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View Full Version : The tragedy of Vandeman.


Eamon Stanley
October 17th 03, 06:25 AM
Try this one if you haven't:

. Do it in Groups.

18400 hits registered. I haven't been around since 1997, and he was
the #1 waste of bandwidth then. This too shall (not) pass away. It
fails of comprehension that so many people with so many other things
to talk and think about waste so much time responding to and thinking
about this "mother of all trolls", who has been arguing with one foot
nailed to the floor for about a decade now. Amazing.
Oh, and Mikey? I don't own a mountain bike, and I don't own a car,
so don't bother.

In Effigy,
Sandmaster

October 19th 03, 10:14 PM
Eamon Stanley > wrote:
: 18400 hits registered. I haven't been around since 1997, and he was
: the #1 waste of bandwidth then. This too shall (not) pass away. It

Well, a decade of internet campaigning shows some determination,
right? And determination as well as achievement are good things,
right? (Or is that just a national prejudice ->
http://www.sisugrp.com/sisuis.htm) So it's a merit of kinds... a
reputation for having the merit, etc.

: fails of comprehension that so many people with so many other things
: to talk and think about waste so much time responding to and thinking
: about this "mother of all trolls", who has been arguing with one foot
: nailed to the floor for about a decade now. Amazing.

There could be multiple reasons why such behaviour could be
classified rational. Maybe trolling serves online discussion.
Spamming is a huge problem and people like to address it. Or
people like to grasp the earliest available possibility to exhibit
their views :-)

--
Risto Varanka | http://www.helsinki.fi/~rvaranka/hpv/hpv.html
varis at no spam please iki fi

RK
October 22nd 03, 07:01 PM
wrote in message >...
> Eamon Stanley > wrote:
> : 18400 hits registered. I haven't been around since 1997, and he was
> : the #1 waste of bandwidth then. This too shall (not) pass away. It
>
> Well, a decade of internet campaigning shows some determination,
> right? And determination as well as achievement are good things,
> right? (Or is that just a national prejudice ->
> http://www.sisugrp.com/sisuis.htm) So it's a merit of kinds... a
> reputation for having the merit, etc.
>
> : fails of comprehension that so many people with so many other things
> : to talk and think about waste so much time responding to and thinking
> : about this "mother of all trolls", who has been arguing with one foot
> : nailed to the floor for about a decade now. Amazing.
>
> There could be multiple reasons why such behaviour could be
> classified rational. Maybe trolling serves online discussion.
> Spamming is a huge problem and people like to address it. Or
> people like to grasp the earliest available possibility to exhibit
> their views :-)

obĚsesĚsion
n.
1)Compulsive preoccupation with a fixed idea or an unwanted feeling or
emotion, often accompanied by symptoms of anxiety.
2) A compulsive, often unreasonable idea or emotion.


Obsesive-Compulsive Personality Disorder

Diagnosis Program
Online diagnosis of this disorder is available at MyTherapy.com , Dr.
Phillip Long's website.
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European Description

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The ICD-10 Classification of Mental and Behavioural Disorders
World Health Organization, Geneva, 1992
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F60.5 Anankastic (Obsessive-Compulsive) Personality Disorder
Personality disorder characterized by at least 3 of the following:

(a) feelings of excessive doubt and caution;
(b) preoccupation with details, rules, lists, order, organization or
schedule;
(c) perfectionism that interferes with task completion;
(d) excessive conscientiousness, scrupulousness, and undue
preoccupation with productivity to the exclusion of pleasure and
interpersonal relationships;
(e) excessive pedantry and adherence to social conventions;
(f) rigidity and stubbornness;
(g) unreasonable insistence by the patient that others submit to
exactly his or her way of doing things, or unreasonable reluctance to
allow others to do things;
(h) intrusion of insistent and unwelcome thoughts or impulses.

Includes:
* compulsive and obsessional personality (disorder)
* obsessive-compulsive personality disorder

Excludes:
* obsessive-compulsive disorder


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Personality Disorders
A personality disorder is a severe disturbance in the
characterological constitution and behavioural tendencies of the
individual, usually involving several areas of the personality, and
nearly always associated with considerable personal and social
disruption. Personality disorder tends to appear in late childhood or
adolescence and continues to be manifest into adulthood. It is
therefore unlikely that the diagnosis of personality disorder will be
appropriate before the age of 16 or 17 years. General diagnostic
guidelines applying to all personality disorders are presented below;
supplementary descriptions are provided with each of the subtypes.

Diagnostic Guidelines
Conditions not directly attributable to gross brain damage or disease,
or to another psychiatric disorder, meeting the following criteria:

(a) markedly dysharmonious attitudes and behaviour, involving usually
several areas of functioning, e.g. affectivity, arousal, impulse
control, ways of perceiving and thinking, and style of relating to
others;
(b) the abnormal behaviour pattern is enduring, of long standing, and
not limited to episodes of mental illness;
(c) the abnormal behaviour pattern is pervasive and clearly
maladaptive to a broad range of personal and social situations;
(d) the above manifestations always appear during childhood or
adolescence and continue into adulthood;
(e) the disorder leads to considerable personal distress but this may
only become apparent late in its course;
(f) the disorder is usually, but not invariably, associated with
significant problems in occupational and social performance.

For different cultures it may be necessary to develop specific sets of
criteria with regard to social norms, rules and obligations. For
diagnosing most of the subtypes listed below, clear evidence is
usually required of the presence of at least three of the traits or
behaviours given in the clinical description.


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American Description

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Diagnostic Criteria
A pervasive pattern of preoccupation with orderliness, perfectionism,
and mental and interpersonal control, at the expense of flexibility,
openness, and efficiency, beginning by early adulthood and present in
a variety of contexts, as indicated by four (or more) of the
following:

is preoccupied with details, rules, lists, order, organization, or
schedules to the extent that the major point of the activity is lost
shows perfectionism that interferes with task completion (e.g., is
unable to complete a project because his or her own overly strict
standards are not met)
is excessively devoted to work and productivity to the exclusion of
leisure activities and friendships (not accounted for by obvious
economic necessity)
is overconscientious, scrupulous, and inflexible about matters of
morality, ethics, or values (not accounted for by cultural or
religious identification)
is unable to discard worn-out or worthless objects even when they have
no sentimental value
is reluctant to delegate tasks or to work with others unless they
submit to exactly his or her way of doing things
adopts a miserly spending style toward both self and others; money is
viewed as something to be hoarded for future catastrophes
shows rigidity and stubbornness


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Obsessive-Compulsive Personality Disorder
Treatment

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Phillip W. Long, M.D.
1990
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Contents
Medical Treatment
Basic Principles
Hospitalization
Antidepressant Drugs
Psychosocial Treatment
Basic Principles
Individual Psychotherapy
Family Therapy

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Medical Treatment
Basic Principles
When they are confronted with physical illness, individuals with
compulsive personality disorder are particularly troubled by the sense
of loss of control over bodily functions. There may be exaggerated
worries about submitting to authority figures.

The patient will attempt to ward off these anxieties by redoubling
efforts at composure and presenting a precisely detailed, orderly
account of progression of symptoms in an emotionally detached manner.

A scientific approach on the part of the physician - as conveyed in
thorough history taking and careful diagnostic workups - is reassuring
and fosters the trust necessary for an effective therapeutic alliance.
A well-articulated account of the disease process and treatment
alternatives reassures the patient that someone is in control and that
the doctor respects the patient's capacities to participate as an
informed partner in the healing process. The reassurance provides a
foundation upon which the patient can begin to reconstruct a sense of
order in everyday life.

Patients with compulsive personality disorder are not reassured by
vague impressionistic overviews of their prognosis. Patients feel most
comfortable when the doctor provides documentary evidence in the form
of specific laboratory test results, e.g., electrocardiograms or
x-rays, or cites actual reports from the literature when presenting
statistics about risk factors.

The healing process may be promoted by harnessing patients' innate
thoroughness through encouraging intake and output and weight
fluctuations and control of graduated exercise programs. When
feasible, patients can take over management of more routine
procedures, such as changing their surgical dressings. Meticulous
adherence to treatment protocols will restore morale as patients
regain a sense of mastery and dignity in taking charge of their lives.
The physician must remain alert to the possibility that compulsive
patients may wish to carry this self-healing process too far and cross
the boundaries of their competence while stubbornly resisting the
expertise offered by the health care team. The use of medications in
these patients is generally not productive.

Hospitalization
Occasionally, when obsessional rituals and anxiety reach an
intolerable intensity, it may be necessary to hospitalize the patient
until the shelter of an institution and the removal from external
environmental stresses bring about a lessening of the symptoms to a
more tolerable level.

Antidepressant Drugs
During the past decade, sporadic case reports have described dramatic
improvement in severely disabled obsessive-compulsive patients after
the administration of tricyclic antidepressant or monoamine oxidase
inhibitors.



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Psychosocial Treatment
Basic Principles
Patients with Compulsive Personality Disorder who seek treatment
usually do so because of symptoms which reflect, or are similar to,
Axis I diagnoses of Obsessive-Compulsive Disorder, Affective Disorder,
or occasionally Paranoia.

Individual Psychotherapy
Long-term psychotherapy is the treatment of choice. The focus must be
on feelings rather than thoughts and would emphasize the clarification
of the defenses of isolation of affect (intellectualized distancing
from emotions) and displacement of hostility.

The treatment of the personality disorder itself should be
psychotherapeutic, and may be intensive in nature if the patient is
sufficiently motivated and tolerant. Needs to control and related
fears of destructive impulses are important issues at all levels of
treatment, from simple scheduling requests, to intellectualization and
rationalization, to other resistances to fantasy and free association.
Many of the characteristics which lead to a successful life for such a
patient, and which appear to the inexperienced therapist to make for
an excellent therapeutic candidate, are actually symptoms which can
become serious impediments to psychotherapy.

The therapist must avoid competing with the patient and should be able
to tolerate the patient's verbal attacks, retaining a therapeutic
posture rather than allowing the session to deteriorate into an
intellectual discussion or otherwise nonproductive interchange. Those
patients with Compulsive Personality Disorder who show signs of
deteriorating toward severe rituals or paranoia under stress should
probably not be treated so intensively.

As is always the case in choosing patients for insight psychotherapy,
the criteria for selection depend primarily on factors other than
symptoms: (1) the prominence of situational precipitating events, (2)
the capacity to relate to the physician, (3) evidence of good
relationships with others, (4) stable work patterns, (5) the capacity
to tolerate anxiety and depression, (6) the ability to express
emotion, (7) intelligence, (8) the ability to be introspective, (9)
flexibility in thinking and behavior, and, perhaps most important of
all, (10) motivation for change.

Supportive psychotherapy undoubtedly has its place in the
psychiatrist's armamentarium, especially for that group of
obsessive-compulsive patients who, despite symptoms of varying degrees
of severity, are able to work and make a social adjustment. The
continuous and regular contact with an interested, sympathetic, and
encouraging professional may make it possible for patients to continue
to function by virtue of this help, without which they would become
completely incapacitated by their symptoms.

Group and behavioral therapy occasionally offer certain advantages. In
both contexts, it is easy to interrupt the patient in the midst of his
maladaptive interactions or explanations. Preventing the completion of
his habitual behavior raises his anxiety and leaves him susceptible to
new learning. The patient can also experience direct rewards for
change, something less often possible in individual psychotherapies.

Desensitization techniques may be helpful to certain patients in
removing or reducing the severity of symptoms. As in the phobias, a
hierarchy of increasingly anxiety-provoking stimuli is constructed,
and the patient is systematically exposed to these stimuli step by
step, either in imagination or in vivo, in combination with a variety
of measures applied to induce a countering relaxation.

In flooding, the patient is required to face the most
anxiety-provoking stimuli and to experience the full tide of anxious
affect thus aroused. Flooding is often combined with response
prevention, called apotrepic therapy by some clinicians; the patients
are not only confronted with the frightening stimulus, but are
restrained from carrying out their defensive-compulsive actions.
Modeling may be added to response prevention; that is, patients are
accompanied by the therapist, who remains calm and inactive during the
exposure to the arousing stimulus and who provides patients with a
model after which to pattern their own behavior.

Therapeutic techniques have also been devised to control obsessional
thoughts. Saturation requires patients actively to concentrate on the
obsessional thought without letting their minds wander. Clinical
experience shows that, after 10 to 15 minutes of such concentration,
the obsessional thought loses some of its attention-compelling energy,
and patients are unable to keep their minds focused on it.
Thought-stopping involves the therapist in a vigorous interaction with
the patient. As the patient broods on the obsessional thought, the
therapist suddenly yells "Stop!" or applies an aversive stimulus to
counteract the patient's obsessional preoccupation.

Family Therapy
Any psychotherapeutic endeavors must include attention to family
members through the provision of emotional support, reassurance,
explanation, and advice on how to manage and respond to the patient.




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