mental health, psychiatry, and friends 💊 🩺

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

Some people, especially those who are autistic, dohave a flat emotional affect, do rely on scripts and do have a clear-cut sense of justice which leads them to cut off those who transgress it. When we talk about these traits as inhuman and robotic, what are we implying about the people who display them? The impulse to be unapologetic about emotiona... See more

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 in

... See more

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 f... See more

Szaszians hold on to a fantasy where an objective definition of “disorder” not only exists, but it also successfully covers recognized disorders in general medicine while conveniently excluding mental illnesses as faux-disorders. Szaszians also commit themselves to some version of the idea that medical authority only applies to genuine disorders, a... 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 .

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

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

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 ha... See more