mental health, psychiatry, and friends 💊 🩺

The search for root causes often means a life event that has triggered the mental disorder. When I hear people talk about root causes, it usually means they are not happy with a biological explanation and want something more psychological, more meaningful, more profound.

In clinical practice, this is tricky though - we can rarely, if ever, put our... See more

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

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 .

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

There is only so much powerlessness, so much indignity in the mounting pressure that people can tolerate, and God, family values, or appeals to a mythical utopian past quite frankly are not going to change a single concrete thing for them. Resorting to the dopamine rush of endless scrolling, or to the sticking-plaster medical intervention of SSRIs,... See more

Philosophy of science has had a long-running debate about the status of such postulated entities. Two major positions have evolved: scientific realism and instrumentalism. Advocates of the former argue that these constructs truly exist. Instrumentalists are more modest and argue that such constructs should be treated as tools and evaluated on their... 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