Posted by: thealienist | May 9, 2013

Foundations of Mental Health: Dependency

In my previous post, I talked a bit about responsibility.  Unfortunately, many (in the pursuit of excessive responsibility and imagined independence) overlook the health promoting effects of appropriate dependence.  In this post, I would like to discuss how dependence can be effective for one’s mental health and for the mental health of those around them. Read More…

Posted by: thealienist | May 1, 2013

Foundations of Mental Health: Responsibility

One of the fascinating things about mental health issues is the realization that careful balance that needs to be observed in order to live life well.  One of the issues I frequently encounter in my life, in my patients’ lives, and in public discussion is the balance between responsibility and dependence.  Today, I would like to start a discussion on the side of responsibility. Read More…

Posted by: thealienist | April 23, 2013

I’m Back – and Wondering About the Past Year

I’m sorry for the prolonged absence, but I have been busy at school, in practice, and with my family.  For those who occasionally stop by, thanks.  I hope to post more regularly from now on.

It seems to me that more issues of mental illness have been coming up in the news lately.  We had the Aurora cinema shooting, the Sandy Hook school shooting, and the Boston bombing.  We have the gun control debates.  In each of these, and in numerous other reports, conversation has turned to the issue of mental illness and public safety.  The argument seems to be that “if only we (society) had known that these people were mentally ill, we could have prevented this.”  Does anyone else see a problem with this?

Read More…

Posted by: thealienist | August 5, 2011

An Analysis of “Anatomy of An Epidemic”: Part III

Chapter 3 of Robert Whitaker’s book, Anatomy of an Epidemic, is fairly short and begins his discussion of the history of psychopharmacology and the changes it brought to the practice of psychiatry.  Much of this section seems to revolve around the concept of the “magic bullet.”

Read More…

Posted by: thealienist | August 1, 2011

Critique of the Double-Blind, Randomized, Controlled Trial

The crown jewel of biological psychiatry is the randomized, controlled trial.  If it is well-constructed, it can be simple, elegant, and powerful.  But in assessing medications, it can have some problems.

How can we assess the value of a tool independently of the one who uses it?  If I give golf clubs to 100 people, the better golfers will use them better and have better scores.  If I give paintbrushes to 100 people, the better artists will make better paintings.  If I give hammers to 100 people, the better craftsmen will make better structures.  What will happen if I give better medications to 100 doctors? Read More…

Posted by: thealienist | July 29, 2011

Foundations of Mental Health: Ceremony/Ritual

I recently sang at the funeral for the wife of a friend of mine.  The funeral was very nicely done.  It impressed on me the positive role that ritual can have in our lives.  The function like sign-posts and mile markers on our travels through life.  They remind us of the major events in life and encourage us to stop for a moment, get outside ourselves, and share in the intersection between our own personal self-realization and our communal social existence.  Read More…

Posted by: thealienist | July 28, 2011

An Analysis of “Anatomy of an Epidemic”: Part II

I hope this post will be short.  It seems unfair to expect much out of a chapter entitled, “Anecdotal Thoughts,” but Robert Whitaker felt it was important enough to include, so I will cover it. Read More…

Posted by: thealienist | July 21, 2011

What Would You Do With Raskolnikov?

I just finished reading Crime and Punishment by Fyodor Dostoevsky.  In it, the main character, Rodion Rommanovich Raskolnikov, commits a double murder, and through the narrator we are given access to all his thoughts and feelings leading up to, continuing through, and following the murders.  In some ways, this is an excellent (thought fictional) case study of an intensely conflicted and unstable mind.  Rodion is sometimes called “mad,” but no diagnosis is ever given.  All we are given are the “facts” of the case in greater detail than any court or mental health provider will ever experience.

So my questions to any readers who happen by here are as follows:

1.  Is Rodion Rommanovich Raskolnikov mentally ill?  How can we know?

2.  If you somehow knew what was going on, would you have involuntarily hospitalized him?  How would you approach the decision?

3.  In the book, Rodion is found guilty of the murder but was given a reduced sentence because of his mental state.  Was justice done?

I hope that these questions will generate some productive discussion and lead some to enjoy this fascinating book.

Posted by: thealienist | July 19, 2011

An Analysis of “Anatomy of an Epidemic”: Part I

One recent book that has many people talking is Anatomy of an Epidemic, by Robert Whitaker.  This book is a challenging read and throws the gauntlet down to psychiatrists who believe that medications are helping their patients.  The book is extensively researched and refers to a great deal of data.  Despite this, I believe that his conclusions are wrong.   I hope over the next several months to address his book in several posts.  Today, I will start with his first chapter. Read More…

Posted by: thealienist | July 14, 2011

“Tangled” Up in Knots

Everyone in my family is a big fan of Disney movies.  Last week, my daughter wanted to watch “Tangled” again, so we took a few hours out of our Saturday and watched it together.  Although (like most Disney movies) the story was significantly altered from the known early versions, I was struck by the portrayal of the relationship between the “mother” and her “daughter.”  The story opens up interesting issues that touch on trauma and “care-giving” run amok. Read More…

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