Great conversation! With regards to the stuff with increasing identification with diagnosis, I think the book Far From the Tree by Andrew Solomon goes into this idea of disability as identity in really interesting ways. I have also noticed some pushback on the pathologization of everything and overuse of trauma in the same social media spaces where these trends came from in the first place.
This was extremely interesting. I'm a lay person with a long interest in these subjects and I have really enjoyed this and look forward to hearing more.
As the parent of an adult who is currently disabled (housebound) with psychiatric symptoms this conversation gave me some hope. A retired academic librarian living in the Boston, with access to the myriad resources here, I’ve done much research and reading in the area of mental illness but still feel helpless and at sea. The conversation among these four smart, compassionate, dedicated clinicians was very helpful and encouraging. Just to know they’re out there. On the issue of identification with psychiatric labels, Rachel Aviv, “Strangers to ourselves” explores the tension between the need to take symptoms seriously enough to get help when needed (in a system that requires diagnostic codes for insurance reimbursement) and on the other hand getting stuck in the “mental patient” role, in system with categories like SMI (relevant for disability benefits eligibility).
The issue of anosognosia is another aspect of this—the opposite problem, in a way. I have found the anti-psychiatry movement unhelpful. My daughter thought she was having a spiritual awakening when she experienced ecstatic alternative realities at a meditation retreat, refused a follow-up with a psychiatrist (after being hospitalized for the manic psychotic symptoms) or to view her situation medically, only to have psychotic episodes recur and turn dark and terrifying. Much has happened since, her combination of symptoms is perplexing, and who knows whether earlier or different intervention might have changed the outcome. My point here is that sometimes prompt intervention can be important. I was completely ignorant about all this and plunged into the deep end six years ago. Her first inpatient psychiatrist— in a small unit part of small general hospital in Boone, NC, where she was transported for lack of beds around Asheville—was very gifted. He talked to her a lot, he read to her from Kay Jamison’s book “Unquiet mind” (the part where she gets mad at her psychiatrist!), he convinced her that without medication she would probably have more episodes and each one would make the next more likely.
As an NP and a quasi acolyte of Nassir Ghaemi I am taken w the dialogue to just listened to and will be going back to review, especially the part of PTSD/trauma. I have often thought about what exactly is trauma separate from the original shell shock and military related experiences. More please
Great conversation! With regards to the stuff with increasing identification with diagnosis, I think the book Far From the Tree by Andrew Solomon goes into this idea of disability as identity in really interesting ways. I have also noticed some pushback on the pathologization of everything and overuse of trauma in the same social media spaces where these trends came from in the first place.
This was extremely interesting. I'm a lay person with a long interest in these subjects and I have really enjoyed this and look forward to hearing more.
Thank you!
As the parent of an adult who is currently disabled (housebound) with psychiatric symptoms this conversation gave me some hope. A retired academic librarian living in the Boston, with access to the myriad resources here, I’ve done much research and reading in the area of mental illness but still feel helpless and at sea. The conversation among these four smart, compassionate, dedicated clinicians was very helpful and encouraging. Just to know they’re out there. On the issue of identification with psychiatric labels, Rachel Aviv, “Strangers to ourselves” explores the tension between the need to take symptoms seriously enough to get help when needed (in a system that requires diagnostic codes for insurance reimbursement) and on the other hand getting stuck in the “mental patient” role, in system with categories like SMI (relevant for disability benefits eligibility).
The issue of anosognosia is another aspect of this—the opposite problem, in a way. I have found the anti-psychiatry movement unhelpful. My daughter thought she was having a spiritual awakening when she experienced ecstatic alternative realities at a meditation retreat, refused a follow-up with a psychiatrist (after being hospitalized for the manic psychotic symptoms) or to view her situation medically, only to have psychotic episodes recur and turn dark and terrifying. Much has happened since, her combination of symptoms is perplexing, and who knows whether earlier or different intervention might have changed the outcome. My point here is that sometimes prompt intervention can be important. I was completely ignorant about all this and plunged into the deep end six years ago. Her first inpatient psychiatrist— in a small unit part of small general hospital in Boone, NC, where she was transported for lack of beds around Asheville—was very gifted. He talked to her a lot, he read to her from Kay Jamison’s book “Unquiet mind” (the part where she gets mad at her psychiatrist!), he convinced her that without medication she would probably have more episodes and each one would make the next more likely.
As an NP and a quasi acolyte of Nassir Ghaemi I am taken w the dialogue to just listened to and will be going back to review, especially the part of PTSD/trauma. I have often thought about what exactly is trauma separate from the original shell shock and military related experiences. More please