Check Your Wallet

Recently, we were writing about the bias that practitioners have that the technique that they they have mastered is the most effective treatment for any condition. We were reminded of this issue very vividly this morning when we met up with one of our favorite people, an older man who has been seeing us for a couple of years. He …

DSM5

In the next few days the American Psychiatric Association is meeting in San Francisco and will announce the latest version of its diagnostic and statistical manual: DSM5. Tom Insel, the Chief of the National Institute for Mental Health, created quite a stir last week by seeming to announce that the new diagnostic manual was an emperor with no clothes. The …

Mary Poppins: Overcoming the Winter Months

What I most want to have available to me in the long winter months, to help me with my patients with bipolar and depression, is access to someone a lot like Mary Poppins. You may remember that Mary, played by Julie Andrews, was the incredibly cheerful nanny who transformed the unhappy and dysfunctional lives of the family she joined. What …

Parody No More: Mental Health Parity Law

In yesterday’s clinical team meeting we were talking about the mental health parity law, which has been largely ineffective at ensuring access to care. One of the psychologists said, “I call it the mental health parody act,” because it is a parody of meaningful change. That may be changing. President Obama announced that the Sandy Hook school killings had galvanized …

Body Work

Several months ago a young attorney who I have been seeing for a couple of years came in and, reluctantly, told me that he and his wife had not had sex for the past year. It took two or three months to get him to consider going for couples counseling.  I found a therapist who specialized in working with couples …

Inspiration and Skepticism

A very dear and cherished friend is visiting us. She has inspired this post. Every time we are fortunate enough to visit with her I have an opportunity to wrestle with the dichotomy of faith and inspiration, as opposed to science and skeptical inquiry, that is at the heart of Western medicine. Carey has vigorously embraced healing and faith. And …

Healing the Inner Child

Right off, we have to say that much of what has been written on this subject sounds pretty flaky. The problem is that the ideas have been popularized and applied to people and situations where they really didn’t apply. “My ‘inner child’ was wounded by your refusing to pay for the ballet lessons that I wanted,” for example. And yet the …

A Little Romance

This week we spent some time with a couple of people who, in different ways, have become “addicted” to romantic relationships. One is a man in his early 40’s. The other is a woman in her early 30’s. They are quite different in terms of personalities, but there are some very strong similarities in terms of their childhood and relationship history. Both had quite …

ACT

The “hot” thing in the therapy world these days is something called ACT (Acceptance and Commitment Therapy). The radical notion behind ACT is that therapy should not be primarily about reducing symptoms (like depression) but rather increasing our ability to have a valued life (a life that is based on our deepest values) even though we have symptoms. And, by …

Retraumatization

After nearly 20 years of work in the field of post-traumatic stress disorder, one thing that continues to trouble and baffle me is the phenomena that was described by Freud as the repetition compulsion.  Why is it that people who have been victimized in terrible ways are at much higher risk of being victimized again.  One would think that they would be …

Rousseau and Nature’s Way: Realistically Thinking about Treatment and Medication

We’ve been thinking about people who come to our clinic, say that they are not sure that they have a mood disorder, and they want to try get off of their medications and use dietary supplements to cope with their ups and downs. We have a lot of interest in the idea of using various non-medication options for managing moods. …

Mood Phobias

We were talking with a couple of wonderful psychologists about what it is that helps people come to terms with moods and learn to live with them creatively.  One of the barriers to successful mood surfing is a fear of moods.  I suppose the analogy is of someone who is afraid of the waves trying to learn how to surf. …

Relationships: Too Many People in the Bed

Many years ago, a consultant we worked with made the observation that there are always at least four people in any intimate relationship. And often, six or more. The four people are (in the case of heterosexual relationship) the man, his female partner, his introjected mother (the internal mother that  developed from his childhood), and his partner’s introjected father. Often, …

Should or Could?

The idea for today’s post comes from a wonderful online resource for folks with moods –  MoodScope.com (they have an interesting mood tracker app and blog). They wrote about the power of changing a single word in one’s thoughts – going from I should do something, or I should have done something, to I could do something. Give it a …

Depression is Depressing

Sometimes helping someone deal with their moods can seem a bit like being a gynecologist in Victorian England. How can you help someone with something (sex, or depression) when the topic itself is off limits. We are exaggerating, but there are so many ways that the idea that “depression is depressing” interferes with actually dealing with the mood. Not to …

Loneliness

This seems to have been the week for discussions about loneliness. We have been talking about the experience of loneliness with a number of people in different situations: A married woman whose husband is away on business, A widowed professional man, A woman who recently ended a two year relationship. What has been interesting in these conversations is that they start …