Best 199 quotes in «psychiatry quotes» category

I believe ADHD is a constellation of symptoms that our society interprets as a medical condition [...]. ADHD certainly "exists," in the sense that many children exhibit behaviors that parents and teachers can see and doctors can measure. But in my view ADHD is neither an unnatural condition of childhood nor an illness that requires medication. Often, behaviors tagged as ADHD are normal childhood responses to stressful situations. I believe ADHD is overdiagnosed and overmedicated and that well-meaning parents from all backgrounds have been duped into believing that their perfectly normal and healthy child needs powerful psychostimulant medications just to be "normal" and successful. I believe this is harmful to parents and to children, and I believe there is a better way.

I began to see that the stronger a therapy emphasized feelings, self-esteem, and self-confidence, the more dependent the therapist was upon his providing for the patient ongoing, unconditional, positive regard. The more self-esteem was the end, the more the means, in the form of the patient’s efforts, had to appear blameless in the face of failure. In this paradigm, accuracy and comparison must continually be sacrificed to acceptance and compassion; which often results in the escalation of bizarre behavior and bizarre diagnoses. The bizarre behavior results from us taking credit for everything that is positive and assigning blame elsewhere for anything negative. Because of this skewed positive-feedback loop between our judged actions and our beliefs, we systematically become more and more adapted to ourselves, our feelings, and our inaccurate solitary thinking; and less and less adapted to the environment that we share with our fellows. The resultant behavior, such as crying, depression, displays of temper, high-risk behavior, or romantic ventures, or abandonment of personal responsibilities, which seem either compulsory, necessary, or intelligent to us, will begin to appear more and more irrational to others. The bizarre diagnoses occur because, in some cases, if a ‘cause disease’ (excuse from blame) does not exist, it has to be 'discovered’ (invented). Psychiatry has expanded its diagnoses of mental disease every year to include 'illnesses’ like kleptomania and frotteurism [now frotteuristic disorder in the DSM-V]. (Do you know what frotteurism is? It is a mental disorder that causes people, usually men, to surreptitiously fondle women’s breasts or genitals in crowded situations such as elevators and subways.) The problem with the escalation of these kinds of diagnoses is that either we can become so adapted to our thinking and feelings instead of our environment that we will become dissociated from the whole idea that we have a problem at all; or at least, the more we become blameless, the more we become helpless in the face of our problems, thinking our problems need to be 'fixed’ by outside help before we can move forward on our own. For 2,000 years of Western culture our problems existed in the human power struggle constantly being waged between our principles and our primal impulses. In the last fifty years we have unprincipled ourselves and become what I call 'psychologized.’ Now the power struggle is between the 'expert’ and the 'disorder.’ Since the rise of psychiatry and psychology as the moral compass, we don’t talk about moral imperatives anymore, we talk about coping mechanisms. We are not living our lives by principles so much as we are living our lives by mental health diagnoses. This is not working because it very subtly undermines our solid sense of self.

I cannot accept the proposition that the four-hundred-year travail of the American Negro should result merely in his attainment of the present level of American civilisation. I am far from convinced that being released from the African witch doctor was worthwhile if I am now - in order to support the moral contradictions and the spiritual aridity of my life - expected to become dependent on the American psychiatrist. It is a bargain I refuse.

Identity confusion is defined by the SCID-D as a subjective feeling of uncertainty, puzzlement, or conflict about one's own identity. Patients who report histories of childhood trauma characteristically describe themes of ongoing inner struggle regarding their identity; of inner battles for survival; or other images of anger, conflict, and violence. P13

I detected a relish in their application of little details, the brushstrokes being added to their work of art as it progressed from a simple line drawing to an ornately decorated and multi-layered, palimpsest painting.

I don’t like psychiatrists,” Alecto told her. “Not because they don’t think I’m real, but because they have no idea what they’re doing.

If the mind fits, shrink it.

I finally saw the whole conspiracy standing as plain as an elephant in the street; also the conspiracy was admitted to me in great detail by one of the princes of the conspiracy." "Bad, Smith, very bad." "If one of the inmates should come to you right now, Doctor, and tell you it was raining outside, you'd say 'Bad, very bad', and make damning marks on his record." " That's probably true. It's an automatic response with me.

If there is one central intellectual reality at the end of the twentieth century, it is that the biological approach to psychiatry--treating mental illness as a genetically influenced disorder of brain chemistry--has been a smashing success. Freud's ideas, which dominated the history of psychiatry for the past half century, are now vanishing like the last snows of winter.

If two people with no symptoms in common can both receive the same diagnosis of schizophrenia, then what is the value of that label in describing their symptoms, deciding their treatment, or predicting their outcome, and would it not be more useful simply to describe their problems as they actually are? And if schizophrenia does not exist in nature, then how can researchers possibly find its cause or correlates? If psychiatric research has made so little progress in recent decades, it is in large part because everyone has been barking up the wrong tree. It is not a question of getting a bigger and better scanner, but of going right back to the drawing board. What’s more, medical-type labels can be as harmful as they are hollow. By reducing rich, varied, and complex human experiences to nothing more than a mental disorder, they not only sideline and trivialize those experiences but also imply an underlying defect that then serves as a pseudo-explanation for the person’s disturbed behaviour. This demeans and disempowers the person, who is deterred from identifying and addressing the important life problems that underlie his distress.

If you are paying someone to motivate you (seriously), you should rather pay to a psychiatrist.

If you doubt your sanity, is that proof?

In the land of the crazies, we are all sane.

Les psychiatres, c'est très efficace. Moi, avant, je pissais au lit, j'avais honte. Je suis allé voir un psychiatre, je suis guéri. Maintenant, je pisse au lit, mais j'en suis fier. Psychiatrists are very efficient. Before, I used to wet the bed. I went to see a psychiatrist, and was cured. Now, when I wet the bed, I'm proud of it.

Imagine a psychiatrist sitting down with a broken human being saying, I am here for you, I am committed to your care, I want to make you feel better, I want to return your joy to you, I don't know how I will do it but I will find out and then I will apply one hundred percent of my abilities, my training, my compassion and my curiosity to your health -- to your well-being, to your joy. I am here for you and I will work very hard to help you. I promise. If I fail it will me my failure, not yours. I am the professional. I am the expert. You are experiencing great pain right now and it is my job and my mission to cure you from your pain. I am absolutely committed to your care... I know you are suffering. I know you are afraid, I love you. I want to cure you and I won't stop trying to help you. You are my patient. I am your doctor. You are my patient. Imagine a doctor phoning you at all hours of the day and night to tell you that he or she had been reading some new stuff on the subject of whatever and was really excited about how it might help you. Imagine a doctor calling you in an important meeting and saying listen, I'm so sorry to bother you but I"ve been thinking really hard about your problems and I'd like to try something completely new. I need to see you immediately! I"m absolutely committed to your care! I think this might help you. I won't give up on you.

In 1949, neurologist Egas Moniz (1874-1955) received a Nobel Prize for his discovery of ‘the therapeutic value of leucotomy in certain psychoses’. Today, prefrontal leucotomy is derided as a barbaric treatment from a much darker age, and it is to be hoped that, one day, so too might antipsychotic drugs.

In psychiatry, Doctor -unlike, perhaps, the world of sexually transmitted disease clinics- there is no such thing as a cure. There is only adjustment.

Instead of seeing ADHD-type behaviors as part of the spectrum of normal childhood that most kids eventually grow out of, or as responses to bumps or rough patches in a child's life, we cluster these behaviors into a discrete (and chronic) "illness" or "mental health condition" with clearly defined boundaries. And we are led to believe that this "illness" is rooted in the child's genetic makeup and requires treatment with psychiatric medication.

Instead of being experienced consciously (either diffusely or displaced, as in phobias) the impulse causing the anxiety is "converted" into functional symptoms in organs or parts of the body, usually those that are mainly under voluntary control. The symptoms serve to lessen conscious (felt) anxiety and ordinarily are symbolic of the underlying mental conflict. Such reactions usually meet immediate needs of the patient and are, therefore, associated with more or less obvious "secondary gain." They are to be differentiated from psychophysiologic autonomic and visceral disorders. The term "conversion reaction" is synonymous with "conversion hysteria." Dissociative reactions are not included in this diagnosis. In recording such reactions the symptomatic manifestations will be specified as anesthesia (anosmia, blindness, deafness), paralysis (paresis, aphonia, monoplegia, or hemiplegia), dyskinesis (tic, tremor, posturing, catalepsy).

It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals. The hospital itself imposes a special environment in which the meanings of behavior can easily be misunderstood. The consequences to patients hospitalized in such an environment-the powerlessness, depersonalization, segregation, mortification, and self-labeling-seem undoubtedly countertherapeutic.

…it seemed to Kirsch that the most reliable guide to the mental landscape of a patient was the patient himself. He was better placed to explain his behaviour and his experiences than anyone else. Yet wherever Kirsch went, the patient was the very last person anyone thought to consult. Because, of course, the patient was insane.

It's okay to not be okay - it means that your mind is trying to heal itself.

I can't see the logic in medicating a grieving person like there was something wrong with her, and yet it happens all the time... you go to the doctor with symptoms of profound grief and they push an antidepressant at you. We need to walk through our grief, not medicate it and shove it under the carpet like it wasn't there.

Implicit [in the psychiatric literature] is a set of normative assumptions regarding the father's prerogatives and the mother's obligations within the family, The father, like the children, is presumed to be entitled to the mother's love, nurturance, and care. In fact, his dependent needs actually supersede those of the children, for if a mother falls to provide the accustomed intentions, it is taken for granted that some other female must be found to take her place. The oldest daughter is a frequent choice... The father's wish, indeed his right, to continue to receive female nurturance, whatever the circumstances, is accepted without question.

I myself must also say I believe it is true that in the end humanitarianism will triumph; only I fear that at the same time the world will be one big hospital and each person will be the other person's humane keeper.

In America, the role of blacks, as for humans everywhere, is to live and flourish and to be fit progenitors for generations to come. To do so, they must oppose racism in an unrelenting way. Psychiatry for such warriors aims to keep them fit for the duty at hand and healthy enough to enjoy the victories that are certain to come.

Invisibility can be good as a superpower. But psychiatry reveals people don't like it very much.

I recently consulted to a therapist who felt he had accomplished something by getting his dissociative client to remain in her ANP throughout her sessions with him. His view reflects the fundamental mistake that untrained therapists tend to make with DID and DDNOS. Although his client was properly diagnosed, he assumed that the ANP should be encouraged to take charge of the other parts at all times. He also expected her to speak for them—in other words, to do their therapy. This denied the other parts the opportunity to reveal their secrets, heal their pain, or correct their childhood-based beliefs about the world. If you were doing family therapy, would it be a good idea to only meet with the father, especially if he had not talked with his children or his spouse in years? Would the other family members feel as if their experiences and feelings mattered? Would they be able to improve their relationships? You must work with the parts who are inside of the system. Directly.

It's been very interesting over the years just how many of those psychiatrists that were openly incredulous and dismissive have become stalwart admitants to the [trauma and dissociation] unit. In fact I can remember one psychiatrist... this is going back more than a decade and a half... it says something about the ambivalence about this area... who rang me saying he doesn't believe that DID exists but nevertheless he's got a patient with it that he'd like to refer. That's called Psychiatrist Multiple Reality Disorder. - 15 years as the director of a trauma and dissociation unit: Perspectives on Trauma-informed Care

It takes two to tango” isn’t even true on the dance floor. One person can do a lot of evil all on his or her own. But the Theory of Mutual Blame arose sometime before Doc was even born. Perhaps it was a takeoff on Freud’s seduction theory or the more generic practice of blaming victims for being alive. Its origins were unclear, but no one had ever had to take full responsibility for their own actions since.

Maybe you’re so good at listening that you have no idea when to speak.” ~Braeden

Medications used to treat psychiatric disorders are commonly referred to as psychotropic drugs. These drugs are commonly described by their major clinical application, for example, antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, cognitive enhancers, and stimulants. A problem with this approach is that these drugs have multiple indicators. For example, selective serotonin reuptake inhibitors (SSRls) are both antidepressants and anxiolytics, and the serotonin-dopamine antagonists (SDAs) are both anxiolytics and mood stabilizers.

My mother, my psychiatrist and an assortment of sedatives eventually convinced me I was delusional.

My sadness is beautiful. It infuses everything I do. It is at the core of my identity and always has been, just as happiness is in some people. I refuse to be told that it's a flaw. I will not mute it with medications for the sake of society. I will hold it close to me and celebrate it rightfully while the rest of the world fails to see it for what it is and it will be their loss.

Never love anybody who treats you like you're normal...they're just the psychiatric hospital staff

No conceptually regimented and normatively informed theory of mental disorder can be devised without taking philosophy of mind seriously and knowing something about this subject area of philosophy and of such topics as consciousness, Intentionality, personal identity, the mind/body problem and rationality.

Nostalgia was diagnosed [as a medical illness] at a time when art and science had not yet entirely severed their umbilical ties and when the mind and body internal and external well-being were treated together...Our progeny well might poeticize depression and see it as a global atmospheric condition, immune to treatment with Prozac.

n sum, let us enter a plea for clinical clinicians who can distinguish unconscious depression from conscious despair, paranoia from adaptive wariness, and who can tell the difference between a sick man and a sick nation.

Of course. A new consciousness - I that that is the word,' said the old man after he had thought a moment. 'That is what I hope it is. You and your African and Colombian, you are speaking the same language now, you know the same ideas. You are conscious that life on earth is flux. Men are better educated. They are more disciplined than in the past - their schedules are harder, their lives move faster, efficiency digs into them. Men are more sophisticated -every day they have more alternatives to choose among than they can possibly exhaust. Through psychiatry they know their strengths and weaknesses. They know the risks of every choice. This is what I mean by consciousness. Men know so much about everything they do. It was much simpler when they didn't know, when they simply acted out of instinct, believed from instinct, loved from instinct, brought up children by their instincts. Perhaps people were even happier. But now we are more conscious. We have got to live with our greater knowledge. We have got to live with our greater freedom.

It takes an insane person to understand the language of insanity.

My other client, whom I will call Teresa, thought Lorraine had MPD and hoped I could help her. Almost no one recognized this condition in those days. Lorraine was forty years old and had been in and out of psychiatric hospitals since she was thirteen. She had had various diagnoses, mainly severe depression, and she had made quite a few serious suicide attempts before I even met her. She had been given many courses of electric shock therapy, which would confuse her so much that she could not get together a coherent suicide plan for quite a while. Lorraine’s psychiatrist was initially opposed to my seeing her, as her friend Teresa had been stigmatized with the "borderline personality disorder" diagnosis when in hospital, so was seen as a bad influence on her. But after Lorraine spent a couple of months in hospital calling herself Susie and acting consistently like a child, he was humble enough to acknowledge that perhaps he could learn some new things, and someone else’s help might be a good idea.

Neither he [Ferenczi] nor Freud believed that a person should be exempted from legal punishment--or worse, that he should be punished by compulsory psychiatric "treatments"--because of psychoanalytic information about him. In the light of current thought, this is a startling and sobering fact.

Once the individual has learned to dissociate in the context of trauma, he or she may subsequently transfer this response to other situations and it may be repeated thereafter arbitrarily in a wide variety of circumstances. The dissociation therefore “destabilizes adaptation and becomes pathological.”[6] It is important for the psychiatrist to accurately diagnose DDs and also to place the symptoms in perspective with regard to trauma history.

One of the most studied ideas as to what causes schizophrenia is the 'chemical imbalance theory,' which derives psychiatric pharmaceuticals themselves. Though the 'mechanism of action' of drugs marketed for their 'antipsychotic' properties isn't understood--plainly, drug companies believe these drugs are effective in lessening psychiatric symptoms, but they don't actually know why--what is known is that they affect chemical levels in the brain. It's therefore supposed that abnormal chemical levels might somehow be crucial to understanding what's different about the brains of people diagnosed with schizophrenia. Testing chemical levels inside brains remains impossible. Despite billions of dollars of investigation, the chemical imbalance theory has never been confirmed.

[One way] researchers sometimes evaluate people's judgments is to compare those judgments with those of more mature or experienced individuals. This method has its limitations too, because mature or experienced individuals are sometimes so set in their ways that they can't properly evaluate new or unique conditions or adopt new approaches to solving problems.

Oggi la mia anima è triste fino al corpo. Tutto me stesso mi duole: la memoria, gli occhi, le braccia.

On Prozac, Sisyphus might well push the boulder back up the mountain with more enthusiasm and creativity. I do not want to deny the benefits of psychoactive medication. I just want to point out that Sisyphus is not a patient with a mental health problem. To see him as a patient with a mental health problem is to ignore certain larger aspects of his predicament connected to boulders, mountains, and eternity.

Other pressing problems with the current medical model [of mental disorder] is that it encourages false epidemics, most glaringly in bipolar disorder and ADHD, and the wholesale exportation of Western mental disorders and Western accounts of mental disorder. Taken together, this is leading to a pandemic of Western disease categories and treatments, while undermining the variety and richness of the human experience.

On having a backup plan: "Always a good plan anytime you want to follow your dream - I love writing, acting, and psychiatry - there are crazy people everywhere which means I can take my career anywhere my dream needs to go.

People may be constrained in two basic ways: physically, by confining them in jails, mental hospitals, and so forth; and symbolically, by confining them in occupations, social roles, and so forth. Actually, confinement of the second type is more common and pervasive in the day-to-day conduct of society’s business; as a rule, only when the symbolic, or socially informal, confinement of conduct fails or proves inadequate, is recourse taken to physical, or socially formal, confinement…. When people perform their social roles properly – in other words, when social expectations are adequately met – their behavior is considered normal. Though obvious, this deserves emphasis: a waiter must wait on tables; a secretary must type; a father must earn a living; a mother must cook and sew and take care of her children. Classic systems of psychiatric nosology had nothing to say about these people, so long as they remained neatly imprisoned in their respective social cells; or, as we say about the Negroes, so long as they “knew their place.” But when such persons broke out of “jail” and asserted their liberty, they became of interest to the psychiatrist.