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Sam Vaknin's Articles in Medicine

  • The Myth Of Mental Illness
    His conduct rigidly and consistently deviates from the typical, average behaviour of all other people in his culture and society that fit his profile (whether this conventional behaviour is moral or rational is immaterial), or

    His judgment and grasp of objective, physical reality is impaired, and

    His conduct is not a matter of choice but is innate and irresistible, and

    His behavior causes him or others discomfort, and is

    Dysfunctional, self-defeating, and self-destructive even by his own yardsticks.

    Descriptive criteria aside, what is the essence of mental disorders? Are they merely physiological disorders of the brain, or, more precisely of its chemistry? If so, can they be cured by restoring the balance of substances and secretions in that mysterious organ? And, once equilibrium is reinstated – is the illness "gone" or is it still lurking there, "under wraps", waiting to erupt? Are psychiatric problems inherited, rooted in faulty genes (though amplified by environmental factors) – or brought on by abusive or wrong nurturance?

    These questions are the domain of the "medical" school of mental health.
  • Euthanasia And The Right To Die
    I. Definitions of Types of Euthanasia

    Euthanasia, whether in a medical setting (hospital, clinic, hospice) or not (at home) is often erroneously described as "mercy killing". Most forms of euthanasia are, indeed, motivated by (some say: misplaced) mercy. Not so others. In Greek, "eu" means both "well" and "easy" and "Thanatos" is death.
  • The Debate About Cloning
    In a paper, published in "Science" in May 2005, 25 scientists, led by Woo Suk Hwang of Seoul National University, confirmed that they were able to clone dozens of blastocysts (the clusters of tiny cells that develop into embryos). Blastocysts contain stem cells that can be used to generate replacement tissues and, perhaps, one day, whole organs. The fact that cloned cells are identical to the original cell guarantees that they will not be rejected by the immune system of the recipient.

    There are two types of cloning. One involves harvesting stem cells from embryos ("therapeutic cloning"). Stem cells are the biological equivalent of a template or a blueprint. They can develop into any kind of mature functional cell and thus help cure many degenerative and auto-immune diseases.
  • Eating Disorders And Personality Disorders
    Patients suffering from eating disorders either binge on food or refrain from eating and sometimes are both anorectic and bulimic. This is an impulsive behaviour as defined by the DSM and is sometimes comorbid with Cluster B personality disorder, particularly with the Borderline Personality Disorder.

    Some patients develop eating disorders as the convergence and confluence of two pathological behaviours: self-mutilation and an impulsive (rather, obsessive-compulsive or ritualistic) behaviour.

    The key to improving the mental state of patients who have been diagnosed with both a personality disorder and an eating disorder lies in focusing at first upon their eating and sleeping disorders.

    By controlling his eating disorder, the patient reasserts control over his life. This newfound power is bound to reduce depression, or even eliminate it altogether as a constant feature of his mental life. It is also likely to ameliorate other facets of his personality disorder.

    It is a chain reaction: controlling one's eating disorders leads to a better regulation of one's sense of self-worth, self-confidence, and self-esteem. Successfully coping with one challenge - the eating disorder - generates a feeling of inner strength and results in better social functioning and an enhanced sense of well-being.
  • The Discovery Of Personal Hygiene
    Personal hygiene was rediscovered only in the late 19th century, having been popular in ancient Greece and Rome almost two thousand years before.

    Water was considered by the sophisticates - perhaps justly - to be the carrier of disease. Bathing in water was a hazardous exercise. Royalty used milk instead. Others were confined to wet towels or to splashing water from basins on one's face and armpits. The great unwashed utilized public baths, built throughout Europe between the 12th and 17th centuries.
  • Typhoid Mary
    Mary Mallon was a "healthy carrier" of an infectious disease, the first ever reported and observed in the New World.

    But, since then, and throughout the first two decades of the 20th century, more than 100 people were added annually to the rolls of "healthy carriers" of typhoid in New-York alone.
  • The Syphilitic Narcissist
    It is common knowledge that brain disorders, injuries, and traumas are sometimes misdiagnosed as mental health problems. But what about "run of the mill" organic medical conditions? Syphilis provides a fascinating glimpse into the convoluted world of differential diagnoses: the art of telling one form of illness from another.

    Syphilis is a venereal (sexually transmitted) disease. It has a few stages and involves unpleasant phenomena such as lesions and skin eruptions. Syphilis can go dormant (latent) for years or even decades before it affects the brain in a condition known as general paresis. Brain tissue is gradually destroyed by the tiny organisms that cause syphilis, the spirochetes. This progressive devastation causes mania, dementia, megalomania (delusions of grandeur), and paranoia.

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