Professional Articles

Doctors Don’t Grieve, Residents Don’t Sleep

Tuesday, May 29th, 2012

Doctors Dont Grieve, Residents Dont SleepMany doctors appear to believe they aren’t human — and don’t have normal human needs like the rest of us. At least according to two new studies recently released.

In an opinion piece published in Sunday’s New York Times, researcher Leeat Granek shares the results of two studies that suggest to her that, “Not only do doctors experience grief, but the professional taboo on the emotion also has negative consequences for the doctors themselves, as well as for the quality of care they provide.”

A different study released by the JAMA journal, Archives of Surgery, last week found that residents don’t get as much sleep as ordinary professionals get — which directly impacts their ability to concentrate and be mentally attentive.

Combined, these studies add to the picture that’s been painted for years by research — that doctors believe they are somehow “super human” and beyond the reach of normal human needs, for both their body and their mind. It’s a disturbing picture, and one that the medical education establishment needs to remedy sooner rather than later.

VA Ups Mental Health Clinicians by 1600, But Is It Enough?

Sunday, April 22nd, 2012

VA Ups Mental Health Clinicians by 1600, But Is It Enough?I applaud the U.S. Department of Veterans Affairs’ (VA) decision last week to increase its mental health staffing in facilities by nearly 10 percent across the board, adding up to 1,600 new clinicians — psychologists, psychiatrists, social workers and more. (My sources within the VA indicate most of these positions will be LPC and Master’s level clinicians — not psychologists or psychiatrists.)

It’s a good step forward as the military struggles with the hundreds of thousands of returning vets who have increasing mental health needs. Most of the new hires — about 1,400 — will be clinicians that work directly with vet patients.

But let’s also put this into some perspective, too. According to its website, the VA operates 172 hospitals across the United States, and 837 outpatient clinics. That’s 1,009 places where a vet can go to get help. That means that, on average, each clinic or hospital will get 1.4 new clinicians.

One and a half new clinicians per facility? Not nearly as impressive.

Publication Bias Again, This Time For Antipsychotics

Wednesday, March 21st, 2012

Publication Bias Again, This Time For AntipsychoticsAs we reported earlier today, new research has discovered that pharmaceutical companies withheld a handful of nonsignificant and negative data from publication when working to get the U.S. Food and Drug Administration (FDA) to approve atypical antipsychotics. However, the problem was significantly less severe than the publication bias researchers found when looking at antidepressants.

Antidepressants have been especially hard hit when looking at the FDA pre-approval research. In fact, in Lesley Stahl’s recent 60 Minutes report on antidepressant research, she walked away completely baffled by the meaning of it all. What does it mean when researchers find such negative findings that were never published?

Let’s find out…

How the Public is Being Misinformed about Grief

Tuesday, February 28th, 2012

How the Public is Being Misinformed about Grief“Have the psychiatrists gone mad? — those who weren’t crazy to begin with! They want to turn grief into a disease!”

This might well be the attitude of many in the general public, having read the misleading news coverage of a debate over the DSM-5 — the still-preliminary diagnostic classification of mental disorders, often referred to as “psychiatry’s Bible.” Now, I am no fan of the DSM model of diagnosis — in fact, if the DSM is the “bible,” I’m something of a heretic. In my view, the DSM’s superficial symptom checklists are great for research purposes, but not very useful for most clinicians or patients.

Nevertheless, I don’t like seeing the work of my DSM-5 colleagues misrepresented. So when I see bogus headlines like, “Grief Could Join List of Disorders” in the usually circumspect New York Times, I cringe.

Before discussing the arcane debate over the “bereavement exclusion,” it’s important to understand what most psychiatrists really believe about grief, bereavement, and depression.

Diagnosis of a DSM 5 News Cycle

Sunday, February 12th, 2012

Diagnosis of a DSM 5 News CycleAs I was sitting around catching up on some mental health news on Saturday, I inadvertently stumbled upon another manufactured news cycle about the DSM 5. Considering no new significant research findings were released in the past week on the DSM-5 revision efforts, I was a little surprised.

This latest fake news cycle started on Thursday, apparently with the release of a Reuters news story from Kate Kelland. Kelland notes the newest concern comes from “Liverpool University’s Institute of Psychology at a briefing in London about widespread concerns over the manual.” There’s no link to the briefing. And I’m not sure what a “briefing” is — a press conference? (And since when is a press conference a news item? It’s not really equivalent to a new research study, is it?)

Kelland fails to note that Europe and the U.K. don’t actually use the DSM to diagnose mental disorders — it’s a U.S. reference manual for mental disorders diagnosis. So while it’s nice that some Europeans are expressing concern about this reference text, their concern isn’t exactly much relevant. Context is everything, and Reuters failed to provide any useful context in that article.

Sadly, Reuters is a brand name. And once you write an article under that brand name, it cascades down an entire news cycle. Let’s follow it for fun!

Submit Your Psychotherapy Stories

Friday, February 10th, 2012

Submit Your Psychotherapy StoriesThere are a ton of good stories out there about people’s experiences with psychotherapy, and we want to feature them each week here on the World of Psychology. By shedding more light on the process of therapy, we believe it will make people more comfortable and perhaps get a better understanding of it.

So we’re putting out a call for any and all psychotherapy stories — from therapists, psychologists, psychiatrists, counselors, clients and patients. If you have a story you want to tell and can do so in under 1,400 words, we’re interested.

We’re not looking (just) for salacious stories. We’re looking for stories that show the personal nature of therapy, and how it can help people.

Read on for details…

Will Depression Include Normal Grieving Too?

Wednesday, January 25th, 2012

Will Depression Include Normal Grieving Too?It’s been heating up now for the past few weeks as a charge led mainly by professionals. And it has caught the eye of the mainstream media. I’m talking about the revision process for the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), the reference manual mental health professionals and researchers use to treat patients and design reliable research studies examining mental illness.

The latest upset? The fact that the new DSM-5 suggests that depression could co-occur with grief. Critics see the changes as suggesting the DSM is trying to “medicalize” normal grieving. Anyone who experiences grief after a tragic or significant loss will now be at risk for receiving — heaven forbid — mental health treatment and a diagnosis.

We’ve covered this ground here on more than one occasion, but it appears time to talk about whether depression can occur at the same time as grief or not. My first reaction was — grief is grief, depression is depression, and the two never really co-occur. But a few years ago, I read a piece here on World of Psychology by Dr. Ron Pies which completely changed my perspective.

6 Unusual Psychology Jobs

Thursday, January 19th, 2012

6 Unusual Psychology JobsWe usually think of psychologists as seeing clients, conducting research, teaching at universities or holding high administrative positions.

But psychologists also work in many unexpected places and on many unexpected topics — perhaps far more than you’d think.

Here’s a short list of psychologists who have some of the most interesting and odd jobs.

1. Circus Psychologist

Psychologist Madeleine Hallé works at Cirque du Soleil helping performers adjust to their new job, overcome fear and stage fright and recover from injuries and fatigue. In 1998 she began working on an as-needed basis but then went full-time as Cirque du Soleil incorporated performance psychology into its training program. Hallé earned a master’s degree in sport sciences with an emphasis on coaching along with a Ph.D in sport psychology from Université du Montréal.

Abuse and Coverups in Mental, Developmentally Disabled Care

Monday, November 7th, 2011

Abuse and Coverups in Mental, Developmentally Disabled CareIt seems like the world will always be full of people who are charged with the responsibility of taking care of others but who just don’t seem to much care about how they do their job. Or whether they do it at all.

When it comes to mopping up after unruly children, whether you care about your job probably isn’t very important. When it comes to ensuring the safety, health and proper treatment of people who rely on you for helping maintain their own health or their very life, it probably is. When a person needs you in order to live — and needs you to give a damn about your job — that is a very serious and real responsibility.

Today I write about two stories in recent headlines that demonstrate the depths of indifference that some people have toward people who are the most vulnerable in our society, and the ones who need our greatest care and protection.

An Open Letter to the DSM-5

Sunday, October 30th, 2011

As the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders continues to develop, there has been more and more reaction from professional groups with concerns. The most recent of these is an open letter that was sponsored by group of American Psychological Association divisions, and you can read it here: Open Letter to the DSM-5.

The biggest complaint here is that the DSM-5 development committee appears to have departed from the “atheoretical” approach that the past two version of have taken, in favor of a clear biomedical approach. The DSM-5 also seems to be changing the very definition of mental disorder by adding the criterion: ‘[A behavioral or psychological syndrome] that reflects an underlying psychobiological dysfunction.’

Relationship Themes in Suicide Notes

Monday, October 24th, 2011

Relationship Themes in Suicide NotesYears ago I worked in a psychiatric emergency room in a large metropolitan hospital. My job consisted of evaluating a steady stream of patients to determine whether they should be hospitalized or sent elsewhere.

I saw people in the throes of mania, psychosis and suicidal depression. I still remember the man who asked if I was a witch who would place a spell on him. And the woman who came barreling at me down the hallway, warning, “You best get out of my way, or I’m going to go Ninja Turtle on your ass!” I remember the man who swallowed six bedsprings in a suicide attempt. And countless others with bandaged wrists, bruised necks, and broken souls. I learned a lot about the breadth and depth of human suffering.

One day I was waxing philosophical about suicide with one of the charge nurses who had worked there for more than 20 years. She shared that she had a collection of 350-odd suicide notes that had been collected by a medical examiner over the course of his career. The notes had been collecting dust in her attic for the past 10 years.

She asked if I wanted them.

The 12 Steps of Positive Psychology

Monday, October 17th, 2011

The 12 Steps of Positive PsychologyThe positive psychology movement is surely gaining momentum. In a recent discussion with two of my colleagues we joked that positive psychology’s really about a type of recovery from negative thinking.

This got me wondering if a 12-step process might be worth identifying. So guess what…? I think it is.

Here is what I propose for the 12 steps of positive psychology.

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