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Psychiatry, as a subspecialty of medicine, aspires to define mental illness as precisely as, let’s say, cancer of the pancreas, or streptococcal infection of the lungs. However, given the complexity of mind, brain, and human attachment systems, we have not come even close to achieving that sort of precision. Understanding what is “wrong” with people currently is more a question of the mind-set of the practitioner (and of what insurance companies will pay for) than of verifiable, objective facts.

The forward to the landmark 1980 DSM III was appropriately modest and acknowledged that this diagnostic system was imprecise. So imprecise that it never should be used for forensic or insurance purposes. As we will see that modesty was tragically short lived.

The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems. Over the past three decades psychiatric medications have become a mainstay in our culture, with dubious consequences. Consider the case of antidepressants. If they were indeed as effective as we have been led to believe, depression should by now have become a minor issue in our society. Instead, even as antidepressant use continues to increase, it has not made a dent in hospital admissions for depression. The number of people treated for depression has tripled over the past two decades, and one in ten Americans now take antidepressants.24

The foreword to the landmark 1980 DSM-III was appropriately modest and acknowledged that this diagnostic system was imprecise—so imprecise that it never should be used for forensic or insurance purposes.8 As we will see, that modesty was tragically short-lived.

The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems. Over the past three decades psychiatric medications have become a mainstay in our culture, with dubious consequences.

Some lives work better with routines, and Liv Halston's is one of them. Every weekday morning she rises at seven thirty am, pulls on her trainers, grabs her iPod, and before she can think about what she's doing, she heads down, bleary-eyed, in the rackety lift, and out for a half hour run along the river. At some point, threading her way through the grimly determined commuters, swerving round reversing delivery vans, she comes fully awake, her brain slowly wrapping itself around the musical rhythms in her ears, the soft thud-thud-thud of her feet hitting the pavement. Most importantly she has steered herself away again from a time she still fears: those initial waking minutes, when vulnerability means that loss can still strike her unheralded and venal, sending her thoughts into a toxic black fog. She had begin running after she had realized that she could use the world outside, the noise in her earphones, her own motion, as a kind of deflector, Now it has become habit, and insurance police. I do not have to think. I do not have to think. I do not have to think.

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Children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines. These medications often are used to make abused and neglected children more tractable. In 2008 19,045 children age five and under were prescribed antipsychotics through Medicaid.

Over the years Jim had heard, and more often overheard, objections to the Program’s expanding practice: Many people who worked and paid taxes struggled to pay for health insurance. Why should their money go to providing what some would consider concierge medicine for these people who lived at public expense? For people who produced nothing except indecent public spectacles, and didn’t even try to take care of themselves? Heard from inside a shelter clinic or McInnis House or out on the van, such protests seemed irrelevant. What was the alternative? Ignore chronically homeless people, as the city used to do, or imitate draconian regimes and imprison all rough sleepers in a stadium? In fact, the Program lightened the burdens that homeless people placed on other medical organizations, and did so while providing good care at lower cost than in hospital emergency departments.

What saves me is people. Strangers. Old women. Shopkeepers. Young lovers and milkmen doing their rounds and window cleaners with ladders fixed on top of their vans. Individuals oblivious to one another and yet, in a way, they act like insurance. An invisible web. Nothing too bad will happen on the street of a small town like this because people are everywhere. If something heinous occurs, then it's likely to be short-lived. Terrible acts are more difficult to conceal in a place like this. Someone will eventually step in or call the police. Horrors can still take place, but people look after people even though they might never think of it that way.

Since then the field of neurofeedback has grown by fits and starts, with much of the scientific groundwork being done in Europe, Russia, and Australia. Even though there are about ten thousand neurofeedback practitioners in the United States, the practice has not been able to garner the research funding necessary to gain widespread acceptance. One reason may be that there are multiple competing neurofeedback systems; another is that the commercial potential is limited. Only a few applications are covered by insurance, which makes neurofeedback expensive for consumers and prevents practitioners from amassing the resources necessary to do large-scale studies.

I have come to realize that psychiatric medications have a serious downside, as they may deflect attention from dealing with the underlying issues. The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems.

him about the proposed change in name. He thought it sounded like nonsense then and hadn’t changed his mind yet. ‘To answer your question though, I think it will depend on how many other crimes they are able to sew up with this discovery. All the different piles of goods in there might each represent a separate reported theft. They could clear a list of crimes and, if they are finding fingerprints or other physical evidence, they might be able to catch multiple criminals. They’ll be trying to find Karl Tarkovsky, but I doubt he’s in the country. I reckon he took the van full of Stilton and fled, getting across the channel before anyone even had a chance to report the van stolen, let alone the cheese.’ ‘I’m sure you’re right,’ Dave agreed. ‘It’s a shame for the festival. And for the dairy, but they’ll recover sure enough. The insurance will pay for it and it’s not like suppliers can go elsewhere to get it. Stilton isn’t Stilton if it’s made by anyone else,’ the security guard said knowingly. He lapsed into silence and neither man spoke for a moment. It became an awkward silence after about ten seconds, at which point Dave said, ‘Well, must be off. Goodnight.’ ‘Goodnight,’ Albert called after the man as he vanished into the dark again. It was good of him to check on Oxford, especially given the day he’d had. Albert watched the police working in the lockup for a few seconds as he continued to chew over the misalignment of clues in his head. The counterfeit note didn’t fit. In fact, the only way he could make it fit, was to assume it appeared in Karl’s room out of pure coincidence, and he didn’t like that at all. Unable to shift the feeling that he was blind to the truth, he turned around and started back towards the pub. Perhaps a gin and tonic to help him sleep was in order. The imagined taste hastened his steps, but he might have walked faster yet had he known what waited for him in the bar.

Half a million children in the United States currently take antipsychotic drugs. Children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines.

As long as our frontal lobes are working properly, we’re unlikely to lose our temper every time a waiter is late with our order or an insurance company agent puts us on hold. (Our watchtower also tells us that other people’s anger and threats are a function of their emotional state.) When that system breaks down, we become like conditioned animals: The moment we detect danger we automatically go into fight-or-flight mode.

The preamble to the DSM-III warned explicitly that its categories were insufficiently precise to be used in forensic settings or for insurance purposes.

Being able to hover calmly and objectively over our thoughts, feelings, and emotions (an ability I’ll call mindfulness throughout this book) and then take our time to respond allows the executive brain to inhibit, organize, and modulate the hardwired automatic reactions preprogrammed into the emotional brain. This capacity is crucial for preserving our relationships with our fellow human beings. As long as our frontal lobes are working properly, we’re unlikely to lose our temper every time a waiter is late with our order or an insurance company agent puts us on hold. (Our watchtower also tells us that other people’s anger and threats are a function of their emotional state.) When that system breaks down, we become like conditioned animals: The moment we detect danger we automatically go into fight-or-flight mode.

Growing up, there were two small letters that sent chills down my spine: PE. Physical Education class was the bane of my awkward, prepubescent existence. The moment I walked into the musky locker room to change, my heart would start to pound. As I surreptitiously tried to change without flashing an inch of skin (sometimes even wearing a second bra as insurance) I would desperately search for any excuse to escape the daily drills and dodgeball games. Paper cut? Haircut? Apocalypse? I tried them all. Looking back, I realize I liked playing outside. What I really dreaded was the moment my coach said, “Line up, let’s pick teams!” Inevitably, the two jockiest kids were assigned as team captains, and then I spent an agonizing few minutes watching them go through my entire class before picking me or my fellow nonathletically inclined buddy, Smelly Matthew. Then one day, my elementary school social life changed. Our coach decided to allow the new girl to be team captain. She had just transferred from a nearby school and didn’t know anyone. In one of the greatest moments in PE history, she picked me first! I was so excited that I ran over to her and then held her hand while she picked the rest of our team. I think we lost in soccer that day, but I was on top of the world. After the game I asked her why she picked me. And then she said one of the greatest things anyone has ever said to me, “I wanted to get to know you.

Between taxes and liability insurance and this and that, we ain’t in it for the money, man … we’re out there for one guitar chord, one note, one beam of light in somebody’s mind. We travel 600 miles a day to do it. It’s not the money.

Batteries, Bug repellent, Belts, Bags , Barbecue equipment, Boots, Bath towels. Bikes, Bike rack. C - Cash and credit cards, Cell phones & chargers, Camera and film/memory cards, Coffee pot, Can opener, Cups, Cutlery, Computer, Clock, Cleaning utensils, Clothes and coats, Camping Guides, Condiments (salt, sugar, pepper). D - Dishes, Drainers, Disinfectant. F - First Aid kit, Fire Extinguishers G - Glasses, (drinking, reading, sun), Games. H -Herbs, Hair brushes, Headphones. K -Keys (house, RV, Lockers), Kindle & cable, Kitchen Gadgets. M - Medication. Money belts, Measuring implements, Maps, P - PERSONAL DOCUMENTS: Passports, Health Certificates, Insurance, Driving License, RV documents, Power adapters, Pens, Pets:

Never put up your personal insurance card on an organizational van rental unless you personally wish to pay for all the damages that occur. Both the rental firm and your organization may leave you holding the bag for the entire vehicle value plus downtime caused by damages.

Craig Says…” Do you have the proper insurance for renting vans? It’s called liability for non-owned and hired vehicles with a clause for physical damage?

The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems.

Children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines.

Noel, I want you to see if you can get me paternity insurance,” he said not long after Edward’s troubles. “Paternity insurance? David, I don’t think there is such a thing.” “Well, there should be. Look into it. I need to protect my penis.

As long as our frontal lobes are working properly, we’re unlikely to lose our temper every time a waiter is late with our order or an insurance company agent puts us on hold.

After conducting numerous studies of medications for PTSD, I have come to realize that psychiatric medications have a serious downside, as they may deflect attention from dealing with the underlying issues. The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems. Over the past three decades psychiatric medications have become a mainstay in our culture, with dubious consequences. Consider the case of antidepressants. If they were indeed as effective as we have been led to believe, depression should by now have become a minor issue in our society. Instead, even as antidepressant use continues to increase, it has not made a dent in hospital admissions for depression.

Half a million children in the United States currently take antipsychotic drugs. Children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines. These medications often are used to make abused and neglected children more tractable.

Ordinarily the executive capacities of the prefrontal cortex enable people to observe what is going on, predict what will happen if they take a certain action, and make a conscious choice. Being able to hover calmly and objectively over our thoughts, feelings, and emotions (an ability I’ll call mindfulness throughout this book) and then take our time to respond allows the executive brain to inhibit, organize, and modulate the hardwired automatic reactions preprogrammed into the emotional brain. This capacity is crucial for preserving our relationships with our fellow human beings. As long as our frontal lobes are working properly, we’re unlikely to lose our temper every time a waiter is late with our order or an insurance company agent puts us on hold. (Our watchtower also tells us that other people’s anger and threats are a function of their emotional state.) When that system breaks down, we become like conditioned animals: The moment we detect danger we automatically go into fight-or-flight mode.

Keep the faculty of effort alive in you by a little gratuitous exercise every day. That is, be systematically heroic in little unnecessary points, do every day or two something for no other reason than its difficulty, so that, when the hour of dire need draws nigh, it may find you not unnerved and untrained to stand the test. Asceticism of this sort is like the insurance which a man pays on his house and goods. The tax does him no good at the time, and possibly may never bring him a return. But, if the fire does come, his having paid it will be his salvation from ruin. So with the man who has daily inured himself to habits of concentrated attention, energetic volition, and self-denial in unnecessary things. He will stand like a tower when everything rocks around him, and his softer fellow-mortals are winnowed like chaff in the blast. We are spinning our own fates, good or evil, and never to be undone. Every smallest stroke of virtue or of vice leaves its never-so-little scar. The drunken Rip Van Winkle, in Jefferson's play, excuses himself for every fresh dereliction by saying, "I won't count this time!" Well, he may not count it, and a kind Heaven may not count it; but it is being counted none the less. Down among his nerve-cells and fibres the molecules are counting it, registering and storing it up to be used against him when the next temptation comes.

Know who will be assuming the risk in advance. Talk to your insurance agent first and get informed as to exactly what will be covered when you rent vans. You have made an investment in your agent as your expert. Follow the advice given and do not deviate. While the decision to accept or decline the extra coverage products will ultimately be yours, you should arm yourself so that the rental firm cannot just sell you everything in their arsenal without you realizing it. Call the rental office in advance and get an explanation of the coverage products. Decide before pickup!

Children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines. These medications often are used to make abused and neglected children more tractable.

Insurance companies require a DSM diagnosis for reimbursement, until recently all research funding was based on DSM diagnoses, and academic programs are organized around DSM categories.

More people are probably run over each year by TV news vans.

Understanding what is “wrong” with people currently is more a question of the mind-set of the practitioner (and of what insurance companies will pay for) than of verifiable, objective facts.

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