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Madness What constitutes delusions

#1 User is offline   pilowsky 

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Posted 2020-September-01, 01:18

Pilowsky is a very unusual surname. There are not many of us about. Strangely enough, the modal occupation for Pilowsky's is "Professor of Psychiatry". I'm not one of them. But I have studied enough to know a bit about it.
My Father told me that people suffering from schizophrenia commonly understand that their thoughts are disordered. They know that something is wrong and that radios are not really putting ideas into their head. It's just that's the only way they can make sense of the world.
My equally famous sister explained to me that when not taking their medications most British schizophrenics suffered from a delusion that they were romantically involved with a member of the British royal family. In retrospect...
Why do I bring this up now? I just listened to Trump being interviewed by Ingraham. This looks like a folie a deux. Both of them might be in a bit of bother if they ran into a competent psychiatrist.
The conversation appears to have hallmarks of paranoid schizophrenia. At the end of the conversation, Trump's words start to become quite jumbled (word salad). Ingraham starts to engage in the delusion.
Here is the link. I have transcribed the conversation as best I could. Mark Vonnegut's Eden Express for further reading.

Sarah Cooper mocks. Scarborough commentates. I think something else may be going on.

Ingraham:

How will a Trump re-election calm things down in the United States?


Trump:

He's a weak person he's controlled like a puppet so it's not going to be calm things down it's going to be they will have won they will have taken over your cities.

It's a revolution you understand that. It's a revolution. The people in this country are not going to stand for that then I can stand for that the vast majority of people feel like me they feel like every time I put law and order up on social media it gets such an incredible positive response the people of this country will not stand for it. If you say calm things down, yeah, it's because they will have taken over.


Ingraham:

Who do you think is pulling Biden's strings? Is it former Obama people?


Trump:

I don't even like to talk about Biden. understand if you say calm things down now because they will have taken over take a look at what's going on and Biden is I don't even like to mention Biden because he's not controlling anything.

People that you've never heard of.

People that are in the dark shadows.


Ingraham:

What does that mean that sounds like conspiracy theories?


Trump:

People that you haven't heard of

They're people that are on the streets.

People that are controlling the streets.

We had somebody get on a plane from a certain city this weekend


Ingraham: Where was this?


Trump:

And in the plane it was almost completely loaded with thugs.

Wearing these dark uniforms black uniforms with gear and this and that.


Ingraham:

Where is this?


Trump:

I'll tell you some time but it's under investigation right now but they came from a certain city and these people were coming to the Republican national Convention and like seven people on the plane like this person and then a lot of people are on the plane to do big damage.


Ingraham: But the money must be coming from somewhere.


Trump: The money is coming from some very stupid rich people. They will be thrown to the wolves like you've never seen before.
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#2 User is online   thepossum 

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Posted 2020-September-01, 18:22

Thanks for the post and the material requiring serious review and response. It will take me some time

But one quick comment or observation on what has been happening too much recently but for a very long time. Far too many people offer a lot of opinions on people's mental health status without having a clue what they are talking about, they actually go against clinical practice by doing so, thinking you can diagnose someone without sitting in a room or at least spending a great deal of time getting to know someone. Im not going to get into hot water by expressing views on President Trump but what I see is some classic Trump rhetoric delivered in his regular style

But what I really want to read and critique is all the other supporting information to your post and the people behind it and their various theories and positions on things. I could try and critique it word by word but don't really have the time or standing to offer as much authority as many of the people who would play Bridge on this site :)

Just for starters I am concentrating on the theories of Dr(Professor?, Director? apologies) E F Torrey, since that is the source of the schizophrenia excerpt you put up. From a cursory glance Torrey is taking one end of a complex and long standing debate. As I said though there is a great deal to read before giving much comment in order to do justice to the theories. However as a few quick comments I do believe some of the reported philosophies he puts forward around causes of schizophrenia (eg opposition to or downplaying social contributing factors) and his reported views on violence and causes of stigma due to a minority of violent people are actually counterporductive to an understanding of the illness/condition/disorder/whatever and could actually arguably contribue towards stigmatisation. However I need to read more to make sure I am being fairr with that cursory view. And since you used anecdotes as part of your backing, I imagine you have no problem in anecdotes being included with review of published research to back me up

Also, despite the tendency of some to unnecessarily use some kind of professional authority to back them up I think we can leave that out too. Its totally unnecessary and burdensome when engaging in intellgent debate. I could, if I felt like give you plenty of personal and professional backing but it is unnecessary. Lets stick to facts, words and points of view expressed on paper/online please. Howvere if necessay I am sure my backing and authority could easily outweigh the majority of people here including many with Dr/Professor attached to their names - depending of course on their field and how much they actually know, experienced, have studied or read on the subject at hand

Note. I don't like to get too personal in critiques so I may actually even avoid challenging your personal family anecdotes about questionnable views/theories on schizophrenia. One thing I will say though is that its not really wise to start discussion on such a serious toppic which such easily challengeable views on so many things. I will obviously try my utmost to argue respectfully in every way. But please accept that respectful argument with a Doctor or Professor or even a Psychiatrist does include the legitimate statement or production of evidence to show that what they say or believe may be erroneous or at least open to substantial challenge.

I am also hopeful based on some of our earlier interchanges and attempts to make reference to me personally that none of this is an attempt either to identify me, smear me, professionally attack me any way shape or form. One always has to be wary of such things in this climate. On that I am trusting you. Its a small world, small cirlces and sadly some of those circles can intersect in very unfortunate and personally damaging ways. Some of us have very legitimate reasons for using an alias (despite some knowing my identity). I would prefer to keep it that way. Its a very dirty world, especially for advocates against power. And. sorry for going on, some of us have very serious risks that could or have been used against us. You used the words "competent psychiatrist" in your opening. I am happy that I could easily sit in a room with anyone truly competent in the field and be fine. What worries me is those who lack competence getting involved. However, for starters on that score I have sat at conferences (while undergoing clinical and other post degree training) and argued issues of mental health and schizophrenia with some senior mental health professionals and their views and over-confident assertions certainly did not stack up against the research. It is rather concerning that some of those people are involved in care of and making policy about people with serious mental health concerns

I did try, late in life, to become certified (professionally that is ;)) and research schizophrenia and psychotic illness and even influence policy and diagnostic criteria. That was a goal but sadly I embarked on it late in life and sometimes mental health can get in the way. But just for the record, at risk of identifying myself I have a lifetime experience of serious mental health issues including psychosis, a few spells in a psych ward and have been on the receiving end of stigma about violence by community, and professionals inside a ward. Just so you know some of my standing. I also have substantial professional, academic and some research knowledge and experience in the field too. I could confidently sit and critique most publications in the field except for the obvious specialist details on neurobiology etc, but at the general level I could happily debate that too.
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#3 User is offline   pilowsky 

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Posted 2020-September-01, 19:28

You are reading the synthesised opinion of 40 years of knowledge.
I have no intention of providing more than I already have. Others will do that. In fact, they already have.
Far too many people are trying to frame Trump's extremely crazy talk into the narrative of a normal person when in fact it is obvious when you listen carefully to what he says that it is completely 'mad'.
I use the term 'mad' in the technical sense. It means making no rational sense. If you listen carefully to the Ingraham interview - and other interviews as I have, it is clear that something is not right.
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#4 User is online   thepossum 

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Posted 2020-September-01, 19:32

I would rather not debate the Trump issue. As I said Dr Torrey's position is open for debate and challenge by those within the profession and those with other serious relevant knowledge and experience. You need to be careful about sources of material. They may be from somewhere seriously open to challenge but I will address the material you posted. I'm not a fan of ad hominem tactics to defend or attack a position. However in realtion toDr Torrey's position, from what I can see he is (like many psychiatrists) much more at the medical model end of the debate and does not give enough consideration to other aspects of serious mental illness. That is my understanding so far.

But as far as I know there is considerably more and diverse knowledge about schizophrenia and psychosis since that excerpt was written.

I may occasionally ask you to clarify certain physiological related issues. I would appreciate that input.

I wasn't going to critique one of your opening anecdotes. But I think you have something of a statistical fallacy going on. Just because most people who have been fixated on or stalked royals had delusions does not mean that most people with psychosis have delusions about the royal family.

As I said none of the errors in anything you say should be used to undermine any of your other statements but they dont help

Apologies for edits. Often I cannot see them until after they are posted. I don't know why. I always need an third party editor. If I edit anything relating to any of your comments I will make it clear and not edit anything to undermine anything you say.

In my defence of making typos or posts that need edits. I am involved in reading and rebutting so much information on so many platforms that I often write very quickly, often on my phone in tiny edit boxes and I don't always have time to review anything or everything and carefully write and structure every sentence.
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#5 User is online   thepossum 

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Posted 2020-September-01, 20:11

Regarding delusions I will offer a reasonably informed but personal view that the majority are too readily dismissed without making an effort to understand the experiences and knowledge that an individual may have that lead to apparently strange or in some cases bizarre beliefs. Many I believe are quite easily analysed and explained both in terms of experience, culture, traumas, etc in combination with the way thoughts are encoded decoded and constructed. As you said most sufferers if delusions can observe and discuss them themselves. Even some that many would regard as bizarre may represent limited knowledge of the world by the person making the assessment. It's a highly subjective and arbitrary issue up for debate. As someone who has to be wary of such limited knowledge by some potential assessors you learn which are safe to discuss and which are not. Most people are not knowledgeable enough to make assessment. You learn firstly to assess the life experience, knowledge and attitudes of any potential assessor before you start divulging anything to them and keep stuff at their level of knowledge and understanding. And these days I even like to have some hard evidence to back them up just in case.

One interesting thing I learned early in my experience or knowledge of psychosis are the very different ways people are assessed in the USA and other countries. There are professional differences in criteria for example. Many more people are diagnosed as having schizophrenia in the USA than are thought to actually have schizophrenia as would be diagnosed elsewhere. And as I said most diagnosis is limited by the experience and knowledge of assesors who it has to be said generally come from very different circles of life experience

For example the belief that the whole world is against you is very reasonable belief for many

And in my personal case it's not unreasonable for me to be anxious about my forum posts being scrutinized and used to attempt to diagnose my mental state :) which at the moment is understandably and obviously highly anxious. Hence the way my posts are constantly edited, fixed, added to etc.
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#6 User is online   thepossum 

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Posted 2020-September-01, 20:39

Surely saying that a political opponent is influenced or controlled by dark or shadowy forces is not totally ridiculous rhetoric
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#7 User is offline   pilowsky 

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Posted 2020-September-01, 20:55

I understand what you mean.
If a person comes up to you and says that a man with a long white beard created the entire world in 6 days then took a break while a few of his friends wrote a book about it, it might sound a little crazy.
Until you discover that a whole lot of other people believe the same thing as well. And there is a coherence to the story. Personally I don't agree.

This is different. Trump created this story. Also, he has started retelling it and changed the facts. When you listen to the interview he rambles. This is a sign of incoherence.
Regarding your other points: yes psychiatric disease like cardiovascular disease is incredibly complex. You need to study very hard for a long time to understand the nuances of it.
Even in non-psychiatric disease, there are different fashions of treatment for different disorders.
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#8 User is online   thepossum 

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Posted 2020-September-01, 21:13

View Postpilowsky, on 2020-September-01, 20:55, said:

I understand what you mean.
If a person comes up to you and says that a man with a long white beard created the entire world in 6 days then took a break while a few of his friends wrote a book about it, it might sound a little crazy.
Until you discover that a whole lot of other people believe the same thing as well. And there is a coherence to the story. Personally I don't agree.

This is different. Trump created this story. Also, he has started retelling it and changed the facts. When you listen to the interview he rambles. This is a sign of incoherence.
Regarding your other points: yes psychiatric disease like cardiovascular disease is incredibly complex. You need to study very hard for a long time to understand the nuances of it.
Even in non-psychiatric disease, there are different fashions of treatment for different disorders.


I have always had something of a personal issue with the cultural out on certain delusions. Its highly political and convenient but then again where would you get suggesting that any major relgious group was deluded. This issue goes to the very basis of what a delusion may or may not be and where they come from. Some are incredibly deeply engrained personally and cultural. It is when they go against cultural norms they become regarded as problematic. Which then begs the question how appropriate is is to pathologise abnormality in any way shape or form. Diagnostic criteria and the definition of illness have been highly political and socially and culturally contstructed. That is one alternative view to Dr Torrey's much more medical model view. I have concerns about any form of assessment that is so arbitrary to allow for very discretionary definition of normality and abnormaity at one end and even more cocnerns at anyone who thinks any complex psychological or psychiatric condition could be explained purely in medical terms

While I am being very careful being drawn into any discussion about President Trump, I appreciate to many his style and what he says come across the way you may suggest. Having seen the President speak (online of course) or be interviewed in different situations he usually comes across as a mixture of reasonable, controversial, provocative, sometimes carefully scripted other times very off the cuff - all kinds of things. I'm not prepared to be drawn any further. I keep wanting to say more but it is wrong for me even to discuss an individual case in this way. I'm not prepared to be drawn any further. EDIT I will add though that many people react very differently in public situtations, or anxiety provoking situations. Sometimes many of us can come across as somewhat disorganised/confused for a while - thats the nature of certain situations and personalities. Whether something becomes a clinical issue or not is a totally different thing and can certainly not be assessed watching a 5 minute TV interview segment

If I may offer a view on something I personally feel you are ill advised talking about anyone in this way. But maybe you dont have to be as personally and professionally cautious as some of us do. And depending on what you actually know about me I think I have some reasonable reasons to be extremely cautious beinng dragged into these discussions in this way. I am sorry but that is not an unreasonable anxiety

EDIT I apologise to everyone for constant editing but often something needs clarifiying and everything I say is a highly informed personal view
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#9 User is offline   pilowsky 

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Posted 2020-September-01, 21:39

I know nothing about you.
You are always careful to keep your identity under wraps.
I'm the opposite.
If you do not wish to discuss the matter: don't.
Nobody is compelling you to.
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#10 User is online   thepossum 

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Posted 2020-September-01, 21:45

View Postpilowsky, on 2020-September-01, 21:39, said:

I know nothing about you.
You are always careful to keep your identity under wraps.
I'm the opposite.
If you do not wish to discuss the matter: don't.
Nobody is compelling you to.


Sorry but you had previously discussed my identity having come up as a discussion point in one of your circles in Sydney. And as I said its a very small world. I wasnt having a go. Just trying to express a highly legitimate concern I have over being dragged into certain discussions, and even arguments on public forums. I am just explaining a reality of the world. Others have abused situations to undermine me personally and professionally thats all.

And unfortunately you made some very questionable assertions and posted some challengeable material on an issue outside your area of expertise, despite you claiming some authority. And I feel obligated to challenge it. I am certainly not going to challenge any views you may have on obesity or related physiological conditions, say, but on this I claim every bit as much of not more authority to debate the issue. And if you do not understand the professional and personal complexity of such discussions on public forums I am surprised. If you can't understand my anxieties about even having to challenge you I am surprised. There is a thing called professional respect. There are people in many forums either deliberately or unintentionally provoking people into damaging statements due to the nature of the medium, provocation, anxiety etc
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#11 User is offline   pilowsky 

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Posted 2020-September-01, 21:59

You are wrong. It is well within my area of professional expertise.
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#12 User is online   thepossum 

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Posted 2020-September-01, 22:02

View Postpilowsky, on 2020-September-01, 21:59, said:

You are wrong. It is well within my area of professional expertise.


I couldn't find any papers you have written in the subject. And as I said I see or feel evidence of someone trying to draw me in to a professional faux pas. But I am happy to debate delusions, hallucinations, psychotic illness and different philosophies and views on mental illness any time. People have very different views. They use all manner of questionnable to logic to move from certain models and some evidence to making a blanket statement with far too much certainty in my view. Its all well and good to say that it maybe entirely a biological or medical issue. But that doesnt get you very far in really explaining where it comes from and how to deal with it - unless the only solution on the table is chemicaltreatment or (more alrmingly) genomic analysis and approaches As an aside though, without getting myself into any trouble, I am hopeful one day of getting a legitimate script for MDMA or something the like. My days of trying to source unapproved drugs are well behind me

Also I can tell from what you have written already in this thread but on other issues elsewhere that I often know a hell of a lot more about it than you. And I annoy going to be intimidated or bullied into silence or intimidated with irrelevant letters either. In your circles you may get away with that phony abuse of disrespect. They do not stack up in genuine debate or discussion. I respect what you are qualified in and treat every other statement on its merit Edited out auto-generated apostrophe. Some combination of phone or app doesn't understand it's and its. You type the latter and some ignoramus somewhere has it converted to it's

Just as an aside. Part of my self-diagnosis on anxiety levels relates to whether these annoying cruel voices in the back of my head show up. One of the most annoying ones has been bugging me for the last hour thanks to this. But they are very faint, almost like a whisper, but very annoying. Same boring criticims every time, actually thats another disucssion where those voices come from, what they are etc. It still hurts. Usually I can ignore it. Maybe you have an explanation for me :) Sometimes I tell them to **** *** etc. Its a good indiciator anxiety levels
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#13 User is online   thepossum 

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Posted 2020-September-01, 22:57

What seriously concerns me about so many theories or models of mental illness is that many ignore the social and the cultural. I think it is ridiculous to even contemplate that it is possible. Without wnating to disrespect certain professions and their views and models on the world I think there needs to be a combination of the mechanistic biological type approaches and a genuine understanding of all the other factors (and associated disciplines) that can contribute towards its explanation. I wont list them all here but to me the list os very long indeed

Sadly the same can be said about many issues where people take a very narrow almost mechanistic approach to very complex, partly constructed, and highly complex issues

There are some delusions where I think almost 100% of people would agree in their unusualness or unbelievability. For many though it is a very complex area and highly philosphical and inexact on what constitutes a delusion and what type of delusion it is

And as a final comment (I promise on this post) mental illness has been and I believe always will be highly politicised. We can never ignore the aspects of power and how the concept of mental illness has been abused to oppress people for millenia. With apologies to those who only look at the medical side of things. And I personally feel that hisotircal injustice (and ongoing injustice) need to be remembered and never forgotten or repeated. Sadly very few people (even those of us with mental illness) know the extent of the brutal oppression of the mentally ill and those politically deemed to be mentally ill through history - some of it within some people's living memory. Even as someone who has read about and experienced this stuff my whole life, some of those atrocities have only recently come to my attention
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#14 User is online   thepossum 

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Posted 2020-September-02, 18:53

Early post deleted and being editted. Sorry
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#15 User is offline   barmar 

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Posted 2020-September-03, 21:18

Many people believe in conspiracy theories. Too many (perhaps a quarter of Americans) to consider it a form of madness. It's much more like being indoctrinated into a cult or religion.

Cognitive scientists and psychologists debate the details, but there are some common traits of conspiracy theorists. A recent Scientific American article says:

Quote

Experiments have revealed that feelings of anxiety make people think more conspiratorially. Such feelings, along with a sense of disenfranchisement, currently grip many Americans, according to surveys. In such situations, a conspiracy theory can provide comfort by identifying a convenient scapegoat and thereby making the world seem more straightforward and controllable. “People can assume that if these bad guys weren’t there, then everything would be fine,” Lewandowsky says. “Whereas if you don’t believe in a conspiracy theory, then you just have to say terrible things happen randomly.”

As far as Trump goes, It's really hard to know what he really believes, versus what he's saying just to try to stir up fear, which is how he got elected in the first place. He's a master BS artist.

#16 User is offline   pilowsky 

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Posted 2020-September-03, 22:22

What you say is true Barry.
It takes a great deal of experience to be able to detect the difference between trolling, madness, psychosis, inflammatory speech and so on.
Trump, because of his constant public utterances, provides a wealth of clinical detail which is why so many psychiatrists and physicians have been willing to weigh in.
The consensus favours derangement, not a genius.

Clearly he is not completely psychotic. He can put sentences together fluently.
He seems to be able to read from a teleprompter at the level of a 13-year-old child.
The problem is the content.
If someone walks into your office and in a calm voice says "Barry, I'm bored of life I'm going to kill myself". The appropriate response is not to say: Fair enough, "that's your right it's a free country".
The stuff that is coming out of Trump's mouth is a 'danger to others' it is getting them killed.
This is a technical medico-legal term for delusional content that should be cause for alarm. Whatever label one applies.
It doesn't have anything to do with politics - or Bridge. It's life or death.
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#17 User is offline   pilowsky 

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Posted 2020-September-04, 01:38

I would add to this that a lot depends on the context.
Look up Abnormal Illness Behaviour. I didn't invent it, but I studied it very carefully.
The idea, simply put, is that claiming a sick role for a disorder - say a cough or a cold - is appropriate in normal times, but not during the middle of a raging battle.
Similarly, while it may be appropriate for some person to aver that men in dark shadows control the streets, or that it is safe for children to return to school when it isn't, maybe fine if that person is sitting on a barstool talking to themselves.
It is a wholly different matter when that person is, just hypothetically speaking, the President of the United States of America, At that point it becomes, sociologically and politically speaking a monumental disaster.
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#18 User is online   thepossum 

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Posted 2020-September-04, 17:02

And the one person here with qualifications and clinical and research experience in psychology is ignored - and ignored by someone who should know better not to claim expertise in something they are not. I am risking that being disrespcet but none is intended

I am still working on my edits. A full response and rebuttal of some of the above will take a long time. I am getting a bit sick of some of the arrogance on display on this and other issues; and the attempts (successful or not) to dazzle the ignorati with pseudo knowledge on subjects

It goes like this. I know/met a psychiatrist or some membrs of my family who are psychiatrists and share the same name have discussed a few anecodes.
EDit Sorry forgot this bit. As a professor/doctor with expertise in physiology and using one particular, hotly debated biological/medical model of schizophrenia that also makes me an expert - because the ignorati think that any long words starting with phy, psy etc and ending in ology/iatry must be similar areas of expertise

I also read an old narrative style book, allegedly a handbook for familes/cares of people with schizophrenia, written by a psychiatrist/doctor(?) with some very specific positions on the longstanding debate around various issues of mental health care. Here is an execpted paragraph about schizophrenia I found on the internet. I rest my case as an expert. And using that expertise it is quite obvious to me watching a few minutes interview that President Trump has paranoid schizophrenia etc

When you said you have studied this subject Pilowsky, was that by reading a few wikipedia articles or do you have letters in the subject :) Not that it should matter. I promised only to dismantle the things you said, not who you are
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#19 User is online   thepossum 

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Posted 2020-September-04, 17:55

View Postpilowsky, on 2020-September-03, 22:22, said:

It takes a great deal of experience to be able to detect the difference between trolling, madness, psychosis, inflammatory speech and so on.

It does indeed, and your posts to date suggest you do not have that experience and are relying on hearsay from other professionals who to be blunt should not be offering such advice without having sat in a room for many sessions. Then it is uqestionnable whether it is appropriate to discuss in the open by any professional. There is obviously public interest given the importance, but I believe people are on very dangerous territory and have let politics blind their clinical guidelines and practice

Are you a psychiatrist or not. Do you practice clinically. Have you sat in consultations with president Trump over many sessions etc

You may say this is no tricial matter that some people opine that The President is suffering psychotic symptoms and may not be fit for office. But something just as/if not more alarming has been the disgraceful display by professional people over recent years behaving unprofessionally and politically through social media and forgetting a few important principles of being a professional

And at a time like this, politically and in the middle of a global pandemic with trust of so many institutions under threat it is frightening the amount of pseudo-professional and pseudo-expert BS coming out of people's mouths on social and other media, claiming authority they do not have to intimidate the ignorati (population and media)

If you wonder why this particular issue winds me up so much I have already discussed my concerns over excessively medical and uninformed approaches to understanding serious mental illness. I am still editing a long response. However in relation to the pandemic, even from a position of simply being highly trained and qualified I have seen disgraceful claims made out of ignorance or from political motives over all aspects of the pandemic from some people who should know better. What frightens me is that so many of them clearly don't know better. That is truly frightening. And whether you like it or not I stack my lifetimes training and personal experience in numerous fields up against what you have provided so far - and I am comptenet enough to see BS in most scientific fields, even if I do not know all the details of every disciplne. There are not many papers/disciplines that I could not get a decent understanding of from reading a few papers. Some areas are incredicly highly complex and obscure - but a well written paper and abstract and a small investment of time reading a few related academic articles provides enough understanding to any scientifically and academically competent and trained person. I won't use the word intelligent but I could. You have raised it in the past an issue in a way I challenge. It is highly charged issue and very dangerous if not discussed well but I believe all individuals have natural strengths and weaknesses and ability to learn different things to different levels

Sorry I am rambling again and my post is growing. But you were the one who raised the issue of being able to distingusih between trolling and other forms of communication
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#20 User is offline   pilowsky 

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Posted 2020-September-04, 18:20

View Postthepossum, on 2020-September-04, 17:55, said:

It does indeed, and your posts to date suggest you do not have that experience and are relying on hearsay from other professionals who to be blunt should not be offering such advice without having sat in a room for many sessions. Then it is uqestionnable whether it is appropriate to discuss in the open by any professional. There is obviously public interest given the importance, but I believe people are on very dangerous territory and have let politics blind their clinical guidelines and practice

Are you a psychiatrist or not. Do you practice clinically. Have you sat in consultations with president Trump over many sessions etc

You may say this is no tricial matter that some people opine that The President is suffering psychotic symptoms and may not be fit for office. But something just as/if not more alarming has been the disgraceful display by professional people over recent years behaving unprofessionally and politically through social media and forgetting a few important principles of being a professional

And at a time like this, politically and in the middle of a global pandemic with trust of so many institutions under threat it is frightening the amount of pseudo-professional and pseudo-expert BS coming out of people's mouths on social and other media, claiming authority they do not have to intimidate the ignorati (population and media)

If you wonder why this particular issue winds me up so much I have already discussed my concerns over excessively medical and uninformed approaches to understanding serious mental illness. I am still editing a long response. However in relation to the pandemic, even from a position of simply being highly trained and qualified I have seen disgraceful claims made out of ignorance or from political motives over all aspects of the pandemic from some people who should know better. What frightens me is that so many of them clearly don't know better. That is truly frightening. And whether you like it or not I stack my lifetimes training and personal experience in numerous fields up against what you have provided so far - and I am comptenet enough to see BS in most scientific fields, even if I do not know all the details of every disciplne. There are not many papers/disciplines that I could not get a decent understanding of from reading a few papers. Some areas are incredicly highly complex and obscure - but a well written paper and abstract and a small investment of time reading a few related academic articles provides enough understanding to any scientifically and academically competent and trained person. I won't use the word intelligent but I could. You have raised it in the past an issue in a way I challenge. It is highly charged issue and very dangerous if not discussed well but I believe all individuals have natural strengths and weaknesses and ability to learn different things to different levels

Sorry I am rambling again and my post is growing. But you were the one who raised the issue of being able to distingusih between trolling and other forms of communication


I only discuss things with people that I know. I don't know who you are. This is my last comment on the matter with you.
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