After a decade of diminishing control and exclusion from provider panels, psychiatrists are developing strategies to regain some control of health care. With the help of consultation services like those provided by the American Psychiatric Association, they are learning to survive and prosper in this era of managed care.
A scandal-rocked Medical College of Georgia has announced tightened compliance controls for clinical studies in the wake of a 172-count indictment that charged two former professors with diverting more than $10 million in research funds. Richard L. Borison, M.D., the former chair of MCG's department of psychiatry and health behavior, and Bruce I. Diamond, Ph.D., once a professor in the department, were jailed in February.
Causal Explanations that Suggest How to Change
Orally active compounds called neuroimmunophilins were demonstrated to protect and to stimulate the regeneration of brain cells in animal models with Parkinson's disease, according to a study published in the March 4 issue of the Proceedings of the National Academy of Sciences.
During this first century of Western psychotherapy, arguments among and between the schools of psychotherapy have dominated discourse. The psychotherapy of the next century is likely to place theory and associated techniques in their appropriate, practical places in the psychotherapy outcome puzzle.
Trauma, by definition, is the result of exposure to an inescapably stressful event that overwhelms a person's coping mechanisms. Since it would be immoral to expose laboratory subjects to the sort of overwhelming stimuli that give rise to the dissociated sensory reexperiences characteristic of posttraumatic stress disorder (PTSD), we are uncertain to what degree the vast literature involving laboratory studies of less stressful events is relevant to understanding how people process traumatic memories.
The power of Superman's spell endures mightily, and the values of truth and justice he communicated through comics, and then television and movies continue to pass undiminished from generation to generation.
The important thing about teachers listening to Ebonics is for them not to equate it with the students' being stupid, says Alvin Poussaint, M.D., professor of psychiatry. "It means they've learned a way to speak in their community or home that's a natural way for them to speak, which they then carry with them to school." While the language is part of who they are and their connection to their community, it doesn't absolutely have to exist to preserve a black identity.
Panic disorder is a prevalent, debilitating illness associated with high utilization of multiple medical services, poor quality of life and a high incidence of suicide. Short-term efficacy of time-limited cognitive-behavioral and medication treatments has been demonstrated in many studies. Evidence for long-term efficacy of these treatments, however, is sparse and less convincing.
Despite the proliferation of competing psychoanalytic theories in the past three decades, for most analysts the recognition and interpretation of resistance (as well as transference) remains at the core of psychoanalytic technique. While resistance has been defined as encompassing all of a patient's defensive efforts to avoid self-knowledge (Moore and Fine), operationally it means those behaviors that help the patient ward off disturbing feelings such as anxiety, anger, disgust, depression, envy, jealousy, guilt and shame.
Adolescents are among the most difficult populations with whom to work therapeutically. Giovacchini (1985) wrote that they possess a "propensity for creating problems within the treatment setting [including]...their reticence about becoming engaged or their inclination to express themselves through action rather than words and feelings."
Fantasy Codes - Poetry of the Times
The state of North Carolina has relatively liberal policies regarding petitions for involuntary commitment. If such documents bear words like "dangerous" or "mentally ill," even in the most nebulous sense imaginable, the police will surely locate the relevant individuals and dutifully bring them to the emergency department. This generosity of interpretation produces some sticky situations for the lucky ED resident of the day.
Sleight of Hand - Poetry of the Times
Code Blue - Poetry of the Times
What are you looking for?
Spring Planting - Poetry of the Times
In recent years, psychiatry and psychoanalysis have been drifting apart. As has been stated, psychiatry is losing its mind as it concentrates on chemistry and biology. This is a pity, because it is always good to have a mind.
When Natalie Rogers was very young, she would enter the living room of her home where her parents, renowned psychotherapist Carl Rogers and artist Helen Elliott Rogers, sat reading. She'd turn on some music, look over at them and say, "Please don't watch me." Then she would begin to dance, describing this blissful experience as "the music flowing through me." Little did she know these impromptu rituals would set the stage for her own important work that would expand on the humanistic principles of her father, yet encompass elements of the creative process itself.
As a practicing psychiatrist, I have watched with growing dismay and outrage the rise and triumph of the hegemony known as biologic psychiatry. Within the general field of modern psychiatry, biologism now completely dominates the discourse on the causes and treatment of mental illness, and in my view this has been a catastrophe with far-reaching effects on individual patients and the cultural psyche at large. It has occurred to me with forcible irony that psychiatry has quite literally lost its mind, and along with it the minds of the patients they are presumably supposed to care for. Even a cursory glance at any major psychiatric journal is enough to convince me that the field has gone far down the road into a kind of delusion, whose main tenets consist of a particularly pernicious biologic determinism and a pseudo-scientific understanding of human nature and mental illness.
Psychotherapy is as old as civilization. Literally soul therapy, the term is a misnomer, since soul is a mystical notion and what is meant is the whole person. The misnomer also survives in the name psychiatry, literally soul medicine. Yet nobody is crusading against psychiatry and psychotherapy because soul is unscientific. What is important is that psychotherapy and psychiatry are job descriptions that refer to what we actually do when as providers or recipients of the service called psychotherapy, we use words to convey meaningful messages to each other, or to evoke desirable acts from each other.
In 1885, Georges Gilles de la Tourette, M.D., described in the Achives of Neurology a neuropsychiatric disorder characterized by chronic motor and vocal tics that begin in childhood. During the next century, researchers demonstrated that the disorder, which came to be called Tourette's syndrome (TS), is probably inherited as a dominant gene that expresses with widely varying symptoms, even within monozygotic twin pairs.
Mood disorders and their impact on women and their families was the topic of a half-day conference held at New York City's Algonquin Hotel;, former haunt of the famous-and depressed- writer Dorothy Parker, who made at least one suicide attempt there in the early 1900s.
"The Internet is like being in another world- you can pretend to be everything you ever wanted to be. There are no rules and no sense of time. In one hour you can tell each other all about yourselves. It's so interactive- question and answer and so quickly. No limits." Exhilaration was the expression of a 49-year-old divorced male gynecologist with the password "lady's doc."
The past decade witnessed major strides in our understanding and treatment of affective disorders in adults, children and adolescents. One of the baffling problems in child and adolescent psychiatry was the question of psychiatric illness spanning a lifetime. The existence of depressive disorders in prepubertal children has been generally recognized and acknowledged since the 1960s; however, only in the last decade did evidence become available that supports the notion that depression in different ages represents the same entity, albeit manifesting different clinical symptoms in each developmental period (Cytryn and others 1986).
In what well may be a first in the managed behavioral health care industry, the New Jersey Psychological Association (NJPA) and seven psychologists filed a lawsuit against MCC Behavioral Care Inc. contesting the firm's utilization of "without cause" termination contract provisions. The case may break new ground in the way managed care companies interact with providers, and may question whether managed care companies can deselect providers despite the potential harm to patients.
September 1996, Vol. XIII, Issue 9Reflecting today's surging interest in computers and what they can do for mental health professionals, it was standing room only at many of the 19 computer-related presentations offered at the American Psychiatric Association's 149th annual meeting, more than triple the number included at last year's convention.
With the exploding growth of the Internet, more and more people are going on-line. Mental health professionals are finding discussion groups filled with like-minded researchers and practitioners in every aspect of the field. Laypeople are discovering the value and enrichment that mutual self-help support groups and educational materials lend to their treatment. It is important, if not invaluable, to become familiar with this new world of opportunity and to learn about what's currently available and what's coming in future years.
Piano Music - Poetry of the Times
The development of computerized speech dictation has been a long-standing goal of mental health professionals who spend an extraordinary amount of time and money on dictating patient records.
