Confused About Mental Health? .Start here: A Simple Guide for Complex People.

I'm getting a new therapist.

RT @awaisaftab: On Aug 28, 2025, @APApsychiatric issued a brief statement on X assuring the public of the efficacy and safety of psychiatri….

RT @AAJDeVille1: I've lost count of the number of times I've quoted this to people who view him as dogmatic or fanatic in defending psychoa….

RT @nadeemhasanpsyd: I’m happy to share that I’ve started my own private practice. I’ll be seeing individuals virtually anywhere in CA. Fe….

💯. Helpless-sounding authorities & professionals plead: “It’s like trying to find a needle in a haystack.” . Wrong. (Difficult, yes; but that could actually be done.). It’s more like trying to find a single piece of hay (which looks just like all the others) in a haystack.

This gentle man lives on the streets near me, has for years. Gets lots of sunlight, exercise, & good food (near-expired produce fr grocer, whose patio bench he sleeps on). Refuses approach by would-be helpers lest, we interrupt his talk w what he hears (that may need nurturing.)

Repression is the prototype of all the adaptive mechanisms—if you cannot bear it, forget it. …throughout much of his career Freud used the terms defense & repression synonymously: “Repression is the cornerstone on which the whole structure of psychoanalysis rests”. G Vaillant MD.

The hostility isn’t toward “the idea”; it’s toward the proclamation or declaration as such.

“What psychiatrists and psychologists too often lose sight of is that neurosis—obscure, back-breaking business that it is—can be used for adaptation as well as for self-defeat.”. George Vaillant, MD.Adaptation to Life.

It surely can be stigmatizing, for a subset of people (maybe a majority)… this only elevates the crucial importance of acknowledging the subset of emotional suffering that IS mental illness; denying or ignoring that prospect results in tragic degrees of preventable suffering.

“This troubleshooting is the norm. Maintaining optimal mental health and recovering from mental illness are fluid expeditions. They aren’t races to the finish line.”.Jonathan Stea PhD.“Mind the Science”.@jonathanstea

"That very restrictiveness, aimed to forestall anxiety, creates conditions that generate new anxiety. For example, the carefully controlled, guarded person is no longer discomforted only by the circumstances or conflict originally responsible for his guardedness; once guarded, he.

“Proficiency at individual psychotherapy is perhaps the hallmark of the dynamic psychiatrist. Evolving as it does from psychoanalysis, dynamic psychiatry understandably emphasizes the nuances of the healing relationship between psychotherapist and patient.”. Glen Gabbard 1994.

“The real world of mental health care saves lives…but it also consists of long ,winding, and bumpy roads.”.Jonathan Stea, Ph.D. “Mind the Science”. @jonathanstea

PATIENT: (returning from long holiday weekend, visiting family out of state) "You will NOT believe what my father said over the dinner table!" . THERAPIST: "Oh yes, I most certainly will.".

“What differentiates sublimation and altruism from the neurotic defenses …is the elegance of the former mechanisms, their flexibility, and their capacity to mitigate future as well as present suffering.”. George Vaillant MD, Adaptation to Life.

Psychiatry is swimming upstream. Thorough treatment has all but disappeared. Little depth psychotherapy is available, robust inpatient extended stays no longer available (most IP units are just management/supervision mills. Suicide/suicidality track most strongly (& inversely).

RT @proud_penelope: Also, let’s be real, we don’t like it when McWilliams is criticized because she has written great, helpful books…. But….

"Although intellectualization may make for a brilliant academic record in high school, in adult life it must be tempered by a more flexible defense system—one that lets instinctual pleasure peek through.". George Vaillant, MD Adaptation to Life.

As inpatient psychiatrist mid-90s I spent 1-2 hrs ev day on calls like this, pleading for xtra days for psychotic & suicidal patients. Once asked how I knew pt was suicidal, said “he bought a gun.” .Reviewer: “Was it loaded?”.I knew it would hit the rest of medicine eventually.