Thursday, December 1, 2022

Comments by Therapyfirst

Showing 43 of 43 comments.

  • Good luck with this as a viable model to apply across the planet. Medications have never now, nor should be in the future considered “THE” answer, but to dismiss them entirely is simply pathological denial.

    It is a fair analogy here, it is telling diabetics that they will never need insulin, just adhering to diet management and responsible weight control will avoid invasive medical interventions.

    You are just practicing “pendulum mentality”, watch the excess swing one way of too much meds to be allegedly effectively compensated from the opposing swing back of no medication use. All that happens is people get bashed by the full brunt of the pendulum swing at either end.

    But, again, good luck with this sales pitch, and start formulating the rebuttal when this narrative comes to a basic failed fruition. And explain to people who are harmed by believing this narrative why you meant well.


    Joel Hassman, MD
    Board Certified Psychiatrist

  • Politicians are representatives, and as George Carlin so wisely pointed out over 20 years ago, is it the politicians who “stink” (not the word he used), or, the public? These politicians come from American homes, schools, businesses, and communities, they are nurtured and built by the system around them, they are not islands, they do not pass thru some membrane of an alternative reality.

    So, is this the ultimate denial, projection, deflection, and pathological rationalization by the masses, or, have we gotten what we deserve? It is both, and thus, why Americans as a whole are lost.

    Hey, I’ve been practicing over 20 years, and I have seen a lot, never all, but, at some point, isn’t my sarcastic joke of “if I had a drug that improved insight and judgement, I’d be out of a job” beyond accurate??? But, too many who pass thru my door aren’t so interested to really reexamine insight and judgment, no, they want what is popular, easy and convenient.

    Hence the choices we had last November, and now the fallout. We have the representation we deserve, as of now, unless, we will gain genuine insight and judgment from this current situation?…

    Joel Hassman, MD
    Board Certified Psychiatrist and independent registered voter for 24 years now…

  • One comes to this blog, reads a title like the one for this post, and then wonders if MIA really is interested in attracting a diverse audience to encourage consideration of a viewpoint, or, maybe it is really just ramping up the entrenched base for choir shrieking.

    Really, Eugenics?! It is so over the top an accusation, I have to wonder why I should make any effort to come here to see if there is a genuine effort to debate and educate or just realize extremism has conquered any opportunities to pursue healthy and effective change.

    Sincerely, if Mad In America really wants to be taken seriously on a consistent and ongoing manner, posts like this need at least better headlines. Otherwise, not if, but when I should hear there is a post entitled “Psychiatry needs to be exterminated” printed here, well, good luck maintaining a responsible following that validates MIA’s mission statement.

    This site is now a de facto “Psych Li(v)es Matter” redux. Good luck with that if I am right…

    Joel Hassman, MD
    Board Certified Psychiatrist

  • Thank you for your reply, I just want to make sure you understand that the term narcotic is not so globally used for any controlled substance. Narcotics by my terminology are for opiates and other substances that are used for pain management. Stimulants are controlled substances, but are not in the same class as narcotics.

    I defer to your own use of terms, but that’s the way I use them so I appreciate the clarification.

    Again, I wish you well in current and future pursuits, and hope any medication use will keep you safe and functional.

    Joel Hassman MD

  • I respect your odyssey with being overmedicated, especially with stimulant prescriptions, but, I didn’t miss something that I interpreted as being added to be “under the radar” but as a physician, a critical piece of information to your story:

    “I stopped seeing Dr. Fox, save the one monthly visit to her office for a written Rx for my narcotic medication, given to me curtly by the receptionist.”

    Hmm, was this Dr Fox in position to be writing for ‘narcotic medications”, you did not specify exactly what that entailed, but, opiate use, if in fact in that drug class, could be a confounding part of your presentation, especially per dosage and quantity used per month.

    Could be a red herring, but, it is part of your story, and I think readers who are attentive to ALL the medication matters here, should be educated to that part as well.

    By the way, did you know that more people these days “speed ball” with prescription opiates and stimulants than they do with heroin and cocaine? Perhaps if readers interested in understanding fully the agenda with “speed balling”, read this link?

    from there: “Cocaine acts as a stimulant, whereas heroin/morphine acts as a depressant. Co-administration is meant to provide an intense rush of euphoria with a high that is supposed to combine the effects of both drugs, while hoping to reduce the negative effects, such as anxiety, hypertension, palpitations and other common side effects of stimulants and sedation/drowsiness from the depressant. While this is somewhat effective, as one drug (the CNS stimulant) triggers the sympathetic nervous system and the other (the CNS depressant) triggers the parasympathetic nervous system, the two systems that regulate the fight-or-flight and rest-and-digest responses, respectively, and simultaneous activity of the two pathways is what normally keeps one’s body in natural homeostasis, there is an imperfect overlap in the effects of stimulants and depressants. Additionally, by suppressing the typical negative side-effects of the two drugs, the user may falsely believe they have a higher tolerance, or that they are less intoxicated than they actually are. This can cause users to misjudge the intake of one or both of the drugs, sometimes fatally.”

    How John Belushi died, and probably some other well known celebrities at the tip of the iceberg of overdosing. Glad you are not part of that toxic mass floating around in society…


    Joel Hassman, MD
    Board Certified Psychiatrist

  • The point was lowering the dose, not stopping it. Pay attention to what is discontinuation syndrome, it means discontinued.

    And yes, it was just one study, but, one can accumulate a group of “studies” that allegedly support a hypothesis, but is there full transparency what is the intent, just to find negatives and ignore there could be a plethora of other studies that show benefits?

    Yeah, here there is such pervasive transparency. Starting with the predominance of people who go by aliases. Besides, the affected population were our vets, but, do they count as an important population here in America?

    Cue a recent article in USA Today:

    “Suicides across the military rose precipitously from 2005 to 2009 and have remained at record numbers since then, according to Pentagon data. The most recent suicide rate provided by the Pentagon, for 2014, is 19.9 per 100,000. The national civilian rate for that year was 12.93 per 100,000, according to the American Foundation for Suicide Prevention.”

    How many readers here are outraged by that stat? Oh, they are not really depressed, just affected by the misuse of meds, hmm?

    I’m curious, how many other psychiatrists comment at MIA these days who don’t regurgitate the mission statement here, eh, Steve?

    We do the best we can with what society has pigeonholed us into, and I still don’t see posts here that accept mental health is a legitimate problem that needs care, forget meds for a minute, and I am not talking about this section of “in the news”.

    And getting back to the point of this post’s article and thread, yeah, citalopram ain’t perfect, but it is better than some other SSRIs, like Paxil, which I haven’t written a starting prescription for in about 10 years now. And not a big fan of how Forrest tried to make Lexapro the second coming of Christ, at the expense of their parent medication Celexa, Citalopram.

    I pay attention to agendas, as I espouse principles. One of my main principles is helping people help themselves. Can this site honestly and truly say that for the public?

    Just my opinion, from what I read here. But, the “in the news” section has been educational and informative at times, hence why I come here.

    Happy Memorial Day upcoming to you and all.

    Joel Hassman, MD

  • Hmm, going to write a post or News Story about this too?

    Only if it fits the narrative, right?

    Reduction of prescribed citalopram dosages to a new safety limit was associated with a higher rate of hospitalization in a large patient population who had been treated with substantially higher dosages. Stipulating a safety limit for citalopram dosages before the benefits and risks of doing so were firmly established appears to have had unintended clinical consequences.”

    Just trying to educate the masses…

    Joel Hassman, MD

  • I know this comment will not be published, but, as much as it is directed to Dr Hickey as well as Ms Mead, just curious, let’s jump ahead a couple of years or so and see psychiatry has been ostracized to the netherworld, and now there is no medical specialty to manage mental health problems. So, how do mental health patients get treated? And don’t try to raise this dishonest, disingenuous, and disdainful rebuttal there really are no mental health problems in America, much less the world, I just want to read you have gone to someone’s home who have just endured a suicide or a family member’s psychotic break and tell the survivors their pain is short lived or not realistic to experience.

    Has MIA and the most voracious of bloggers/commenters who write here think of the outcomes in zealously seeking out the demise of all of psychiatry? If you get what you want, is it going to play out so wonderfully for the rest of the public?

    I keep trying to write here, yes, there are cretins and losers who have no business being able to prescribe medication, and others who have no business setting clinical policy, but, it is not ALL of the profession. But, and here is where the comment will be striken, this site has the same elements of other extremist, zealot, and rigid narratives that seem to create so much havok, pain, and disruption in the society/country/planet if global enough to be felt across continents, the agenda becomes more than a passion, but, a missive, a manifesto, a platform so devoid of variation or consideration of exceptions, well, we know what happens to those who preach “my way or no way!”

    So, do with this what you will, and I have to ask again, doesn’t it get a bit mistifying at the very least almost all comments in every thread just echo the same things, there is never a healthy debate or effort to entertain alternatives or moderation? I read here that there is a desire to be a bigger part of the debate about mental health care injustices and errors, and yet, I don’t read of MIA in any article or well read moderate blog or site that is interested in discussion about mental health care problems.

    Please, direct me to places that quote MIA and do so as valid opinion and perspective, not just example of extremist failure and rigid platitudes. I honestly would like to read others quote your site in a positive and respected light.

    Sorry, won’t be holding my breath for the reply. Oh, and I comment at a Dr Hickey post because he is not qualified to critique psychiatric medication issues, unless finally he will document valid and appropriate credentials to get this validaton as a psychopharmacology critic at a site that now offers continuing education credit.

    yeah, I didn’t forget that promotion drive, so to give credit, don’t valid credentials count to justify the accreditation credits?!

    Frankly, if I were the editor here, I would post this comment, it could be an opening for honest and fair dialogue, or at least give you more hits to sell your site as so popular on the Web!

    Good luck with your success in realizing your mission statement. MIA would have potential if it just would be a bit more responsible and fair minded in encouraging dialogue, not monologue.


    Joel Hassman, MD

    (and I will be noting this comment at my blog in coming days)

  • Two points, one hypothetical, one per experience:

    1. Hypothetical, I would bet Ronald Pies belongs to the APA and is one of their “emeritus” academicians, thus he can’t and won’t buck the APA bylines of “drugs are us” by those who belong to that corrupt and derelict organization. I don’t know about Allen Frances, but sense he does not belong. I don’t, left it in 1995, never looked back, and my blog is constantly critical of the APA. Don’t go there, other commenters…

    2. You, Dr Whitaker, seem to frame issues in black-white/polarized terms, well, it defines who and what you are until proven otherwise. Every drug has a place, and every drug runs a risk of misuse. At the risk of outrage, yes, some second generation antipsychotic medications have saved and improved some peoples’ lives, and usually in limited and reduced dosage use over time.

    Cue the 4 Ps of pharmacology that applies to every single medication that has been on the market throughout life, until extreme exceptions show up, and such exceptions are counted on 2 hands at best:

    Promise, Panacea, Placebo, and Poison. Med A comes out for indication A, seems to have a legitimate impact, and gets approved. Then, per Panacea, the company with Dollar Signs as pupils sees multiple indications and overshoots the needs recklessly and cluelessly. Thus the following “Placebo” is not always solely about a sugar pill, but, older and more established meds that their pros and cons have been responsibly clarified, and then wonder why this new med A trumps the use of older drugs.

    Finally, we all know the poison conclusions. Which this blog seems to solely focus on, ignoring there are legitimate needs for medications. Makes you wonder why so many here still ignore my analogy to penicillin and opiates. Doesn’t fit the narrative, honestly, Dr Whitaker?

    Mad In America wants a place in the debate about Psychiatry, and mental health care more in general, and yet zealotry and extremism is the message at the end of the day. All this site does is cancel out the extremism and zealotry of the APA and their ilk.

    Umm, like the rhetoric this country has to endure from Democrats and Republicans these past 15 years or so??? Who really wins at the end of the day?

    Not the public…

    the comment is fair and reasonable, sorry it does not fit the agenda though. Maybe if the blog editors really want honest and fair debate, comments like this would be included. I am used to being censored, and those who have come here and then related their experiences to me as moderate and reasonable readers and attempted commenters seem to echo my same impression.

    But, at least your “In the news” section has been educational at times.

    Respectfully submitted:

    Joel Hassman, MD
    board certified psychiatrist

  • Enlighten us, all you cannabis defenders, of all those people out there on the planet these past 50 years who are or were outward and entrenched users of cannabis who have truly, honestly, and wholeheartedly across general public opinion have genuinely improved our lives without dissent. My money is even if someone will offer an example, it will not be universally accepted by those who are unbiased and objective as an honest example.

    What a disingenuous, dishonest, and frankly, despicable effort here at this thread to claim that cannabis use benefits the public at large. You as cannabis defenders use alcohol as a convenient and disposable analogy when it suits a defense, then dispose it when it suddenly loses it’s benefit, and then gloss over the realities that psychotropic agents aren’t just about the sole highs, but have painful lows as well.

    Like, the pharmacological ones the FDA legitimizes, hmm?

    Oh, and by the way, there are those who are using the efforts to legalize cannabis to then pave the way for cocaine and heroin next. Yeah, tell us all how that is going to work out.

    Anyone who honestly reads here who tries to be objective and impartial, remember the defenses of the addict or hopelessly dependent chemical user, it starts with denial, moves on to projection, then shifts to minimization and deflection, and ends with frank pathological rationalization.

    All immature, ineffective, and painfully wasted efforts. What the addict wants you to miss, for every possible real benefit, the next 9-10 will be harmful and disruptive.

    Hey, just one person’s opinion, but, does it serve the narrative here?

    Joel Hassman, MD

  • Just jump in the deep end of the pool and find out how deep it is and what happens when you don’t either know how to swim or at least have a life jacket on.

    It is beyond ridiculous and amusing simultaneously when patients come in almost demanding I cater to their attitude how wonderful pot is for their mental health problems, and yet, they are coming in for problems. Um, is it really just me, or with marijuana laws so lax now that people can get away with using pot without much legal consequences, that the hypocrisy of this attitude is not worth my time?

    I say legalize it without caution, and watch the fallout for both users and careless, inattentive enablers and co dependents. The writer above notes the obvious consequences from alcohol this culture has dealt with for decades, why not just compound the problem addicts and abusers of drugs use as denial, projection,and deflection to demand their next drug of abuse and dependency be accepted without dissent.

    We have become a pervasive lot of rigidity, inflexibility, entitlement, oh,and of course dependency in so many facets of life, what’s one more element that benefits the few and harms the many?!

    Amazing how agendas continue to trump principles, eh?

    Hey, if I am wrong, we will be happy…

    Joel Hassman MD

  • Yeah, I would love to bolt from psychiatry if I could, but, like many people in this country, I just can’t pick up and leave my career and abandon my family who depends on my income, which I know most readers will either blatantly deny or try to falsely rationalize otherwise, is not so large for the training and experience I have logged these 20 plus years. But, that day probably will come sooner than later once certain obligations are completed.

    I have been critical of many of my fellow psychiatrists for a lot of years, but, like most of this country, money, power, and influence have more control than pride, ownership, integrity, and responsibility to Hippocratic Oath principles. People here seem to allude that psychiatrists are the primary villains to what ails the field, yet, I don’t read many columns going directly after Big Pharma, managed care, and health care administrations of hospitals and large outpatient groups.

    Is that because it is too hard to effectively go after these organizations, or, is it really a narrative about a select group easy and convenient to attack?

    I have established this site will not consistently and responsibly name the role of patients to these psychotropic problems, because, well, that would possibly alienate a needed portion of the blog audience??

    Cue Michael Jackson’s song “Man in the Mirror”…


    Joel Hassman, MD

  • Um, there are writers in the Psychiatric literature of late noting the inappropriateness of the pervasive use of benzos, yet, people here must be a bit clueless or delusional to think that a profession controls 90% of its specialist providers. Is there a column here about outrage regarding that oncologist who abused people with chemotherapy agents for years simply for a buck, now at least going to spend the rest of his life in prison? I guess I missed it.

    Besides, I think a lot of readers gloss over the fact that over 70% of many psychotropics are written by non psychiatrists, and I think simply because it does not fit the narrative of this blog. Sooo, you want me to pound away at all the providers who write inapproriately? Sorry, not taking on that responsibility, I can only control myself, and I think if anyone here actually knew me by interacting with me in an office I have or am currently working at, you would know I am a responsible and wary providers, especially with controlled substances.

    Oh, and yeah, part of the drive for benzos these past 7 or more years is being created by the onslaught of opiate scripts, either to minimize the withdrawal symptoms a lot of patients are experiencing with reckless misuse of their Rx opiates, or, poor support with dealing with chronic pain and thus dealing with the endless “what if’s” that chronic pain creates in patients’ minds. But again, is that being prescribed by psychiatrists more often than not? NO.

    I get it having read here in the past, the APA and KOLs in psychiatry are losers, but this site extrapolates that to anyone with the title MD and psychiatrist after one’s name is guilty. Your (as in the MIA readership as a whole) points of true validity get lost with the overgeneralizations and demand for abolishment of all providers.

    I am just curious by the way, what are the author’s credentials to write these repeated columns of such specific allegations and statements alluding to psychotropic expertise that, to my knowledge, aren’t in this author’s background of training or treatment ability? I have no problem with someone being critical, but these posts come off as peer equivalent criticism. Isn’t that a bit unprofessional at the very least, if my opinion is valid?

    Anyway, to Steve, thank you for what was a more respectful reply.

    Joel Hassman, MD

  • Um, even back in the days these medications first hit the market, PCPs and other non psychiatrists wrote more than 50% of them, so, to focus your ire on psychiatry is a bit disingenuous at best. I would bet good money today that over 70% of non psychiatrists write for benzos in general as a class, and over 85% write for Xanax/alprazolam. Oh, and patients demand, not ask for them until proven otherwise.

    So, who is at fault for this misuse, providers alone? I await your column slamming the pervasive use of opiates, maybe start with the recent Time magazine article for some direction?

    Joel Hassman, MD

  • Projection at its finest by a psychiatrist who is the real menace to society.

    I’d bet $10 that if Lieberman took the Minnesota Multiphasic Personality Inventory, he would score in the 90+%ile for narcissism and probably some antisocial traits too.

    And the APA made him a President. Speaks volumes why I don’t belong.

    Joel Hassman, MD

  • First of all, I want to be again candid and note I will not be commenting here further, as I don’t see the point of trying to dialogue with those who only monologue here, albeit there are some commenters who do seem to understand the concepts of moderate and not generalize to the 99th percentile. To those, my apologies I won’t be back to debate honestly.

    So, let’s address who did wallop, er, weighed in. As always, the inconsistencies with AA speak volumes, the first comment being censored, and for the editors to do so, I can only assume “WOW”, it must have been ugly.

    Which the Berit was quick to support. Then AA’s second comment ends asking me to be sensitive to the commenter’s issues, but, where was AA’s sensitivity to the first instinctual response? Lucky for you, AA, the comment was gone before I read it, could have given me more ammunition to my point about antipsychiatry attitude outwardly??

    As to Kim, well, your comment for me exemplifies my point to the overgeneralizing that goes on at sites like this as an overall commentary about psychiatry.

    Then Berit’s second comment lumps me in with the Liebermans’ et al and yet, what have I published in the press or in psychiatric literature that gives me some position of influence or authority to then make such an unsubstantiated claim Berit offers? Oh, I forgot, my MD after my name makes me complicit. Again, thank you for the validation as a representative of the standard antipsychiatry commentary.

    Finally, to Steve, while you were certainly fair and respectful in your comment, Whitaker does not note in the post, unless I missed it, that there is a sizeable percentage of psychiatrists OUTSIDE the Lieberman box (or to me, the coffin), who do not embrace nor echo his and his failed legion of “medicate until proven otherwise”. So, the absence of such a disclaimer is a loud point to me, especially since the point of this site is to document the failings of mental health care as the overall theme.

    Also, Whitaker is a primary player to this site, and for what I have read in past posts and to me some of the most heinous threads about psychiatry allowed printed on the Net, I believe one is associated with a following or group that speaks around such person. Unless, the person realizes the following is NOT speaking the message that is intended, and would at least distance by some disclaimer or showing some more effective censoring that would drive the zealots and extremists away for not being able to smear and demean with pleasure and reckless abandon.

    So, while I thank the editors here for allowing my first comment to be printed, and hopefully this one as well, and also sparing me the harsh attitude of at least one commenter, I respect Dr Whitaker has issues with some of psychiatry’s poor insights and judgments but he seems to just flame the fires of hate and disdain for ALL in the field, until future commentary says otherwise. If Mad In America wants to be seen as a consistent and viable voice in the honest debate about mental health care failings, it starts with moderation and avoidance of extremism. Yes, there are commenters here who are fair and respectful, but, if I wrote here with regularity, I would call out on some commenters who just don’t get it.

    At least so readers know I have boundaries and abilities to work on resolution, not absolution and dissolution. Be well and safe to all, but, be tolerant to those who are noting there are grays out there, if you can.


    Joel Hassman, MD
    (and again, when I first logged in here, I was given the illusion I had to have an alias to be a commenter, so why “therapyfirst” is my lead, I ALWAYS sign my name at the end of all my comments, so end this agenda allegation, please)

  • it never ceases to amaze me how disingenuous both the leadership of the APA, as well as the extremists of the anti psychiatry movement, want to villainize the other with glee and complete overgeneralizations.

    There are people who have legitimately been injured by poor treatment, and there are physicians who are being slimed by this narrative that are in fact honest sincere appropriate doctors.

    Let’s have a moment of candor, can we knock off this brutal assault on both extremes of this argument and try to find some moderation!?

    Joel Hassman MD

  • Hey, and thus the blog has moderation and control outside your own opinions and agenda. that has to hurt a bit for some here. The rigid and inflexible really can’t handle honest and fair boundaries if it doesn’t benefit the narrative.

    I know, I have seen other sites that keep you folks out overall.

    Joel Hassman, MD

    Oh, and trolls almost always don’t use their names, don’t offer facts and truth, and never say sorry. Oops…

  • Who here who has no faith or hope that psychiatry will do nothing of benefit for the public thinks I am misinterpreting that David Healy is saying that basically “the easiest place on earth to be an abuser is in the doctor’s office and thus most, if not all doctors, are abusers until proven otherwise”.

    If you disagree, then there is hope the profession has some benefit. If you agree, then you are damning almost every doctor/psychiatrist. Again, careful here…

    Coherent enough now?

    Joel H

  • i am going to end my participation at this thread for the next couple of days with this effort to give you an image who Joel Hassman, the citizen first, is about at the end of the day:

    Know the movie “Field of Dreams” well, the scene where Costner and wife are in the Gym fighting the school board trying to get books banned? Well, I greatly identify with the wife who stands up watching all the weak and disempowered just go along with their failed leadership, saying fairly much “who wants to be ruled by Stalin, by Hitler, who wants to just roll over and have it given to you long and hard!?” Yeah, I am the guy who will have the guts to say, “Man, this is wrong, and you all sit here and say nothing, you deserve to be not only screwed, but then say thank you for the assault at the end!”

    When you think someone is wrong, you speak out, and you listen to the rebuttal, and if it is wanting dialogue and negotiation, then you will be not only be thanked by your choir, but by at least some from the opposition too.

    But, I think the pervasiveness of personality disorder in multiple facets of our culture is not only entrenched, but effective. And they want you, the public, to just shut up and do nothing. Again, stick to the facts, the truth, and how it impacts the public at large, and then watch the enemy either slink away, or be ready for them to be in your face.

    At least the latter shows the real agenda at that point!

    Be safe, be well, be fair, and be honest. The Quadfecta for the week until Thursday.

    Joel Hassman, MD

  • But I take it as a damning generalization, maybe I am wrong in my interpretation, but, I am not interested in this group’s narrative to define my needs and wants. He writes this to be used to fuel the partisan agenda of antipsychiatry, again, my interpretation.

    Who here that is one of the loudest proponents of psychiatry should be muzzled will tell me I am wrong.

    Careful here…

    Joel Hassman, MD

  • Oh, I want abusers not only punished, but ostracized and removed from public risk as far as appropriately and legally as possible! But, if you claim abuse is “that hurt me” , but doesn’t meet a standard that the general population around the alleged abused individual would inherently support, then, is it abuse, or a feigned injury that, to use an illustration from Healy’s argument above, will be shown to be faked for primary or secondary gain that Somatoform Disorders intend?

    If I say “NO’ and you shriek “ABUSE” as retort, well, words can hurt, but so can neglect. Which is it with some of you, anything a doc does is abuse, and then if he/she chooses to ignore you, then more abuse!?

    Oh yeah, that “damned if you do or don’t adage”. Well, I learned in my training “better to care than to be care-less”. Sort of like that other adage, “better to be judged by 12 than carried by 6”, hmmm???

    Define the boundaries and expectations, but once again, that creates accountability and defined goals. Not an Alinsky agenda at the end of the day, eh? See below at 6:52 for the comment for clarification.

    Joel Hassman, MD

  • You are two faced AA, perhaps writing this will get the comment stricken, but, I am on to you now, and you don’t know me but make comments like you are over my shoulder every day of my life!

    Dishonest and disingenuous, you can infer and interpret as you want from what i WRITE, but, you write like your opinion is gospel. And, it ain’t!

    Good luck in your pursuits.

    Joel Hassman, MD

  • Sorry, I do not see these alleged muzzle prints from figurative guns against these patients’ heads many of you claim are in place.

    Patients have said “NO” to me in various elements of care, as an intern, resident, and sole practitioner, and I have begrudgingly said, “fine, your choice, but, hope you weigh all those risks and benefits”.

    And let’s have the most brutal and honest moment of candor about involuntary commitment, which is the real sole topic you as a group may have some legit gripe to bear here. I haven’t practiced inpatient work for much of my career after residency, but, I have NEVER met a patient, without felony or civil charges above the psychiatric matter alone, that has been kept in a psychiatric hospital for many months or years. And that is again one of the disingenuous and dishonest parts of your shrill debate, well, where is the outrage with the judge per those court related matters outside psychiatric competency per psychiatric illness alone?!

    Patients get out of the hospital, maybe at times inappropriately mistreated and very wary to ever cross the mental health system again, but, psych hospitals for mental health care alone are not prisons these past 20 years I have been an observer. Debate the Forensic portion separately, so the apples are apples and the oranges are oranges!

    I very painfully and cautiously, but equally very honestly want to watch the reactions from some of you should you or someone close to you be harmed by an acutely ill psychiatric patient who has no insight and judgment to avoid harming others while in the midst of serious illness. That getting them hospitalized, even for a brief period of time, a few days is the realistic amount more often, might have some impact for pause and reflection to prevent tragedies we seem to read about with too much regularity these past several years.

    Yeah, then the hypocrisy will really flow!

    I am genuinely sorry some of you have been inappropriately treated by providers, and I really believe you have some options that are legitimate and appropriate to try to spare others similar, if not greater pain and anguish. Beating the drum at 100dBs to eradicate a profession is not going to accomplish an effective endpoint at the end of the day.

    But, hate blurs boundaries and realistic expectations, I know, I have been there.

    Joel Hassman, MD

  • Hey, be silent when the equally heinous politicians set the bar for care they have no freakin’ clue where it should be set per honest and responsible standards of care that have shown to be appropriate.

    I think my blog clearly and consistently has noted how I feel about the scum and treachery I would bet over half of you vote for over and over for years that in the end are incompetent, selfish, and disruptive people masquerading as leaders. Irregardless of party affiliation.

    My advice, for what it is worth, pay attention to the forest, not the sole tree in front of you.

    Joel Hassman, MD

  • I’ll accept I made the mistake of glossing over what Healy wrote in the middle per his interpretations of abuse, but, having read it again, I offer to readers this perspective I have had patients share with me over the years perceived as abuse:

    Saying “NO” is abuse. Well, “NO” to what seems to have to be included in the discussion. “NO” in denying people access to basic needs and healthy wants that can be effectively denied certainly could be abuse, but, “NO’ to requests seen as unrealistic or unhealthy, or just plain disruptive or destructive agendas or intents isn’t abuse, it is a boundary. And I strongly feel the answer “NO” should have clarification: if it is absolute, or may change to a “YES” if circumstances change that show healthy and responsible insight and judgment are pursued.

    “NO” I won’t be a part of a plan to harm oneself or others is not abuse. “NO” I won’t write a prescription for a medication that could be abused or misused is certainly not abuse. “NO” I will not ignore you are in pain or distress yet have come to me for some level of help is not abuse.

    Patients do have the right to say “NO”, and if they reveal they have alternatives that show some interest to problem solve or pursue improvements in fashions the doctor either can’t support or can’t understand, but said physician accepts is about seeking health, well, good luck with your “NO”.

    Healy strikes me as a guy who either can’t say “NO” responsibly, or, doesn’t understand that “NO” by itself does not demand respect nor a free pass. I really hope he will respond directly to clarify the abuse definition that fits the narrative of abuse in the doctor’s office, and why he would want to associate with a profession that is instinctively a risk for abuse.

    After all, aren’t we at risk to be judged by who we associate with, eh?

    Hope the above makes sense.

    Joel Hassman, MD

  • No takers at the end of the first evening about my suggestion there are other more abusive relationships in this country that should be scrutinized even moreso than the above allegation of abuse by physicians of their patients, “the easiest place on this earth for an abuser to flourish is in a doctor’s office”. Frankly, why does Healy even add the MD after his name, to add to the alleged abuse covertly??

    What about The Church? The Police? Hey, let’s even throw a third one here I did not really think of until just a moment ago, teachers?

    Damn that narrative here! But, as long as I am allowed to comment, I will continue to press my question, is it fair for Dr Healy to make the generalization without even defining in a realistic fashion what meets the definition of abuse by the physician?

    Talk, or write amongst yourselves, I am busy until 7PM tomorrow night but will be here in earnest to any and all interested to read and reply. Perhaps to interests to dialogue, not just have to duck the projectiles headed at me??

    Be safe, be well. And, try this one, be fair!?

    Joel Hassman, MD

  • Well, that is your interpretation, but, I would be interested in NON blog authors or other commenters who do not have direct benefits from this blog to tell me where I was asking for an alleged type prisoner exchange in the above comment.

    So far, only one person to respond to me has been honest and respectful, so I guess Ms Mead you are right on that point, the others are being honest, and disrespectful. And I won’t have my hands tied behind my back to engage in a verbal knife fight most of the participants here want demanded of physicians.

    I advise readers who are fair and impartial to read up on Saul Alinsky and see if his tactics fit the narrative of the usual dialogue of these threads that have any physician input.

    You might be surprised I may have a legitimate perspective. When people are shooting figurative rockets at you, you don’t just sit down and say “let’s talk about it”, unless you enjoy being blasted endlessly.

    No, the antipsychiatry dialogue does not gain kind, pleasant responses anymore, I learned that lesson at Furious Seasons.

    When in Rome, Ms Mead?…

    Joel Hassman, MD

  • Again, projecting your interests onto me, sorry I am not interested in the baggage, ma’am. We, which seems to not include you, is to dialogue with others here in an honest and respectful manner if Dr Healy has the right to demean physicians with the generalized comment he ended the post as repeated twice now by me.

    And your effort to take control over a thread neither one of us has any control over at the end of the day speaks volumes for your interpretation. Should the firearm have a wood or ceramic handle?

    Joel Hassman, MD

  • Is this the same Wiley at who wakes up some mornings wanting to pistol whip Freud, or the nearest facsimile that is an active living psychiatrist you think wronged you of late?

    If you are, maybe entertain the masses what you dream of doing to me, and have the intestinal fortitude to share it with the blog, so your outstanding management skills will surely shine brighter than mine.

    If you aren’t, my sincere mistake, but, I never spoke of asking to be master and having my butt kissed, but I’ll go out on a limb and suggest you might be projecting your wants and expectations onto me so I can maintain that defacto villain role you and the other antipsychiatrists crave so eagerly.

    Step off, what, the cliff so I can fulfill some twisted fantasy I help the usual suspects envision that psychiatry won’t exist anymore? yeah, I read that beauty by another commenter here a month ago.

    Time to move onto the next feeder…

    Oh, and I see me being censored while the other attacks stay in place. Gee, like the Hamas analogy I believe fits more and more from posts like this and the ensuing thread…

    Joel Hassman, MD

  • Umm, can we stick to the issue at hand I raised in my first comment today?

    Again, for the sake of being respectful for the moment, DR Healy wrote this:

    “The place on this earth where there is the greatest mismatch in power between two people is when doctors meet patients. The easiest place on this earth for an abuser to flourish is in a doctor’s office. Have a look there.”

    Yeah, well I forgot two other important components to American society that I think bests the doctor-patient mismatch: The Catholic Church, and the police.

    Let’s see who can honestly and respectfully debate those two elements aren’t even more dangerous to be abusive than doctors.

    Healy wrote something that is plainly ignorant, if not reckless and insulting on a general scale for physicians. I do not expect the usual suspects at these threads to understand the tone of Dr Healy’s comment, but, I do expect other physicians who read here to think about it, a bit.

    I think after over 20 years of practicing psychiatry the way I was trained and gravitated to providing to all types of people, I have been doing it right and responsible. But, the narrative of this blog must be maintained, and there are no innocent psychiatrists, much less responsible ones with the pervasive tone of posts being presented since I first came here over a month ago.

    I have no issue with you, Mr/Dr Keyes, but, let’s define abuse and make sure it is applicable to what doctors are allegedly doing with any legitimate charge of malfeasance before just uttering it as a generalization?

    Unfortunately to me, there is a Hamas-type element to dialogue here too often, and it needs pondered by the blog authors, in my opinion.

    Thank you for your direct and respectful reply, Jonathan.

    Joel Hassman, MD

  • What passes as “discussion” at this blog is just pathetic. Where in god’s name did you twist my comment to a “prisoner exchange”? But, it isn’t about discussion, it is about unsubstantiated accusations and jamming all those sick psychiatrists into that hideous mold called mental health care by the Marquis de Sade, eh?

    I am going to keep coming back to this thread and take each and every one of you on until you either have a honest and respectful dialogue, or, the authors here will allow the shout downs be so persistent and ugly that it will define once and for all my accusations what this blog is about.

    Or, I’ll just be censored to make sure the agenda stays pure, hmm?

    Maybe the authors of the blog can give me the appropriate interpretation I was to alternately conclude from the above by “Boans”?

    Joel Hassman, MD

  • After reading this post, I am compelled to ask just one question of David Healy: if you already haven’t done so, when will you renounce your Medical Degree after writing that ending above:

    “The place on this earth where there is the greatest mismatch in power between two people is when doctors meet patients. The easiest place on this earth for an abuser to flourish is in a doctor’s office. Have a look there.”

    No, Mr Healy, the easiest place for an abuser to flourish, in order, is one’s home, one’s extended family, one’s business, and overtly of late throughout the globe, one’s political office.

    For every legitimate “abuser” you can document in a doctor’s office, I will be able to show you dozens masquerading as politicians, as business leaders, and “pillars” of the community at their home owner meetings/country clubs/PTA meetings.

    Again, thanks for the validation this blog is as antipsychiatry and antiphysician I have read since the garbage over at

    Here the rustle in the brush around this thread? And the attempt at feeding commences!!!

  • I am compelled to respond to you AA, simply because you have no idea who I am and what I do in my office, yet make comments like you do.

    First of all, what problem do you have when I say I don’t want to participate here, but, I think you do it to bait me, so congratulations, you win this time. But, while you get a return comment, I think people need to know what I have ascertained about you between here and

    You don’t like psychiatrists, and offer some superficial pleasantries and then go for the jugular when you sense it is time to pounce.

    I hope there are more psychiatrists like me, because I believe I practice psychiatry the way it was intended: to treat people as individuals, find out who and what they are about, and then come up with a treatment plan that hopefully intervenes with the issues that drive the need for care. I.e. bio-psycho-social factors, and believe me when I write this, meds are not my first choice over 50% of the time, but, as of now, people rebel and outrage when I mention therapy and self reflection to consider change with social factors.

    So, I accept the charge of hypocrisy in writing this comment, and hope the authors will allow it simply because I am accused of things I would like to rebuke as accepted as legitimate defense, and, I would like people to come to my blog and debate me in honest and fair fashion.

    Hey, you might prove me wrong with something, and shockingly, I will acknowledge it, and gasp, thank you for the correction!

    But, as I wrote at a post at my blog this weekend, I am not timid, not reflexively letting people be labeled as victims without accountability as comfortable sharing, and, I moderate.

    There are some sending comments, and so far ALL are being printed. Because I think people who want to engage with me want dialogue and debate, not shout downs and raging without limits.

    Hey, if you are interested, I will be working in Frederick Maryland for two months come July. See me as a patient or as an interested personal discussion, you might walk away seeing me as a responsible and respectful doctor, and genuine person.

    Zero tolerance for antipsychiatry though. Rigidity and inflexibility does not deserve efforts to engage when shown to be “my way or no way”. Hope this reply is worth your consideration, AA. And to be fair, I don’t want to dialogue with you anymore after this post, sorry if that is received as me claiming “the last word”

    I just give up interacting with you. Be safe, be well, and thrive as productively and effectively as you can.

    Joel Hassman, MD

  • Wow, your own site seems to at least somewhat echo my point of view:

    ” “Now we see a huge rise in support groups, we see pressure brought to bear to bring in labels.” He said parents and teachers also put enormous pressure on physicians to label and treat children.”

    Yeah, we the doctors are still the primary villains even to this day, truth that doesn’t fit the narrative here needs bashed and buried!

    Incredible! And save your typing, I won’t be replying further, talk amongst yourselves.

    Joel Hassman, MD

  • “Psychiatry should not exist”? Tell us how that is different from the rhetoric of the Nazis saying Jews should not exist.

    Again, hypocritical of me to comment, but when do those of you who want to be legitimately heard distance yourselves by ostracizing this extremist ugliness to where it belongs?

    Your silence as a group is why responsible and fair people avoid you all like a plague.

    Umm, maybe write “incompetent and unethical psychiatrists should be removed from practicing”. Then you have a legitimate and respectable forum.

    Hate seems to sell well here!

    Joel Hassman, MD

  • I see you sent a comment to my blog, Dr Hickey, so I will comment here this one time to reciprocate as respectfully as I can offer in this forum.

    So, to you and the followers here, educate all of us physicians what to do with the growing number of patients, especially in Community Mental Health Clinics, who have NO interest to approach care in a multifactorial manner, just medications. I sincerely say this, if the message from the “psychiatry critics” is so irrefutable, why hasn’t this message found a way to impact on some sizeable portion of the general public? Patients are not showing any decrease in drug seeking, no, it is a steady increase in the past 5 years, at least.

    And I like the way the narrative here frames it as “blaming the clients/victims”, which to me shows some subtle disrespect to the framing of the interaction in this process, they are “patients” to us. It really does reinforce the “narrative” that defines the antipsychiatry movement I have crossed paths with these past 4 plus years on the Net. Ignore the 95% of debate and commentary that might encourage fair and reasonable discussion, but just hone in on the 5%, the random chance mistake or diverging view an author or commenter makes, and then not only shine the spotlight on it with 10,000 lux lighting, but make sure any moderate or unbiased reader is sufficiently blinded and has no ability to see there is more to the commentary/discussion that might actually have validity and make sense to why a position is held.

    Oh, and while the detractors to psychiatry have some valid criticisms and concerns, they don’t own the debate and run the discussion alone.

    Please read the Open letter Dr Hickey links to above at, not to solely go to my site, but read the post, period. You might want to look at some other related posts, if interested, and I say up front you don’t want to read my political posts, as I am very cynical and outspoken about our political system these days. In my opinion, politics as illustrated by what I feel this blog exemplifies as the extremist and zealot attitudes that fuel our alleged representatives at state and federal levels.

    Been practicing 21 years now, do the best I can do with the little left I have options to provide and encourage patients to explore for care interventions, and yet I will end this one time comment at this thread with this challenge for those readers who are genuinely interested in care and support, provided by physicians with responsibility, integrity, and concern for individuality:


    I think this post today reinforces my points about the antipsychiatry movement. But, I do appreciate some direct approach to a discussion, even if it will be framed in a narrow and boxed perspective.

    You have your choir, Dr Hickey, and I am not one of them. Again, thank you for the heads up in your comment to me earlier today about this.

    Have fun, everyone.


    Joel Hassman, MD
    Board Certified psychiatrist

  • You know what I love when people use that term “straw man”? It is their outlandish projective spotlight saying “I am going to accuse you of what exactly I am really doing”.

    I am going to leave readers with this comment below from “Uprising” which, to me, seems to just echo my earlier point:

    “Having said that, I personally think that psychiatry should not exist, and I find it offensive that you should paint those who actually do fit the general description of being “anti-psychiatry” as some kind of oppressive group.”

    Great, a profession that has some people who do help others should be relegated to the scrap heap, thanks for arguing my point for me, Uprising.

    Done with this thread, I guess I should have really thought out commenting here before I have my Deja Vu moment with Philip Dawdy’s “Furious Seasons” blog. I guess some things, and some people, just don’t change.

    Be safe, be well.

    Joel Hassman, MD

  • I am sorry, where are the muzzle prints on these “victims” foreheads that demand they take medication?

    And yes, I stand by my interpretation that the rhetoric of the antipsychiatry movement as mirroring that of the World War II German Hierarchy in looking for scapegoats and villains for the very behaviors of the leaders and blind followers, that is what movements that demand people be exiled or exterminated. But, I don’t expect the very group I excoriate here now to see it.

    The antipsychiatrists here will never get it, but I will remind honest and fair minded readers what is going on here, yes, there are villains in psychiatry, and there are responsible clinicians, but, antipsychiatry vilifies ALL who have the title Psychiatry/MD after the name.

    There are years of posts and thread comments to back me up, and just like the past Germans and current Jihadists of Islam, if you are in the vilified group, you must die or be ostracized horrendously. Tell me I have not read that from writers at various mental health sites?

    As long as extremists, from both sides mind you, hijack efforts at reasonable and fair debates, forget psychiatry for a second and watch the debacle of the Bergdahl matter this past week, people in the middle gets screwed. I can’t reason at all with my impaired and dishonest colleagues, because we all know money talks in this country until proven otherwise. I continue to offer possible ideas to derail them, but, it takes a group to rid the village of the idiot!

    Oh, and funny how I don’t read about people looking to get rid of the most notorious and pervasive equally disruptive elements to health care consequences, the insurers and politicians. Anyone here deal with an “authorization” problem getting legitimate and fair meds theses days? I will not belabor what managed care has done that equally the public was complicit in going along with, forget the idiocy of psychiatrists in the 1990s!!!

    But, returning to the point at hand, you as a patient come to someone with an expertise and then have the gall to argue and demand interventions that do not fit as treatment A for the problem in front of the clinician, and I am to refer to him/her as “victim”?? Get real!

    Joel Hassman, MD

  • “Irregardless” is in the dictionary, while Webster’s New World dictionary does note it to be an “Americanism” term, it is there. And it gets old when the first attack is about spelling, punctuation, or other “English teacher” pontifications. Come on, focus on a legit issue.

    I have NEVER debated against there are idiots and cretins in my profession, but the way antipsychiatry has carried on for the past 4 plus years I have been reading at blogs now, are they going to carry it on to attacking the police profession next, after all, certainly are idiots and cretins in that field too!

    Sorry, but if there is going to be a valid and honest discussion/debate about who is at fault in the “chemicalization” of mental health, don’t just pick on the doctors. Patients are pervasively demanding drugs, often ones of abuse potential of late, and have little to no interest in problem solving nor wanting to implement real and effective change for the better.

    When people come onto public sites and then want to demonize a select percentage of the group at fault, and just conveniently or plainly villainize one portion to further an agenda, does it make it more acceptable than similar actions like what pre World War Germany did or current extremist Islamic leaderships are doing?

    Everybody wants a scapegoat when things don’t go as planned. I’m just curious of the antipsychiatry crowd, are all the mirrors in your homes covered or just removed? No culpability for negative outcomes on your parts, eh? Oh, my mistake, the other part of the equation, everybody has to have a victim too.

    Just like how our politicians problem solve these days. I guess we do get the electorate we deserve. Not a mistake in terms there, see the George Carlin rant in one of my recent posts at my site, it will make sense then.

    Joel Hassman, MD

  • First of all, why registering would not accept my name, Joel Hassman MD as the name for my comments is bizarre. So, I guess I have to sign every comment here in the future with my name.

    Everyone rails about psychiatrists and other prescribers just dumbing down mental health care complaints to writing scripts, but, in the last 10 years or so, people come into treatment venues just wanting drugs, and dismiss any other intervention for care, irregardless of how appropriate and indicated as a standard of care such a treatment is warranted. So, where are all the blog authors and commenters moaning about patients demanding drugs from providers who don’t want to reflexively write them at moment one?

    Seems to me it fits the antipsychiatry narrative at the end of the day. It is easier to crucify the doctors, harder to attack the general public who are reinforcing “better living through chemistry”, eh?

    Joel Hassman, MD