 is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. To create a better world, he is an advocate for treating mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism. He serves on the Editorial Board of

H. Steven Moffic, MD

“Dear, dear! How queer everything is to-day! And yesterday things went on just as usual I wonder if I’ve been changed in the night?”

Recently, my wife and I saw the powerful world premiere of the revised opera “Harvey Milk,” put on by the St. Louis Opera. There also is an earlier movie about his life.

Would I Do the Same Approving of Abortions for Psychiatric Reasons as I Did 50 Years Ago?

You may recall that Milk was a gay politician in San Francisco. He happened to also instigate the design of the gay rainbow flag for the Pride March there in 1978. In the opera, he is depicted as fighting against both anti-Semitism and homophobia, but was gunned down on November 23, 1978 by his political opponent, Dan White.

Pride Month is now celebrated every June as a tribute to those who were involved in the 1969 Stonewall riots in New York. June 28th has become the Pride Day, celebrated by many communities, as that was the day when the first pride march was held in New York in 1970.

It seems like the word “pride” was chosen as sort of a positive psychological reframing to offset a social history of being closeted for security, shame, and stigma about one’s sexuality. Over time, it has become more broadly applied to the LGBTQ (Lesbian, Gay, Bisexual, Trans, Queer) identity.

, Kristen Arnett, who self-describes as queer, ended her article “The Bittersweet Experience of Celebrating Pride in Florida” with what she thought pride meant

“Pride is an embrace. Pride is an action, a verb.

Pride is a commemoration. A celebration. A reckoning. A vow.

That’s what I want for my community. Pride all year long.”

However that pride is defined, it may be in jeopardy in view of the overturn of 

. There are suggestions that gay marriage is at risk, to which I would even wonder if their now common practice of having and adopting children is also at risk, even though the data supports the quality of their parenting.

On the other hand, I hardly ever hear the word pride applied in psychiatry. Certainly, given the American Psychiatric Association’s history of having homosexuality as an official diagnostic category for many years does not evoke pride in that history. As I was to learn when I was asked to become Medical Director of a clinic specializing in transgender care in the 1990s, psychiatry also at first tended to apply a misleading etiology of blaming mothers and supporting opposition to gender reassignment. It was also classified as a DSM-5 disorder at first, and still continues in its “dystonic” version.

Thankfully, organized psychiatry eventually seemed to learn some lessons on erroneous psycho-pathologizing. We can take some pride when we admit and learn from our mistakes, but should also be in the vanguard of the current societal LGBTQ challenges.

is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of

1. Arnett K. The bittersweet experience of celebrating Pride in Florida. 

https://time.com/6172365/pride-florida-2022-kristen-arnett/

Articles

Taking Pride in Pride Day

In the midst of Posttraumatic Stress Disorder (PTSD) Awareness Month, it could be said that its culmination is today, PTSD Awareness Day.

Trauma, Conspiracy, and Cognitive-Behavioral Therapy in the Congressional 1/6 Hearings

Of course, historically, we have been aware of PTSD, but did not call it that. It is described in classic literature, such as the warriors of Homer’s epic Greek poems, the 

. Such descriptions occurred in many ensuing wars under various terms, including “shell shock.”

The Vietnam War was the more recent stimulus for more formal study, along with concomitant research on World War II’s Holocaust and rape victims, resulting in the formal classification of PTSD in our DSM III in 1980. National PTSD Awareness Month was designated by the Senate in 2014, and recognizes the importance of all kinds of trauma.

Early treatment was electric shock, followed by group therapy in the 1950s. More recently, besides various psychotherapies and medications, EMDR and the psychedelics have emerged. There are no antitrauma medications, in contrast to antidepressants, antianxiety, and antipsychotics.

What makes the call for awareness so important is to keep repeating that the emergence of symptoms—such as hyper vigilance, flashbacks, and avoidance—can be delayed for weeks, months, and even years. Triggers that relate to the original trauma can precipitate the emergence of symptoms time and again.

Some feel that there is a pretraumatic stress disorder, such as is emerging in the expectations of future increased climate instability trauma. In our June 15th video “

,” I wondered if we are now a traumatized country beyond individuals. On the other hand, we have to be careful about over-diagnosing it as a too ready faddish explanation for problems.

The good news is that PTSD can be preventable and, even if not, can lead to improvement from the prior baseline in recovery. Most obviously, it can be reduced by the social elimination of life-threatening traumas caused by mankind, as well as the harm done by multiple less severe traumas. Micro trauma also seems to insidiously contribute to burning out.

As our understanding increased, and unique among psychiatric disorders, it seemed possible to end up with posttraumatic growth, strength, and resilience. It takes community support, learning from the experience, and a new positive vision for the future. No one wants the suffering involved in PTSD, but there is some consolation when we can obtain such a positive ending. When trauma cannot be presented, it still has the potential to give way to joy as long as it is not ignored.

It’s PTSD Awareness Day: Be Aware!

Well, it is that time for a pop-up column again. As anticipated, the Supreme Court has just overturned 

, removing the constitutional right to abortion and opening up the likelihood of more formal legal denials of abortions in many states.

Though I am unofficially “retired” from clinical practice, I still have my medical license. In anticipation of this happening, I wondered on and off if I would return to doing what I could when the need for abortion seemed to be endangering the mental health of the would-be mother and fetus—yes, and fetus.

During medical school, my original required research project was about whether a pregnant woman’s emotional status influenced the development of the fetus, especially mental-health wise. I hypothesized it did, but never got to complete the research, choosing one on depression in medical inpatients instead. But, thankfully, by now there is more research on how emotional distress in pregnant mothers can adversely affect their babies.

My experience in the first half of my psychiatric residency at the University of Chicago had also been mentioned in the 

 article by the psychiatrist Sally Satel on June 4, “The ‘Open Secret’ on Getting a Safe abortion Before Roe v. Wade.”

 She suggested that I and others were committing small acts of rebellion by stretching ethical boundaries. She quoted me out of the context of the recent 

 article that I had written May 3rd on abortion, “Calling for a Psychiatric Analysis on the Mental Health Implications of Roe v Wade”

“I recommended abortion for all. My mental health analysis at the time was not only about the mental health of the would-be mothers, but their upcoming children if abortion was not done.”

However, the point of my original article was not what I did, but the need for organized psychiatry to prepare how we might respond if 

 ended. It has ended, but I have not seen any such plans. Most of us were taking risks to our reputations with our more underground involvement back before 

. Nevertheless, I would do it again if needed. After all, I have proudly been called a gadfly.

1. Satel SL. The ‘open secret’ on getting a safe abortion before Roe v. Wade. 

https://www.nytimes.com/2022/06/04/opinion/sunday/psychiatrists-abortion-roe.html

2. Moffic HS. Calling for a psychiatric analysis on the mental health implications of Roe v Wade. 

https://www.psychiatrictimes.com/view/calling-for-a-psychiatric-analysis-on-the-mental-health-implications-of-roe-v-wade

Roe v. Wade has been overturned. How will this affect the mental health of both mothers and fetuses? 

Is there a way to psychiatrically understand the 1/6 Congressional committee hearings?

Humiliation and Dignity in Ukraine and Life

9 Mental Health Benefits of Title IX for Women on its 50th Anniversary

Listening to some of the hearings about the unprecedented and dangerous storming of our Capitol for a coup reminds me some of the psychotherapy process with a patient suffering from posttraumatic stress disorder. As in such patients, finding the truth in the history and memories of trauma is a slow process. Sometimes values trump the truth. Ultimately, for recovery, some positive reframing, as occurs in cognitive-behavioral psychotherapy, is necessary to move forward successfully.

In a typical trauma psychotherapy process, there are risks, such as pushing the trauma into consciousness too quickly. The therapist can also make interpretations that the patient is not ready to access and accept. False memories can be implanted. Truth by itself may not be therapeutic.

The patient in the hearings may be our country itself. The committee may represent the therapist, the witnesses the avoided memories, and the perpetrators the psychological resistance.

It seems like some of the repressed trauma emerged on Tuesday, tearfully and therapeutically. There was Arizona Republican House Speaker “Rusty” Bowers, who had resisted the conspiracy accusations of voter fraud, and then testified that because of his faith in the US Constitution, that what he was asked to do was “foreign to my very being.” Then were 2 Georgia election workers, a mother and daughter, who testified that they lived in fear after being wrongly accused of voter fraud.

I am not at all sure if this is an appropriate or understandable parallel approach to analyze the hearings. Applying concepts that pertain to an individual may or may not fit the dynamics of groups but, then again, people are people and we share common human nature characteristics. Untreated major trauma in an individual, and perhaps in a country, can greatly impair functioning indefinitely. After yesterday, there will be a break in the hearings, allowing for time for us all to reflect on what it all means so far and how to further respond.

One thing I do know for sure is that our country needs the psychological healing of our increasing divisiveness and conflicts through the reduction or removal of this invasive trauma internally in our minds and externally in society.

“Our country needs the psychological healing of our increasing divisiveness and conflicts…”

Exactly 50 years ago, on June 23, 1972, President Nixon signed into law Title IX of the Equal Education act. Here is what it said:

“No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance.”

Note that nothing is said specifically about sports, though the development of women’s sports is what has received the most publicity. Certainly, I would conclude that sports benefit mental health, but also promise possibility and shatter stereotypes. Here’s 9 benefits.

The Serendipity of Juneteenth and Father’s Day Coinciding

1. Participation in formal sports in schools has enhanced the self-esteem and body image of women, while reducing the perception of physical frailty.

2. Women have been competitive with men in endurance sports and those with specific skills not requiring extreme strength or speed, like fencing and shooting.

3. It eliminated quotas for the admission of women to colleges and universities, including postgraduate education in medicine and psychiatry. For example, from about 10% of all doctorates, women now earn over 50%.

4. It resulted in more women being able to receive tenure.

5. Despite such significant notable examples as the sexual abuse of women gymnasts, it seems to have reduced the proportion of sexual harassment, assault, and ensuing traumatic repercussions of women on campus.

6. It helped equalize financial assistance.

7. It helped to equalize student services and counseling.

8. Its benefits were extended to transgender athletes in 2021, although that has brought up the controversy of the benefits of the remnants of male physical development after physical transition to female athlete.

9. Most recent women business executives were athletes in school.

A current question is which sports, if any, should become integrated? How can this integration include transgender athletes? There is even a relevant question of how to define transgender, on a spectrum of boyness or girlness, or not. Moreover, sports are still dominated by a male model, leadership, and earning power.

From the start, there has been resistance by male administrators, as well as some racism, but ultimately the fairness and equality should also enhance the meaning of accomplishment.

H. Steven Moffic, MD, discusses the national mental health crisis and proposes 5 ways we can address these challenges.

Hiding in Plain Sight: Youth Mental Illness

Do you have an idea for how to address the national mental health crisis? Let us know at 

How can we address our national mental health crisis?