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See Inside Scientific American Mind Volume 23, Issue 4

Readers Respond to “Feeling Free”— and More

MIND-ALTERING METAPHORS

In regard to “This is Your Brain on Drugs,” by Christof Koch [Consciousness Redux], we are to be surprised that taking hallucinogens results in reduced brain activity. After all, such drugs are called “consciousness-expanding” and “mind-expanding,” based, I suppose, on the wow effect one experiences. Yet what are “consciousness-expanding” and “mind-expanding” supposed to mean? What actually expands? Wowness? Maybe the surprise is increased by a bad choice of hyperboles in the first place.

George Gillespie
Moorestown, N.J.

UP IN THE AIR

“The Aviator's Dilemma,” by Stephen L. Macknik, Susana Martinez-Conde and Ellis C. Gayles, is a great article! The illusions that pilots experience were well explained. I flew as a passenger in navy P3 planes during the cold war, and it was easy to become somewhat disoriented flying between cloud layers that seem horizontal but aren't always actually horizontal; they form along pressure gradients rather than just altitude.

Not only that, but the relatively slow-moving P3 sometimes feels like it is flying backward after a great many hours of cruising. Not only does one get visual effects, but also auditory effects as one's ears try to make sense of the constant droning of engines and avionics. Sometimes I heard classical music—not like a replay in my mind, but I could actually hear it amid the droning of the engines. Knowing it was an illusion did not make it go away.

When you drop down to 500 feet above the oft-stormy sea to inspect a ship, you depend almost entirely on the radar altimeter and attitude indicator because there is no horizon, and you have absolutely no idea whether you are too close to little waves or adequately high above really big waves—it all looks the same. Then you finally see the ship and realize the waves are really big, twice the distance crest to crest as a supertanker is long.

“mggordon”
commenting at www.ScientificAmerican.com/Mind

INTERPRETING THE “BIBLE”

In “Redefining Mental Illness,” Ferris Jabr writes, “Although many psychiatrists do not sit down with the DSM and take its scripture literally ...”

This is an important caveat. And it illustrates why more attention needs to be drawn not to what's in the book but to how the book is used.

As a practicing psychiatrist, I agree with Jabr that many clinicians rely “on personal expertise to make a diagnosis.” What we are forced to write in the chart, however, is dictated by the DSM. From that point on, the diagnosis—NOT the patient—becomes the focus of treatment. The diagnosis serves as a gateway not only to a wide range of social services—which could be beneficial—but also to a potential lifetime of medication trials and other ill-advised treatments.

Most psychiatrists view the DSM and the diagnostic process as a necessary evil: “necessary” for reimbursement and to be able to help the people who seek our assistance but “evil” because in many systems the assistance we provide is dictated by the diagnosis, not by the unique needs of the individual.

“SteveBaltMD”
commenting at www.Scientific American.com/Mind

POST-STRESS DISORDER

I am not sure what is new about Scott O. Lilienfeld and Hal Arkowitz's article “When Coping Fails: Revisiting the Role of Trauma in PTSD” [Facts and Fictions in Mental Health]. Complex PTSD (C-PTSD), proposed for inclusion in the DSM-V, was described in 1992 by trauma expert Judith Herman in her classic Trauma and Recovery (Basic Books). The notion, in a nutshell, is that various life stressors and events can collectively lead to PTSD-like symptoms and conditions, which may be remediated via treatments used for conventional PTSD, notably EMDR [eye movement desensitization and reprocessing].

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