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A couple of the research blogs I follow lately have had some insight that really struck me as they fought off dualism in regards to the thorny issue of psychological vs. physical addiction and the brain, arguing that the elimination of mind and body distinctions is a good thing, as addictive pathways are real, physical represented by neuronal circuits.

This is an interesting argument, that collapsing psychology to the brain mechanisms brain can erase stigma by medicalizing it and making it a matter of physical function.    In addiction it makes quite a bit of sense.  We know what part of the brain is being stimulated, that dopamine reward pathways are building and feeding the habit.  The derogatory statement, “It’s all in your head,” remains technically true, but loses its bite when you can explain it in such a real and tangible way. Read the rest of this entry »


Welcome, one and all to my wrap up of all the best posts to be found on-line in my adventures in cyberspace.  This time we have no worries, the importance of intelligences, the fine line between creativity and madness, wet bugs and so much more, so dig in. Read the rest of this entry »

Few things in medicine are harder than trying to explain to a patient that you don’t understand what is going on.  As is common, I recently had an adolescent patient that had either psychosomatic stroke symptoms or actual acute resolving weakness exaggerated by anxiety.   As we very gently let him down, we explained that we could not find a physiologic reason for his weakness, now better, and that we would likely never know what caused it.  All the patient often hears in these conversations is a booming, “It’s all in your head.”  So it was under these conditions that the patient caught me off balance.  “How can you not know, you have been studying this stuff for your entire life?!” 

Avicenna, Islamic physician and philosopher

Avicenna, legendary Islamic physician and philosopher

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One thing that consistently amazes me about the human mind is its intricate relationship to our health and well being. In anxiety, your muscles remain constantly tense and flexed, burning your energy supply, leaving you exhausted. Panic attacks can feel identical to heart attacks, as your body is flooded with stress hormones.

Every specialty has their own somatoform disorder. These are real physical symptoms that occur as a result of an outside stressor. They can include headache, irritable bowel syndrome, wheezing and trouble breathing, nonepileptic seizures, paralysis, chest pain, rashes or a host of other symptoms. Despite the tendency to claim, “It’s all in your head,”all of these conditions are very real and lead to the consumption of a lot of physician’s time.
Unfortunately because they are intricately related to the mind, they tend to be written off by doctors. We tend to see conditions as either physical or mental when the truth with any disease is that there are always strong components of both.

So where does this prejudice stem from? Oddly enough, I think it is rooted in our scientifically useful proof of the mind body connection, the placebo. Read the rest of this entry »

I think I may be hitting the three month blogger’s wall. I don’t want to write stuff just to write stuff. I would like for it to actually be good and worth reading, and yet I feel a compulsion to blog, blog, blog. Work is getting busy, busy, busy. Lack of time and perfectionism seem to have buried my muse. So I am slowing down to regroup. Thankfully, I can always score points on all the stuff I wish I wrote. Here is the very best of the internet to have crossed my eyes this past week.

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