Has medicalization gone too far?

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Mkoll
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Re: Has medicalization gone too far?

Post by Mkoll »

HePo wrote:The 14 % in the US - i lived in the SF Bay area for a long time and based on that my estimate would be a lot higher.

Lol, yeah me too. I'd estimate the same thing.
HePo wrote:However, i meant to comment on Ambrosius's post and it would be unfortunate if this is the only fact you did read.
Nope. I read your other facts but didn't find anything there I wanted to respond to.
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Re: Has medicalization gone too far?

Post by Johnny Dangerous »

Jesse wrote:
Mainly I think anti-psychotics aren't really to help patients in most cases, they are to alleviate the fear of those who know the schizophrenic person. My best friend developed schizophrenia, and I remember asking him why he doesn't take his medicine.. he told me he just wanted to be accepted for who he was, not medicated for the benefit of those who are afraid of him.
Right well, going on one conversation with your best friend is maybe not the most accurate way to judge trends involving thousands upon thousands of people, over a trend of something like 50 to 60 years (since anti psychotics were found, iirc thats about how old they are). I think there is some truth to this, but then the question becomes what exactly you suggest as an alternative. One thing that anti-psychotic drugs allowed for is de-institutionalization...something which I think should be viewed as an overall positive, the status of schizophrenics today, while far from perfect, is light years beyond what it was int he 1900's for example, due in part to the discovery of anti-psychotics reducing the symptoms.

I don't disagree entirely with what you're saying here at all, in fact with a lot of this stuff your criticisms themselves are IMO right on the money. In this case though I think you are ignoring the fact the drugs enabled the existence of things like community-managed mental health in some ways, which, while imperfect, poorly funded etc. is SO much better than locking people away permanently in institutions. It's easy to dismiss the way we treat severely mentally ill people today, there are so many travesties..lack of help for veterans, the disproportionate lack of resources for minorities with severe mental illness, pick one. However, the field is where it's at, there is a lot that needs changing.
Anti-psychotics both a-typical and the older variety have terrible side-effects, alot of people would probably describe being on them similarly to being poisoned.

I am also familiar with psychosis, and it's my personal belief that psychosis can only really be treated by mind-training, and self-knowledge of how the mind works, combined with effort to mitigate factors which cause psychotic episodes.
Yes, there are a lot of things that are terrible about the drugs, for sure. I once got prescribed seroquel for sleep (lol WTF), and I remember getting freaked out because I couldn't do basic math on it. Horrible drug, I can't imagine taking something like that unless basically I had no other option.

You are of course, welcome to your own opinion, and I have no doubt it's what has worked for you but it's not borne out by clinical evidence on a larger scale as far as I know. For example, stuff like CBT - which IS essentially mind training, or the closest thing to it available to western psych, has not been found to be anywhere near as effective at symptom reduction as the drugs plus the therapy. Basically, at this point the drugs are the most effective thing at symptom reduction for schizophrenia - by far.

So in my opinion, to combat psychosis first you need to understand how the mind creates these realities, you need mindfulness to watch the mind as it does it, and then obviously you need to stop the mind from doing it. I won't deny the medications can help someone in the grip of an acute psychotic episode, but the medications do not HEAL the problem. They are hard-core drugs that should be used short-term at best.

Anyway, that's my 2c.
See above, there simply isn't clinical evidence that people with many severe disorders (at least not yet, AFAIK - I could certainly be off the mark, this is all off my own limited education) are capable of "mind training" of any sort without having the addition help of drugs. I can easily believe there are exceptions of course, and I hope more and more that integrated approaches become the norm, instead of ignoring the needs and feelings of the patient and simply medicating them. I also hope integration of severely mentally ill people into community care continues and gets supported, and that the the stigma attached to these life situations lessens.

The issue of "healing" IMO is a larger one in western medical thought generally. When you approach things from a purely biological perspective (which is what drug therapy is), there is really no such thing as "healing"...there is just reduction of symptoms. It's the often-repeated statement of treating a symptom and not a cause. Being Buddhist, we know there are causes of this stuff that are not acknowledged by western psych...IMO that is worth thinking about...but as this point in time certainly nothing an average therapist can help us with.

IMO it's worth considering stuff like this if you are in the position of having to advocate for yourself with mental health professionals, people that do not come from a holistic perspective are just going to look at the data and say "well, clearly the drugs work best". I agree this is a short-sighted approach for sure. Personally I think the sanest thing is for pharmaceuticals to almost always just be a triage, short-term kind of approach, long term of use them..for so many things they carry too many side effects and problems with extended use. Hell, i've had problems like this for the year I had to take pharmaceutical acid-reducers for ulcers..they worked to make me functional, but over time they messed up my system so bad in other ways that I phased them out when it was possible.
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Re: Has medicalization gone too far?

Post by Ambrosius80 »

HePo wrote:As Ambrosius seems rather strong opinioned with a great disregard for facts.

Healthcare in Finland

(Wall of text)
That survey was done almost fifteen years ago. It actually was in last week's news that the people in general dislike the state of our healthcare, and hope that the recent reforms in both social care and healthcare improve the situation somehow.
A lot went down here after the economical crisis, including the quality of healthcare in public hospitals. If you allow this strong expression, the late nineties to early 2000's were our golden age when it came to medical care. Nowadays rich people generally go to private hospitals, and poor people go to the public healthcare, which is having difficulties financing its functions. This has been a publicly acknowledged problem for years, as it increases the divide between the wealthy and the poor.

Furthermore, that statistic about disposable income is distorted because most of us have to travel even dozens of kilometers by car daily, buy lots of fuel to keep our houses warm, and buy food which is very expensive here, about 30-40% more expensive than in Germany for example. A recent phenomenon has also been that wages go down, but prices continue to go up, especially the prices on food.

It is true that fewer people smoke here and may not use cannabis, but you will be surprised if you look at the statistics for alcohol consumption and diseases caused by it. Besides, a lot of us tend to go to Estonia in order to buy cheap booze. That booze is then "smuggled" through customs. Its kind of an age-old tradition here, and doesn't show up on the official statistics as official consumption because then the government doesn't know how much everyone really drinks. Most of the drinking here is done in order to get intoxicated as quickly as possible, instead of for example using alcohol for socializing. This article states Finns consume alcohol more than the average European, even officially: http://www.paihdelinkki.fi/articles/111 ... in-finland" onclick="window.open(this.href);return false;" But this is beyond the point.

As for your last point, I was not saying people can become doctors without any personality tests in Finland. I was saying it is a mistake to let people become doctors without such tests in the first place, as not every country demands such proceedings from their medical schools. I also mentioned that a lot of doctors come from abroad to Finland these days. Their countries may not have such high criteria in their training, a fact which makes your point irrelevant in any case.
Johnny Dangerous wrote:Can you please provide some specifics on the last part Ambrosius? What school of psychology teaches that suffering people are weak minded losers who simply require medication? It sounds to me like you have very little knowledge of the field, or the range of things taught in it, but i'll anxiously await being proven wrong.

So by all means, tell me the specifics of what you disagreed with in your education in the field of psychology, therapy etc. I'm definitely gonna expect that you back up a bold claim like that with something.

Especially if you're going to do things like blame suicide rates on mental health professionals, you need to substantiate thay with something other than the vaguely presented claims in your last post.
Do I sense frustration in your post? Anyway, I could show you a few newspaper articles, but I doubt you would understand them as they are written in Finnish. Therefore, I'll try to explain without them.

In January, a study was published by the university of Helsinki about the most common reasons people commit suicides. Reasons that made to the top included loneliness, depression, and financial difficulties. The interesting fact was that 64% of those who killed themselves had in fact received psychological counselling and support from professionals, some even for years. The study concluded that there were faults in the mental healthcare system, and that it was ineffective in treating people.

My knowledge in psychology is indeed limited, as I never studied long enough to become a professional.But then again thanks to free speech, I don't have to be a professional in order to have an opinion.
Nevertheless, the books we had to study for our entrance exams pretty much ignored the idea of actually supporting the patients mentally, and instructed to treat eg. a clinically depressed patient by hard medication and encouraging him to play with cards. In no point was it stated how you need to be supportive, compassionate or understanding for such a person, so he can really begin to get over his depression. The whole case was a textbook example on how to treat a patient as the sickness he is suffering from. I had trouble believing my eyes when I read that part among others.

Even though I understand the card games were probably intended to offer something creative for the patient to do and disallow him to concentrate on his depressed state of mind, the part was still written in a manner which was both naive and insulting to the patient's intelligence. I cannot explain it any better to you. There were other weird statements in the book as well, which caused me to shake my head in stupor. (The book was written by a group of people, I recall Marja Vuorinen being its writer among others. I believe the name of the book would be "From the Academy to the Clinic: the Book of Practical Psychology." in English.)

Anyway, I decided to drop psychology after coming to the conclusion that the way it was being teached here didn't appeal to me. After reading the University of Helsinki's study about how our mental healthcare system seems to suffer from a lack of efficiency in treatment, I personally deduced the problem is at least partly in the education.
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Re: Has medicalization gone too far?

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Perhaps it's a subject taught entirely differently in Finland.

I'm frustrated because frankly I am suspicious that you are making the content of the classes up, you are so light on specifics, it's odd. If you are being truthful in some sense about the classes, then yes that sounds like very backwards education.

And no you don't need an education to have an opinion, but IMO you need to make better arguments and fewer sweeping claims to be taken seriously in a discussion.

Far as the specific book, I have never heard of 'intro to psych' sort of textbook that center on advocacy of mediately drugging someone, then making them play with cards. So which was ot, entrance exam, textbook...how many actual clases did you take, and do you know the actual protocols taught in schools to students of psychology, therapists, etc., or are you basically just making up what is taught in the classes because you don't have a real picture of the programs or what they teach?

I think it's likely you don't actually have much of an idea of what's taught, and it makes the discussion difficult because it usually ends up being creation of straw men arguments like those above. I don't have any idea what approach to psychology advocates immediate drugging, lack of compassion, and card games. Maybe one exists, but it sounds like you are taking this one (poorly contextualized) anecdote and claiming it represents the field a whole.
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Re: Has medicalization gone too far?

Post by lorem »

Ambrosius i got hit by a diesel truck and went home and hid in my house and broiled in adrenaline for a year before seeking help. Have ptsd and the docs said damn that was dumb you could have come to hospital and we would have given you something.

Then they just used the book and went from drug to drug trying to help but turned out to be a farce. Finally met a doctor who said sorry about all that and got me going again.

When it comes to really serious stuff I learned if the doctor is not helping seek as many opinions as need be.
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Re: Has medicalization gone too far?

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Johnny Dangerous wrote:Perhaps it's a subject taught entirely differently in Finland.

I'm frustrated because frankly I am suspicious that you are making the content of the classes up, you are so light on specifics, it's odd. If you are being truthful in some sense about the classes, then yes that sounds like very backwards education.

And no you don't need an education to have an opinion, but IMO you need to make better arguments and fewer sweeping claims to be taken seriously in a discussion.

Far as the specific book, I have never heard of 'intro to psych' sort of textbook that center on advocacy of mediately drugging someone, then making them play with cards. So which was ot, entrance exam, textbook...how many actual clases did you take, and do you know the actual protocols taught in schools to students of psychology, therapists, etc., or are you basically just making up what is taught in the classes because you don't have a real picture of the programs or what they teach?

I think it's likely you don't actually have much of an idea of what's taught, and it makes the discussion difficult because it usually ends up being creation of straw men arguments like those above. I don't have any idea what approach to psychology advocates immediate drugging, lack of compassion, and card games. Maybe one exists, but it sounds like you are taking this one (poorly contextualized) anecdote and claiming it represents the field a whole.
I never lie to people, that is both against my own morality and the five precepts. I can express my opinions in a civilized manner without having to resort to using made up claims.

I admit I never took any classes. I was formally admitted entrance as I did well in the entry exams, but I refused the invitation and let someone else take my place. I was frankly so upset by the fact such a terrible book was the official entrance exam book. Who knows, maybe I am wrong, but back then I doubted the teaching itself would be much different, given that some people high in the hierarchy of the university actually accepted such a book to be used for testing applicants out. And yes, into the book was indeed crammed the basics of neuro-psychology, history of psychology as a science, different forms of therapy, some classics like Maslow's hierarchy of needs or Skinner's rat experiments and so on. Somehow that made the whole thing even more absurd. I cannot fathom why there weren't a couple of more specific books instead of one single book that tried to tell something about everything.

As for the reportedly low efficiency of therapy, there is in my opinion a connection between it and the oversupply of candidates, fairly low entrance exam point limits, and the survey's results from January. Because I am not the Minister of Education, I have no idea if that is true, but still it is my opinion. The fact the entrance exam textbook was so bad was only a detail among others, but as I said they seem to point out collectively that there indeed is a problem in our mental healthcare.

But sure, there are very good psychologists and psychiatrists in Finland, I personally have the honor to know one of them. I am not generalizing every single one of them into one group if that's what you are thinking. The whole idea of this thread is to cause conversation about modern medicalization and healthcare in general. I am simply stating my personal view.

That is very true, lorem. I have a friend who got kicked in the knee when he was playing soccer in high school. The ligaments of his knee were severely damaged, and he went from doctor to doctor, surgery to surgery for many years, before finally finding the doctor who really knew what would ease his pains. Today his knee is functioning very well, and he can even play some sports again.
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Re: Has medicalization gone too far?

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Ambrosius80 wrote: I never lie to people, that is both against my own morality and the five precepts. I can express my opinions in a civilized manner without having to resort to using made up claims.
I don't think you are lying, I do think that maybe you are greatly embellishing some poorly-remembered or understood event in your experiences to 'prove' some vague point about the field.
I admit I never took any classes. I was formally admitted entrance as I did well in the entry exams, but I refused the invitation and let someone else take my place. I was frankly so upset by the fact such a terrible book was the official entrance exam book. Who knows, maybe I am wrong, but back then I doubted the teaching itself would be much different, given that some people high in the hierarchy of the university actually accepted such a book to be used for testing applicants out. And yes, into the book was indeed crammed the basics of neuro-psychology, history of psychology as a science, different forms of therapy, some classics like Maslow's hierarchy of needs or Skinner's rat experiments and so on. Somehow that made the whole thing even more absurd. I cannot fathom why there weren't a couple of more specific books instead of one single book that tried to tell something about everything.
Most introductory textbooks are just that, a broad overview of a field, why do you find that strange? You would get the same with an introductory class or textbook of philosphy, western literature, western civ., many other subjects. I'm again interested in the specifics of the claim where this book, or some other source advocates treating depression with heavy medication, card games, and lack of compassion - and I think you should provide something more substantial with that claim of yours, as it seems to be something you mention repeatedly, which has evidently colored your view of a whole field...which you admit you've not had a single class in, and know very little of.
As for the reportedly low efficiency of therapy, there is in my opinion a connection between it and the oversupply of candidates, fairly low entrance exam point limits, and the survey's results from January. Because I am not the Minister of Education, I have no idea if that is true, but still it is my opinion. The fact the entrance exam textbook was so bad was only a detail among others, but as I said they seem to point out collectively that there indeed is a problem in our mental healthcare.
.
To be blunt, why would I put any weight in your opinion on what's causing the problem? You can't even provide basic information about how education in psychology works in Finland, much less real data or specifics about problems in that area - which ironically I could probably get from people in the field itself. Maybe you're unaware of this, but many reforms in the field have come from within the field itself..and while as a whole it's definitely been guilty of huge lapses in judgement, it does study itself, and much relevant data about the field comes from within the field.

If you can provide english language links to the study about suicides mentioned earlier, i'd honestly also be interested in reading them, and more about the actual state of this stuff in Finland.
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Re: Has medicalization gone too far?

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Two things I'd like to add.

First, I think it really does depend on the individual mental health professional. I had one person who basically wanted to fill me up with meds for an issue that basically was relationship based. More recently I told another professional that I was willing to talk but not take meds and she agreed to get me with a therapist.

Second, I think that the mental health field and Buddhism have two different aims. As far as I can see the mental health profession is designed to assist individuals through various methods of treatment to be able to function in society more effectively. Buddhism, on the other hand, is designed to assist individuals through various methods to achieve a state called "Nirvana", which doesn't necessarily allow one to function in society more effectively(and in some schools of Buddhism it is actually encouraged to not function in society at all or at least in a vastly diminished capacity) and depending on who you talk to can't really be concieved as "good"(or bad, but that's neither here nor there). Any practice enhancing results of therapy/medication/etc and any mental health improving results of Buddhism are secondary to the overall goal of the respective modalities.
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Re: Has medicalization gone too far?

Post by Johnny Dangerous »

http://www.apa.org/monitor/2012/06/prescribing.aspx" onclick="window.open(this.href);return false;" onclick="window.open(this.href);return false;" onclick="window.open(this.href);return false;"
Posting this again, so people can see a take on it from the field itself.

Here's some quotes from it:
Today, patients often receive psychotropic medications without being evaluated by a mental health professional, according to a study last year by the Centers for Disease Control and Prevention (CDC). Many Americans visit their primary-care physicians and may walk away with a prescription for an antidepressant or other drugs without being aware of other evidence-based treatments — such as cognitive behavioral therapy — that might work better for them without the risk of side effects.
Most antidepressants are prescribed by primary-care physicians who may have limited training in treating mental health disorders.
IME this has been true, exceptionally so. PCP's seem way too willing to simply give someone prescriptions for Xanax and Zoloft and not worry about therapy.

another relevant quote from the article, that shows IMO what a bad idea it is rely on black and white, simplified statements about mental heatlh:
Lower clinician reimbursement rates for psychotherapy and higher out-of-pocket costs to patients most likely contributed to the declining use of therapy, the study found. "Antidepressants are overprescribed and underprescribed in the United States," Olfson says. "Many adults with major depressive disorder go for long periods of time without receiving treatment." At the same time, many people with mild depression are prescribed antidepressants even though they aren't likely to benefit from the drugs, he added.
Health insurance reimbursements are higher and easier to obtain for drug treatment than therapy
hint hint: At least in the US, if you want to be upset about this issue, your time might be better spent looking at the insurance industry, and it's undue influence on how care is conducted IMO.

and a quote covering something Jesse was talking about:
The use of second-generation antipsychotics nearly tripled from 1995 to 2008 in the United States, ballooning to more than 16 million prescriptions for drugs such as aripiprazole (Abilify), clozapinel (Clozaril) and quetiapine (Seroquel). More than half of those prescriptions in 2008 were for uses with uncertain scientific evidence, according to a study from Stanford University and the University of Chicago based on more than 1,700 physician surveys (Pharmacoepidemiology and Drug Safety, 2011).
Of particular concern is the prescribing of antipsychotic drugs to vulnerable populations, including foster care children and elderly nursing home residents. Foster children are up to four-and-a-half times more likely to receive psychotropic drugs than other children covered by Medicaid, according to a Government Accountability Office report last year. The investigation of foster care programs in five states found that hundreds of children were prescribed multiple psychotropic drugs, including antipsychotic drugs at excessive dosages. Infants also were prescribed psychotropic drugs despite no scientific evidence supporting that use. In response to those findings, the GAO recommended the development of federal best-practice guidelines on the use of psychotropic drugs by foster care programs.
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Re: Has medicalization gone too far?

Post by odysseus »

Challenge23 wrote:Buddhism, on the other hand, is designed to assist individuals through various methods to achieve a state called "Nirvana", which doesn't necessarily allow one to function in society more effectively(and in some schools of Buddhism it is actually encouraged to not function in society at all or at least in a vastly diminished capacity)
You are wrong. Nirvana can´t be called a "state of mind" and it does makes you function even more "effectively" wherever you are. Therefore, Buddhism is far superior to any psychiatry/psychology/psychotherapy and meditation is not psychotherapy.
If any school encourages you to "not function at all in society", it´s not Buddhism. Buddhism is also about showing responsibility, not only for yourself but for society as well.
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Re: Has medicalization gone too far?

Post by odysseus »

For fun, I´ll post this joke. The only sad thing is that Dr. Hannibal Lecter was actually a good man. lol


The head-doctor
------------------------

This is a hip-hop rhyme, see
You´ve heard about the head-doctor, G..?
He´s a joker with MPD
It stands in the DSM-V
But he´s got nothing to do with me
Personally

--
* MPD = Multiple Personality Disorder
* DSM-V = Diagnostic and Statistical Manual of mental disorders

Image
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Re: Has medicalization gone too far?

Post by Johnny Dangerous »

odysseus wrote:For fun, I´ll post this joke. The only sad thing is that Dr. Hannibal Lecter was actually a good man. lol


The head-doctor
------------------------

This is a hip-hop rhyme, see
You´ve heard about the head-doctor, G..?
He´s a joker with MPD
It stands in the DSM-V
But he´s got nothing to do with me
Personally

--
* MPD = Multiple Personality Disorder
* DSM-V = Diagnostic and Statistical Manual of mental disorders

Image

Yep, pretty consistent with the level of nearly everything you've posted in the thread.
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Re: Has medicalization gone too far?

Post by odysseus »

Johnny Dangerous wrote: Yep, pretty consistent with the level of nearly everything you've posted in the thread.
It´s meant to be a little nudge-nudge. Say no more, do you know what I mean? (Monty Python´s Flying Circus).

I´m laughing my socks off of such a bunch of losers. They will not win.

Sorry to be so blunt, but they´re not correct in their practice... It´s kinda obvious. Let them hide and then come back with something better.

:smile:
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Re: Has medicalization gone too far?

Post by Mkoll »

Johnny Dangerous wrote:Yep, pretty consistent with the level of nearly everything you've posted in the thread.
Not to mention this forum.
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Re: Has medicalization gone too far?

Post by odysseus »

Mkoll wrote:
Johnny Dangerous wrote:Yep, pretty consistent with the level of nearly everything you've posted in the thread.
Not to mention this forum.
Because I´m consistent in general. Like unshakable confidence, but I guess you folks have no idea about Buddhism. A short primer for you hardballers: The first Noble Truth says: Suffering exists. :namaste:
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Re: Has medicalization gone too far?

Post by Mkoll »

odysseus wrote:
Mkoll wrote:
Johnny Dangerous wrote:Yep, pretty consistent with the level of nearly everything you've posted in the thread.
Not to mention this forum.
Because I´m consistent in general. Like unshakable confidence, but I guess you folks have no idea about Buddhism. A short primer for you hardballers: The first Noble Truth says: Suffering exists. :namaste:
I have no idea what you think Buddhism is, that's for sure.
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Re: Has medicalization gone too far?

Post by odysseus »

Mkoll wrote: I have no idea what you think Buddhism is, that's for sure.
Perhaps it´s because you keep talking the talk, but you don´t walk the walk. :crying:

To be fair, I have no idea neither but Buddhism makes me happy and gives me a good life OK? That should be enough for anybody, Mr. kill-joy.
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Re: Has medicalization gone too far?

Post by Mkoll »

odysseus wrote:
Mkoll wrote: I have no idea what you think Buddhism is, that's for sure.
Perhaps it´s because you keep talking the talk, but you don´t walk the walk. :crying:
Nope. It's because your ideas are often inconsistent and senseless.

TBH, I think many of your posts here are simply trolling, given that you said "this forum gives me a good laugh..." in another post. Trolls like to rile people up so they can laugh at their consternation. That's what I see you doing.
Namo tassa bhagavato arahato samma sambuddhassa
Namo tassa bhagavato arahato samma sambuddhassa
Namo tassa bhagavato arahato samma sambuddhassa
odysseus
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Re: Has medicalization gone too far?

Post by odysseus »

Mkoll wrote: TBH, I think many of your posts here are simply trolling, given that you said "this forum gives me a good laugh..." in another post. Trolls like to rile people up so they can laugh at their consternation. That's what I see you doing.
Well, I detect you want to ban each and every post that doesn´t fit your own concrete views. Where did the humour end up in the end? * laugh*

Don´t you detect that "a good laugh" means that you guys are cute? * laugh*
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Johnny Dangerous
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Re: Has medicalization gone too far?

Post by Johnny Dangerous »

Locking this for obvious reasons.

Here's some relevant bits from the ToS:

No Trolling

Do not be disruptive. Dharma Wheel is an environment for the discussion of Mahayana and Vajrayana Buddhism. All are welcome but are required to abide by the Terms of Service (ToS). The staff team reserve the right to edit/remove inappropriate content, and to remove or transfer any posts or threads that are not relevant to the sub-forum in which they are posted. Any subject matter that may be off-topic or is intended only to cause disruption....
Meditate upon Bodhicitta when afflicted by disease

Meditate upon Bodhicitta when sad

Meditate upon Bodhicitta when suffering occurs

Meditate upon Bodhicitta when you are scared

-Khunu Lama
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