“Being with” patients in the office and online

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

Retronyms, teletherapy, and implicit bias

What is a retronym?

 Retronyms are adjectival qualifiers, like “acoustic” guitar and “snail” mail, that were previously unneeded — because all guitars were acoustic and all mail was slow.  We only added qualifiers when alternatives arose.  As these two examples illustrate, retronyms can be nearly neutral — the status and popularity of acoustic and […]

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 […]

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 […]

Verbal neuromodulation: old wine in a new bottle

Neuromodulation is a hotly studied field.  Research groups worldwide are exploring genetic and epigenetic modulators, inflammatory processes, optogenetics, dietary effects, and other modalities.  Although neuromodulation can influence many non-psychiatric conditions, one tantalizing hope is that by modifying critical brain physiology and the connectome we may someday attack the root causes of mental illness, a […]

Dialectics in psychotherapy

The word “dialectic” has a long history, from ancient Greek philosophers, through Hegel and Marx, and to the present day. Its meaning has changed over the centuries, and according to different thinkers. In psychotherapy, “dialectic” is almost wholly associated with dialectical behavior therapy (DBT), where the term identifies a particular type of treatment — […]

"Evidence based" psychotherapy

When a mental health clinic, online referral service, or private practice offers “evidence based” psychotherapy, that certainly sounds like a selling point.  It suggests solid science supports the therapy offered — and that competing services lack this support.  But what does this phrase really mean?

“Evidence based medicine” first appeared in the medical literature […]