Choose your actions, not your feelings

Again and again in therapy I find myself emphasizing the distinction between feeling an emotion and acting on it. Many patients, and non-patients too, take undue responsibility for their emotions, as though feelings were volitional behaviors, the result of a choice. Often there is a stated or implied should: “I should feel this, not that.” […]

Behavioral science versus moral judgment

George S. Patton, Jr. commanded the Seventh United States Army, and later the Third Army, in the European Theater of World War II. General Patton, a brilliant strategist as well as larger-than-life fount of harsh words and strong opinions, was also infamous for confronting two soldiers diagnosed with “combat fatigue” — now known as post-traumatic […]

Defining the competent psychiatrist

What defines a competent psychiatrist? To staunch critics of the field, perhaps nothing. Some believe psychiatry has done far more harm than good, or has never helped anyone, rendering moot the question of competency. What defines a competent buffoon? A skillful brute? An adroit half-wit? Having just finished Robert Whitaker’s Anatomy of an Epidemic: Magic […]

Between medical paternalism and servility

Even today there are patients who leave diagnosis and treatment entirely to their doctors. They make no effort to inform themselves about their illness or chart their own course; they do whatever their doctors advise. Once the norm, this passive, willfully naive attitude has withered in the face of a multigenerational attitude shift, coupled with […]

On responsibility

I’ll leave the “sloppy thinking” series for now, although I expect to return to it in the future. In this post I’ll share some thoughts about personal responsibility, especially as it pertains to the insanity defense. It’s a topic much in the news lately, due to tragic actions by now-household names such as James Eagan […]