Couch in Crisis

Osama Bin Laden is dead. 9/11 lives on. The sudden annihilation of the man responsible for that cruel and ultimately defining act brought me joy, and rekindled a sense of pride in our country and its capabilities.

The proposal to include "coercive paraphilia" as an official diagnosis in the main body of DSM-5 has been rejected. This sends an important message to everyone involved in approving psychiatric commitment under Sexually Violent Predator (SVP) statutes.

In addition to receiving birthday cards, on this birthday, one of our bloggers, Dr. Moffic, decided to send out a card to all those he loved. It is being reprinted here. "If you are what you love, There is no longer reason to be most modest, so step aside Muhammad Ali, for I Am The Greatest!"

What should clinicians do if they realize that they don’t like a particular patient who has come to them for help

Can the death of a terrorist be something to celebrate? Should it be? What can this tell us about ourselves? What is the "proper" reaction?

Rape is always a heinous, ugly, violent, and cruel crime. But the violence and cruelty that are part of all rapes should not be confused with the specifically motivated violence and cruelty that distinguish sexual sadism...

When my clinic manager told me that prison may be the best place to practice psychiatry nowadays, I didn’t believe him. After all, prisons often seem like a world apart, often in isolated rural areas or in windowless, nondescript urban buildings.

The personality proposals are certainly not the most dangerous part of DSM-5-but they do win the prize for being absolutely the silliest. They offer a riot of impossibly intricate detail with a level of complexity that could never be of any use in any real world setting.

Whenever a suicide happens in the New Asylums, a palpable, muted dread descends over the institution. It stays there in full force for weeks and months afterwards, sometimes longer. After that, it is added as another sedimentary layer to the strata and culture of the particular institution. Before things get too deeply buried, it is important to excavate.

II would have to wait until the next day, when K’s internal flames of resistance had died down, to learn why he had burned so fiercely. When we finally sat across from one another, his embers still glowed, and I learned that the source of his combustion had been the classic lose-lose scenario.

Had the National Rifle Association had its way and Bill 432 had been voted into law in Florida, physicians would have been prohibited from asking their patients whether they have access to firearms.

On April 1, a secret source let me in on a special addition to the new “Obamacare” healthcare reform law, which just had its 1-year anniversary. It will be released by the new Convocation speaker at the upcoming annual American Psychiatric Association (APA) meeting in May.

The Alliance for Human Research Protection is attempting to draft me as an unwilling soldier in its dangerous campaign to discredit psychiatry and to discourage psychiatric patients from staying in treatment and taking medication.

Addressing a few subjects that may have the potential to create a more insidious and enduring form of misrepresentation ... namely, the implications that psychiatrists must now “play the game,” and resign themselves to a bleak future of harried pill dispensing. 

The New York Times of February 14 carries the disturbing news of an alarming increase in deaths from accidental overdose among our active duty military personnel and our war veterans.

Watson, as many will know, is not necessarily the name of a human, though the Watson of DNA fame may come to mind. Rather, in this context I am referring to IBM's artificial intelligence computer system.

Pascal’s “Wager” uses “reason” to conclude that even though the existence of God cannot be determined, one should nevertheless “wager” as though God exists, because one has everything to gain, and nothing to lose.

I recently shared a research article on “no-suicide contracts” with a colleague who is very knowledgeable about suicide. That article concluded--as virtually all the previous literature had-that use of suicide prevention contracts (SPC) remains a questionable clinical practice intervention.

Ray Moynihan (who previously gave us the invaluable book "Selling Sickness: How Drug Companies are Turning us All Into Patients") has published a new expose titled "Sex, Lies, and Pharmaceuticals."

A reporter asked, "Can you do psychotherapy in a cage"? What immediately came to mind was the sociopathic psychiatrist Hannibal Lecter in the movie Silence of the Lambs.

I would like to start off this blog with two stories that happened many years ago.

A large new study from Australia found that DSM-5 would cause a sky-rocketing 60% increase in the rate of alcohol use disorders.

Is it possible to “forgive” Jared Lee Loughner for what he is alleged to have done? Is it morally justifiable to do so? There are serious ethical problems with the notion that anyone other than the survivors of this horrific shooting can “forgive” the assailant.

Gary Greenberg, PhD is a psychotherapist, author, teacher, and historian of psychiatric diagnosis. His writings are characterized by penetrating insight, elegant wordsmithing, entertaining story telling, and a dig-deep, no-holds-barred search for underlying meaning.

There have been three positive developments. The rest of the DSM-5 news continues to be extremely worrisome, and time is running out.