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Medicalization of Deviance?

well, i studied psychology (visited a mental hospital w/ my 400 level class) for several years in college, and I've read and experienced enough to formulate my own opinions about the matter. and thats all that either of us have- opinions. It is my opinion that behavior and thoughts allow mental health professionals to categorize someone as sane or insane. i dont believe such a distinction is valid, as mental health is complex, and not dichotomous like they would have you believe.

I'm not concerned that they make a profit. everyone has bills to pay. im simply concerned that the pseudoscience of psychiatry has convinced our culture that people like you or myself are unfit to govern our own lives and must be aided pharmacologically. The problem is not behaviour or personal conduct, it is the restrictions and ordinances placed on the population that cause a disruption in one's well-being.
 
First off, mental health professionals have not used the term sane or insane for at least 70 years, the term is now only used in legal settings and has no meaning or relevance to psychology or psychiatry.

It is my opinion that behavior and thoughts allow mental health professionals to categorize someone as sane or insane. i dont believe such a distinction is valid, as mental health is complex, and not dichotomous like they would have you believe.

Secondly, I agree. Mental health is definitly not dichotomous and any psychiatrist/doctor/phsycologist who believes it is should lose their degree. But i dont believe most believe it is. For instance Even the DSM recognizies the complexities of diagnosing mental disorders. A recent change to the next edition of the DSM(I think this is true correct me if im wrong) will be the removal of aspergers and the inclusion of an autistic spectrum(which will include aspergers), hence the DSM is recognizing the huge variety and complexity of autism and the fact that it is not a single disease much alike to schizophrenia, which is also considered a spectrum of diseases rather than just one.

I agree with both sides of this argument, but there are ways to look inside the brain in fact there are many ways: MRI, fMRIs, ECG, CT or CAT and many others ways to look inside the brain. And in a lot of mental illnesses they have shown differences between the brains of people with a mental illness and people without, for instance the frontal lobes are indicated in ADD/ADHD and a structure(i forget which one) within part of the frontal lobes is abnormal within an ADD/ADHD mind, they have done brain imaging with major depression and discovered subtle differences/abnormalities compared to a "normal brain" too.
Also Psychology does deal with the brain in fact there are many fields focused on the brain within psychology, probably the most relevant would be NEUROPSYCHOLOGY! its a huge developing field where they study the brain in great detail and how human behavior relates to brain structures. I am currently enrolled in an undergraduate course on Neuropsychology.

If a doctor could look at a person's brain, point out an area where there is a physical, tangible difference and say "this is why this person has ADD/depression/anxiety" I would agree and say it is an illness. Otherwise, I look at it as strange behaviors due to something possibly in the person's upbringing.
^They can look at a person's brain and as i explained before there are tangable differences between ADD/(major)depression/anxiety(Generalized, PTSD, chronic..) and a "normal" brain.

To say that psychology doesn't look at or deal with the brain is ridiculous... it is just that in most cases a patient or a client cannot afford a MRI or other brain imaging technique so they base the diagnosis off of reported symptoms and observed behavior.
That being said I do believe that many many drugs like SSRI (and other anti-depressants), benzos, and amphetamines are over prescribed and are not a cure for an illness, in many cases they hinder progress. I also agree with you that people who may show eccentric or antisocial(not the personality disorder, but antisocial as in shy, introverted, nontalkitive.) tendencies are given drugs to "normalize" them when they should not be. Whats going on today with children and ADD/ADHD diagnosis in this country is appaling(and reckless, disgusting, inhumane even) and seems like an attempt for parents/society to control there childs behavior.
Finally one of the basic concepts behind psychology is the nature vs. nurture philosophy: For example when looking at twin studies(identical, gentically clones) with schizophrenia spectrum disorders, if one twin has schizophrenia the chances the other twin will have it is very high, but if the twins were raised seperatly by different parents and again if one twin has schizophrenia, the chances of the other twin having it are lower, than if they were raised together. But the chances of the twin, whose other twin has schizo.., and was raised seperatly still has a much greater chance of having becoming schizophrenic than the average person. Hence there is evidence that schizophrenia is partly genetic (nature) but also life events, upbringing and personal history/story (nurture) plays a large role in whether someone will become schizophrenic or not. One of the most important concepts within psychology is that no illness/disease/disorder is all nature or all nurture its a mixture of the two.
here is a link to what i was talking about, has pictures that show obvious differences in the brains of identical twins one with schozophrenia and one without:
http://www.schizophrenia.com/research/hereditygen.htm
 
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In my undergrad I did a few research positions (like you know, go and be a bitch to a Doctoral student, who is in turn the Prof's bitch and do lab work) in radiology and nuclear medicine. In one of them, we where doing diffusion tensor MRI and single photon emission computed tomography comparison between people bipolar 1 and control. I do recall there being a subtle, but statistically significant difference in blood flow to certain areas of the brain at the level that I was working at. (Which was essentially just crunching numbers from raw data...I was not blinded, and that was indeed part of the reason I was there, to be able to crunch numbers and work with data without needing to be blinded between experimental and control populations...the Doc students and Prof needed to be kept blinded).

Currently, my research assignment in my M.Sc physics degree is related to radiotherapy of solid neurotumours. While not directly related to this issue in the thread, we do note a difference in cognition and behaviour based around what areas of the brain are irradiated at extremely high doses. Because, well, ya, it damages the brain, and we have to find collametry techniques to avoid this as much as possible. But as some the induced lesions caused by over-dosage of radiation have similarity to some mental illness, it provides evidence that mental illness, like everything else to do with the mind, be reduced to the physical state of the brain.
 
Though (as usual) I'll second just about everything said by rangrz, Jerry, and MDAO, I'm surprised that no one's yet broached the thorny topic of the so-called 'personality disorders' as described by the DSM. In contrast to the readily apparent debilitation and distress induced by, say, psychoses or anxiety disorders, many of these 'illnesses' (if you could even validly index them by that name) of personality are classified by the extremity and variety of 'deviate traits' exhibited by their 'sufferers.' For obvious reasons, personality disorders are perfect representative cases of the critical points made by Foucault, Laing, and the anti-psychiatrists. While I do not sympathize with the sentiments of hardline anti-psychiatrists, I am of the firm opinion that the current edition of the DSM (the manual providing the descriptive paradigm within which most researchers work and to which most clinicians refer for diagnostic purposes) is of mixed clinical value at best. It is a bloated, ethically questionable catalog purporting to enumerate and describe the full scope of human mental dysfunction, which dysfunctions include, in some cases, mere deviance from a vague societal norm, as the OP addressed in the title of this thread.

Take, for instance, 'Schizoid Personality Disorder,' which effectively categorizes apathetic, dreamy loners as having a mental disorder that shares a loose (unproven?) epidemiological connection to psychosis. This is a particularly innocuous example, as diagnosis of SPD is rare, but a quick glance at the DSM criteria for a variety of such 'illnesses' will reveal a distressing pattern indicating that the psychiatry, as a field of medicine and a discipline in its own right, has quite a long way to go before it fully dissociates itself from its dubious origins as means of social control on the one hand, and a verbose, overly descriptive pseudo-science on the other.
 
Thats true the personality disorder diagnosis definitely seem like a remnant of psychology's past more pseuodoscience theories, like Freud and many others these theories that attempt to broadly categorize "strange"(non-societal) behaviors. Is there any empirical evidence supporting the personality disorders? Also part of the dogma around personality disorders is that they are essentially permanent and unchangable, hence what's the point in a diagnosis of there is no cure, treatment, or even the attempt to find a cure or treatment. In some ways personality disorders could be seen as scapegoat diagnosises...
Haha im rather green in the head atm.
 
well, i studied psychology (visited a mental hospital w/ my 400 level class) for several years in college, and I've read and experienced enough to formulate my own opinions about the matter. and thats all that either of us have- opinions. It is my opinion that behavior and thoughts allow mental health professionals to categorize someone as sane or insane. i dont believe such a distinction is valid, as mental health is complex, and not dichotomous like they would have you believe.

I'm not concerned that they make a profit. everyone has bills to pay. im simply concerned that the pseudoscience of psychiatry has convinced our culture that people like you or myself are unfit to govern our own lives and must be aided pharmacologically. The problem is not behaviour or personal conduct, it is the restrictions and ordinances placed on the population that cause a disruption in one's well-being.

Whatever dude. Sounds to me like you had a bad experience and you're blaming the system without having participated in it deeply enough to create an informed opinion of it. It sounds like you still do not know what it is like to actually BE mentally ill. By your logic, since you have not experienced it then it must not exist. That's fine, I hope you never do.

I'm not saying it's a perfect system but what system is?
 
Personality disorders are not common diagnoses, IME. I seldom ever see one in a person's medical history. Remember, folks, it's a problem if you suffer from it. If you seek treatment, or someone who's close with you seeks help on your behalf out of grave concern or utter frustration, the odds are your mentations are a source of problems, and you know it at some level. Personality disorders are simply beliefs about one's relationship to the greater world and other people that are maladaptive. Some people have such unhelpful ideas of what the world owes them and what they do or don't owe the world, that they stand to benefit from treatment.

Yellownikes, I didn't say psychology and psychiatry don't look at or deal with the brain. Of course it does. It's impossible for any branch of medicine and the health sciences to not look at and deal with the whole human body, after all. But I did say these disciplines study primarily behavior. Meaning that most of the experimental data in these sciences are human behavioral acts. When it comes to the clinically important research and clinical practice of these sciences, brain scans (and biopsies) play a much more minor role than pop science might have you believe.

I'm not denying that there is cutting edge research at top-tier research institutions making great strides in bridging neurology with psychiatry and psychology. Nor do I deny that some of the fruits of this research will have profound influences on the future practice of both disciplines. I'm simply saying that for most activity of most people involved in any way with psychiatry and psychology today, results seldom consist of anything but stimulating people a certain way, and documenting the responses observed.

trees_please, try to see your experience as the justice system allowing you a graceful out. Because that's essentially what they gave you by ordering you to see a mental health professional. They gifted you with a chance to save face, by being able to say that whatever you did to land yourself in court was the unfortunate result of your mental state run amok, rather than the less charitable alternative that you're just a scofflaw who knew exactly what he was doing. Don't see your experience as a taste of the mental health system, so much as a court experience masquerading as a mental health experience.

Again, I don't know your story. All I'm saying is, I think if you sought out a mental health professional yourself for a thought process that was really bothering you and keeping you from focusing on important things, you'd likely have a very different experience.
 
Wow I haven't looked at this thread in a few days, glad to see some people discussing.

I just wanted to reply to Jerry Atrick. I wasn't trying to insult anyone or be insensitive in making this thread and I do apologize for that, I realize my arguments could definitely be insensitive to a person suffering from some of the things we are discussing. Also, my use of the word insane wasn't really right... I knew I'd get some grief for that haha.

I think I shouldn't have made such a broad statement, like "mental illness doesn't exist." I think that's not really what I'm trying to say. I think we classify what is called "mental illness" badly... I still feel that it is not necessarily an illness. It is simply learned or acquired behavior. Now, that does not mean these behaviors won't have some terrible consequences. If you act "strange," people are less likely to associate with you.

I think the thing I am particularly upset about is the hard to diagnose conditions that often have handfuls of drugs thrown at them. Things like depression, ADD, and to an extent, anxiety. Like I said, it is far too easy to get prescribed Xanax or ADD meds. I recently heard a story of a mother putting her 3 year old son on Adderall.. does that not sound terrible to anyone else? I think people look for instant cures far too much, when healthier alternatives may help. As the title states, I think the very act of being different, of not conforming, is being medicated. Another idea... Not long ago, homosexuality was considered a mental illness.

Well anyways, just wanted to apologize if I was coming off as horribly insensitive haha cheers everyone
 
MDAO said:
Yellownikes, I didn't say psychology and psychiatry don't look at or deal with the brain. Of course it does. It's impossible for any branch of medicine and the health sciences to not look at and deal with the whole human body, after all. But I did say these disciplines study primarily behavior. Meaning that most of the experimental data in these sciences are human behavioral acts. When it comes to the clinically important research and clinical practice of these sciences, brain scans (and biopsies) play a much more minor role than pop science might have you believe.

For my part, I simply linked to those imaging studies and described my (minor) hands on experience with this kind of research just to demonstrate that, at least in the realm of academic science (although, as you state, not really so much in clinical medicine) neuro imaging can readily demonstrate some sort of organic brain anomalies which have a statistically significant association with various mental illnesses. Similarly, I wanted to high light some of the general concepts/techniques that are used to pharmacologically show a very real, physical mechanism behind the symptoms of mental illness.
 
rangrz, I definitely agree that CNS diseases and injuries produce problems thinking, so by definition, psychiatric diseases. Docs would classify these as secondary psychiatric illnesses, or more commonly, "organic brain disorders". There are also primary psychiatric illnesses, that are primary disorders of thought and mindstate, not reliably causally linked to a specific insult to the nervous system. Secondary psychiatric issues are usually treated, like most secondary diseases, by treating the underlying issue. So it's usually a neurologist who manages these patients. Sometimes they'll collaborate with a psychiatrist or psychologist, especially if the thought problems are a major source of distress.

Primary psychiatric problems, on the other hand, are typically treated by psychiatrists, or even primary care doctors sometimes if they're not too complex. The treatments used, especially those involving psychoactive drugs, are definitely supported by research showing correlations between brain imaging in people with and without the thought problems, and/or patients before and after starting a certain drug. I'll grant you that these sorts of studies make drug design possible in a way that's far less hit-or-miss than eating wild plants willy nilly. :)
 
^

Yeah, I know what you mean by the distinction between secondary psychiatric from a brain pathology or endrocrine disorder vs primary psychiatric. While the primary psychiatric disorders don't have quite the same precise and definitive link to an identifiable and specific physical pathology, I was under the impression that, like in the studies I linked to, at least in the abstract and sky gazing atmosphere of academic research, there are many studies showing some non-focal and non-specific brain differences between control groups and experimental populations who have already been diagnosed with a primary psychiatric illness via the accepted criteria, and I just wanted to post that to help debunk the myth that mental illness is either "made up" or that the mind does not reduce to the state of the brain.

Would not the effectiveness of pharmacological treatments for mental illness and the ability of pharmacological agents to induce, at least temporarily, symptoms very similar to assorted mental illnesses not in some sense imply a strong casual connection between certain pathways and systems in the brain, and aberrant processes within them giving rise to mental illness? Particularly when combined with the imaging studies?

Certainly, these are not perfect models, but no model is ever perfect, and let's face it, between the sheer difficultly of working with biological systems as complex as a brain, and the ethical implications of it, we can't expect to experiments that are as perfect as the type we use in physics or chemistry. But the models are decent.

I also think educating the population about the links between the physical system of the brain and the mind is important and helpful to reduce the stigma of mental illness and get people to take it seriously, and not just as "being weak"...they generally would not call someone with a Meningioma "weak" or stigmatize them, so I think by showing that in some sense, mental illness is physical, just on a smaller size scale and more complex mechanism, they will be less likely to be dismissive of mental health patients and more likely to seek help and comply with their physician's treatment recommendations, would you not agree?
 
rangrz, I'll go into more detail on this later, but I don't think mental health care should hinge in any way on philosophy of mind. I am skeptical that a form of (or replacement for) psychiatry that switches the target of care entirely from the patient's subjective mindstate to their physical brain would achieve greater mental wellbeing across the population, or better compliance.

I soundly reject any suggestion that I have an obligation under the ethics of healthcare to champion a materialistic monist account of the human mind, if that's where you're going with this. One can conclude that a problematic mindstate is probably the result of a chemical anomaly in their CNS (and treat accordingly) without any global commitment to any one account of what and why consciousness is, and I think that's the way it should be.
 
Rangrz said:
there are many studies showing some non-focal and non-specific brain differences between control groups and experimental populations who have already been diagnosed with a primary psychiatric illness via the accepted criteria, and I just wanted to post that to help debunk the myth that mental illness is either "made up" or that the mind does not reduce to the state of the brain.

I think that this point is fair, but we're also talking about small differences between statistical averages of the experimental and control groups that fall out once a study has sufficient statistical power (with some fMRI studies, though, this occurs with relatively small Ns). It's not the case that we can use tools like fMRI to reliably diagnose individuals. Really, cognitive neuroscience is in its very infancy, and we'll need better scanning tools (that is, with a very high temporal and spatial resolution but non-invasive) and better theories of how cognition relates to physiology before we have valid, enduring neural theories of psychopathology.

However, this still doesn't get at issues with the social construction of psychopathology. Even if there are clear physiological correlates with a particular disorder, this doesn't really justify the validity of one empirically consistent typology of diagnosis over another without a clear causal theory of how neural pathology manifests.

Would not the effectiveness of pharmacological treatments for mental illness and the ability of pharmacological agents to induce, at least temporarily, symptoms very similar to assorted mental illnesses not in some sense imply a strong casual connection between certain pathways and systems in the brain, and aberrant processes within them giving rise to mental illness?

Not quite. The dopamine hypothesis for schizophrenia or the serotonin hypothesis for depression make rather telling examples. While it is the case that exogenously increased dopaminergic activity is psychotomimetic and that dopamine antagonists relieve some symptoms of schizophrenia, the efficacy of other types of agents as psychotomimetic and medications other than dopamine antagonists as anti-psychotics suggests that something more complicated is going on. While it's highly likely that dopamine plays a role in modulating the neural circuits that 'malfunction' in the case of psychosis, dopamine's effects manifest quite downstream and may also mostly be a consequence of other neural pathology.

The case is even more clear with the serotonin hypothesis for depression. It seems that SSRIs are effective insofar as they induce profoundly downstream effects, and that the primary neural mechanism for depression lies several steps downstream from serotonergic modulation (right now, epigenetic regulation of BDNF synthesis is a good candidate for main mechanism lying behind depression).

To make another analogy, if I like coffee in the morning, does it suggest that I have an overactive adenosine system that needs to be antagonized? No, probably not. :p

But the models are decent.

Not yet, they're not. These models are very young and will be subject to stark 'paradigm shifts', likely pushed largely by further technological development.

ebola
 
i agree with ebola. i dont think we know much at all about neuropsychology, and even less about human consciousness. you can be sure as shit about that.
 
i agree with ebola. i dont think we know much at all about neuropsychology, and even less about human consciousness. you can be sure as shit about that.

We do, however, know about human experience. Some people suffer from a severe mental illness and are able to obtain the proper therapy and/or medication regimen and are lucid enough to talk about their previous or current experiences.

Would you rather learn about this stuff from the primary source (the patient) or learn about it after being filtered through the interpretation of a secondary source (the doctor or therapist)? The question is rhetorical and I imagine the most accurate answer lies somewhere in between the two poles.
 
The fundamentals of human experience vary greatly. no two individuals are the same. therefore, a diagnosis of mental health does very little in the way of helping the person.

And in response to your rhetorical question, one does not gather information from a single source. That's an effective way to develop opinions or bias.
 
The fundamentals of human experience vary greatly. no two individuals are the same. therefore, a diagnosis of mental health does very little in the way of helping the person.

I'm not denying that. In your previous post, you said we didn't know anything about neuropsychology and human consciousness. I was merely stating an alternative to those two things that apparently nobody knows anything about.

You are correct that no two individuals are the same. However, unique individuals can display patterns of behavior that can be documented and compared with other unique individuals.

And it isn't as black and white as you make it out to be. You seem to think that if no two individuals are the same, then the entire discipline of mental health is somehow invalid. It doesn't work that way. Sorry. Your closed mindedness, and I don't mean that as an insult, isn't helping you.

And in response to your rhetorical question, one does not gather information from a single source. That's an effective way to develop opinions or bias.

First, I was speaking in general terms when I said "the patient" or "the doctor." It could be any patient or doctor.

Second, although one may have difficulty drawing conclusions from a single source, a walk of a thousand miles begins with a single step. Over time, one can take dozens or even hundreds of "single sources" and learn from the patterns that manifest. Not all qualitative research is lacking in quantitative analysis. Have you ever done research? Not library research for an undergrad class, I mean real research where....you know....you interview people and stuff. It sounds like you are not in grad school but maybe you wrote an undergraduate honors thesis or something.

There is a whole discipline to doing qualitative research. I've taken undergrad and grad courses in it and completed a master's thesis to earn another degree.

Once again, this type of research is not as black and white as you may think. Science snobs often discount it as not having enough sources or math or some shit. That's only because their minds are trapped in a box of numbers and they can't think outside of it. Qualitative research, when done correctly, is both valid and useful.

Third, tell us the sources of your opinions and bias. I shared how I came to know the MH system. You shared with us that you stuck your toe in the water but never jumped (or fell) in. It sounds to me like my opinions and bias come from first-hand experience while your opinions and bias come from hearsay.
 
Im not sure if youre just making assumptions about me or what, but im pretty sure i explained; ive experienced anxiety and depression for much of my life, studied psychology (yes, unergrad. youre correct). had a brief experience with counseling, and the obvious 20+ years ive had on our planet to observe and think of these things has brought me to the conclusions ive made.


And it isn't as black and white as you make it out to be. You seem to think that if no two individuals are the same, then the entire discipline of mental health is somehow invalid. It doesn't work that way. Sorry. Your closed mindedness, and I don't mean that as an insult, isn't helping you.

dude thats literally the opposite of what ive been arguing. that it isnt black and white! no one is depressed or not depressed, bipolar II or not bipolar II. I know for a fact that the system of mental health is based on theories and subjectivity as opposed to fact and objectivity. its not really relevent why i think that, so why dont you explain otherwise, because your years of research has clearly provided you with more insight and knowledge than my misleading experiences.
 
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I soundly reject any suggestion that I have an obligation under the ethics of healthcare to champion a materialistic monist account of the human mind, if that's where you're going with this. One can conclude that a problematic mindstate is probably the result of a chemical anomaly in their CNS (and treat accordingly) without any global commitment to any one account of what and why consciousness is, and I think that's the way it should be.

No, not an ethical obligation. I would say as long as you treat your patients based on scientifically valid and tested treatments, and give them accurate/truthful information, you're meeting the highest standard of ethical conduct a human being can do, that of compassionate and effective reduction in the suffering of another.

I was more suggesting that the physical emphasis of mental health be a public type thing. Not between a physician and his or her patient, but by teachers in classrooms and in those typical PSA's put out by government and medical institutions/interest groups, just because I think on a population level, people* are far more accepting of illness's they perceive/understand as being physical/biological, and marginalize the ones they don't as more or less "That person is just a pussy/stupid fuck/depraved cunt" I see this even with illness's that not per se mental health issues but for which there is no obvious or distinct physical pathology. "Pain patients are just drug seekers" or "Fibromyalgia is just a bullshit syndrome made up by lazy, bitchy women." that sort of attitude seems to be present in a lot of people's opinion of mental health, and I think it's for the same reason, the lack of a tangible physical pathology they can see/understand, or that they can wiki or have handwavey explanations provided to them by a Dr or whoever, like one can do with most internal medicine conditions, even if they are esoteric, one can still say "sickle cell disease is cause of a gene that makes the red blood cells misshaped and they can't fit though capillaries properly so the patient's body does not get enough oxygen and this can cause debilitating pain and weakness so sometimes they can't go to work/school when it flairs up" People accept that, cause it seems "physical" and therefore 'real' and beyond the patients control and not just weakness or laziness. If you tell them "This person has depression. So sometimes he gets really sad due to situations that would not make normal people so sad, and becomes overwhelmed and withdraws and disengages from social activity and life in general and even attempted suicide because he had no will to live." People hear that as "lolol, this guy is just a weak, attention seeking faggot who needs to get over it."

*people being the general population lacking any sort of biomedical background, or more generally, lacking a scientific education of any sort beyond high school.
 
Im not sure if youre just making assumptions about me or what, but im pretty sure i explained; ive experienced anxiety and depression for much of my life, studied psychology (yes, unergrad. youre correct). had a brief experience with counseling, and the obvious 20+ years ive had on our planet to observe and think of these things has brought me to the conclusions ive made.




dude thats literally the opposite of what ive been arguing. that it isnt black and white! no one is depressed or not depressed, bipolar II or not bipolar II. I know for a fact that the system of mental health is based on theories and subjectivity as opposed to fact and objectivity. its not really relevent why i think that, so why dont you explain otherwise, because your years of research has clearly provided you with more insight and knowledge than my misleading experiences.

I dunno, maybe I was getting your posts confused with Euphio's. Weren't you the one who said you once had court-ordered therapy and at another time went to a psych hospital as part of a class to talk to patients? That on top of studying psychology in college? I'm recalling this from memory and I am high, but I thought that was one of your posts. If it was your post and you are telling the truth, then no, I'm not making assumptions. Is there anything you are not sharing that would cause my statements regarding your own history (as told by you) to be false?
 
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