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).

Illustration of a man in a suit with a weight chained to his leg. He is reaching for graphs and dartboards against a blue background.

The Mental Health Industry Speaks Volumes About Our Society’s Priorities

An educated public has a much better chance of advocating from the grassroots for safe and effective treatments in the face of a pharmaceutical industry more interested in profits than people.

Shedding the Limits of ‚ÄúSevere Mental Illness‚ÄĚ Labels

When people seeking help are relegated to ‚Äúthe Other,‚ÄĚ how can they ever form a ‚Äútherapeutic alliance‚ÄĚ? Without collaboration, treatment devolves into coercion and oppression. We must change our language and relationships so new narratives can be born.
3D illustration of a skeletal robot hand emerging from a laptop computer screen, against a background of purple and blue 80s style lasers.

New App Aims to Predict Whether People with Psychosis Are Worth Hiring

‚ÄúUnfortunately, the ethical considerations of incorporating these tools are rarely acknowledged in published prediction articles,‚ÄĚ the researchers write.
An illustration of dots that represent people forming the shape of the country Denmark, in the colors of its flag.

Denmark Is the Only European Country Where the Usage of Depression Pills Has Dropped

Between 2010 and 2020, the consumption of depression pills increased by 37% in 24 European countries. Denmark was the only country where usage dropped (a 4% drop).
3D illustration of a model house in construction on a table of blueprints

Feel Hopeless About Reforming a Broken System? Incremental Change Is Still Change

Despite all our efforts, it seems that a radical transformation of the system has not yet occurred. However, incremental changes can directly improve the lives of thousands.
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Improving Therapy Outcomes: The Case for Deliberate Practice

With Deliberate Practice, I doubled the number of sessions I had with my clients, cut the amount of unplanned dropouts in half, and improved the number who experienced clinical change.
A colorful illustration in blues and greens depicting a figure standing atop a globe, holding an orange ball in their hands.

Growing Good Mental Health with Choice Theory

On those days when I’m experiencing discomfort, anger or frustration, I ask myself: Which need is not being adequately met and which is driving my discontent?
Close-up photo of hands writing in a journal or notebook

6 Good Things That Happened When I Stopped Believing in ‚ÄėMental Health‚Äô

The pursuit of mental health had made me mad. After 12 years, I quit Prozac and found a new psychoanalytic therapist. Life changed, almost overnight.
Close-up photo of the shift button on a computer keyboard, but it's labeled "Paradigm shift."

Are We Witnessing the Emergence of a New Paradigm?

Increasing numbers of people are finding the perspective that sees mental distress as an isolated, static category, fixed within a biological predisposition or malfunction, to be insufficient.
An illustration of a woman in a white dress, trapped inside a bottle full of blue and white pill capsules, against a gold background.

Why Detox Facilities and Psych Wards Are Not the Place to Come Off Psychiatric...

In online communities, patients learn their strange symptoms may be due to the medications they are taking, and are offered solutions that provide hope.
A black teen in a hooded sweatshirt sits on the stairs, hiding their face, looking depressed.

The ‚ÄúS‚ÄĚ Word: How the Culture of Fear Has Failed Youth in Crises

I learned at a young age that my suicidal thoughts and feelings would be met with panic and punishment from adults.
A photograph of an archery target with three arrows in it. None have hit the bullseye.

From the Health Minister Down, Nobody Is Seriously Interested in the Quality Control of...

The ultimate metric is whether psychological treatment makes a real-world difference to client’s lives. But the data cannot answer this key question.
A kaleidoscopic photograph depicting a busy street, reflected multiple times

The Problem of High Functioning Anxiety

We have accepted that the busier we keep ourselves, the happier we can expect our lives to be. "Acceptable behavior" is defined by increased productivity across all aspects of life.
open dialogue

Re-humanising Mental Health Systems: A Discussion with Jaakko Seikkula on the Open Dialogue Approach

Clinical psychologist, researcher, and professor Jaakko Seikkula, along with Markku Sutela, created the Open Dialogue approach to acute crises in Finland.
A photograph of a bust of Cicero

A New-Old Way of Coping with Grief

"How to Grieve" is a Renaissance recreation of a lost text from ancient Rome by Cicero, and it’s meant for a wide audience. It's packed with talk-therapy strategies for coping with grief.
Perplexed, confused scientists looking at lab results. White background.

The Spravato Controversy: A Row Over the Drug’s Efficacy Compels a Reassessment of...

The UK's drug regulator rejected Janssen's esketamine nasal spray. Why did the US FDA approve it?
An illustration depicting a man opening a door in his chest, light spilling out

The Answers Are in Our Weak Spots

When looking at your own weak spots as a therapist, it would be a safe bet to first consider how you can improve your skills in developing a stronger alliance.
A woman in a suit with a skirt holds a lantern while standing on a desert landscape below a night sky full of stars

Grief, Intense Feelings, and Pathologization: Can We Conceive a Different Approach?

We still try to shove every kind of emotion into a neatly organized box, give it a label, maybe even an accompanying medicine to make it neat and predictable.

Mental Health & Our Schools, Part 2

Schools are rolling out programs and services intended to safeguard students‚Äô emotional well-being. They are full of potential‚ÄĒand pitfalls.
Seated among others at a town hall meeting, an older adult white woman raises her hand

20 Concrete Steps to Achieving System Change

I offer the following 20 suggestions for advocates who want to get something done and not just vent their quite justifiable criticisms of the mental health system.
Black and white illustration of a flying origami bird with a giant realistic bird for a shadow

An Illness, or Risky Experimentation?

Questioning is what I did, but once I started questioning so much of what I had learned and of what my identity had been, it wasn’t obvious to me where I should stop.
Illustration of a naked person's back with a blue butterfly perched on their shoulder

A Return to Dignity from Psychiatric and Childhood Abuse

Homebirth was a reflection of how the mental health system should work: Informed person-centered care while respecting your agency.
Illustration depicting a keyhole in a person's shirt/chest. They are holding an old-fashioned skeleton key near it.

Why We Urgently Need New Approaches to Mental Health

Emotions function like a guidepost to what we need. But if we are not aware this, we cannot understand what they are trying to convey.
Photo of a man in a white button-down and tie, sitting at a desk in an office, with one hand on a computer keyboard and the other holding a red toy airplane

Meaningless Distractibility, or Meaningful Mind-Wandering?

What do we lose when we view boredom and curiosity as "symptoms" of ADHD? It can rob us of intuitions that crucial life changes desperately need to be made.
Vector drawing of pills and a box labeled "Placebo"

The Psychiatrist’s Dilemma: In Defense of Placebo Psychiatry

Telling stories they know are or may be untrue has become standard practice in psychiatry. It is a small step to set aside the need to provide truly informed consent.