Category Archives: Symptoms

Blame it on biology: how explanations of mental illness influence treatment

“The “therapeutic alliance” between clinician and client is a key ingredient in successful treatment, responsible for better clinical outcomes and lower rates of dropout. Biogenetic explanations held by clinicians can impair the therapeutic relationship and those held by clients can impede their recovery.” Nick Haslam

Blame it on biology: how explanations of mental illness influence treatment

Australasian Psychiatry Feature on Psychotherapy –

Edwin Harari 2104 Ghost Busting: Re-introducing psychotherapy for the psychiatrist

Abstract

Objective: The purpose of this paper is to provide a clinically relevant historical and conceptual overview of psychotherapy as an introduction to a forthcoming series of papers on specific models of psychotherapy. The author offers a selective review of some key ideas in the history and practice of psychotherapy.

Conclusion: The principles of psychotherapy should inform all psychiatric practice, including the doctor– patient relationship, multidisciplinary teams caring for patients with complex or ‘treatment resistant’ problems, and patients who are non-compliant with psychotropic medication.

Keywords: psychotherapy, doctor–patient relationship, treatment resistance, psychotherapy and medication

Australasian Psychiatry 2014, Vol 22(5) 433–436 © The Royal Australian and New Zealand College of Psychiatrists 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav

Australasian Psychiatry – Signposts http://www.apy.sagepub.com DOI: 10.1177/1039856214546673

Ghost Busting: re-introducing psychotherapy for the psychiatrist

Edwin Harari Consultant Psychiatrist, St. Vincent’s Hospital Area Mental Health Service, Fitzroy, VIC, Australia

Psychotherapy (‘healing the mind’) is a particular type of interpersonal influence, wherein one person, acknowledged by society as possessing relevant skills (the psychotherapist) seeks to change the thoughts, feelings, attitudes, behaviours, relationships or personality of a suffering other (the patient):

If one posits that the relation between doctor and patient has been critically wounded, how are we to understand whether, and on what basis, that relationship may be reasserted ? AI Tauber

The pedagogy for engaging hidden values and divided selves is the moral building of the clinician as a full developed human being. A Kleinman

I do not favour the way Descartes ontologically screwed up a reasonable search for mind-brain docking during the past four centuries yielding life-denying monstrosities like radical behaviourism and an emotionless information processing cognitivism… J Panksepp

The possibility of intersubjective knowledge offers a welcome relief from a forced choice between pure subjectivity (Descartes) and true objectivity (Kant). EM Hundert

The outcome of the game is to convert what would otherwise be a nameless trauma into a loss. J Lear

As a general rule throughout Asia, the more patriarchal the society, the more the Buddha looks like a woman: the more egalitarian the society, the more the Buddha looks like a man. L Shlain

Psychotherapists, especially, appreciate [that]… this painful ambivalence is as old as the ice-age, a hallmark of Cro-Magnon man, torn between his craving for consolation and his fear of revenge. J Cawte

Each of the above quotations may serve as a conceptual signpost or creative condensation of the argument each of the authors’ advances in their respective texts which bear on the nature, subject matter and practice of psychotherapy.

Read more here

References
 Tauber AI. Confessions of a medicine man: an essay in popular philosophy. Cambridge, MA: MIT Press, 2002, p.103.
 Kleinman A. The divided self, hidden values and moral sensibility in medicine. Lancet 2011; 377: 804–805.
 Panksepp J. The self and ‘its’ vicissitudes. Critique of commentaries. Neuropsychoanaly-sis 2002; 4: 50.
 Hundert EM. Philosophy, psychiatry and neuroscience. Three approaches to the mind. Oxford: Clarendon Press, 1990, p.297.
 Lear J. Happiness, death and the remainder of life. Cambridge, MA: Harvard University Press, 2000, p.92.
 Shlain L. The alphabet versus the goddess. New York: Penguin, 1998, p.200.
 Cawte J. Aboriginal healing: psychotherapy in ancient society. Aust J Psychother 1988; 7: 14.
 Doidge N. The brain that changes itself. Melbourne: Scribe, 2007, p.216.
 Wolff HH. The therapeutic and developmental functions of psychotherapy. Br J Med Psychol 1971; 44: 117–130.
 Markowitz JC and Milrod BL. The importance of responding to negative affect in psycho-therapies. Am J Psychiatr 2011; 168: 124–128.
 Frank JD and Frank JB. Persuasion and healing: a comparative study of psychotherapy (3rd edition). Baltimore: Johns Hopkins University Press, 1991.
 Kernberg OF. Severe personality disorders: psychotherapeutic strategies. New Haven, CT: Yale University Press, 1984.
 Gabbard G and Kay J. The fate of integrated treatment: whatever happened to the biopsychosocial psychiatrist? Am J Psychiatr 2001; 158: 1956–1963.

http://thestringer.com.au/deconstructing-schizophrenia-in-australian-aborigines-9049#.VHQ3_YE_7qB.
In places where an increase in the incidence of schizophrenia has been reported, these can be attributed mainly to substance abuse (eg Drug Induced Psychosis). However, there are additional explanations for psychosis differential diagnoses. The most important of these is stress, and especially complex or traumatic stress – presenting as depressive psychosis in both its unipolar and bipolar forms.

How Cannabis Causes Paranoia: Using the Intravenous Administration of ∆9-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia

“… it was definitively demonstrated that the drug triggers paranoid thoughts in vulnerable individuals. The most likely mechanism of action causing paranoia was the generation of negative affect and anomalous experiences”

How Cannabis Causes Paranoia: Using the Intravenous Administration of ∆9-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia.

Amy Cuddy: Your body language shapes who you are – YouTube

Here are practical steps to self empowerment – simple lessons from the neuro-science of posture. Amy’s self disclosure and empathy around 16 minutes in make this a real gem! (Show this to your clients!!!)

Amy Cuddy: Your body language shapes who you are – YouTube.

Childhood maltreatment associated with cerebral grey matter abnormalities: Abuse could lead to permanent brain damage — ScienceDaily

Is this where social policy, social and criminal justice,  and neuro-psychiatry finally meet? And importantly, who is to blame for this continued abuse?

Childhood maltreatment associated with cerebral grey matter abnormalities: Abuse could lead to permanent brain damage — ScienceDaily.

PLOS ONE: Psychedelics and Mental Health: A Population Study

Results: “… in several cases psychedelic use was associated with lower rate of mental health problems.”

PLOS ONE: Psychedelics and Mental Health: A Population Study.

21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes.

Long-term Antipsychotic Treatment and Brain Volumes… More medication means less white & gray matter

It’s official: Antipsychotics shrink the brain!

Ho, Andreasen and colleagues report that:

More antipsychotic treatment was associated with smaller gray matter volumes. Progressive decrement in white matter volume was most evident among patients who received more antipsychotic treatment. Illness severity had relatively modest correlations with tissue volume reduction, and alcohol/illicit drug misuse had no significant associations when effects of the other variables were adjusted

JAMA Network | JAMA Psychiatry | Long-term Antipsychotic Treatment and Brain Volumes:  A Longitudinal Study of First-Episode Schizophrenia.

Withdrawing From Psychiatric Drugs: What Psychiatrists Don’t Learn | Mad In America

Withdrawing From Psychiatric Drugs: What Psychiatrists Don’t Learn | Mad In America.

“I am a resident psychiatrist. Like other psychiatrists in training today, I learn a lot about psychotropic drugs: the putative mechanisms of action, the evidence base, the indications, cautions and contraindications, interactions, side effects, toxicity, and monitoring. We learn how to initiate different agents. We learn how to combine different psychotropic drugs, what is called ‘rational polypharmacy’. We even learn how to switch from one drug to another, what is called ‘cross-tapering’. What we do not learn is how to stop these drugs. What there is no guidance on is how to stop these drugs. What there is no evidence on is how to stop these drugs. Unsurprisingly then, we never seem to stop these drugs!”

Most helpful thing this voice-hearer heard: ‘The voices are real’ | MinnPost

Congratulations, Ron! Most helpful thing this voice-hearer heard: ‘The voices are real’ | MinnPost.