Psychology Today Blog

What an exciting turn: In a recent Viewpoint published in JAMA Psychiatry​​​​​​, thought leader Kenneth S. Kendler, M.D., of Virginia Commonwealth University, urged the field to jettison the prevalent idea that some type of brain disease causes each mental illness.1 Instead, he urged that we identify critical causal pathways in the brain that are associated with psychiatric disorders. It’s likely that mental disorders derive Read more about Is Psychiatry Waking Up to the Truth About Mental Illness?[…]

Complexity in Health Care: A Paradigm shift for Clinical Practice (Springer 2023) by Steven A. Frankel, Steven D. Thurber, and James A. Bourgeois offers a healthy departure from standard approaches to diagnosis and treatment in psychiatry. Standard approaches follow set protocols and algorithms, such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and various Read more about Patients Are More Complex Than We Realize[…]

Outlive is well-written, well-balanced, and makes no fantastic claims. Further, while providing clear guidance for achieving better health, Dr. Attia does not advise but, rather, shows a way to think about one’s own health. His idea is for each of us to set our own individual health plan, the one that works best for us, so Read more about Thinking About Healthspan to Live Longer and Better[…]

A new book presents an important new understanding of chronic pain and the role of prescribed opioids—one that can help troubled patients and their distressed doctors alike. The Right to Pain Relief and Other Deep Roots of the Opioid Epidemic,Oxford, 2023, by psychiatrist, philosopher, and pain expert Mark D. Sullivan and anesthesiologist and pain expert Read more about A New Book Puts Chronic Pain in Better Perspective[…]

Most will find the 2022 CDC opioid guidelines, also published in the New England Journal of Medicine, similar to the CDC guidelines of 2016. But a new comment troubles me and adds to my worry that the previous recommendations were too liberal. The recent version, in my opinion, more clearly condones initiation of opioids in Read more about Are Are CDC Guidelines Too Liberal Around Prescribing Opioids[…]

A rigid medical culture prevents addressing society’s present needs. KEY POINTS 1. An unconscious culture guides medicine. 2. This culture perpetuates medicine’s successful treatment of diseases. 3. The culture, however, precludes needed efforts to prevent and treat chronic diseases. 4. Only a change in medical education can correct this adverse culture. A similar version of Read more about The Dangers of Medicine’s Pernicious Culture[…]

No one is in charge of training providers for mental health care. Key points: 1. The US has a massive mental health crisis. 2. There is a chronic, severe shortage of mental health professionals. 3. The medical clinicians who provide 85 percent of care lack training. 4. No federal agency has responsibility for health care Read more about America Needs a National Institute of Healthcare Education[…]

Dr. Thomas Insel’s new book makes poor mental health care a human rights issue. A similar version of this post was published earlier in Psychology Today. A momentous event for the mental health field occurred with publication of Dr. Thomas Insel’s new book: Healing: Our Path from Mental Illness to Mental Health (2022).1 His severe Read more about Poor US Mental Health Care Confirmed From a Top Authority[…]

Disabling physical disorders often are associated with mental disorders. A similar post was made earlier in Psychology Today. In patients with chronic, disabling physical symptoms, an associated mental illness often co-exists unrecognized. When consulting their clinician, these patients typically do not offer the expected psychological symptoms needed for a diagnosis, instead focusing only on their Read more about We Miss Many Psychiatric Diagnoses[…]

Empathic skills pave the way to effective communication. Camille Pissarro  (1830–1903): Conversation  CC-PD-Mark A similar version of this blog was posted earlier in Psychology Today. Many have advocated using person-centered skills since the seminal work of Carl Rogers,1 but few describe the specifics, especially, for being empathic. Our Michigan State research in medical education generated Read more about How To Effectively Communicate With Others[…]

Mental illnesses in primary care often present with physical symptoms. KEY POINTS 1. Effective mental health care in medical settings requires awareness of physical symptoms as well as psychological symptoms. 2. Chronic illness patients with lifestyle limitations often have unrecognized depression, anxiety, or substance abuse. 3. Disabled, chronic disease patients typically do not offer psychological Read more about Psychiatry’s Mismatch With Primary Care[…]

How would you diagnose chronic pain? This blog was posted earlier in a slightly different form in Psychology Today. Trying to make a diagnosis in the patient with chronic pain confuses clinicians and interferes with care. In this post, I’ll review the diagnostic problem and suggest some ways around it. In an earlier post, Chronic Read more about Chronic Pain Is A Symptom[…]

Non-professionals can improve others’ mental health care—by inquiring. I similar version of this post was published earlier today in my Psychology Today post. Because there was interest in my post describing how non-professionals can facilitate help for the suicidal patient, I thought it could be useful to extend this effort to a variety of other Read more about Improving the Mental Health Care of Those Close to You[…]

Medical faculty could teach mental health care—if they were first trained. A similar version was published earlier in Psychology Today. You heard in my last post the encouraging news that some medical educators embrace the psychological and social aspects of medicine, reflecting a belief that they must integrate these features with medicine’s already strong disease Read more about We Don’t Train the Physicians Who Provide Mental Health Care[…]

Medical educators lead the charge, but more work remains. A similar version of this post was published earlier today in Psychology Today. In my previous posts on medicine’s loss of mind, Descartes, and modern science, I described the medical profession’s profound dereliction of duty for its most common patient population. Medicine completely fails to train Read more about Hope for Improved Mental Health Care[…]

How you, as in individual, can save valuable lives. This post was published earlier today in a slightly different form in Psychology Today. With 45,000 suicide deaths in the U.S. in 2016,1 someone has to do something. I’m proposing that someone is you. Sound outlandish? Maybe so, but would you respond similarly if I recommended Read more about You Can Prevent Suicide in Someone Close to You[…]

“Looking where the light is.” This post was previously posted earlier today in Psychology Today. In a previous post, you heard how Rene Descartes and other Enlightenment philosophers split the mind and its mental operations from the body, leaving medicine with an almost exclusive focus on the physical body and its diseases. Beneficial as this Read more about Medicine’s Way of Thinking Prevents Progress in Psychiatry[…]

Your response to the coronavirus stems from evolution. This blog was also posted earlier in Psychology Today. Evolutionary psychiatry can help people accept their own or another’s mental illness. It provides one way to understand why the illness occurred. Key to an evolutionary understanding is the way natural selection maximizes passage of one’s genes to Read more about Why Do People Develop a Mental Disorder?[…]

Addressing psychosocial and mental issues improves physical disease care. A slightly different version of this was posted earlier today in Psychology Today. In an earlier post, I expressed my concern about poor mental health care in the U.S., and that it stems from the medical physicians who provide 85% of it. It’s not their fault, Read more about Medicine Can Improve Physical Diseases Care[…]

Psychiatry is as reductionistic as the rest of medicine. A similar blog was posted earlier today in Psychology Today. In a recent article in the New England Journal of Medicine, Gardner and Kleinman make a point that parallels what I’ve been saying since my initial post. Modern medicine is so anchored in the reductionistic disease Read more about The Crisis in Psychiatry[…]

Stigma is a major deterrent to mental health care. A similar post was made earlier today in Psychology Today. While many are aware of the national problem of poor mental health care, how might we as individuals and as a society be contributing to it? We do so in spades by stigmatizing those who suffer Read more about How We Interfere with Our Own Mental Health Care[…]

Presidential Candidate’s Plan to Improve Mental Health Care One governor takes a bold, new direction. A somewhat altered version of this post was published earlier in Psychology Today. Governor Jay Inslee (D-WA) recently spearheaded and then signed into law in Washington state one of the most far-reaching mental health initiatives in recent history. HB 1388 Read more about Presidential Candidate’s Plan to Improve Mental Health Care[…]

Chronic Pain—the Humane Use of Opioids Some physician prescribers misread CDC guidelines. This blog was published earlier today in a slightly different form in Psychology Today. The contribution of prescribed opioids to the national opioid crisis (which includes non-prescribed drugs like heroin and cocaine) has been well described. Concern with the role these legal drugs Read more about Chronic Pain – the Humane Use of Opioids[…]

Is Medicine Greedy and Morally Bereft? There may be another consideration. This post was published earlier today in Psychology Today in a slightly different form. We must consider what many believe: that the U.S. healthcare system, represented by the medical industrial complex (MIC), is rigged for profit at the expense of care. The MIC comprises Read more about Is Medicine Greedy and Morally Bereft?[…]

Medicine Flaunts Modern Science Does the Medical Profession Reject Modern Science? Sometimes it Does. This post was published earlier in Psychology Today in a slightly different form Let’s be clear. Twenty-first century medical science has produced some amazing advances. Yet in many respects, it remains centuries behind modern science. That’s because medicine’s basic conceptual (theoretical) Read more about Medicine Flaunts Modern Science[…]

Does Donald Trump Mirror the Majority? If you criticize Donald Trump, take a close look at the rest of us. This post appeared earlier in Psychology Today in a slightly different form. Like many of you, I’m shocked and offended as I read daily of Donald Trump’s foibles: he’s narcissistic, aggressive, rude, greedy, dishonest, and Read more about Does Donald Trump Mirror the Majority?[…]

The Diagnosis and Treatment of Chronic Pain Effective, non-opioid treatment for chronic pain exists. Published earlier in a slightly different form in Psychology Today. In spite of yeoman efforts by the American Pain Society, the American Chronic Pain Association, the U.S. Pain Foundation, the American Academy of Pain Medicine, and many others, there has been Read more about The Diagnosis and Treatment of Chronic Pain[…]

Chronic Pain Is an Over-Determined Survival Response Understanding how pain is experienced can lead to better care. In a slightly different form, this post appeared recently in Psychology Today. In an earlier post, “Chronic Pain Is Not a Disease,” I disagreed with the Institute of Medicine’s idea that chronic pain is a disease. Here, I Read more about Chronic Pain Is an Over-Determined Survival Response[…]

Which Physicians Prescribe More Opioids? There is no free lunch. Currier & Ives—A free lunch CC-PD-Mark   This post was earlier posted in Psychology Today in a slightly altered form. You heard the prescription opioid crisis is getting better? If so, I commend the May 30, 2018 issue of the Chicago Tribune. Karen Kaplan in Read more about Which Physicians Prescribe More Opioids? There is no free lunch.[…]

Rene Descartes—Villain or Savior for Mental Health Care? Is medicine able to advance as a science? This post was posted earlier in Psychology Today. Rene Descartes (1596-1650) was a brilliant philosopher, mathematician, and scientist. Most scholars consider him responsible for modern medicine’s splitting the mind and mental issues away from the body and its diseases.1-3 Read more about Rene Descartes—Villain or Savior for Mental Health Care?[…]

A brief history of human anatomy: how medicine lost its mind. After William John Wilgus. Ichabod Crane and the Headless Horseman. CC-PD-Mark This post was posted earlier in Psychology Today. We know that the medical profession largely ignores mental disorders. That’s why, according to the Healthy People initiatives, only 25% of patients who need mental Read more about Extra, Extra, Read All About It – Medicine Guillotined[…]

Medicine must decide it wants to prevent suicides. This post is slightly altered from one published earlier in Psychology Today. We are missing an easy way to prevent suicides. Half or more of all suicides are potentially preventable. First, here’s a summary of the problem that once again came to our attention with the unfortunate Read more about We Can Prevent Half or More of all Suicides[…]

Mistakes the Institute of Medicine made in saying pain is a disease. This post was published previously in a slightly modified form in Psychology Today. Is chronic pain a disease? August groups, such as the American Academy of Pain Medicine (AAPM) and the Institute of Medicine (IOM) (now the National Academies of Sciences, Engineering, and Read more about Chronic Pain Is Not a Disease[…]

Is anyone you know misusing opioids? This post was presented in a slightly modified form in Psychology Today on April 28, 2018. From the Centers for Disease Control and Prevention, we know that there is no benefit whatsoever from taking opioids for chronic, non-cancer pain, and there are many harmful effects to the patients (and Read more about Suspicious Behaviors Suggest Opioid Misuse[…]

  Tanya Little – Flickr: 9 of 365 ~ Frustration CC BY-SA 2.0 A slightly different version of this post was posted in Psychology Today on March 11, 2018. Physician burnout has been much in the news of late, and appropriately so. As many as one-half of primary care physicians are burned out, meaning they Read more about Physician Burnout – More Than Meets the Eye[…]

Do you know what a safe opioid dose is? A slightly different version of this post was posted on Psychology Today on April 2, 2018 Most agree that there is no proven benefit from the chronic use of opioids (Vicodin, Oxycontin, Fentanyl) for non-cancer pain. From the Centers for Disease Control and Prevention, studies show Read more about Opioids Complications are Related to the Dose[…]

Every day there is something in the media on prescription opioids. For good reason, the problem is real—overdose deaths, selling them, and addiction. It all comes from the Vicodin, Oxycontin, and Fentanyl physicians prescribe. OxyContin tablets crushed into powder for insufflation (snorting). Notice the tablets at the top with the coating removed. By 51fifty at Read more about Prescription Opioids Create A National Crisis[…]

  Your physician is not trained to treat your mental health problems. A slightly different version of this post was posted on Psychology Today on February 7, 2018 Since 1985, I’ve focused on patient-centered communication and mental health care in medical settings. That’s right—medical settings—not psychiatric settings. That’s because primary health care physicians are typically Read more about Has Medicine Lost its Mind?[…]