Frontier Psychiatrist Quotes

Kandel argues that when psychotherapy changes people, 'it presumably does so through learning, by producing changes in gene expression that alter the strength of synaptic connections, and structural changes that alter the anatomical pattern of interconnections between nerve cells of the brain.' Psychotherapy works by going deep into the brain and its neurons and changing their structure by turning on the right genes. Psychiatrist Dr. Susan Vaughan has argued that the talking cure works by 'talking to neurons,' and that an effective psychotherpist or psychoanalyst is a 'microsurgeon of the mind' who helps patients make needed alterations in neuronal networks.

Internal medicine doctors know the functions of the kidneys. They don’t confuse protective defenses such as cough and pain with diseases such as pneumonia and cancer. Psychiatrists lack a similar framework for the utility of stress, sleep, anxiety, and mood, so psychiatric diagnostic categories remain confusing and crude.

In the past few decades, we have witnessed an explosion of information about death and the afterlife, generated by an ever-growing number of psychologists and psychiatrists, physicians, hospice nurses and bereavement counselors, near-death experiencers, researchers in parapsychology, and, of course, mediums, who are working toward a better understanding of the world to come. This is one of many signs that the human race is poised to enter a new era, an era I would call a revolution in consciousness. Another sign is that belief in survival after death is on the rise, up to 89 percent according to some surveys.7 In Western countries, more and more people believe in a kinder hereafter. Instead of hell they expect joy, reunion with loved ones, and the complete absence of pain and worry. As concepts of the afterlife are inextricable from concepts of the Divine, when one changes, so does the other. Predictably, the fear-inspiring God of old is giving way to a more abstract Supreme Being whose laws are written in the spirit of love, compassion, and forgiveness rather than judgment.

The problem is not merely theoretical. A psychiatrist in training concluded a grand rounds case presentation by saying, “This patient has sleep problems, low interest, low energy, poor concentration, low appetite, and a seven-pound weight loss, so she qualifies for a diagnosis of major depression. We will begin antidepressant treatment.” When asked, “What set this all off?” the young doctor replied, “Family problems.” “What kind of family problems?” “Her husband left her.” Did she see warning signs about his leaving? Don’t know. Was this her first marriage? Don’t know. Does she have a relationship with another man? Don’t know. Was she abused in childhood? “I didn’t ask about those things because they aren’t relevant. The diagnosis is major depression, and the treatment plan follows established evidence-based guidelines for this brain disorder.” The excessive confidence in and commitment to a narrow ideology were as breathtaking as the willful ignorance about the patient.

Psychiatrists are supposed to help their patients get in touch with things they are trying to avoid.