Returning to the office

I finally returned to my office after a year and a month. Or more accurately, since I was in my office all along making video calls, it’s some of my patients who returned.

Two weeks ago the CDC issued new guidelines: people vaccinated against COVID-19 can meet safely inside without masks. The guidelines appear […]

Does psychiatry add to political discourse?

Quick, grab a weapon!

Millions of alarmed Americans, and people the world over, grabbed the nearest bludgeon to fend off the Trump presidency. They reached for anything handy: street marches, sympathetic pundits, counter-tweets, progressive infotainment, social media. Unfortunately, most of these reactions only fed a vicious cycle of attack and counter-attack.

For the relatively […]

HIPAA-compliant email: a review

The problem

In the months since the COVID-19 pandemic forced me to practice by video and phone, I’ve exchanged much more email with patients than I did before. Previously, I discouraged email from patients. For one thing, I knew it was an insecure channel, not “HIPAA-compliant.” It’s also somewhat less personal than a phone […]

COVID-19 neurosis

Back when traumatic experiments on animals weren’t ethically prohibited, human anxiety was modeled by subjecting lab animals to an irresolvable approach/avoidance dilemma. The oldest and best known example came from researchers in Ivan Pavlov’s laboratory. They classically conditioned dogs to associate food rewards with the sight of a circle, and also trained the same […]

COVID-19 risk tolerance and therapy

I’m increasingly asked by patients and potential patients when I plan to see people in the office again. I had been an exclusively “in person” psychiatrist and psychotherapist until mid-March of this year, when the pandemic forced even skeptics like me to convert completely to remote (“virtual”) treatment. Like many of my colleagues, over […]

Antisocial masking disorder

Features of Antisocial Masking Disorder include:

Violation of the physical or emotional rights of othersIrritability and aggressionLack of remorseConsistent irresponsibilityRecklessness

(Adapted from DSM 5 Antisocial Personality Disorder)

Whew, that was fun.  Those guys are crazy.  

But let’s be fair and make some distinctions.  At one extreme are those who deny reality.  A few […]

Online therapy revisited, thanks to COVID-19

It was 2013. Hi-tech entrepreneurs were excitedly “disrupting” industries, bringing goods and services closer to users. Uber replaced cabs, Kickstarter replaced investors, and telehealth companies offered convenient, at-home medical care over smartphone video. Why waste time going to an office or clinic, especially if you’re not feeling well? Why spend so much money? The […]