THINKING CAREFULLY
Bob Fancher, Ph.D., is the author of Health and Suffering in America: The Context and Content of Mental Health Care, and Pleasures of Small Motions: Mastering the Mental Game of Pocket Billiards. He has written for The Washington Post and Billiards Digest, among other periodicals, and ghostwritten speeches, books, and articles for clients ranging from Fortune Five executives to academics to “ordinary” folk. Bob was educated as a philosopher at Vanderbilt University and trained as a psychoanalytic psychotherapist at Blanton Peale Graduate Institute. He practiced psychotherapy for many years in New York City and now maintains a counseling practice in Portland, Oregon.
Adverse childhood experiences, genes, and mental illness
by Bob Fancher, Ph.D.
September 13, 2012
Since at least the time of Moses, we’ve wanted to believe that the “child is father to the man,” that to understand adults we need first look to their childhoods. Of late, mental health professionals still wedded to the idea have taken heart from the “ACE” research—adverse childhood events. We need to be careful to read this research accurately, and to understand what it does and does not say.
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Why the Medical Model Won’t Go Away, Part Two
by Bob Fancher, Ph.D.
August 19, 2012
The short answer is that “health” has supplanted virtue or righteousness or sanctity as our culture’s prime normative ideal in personal behavior. “Mental health” is just a subsidiary of the lust after healthiness; mental illness seems, on the face of it, simply its corollary
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Why the Medical Model Won’t Go Away
by Bob Fancher, Ph.D.
August 7, 2012
The success and cultural authority of the mental health industries reflects both hope and need: we hope to escape suffering, and we need professions dedicated to understanding suffering and its relief.
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The Inevitable Illness of Everyone
by Bob Fancher, Ph.D.
July 16, 2012
We’re apt to rant against DSM and the pathologizing of everything that hurts. Rightly so—or not, depending on what we want to accomplish.Patients who want insurance to pay for their care, and clinicians who want more money than their patients are willing or able to give, have little grounds to gripe about the general drift of DSM. The sad fact is that we can expect DSM to skew the thinking of clinicians, and the knowledge base of mental health care, more, not less, in coming years.
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How Talk Therapy Sold Out
by Bob Fancher, Ph.D.
July 1, 2012
Money corrupts, and not just money from pharmaceutical companies. Money’s money, and it spends just as nicely no matter who offers it. It doesn’t just corrupt psychiatry. Talk therapy has been badly corrupted in recent years, too. The money corrupting talk therapy comes from insurance companies.
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The Idea of Depression, Part Three
by Bob Fancher, Ph.D.
June 21, 2012
Our current concept of Depression is an artifact, conflating what once was called melancholia—which is an horrific, dangerous state of mind in which we’ve lost agency and control over the pain that assails us—with a great variety of painful negative affects that, in common language, we would call “depression.” This new concept leads to ham-handed, often misdirected care.
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The Idea of Depression, Part Two
by Bob Fancher, Ph.D.
June 1, 2012
Understanding one’s suffering requires attention to two things: the exact form of one’s suffering, rather than its generic affective qualities, and the concrete particulars of one’s situation. Directing attention to the abstract notion of Depression, and attending mainly to the generic affect, precludes both.
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The Idea of Depression
by Bob Fancher, Ph.D.
April 30, 2012
The experience of depression is horrific, and when we’re in it, we want—need—it to stop. Does postulating a disorder named “depression” help much with that?
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Therapy works? So . . . ?
by Bob Fancher, Ph.D.
March 7, 2012
When we pretend that outcome studies “scientifically validate” therapy, we confuse a product that can be used to specific ends with knowledge of how the world works. That’s a pretty serious confusion.
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Set Up for the Con
by Bob Fancher, Ph.D.
February 22, 2012
If biological psychiatrists have lied to us, we need to ask why, as a culture, we have been so willing to embrace those lies. Generally, we’re most apt to be conned when the con men appeal to our hopes and fears. We don’t like to admit that many people rightly fear the influence of therapy. If we want to defeat biological psychiatry, we can’t just show its lack of integrity. We have to offer alternatives that deserve trust.
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Thinking about Care with Care
by Bob Fancher, Ph.D.
January 31, 2012
Weak science and exaggerated reports of discovery aren’t the special province of biological psychiatrists. We don’t really understand much about the suffering that brings people into care. We need to study the beliefs that we like as critically we study the ones we don’t.
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