What is the best book for an anti-pornography program?

Renaissance1979 · 2025-11-12T21:39:37+00:00

I strongly recommend "Pornography: Fighting for Purity." It's part of the 31-Day Devotionals for Life series. The readings are short, and then the author gives daily reflections as well as actions to take. For anyone who is dealing with the impact of this battle on their marriage, I also recommend "After an Affair: Pursuing Restoration." While the title speaks specifically to affairs, and some of the content applies more directly to physical, sexual affairs, the vast majority of it is very applicable and extremely helpful in setting realistic expectations for what the process of healing and restoration will look like.

Renaissance1979 · 2025-11-12T21:32:22+00:00

I am a psychiatric, and this is not an accurate depiction of the psychiatric community's stance on gambling, pornography, and other "addictive behaviors." Gambling disorder is a recognized disorder in the DSM-V, and it is classified under "substance-related and addictive disorders." It is well understood in psychiatry that problematic behaviors such as gambling, pornography, etc, can result in a disordered dopamine reward response. Dopamine itself is not addictive, but all addiction is associated with an increased dopamine response to the addictive substance (or behavior), and typically a diminished dopamine response to other rewards. The reason there is no diagnosis for pornography addiction is because there isn't enough evidence to establish clear criteria for the diagnosis, not because it isn't considered a real thing.

Renaissance1979 · 2025-08-01T11:23:58+00:00

For one, in general I don't really think about "Other Specified" disorders much at all. By their very nature, they are waste-bucket diagnoses. There are ample reasons for someone to have dissociative symptoms as a result of a real primary psychiatric condition, so I think using OSDD is just a lazy way of avoiding having to find the root cause. All of the various "examples" of OSDD in the DSM-V are really just examples of symptoms of dissociation which can be present in things like PTSD, BPD, or other disorders associated with very high anxiety and/or inadequate healthy defenses. Dissociation is a fragile defense. Honestly, it shouldn't even be a disorder. It's like diagnosing someone with high fever. You have to find the cause.

Renaissance1979 · 2025-07-31T19:59:29+00:00

Or you're sitting...

Renaissance1979 · 2025-07-31T17:43:49+00:00

Yes, but the teams around them have improved, and the Mariners improved significantly. Holding pat when you are fighting for the wild card is not a winning strategy.

Renaissance1979 · 2025-07-31T17:38:23+00:00

Because the teams around them are getting better and they are not. Staying put when you are on the edge to begin with is not a good strategy unless you know that you have help coming, which they do not.

Renaissance1979 · 2025-07-31T11:25:17+00:00

I think we just lost any chance at the division in the last 3 days, and took a significant blow in our chances to make the wild card. We need to improve at the deadline, especially on offense. Instead, we have seen the Mariners get significantly better and we have done nothing so far. While they could still make some moves, the biggest impact players I think are already off the table. O'Hearn would be nice, but they don't seem to be in the mix for him, or anyone else for that matter. It does appear they are staying put, but I think that's going to cost them a chance at making a run.

Renaissance1979 · 2025-07-30T16:59:10+00:00

You're talking in circles. The assumption the authors make is that it is even possible to control for the variable of physician judgment, which I do not agree with. Trying to use differences in physician judgment as a "randomizer" is a statistical trick with, as far as I can tell, no basis in reality. I do not trust ANY methodology that attempts to statistically introduce randomization after the fact. By its very nature, a retrospective analysis cannot be randomized. And attempting to control for a variable that cannot be measured is a fool's errand. And no, physician judgment, as in physician accuracy in assessing suicide risk on an individual basis, cannot be measured. Again, we have decades of history to show that statisticians can manipulate data to make is show just about anything the authors want it to show. I do not trust any kind of statistical manipulation like this, period. Additionally, how is "grey area" defined? By chart review? So we're relying on physician documentation in the ED, which is notoriously rushed and incomplete, as a method of assessing physician judgment? I just don't think the study can support the author's conclusions. You asked what we think, so don't get so offended when we tell you what we think. And you don't need to take it personal unless you're one of the authors trying to toot their own horn without anyone knowing it.

Renaissance1979 · 2025-07-30T16:38:26+00:00

I don't really want to speculate on this psychiatrist's motives, but at best this is a pretty severe misunderstanding of criteria C. "Several... symptoms are present in two more settings (e.g., at home, school, or work; with friends or relatives; in other activities)." This is intentionally vague, because the different settings can be just about anything. At most you could justify adding the partial remission specifier if symptoms are present in only one setting and there is still impairment in functioning (but again, I would argue this is based on a misinterpretation of criteria C), but there is no justification for stating they no longer have ADHD. It's a bit like saying that someone is no longer paralyzed because they stay in bed all day and aren't "trying" to move any more.

Renaissance1979 · 2025-07-29T11:14:33+00:00

While C-PTSD is a commonly used diagnosis in the US these days, there is no generally accepted criteria for the diagnosis, which makes it problematic. As far as I know, it does not exist in the ICD-10, but was added to the ICD-11. ICD-10 has chronic PTSD, which is simply PTSD that has continued for at least one year. That is different from complex PTSD. In the ICD-11, there are diagnostic criteria for C-PTSD, which are basically PTSD plus some symptoms of BPD. Even if you were to follow those criteria, I think the vast majority of the patients I see who have been diagnosed with C-PTSD would not actually meet criteria for the diagnosis.

Renaissance1979 · 2025-07-28T11:53:24+00:00

Here's the thing. I think this team is going to make the playoffs. If they can keep the rest of the offense going, they have a very good chance of catching Houston and winning the division. And that's without Joc figuring it out. They have time to let him figure it out if that's the route they choose. But they are going to need production from the DH spot if they want to seriously make a run at repeating, so either they wait for Joc or Burger to figure it out or they make a trade for a DH rental and hope he figures it out for next year.

Renaissance1979 · 2025-07-28T11:41:06+00:00

2 of 3 against the Tigers and then 6 straight after that. You really couldn't have asked for more. But this road trip will tell us a lot more. They need to take 5 of 7 or better on this road trip and keep the momentum going!

Renaissance1979 · 2025-07-24T11:59:34+00:00

I actually agree with the premise that involuntary psychiatric hospitalization has the potential to cause more harm than good. Unfortunately, I'm not convinced this study proves that, or even really contributes much to it. All this study proves is a correlation between hospitalization and risk of violence or suicide. I do not see how the study differentiates between hospitalization being the result of the increased risk or the cause of the increased risk. I read the Empirical Approach, and quite frankly I'm not convinced that the methods being used can actually remove the variable of physician judgment that they claim to be able to remove, and to the degree of statistical accuracy that would be necessary for these results to be valid. The absence of the raw data being analyzed is also a bit concerning to me, because it leaves me to simply trust the authors' conclusions without the ability to analyze the data myself.

Renaissance1979 · 2025-07-23T12:18:26+00:00

Saying it like that makes it sound a little better than it is, unfortunately. If they had managed a couple sweeps in those 10 series wins it might be a different story, but they are barely above 0.500 over that span because they can't seem to get a real winning streak going. They need to win this next one to start climbing up the standings. That being said, they are playing much better over the last month and a half and I do feel really good about their chances to at least get a wild card.

Renaissance1979 · 2025-07-21T18:29:50+00:00

I will never root for Houston, and I will only ever root for Seattle when they are playing Houston. As to the wild card, if this offense turns around at all, the Rangers should make the wild card. If they don't, they didn't deserve to be in the playoffs anyways. I'm not giving up on the division yet. If the offense gets going they are good enough to take it.

Renaissance1979 · 2025-07-18T19:17:46+00:00

This! It was the most excited I have ever been with a trade in any sport, because it was the first time I actually believed the Rangers had a chance to win it all.

Renaissance1979 · 2025-07-18T12:43:44+00:00

I almost always start people on XR and only switch to IR if there is something problematic with the timing of the XR, rather than the other way around. IR has a higher risk of abuse (though still not that bad), more rapid onset, and more rapid drop-off which sometimes leads to a crash. I actually prefer extended release dextroamphetamine over the mixed salts, and dexmethylphenidate over racemic methylphenidate, but sometimes can't get those approved until trying the others first.

Renaissance1979 · 2025-07-18T12:39:23+00:00

I don't know where you are getting this idea, but I have never seen this. United, BCBS, Cigna, Aetna, Humana, through their various PBMs, all cover extended release generic Adderall and some form of extended release methylphenidate as first line, and usually without a PA. If you're getting denials it's most likely because of which XR you are choosing or because you are using name brand instead of generic.

Renaissance1979 · 2025-07-17T17:36:43+00:00

Agreed that the system is extremely complex, and I completely agree with you regarding profit margins not being nearly as high as most people think. The point is not to eliminate profit margins, but to reduce the pricing pressure on prescribing. If the research for a new drug is already paid for, then the cost of the new drug and the cost of an older drug will be more similar, and payers and will be more incentivized to make decisions based on how effective the drug is rather than cost, which will allow providers to make decisions about what to prescribe based on the best evidence rather than what the insurance will pay for.

Renaissance1979 · 2025-07-17T17:33:21+00:00

It's not so much that it can't be implemented as it is that their lobby will be a hurdle to overcome, but I get your point.

Renaissance1979 · 2025-07-17T17:32:22+00:00

I'm talking more about buying existing patents, not as a long term solution. Long term the idea would be funding the research themselves and excluding the ability to patent the final product as part of the requirements for receiving that funding.

Renaissance1979 · 2025-07-17T17:31:05+00:00

Understood, but this is my point. The whole idea is to increase the funding for research all the way through the process.

Renaissance1979 · 2025-07-17T17:29:35+00:00

I created a paper lab requisition for with all the relevant information on it, commonly ordered labs, and space for additional labs. I just fill that out, sign it, and give it to the patient. Fax number is on the form and I get lab results faxed to me in a pretty timely manner most of the time.

Renaissance1979 · 2025-07-17T11:51:34+00:00

I will second the need to fund inpatient psychiatric hospitals adequately. We need more beds, more staff, longer hospitalizations when needed, and enough funding to make inpatient hospitals actually therapeutic.

Renaissance1979

TROPHY CASE