as a psychiatric case and who has a medical or psychological degree is a dangerous incompetent or a dangerous liar, who behaves as a sadist, though he or she may not know this or choose to deny the evidence.

So yes, being a psychologist myself, who never could do anything with his excellent degree in psychology (for that is what it happens to be: I do have the degrees that would have gotten me a university career had I been physically healthy, and I got my degrees while being ill with M.E.):

It seems to me that most medical doctors I have met because of my complaints with M.E. were dishonest, incompetent or sadistic, and must all have known that they were lying when they said it must be "psychosomatic" if they were not able to explain it otherwise - indeed unless they were themselves quite deluded about their motives to be in their profession.

And to finish this diatribe, based on 34 years of nearly continuous pain without effective help - in which indeed I also have met some good doctors, who did not lie, and did not pretend to have positive knowledge they knew or should and could know they did not have:

The diagnosis that one's physical suffering - for that is what my ex and I complained of - is "psychosomatic" or  "psychiatric" is a lie or an article of quasi-religious faith that is both immoral and unscientific, and no more   "rational" than the claim that
one's physical suffering is caused by ones sins and the devil.

Also, in the case of my ex and myself, and in the case of millions of others with complaints like us, indeed also regularly with excellent university degrees, and also sometimes themselves psychologists, psychiatrists, orn medical doctors, the very bitter fact is that ALL the medical folks that diagnose on as "psychosomatic" did so on the basis of NO research whatsoever, or only on the basis of some standard blood tests, without ever trying to find out more than a brief diagnostic consultation in the doctor's own practice could produce "in evidence":

It is like being judged a mad sinner by a priest in the Holy Church Of Psychiatric Medicine, on the ground that one does not believe as the one who is verbally, socially, personally and medically abusing one.


It is an abuse of medical authority in the case of medical doctors, for they cannot possibly know that they know all there is to know about all possible diseases, and they can and usually do know that their diagnosis that one is "a somatoformer" will in effect put one on the social rubbish heap of those who deserve no help because they brought their probllems on themselves by
dysfunctional belief system". It is clear and manifest sadism that is in evident clear confllct with the moral duty of a medical doctor to "First do no harm".

Indeed what one finds, if one has years or decades of M.E. without any help and with many insolent defamations of one's character, personal integrity, intellectual abilities, and human dignity is that a part of medicine  and most of psychiatry is much more like Edgar Allan Poe´s clinic of Dr. Tarr and Professor Feather than like real medical science that "First does no harm": In psychiatry all too often the madmen and the sadists run the asylums and make the diagnoses.
(See: Rosenhan-experiment, and Dr Ewen Cameron.)(

For it pays well, it gives many kicks, for those who like those things, perhaps unconsciously, and the perpetrators can prance around as "medical" or "psychological" authorities because they have a degree of that kind, and most of their victims do not:

"The mild and the long-suffering may suffer forever in this world. As long as the patient will suffer, the cruel will kick."
-- Sidney Smith


And especially if it pays a medical, psychiatric or psychological fee.

 
3. On statistics and medicine

"There are lies, there are damned lies, and there is statistics."

I think the saying is Disraeli's, and my eyes are too problematic to check it. In any case, it is a fine saying and a real insight: Few techniques have been as much and as subtly abused to mislead, misrepresent, or indeed outright lie as statistics.

The reason is mostly that if well and honestly used, statistics are powerful techniques for summarizing many data to useful abstracts from the data, and also powerful techniques for testing hypotheses, but precisely because they are mathematical and summary and, as regards to hypotheses testing subtle and difficult to understand fully, or to refute easily, on the basis of relevant knowledge, they are very easy to abuse.

Besides, they are quite often abused unintentionally: Most social scientists, including psychologists, may have had some education to do statistical hypotheses testing, but then that is of the cook book variety, that is, without understanding the real thing, mathematically and methodologically, while applying recipes and rules from their introductions to statistics.

Here are six points about statistics, that are not as widely known and appreciated as they should - and I speak as one who has been reading and studying rather a lot in the foundations of probability theory and statistics, because these mathematical techniques are interesting, if well and honestly applied very useful, and sometimes revealing in ways no other treatment of data could produce, and also independently interesting as mathematics or as techniques of human reasoning.

(0) The foundations of both probability theory - regardless from its applications - and of statistics are in many fundamental respects quite unclear and unclarified.

This is a basic fact any serious student in the subject of probability theory knows, and I may restrict myself to that, because statistics is applied probability theory, and is the reason there are many different conceptions what probability is, and how probability should be used for the purpose of statistics.

Those who want to know more about this, and have some understanding of mathematics, should consult T. Fine, "Theories of probability".

(1) Statistical distributions in general are based on assumptions of independence that are introduced for mathematical convenience but may not be true in fact.

The general point is that to do it without independence is mathematically impossible. This may often be innocuous - a somewhat misfitted statistical distribution is a lot more useful that none at all, as with maps of territories - but that is the fact. (There are quite a few distributions, and the mathematical wizardry involved  varies. They all involve assumptions, that may not hold in fact, rather as with Euclidean geometry.)


(2) Medical statistical distributions - I found to my dismay - seem to be modelled after mathematical distributions, that do empirically hold, or mostly so, for simple invariant physical things, like iron balls dropped in Galton boards, that tend to neatly conform, on statistical average (!), to what they should be mathematically. Idem with shuffling playing cards, and drawing balls from urns.

The main reason this is the case is the cook book approach all sciences that are not thoroughly mathematical rely on to teach statistics to their students - which also is hardly avoidable, save for a few with real mathematical interests and real mathematical competence - and even then both of the previous points remain true.

One problem with (3) is:


(3) In living things all sorts of internal processes are interdependent in all sorts of ways and strengths.

So... when I read, as I did, that (paraphrasing) "the statistics were quite good, with a sufficient sample of 37 patients", I am feeling a bit flabbergasted: Even if indeed this is the best they can do, mathematically, the assurance they feel is totally unjustified, since in fact the mathematical sufficiency is based on a mathematics that is at best known to be true of simple invariant things like nearly identical iron balls.

Since there are very many possible reasons why living things may vary a lot in their behaviour in similar circumstances, due to their having partially unique constitutions or experiences, one needs larger samples than are fit in the study of nearly identical balls, and their averages and spreadings in various conditions.

The above also applies to the crazy stories on 1 boring old man's site about the statistical research done on the newer anti-depressives, except that these seem also to be intentionally flawed, sometimes at least. (Or else the statistics that are published are only reported if significant, and not if not, which also is - very common - fraudulence: To get at the truth one needs the outcomes of all proper empirical tests, and not just those that support a theory or a product.)

Also, apart from fraudulence, data manipulation and mathematical problems, statistical testing tends to test a hypothesis ("something is so and so") against a null hypothesis ("everything is distributed as per a known standard distribution") in terms of 1 in 10 (90%), 1 in 20 (95%), or 1 in a 100 ("99%" - "virtually certain" in social science land), normally meaning that what is found in fact, fits in the presumed distribution, in those fractions of cases. (This is what "level of significance" tends to mean in these contexts: That no more than 1 in 100, 1 in 20, or 1 in 10 satisfy the distribution that is assumed as normal, and that therefore, as - say with the XMRV-statistics, in 2009 - if in (reported) fact 2 out of 3 of those in the sample show what would be so only in 1 in 10 or 1 in 20 cases if the theory was false,  one has "a significant finding", and a ground to believe the theory has been supported by the facts that were found: 2 out of 3 as per the theory, or 1 out of 20 if the theory is not true.)

Apart from the shortcomings mentioned so far, this kind of testing is often done poorly, and the tests used may not at all be the best kind of tests for those data or subjects to get at the truth. Also, the levels of significance used may be - and usually are - not adapted to the importance of the applications of their theoretical results if the theory happens to be false: If - say - the results are signicant on one of the levels mentioned, which are those typically used, the value of the case of failure may be quite extreme, and especially so in medical cases.

If you don't know what Softenon is, a search on the internet will show you what horrors "mathematically sufficient statistics" may lead to.


Then again, as I said before, but as bears stressing in view of e.g. the Softenon drama and the importance of safe and effective medicines for patients, especially if the medicines they are prescribed are highly profitable to their producers and these days also quite often to the doctors who prescribe them, for a percentage:


(4) one must realize that especially social scientists, but also medical folks, rarely really understand the statistics they use, and that especially the social scientists usually want "a significant result" (i.e. one of the above three), to have a publishable paper.

Indeed, in fact the mathematics at the basis of statistical testing is quite sophisticated, not at all easy, not at all explained for social scientists, and in fact, because of (1) and other reasons, much more doubtful than most folks using these tests are aware of, even if they are totally honest, and worked by the book, as well as they could.

And besides, social scientists and medical researchers tend to be interested far more in getting and publishing significant results rather than publishing the statistically non-signifiicant but logically quite important results their statistical tests of their hypotheses yielded.

That is to say:


(5) In psychology and sociology, at least, often distributions and tests are used that are not the best for the case at hand mathematically or methodologically, to find out what is really the case, but to get a publishable paper.

I have seen this myself both in published papers, and also in actual fact, where I have heard psychologists researching education in school children in Holland repeatedly say "Let's throw a chi-square over it, to get a significant result" - and this chi-squared test is indeed a statistical distribution and test that is prone to show "significant" results, also where that may be of no factual significance.

This happened in Amsterdam, in the Kohnstamm Institute in 1978, supposedly a high-reputation institute. It was clear intentional fraud, and was the first example of this that I saw and heard in psychology. I worked there then as a typist, having been removed for the first time from the university, because my grant was withdrawn, because the study adviser of philosophy had advised me wrongly, probably on purpose: He was a queer freak in all senses of that term, who for some reason hated me from the beginning, and who also had advised me "mistakenly" the year before, which led to my missing a grant, thus forcing me to accept a loan.

The psychologists working in that institute, who were freely effectively admitting fraudulence - using tests likely to be significant, rather than tests likely to reveal what is true - in my hearing, thought I was a mere typist, but I was then already thwn statistically and methodologically savvy, being interested in these things since 1971, and having read up on them for that reason: I knew about chi-squared tests, and their proneness for "significant" flukes, from the literature, as they also must have done.

Indeed, it is for reasons like these, of which I later saw more examples, plus the fact that I did not get in my academic education in psychology anything as remotely as good as William James's "The Principles of Psychology", which originally moved me to the study of psychology, given also my basic interest in understanding human reasoning since I was 15, having then decided this must be the most interesting subject since reasoning is what  makes human beings so special, that already in the first year of my university study of psychology convinced me it is not a real science.

Having begun, I took the B.A., since the study was also remarkably easy for me, and the reason I did take also the M.A. is that I was removed from the study of philosophy briefly before taking my M.A. in that, because I asked questions that the folks who had the power in the University of Amsterdam did not want to hear posed nor honestly answer.

And so it went...

---

Maarten Maartensz


P.S. My eye problems



                  PS: Any necessary corrections have to be made later.