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28 October 2008 @ 04:29 pm
Therapy vs. Drugs, Jealousy vs. Envy, Mistress Isobel  
In keeping with my new policy of putting my long-winded responses to Isobel Wren's videos on LiveJournal instead of YouTube, I'm responding here to the latest video, with reference to Samantha Grace's video from last week. I decided to use my own LiveJournal this time instead of the isobellezza community, but I'll link back from there.

Therapy vs. Drugs

From Samantha's video:
And another problem I have with the mental health system is that I think they tend to...just hand out medication way too freely, and sometimes I think people have bad reactions with medication and it just doesn't get noticed.
Which Kim (Kimberly Marvel, I think, sitting next to Samantha in the video) amplifies:
Well, with the medication, it's like putting a Band-aid; it's not solving the problem. You know. You just say it's like, "OK, well, you've got a problem. Here, take this to make you happy." You're not really making that person happy inside.
This week Isobel states her agreement:
I also totally agree that medicine is overprescribed. "Something wrong? Gee, dose 'em up. That way we don't have to deal with them." But also it's harder to fight your problems and work against it than to just medicate yourself. So I think it's kind of forgivable for people to want to be medicated, because that's a lot easier, but it's not that cool.
So here's my response:
Isobel, this makes no sense. Just last week you were talking about how psychotherapy is fucked up, because it's all based on Freud, and Freud was full of shit. Now you're saying that instead of prescribing so much medicine they should...what? Put people in psychotherapy?

Now, of course, since psychotherapy is not really based on Freud any more, it's a lot better than what you implied last week, but it's still no better than drugs, in general. They've done studies on this, and I'm not sure what the current conclusions are, but the general idea has been that both drugs and psychotherapy can work, individually or in combination, for different people. (Some do better with drugs, some with psychotherapy, and some with a combination.) Last time I checked there was no evidence to support the idea that psychotherapy has, in general, more lasting or more profound effects than drug therapy.

But the real issue is cost-effectiveness. Our economy is being totally eaten up by the cost of health care. If current trends continue, we'll eventually get to the point where half the people in the country are working in the health care industry. We need to limit costs whenever it's practical to do so. We just don't have the resources to give psychotherapy to people who would do just as well with drugs, or to try psychotherapy before trying drugs on someone who has a good chance of responding well to drug therapy.

And the idea that drugs are a way to avoid dealing with your problems is just totally wrong. It's a misconception that many people have. Perhaps based on the fact that recreational drugs often are a way to avoid dealing with problems. But generally, psychiatric drugs -- in cases where they are effective -- make it easier to deal with your problems, so you're more likely to deal with them. When people don't take medication, that's when they avoid dealing with their problems.
Samantha is right BTW that some people have bad reactions to medication, but I think it does get noticed. That's one of the main reasons, for example, that they keep developing new antidepressants -- because some people have bad reactions to the old ones. First there were MAO inhibitors, then Tofranil, then a bunch of other tricyclics, then Prozac, then a bunch of other SSRI's, then the SSNRI's, then all these crazy new things that they advertise on TV, which I don't know what the hell categories they're in. Anyhow, each new type of drug is touted as avoiding the side effects of the old ones, but of course the new ones have different side effects. But they measure these things when they do studies.

I want to make one other point regarding Kim's comment: a large part of the intent of medication for depression (which seems to be her main reference) is not to make people happy but to make people functional. The "happy" part is just a pleasant side effect. I'm not sure I believe in the concept of "happy inside," and I certainly don't believe it's something that most people can achieve -- with or without medication. But the difference between being able to work, able to deal with other people, and so on, vs. not being able to do those things, that's a really important difference, whether you're "happy inside" or not.

Jealousy vs. Envy

Continuing in Isobel's video, we have:
Ladies, I'm curious to know what you do about jealousy. I have submitted my photos to Penthouse five different times, and I never ever heard anything back from them. The other day Malloy said, "I think I'm going to submit to Penthouse." And she did. And they called her, like, immediately, and they're like, "Why don't you come test?" I'm mildly jealous.

It's a horrific thing to me to be jealous of your friends. Malloy's got the look that they want, and I don't, and that's just how it is. And it's a bummer, because Malloy gets this really cool thing that I really want, and I'm just not their type. And I'm like, "[nonverbal sound and grimace]...I want that. That sucks." It's tough, because you can't be like well, you know, "She sucks" or whatever, because she doesn't; she just has the look that they want.

So what do you do to combat the little green monster? Because I sure as shit don't know anything to do. I go, "Well, that's just how it is," but perhaps there's something more constructive that I could be doing...with my rage, rage...
Acutally (on a side note) Isobel is an excellent writer, but maybe she'd be an even better writer if she were better acquainted with the fundamentals of English grammar and diction. This is my comment:
"Jealousy" is not the same as "envy." Jealousy generally has to do with something (or more likely, someone) that you already have. You can be jealous because your boyfriend is flirting with some other girl (not that Isobel would be jealous in that situation), or you can "jealously guard" some possession to make sure nobody steals it, but you can't be jealous about somebody else's success in some endeavor where you never did succeed.

When you want something that someone else has, that's called envy. I suppose that, maybe, if you think you deserve something, and someone else gets it, you could be jealous, because you think of it as something that, by rights, you have, even if you don't in fact have it. But that's kind of a narcissistic type of jealousy, and I don't take that to be Isobel's reference in this case.
And while I'm on the subject of grammar and diction, it's really annoying that Isobel, just like Samantha, insists on using "I" as an object pronoun, as in "Vote for Samantha and I." That's evil, I tell you. It's a tremendous sin against the One True Grammar, and you should all go repent in sackcloth and ashes before you end up in writers' Hell!

As to the substance of Isobel's envy, I'd say that Isobel's look is something of a gourmet taste, while Penthouse is aimed more at the mainstream "Big Mac and fries" set who haven't learned to appreciate that subtlety. That's my spin.

Mistress Isobel

The opening credit refers to "Isobel Wren, Monday Mistress" (Two weeks ago she was "Monday Muchacha"). My comment:
Are you becoming a domme now, Isobel? Does this have anything to do with your breakup with Jesus?
OK, I guess the relevance of Jesus may not be clear to anyone except Isobel, because it refers to something in a email I sent her a few months ago, which I don't have time to explain right now. So it's kind of silly of me to say that, since Isobel isn't going to read this. Whatever.