HIPAA-compliant email revisited

In January 2021, I described my search for a HIPAA-compliant email provider for my practice, and reviewed several options. In the end I chose Hushmail for Healthcare. It was, and is, a good service: thoughtfully featured, reasonably priced (with minor changes since then), and fast support when needed. But the truth is, I didn’t […]

Psychiatry's hubris

Is it fair to take a balanced, well researched critique of psychiatry, and use it as a springboard for polemics? It wouldn’t be the first time. This week, in reviewing Anne Harrington’s upcoming book, Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness, psychiatric critic Gary Greenberg champions the measured points made […]


“60 Minutes” ran a segment last Sunday on electroconvulsive therapy (ECT), better known as shock treatment. Kitty Dukakis was interviewed as a long-time recipient and advocate of ECT for her severe depression. The piece was almost entirely positive, save for brief mention of memory loss as an unfortunate side-effect. This was soon left behind by […]

Does severe remorse require a specialist?

In her recent New Yorker article, “The Sorrow and the Shame of the Accidental Killer,” author Alice Gregory claims there are no self-help books for anyone who has accidentally killed another person. Nor published research, therapeutic protocols, publicly listed support groups, nor therapists who specialize in their treatment. She profiles several such tormented souls who […]

The high-risk psychiatric patient

A woman recently requested a medication evaluation at the suggestion of her psychotherapist. The caller told me her diagnosis was borderline personality disorder. She hoped medication might ease her anxiety. She also admitted that two other psychiatrists refused to see her because she was too “high risk.” I asked if she was suicidal. Yes, thoughts […]

Psychodynamically informed clinical work

In a world of diverse mental health treatments and treatment settings, psychoanalysis and psychodynamic psychotherapy have lost their former prominence. Only a small fraction of patients have the time, money, and interest to engage in long-term, open-ended mental exploration — even if doing so would get to the root of their problems and lead to […]

“Brain disease”: the anti-psychiatrists respond

I don’t avoid reading opinions strongly critical of psychiatry. They help sharpen my reasoning skills. It’s always possible they might alter my views in some way. And like most everyone, I consider myself openminded and receptive to criticism. However, after years of reading Thomas Szasz, Robert Whitaker, and the screeds of the less articulate, after […]