Essays by a diverse group of writers, in the United States and abroad, engaged in rethinking psychiatry. (The directory of personal stories can be found here, and initiatives here).

Tsunami of Frozen Grief Found in the Clinical Work

One of the primary clinical teachings found in the pursuit of prescription drug withdrawal: we need stepping stones and a great many of them to navigate the perilous terrain.

October 25, 2010

Bob-- A couple of weeks ago, I got a call from the mother of one of my teenage patients, a 14 year old Chinese-american boy...

In Praise of Families

This anecdote is offered as a story in praise of families and a recognition of their importance to the process of recovery.

The Empire of Humbug: Not So Bad Pharma

At the 50th American Psychosomatic Society meeting in New York, Michael Shepherd was speaking. His topic - The Placebo. When the lecture finished, Lou Lasagna said "this paper is now open for questions." Nothing happened. Nobody said anything at all. Lasagna couldn't refrain from commenting: "There are 3 possible explanations. First, you were all asleep and therefore you heard nothing. Secondly, it was so bad that since this speaker has come 3,000 miles you didn't want to embarrass him. Third, it is genuinely so original and new that you don't quite know what to make of it. I'll leave you to decide which it was". What had Shepherd said?

Dispatches from a Reluctant Guide on the Path to Disability

I graduated in 1987 with a Bachelor of Science in Psychology. The attitude of my professors in the Psych Department was that the science of Psychology was coming to an end. The mysteries of the mind had been unraveled through the new neuroscience, and all that was left was some mopping up. It all seemed very convincing, and I believed it myself for many years.

Introducing Myself

I’m an Associate Professor at the Georgia State University in the School of Social Work. Early in my career in the late 1960s and...

Letters from the Front Lines

Bob-- An encounter from this week: I saw a 24 year-old theater actress who was started on Lexapro nine months ago for a one-time "panic attack"...

Your Input Welcome For 2012 Alternatives Keynote Speech – SURVEY

I was invited to give a Keynote Address at the 2012 Alternatives Conference in Portland Oregon, and I'm collecting your input on what I should...

The Empire of Humbug: Bad Pharma

Some psychiatric drugs are extraordinarily effective, for instance benzodiazepines for catatonia or SSRIs for premature ejaculation. These treatments are so effective that controlled trials are an irrelevance. Every trial conducted would show a positive result. The point here is not that it is impossible for a treatment to achieve effectiveness but rather that controlled trials have little useful to contribute to the issue of effectiveness. Randomized placebo controlled trials have not shown any drug within the mental health domain is effective. If a treatment were effective virtually every RCT undertaken would show a positive result.

March 4, 2011

Bob-- I'm going to share with you a case from today that did not involve psychotropics, but I think it illustrates an important point about...

February 14, 2011

Bob-- Recently, I saw a thirty-six year-old Bulgarian man for a follow-up visit. He is my age, with three children almost exactly the same ages...

Volunteers for Psychotherapy Is A Finalist for International Award

Volunteers for Psychotherapy, which is located in Hartford, Connecticut, and has for years run an innovative program that gets clients involved in community programs,...

Better Broadband

So many treatment colleagues have shared that prior to finding an approach that really works to turn a child’s intensity to greatness, they felt no recourse other that to look for ways to moderate the accelerating poor choices that children they worked with were making. Most relevant here is, that in retrospect, they felt that it boiled down to simply being faithful to their training, which it turns out so often is a set up to fail with difficult children.

Site Updates and Posting Policy

Shortly after Mad In America launched at the beginning of the year I was invited to take over the site’s web development and to...

Resolving to Make This Year Mean More

Every year around this time, millions of people make their New Year’s resolutions. In many ways, our resolutions mirror the willful approach that is needed to overcome psychological conditions, even those of a severe nature. We must be cautious about agents which serve to dull us to our particular circumstances and state of mind, whether it be medications or otherwise.

In Search of Change: My Journey

It is more helpful to focus on what clients do well than what they are lacking. These are simple things, but it takes a lot of discipline for professionals to stay focused, stay simple, respect clients as the expert on their life and listen intensely for their strengths and resources.

April 30, 2011

Bob-- I have found that many patients, and even many physicians, don't appreciate the basic differences between psychology and psychiatry. For most of your readers,...

Challenges and Visions for the “Mental Heatlh” System

I envision a world where there is no need for a mental health field/system because communities are strong and we have a holistic understanding...

October 17, 2010

Bob-- A couple of very positive patient encounters yesterday: • First, I saw a fit, vibrant 45 year old woman who presented for the first time...

November 4, 2010

Bob-- Today, I saw a healthy, strapping young man, 28 years old and an avid recreational softball player. He is a former college athlete and...

November 26, 2010

Bob-- Very interesting case today, a forty-six year-old woman, new patient, overweight, and very pleasant. She is someone who, at first glance, I never would...

October 28, 2010

Bob-- I had an interesting case today. A friendly, 24 year old, very slender and slightly distracted Vietnamese woman who has a 18 month-old...

New Study on a Non-Toxic Intervention for Those at High Risk of Psychosis

A new multi-centered study was released about using cognitive therapy for young people who were seen as being at high risk of psychosis. The article reporting the study is on the British Medical Journal website, available in full – It’s curious to see how it is being reported in the press.

April 11, 2011

Dear Bob-- I want to share an email I received from a physician friend, who practices in a hospital-based specialty. He is highly intelligent, naturally...

US Senator Raises Concerns About Possible Stock Manipulation by Vertex Executives

Senator Charles Grassley is upping the ante on the controversy surrounding the Vertex pharmaceutical executives who cashed in on overstated clinical trial data --...