mental health, psychiatry, and friends 💊 🩺

At the core of it seems to be a belief that you - the patient, the self-healer, the consumer - are not the problem, and everyone else is toxic, or a narcissist, or an abuser. You are just vibrating at a higher frequency than they are. Everyone is out to get you. Crucially, the customer is always right.

We psychiatrists tend to start our first sessions with some variant of the question: “What would you like to change?” People often list negative goals: to be less depressed, stop using drugs, feel less anxious, etc. It’s a start, but we often need more. There is a helpful reframing found in Acceptance and Commitment Therapy: no dead person’s goals.... See more

Studies have shown promise in treating Alzheimer’s and Parkinson’s with GLP-1 drugs, perhaps by regulating insulin levels and reducing inflammation, and the drugs may yet prove useful in treating many other conditions made worse by chronic inflammation. Some studies have found large decreases in the risk of depression and anxiety; others found... See more

Also, psychedelics have a fundamental discordance with allopathic research which can never be overcome. The placebo problem is unsolvable. And these medicines are customarily adjacent to non-directive therapy, and ongoing integration. We'll never be able to quantify those things in a trial format the same we we can for a blood pressure pill.... See more

The so-called ‘HR-ification’ of interpersonal relations – an appropriate term, given the particularly capitalist bent of its aetiology – involves Insta-therapists encouraging the use of social scripts full of meaningless jargon, such as the much maligned template above, to ‘protect your peace’ and ‘assert your boundaries’ against those... See more

IFS illuminates the mind's landscape as a mosaic of distinct parts, each with its own voice, identity, and role to play. This concept resonates with our daily experiences; we often catch ourselves saying, "A part of me wants this, but another part of me wants that." Addiction can amplify this internal dialogue, making it feel like an alien force... See more

The same is true for any assumption that holds the mind or its pathologies to be inexplicable in some fundamental sense: it can only lead to extremely bad explanations. We have no choice but to treat mental illness as unknown but knowable .

1. Some therapists have an overly reductive understanding of psychiatric diagnosis. They seem to think a diagnosis of mental disorder necessarily implies there is some intrinsic brain abnormality. They think if someone’s symptoms can be explained with reference to a history of abuse or trauma, then a diagnosis doesn’t apply to them. The logic is so

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Many scientific theories assume constructs that are not directly observable (muons, genetic drift) but whose existence is inferred. In mental health research, psychiatric diagnoses play such a role. We assume that constructs, such as schizophrenia or alcohol use disorder, exist but we can only observe the signs, symptoms, and course of illness that... See more