Illness, treatment, and tragedy

In the wake of the Connecticut killings, I have been asked many times “what did that guy have, you think?” I have no idea – smarter people than I have speculated he had a neurodevelopmental disorder, that he looked odd, and the history suggests he struggled socially – that he was something of a pariah. I don’t doubt any of these hypotheses – they all fit the bill. I’m just not so sure knowing really makes much of a difference at this point. Maybe, perhaps, ideally it might have helped to know his diagnosis prior to his snapping and murdering innocent people, but even then, I’m not so sure. Let my gratitude for the DSM V revisions not be overlooked…
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Healthy Focus

Everyone says “you better love what you do” probably because we spend so much time doing it! I think there’s something more and recently I’ve come to think that loving your work enables a healthy focus and this healthy focus can be protective – it feeds and sustains you when the chips are down. And the chips can really be down at work – low morale, frustrating interpersonal conflicts, you name it. But if the work is compelling to you, if you find kernels of meaning in your work, a healthy focus on the work itself enables a healthy distance from the vicissitudes in the workplace. This is of course complicated when co workers critique or worse disparage our efforts,…
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Finding Silver Linings

You know, most developments in our lives can be viewed from different if not utterly divergent perspectives. I was reading snippets the other day from one of Gottman’s book on Divorce ( and a fascinating principle that must broadly apply to other domains of life besides marriage is this notion of a struggle between positive and negative interpretation of events. He argues that well compensated (not financially, though I’m sure that must help) individuals in the marriage dyad tend to view and or incorporate negative data from their partners into a fundamentally positive paradigm — that is, when you’re in a good mood, even things that usually piss you off roll off your back. And the converse is true: irritable…
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The New York Times loves psychiatry

… which of course is great and the articles they publish are mostly incredibly well thought out and cogent. But sometimes even cogent articles raise questions in patients’ minds… which is good, but perhaps unsettling. Best, I would think, to raise these questions with your therapists, psychiatrists etc straight away – not necessarily as a test to make sure your therapist or doctor is apprised of what’s going on in the NYT — but more to feel that any unanswered questions or unsettled feelings get addressed, because unspoken concerns in psychotherapies and psychiatric treatments can impact them deeply.

Early detection of psychopathy> Powerful story I spend a lot of time with young people, and sometimes I wonder… can we teach empathy??

The schedule book

Never did I think that I would come to depend on my schedule book like I do now – I feel anxious without it. I tried programming everything into the phone — not the same. I need to see it and hold it to feel like I am controlling my time but it’s an illusion, I think. “… best made plans” — but still, I love trying to order my time and plan my days. I feel A little more effective.

Long hours

It seems like it should be easier, feeling whole – feeling sane – feeling better. But it slips away time and again Leaves you feeling like even though you’ve put in the long hours There are many more to go.

Flowers and Trash

Ten years a go I heard Thich Nhat Hanh ( say that when he looks at a flower, he sees trash…. Didn’t get that until today… Amazing how long some things take to sink in.

Developmental Parenting?

We all know how important childhood development is, and quite a bit is known about adult development, but parenting as a developmental process is is not as well understood. What I mean is, just as children and adults progress through a series of well-characterized cognitive, affective, and physical stages, I believe people as parents do, too. Parenting as a developmental process has its roots in psychoanalytic theory. As that story goes, “normal” individual development consists of sequential transformations determined by interactions with the environment. But when development goes awry, we get “stuck.” In most cases, we get over it, but sometimes when our own kids’ developmental ebb and flow reminds us of our own early struggles, we become vulnerable to…
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Robert Whitaker, what’s your angle?

His book, The Anatomy of an Epidemic has made a splash and grabs the low hanging fruit off the psychiatric research tree (i.e., pathophysiology of depression still a “work in progress”), but you gotta wonder what’s underneath his curiosity…