A friend with bipolar disorder writes:
When I wrote in your blog that I use your discovery daily, it means that every day I look in a mirror for an hour, starting at approximately 6:30 a.m. I have the mirror about 20 inches from my face because I have read that a mirror image is half the size of the object reflected. [Life-size faces appear to work best. Using a mirror means the face you see is perfectly life-size, allowing for distance. TV faces can be larger or smaller than life-size.] To keep from being bored while looking at my face in the mirror, I mostly listen to tapes of C-SPAN programs. Sometimes I listen to music. Once or twice a week I may just think, or plan my day. That does get boring after about 30 minutes.
Sorry, I definitely was exaggerating when I wrote “doctors are amazed”. “My doctors” refers only to my psychiatrist and psychotherapist; at best, they seem “impressed” by my condition. My therapist regularly says that I’m doing “great”(variously referring to social relations, self-awareness, and general functioning) — “especially considering my situation“ and my psychiatrist once exclaimed that my bipolar disorder was in “complete remission”, albeit when we were composing an online personal ad. I do think both of them are at least mildly surprised that I seem to be doing alright on half the standard therapeutic dose of Depakote, and a low dose of Prozac.
There was an actual experience that weakly supports my claim about practitioners having no interest in utilizing your idea. I once asked my therapist to suspend his disbelief, and just imagine that your treatment does work as a strong antidepressant. Then would he mention the treatment to his other patients, or give a talk at a conference, or write up a report, or tell his colleagues? In all cases, he said “no”. Although he agreed that ideas for clinical trials have to come from somewhere, evidently that somewhere was not part of his concern.
I stress that my therapist is compassionate and reasonably intelligent, and he has helped me deal with many important practical problems. And of course in your blog even you have admitted that your idea, on the face of it, sounds way too crazy. It’s to my therapist’s credit that he claims to believe your treatment works to some degree — adding positively, “whatever works for you”. Unfortunately, that addition implies that your treatment is somehow working “psychologically” for me (e.g., as a kind of meditation) rather than working “biologically” in a way that, presumably, would work for most people.
If my doctors were following my particular case as closely as they pretend to, then they ought to be amazed. Instead, my sense is that they see me through the lens of their diagnosis. Without actually dismissing the sheer statistical improbability of my having been off of drugs and without a hospitalization for four years, they do seem to forget that fact when we discuss drug therapy. When I mention those four years, they sometimes play the skeptic, offering up alternative possibilities: it was a fluke, or I was in remission anyway, or something else. I don’t try anymore to persuade anyone, not even family, about the treatment — it’s not worth the effort.
I suppose the bigger picture is that there is little credibility to the testimony of a bipolar person who has experienced psychosis. (Perhaps my case is not helped by dramatic pronouncements of mine such as, “History will judge you. People will wonder, “why didn’t they listen to him?”) Too, I’m not paying my doctors enough to get lengthy consultations. If I were paying enough, and if I made the case with details to my psychiatrist, she might be persuaded that there is a big effect. She has a high opinion of you; in fact, she’s the person who told me of the report in The SF Chronicle (5/30/06) about the SLD diet. And, she gives some credence to Dr. Stoll’s results with omega-3 for treating bipolar. Nevertheless, for what it’s worth, I would stand by my original opinion about her not changing her practice.
There’s something else going on, as well. The psychiatrist and psychotherapist he mentions are clinicians, acting in the role of technicians. Observations of technicians in all fields are routinely discounted, particularly if they conflict with common theory. To the degree that these people also, occasionally, present themselves as scientists, their credibility is at stake if they offer the wrong kind of idea.
In medical fields there is somewhat less segregation among technicians (of certain sorts), engineers (never called that) and scientists than in others. Airline pilots typically report uncatalogged meteorological phenomena over and over for decades before they are acknowledged by meteorologists.
A third thread is legal. It’s one thing to acknowledge that something a patient is doing helps. Suppose, though, this psychiatrist recommended it to another patient, and reduced the drug dosage, and then the patient (as depressed patients do) committed suicide. What would that psychiatrist say in court? They need to be able to point at professionally approved documents justifying the treatment.
Getting from “it works” to “it’s officially approved” is very expensive. If no money needs to change hands when “it works”, who is to pay for the process? With drugs, there’s a ready source of funding for the process. This is an argument for public funding of therapies. The problem, then, is how to ensure that the money is mostly spent on therapies that end up demonstrated to work. If whoever does the work gets paid just as much for any old quackery, it’s easy to find quackery to get paid to test.
The Free Software movement has bridged the gap from “it works” to “officially approved”. Often it is able to take advantage of public funding, but more usually not. Alternative therapeutics ought to be able to adapt some lessons from Free Software.
Nathan, I tend to agree. But consider this: When a SF doctor figured out that her patients were getting mercury poisoning from fish, she told them. She didn’t worry about being sued because this was a new idea. Not only she told them, she wrote about it. Had a big effect. Obviously mercury poisoning is a far more conventional diagnosis than “not enough morning faces”. But it is possible for clinicians to have new ideas, to learn from their patients.
This is interesting, but it would be good to hear the context — how long was this person suffering what symptoms, when did they try the intervention (four years ago?), what level of remission since (half the “normal” dosage of Depakote — presumably half their previous dosage?)… it sounds like there is some backstory here that would be useful to hear. Additionally, bipolar includes mania, so if this intervention has been helpful then the mirror-strategy isn’t only anti-depressant, but mood stabilizing.
Another option might be to incorporate meditation into the morning-faces strategy, as mindfulness meditation is also, separately, used as a preventive for depression — Mindfulness Based Cognitive Therapy. There is research on this, showing mixed results, but I think the mixed results comes from the structure of the studies rather than the efficacy or lack thereof for meditation as a technique. If one were able to combine the two — staring at one’s face while meditating — perhaps it would offer another benefit — calming the mind so experiences like aversion, attraction, and boredom can be experienced with equanimity. There is also a form of compassionate meditation that people find useful for such problems.
The original post states “I have the mirror about 20 inches from my face because I have read that a mirror image is half the size of the object reflected. [Life-size faces appear to work best. Using a mirror means the face you see is perfectly life-size, allowing for distance.”
Does anyone have more comments regarding mirrors and face image size? For example, I would be interested in answers to the following questions:
Why is a distance of 20 inches, and not some other distance, correct for perceiving a life-size face image?
How about using a 2X mirror? Wouldn’t such a mirror scale the half-size image to a life-size image?
Is anyone else using a different mirror method, such as a 2X mirror, and also achieving good results?
Dean, when you look at a face in the mirror it will always be life-sized so long as distance is taken into account. In my studies of this I found that distance matters — so distance is taken into account. The best distance was roughly a conversational distance.