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This is so true. There are a lot of things that we cling onto, a lot of addictions, some good, some bad, but reading is something that is so innately human.

Reading is such a wonderful skill, and changes the way our brains think with every single word that we read. Our brains change, we change. Even down to the individual neurons, reading strengthens and weakens, forms so many connections in our brains… We develop and refine as people, which is a marvelous thing :) 

What’s your favourite book?

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Hidden: Psychiatric Hospitals. Photographs from psychiatric wards in Serbia and Kosovo, by George Georgiou 

“The worst aspect was the total lack of care and stimulation and the high number of people who should never have been in these places. People with physical disabilities, downs syndrome, a high proportion of Roma or children whose misfortune was to have been born in the institutions. By living in this environment of deprivation, with little stimulation or compassion they start to display repetitive rocking behaviour and self-injury.”

Falling in Love!!

Hello, brain people!

Love!! What on earth happens to your brain as you fall in love? There are three stages that we all go through as we fall in love with that special somebody: Lust, Attraction, Attachment

During Lust, sex hormones are released - this being oestrogen and testosterone in women and men respectively.

Throughout Attraction, you feel all wonderful and love-stricken! You can’t think of anything other than that special somebody. There are three main neurotransmitters that are involved in this stage, with each type acting within a specific pathway in the brain. These neurotransmitters are: Adrenaline (Epinephrine), Dopamine, and Serotonin.

Epinephrine is released during your body’s “stress response”, making your blood levels of adrenaline and cortisol increase. This means that even meeting with that somebody can make your heart race, as you also start to sweat. How lovely!

Dopamine is closely related to our brain’s “appetite system”, the system that is active whilst we are craving something. Dopamine stimulates “desire and reward”, and does this by triggering a rush of pleasure! This has a very similar affect to cocaine on the brain! Love is a drug!

Serotonin is an anti-depressant, and may also explain why, when falling in love, your love stays on your mind.

Finally, we have attachment! This is the tight bond that keeps couples together long enough for them to raise children. Yet again, we have chemicals to thank for this! These are: oxytocin and vasopressin.

Oxytocin, the cuddle hormone :), is a very powerful hormone released by men and women during orgasm, and is said to deepen the feelings of attachment between the couple, making them feel much closer to each other. As the theory goes, the more sex that the couple has, the deeper the connection they feel for one another. Sounds good to me! :) 

Vasopressin is an anti-diuretic hormone that works with your kidneys to control thirst. Although little is known about the affects of this hormone, when male prairie voles were given a drug that suppresses the effect of vasopressin, the bond with their partner fell apart immediately, as he then would fail to protect his partner.

So go out there! Bump into a complete stranger, tell them about yourself, and fall in love! :)

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Photographic Portraits Of Victorian Mental Institution Patients

Before asylums were built, the bulk of care for the mentally ill rested squarely on the shoulders’ of the patient’s family and relatives. If they were lucky that is, many were simply homeless and were on their own. Mental institutions became more common in the 1600s and 1700s. In the 1700s, William Tuke, a Quaker businessman, began advocating for less physical restraints to be used on patients. Others soon came to support more gentle ways of caring for mentally ill patients as well. In the 19th and 20th centuries, asylum construction boomed.

Read more: http://bit.ly/204tpur

Physician Reprimanded for Overprescribing Therapy Dogs

http://gomerblog.com/wp-content/uploads/2016/01/therapy-dogs.jpg

Rancho Cucamonga, California – An Inland Empire doctor has been placed on probationary status by the Medical Board of California for overprescribing therapy dogs, prescribing inappropriate therapy dogs, and giving unnecessary dog therapy to patients. Doctor Adam Liu, a Montclair family m…

Read more on http://gomerblog.com/2016/01/physician-therapy-dogs/?utm_source=TR&utm_campaign=DIRECT


www.gomerblog.com
psychrights.org
On Being Sane In Insane Places

So a while ago @cranquis linked to the above in a post I reblogged (here). I opened the link but it took me a while to actually get to it (I have a lot of tabs open…) so here we are, months later. Anyway.

It’s the account of David L Rosenhan’s pseudopatients project which is now infamous in the psych world as the time “sane” people were admitted to institutions and hospitals despite their sanity. But that common knowledge notoriety is really just the tip of the iceberg. Please read the whole account. I picked out some excerpts and have added some commentary but before I start, I want to say that I hope you’ll all read the whole thing.

So eight people agreed to participate in the project. They went to hospitals, and they said they heard voices but changed no other details about themselves or their lives (besides to maintain anonymity). All of them were admitted. As soon as they were admitted, they stopped complaining of hearing voices, behaved as usual, and answered questions honestly. The patients on the units were more able to recognize something was up than the staff:

…it cannot be said that the failure to recognize the pseudopatients’ sanity was due to the fact that they were not behaving sanely. …their daily visitors could detect no serious behavioral consequences—nor, indeed, could other patients. It was quite common for the patients to “detect” the pseudopatient’s sanity… “You’re not crazy. You’re a journalist, or a professor (referring to the continual note-taking). You’re checking up on the hospital.” …The fact that the patients often recognized normality when staff did not raises important questions.

Failure to detect sanity during the course of hospitalization may be due to the fact that physicians operate with a strong bias toward what statisticians call the Type 2 error. This is to say that physicians are more inclined to call a healthy person sick (a false positive, Type 2) than a sick person healthy (a false negative, Type 1). The reasons for this are not hard to find: it is clearly more dangerous to misdiagnose illness than health. Better to err on the side of caution, to suspect illness even among the healthy.

But what holds for medicine does not hold equally well for psychiatry. Medical illnesses, while unfortunate, are not commonly pejorative. Psychiatric diagnoses, on the contrary, carry with them personal, legal, and social stigmas.

But I think the point that gets made as this piece goes on is that destigmatization isn’t enough. Our approach to mental health and illness that tried to structure it like medical illness purports that symptoms lie clearly trapped within a body whose boundaries are well-demarcated from the rest of the world, like a fracture housed cleanly in an arm. But this just isn’t the case with mental health.

…it has long been known that elements are given meaning by the context in which they occur. Gestalt psychology made the point vigorously, and Asch[5] demonstrated that there are “central” personality traits (such as “warm” versus “cold”) which are so powerful that they markedly color the meaning of other information in forming an impression of a given personality.  “Insane,” “schizophrenic,” “manic-depressive,” and “crazy” are probably among the most powerful of such central traits. Once a person is designated abnormal, all of his other behaviors and characteristics are colored by that label. Indeed, that label is so powerful that many of the pseudopatients’ normal behaviors were overlooked entirely or profoundly misinterpreted.

This underlies the “Great Divide” between staff and patient on a psych unit. Everything a patient does is “crazy” – even if it’s being made uncomfortable by observation by 5 students at once; even if it’s requesting pain medication that wasn’t given on time; even if it’s making art.

One tacit characteristic of psychiatric diagnosis is that it locates the sources of aberration within the individual and only rarely within the complex of stimuli that surrounds him. Consequently, behaviors that are stimulated by the environment are commonly misattributed to the patient’s disorder. For example, one kindly nurse found a pseudopatient pacing the long hospital corridors. “Nervous, Mr. X?” she asked. “No, bored,” he said.

… The notes kept by pseudopatients are full of patient behaviors that were misinterpreted by well-intentioned staff. Often enough, a patient would go “berserk” because he had, wittingly or unwittingly, been mistreated by, say, an attendant. A nurse coming upon the scene would rarely inquire even cursorily into the environmental stimuli of the patient’s behavior. Rather, she assumed that his upset derived from his pathology, not from his present interactions with other staff members. Occasionally, the staff might assume that the patient’s family (especially when they had recently visited) or other patients had stimulated the outburst. But never were the staff found to assume that one of themselves or the structure of the hospital had anything to do with a patient’s behavior. One psychiatrist pointed to a group of patients who were sitting outside the cafeteria entrance half an hour before lunchtime. To a group of young residents he indicated that such behavior was characteristic of the oral-acquisitive nature of the syndrome. It seemed not to occur to him that there were very few things to anticipate in a psychiatric hospital besides eating.

This is the point of yesterday’s DSM5 dystopia satire (EDIT: link here). The context matters, and the message we’re sending by putting the onus on the individual matters. This happens on a micro and macro level within society. Also, if you think all PRN IMs of haldol/ativan are warranted because of the patient’s disease, then read the above paragraph and think again.

The inferences to be made from these matters are quite simple. Much as Zigler and Phillips have demonstrated that there is enormous overlap in the symptoms presented by patients who have been variously diagnosed,[6] so there is enormous overlap in the behaviors of the sane and the insane. The sane are not “sane” all of the time. We lose our tempers “for no good reason.” We are occasionally depressed or anxious, again for no good reason. And we may find it difficult to get along with one or another person – again for no reason that we can specify. Similarly, the insane are not always insane. Indeed, it was the impression of the pseudopatients while living with them that they were sane for long periods of time – that the bizarre behaviors upon which their diagnoses were allegedly predicated constituted only a small fraction of their total behavior. If it makes no sense to label ourselves permanently depressed on the basis of an occasional depression, then it takes better evidence than is presently available to label all patients insane or schizophrenic on the basis of bizarre behaviors or cognitions…

It is not known why powerful impressions of personality traits, such as “crazy” or “insane,” arise. Conceivably, when the origins of and stimuli that give rise to a behavior are remote or unknown, or when the behavior strikes us as immutable, trait labels regarding the behavior arise. When, on the other hand, the origins and stimuli are known and available, discourse is limited to the behavior itself. Thus, I may hallucinate because I am sleeping, or I may hallucinate because I have ingested a peculiar drug. These are termed sleep-induced hallucinations, or dreams, and drug-induced hallucinations, respectively. But when the stimuli to my hallucinations are unknown, that is called craziness, or schizophrenia –as if that inference were somehow as illuminating as the others.

This article goes on to talk about the kinds of subtle dehumanizing actions that are perpetrated by staff on psych wards – e.g. lack of eye contact, avoidance of questions, etc – and I can confirm all of these microaggressions and more with my own experience working on hospital psych floors. It talks about the ways in which the Great Divide is built up and manufactured by literal glass walls. And it reminds us that this divide is, in fact, socially manufactured.

If you’re not convinced of the blurriness of the line between mental illness and not after reading this, maybe read it again. Or think harder about it. I dunno.
But don’t fool yourself into thinking these are things of the past. These scenarios occur daily on psych wards across the country – I would be surprised if these pseudopatients had much trouble being admitted today.

So – if sanity and insanity exist, how shall we know them?

The Specialty Post: Part Two

The second installment: Psych, OB/Gyn, Surgery, Radiology!

Psychiatry: As a very astute friend once said, “The trick to being a great psychiatrist is getting someone to tell you everything while you reveal nothing and say even less.” They are the friend to whom you spill your guts too, listens silently and nods, perhaps occasionally patting your back. Never play poker with them. First, because they have the best poker faces and second, they can read everyone. Excellent story-tellers. They are all musical and have a fondness for writing and performance arts, either as a participant or a patron. And I’m not sure why, but psychiatrists are terrible at telling jokes. Puns, wordplay? Totally fine. Jokes? Painfully bad.

Originally posted by trianglegloss

OB/GYN: It’s too easy to fall back on the boring stereotype “OB/GYNs are bitches, OB/GYNs are feminazi man-haters.” Let’s be more intelligent. To start, they are all more than they appear; they usually cultivate a distinct professional personality that has nothing to do with their daily-life personality. Usually neat and  clean in appearance, the fiercest champions for their patients and lucky loved ones, and experts of the side-eye. They don’t do anything half-assed, in work and life. They have no problem calling people out, which can be good, but immature OB/Gyns give the rest a bad rap by making this method of asserting power. Their drink of choice is wine, and every ob/gyn I’ve met has a sweet tooth (usually for cake). They have two weaknesses: over-using hashtags and shoes. Every OB/GYN I know has a closet full of shoes (including men. The male OB/GYNS are definitely not exempt.)

Originally posted by foreverpatch

Surgery: Surgeons are beyond human. They HAVE to be, that’s what they’ll tell you and that’s how they live. Focused, driven, relentless in improving themselves, always in pursuit of perfection, dedicated. The best surgeons are nearly superhuman: passionate, inspiring in their work ethic and stamina, yet down-to-earth. The worst? Supervillains. Only scrubs will do for their wardrobe. Like internists, there are a variety of surgical personalities (you can guess a surgeon’s preferred sub-specialty by the music they play in the OR), but I will say that there are four unifying traits for surgeons: gorgeous hands (you could all be hand models), dead-pan sarcasm as the primary form of humor, a love for jackets, and incredibly high proficiency in at least one hobby (and when I say proficiency I mean they could totally have gone pro at this hobby but they didn’t.) 

Originally posted by heckyeahreactiongifs

Radiology: Is it because you all spend so much time in dark rooms and need to get out or because the hours are amazing and you have time? Radiologists have rich lives outside of work in the form of travel, hobbies, coaching or participating in sports, etc. Not surprisingly, they are highly visual people and many have photography as a hobby. Many are foodies, the only specialty with a higher concentration of foodies is gastroenterology. Usually people of few words and conflict-avoidant, but not necessarily introverted. Most likely to tell you they marathon-ed a TV show on Netflix…repeatedly. For weeks. Predominantly cat people. Finally, radiologist style is always about comfort. Comfort IS the style. 

Originally posted by smithsonianchannelcanada

The Forgotten People, The State of Chinese Psychiatric Wards.

China. Tianjin. 1989. Mental Hospital Tianjin. Zhang Shuhua ®, age 38, has been hospitalized for over two months. Because there is no one to turn her over and wash her, she has grown fist-sized bedsores. Ten days after this picture was taken, she died in the hospital.

Been going through old documentaries about repressed/false memories lately. I gotta ask, what was with the trend of psychiatrists convincing their patients they were victims of Satanic ritual abuse?

I mean, I know abuse in religious orders definitely happens, but we’ve learned by now that there weren’t nearly as many cases of kids getting killed or abused by Satanic cults as people liked to report back in the 80s and early 90s. And it especially disgusts me when the patients’ legitimate mental issues could easily be tied to other causes.