thoughts & reflections on psychiatry by Steven P Reidbord MD
Last week I met with a patient of mine. He s a sweet, kind middle-aged man without a hostile bone in his body. He and his brother both have schizophrenia. Both of them fear psychosis and cooperate fully with psychiatric care to keep it at bay. My patient is the higher functioning of the [...] The post Movie Villains Add Fear and Stigma to Mental Illness first appeared on Reidbord's Reflections .
A Target of Ridicule When Governor Tim Walz accepted the Democratic nomination for vice president, his son Gus, 17, was overcome with emotion and wept on national television. Punditry about this was quite mixed. Commenters on the right ridiculed the young man as a puffy beta male, a blubbering bitch boy, and [...] The post Gus Walz: lost in the culture wars first appeared on Reidbord's Reflections…
Over a decade ago, I noticed a new term cropping up in psychiatry: anosognosia. Actually, it was an old term, coined a century earlier by neurologists to describe a behavioral sign in certain types of brain damage. But by the time I took notice, this mouthful of a word was doing double duty. [...] The post Anosognosia revisited first appeared on Reidbord's Reflections .
The application of palliative care to intractable psychiatric disorders has been debated at least since 2010, when a journal article reported that a patient with severe anorexia nervosa died in hospice, after referral there by her psychiatrist. The New York Times published a thought-provoking article earlier this year on the same topic: whether [...] The post Palliative psychiatry first appeared…
Two senses of “psychotherapy is political” are often conflated. The first is the notion, popular lately, that psychotherapy either allows or demands political advocacy in the therapy room itself. The other is recognition that political factors influence the nature and practice of psychotherapy. It is a conceptual error to confuse the two, and [...] The post Political advocacy and psychotherapy…
In January 2021, I described my search for a HIPAA-compliant email provider for my practice, and reviewed several options. In the end I chose Hushmail for Healthcare. It was, and is, a good service: thoughtfully featured, reasonably priced (with minor changes since then), and fast support when needed. But the truth is, I [...] The post HIPAA-compliant email revisited first appeared on Reidbord's…
Currently, therapy apps featuring a nonhuman “therapist” aim fairly low at best, and at worst willfully mislead the public. However, the advent of large language models (LLMs) such as ChatGPT-4 brings exciting potential for genuine depth psychotherapy delivered by AI — and many challenges and potential pitfalls as well. Since “therapy” has [...] The post Making an AI dynamic therapist first…
I wondered whether to recommend Nuedexta for my elderly relative with worsening Alzheimer’s disease and daily spontaneous crying. Often she would deny feeling sad and couldn’t account for her sobbing. Avanir Pharmaceuticals released Nuedexta in 2010 to treat pseudobulbar affect: involuntary emotional outbursts due to certain neurologic conditions or brain injury. I [...] The post Old medications…
When one of America’s most prominent psychiatrists expresses deep disdain for depth psychotherapy, especially when that criticism is misinformed and hopelessly outdated, it should concern all of us. Dr. Tom Insel directed the National Institute for Mental Health (NIMH) from 2002 to 2015. Formerly a psychiatric researcher “at the cellular level,” he [...] The post Dr. Tom Insel scorns traditional…
Hype cuts through the noise to reach a jaded public. It's common to use psychological terms, especially related to trauma and abuse. What are the pitfalls? [...] The post Psych jargon as media hype first appeared on Reidbord's Reflections .
Is there more "presence" during online therapy, or in the office -- even while wearing masks? [...] The post “Being with” patients in the office and online first appeared on Reidbord's Reflections .
What is a retronym? Retronyms are adjectival qualifiers, like acoustic” guitar and snail” mail, that were previously unneeded because all guitars were acoustic and all mail was slow. We only added qualifiers when alternatives arose. As these two examples illustrate, retronyms can be nearly neutral — the status and popularity of acoustic [...] The post Retronyms, teletherapy, and implicit bias…