When I am with a patient, time and distractions fade out.  I listen to the story the patient is telling me, and within that I am listening for the story he is telling himself.  I focus on what is being said, how it is being said, while at the same

I have come to appreciate some simple truths as I hit mid-life that a former, younger version of myself would have dismissed with a smug smile and a raised eyebrow as if to say, "maybe for you".  One of these simple truths is...life is hard. I have

Taking medication for mental health is a very personal decision.  Patients tell me of the stigma they feel when on medications classified as antidepressants or antipsychotics. When deciding to take a medication for mental health, the principals from other realms of medicine apply: 1. Know why you are taking the

If there is a word for 2023, it would be crisis. Mental health crisis Climate crisis Economic crisis Energy crisis Affordability crisis You get the idea.  They have been very unwelcome guests that have intruded on almost all aspects of our lives. And no wonder.  Crisis is a word that

I have been very interested in the concept of identity and its role in mental health ever since I saw "identity disturbance" and "lack of sense of self" as a diagnostic criteria for a mental illness in the Diagnostic Manual for psychiatric disorders. It was not

A patient tells me that the lithium is working.  "It keeps me neutral", she says. "How do you feel about that?" I ask. She tells me that she had a panic attack on her way home from the bus stop and that it lasted for several

Part of my practice is in first episode psychosis and it is a wonderful area in which to work. It may come as a surprise, but I find this patient population dynamic, and the work itself quite optimistic. We see people experience complete personality changes, do unspeakable things in the

When a patient tells me, "I am not doing any better. I can't take it anymore." What I would like to say, "I can not fix you right away. I am saddened by this, I may even be sorry. But I am doing my best

Briefly, obsessive compulsive disorder (OCD) is a mental illness characterized by unwanted, intrusive, and repetitive thoughts or images(obsessions) that can have accompanying rituals or other behaviors/acts (compulsions) that a patient feels they must engage in to alleviate the anxiety brought on from the obsessions.  You can still have

Did you know you can feel upset, for no clear reason, and NOT judge yourself for feeling this way?  Despite being a therapist, this was a revelation for me. To be mentally well is often confused with being happy all the time or to have an explanation for all of

In my work as a psychiatrist, I have found myself repeating the same words over and over to many of my patients and in so doing, I have been very deliberate about trying to embody them myself. I have found these words to be the bedrock of resilience and mental

There is a course I took that asked me to think about the "ideal reader" for this blog. The prompt was: "Brainstorm the kind of person you hope will read your blog. What do you want to say to them?" Here is my answer: The kind