Psychiatric Best Quotes

Let me tell something, seeing your name and psychiatric ward on the same piece of paper isn't the best way to start your day.

And if we do speak out, we risk rejection and ridicule. I had a best friend once, the kind that you go shopping with and watch films with, the kind you go on holiday with and rescue when her car breaks down on the A1. Shortly after my diagnosis, I told her I had DID. I haven't seen her since. The stench and rankness of a socially unacceptable mental health disorder seems to have driven her away.

It just begged the question: If it took so long for one of the best hospitals in the world to get to this step, how many other people were going untreated, diagnosed with a mental illness or condemned to a life in a nursing home or a psychiatric ward?

The great unspoken paradox of the arduous process of psychoanalysis is that the best patients are the ones who never really needed it in the first place. Abnormal

Mental disorders should be diagnosed only when the presentation is clear-cut, severe, and clearly not going away on its own. The best way to deal with the everyday problems of living is to solve them directly or to wait them out, not to medicalize them with a psychiatric diagnosis or treat them with a pill.

What I aim to do here is to deliver in plain English the inspiring science connecting exercise and the brain and to demonstrate how it plays out in the lives of real people. I want to cement the idea that exercise has a profound impact on cognitive abilities and mental health. It is simply one of the best treatments we have for most psychiatric problems.

The uncomfortable, as well as the miraculous, fact about the human mind is how it varies from individual to individual. The process of treatment can therefore be long and complicated. Finding the right balance of drugs, whether lithium salts, anti-psychotics, SSRIs or other kinds of treatment can be a very hit or miss heuristic process requiring great patience and classy, caring doctoring. Some patients would rather reject the chemical path and look for ways of using diet, exercise and talk-therapy. For some the condition is so bad that ECT is indicated. One of my best friends regularly goes to a clinic for doses of electroconvulsive therapy, a treatment looked on by many as a kind of horrific torture that isn’t even understood by those who administer it. This friend of mine is just about one of the most intelligent people I have ever met and she says, “I know. It ought to be wrong. But it works. It makes me feel better. I sometimes forget my own name, but it makes me happier. It’s the only thing that works.” For her. Lord knows, I’m not a doctor, and I don’t understand the brain or the mind anything like enough to presume to judge or know better than any other semi-informed individual, but if it works for her…. well then, it works for her. Which is not to say that it will work for you, for me or for others.

As work continued, an important qualifier emerged. Low serotonin didn’t predict premeditated, instrumental violence. It predicted impulsive aggression, as well as cognitive impulsivity (e.g., steep temporal discounting or trouble inhibiting a habitual response). Other studies linked low serotonin to impulsive suicide (independent of severity of the associated psychiatric illness).107

Leftist university professors in Western Europe and the United States have also been agitated about one other country’s wars—Israel’s. Hence the numerous attempts by Leftist professors at Western universities to boycott Israeli professors and universities. But, of course, Chinese professors and universities are not only exempt from boycotts; they are enthusiastically sought after despite the lack of elementary freedoms in China, the Chinese government’s incarceration of dissidents in psychiatric wards, the decimation of much of Tibetan culture, and the increasing Chinese occupation of that ancient country.

just begged the question: If it took so long for one of the best hospitals in the world to get to this step, how many other people were going untreated, diagnosed with a mental illness or condemned to a life in a nursing home or a psychiatric ward? CHAPTER 30 RHUBARB By my twenty-fifth day in the hospital, two days after the biopsy, with a preliminary diagnosis in sight, my doctors thought it was a good time to officially assess my cognitive skills to record a baseline.

I have no aspiration here to reclaim mystery and paradox from whatever territory they might inhabit, for there is, indeed, often a killing in a kiss, a mercy in the slap that heats your face . . . There is, nevertheless, a particular poverty in those alloplasts who, addressing tragedy, seek to subdistinguish motives beyond those we have best, because nearest, at hand, and so it is with love and hate--emotions upon whose necks, whether wrung or wreathed, may be found the oldest fingerprints of man. A simple truth intrudes: the basic instincts of every man to every man are known. But who knows when or where or how? For the answers to such questions, summon Augurello, your personal jurisconsult and theological wiseacre, to teach you about primal reality and then to dispel those complexities and cabals you crouch behind in this sad, psychiatric century you call your own. It is the anti-labyrinths of the world that scare. Here is a story for you. Your chair.

Among the factors that the schema of the differing severity of mental illness fails to take into account is an ephemeral something in the individual patient which might be called 'a will to grow.' It is possible for an individual to be extremely ill and yet at the same time possess an equally strong 'will to grow,' in which case healing will occur. On the other hand, a person who is only mildly ill, as best as we can define psychiatric illness, but who lacks the will to grow, will not budge an inch from an unhealthy position. I therefore believe that a patient's will to grow is one crucial determinant of success or failure of psychotherapy. Yet it is a factor that is not at all understood or even recognized by contemporary psychiatric theory.

Hormonal responses to various fetal and childhood experiences have epigenetic effects on genes related to the growth factor BDNF, to the vasopressin and oxytocin system, and to estrogen sensitivity. These effects are pertinent to adult cognition, personality, emotionality, and psychiatric health. Childhood abuse, for example, causes epigenetic changes in hundreds of genes in the human hippocampus.

Since it morphed from “battle fatigue” or “shell shock” into a formal psychiatric illness, combat PTSD has been framed as a result of the sheer terror of being under attack, of someone trying to kill you and those around you. As we’ve seen, it is an illness where fear conditioning is overgeneralized and pathological, an amygdala grown large, hyperreactive, and convinced that you are never safe. But consider drone pilots—soldiers who sit in control rooms in the United States, directing drones on the other side of the planet. They are not in danger. Yet their rates of PTSD are just as high as those of soldiers actually “in” war. Why? Drone pilots do something horrifying and fascinating, a type of close-range, intimate killing like nothing in history, using imaging technology of extraordinary quality. A target is identified, and a drone might be positioned invisibly high in the sky over the person’s house for weeks, the drone operators always watching, waiting, say, for a gathering of targets in the house. You watch the target coming and going, eating dinner, taking a nap on his deck, playing with his kids. And then comes the command to fire, to release your Hellfire missile at supersonic speed.

It’s joyful to know you could be diagnosed with a mental disorder but to opt out, to say yes to yourself instead, to have the patience and care to resist the label that never got you anywhere before, that was voted into existence as an illness, that simply isn’t helpful in looking at your life. Nothing tastes sweeter than inching toward self mastery, self intimacy, the progress that comes slowly over a long period of taking good care of yourself, the very best way you know how to, and very imperfectly at that.

I believe the perception of what people think about DID is I might be crazy, unstable, and low functioning. After my diagnosis, I took a risk by sharing my story with a few friends. It was quite upsetting to lose a long term relationship with a friend because she could not accept my diagnosis. But it spurred me to take action. I wanted people to be informed that anyone can have DID and achieve highly functioning lives. I was successful in a career, I was married with children, and very active in numerous activities. I was highly functioning because I could dissociate the trauma from my life through my alters. Essentially, I survived because of DID. That's not to say I didn't fall down along the way. There were long term therapy visits, and plenty of hospitalizations for depression, medication adjustments, and suicide attempts. After a year, it became evident I was truly a patient with the diagnosis of DID from my therapist and psychiatrist. I had two choices. First, I could accept it and make choices about how I was going to deal with it. My therapist told me when faced with DID, a patient can learn to live with the live with the alters and make them part of one's life. Or, perhaps, the patient would like to have the alters integrate into one person, the host, so there are no more alters. Everyone is different. The patient and the therapist need to decide which is best for the patient. Secondly, the other choice was to resist having alters all together and be miserable, stuck in an existence that would continue to be crippling. Most people with DID are cognizant something is not right with themselves even if they are not properly diagnosed. My therapist was trustworthy, honest, and compassionate. Never for a moment did I believe she would steer me in the wrong direction. With her help and guidance, I chose to learn and understand my disorder. It was a turning point.

From the year of his death, 1963, to the publication of Rosenhan’s study in 1973, the total resident population in state and county psychiatric hospitals dropped by almost 50 percent, from 504,600 to 255,000. Ten years later, the US psychiatric population would drop another 50 percent to 132,164. Today 90 percent of the beds available when JFK made his speech have closed as the country’s population has nearly doubled. Trouble is, for all of its idealism and promise, the dreams of community care were never actualized because the funds never materialized. The money was intended to follow the patients. It didn’t. The community care model at its very best provided nominal care to the least impaired. Those with the most severe forms of these disorders were ignored or cast aside.

In 1978, an activist named Judi Chamberlin published one of the movement's most revered manifestos called 'On Our Own: Patient-Controlled Alternatives to the Mental Health System.' Chamberlin had been diagnosed with a mental illness and found traditional psychiatric intervention unhelpful and even traumatic. She did recover, however, and she credited that recovery to an alternative mental health care facility she stayed at in Canada. Chamberlin and many other madness pride activists believe that people with 'lived experience' should not only have a proverbial seat at the table when it comes to the creation of mental health care systems, but that such people are uniquely equipped to understand what constitutes the best treatment. A slogan Chamberlin sought to make famous was 'Nothing about us without us.

games. A summary: Exposing children to a violent TV or film clip increases their odds of aggression soon after.41 Interestingly, the effect is stronger in girls (amid their having lower overall levels of aggression). Effects are stronger when kids are younger or when the violence is more realistic and/or is presented as heroic. Such exposure can make kids more accepting of aggression—in one study, watching violent music videos increased adolescent girls’ acceptance of dating violence. The violence is key—aggression isn’t boosted by material that’s merely exciting, arousing, or frustrating. Heavy childhood exposure to media violence predicts higher levels of aggression in young adults of both sexes (“aggression” ranging from behavior in an experimental setting to violent criminality). The effect typically remains after controlling for total media-watching time, maltreatment or neglect, socioeconomic status, levels of neighborhood violence, parental education, psychiatric illness, and IQ. This is a reliable finding of large magnitude. The

ever. Amen. Thank God for self-help books. No wonder the business is booming. It reminds me of junior high school, where everybody was afraid of the really cool kids because they knew the latest, most potent putdowns, and were not afraid to use them. Dah! But there must be another reason that one of the best-selling books in the history of the world is Men Are From Mars, Women Are From Venus by John Gray. Could it be that our culture is oh so eager for a quick fix? What a relief it must be for some people to think “Oh, that’s why we fight like cats and dogs, it is because he’s from Mars and I am from Venus. I thought it was just because we’re messed up in the head.” Can you imagine Calvin Consumer’s excitement and relief to get the video on “The Secret to her Sexual Satisfaction” with Dr. GraySpot, a picture chart, a big pointer, and an X marking the spot. Could that “G” be for “giggle” rather than Dr. “Graffenberg?” Perhaps we are always looking for the secret, the gold mine, the G-spot because we are afraid of the real G-word: Growth—and the energy it requires of us. I am worried that just becoming more educated or well-read is chopping at the leaves of ignorance but is not cutting at the roots. Take my own example: I used to be a lowly busboy at 12 East Restaurant in Florida. One Christmas Eve the manager fired me for eating on the job. As I slunk away I muttered under my breath, “Scrooge!” Years later, after obtaining a Masters Degree in Psychology and getting a California license to practice psychotherapy, I was fired by the clinical director of a psychiatric institute for being unorthodox. This time I knew just what to say. This time I was much more assertive and articulate. As I left I told the director “You obviously have a narcissistic pseudo-neurotic paranoia of anything that does not fit your myopic Procrustean paradigm.” Thank God for higher education. No wonder colleges are packed. What if there was a language designed not to put down or control each other, but nurture and release each other to grow? What if you could develop a consciousness of expressing your feelings and needs fully and completely without having any intention of blaming, attacking, intimidating, begging, punishing, coercing or disrespecting the other person? What if there was a language that kept us focused in the present, and prevented us from speaking like moralistic mini-gods? There is: The name of one such language is Nonviolent Communication. Marshall Rosenberg’s Nonviolent Communication provides a wealth of simple principles and effective techniques to maintain a laser focus on the human heart and innocent child within the other person, even when they have lost contact with that part of themselves. You know how it is when you are hurt or scared: suddenly you become cold and critical, or aloof and analytical. Would it not be wonderful if someone could see through the mask, and warmly meet your need for understanding or reassurance? What I am presenting are some tools for staying locked onto the other person’s humanness, even when they have become an alien monster. Remember that episode of Star Trek where Captain Kirk was turned into a Klingon, and Bones was freaking out? (I felt sorry for Bones because I’ve had friends turn into Cling-ons too.) But then Spock, in his cool, Vulcan way, performed a mind meld to determine that James T. Kirk was trapped inside the alien form. And finally Scotty was able to put some dilithium crystals into his phaser and destroy the alien cloaking device, freeing the captain from his Klingon form. Oh, how I wish that, in my youth or childhood,

Our society always wants to believe in cures by the “magic” pill, but I have found from my years of experience in treating psychiatric and sexual issues that it is even better if a patient never has to take medication.

In the introduction to my 2001 best-selling book Beyond Prozac, I wrote that within so-called developed societies, much emotional and psychological distress has for decades been re-packaged as ‘mental disorders’. I wrote that I would refer to ‘mental illness/mental disorders’ within inverted commas, to illustrate ‘my disquiet at the widespread acceptance of these terms without debate about what the terms mean and what might be better words to use’.[3] I added that the experiences themselves were real and valid in their own right. This situation continues to this day. None of the psychiatric diagnoses have any scientific validity.[4] Throughout this book series therefore, I also use inverted commas when referring to these commonly accepted concepts. I do this to signify that these are not what they are claimed to be; they are not verified medical illnesses.

Psychiatric diagnosis is at best a common language, and current categories should not be treated as “real.

we neglect what are the best forms of prevention—i.e., promoting exercise, proper diet, moderation in alcohol use, abstention from tobacco and drugs. These extremely useful and remarkably cheap prevention measures aren’t profitable for the medical-industrial complex and therefore lack its powerful and well-financed sponsorship.

When I started school, I began to see less of her. More and more, I noticed my father encouraging me to spend time with the Hudsons, old family friends. Then when I was nine, he finally sent Camilla away. I don’t even remember saying goodbye to her, and I never visited her. My father thought it best that I didn’t. She’d cracked and lost her mind, he’d said. But he’d reassured me that the doctors at her psychiatric hospital were some of the best in the world. Truth be told, I didn’t ever feel the urge to track her down. After she moved out, I thought

To differentiate between symptoms of depression and anxiety secondary to ME/CFS and psychiatric disorders, ask the patient what they will do the next time they have a “good day”. A patient with ME/CFS will have a long list of ideas whereas a patient with major depressive disor- der will say they can not think of anything they enjoy any more. Patients with an anxiety disorder will have a list of reasons why they won’t be able to do or enjoy the activities.

Had psychiatry got the causal direction wrong, and it was sleep disruption instigating mental illness, not the other way around? No, I believe that is equally inaccurate and reductionist to suggest. Instead, I firmly believe that sleep loss and mental illness is best described as a two-way street of interaction, with the flow of traffic being stronger in one direction or the other, depending on the disorder. I am not suggesting that all psychiatric conditions are caused by absent sleep. However, I am suggesting that sleep disruption remains a neglected factor contributing to the instigation and/or maintenance of numerous psychiatric illnesses, and has powerful diagnostic and therapeutic potential that we are yet to fully understand or make use of.

News of the verdicts brought a marked change in Rogers. He became almost obsessive in his desire to discuss the fire on the Morro Castle. Increasingly, he dwelt on how the blaze had been set. Doyle began to keep a record of his assistant’s statements. Finally, he noted: “George knows that I know he set fire to the Morro Castle.” Doyle decided to wait. He knew that what Rogers had told him was not strong enough to obtain a conviction. If questioned, Rogers could always escape by pleading idle boasting, something his police colleagues knew he was capable of. Vincent Doyle told no one of his suspicions. But he continued to question Rogers on every aspect of the Morro Castle disaster, and began to form a picture of Rogers which was remarkably in tune with later psychiatric reports. The strange cat-and-mouse questioning went on until early March 1938. Then, on March 3, a quiet Thursday afternoon, Doyle and Rogers sat down for yet another discussion on the peculiar fate of the Morro Castle. At the end of it Doyle knew “exactly how Rogers set the fire. He told me how to construct an incendiary fountain pen; how it had been placed in the writing-room locker’.” Doyle wondered how best to present his sensational evidence to his superiors. He was still worrying over it next afternoon when he met Rogers outside the police radio department. Rogers seemed pensive and withdrawn. “There’s a package for you,” said Rogers. Doyle nodded and went into the department. Rogers remained just outside the doorway. On the workbench was a package. Doyle unwrapped it and found a heater for a fish tank. There was nothing unusual in that; from time to time Doyle used the department’s facilities to repair electrical equipment for his colleagues. Attached to the fish tank was a typed label: This is a fish-tank heater. Please install the switch in the line cord and see if the unit will work. It should get slightly warm.

I was standing by the door wearing my smartest and best ‘I am psychiatrically A1’ expression.

Large-scale studies of thousands of youth show that the average anxiety level of a young person now exceeds the levels recorded by hospitalized psychiatric patients in the 1950s.

Our classification of mental disorders is no more than a collection of fallible and limited constructs that seeks but never finds the truth - but this remains our best current way of communicating about, treating, and researching mental disorders. [...] It is good to know and use the DSM definitions, but not to reify or worship them.

[D]iagnosis needed to rest in order to let research catch up. It made no sense to keep rearranging the furniture of descriptive psychiatry, creating new diagnoses or altering the thresholds of existing ones, based only on the whims of the experts who happened to be in the room. [...] Changes in diagnoses should be few and far between until we gained much deeper understanding of what causes the mental disorders and how best to define and treat them.

The mental health field also maintains authority through selectivity of its members and suppressed dissent. There is a pretense of certainty propagated by leaders in mental health, with oft repeated promises of supporting evidence to be discovered soon; it is taken for granted that their authoritative stance is merited. Despite this political posturing, several areas of concern actually leave much to question, for instance: it is rare for findings to be replicated (Open Science Collaboration, 2015), with only about 3% of journals even being willing to accept articles attempting to repeat previous studies to see if their findings were more than just a fluke (Martin & Clarke, 2017); the peer -review process of journals is biased toward recognizable names and against newcomers or detractors (Bravo, Farjam, Grimaldo Moreno, Birukou, & Squazzoni, 2018), setting up a sort of “good ol’ boys’ club” dynamic; the rates of authors retracting their studies due to problems or false findings are rapidly rising (Steen, Casadevall, & Fang, 2013); the subjects used in studies are consistently biased (Nielsen, Haun, Kartner, & Legare, 2017) and based on samples that are among the least representative of humans, in general (e.g., Arnett, 2008); spurious and meaningless correlations are frequently reported as exciting new discoveries (see Richardson, 2017); gold-standard “evidence-based treatments” are, on average and at best, only helpful for about 25% of people (Shedler, 2015); selective reporting, guild interests, and researcher allegiance heavily bias psychiatric research (Leichsenring et al., 2017; Whitaker & Cosgrove, 2015); and, perhaps most important, with all the purported advances in treatment, the prevalence and long-term outcomes of diagnosable mental disorders has not decreased in the last century (Jorm, Patten, Brugha, & Mojtabai, 2017; Margraf & Schneider, 2016), while disability rates continue to rise exponentially (see Whitaker, 2010 for an analysis on this trend).

The truth is, wanting to harm or kill someone is a common part of the human mental circus. While there are some moral saints out there who have never wished ill on anyone, twenty percent of human beings have weighed the pros and cons of killing someone at some point in their lives. Five percent have the moral flexibility to act on the possibility. A tenth of a percent obsess over it, and the best intentioned of those seek psychiatric help with their fixation.

A year later, Maurice Rappaport at the University of California in San Francisco announced results that told the same story, only more strongly so. He had randomized eighty young newly diagnosed male schizophrenics admitted to Agnews State Hospital into drug and non-drug groups, and although symptoms abated more quickly in those treated with antipsychotics, both groups, on average, stayed only six weeks in the hospital. Rappaport followed the patients for three years, and it was those who weren’t treated with antipsychotics in the hospital and who stayed off the drugs after discharge that had—by far—the best outcomes. Only two of the twenty-four patients in this never-exposed-to-antipsychotics group relapsed during the three-year follow-up. Meanwhile, the patients that arguably fared the worst were those on drugs throughout the study. The very standard of care that, according to psychiatry’s “evidence base,” was supposed to produce the best outcomes had instead produced the worst. “Our findings suggest that antipsychotic medication is not the treatment of choice, at least for certain patients, if one is interested in long-term clinical improvement,” Rappaport wrote. “Many unmedicated-while-in-hospital patients showed greater long-term improvement, less pathology at follow-up, fewer rehospitalizations, and better overall functioning in the community than patients who were given chlorpromazine while in the hospital.

Everyone hates the Bulgarians. The UN pays countries cash to send soldiers on peacekeeping missions. When the Soviet Union collapsed, Bulgaria lost its subsidies and was broke. The Bulgarian government wanted money but didn’t want to send their best-trained troops. So, the story goes, they offered inmates in the prisons and psychiatric wards a deal: put on a uniform and go to Cambodia for six months, you’re free on return. All you have to do is stand guard and give away food, they said, the UN is not a real military. A battalion of criminal lunatics arrives in a lawless land. They get drunk as sailors, rape vulnerable Cambodian women, and crash their UN Land Cruisers with remarkable frequency.

Psychiatric services are presented with two kinds of people: those who most want attention, and those who most need it. I'm too afraid to look into the evidence about which kind of person is most likely to receive it.

Second Week Of June 2012 I agreed to be Dr. Arius’ case study. In my reply to the psychiatrist, I wrote: Good Day Dr. A. I’m surprised and flattered that you consider me an appropriate candidate to conduct a case study on my unique E.R.O.S., Bahriji, elite Arab Household, and secondary school experiences. As much as I am delighted to agree to your proposed challenge and to answer your questionnaires to the best of my abilities, I also have questions for you for which I would like answers before being an active participant in the survey. * Are you planning to publish professional psychiatric papers and publications to your findings? Or are you working on this project solely for your personal interest? * If your research reveals a positive alternative to the current accepted educational norm, are you planning to actively advocate for change? As you are aware, I can only provide you with my personal opinion on my educational experiences. I cannot speak for other  E.R.O.S. members. Before I agree to undergo this case study, I wish to make it very clear that I only speak for myself. Under no circumstances will I undermine to reveal the actual names of people and places, or jeopardize their society and individual standing in any way. I am obligated to honor my oath of confidentiality and pledge never to reveal the true identity of the clandestine society. As long as you are aware of my pledge, I am happy to answer your questions to the best of my ability. Although I have not known you for very long, I consider you a trusted friend. My intuition tells me you are a man of integrity. I have always trusted my inner voice and it has never failed me. I look forward to your next correspondence and your answers to my questions. I hope all is going splendidly in your part of the world. Keep me posted on the progress of your gay organization. It is good to receive your emails as always. Yours truly, Young.

Mid June 2012 …Young, as time passed, I missed you more than ever. My exasperation with Toby festered with each passing day. When I finally could not tolerate our tempestuous relationship, I confronted the young man. After a heated emotional argument, Toby left our unfinished discussion in a state of vexation. I did not realize he was using the age-old psychological threat of overdosing himself to obtain my attention. I found him unconscious, foaming at the corner of his mouth from consuming an entire bottle of sleeping pills. He was rushed to hospital. I would not have been able to live with my guilt if Toby had died. He recovered from this ordeal, but my respect for him had plummeted. Instead of loving him, I felt sorry and pitied him. This was a malignant sign of what was to come. To appease him, we often kissed and made up after impassioned disputes. I made false promises that I had no intention of keeping. These desolate pledges soon dissolved into self-abhorrence. I had allowed myself to be trapped into a situation, and I could not figure out a solution. Throughout this ordeal, I threw myself into my engineering studies, channeling my unhappiness into what I enjoyed best. I could not give myself fully to the boy, and had little respect for him. When we made love, I shut him out. Instead, I saw you in our sexual liaisons. Toby was merely a vehicle to satisfy my sexual desires to be with you. Throughout the years we were together, it was you I made love to, not Toby or anyone else. I could not and would not release you from my mind. The pain of losing you was too oppressive, until the fateful day I suffered a nervous breakdown. I ended up in a hospital, in the psychiatric ward. Aria and Ari came to nurse me back to health. Aria stayed for two weeks until I could commence classes again. I knew I had to get away from this toxic relationship. The day I graduated I enrolled in a postgraduate program in Alberta, Canada. I desired to be as far away from New Zealand as possible; I needed to be away from Toby and to find myself again. I finally had a solid and legitimate excuse to separate from the boy. I was glad when Toby’s parents demanded their son’s return to the Philippines after his graduation so that he could take over his father’s business. Toby did not wish to return to Manila, but had no choice. His father threatened to cut off his financial support if he did not return. Thanks to universal intervention, my freedom was restored. I began a new life in Canada. That, my dearest Young, was the beginning of a new chapter in my life. The rest will be revealed to you in our next correspondence. For now, be happy, be well, and most importantly, be you at all times: the Young whom I love and cherish. Andy, Xoxoxo

The beauty of poker is that while luck is always involved, luck doesn’t dictate the long-term results of the game. A person can get dealt terrible cards and beat someone who was dealt great cards. Sure, the person who gets dealt great cards has a higher likelihood of winning the hand, but ultimately the winner is determined by—yup, you guessed it—the choices each player makes throughout play. I see life in the same terms. We all get dealt cards. Some of us get better cards than others. And while it’s easy to get hung up on our cards, and feel we got screwed over, the real game lies in the choices we make with those cards, the risks we decide to take, and the consequences we choose to live with. People who consistently make the best choices in the situations they’re given are the ones who eventually come out ahead in poker, just as in life. And it’s not necessarily the people with the best cards. There are those who suffer psychologically and emotionally from neurological and/or genetic deficiencies. But this changes nothing. Sure, they inherited a bad hand and are not to blame. No more than the short guy wanting to get a date is to blame for being short. Or the person who got robbed is to blame for being robbed. But it’s still their responsibility. Whether they choose to seek psychiatric treatment, undergo therapy, or do nothing, the choice is ultimately theirs to make. There are those who suffer through bad childhoods. There are those who are abused and violated and screwed over, physically, emotionally, financially. They are not to blame for their problems and their hindrances, but they are still responsible—always responsible—to move on despite their problems and to make the best choices they can, given their circumstances.

You're not going to get patients to take medications unless they trust you. Everyone may have the best of intentions, but if you drag someone to a place, then hand them a bunch of pills, they may get agitated and combative and end up being injected. And then the damage is done.

So armored is he by the righteousness of his new calling that he can't seem to see the effect it's had on me and the two kids. The fact he won't even start earning money for another two years. Two years! By then, I'm the one who will need psychiatric help. As I load the dishwasher in my best clattery, passive-aggressive manner, Rich continues to make helpful suggestions about ways we can cut back... I am becoming, I realize, little more than a lodger in his eyes, and a slightly unreliable one at that.

...I'd learned right away, a psychiatric diagnosis like schizophrenia is a hypothesis. There is no test to prove you have schizophrenia. The best doctor on earth cannot 'see' schizophrenia in your blood, in your hair, in your piss, in your genes.

Sylvia Plath's achingly powerful The Bell Jar weaves her personal battle with depression into the tapestry of fiction. Ned Vizzini's best-selling It's Kind of a Funny Story was inspired by his own psychiatric hospitalization. The House on Mango Street, by Sandra Cisneros, contains

Still, the story hangs over her memoir, and over the history of law and psychiatry, whose marriage, divorce, and rapprochement are still wending their slow, uncertain way through the courts. The young man had needed psychiatric help but had received legal help. Now he needed legal help. Perhaps in jail he would receive psychiatric help.