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Cross-cultural psychiatry
March 14, 2009 12:34 AM   Subscribe

West treats East. "To help traumatized Tibetan monks, doctors in Boston turn to cross-cultural medicine." [Via]
posted by homunculus (16 comments total) 2 users marked this as a favorite

 
The Web turns 20 -- in the sidebar -- was a lot more interesting read.
posted by RoseyD at 1:50 AM on March 14, 2009


Every one of my reincarnations was due to post traumatic stress disorder.
posted by twoleftfeet at 3:00 AM on March 14, 2009


Is it me, or is there basically nothing here about the efficacy of Western medicine alone? Both articles appear to me to say "Eastern practices weren't working, so we added some Western practices, and bam! Health." There seems to me, at least, to be a step missing at the end.
posted by Pope Guilty at 4:21 AM on March 14, 2009


hey, you know what's really cool here? You can get a free online sample of the journal they cite. Go here: http://www.informaworld.com/smpp/title~content=t713437783~tab=sample~db=all

Enjoy!
posted by Lipstick Thespian at 7:06 AM on March 14, 2009


"Error: Username/password combination was not recognised."

Can't register.

Hmm . . .
posted by RoseyD at 7:16 AM on March 14, 2009


What would be really interesting would be if they took these findings and applied them to non-Tibetan patients as well. I'm sure there are plenty of people with PTSD who could use some help with their "life-wind."
posted by grapefruitmoon at 9:26 AM on March 14, 2009


I have a great deal of contempt for medicine which is not based in science.
posted by kldickson at 10:27 AM on March 14, 2009


I have a great deal of contempt for medicine which doesn't heal. This seems like the right approach for this patient, considering his background and what he's been through.
posted by homunculus at 11:33 AM on March 14, 2009 [3 favorites]


What counts as science?
posted by voltairemodern at 3:49 PM on March 14, 2009


I have a great deal of contempt for medicine which doesn't heal.

I think everyone has this goal. The problem is, as Pope Guilty pointed out, we don't know what's doing the healing here. If the Eastern rituals are indeed giving psychological comfort to the patients, of course that's good and worth looking into. But it doesn't imply that those rituals or other traditional practices actually work as anything beyond a placebo. This is the problem (from the second link):

According to the researchers, in order to provide complimentary therapy for the monks, eastern and western medicine needed to be integrated to properly address both conditions. The spiritual aspect of the Tibetan medical model, which is at the core of the monks’ experience of illness, guided this research.

It is important to understand the patient's beliefs concerning medicine, and implement your care in a way that comforts them. But the first sentence seems like the wrong lesson, that you're *integrating* Eastern and Western medicines as if they were entirely equally effective approaches instead of what seems to have been done here, which is using the Eastern concepts to help patients recover with Western medicine. These traditions might have value beyond the placebo effects they provide, but until they have been rigorously studied and those effects identified, care should be taken not to seem to legitimize them as valid alternative medicine.
posted by Sangermaine at 5:06 PM on March 14, 2009


It doesn't imply that those rituals or other traditional practices actually work as anything beyond a placebo.

Hey, it's hard to find a good placebo. Sugar pills don't work for everybody. Finding a bag of tricks that works well for a big group of people is a legitimate medical discovery. Per homunculus, I have a great deal of respect for any medicine which heals.

(and let's face it, psychiatry itself is still little more than a grab bag of tricks, at least until we get another generation or two of brain science under our belts. We kinda understand some problems -- a big improvement over anything in human history -- but there are other problems we're not even sure how to categorize.)
posted by justsomebodythatyouusedtoknow at 5:43 PM on March 14, 2009


These traditions might have value beyond the placebo effects they provide, but until they have been rigorously studied and those effects identified, care should be taken not to seem to legitimize them as valid alternative medicine.

That's a good point, and in other fields of medicine I think it's imperative to do that research, but I don't think it matters as much in this context. If combining cognitive behavioral therapy with singing bowl therapy works best for treating their PTSD, then by all means use them both (and like justsomebodythatyouusedtoknow said, it gets kinda tricky saying which one is the placebo anyway).

One of the things I found most interesting (though not really surprising) about this is that meditation by itself actually seemed to make things worse. Since meditation is being used more and more in therapy these days, it's important to know when to use it and how.
posted by homunculus at 8:47 PM on March 14, 2009


How do these two opinions not contradict each other, homunculus?

in other fields of medicine I think it's imperative to do that research, but I don't think it matters as much in this context

meditation by itself actually seemed to make things worse... it's important to know when to use it and how

posted by jacalata at 10:58 AM on March 15, 2009


It's the difference of whether a therapy is merely a placebo versus a therapy being potentially harmful. In the first case, I was talking about the possibility that some of these practices, like the singing bowl therapy, are just a placebo effect, and that it doesn't really matter for the patient's treatment if that's the case. It's another matter if there's evidence that a particular practice might actually do the patient harm, but there was no suggestion that the singing bowl therapy or the Tai Chi and Qi Gong exercises were doing any harm.

In the second case I was referring to the samatha style of meditation which the monks do, which is a distinct practice. This kind of meditation is often quite calming, but under some circumstances it can be harrowing (I'm no monk, but I've been on a few meditation retreats, and it can be emotionally demanding). So for this patient that kind of meditation by itself isn't appropriate right now. That may not mean it should be completely abandoned; it might be fine in conjunction with talk therapy and/or medications, or maybe it should be put on hold until patient has recovered more. Therapists often have to tweak their patients treatments for awhile until they find the right mix of therapies tailored to the patient.

So I think that if there's evidence of harm, then yes, it is important and needs to be addressed quickly. If there's no evidence of harm and the only question is whether it's just a placebo, then I don't think it's as much of an issue.
posted by homunculus at 11:53 AM on March 15, 2009


Is psychiatry a religion?
posted by homunculus at 10:36 PM on March 16, 2009


NPR Fresh Air: Dr. Michael Grodin discusses his experiences treating Tibetan monks who suffer from post traumatic stress disorder.
posted by homunculus at 12:06 AM on April 3, 2009


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