"yes but the point is"

This is the second continuation of a story that began with “Parallel monologues” and continued in “u still got it wrong”

I was only an observer this time, and the interchange is so surrealistic that I want to document it in screenshots to get the chronological order. 

But first “the point”:

To me, point is that fact is fact and opinion is opinion, and discussions about “getting it wrong” are only relevant about statements that are falsifiable.

I am embedding two images that don’t show in the screenshots:



And the screenshots need to be read upwards.

The sentence in Norwegian at the top of the next image belongs to another conversation, but fits in nicely: “You can realize that I am right or complain and be shown that I am right”. Said by the psychiatrist who borderlined me, in our first meeting.

Iona Heath on "the use and abuse of words"

Medicalsceptic is a rich source of interesting information. Well worth following. 

And this paper is worth being read thoroughly and thoughtfully:  


The allure and tyranny of certainty

Experts who “know” are wonderfully seductive. Whenever I attend a lecture by someone, usually a hospital specialist, who seems absolutely certain of the correct response to a patient in a particular situation, the temptation to take careful notes is enormous. Yet once I’m back in the consulting room the notes are never as useful as I had hoped they might be. Certainty seems to be born of pretending that things are very much simpler than they really are and in our consulting rooms things never seem simple. Yet there is a terrible certainty about much medical rhetoric and in much of what we say to patients.
Isaiah Berlin would recognise the expert who “knows”:
“Happy are those … who have, by their own methods, arrived at clear unshakeable convictions about what to do and what to be that brook no possible doubt. I can only say that those who rest on such comfortable beds of dogma are victims of forms of self-induced myopia, blinkers that may make for contentment, but not for understanding of what it is to be human.”6
As would Jose Saramago:
“assuming he has been wise and prudent enough not to believe blindly in what he thinks he knows, because this rather than ignorance is the cause of the greatest blunders”.7
The pursuit of certainty–the desire for certainty–what Hans-Georg Gadamer calls “the reduction of truth to certainty”8 affects the way we use words and language. So I want to explore the use and abuse of words within the interaction between doctor and patient, and examine the normative basis of power in story, language, and knowledge. I hope to show how easy it is for doctors to use these dimensions of power to constrain and limit our patients’ stories, consign many of them to stories of failure, and reduce their capacity to celebrate, or even recognise, achievement.9

BMJ: "Evidence based medicine on trial"


Carl Heneghan: 

Evidence based medicine on trial

4 Dec, 14 | by BMJ Evidence based medicine (EBM) should form the foundation of effective clinical decision making; however, growing unrest—and an awful lot of criticism—suggests the evidence bit of EBM is increasingly part of the problem, and not the solution.

“Carl Heneghan jointly runs the Evidence Live conference with The BMJ and is a founder of the AllTrials campaign.” 

I am linking to this article because of the Twitter discussion on #understandingpsychosis – and other situations where the word “evidence” sometimes seems to trigger System 1 reactions that block off relevant information. 


Distortion of the research agenda, mainly by commercial decisions, is leading to an ever increasing evidence base that doesn’t meet the needs of patients. With too much focus on the well, and not enough on the sick, the paradoxical situation has arisen whereby medicine is potentially harming the healthy through earlier detection and increasingly looser definitions of disease.

As an example, if you find yourself constantly late, disorganised, forgetful, and overwhelmed by your responsibilities—which could refer to all of us—you might have adult attention-deficit disorder. You will be pleased to know that there are at least four different medications currently available for this condition. You could argue that the pharmaceutical industry is becoming equally good, if not better, at manufacturing diseases as opposed to drugs.

While research publications continue to increase—to the point where the notion of keeping up to date is nigh on impossible—the quality is often very poor, if not sometimes outright pitiful. Although there has been a growth in research to promote implementation, my observations—note the low level of my evidence —have been that while clinicians are extremely good at responding to robust evidence, all too often the quality of the evidence is weak and unworthy of implementation.

Poor quality evidence arises when observational data are used to establish treatment effects; when outcome measures are unimportant to patients or, even worse, are meaningless for patient care; and also when simple factors to account for bias are not incorporated into the research design.

"u still got it wrong"

This is a sequel to

Psychiatric Parallel Monologues


Link to the critique that is mentioned in my first tweet:




Dr Huda won again, and I’m letting him have the last tweet.


I’m posting this to illustrate how impossible it can be to have a dialogue about opinions with certain “experts by knowledge” in the mental help professions.


I wouldn’t bother if it hadn’t been for earlier experiences with mental help experts who had power over me and knew that I “got it wrong” when I did not agree with them.

As I see it, fact is fact, opinion is opinion, and when opinions differ, one can agree to disagree.

A screenshot of my opinion on the parable that Dr Huda insists that I got wrong, from “Psychiatric Parallell Monologues”





Links to psychological research

Much of the original post is now in #GoldwaterRule and Twitter-psycho-patienting, and the post is renamed from “Biased thinking by Coyne?” He does seem to have a clear bias towards information that can be counted: 

Coyne’s research on lucrative psychological products is important, and it does not make him an authority on factors that cannot be counted. I’ve written about that in #GoldwaterRule. I’ll be collecting links to research here, starting with this:  

“Salvaging psychotherapy research: a manifesto” by James C. Coyne

We should take a few tips from Ben Goldacre’s Bad Pharma and clean up the psychotherapy literature, paralleling what is being accomplished with pharmaceutical trials. Sure, much remains to be done to ensure the quality and transparency of drug studies and to get all of the data into public view. But the psychotherapy literature lags far behind and is far less reliable than the pharmaceutical literature.

Troubles in the Branding of Psychotherapies as “Evidence Supported”
By James Coyne PhD

Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror:

Positive psychology is mainly for rich white people

More on the Acceptance and Commitment Therapy Intervention T
 We should have been told that patients died and went to jail.
Published on August 25, 2011 by James C. Coyne, Ph.D.