Couch in Crisis

Would you be surprised to find out that Freud is gaining a foothold in China? As psychoanalysis and related therapies are slipping in the USA, psychoanalysts from the US are beginning to train a cadre of interested clinicians in China.

Similar to some forms of PTSD, this disorder is prone to be severe because the stressor is of human/corporate design. Note: this diagnosis is not currently reimbursed by health insurance carriers.

I am a Registered Nurse of 37 years who has worked in hospice care and psychiatric emergency; I’ve worked as a med/surgical manager and (now) as an inpatient psychiatric nurse. Throughout it all, I most enjoy seeing a patient realize he/she is getting well; I also enjoy conducting small teaching groups to help the patient know how to stay well.

For some, creating art may be a displacement of issues and conflicts that we encounter in our work and personal lives. It can express things that can't be formulated in verbal content, as has been shown in art therapy with patients.

The most disturbing turbulence at the boundary between psychiatry and the law is the misuse of a makeshift psychiatric diagnosis to justify the involuntary, indefinite psychiatric commitment of rapists. This is a disguised form of preventive detention and an abuse of psychiatry.

Just imagine. If you are not a transgender individual, what must it feel like to always think, as far back as you may remember, that you should have the body of the opposite gender? That you were “born in the wrong body”.

The latest information released by the US Army reveals that last year American soldiers attempted suicide at the rate of about 5 /day. There were 160 successful suicides last year and during June the rate was 1/day. Military research has reported that one in 10 Iraq veterans may develop a severe case of PTSD.

It is easy to claim the presumed high ethical ground when one is not involved in the real life situation at hand. It is also easy to project and proclaim strong positions in order to cover our own inadequacies and anxiety.

Empathy is the ability to put yourself in someone else’s shoes and understand what they are feeling. This is something that psychiatrists try to do in our everyday work. Those of us who have worked in medical schools have struggled with the question of whether or not this is something that can be taught.

My medical school clinical preceptor asked me, during my first year, what specialties (at The University of Chicago, the attitude toward general practice was well represented by the dismissive references to ‘LMDs’-local medical doctors) I was considering.

Insurance restrictions sometimes make for strange bedfellows. My story begins with a phone call from a man about to lose his job. He said that he had been placed on probation and was about to be fired. He asked if he could see me. We met the following day.

There is a difference of opinion among psychiatrists whether it is time to restructure the APA to a “leaner and meaner” organization where activities and functions by necessity have to be cut back because of reduced income.

“I just threw him in the lake and expected him to die. . . My only regret is that he lived.”

Due to decreasing revenue, the APA Assembly has been forced to reduce its budget by $200,000 and and many of the APA Components have been eliminated or significantly changed.

It was great to learn that within the past month, the Obama Administration issued new rules that promise to improve insurance coverage of mental healthcare for more than 140 million people insured through their jobs.

When a soldier is killed while in the military service the President writes a condolence letter to the family. However, if a soldier is psychologically injured and then commits suicide, there is no Presidential letter of condolence.

I don’t know how many psychiatrists paid much attention to the climate-change conference in Copenhagen last month, but I came away convinced they need our help. Here’s why.

The debate within the medical profession over “conflicts of interest” (COIs) has often been shrill, and sometimes seems to be based on misunderstandings or myths about what COIs entail. In this psychiatrist’s view, it is helpful to step back from confident proclamations, acknowledge that the issues involved are complex, and aspire to some semblance of humility. Nobody has cornered the market on “the right way” to deal with COI in the realms of medical research, publication, and education.1 At the same time, as Alan Stone, MD, has noted (personal communication, August 27, 2009), ethical considerations lie at the heart of any debate on COI-in particular, the ancient dictum, “Do no harm.” Indeed, ethicist James M. DuBois has pointed out a direct connection between some types of COI and harm to the general public: “Mental health consumers are at risk when studies that involve questionable scientific and publication practices are translated into therapeutic practice.”1(p205)

You have read the blogs and seen the placards a dozen times: doctors prescribe too many “drugs” for too many patients. Psychiatrists, in particular, are popular targets of politically motivated language that seeks to conflate the words “medication” and “drug”-thereby tapping into the public’s understandable fears concerning “drug abuse” and its need to carry out a “War on Drugs.”

Regular readers of Psychiatric Times know that we have been engaged in a comprehensive review of our “conflict of interest” (COI) and disclosure policies, which now include posted disclosure statements from all our editorial board members. So far as we are aware, Psychiatric Times is the only major psychiatric journal to require this of its editorial board, as well as of our regular writers.

My friend Paul Genova’s protean life is not easy to wrap in the winding sheet of an obituary. Paul-who died on December 13th of complications from multiple myeloma-was a man of many talents and sensibilities.

Since 1990, many states have instituted sexually violent predator (SVP) or sexually dangerous person (SDP) civil commitment stat­utes that seek to identify the small group of extremely dangerous incarcerated sexual offenders who would present a threat to public safety if released from custody.