Dr Beech 🌤
@DrDBeech
Psychotherapist, Clinical & Forensic Psychiatrist. Psychodynamics. https://open.substack.com/pub/toosimpletobehelpful
Confused About Mental Health? Start here: A Simple Guide for Complex People open.substack.com/pub/toosimplet…
throwing the baby of really helping people and understanding problems in psychiatry out with the bathwater of overprescribing or sometimes reifying overly simple diagnoses. The antipsychiatry folks seemed completely immune to moderation of their positions. They used a rhetoric
I completely agree that psychotherapy is a vital tool for psychiatrists. Psychotherapy is as much of a biological intervention as it is a psychological one. This thread outlines findings from research. 🧵1/
Two Visions for Psychiatry: The Future of Psychotherapy A psychiatrist argues "Psychotherapy Training Shouldn’t Be Part of Psychiatry" training; emphasizing the importance of mastering biological skills. He sees psychotherapy as a niche, best left to other professionals. I see…
When I started here on Twitter, many of my posts on philosophy of psych diagnoses, the concept of mental illness etc were criticized (with ideas) by people in favor of the medical model of psychiatry, eg Huda or maybe @tylerblack32
Not confusing at all. There's a clear distinction betw good faith engagement (open to new data, respectful comm's, revise positions w new evidence) vs those fixed to ideology who apply skepticism differentially & filter out such new data when it contradicts said ideology.
Well this is a state of affairs that leaves me a tad confused. Dr James Davies and I interacted on a matter we agreed upon and I do not want to miss that he engaged honestly and respectfully. I really valued this. He then liked my post in our last interaction and then blocked me?
LIVESTREAMING NOW: FDA Expert Panel on Selective Serotonin Reuptake Inhibitors (SSRIs) and Pregnancy
LIVESTREAMING NOW: FDA Expert Panel on Selective Serotonin Reuptake Inhibitors (SSRIs) and Pregnancy
“I never could see why people were so happy about Dickens’ ‘A Christmas Carol’ because I never had any confidence that Scrooge was going to be different the next day.” Karl Menninger
My favorite version of this is when you have a patient who recently came back from a retreat of some kind, who then tells you how transformative this was (and subtly or not so subtly challenging this therapy thing they’ve been doing with you). Then we fast forward 6 weeks later.
Nothing 'prevents' MD's from posting rates, or billing for their time...except both are moot for most US MD's; most of them have signed contract(s) with 3rd party payers. In these contracts they have agreed -to accept payer's rate -not to balance bill for 'uncovered' services
Why can't MDs post their hourly rates? When I hire a lawyer, I know what the rate will be for routine services, and I know what the rate will be if we have to go to court, and I know that the greater the expert/specialization of the lawyer, the more I will pay.
Standard differential application of skepticism. Studies show efficacy of AD’s? —> poor design, sponsored by pharma, depression doesn’t exist, not long enough, etc. Now cite those same studies as evidence that the drugs don’t work, are no better than placebo, etc
Funny how anti-psychiatry trolls say mental health services only work because of “placebo,” your belief that it will work — and they want to kill your belief.
"If you have to maintain self-esteem by pulling down the standing of others, you are extraordinarily unfortunate in a variety of ways. Since you have to protect your feeling of personal worth by noting how unworthy everybody around you is, you are not provided with any data that…
Thoughtful article in Psychiatric Times. But the real information is the fact that it has to be written at all The opening fits my experience. When I first became a professor of psychiatry and taught psychotherapy, the residents asked: What does this have to do with psychiatry?
What is the point of therapy? - Psychotherapy faces skepticism in psychiatry, yet it remains vital for understanding patients' narratives and enhancing therapeutic relationships. My latest article: Reclaiming the Narrative: Why Psychiatrists Must Learn Psychotherapy Link below
I agree. That is what the statement should say. “no overall evidence” would receive red marks for ambiguity from an 8th grade English teacher.
The consensus is that the risk is minimal.
Regardless of one’s view of the aggregate risks vs benefits, I hope for a broad consensus that “There is no overall evidence that…” is a woefully inept choice of wording for a statement from a professional organization. Unclear in meaning, assumed to be obfuscating something.
Surely you understand the wording of "the consensus seems to be none to negligible effect, though some studies suggest..." Absolute risk is very very very low for teratogenic effects.
“Why Psychiatrists Must Learn Psychotherapy” 🤦🏼♂️ “Why Cardiologists Must Learn to Read EKGs” “Why Surgeons Must Learn Anatomy” “Why Pediatricians Must Learn Child Development” “Why Obstetricians Must Learn Ultrasonography”
What is the point of therapy? - Psychotherapy faces skepticism in psychiatry, yet it remains vital for understanding patients' narratives and enhancing therapeutic relationships. My latest article: Reclaiming the Narrative: Why Psychiatrists Must Learn Psychotherapy Link below
If psychiatry vanished tomorrow, people would still suffer from trauma, psychosis, OCD, and suicidal depression—even with a perfect diet, daily jogs, good friends, and meaningful work. Dismissing that is not insight. It’s erasure.
"If a fire alarm went off right now, there would be a dramatic change in our thoughts and feelings; if tomorrow someone asked you what happened, you could say 'I had a chemical imbalance'...there would be some truth in this (adrenaline, cortisol, etc)...but if the fire alarm…
I agree with the reason we use the phrase, but my hunch is that most people take it as loose talk more akin to a metaphor. But I’d love to see good subjective analyses of it. And maybe if other phrases we bandy-about in the industry.
I don't think physicians were "trained" (formally) to tell pt's that, though countless did & do. A nuance re wording: "deficiency/deficit" [vs altered transmission (in the Q). Deficiency /deficit suggest absolute quantity, vs transmission, suggests a process (for which there is…
Are physicians still trained to tell their depressed patients that they have a chemical imbalance? Here's a recent flashcard preparing medical students for the USMLE (United States Medical Licensing Examination). Their answer is (C). The problem is...
It is misogynistic for anti-psychiatry to deny the very serious disorder of post-partum depression. No one who has ever seen it up close and personal as a clinician, patient, or family member would ever claim such a thing.
It’s interesting that Dr James Davies denies post-partum depression here on Xitter, yet lists it as a condition he treats at his private Harley Street Clinic.
You said "please", but this person isn't open...to seeking common ground or alternative views. Ironic perhaps that a philosopher's claims so commonly contain such blatant errors of logic, such as assigning binary choices (when the group >2), absolutism, & over-generalization.
Justin, please don’t demean and abandon people with mental illness. Psychiatry doesn’t say “you have no power”—it says you don’t have to suffer alone. Just as a cast helps a broken leg heal, therapy and medication can support healing when the mind is overwhelmed. Pretending…
Being honest = Being nice.
The other day, as I was walking into a local Target, I saw a floor sign that said "Be nice to each other." Every single sign like this is at the heart of the therapeutic ethos degrading everything. They should be replaced with "tell the truth to one another."
I ‘lean’ psychodynamic as Newton ‘leaned’ into gravity: a ubiquitous context. psych: (noun.) of the mind or mental process + dynamic (adjective.) characterized by constant change or activity The mind IS dynamic...how else to helpfully approach, without first stipulating this?
Why do I lean psychodynamic in orientation: Honesty and love of truth We own difficult things to believe about ourself Acknowledging the power of the relationship (why AI will not replace this work)! Transference processing allowing a new depth of experience