Anosognosia revisited

Over a decade ago, I noticed a new term cropping up in psychiatry: anosognosia. Actually, it was an old term, coined a century earlier by neurologists to describe a behavioral sign in certain types of brain damage. But by the time I took notice, this mouthful of a word was doing double duty. In […]

Palliative psychiatry

The application of palliative care to intractable psychiatric disorders has been debated at least since 2010, when a journal article reported that a patient with severe anorexia nervosa died in hospice, after referral there by her psychiatrist.  The New York Times published a thought-provoking article earlier this year on the same topic: whether we […]

“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 […]

Are psychiatric disorders brain diseases?

Some maladies that attract psychiatric attention are unequivocally brain diseases. Huntington’s disease. Brain tumors. Lead poisoning. However, these are not psychiatric diseases. Huntington’s is a genetic abnormality diagnosed and treated by neurologists. Brain tumors are managed by neurosurgeons and oncologists. Lead toxicity is treated by internal medicine. Indeed, a long list of medical and surgical […]


As we grow into adulthood, each of us develops a personal comfort zone located on the continuum between paranoia and gullibility. A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between. Mental health professionals are no exception, and it shows in our work. Is a […]

Parenting medical disruptors

Popularized telemedicine — that is, teleconferencing with a physician over one’s smartphone — worries many critics because it assumes patients can be evaluated without a physical exam. The critics are right that those with a financial interest in “disrupting” health care typically minimize the trade-offs. Convenience and lower cost are trumpeted, while risks of misdiagnosis […]

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 […]