Posted by: thealienist | October 14, 2014

The Game(s) of Life

I have been interested in games and game theory for a long time.  I think that play is an important part of life.  I also think that I see our modern western culture trying (ironically) to squeeze play out of the average person’s life while trying to get more and more people to play their particular type of game.  I have read with interest the works of many authors who emphasize the role of play in human experience, but I have found no agreement among them as to what constitutes “play” or what the essential components of a “game” are.

I am going to use this category to explore (perhaps only for myself) what constitutes “play” and how much of our lives are taken up by games – either intentional or unintentional.  In addition to defining these abstract terms, I plan to comment on and analyze (to the extent of my ability and aided by any who would like to help) how the idea of “games” enriches or impoverishes our lives.  I expect that the posts in this category will be more rambling than usual and may take me (us?) down some blind alleys.  Overall, however, I hope that in our wanderings we will see interesting, beautiful, and revealing sights.

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Posted by: thealienist | October 13, 2014

The Depression Trap

Just as in anxiety and bipolar disorders (see previous posts), major depression has its own traps.  If seen far enough in advance, they are usually easily avoidable.  Unfortunately, many patients do not recognize these traps until they are neck-deep in them.  Let’s examine them in more detail.

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Posted by: thealienist | October 10, 2014

The Bipolar Traps

In the same spirit as I wrote previously in “The Anxiety Traps,”  I see some common traps faced by those who suffer from bipolar disorder.  Some of the traps occur most often in those who find themselves frequently stuck in depressive episodes.  Other traps are built for those in frequent (and especially mild) manic or hypomanic episodes.  Let’s see what it is best to avoid.

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Posted by: thealienist | October 7, 2014

The Anxiety Traps

When it comes to mental illness, I see several “traps” that my patients fall in. How they fall for these traps and how they are lured into these traps are easy to understand. Avoiding them is usually fairly straightforward, though it may be difficult. Let’s talk about the traps that the anxious need to avoid.

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Posted by: thealienist | October 2, 2014

The Psychiatrist as Scout

When I was in residency, my attending psychiatrists sometimes described psychotherapy as two people walking together. The patient is in the lead, and the psychiatrist has a flashlight with which he can point out and illuminate interesting or useful objects or processes. I like this image, though I prefer the image of the old west scout who was hired to guide explorers and settlers through the mountain passes and wilderness paths of America’s frontiers.  Still, this image brings up some questions.  How did this unlikely pair come together?  Where are they walking?  What does the psychiatrist bring that is of value to this pair?  Who is in control?

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Posted by: thealienist | September 29, 2014

Treatment with Antidepressants for Anxiety Disorders

Some of my patients get very confused with they are diagnosed with an anxiety disorder and are prescribed antidepressants.  It is not uncommon for them to have mixed feelings about this and to delay starting medications.  They look on the internet and see that their medications are made to treat depression, and they forget our discussion about how antidepressants are also good treatments for most kinds of anxiety.  Because of this, I want to take a moment to discuss the role of antidepressants in comprehensive treatment for anxiety.

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Posted by: thealienist | September 25, 2014

What Is “Mental Health”?

People often talk of “mental health,” but I wonder if many have given much thought to just what that is.  I know that in my practice, my patients often have very different ideas about mental health than I do.  Some of the things that I often discuss with them is how I define mental health, how I see them deviating (if they do) from my standard of mental health, and how treatment is supposed to restore them to a healthy state.  Although the idea of mental health seems very elementary, I fear that very few have considered what it really means.  Many arguments in blogs between mental health care consumers (I really don’t like that term — sounds to impersonal), mental health care professionals, and others outside the day-to-day mental health area seem to hinge on a failure to agree on just what “mental health” is and its role in society.

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Last summer (after I vanished for a while from the blogosphere), I read several books on literary criticism.  Several books focused on Dostoyevsky (a particular favorite of mine) and one by  Terry Eagleton  addressed literature in general.  I enjoyed the books greatly and may choose to write some posts about them in the future.  In the mean time, I have been thinking about one of the statements I repeatedly encountered in my reading.  It seemed to me that literary criticism was frequently judged on how “interesting” it was.  To tell you the truth, this bothered me.  My initial impulse is to judge academic works as to their “truth.”  I wanted to know how valid and reliable the data was.  How logical were the conclusions, and what kinds of assumptions were made?  In short, my more obsessive-compulsive traits took the lead in evaluating the work.

This is very different from how I deal with information from my patients.  Sure, I want to know how their communications about their life stories match the objective truth of the events in their lives.  I want to evaluate how closely their perceptions of their world and themselves match reality.  Still, I don’t usually become a stickler for the “Truth” in psychotherapy sessions.  I seem to take a more balanced view in evaluating my patients.  In addition to logical scrutiny, I want us to find the patient’s experience interesting.  I don’t want to ruin a compelling and informative narrative by nit-picking the details.  And when I make an interpretation, I want it to be both “true” and “interesting.”

This leads me to some thoughts on a blog post by a very intelligent and interesting colleague of mine.  I was recently browsing his excellent blog (Experimental Theology — see my links) and came across some posts examining one of my favorite comic strips, Calvin and Hobbes.  In one particular post, Salvation by Calvinball, my colleague made a statement that I found interesting but that did not ring true to me.  I started thinking…

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Posted by: thealienist | September 16, 2014

Foundations of Mental Health: The Truth

There are many people who don’t believe that there is any “Truth.”  There are also many who believe that, not only is there “Truth” but that they know this “Truth” absolutely and need to make everyone else believe it.  Some people don’t believe in “Truth,” but believe that there is something called “truth” that may appear differently to different people and may even be contradictory to different people.  Some people base their “truth” on science.  They believe that everything that can be known can be known through science.  Anything that cannot be known through science must then be false.  Others believe that science can show us many things, but that there are things that science cannot know that are nevertheless “true.”

With all the philosophical confusion about what is “true.”  I wonder what the role of truth is in psychiatry and mental health.  I must admit that I am a believer in “Truth.”  Still, I don’t think I have a monopoly on it, though I continue to strive to see more of it.  I also believe that there is more truth than science can reach.  Not that I think that scientific findings are false — I just think that there are things that science is not equipped to speak about.  So, what about truth in psychiatry?

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Posted by: thealienist | September 9, 2014

Mary and Max: Discovering Each Other

Last night I watched the movie, Mary and Max.  For a while, I wondered what the point of the movie was.  A litany of loneliness, mistreatment, alienation, shame, ineffectiveness, and abuse of the soul?  And in claymation, for goodness sake!  But, just as I was feeling the need for a dose of Wallace and Gromit to cleanse my mind, the movie suddenly jelled and a purpose was found for all the suffering that had been portrayed.  Max and Mary found each other.

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