Psychotherapy

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My preceptor in Kansas taught me — while I was finishing my training and in my psychopharmacology fellowship — how to do “ECT”, which stands for “Electroconvulsive therapy.”

AKA: Electroshock therapy Read more on Yes They Can Still Force Electroshock Therapy…

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I asked a longtime patient what her therapist was working on.

“Working on? Well, she listens to me every week and I feel better afterward. I can tell her anything, and I really have nobody else to talk to …”

Another therapist who gets by with an easy hour. That is, of course, not therapy. Read more on What Is Your Therapist Working On?…

Filed under Doctors, Psychotherapy by on . 1 Comment#

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My preceptor — the professor who was responsible for teaching me about psychopharmacology — continuously complained about “polypharmacy.”

I would roll my eyes heavenward and give him one of my usual “clever” retorts like,”Who the heck is she? Your cleaning lady, maybe??” Read more on What We Do With Antidepressants…

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Recently I convinced a patient to buy and use one of these:

She had to pay about 700 dollars cash for it.

I had her on a variety of antidepressants and anti-anxiety drugs, and she had survived untold numbers of similar drugs from the three or so psychiatrists she saw before me. She assured me none of them had been much help. Read more on The Fisher-Wallace Stimulator…

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My husband and I occasionally pick up hard copies of publications, as we did of this one.

My hard copy is marked on the front page as No. 15 Mid March, 2018.

Pages 12 and 13 of this newspaper are marked as “HEALTH” in the upper right-hand corner. Read more on Why It Is Important To Look Who’s Talking…

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There are many times I escort a patient back to my front desk Shouting things like “Never give up! Never surrender!”

I tell them how I was taught to say that when I was on active duty with the US Army Medical Corps.

“Think of whatever inspires you!” If a psychiatrist wonders if a patient is “untreatable,” then all we are really saying is that THAT patient is, at THAT moment, untreatable by THAT psychiatrist. Read more on The Untreatable Patient?…

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No, mental health care is not what it used to be.  Especially inpatient units.

Even though this is a 2014 article, and British, it may articulate the losses more clearly than anything else I have read recently. Read more on …

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At least I finished reading this article without banging the screen.

Even though the amount of psychotherapy I have time to practice is abbreviated and minimal at best, I am glad I know what I do. Read more on …

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I had never heard of ECT (Electroconvulsive Therapy) until I was about 6 years old and my Bobie, my paternal grandmother of blessed memory, was folding laundry on the living room sofa.

“Your mother thinks you are stupid, ” she told me.  “Your mother actually still thinks that you don’t know that her mother, your other grandmother, is locked up in the crazy-house and that is why you never see her and never will.”

I don’t remember yelling or making any sound at all other than bounding up the stairs to my parents where my mother of blessed memory was folding another bunch of laundry on her own bed.

I told her my grandmother had told me this “stuff” and she hadn’t, and I was not stupid and needed to know exactly what was going on.

I barely got the words out of my mouth before my mother slumped on the bed and started crying like an endless fountain, like nothing I had ever seen and told me that it was true, and she just thought I was too young to understand, and she was going to tell later, when she thought I was ready.

I ran quickly into my room and pulled a book from the shelf on my desk and brought it back to her.  As I pointed out, I was reading “All about the Human Body” which told all about sex and the horrible things men and women had to do together to have a child.

They had signed something special that I was mature enough for this so I ought to be able to hear anything about someone who was sick, especially in my own family.

She brought a photo, 9 by 7 inches or so, of her mom in elegant 1930’s clothes.  She looked well-dressed and sophisticated enough, with curly short hair.

My Mother told me then and there that I couldn’t just hear about the sickness.  I had to hear about the woman.  Her name was Sylvia Gutensky Baver.  She has a gravestone in or near Springfield, Massachusetts.  She was a founder and lifelong fundraiser for the Jewish Home for the Aged of Springfield, Massachusetts.

She wanted more education than she had, always wanting to become a nurse or to work in a clinical laboratory or something like that, but my grandfather of blessed memory always said my grandmother was “just fine,” and since he, illustrious son of a blacksmith who owned a pawn shop, would give her everything she needed and she would be fine.

He had been very limiting with her.  She loved to write songs and stories.  He decided there was no question of her becoming published.

“She would have loved you a lot,” said my mother, “because you got to do all the things nobody ever would let her do.”

My mother told me that she sad sometimes happy, with her music and poems and would dance around the house, but became sullen and withdrawn when my grandfather became home.

It had been some kind of one of those old-fashioned Jewish “arranged marriages,” and it sounded to me as if it were some kind of a recipe for a complete disaster.

My mother could only nod.  She cried another flood.  “Yeah, I guess he pretty much drove her crazy.”

She died a couple months later.  My mother took a quick train trip to Springfield for the funeral.  She didn’t tell me why until after she returned.  She didn’t want to hang around with the rest of her family, who were pretty crazy.

I don’t believe her husband could go.  He was confined, by his profound Alzheimer’s disease, to the Jewish Home for the Aged of Springfield Massachusetts, that bore both a plaque to honor her foundership and a plaque as her memorial.

The irony was not lost on me, even then.

My mother told me briefly, only after her mother’s funeral, that my “Bobie Sylvia” had thoughts about killing herself when she got really depressed and saw it really as the only way to get away from my grandfather.

My grandmother’s treatment in Northampton State Hospital of Massachusetts had precious little actual treatment.  Her “work,” my mother said, was a large gray mat, she would knit and rip out and reknit so she “always had something to do.”  She had “some kind of medicine to knock her out,” and there was, of course, the Electric Shock Therapy or “ECT.”

I read enough to know it had evolved.

I didn’t have any kind of major trauma when a senior preceptor offered to “teach” me how to do this.  I did tell my mother, for I felt a little pride the granddaughter of the shockee was going to become a “shocker.”  I was told it paid better than pharmacology, as there was really not much anyone else could think of that could pass as a “procedure” for surgeon-magnitude building in psychiatry.

I think my mother of blessed memory was more traumatized than I when I told her.  Shouldn’t have told her.

Me, I believed (and in a way still do) that this paradox of life simply confirmed that knowledge could produce power.

Here is a little about the history of the procedure.

In my grandmother’s day, the major risk of the procedure was long bone fractures.  Anesthesia is wildly improved since then.

The person lies still and with one or another position or strength of electrode a “grand mal,” seizure, the kind that can make a body shake largely all over, is induced.  Not physically, for the body remains artificially paralyzed, but it is discretely recorded by a little EEG (electroencephalograph) meant to measure the same.

It is still used — and still works amazingly well — for something nobody seems to understand as well as they think they do.  Here is a modern discussion of the procedure from the Mayo Clinic.

Although depression, bipolar illness, and even psychosis can be treated with this, it is usually necessary to show resistance to pharmacology before getting insurance to pay for this.  Even more of a deterrent is patient mythology and fear.  I have not done this for many, many years, mainly because most patients run like crazy when you mention it.  I would not consider it “controversial,” but there are a few side effects and some folks still think it controversial.

As for the illness, my grandmother Sylvia Gutensky Baver was probably bipolar, as were both my parents and my brother, may all of their memories be blessed.

At one time, I kneeled before the Torah on the sacred Jewish altar, thanking God for having spared me from the effects this illness wrought on their lives.

I have used whatever it is I have got to fight this monster.

I think this is a really big piece of how I became the Renegade Doctor.

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I’m on my way to shoot a video with my dear friend Christelle Tachon that will end up on my new podcast site.  This is actually the second time I will have filmed with Christelle, and the first episode with her is nearly completed in the editing process.

Read more on New Podcast Is Available — Mona Jones, Part 2…