PROTECTING THE PATIENTS
Bravo to Scientific American Mind for its two articles on depression. "Antidepressants: Good Drugs or Good Marketing?" by David Dobbs, and "Treating Depression: Pills or Talk?" by Steven D. Hollon, Michael E. Thase and John C. Markowitz, tap into areas increasingly submerged within the domain of psychiatry.
As an R.N. and M.S.N., I wonder: What are we doing with our patients? Does what we do make any difference? How are we empowering patients when we prescribe medication in instances where psychological interventions may provide better inoculation against recurrent illness, as well as enhancement of patients' adaptive capabilities? (In this vein, what are the social and economic costs?) And what are the long-term consequences for the discipline of psychiatry in terms of credibility of psychiatric treatment when the vaunted "evidence-based medicine" serves much less the master of science and more the machinations of Madison Avenue and Big Pharma? Bravo again!
Jeffrey J. Drury
OCCULT VERSUS FAITH
I found it quite troubling that "Casting Out the Demons," by Gunther Klosinski, mentioned the Christian God in a negative, unrealistic light. According to this article, "many psychologically healthy adults are enthralled with everything from magic to the Holy Spirit, with no harm to themselves or others. The real question is: At what point does a person's involvement become dangerous?"
By any realistic definition of a faith system, Christianity is not within the realm of the occult. I support the inclusion of future spiritual discussions in Scientific American Mind, but such articles should be written by individuals who demonstrate tolerance toward all faith systems.
PREDISPOSITIONS AND CHOICE
I enjoyed "The Tyranny of Choice," by Barry Schwartz, but I have a critical comment: I don't think it's surprising that "maximizing persons" are "prime candidates for depression"--because they might already have been depressed. The maximizing behavior as a dysfunctional form of self-regulation reminds me of German psychologist Julius Kuhl's concept of "action orientation" versus "state orientation."
Kuhl defines the latter as the inability to escape a mode of control in which the initiation of intended behavior is difficult, as a result either of preoccupation (for example, rumination) or hesitation. The important thing here is to escape the state-oriented mode when needed, which will lead to balanced "opportunity costs." I think this is not so much a matter of choices but of predisposition. It is possible that the growing number of choices in our society fosters maximizers but that self-restricting habits might also arise from social circumstances. Growing up poor or with strict parents, for example, might be a predictor for becoming a "maximizer," I guess.
In the Letters section, reader Fairfid M. Caudle rightly corrects Robert-Benjamin Illing, author of that issue's "Humbled by History," by stating that William James was nothing if not a champion of consciousness as a paramount psychological topic. Yet the suggestion that Illing might have mistaken James for B. F. Skinner distorts the position of Skinner.
As a cognitive psychologist, I am not a proponent of Skinner, but I do feel that it is incumbent on readers of a publication with the word "mind" in the title to understand his position. What made Skinner a "radical" behaviorist was not that he was more extremely against the mind than other behaviorists. Skinner contrasted methodological behaviorism with radical behaviorism. According to Skinner, "the part of methodological behaviorism I rejected was the argument that science must confine itself to events accessible to at least two observers ... and the behaviorism was therefore destined to ignore private events."