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A kind of epidemic is occurring in the field of psychotherapy and psychology, with its increasing use of disparate approaches, methods, manual-based formulas and different theoretical schools, each having their own understanding and different treatments. Psychotherapy has come to mean everything and at the same time nothing.

There is a great deal of discussion about youth being diagnosed - by general internists as well as psychiatrists - with ADHD, bipolar disorder, autism, irritability and depression and then joining the ranks of the pathologized and overmedicated on a march towards long-term distress. Less attention has been paid to the 27 million children who, covered by federal and state Medicaid programs, are at high risk due to dangerous mismanagement of second-generation anti-psychotic drugs (SGAs). Recent reports have documented the brutal facts.

Making even basic chemicals was beyond us for millennia. But once the process was cracked, discoveries and inventions came thick and fast. Making chemicals that could be used to treat diseases was beyond us for even longer but the pace of discovery began to pick up in the middle of the nineteenth century. The realization of what needed to be done to give a chemical a chance of becoming a medicine led to the hunt for a Magic Bullet.

According to the APA, intermittent explosive disorder is characterized by angry aggressive outbursts that occur in response to relatively minor provocation. This particular label has an interesting history in successive editions of the DSM. Psychiatry needs illnesses to legitimize medical intervention. And where no illnesses exist, they have no hesitation in inventing them. And since they invented them in the first place, they have no difficulty in altering them to suit their purposes. Of course, almost all the alterations are in the direction of lowering the thresholds, and thereby increasing the prevalence.

The image is so familiar it is a stereotype: The physician’s desk, piled high with copies of medical journals, where she or he reads the latest research updates between patients. Medical science, it is said, progresses so quickly that if practitioners do not keep up their knowledge base will be obsolete within five years. But is the reading of journals useful? Can it potentially inculcate misinformation as much as progress? Is the knowledge gained worthwhile?

There appears to be increasing acceptance of the idea that lithium prevents suicide, and even that it can reduce mortality rates. For a toxic drug that makes most people feel rather depressed, this seems curious. I did wonder whether it might be having this effect on suicide by sapping people of the will to act, but the proposed effect on mortality seems completely inexplicable. A closer look at the evidence, however, suggests the idea is simply not justified.

The Low Histamine Chef published a post yesterday: The vagus nerve inflammation connection. I was tickled to get a list of various self-hacks on how to stimulate the vagus nerve. Once the vagus nerve is stimulated we calm down! It’s like magic. The vagus nerve is implicated in all sorts of stress.

This weekend I am celebrating the twenty-fifth anniversary of the Americans with Disabilities Act. Let us get a little bit crazy now! I am introducing a new segment where I boycott so-called normality. Our choice, our only choice, and we always have a choice, is what kind of madness we want.

Only five states remain in which Assisted Outpatient Treatment (AOT) laws have not yet gone into effect -- Massachusetts, Maryland, New Mexico, Connecticut and Tennessee -- and the pressure to start these programs in CO and NM is now very heavy. This article will address the push towards forced treatment for vulnerable populations who are at a high risk of being re-traumatized by these laws. It will also attempt to put a human face on the issues of stigma, labeling and the downward spiral that distressed individuals can get locked into when positive rather than punitive pathways are not made available to them.

While the outcome is disappointing, the revised UN prison rules reflect the stage we are currently in with regard to the incorporation of the CRPD standards elsewhere in the UN system. Some premises derived from the CRPD are brought forward, but the bottom line remains the same, to the detriment of people labeled with psychiatric diagnoses.

In recent years, we've seen an increasing number of articles and papers from psychiatrists in which they seem to be accepting at least some of the antipsychiatry criticisms, and appear interested in reforms. It is tempting to see this development as an indication of progress, but as in many aspects of life, things aren't always what they seem.

As researchers and practitioners, we are deeply troubled by the continuous narrowing of options available to people experiencing emotional difficulty. We believe that a variety of mental health approaches should be available to people from all walks of life and that we need to involve ordinary people in new kinds of conversation on this topic.

Maltreatment is broadly defined as being “characterized by sustained or repeated exposure to events that usually involve a betrayal of trust.” It includes not only physical and sexual abuse, but also emotional abuse, including exposure to domestic violence, humiliation and shaming, as well as emotional and physical neglect. The way maltreatment is defined has great significance in the way we think about the connection between childhood experiences and adult mental illness. The word “trauma” itself may convey a kind of “not me” response, but when the term is defined in this way, we see that these experiences are, in fact, ubiquitous.

For many clinicians like myself, families come to us with insurance that they seek to use in addressing psychological issues. As most know, in order to utilize the insurance benefits, a diagnostic code has to be billed that is specifically assigned to the identified patient, who in my case is a child or adolescent. As has been widely documented on MIA and other venues, this presents many challenges/controversies, both of an ethical and etiological origin. But this article is about a very specific concern, one that is inherent in the categorical, disease-based model, but also one that continues to depict the human person as a set of parts, not a dynamic, holistic being constantly interfacing with his or her environment.

The importance of the gut microbiota for physical health, mood, and perhaps cognitive capacity is a recent discovery. There are still plenty of unknowns. Given that so much of the American diet is based on processed foods, each food additive needs to be interrogated to determine its impact on the microbes in the gut, general inflammation, and mood and behavior. It might be easier to eat lots of nut, fruits and vegetables and avoid the processed foods and artificial sweeteners and start enjoying yogurt (the stuff without the high fructose corn syrup).

It’s now widely known that a good relationship between helper and person to be helped is one of the very most important factors determining the outcome from many different types of mental health treatment. But when people are in an extreme state such as the kind we call “psychosis,” forming a good relationship is not an easy thing to do. And unfortunately, the typical interaction between professionals and clients seen as psychotic in our current mental health system has characteristics which make a positive human relationship almost impossible.

Asking the psychiatrist to discontinue medication was one of our bravest moments. It went against everything doctors had told us over the past twelve months—against Rebecka’s regular psychiatrist’s vehement opposition (“You can come back when it doesn’t work.”). It went against what we heard repeatedly in the media and in pop culture. It went against what we saw in the advertisements during the evening news. And it was the turning point in Rebecka’s journey toward optimal mental health.

The first benzodiazepine – chlordiazepoxide – became available, from Hoffman-La Roche, in 1960. Benzodiazepines largely replaced the earlier barbiturates, which had received a great deal of negative publicity because of their much-publicized role in lethal overdoses, both accidental and intentional. Initially, there was a good measure of skepticism among the general public with regards to benzos, and indeed, with regards to psychotropic drugs generally. The dominant philosophy in those days was that transient, drug-induced states of consciousness were not only ineffective in addressing human problems, but were also dangerous. But pharma-psychiatry systematically, deliberately, and self-servingly undermined this skepticism.

In many respects, resilience is the most important sign of health. This is true in physical health, and even more so in mental health. Resilience is what I spend my working hours trying to help others achieve. Resilience is what I have spent my own life discovering, harnessing, and finally thriving with. Quite simply stated, resilience is the ability to bounce back or recover from the trials and tribulations that living as a human being inevitably comes with.

Psychotherapy (I’m still searching for a better term, since the word ‘therapy’ involves thinking that there is sickness somewhere) is not about knowing everything. It’s about humanity, doubts and uncertainty. It’s about reaching out and reaching in, authenticity and honesty. It’s the most demanding thing I have ever done, because I’ve fully involved myself in this work; I use my own feelings, scratch away at my existential issues and try to care as deeply as I can for people who choose to enter my office. Sometimes, I know exactly what helps and what doesn’t. Sometimes, I have no idea. In a very odd way, it’s the most professional attitude I can think of. But it is also the lonely way.

I have been creating graphics to explain some of the work we do. Infographics have a lot of power. This one is a rough...

Dialogues are an effective process in bridging an illusionary divide. Any group anywhere can follow a dialogue format and propose questions for inquiry and reflection. Dialogues are relatively easy to convene and they typically result in participants establishing deep connections with one another, having new insights and enhancing one’s knowledge and skills about how to be or work in partnership with others.

I’ve been teaching a course on substance abuse for about 30 years now. In this course, I cover a new drug class each week and always review the history of the drug. All of the drugs of abuse, cocaine, alcohol, marijuana, opiates are not new on the human scene. They date back to the Sumerians and the Greeks. The question for me is what accounts for epidemics? I have come to believe that epidemics are supplier driven rather than a function of consumer demand. For the current opiate epidemic, the suppliers were the pharmaceutical houses.

Imagine you wake up tomorrow with your past missing… You may not be able to recognize your home or know where your banks accounts are….You can’t remember your wedding or your college education. Eventually you realize that years of your life have been erased, never to return. Worse, you find that your daily memory and mental abilities aren’t what they were before. Now generally the memory loss that besets ECT recipients is spoken of with little or no explicit reference made to gender. In this article as in certain of the literature, on the other hand, gender is highlighted. My intent in this article is to hone in on gender per se; more specifically to shed light on how ECT, memory loss, and women’s lives come together.

I'm currently a student at the Silberman School of Social Work. This was the final paper for "Human Behavior 3." HB3 is a required class which is basically a crash course in understanding and using the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders). In Human Behavior 1 and 2 they cover all kinds of ideas from psychodynamics to systems theory, and have the students practice writing biopsychosocial evaluations. I'm not sure what it looked like in the past but in recent years HB3 has become a DSM memorization class, so much so that we did most of the 5 week class online with modules that looked like the image I'm posting below. I don't know what other people's papers looked like, but here is what I turned in to my professor last week.