Saturday, August 21, 2010

Ketamine Can Be Used to Treat Depression

EurekAlert reports that ketamine, also known by the nickname "Special K," is a quick and effective antidepressant that "restores connections between brain cells damaged by chronic stress." This medication for people and domestic animals, often administered intravenously, has been around since 1962. FuturePundit adds that this drug can be used to treat bipolar disorder.

Sunday, August 15, 2010

When Understanding Is Not Enough

Michael Bader, D.M.H. has written a column in Psychology Today entitled "We Need a Practical Psychoanalysis." Here are the first few paragraphs:

I'm a psychoanalyst. So it was with great interest that I read Daphne Merkin's New York Times Magazine article about her forty-year history of psychoanalysis and psychoanalytic psychotherapy. Merkin is a terrific writer, a brave observer of her inner life, and a lively critic of the professional cultures devoted to studying and healing inner lives. She found the New York psychoanalytic culture reassuring, even if not always helpful. She says:

"...aside from the fact that the unconscious plays strange tricks and that the past stalks the present.....[there is] a certain language, a certain style of thinking that, in its capacity to reframe your life story, becomes--how should I put this?--addictive....Whether [it does] so rightly or wrongly is almost besides the point."

For decades I've heard that it doesn't matter what theory a therapist holds, what his or her formulation about the patient might be. What matters, the cliché goes, is simply the presence of an attentive relationship. Merkin's variation on this theme is that her idealization of her analysts' wisdom and the rhythms and imagery of a psychoanalytic conversation have been more comforting than anything she's been offered in the way of interpretation and insight. The process, in other words, was more important than the content or outcome.

Now, my psychoanalyst colleagues certainly don't think this is true. It's important to them -- to us -- that our very extensive training (6 - 8 years after we get our professional degrees) has given us access to a special knowledge (transference, unconscious conflict, defenses, primitive mental states, etc.) about the human psyche that is vital to the success of our treatment. Unfortunately, psychoanalysis has unwittingly colluded with the caricature that its practitioners don't really help their patients, but instead foster 40-year treatments more akin to addictions than cures. I thought that Merkin's essay hoisted us on our own petard. And this petard is a big reason why I left organized psychoanalysis....

Wednesday, August 11, 2010

John McManamy Dares to Ask: Why Not Wellness?

In his "Knowledge Is Necessity" blog, John McManamy, with his usual wit and perceptiveness, raises the bar as to what patients with mental disorders should be asking for.

"My last three blog pieces covered the main points I gave in a grand rounds to clinicians at a psychiatric facility two years ago in Princeton. There, I was accorded the same reception as Bill Gates at an Apple convention. Really, it went almost that well...."