Who are our villains?

Last week I met with a patient of mine. He’s a sweet, kind middle-aged man without a hostile bone in his body. He and his brother both have schizophrenia. Both of them fear psychosis and cooperate fully with psychiatric care to keep it at bay. My patient is the higher functioning of the two, […]

Gus Walz: lost in the culture wars

A Target of Ridicule

When Governor Tim Walz accepted the Democratic nomination for vice president, his son Gus, 17, was overcome with emotion and wept on national television. Punditry about this was quite mixed. Commenters on the right ridiculed the young man as a “puffy beta male,” a “blubbering bitch boy,” and “weird,” […]

Political advocacy and psychotherapy don’t mix

Two senses of “psychotherapy is political” are often conflated.  The first is the notion, popular lately, that psychotherapy either allows or demands political advocacy in the therapy room itself.  The other is recognition that political factors influence the nature and practice of psychotherapy.  It is a conceptual error to confuse the two, and a […]

Making an AI dynamic therapist

Currently, therapy apps featuring a nonhuman “therapist” aim fairly low at best, and at worst willfully mislead the public.  However, the advent of large language models (LLMs) such as ChatGPT-4 brings exciting potential for genuine depth psychotherapy delivered by AI — and many challenges and potential pitfalls as well. 

Since “therapy” has no precise […]

Dr. Tom Insel scorns traditional psychotherapy

When one of America’s most prominent psychiatrists expresses deep disdain for depth psychotherapy, especially when that criticism is misinformed and hopelessly outdated, it should concern all of us.

Dr. Tom Insel directed the National Institute for Mental Health (NIMH) from 2002 to 2015.  Formerly a psychiatric researcher “at the cellular level,” he studied medications […]

Psych jargon as media hype

Hype cuts through the noise to reach a jaded public. It’s common to use psychological terms, especially related to trauma and abuse. What are the pitfalls? […]

“Being with” patients in the office and online

Is there more “presence” during online therapy, or in the office — even while wearing masks? […]