Reflections on Psychiatry, Therapy, and Mental Health

Over 20 years ago the respected psychologist and author Patrick Carnes coined the term, 'trauma bonding.' He defined his concept succinctly: “ A betrayal bond is a bonding pattern  that develops from intermittent abuse  and intense emotional experiences , where the victim becomes deeply attached to the person who causes them harm — often feeling unable to leave the relationship, despite the damage it causes.” As therapists, our curiosity as to why people will repeatedly enga

Winnicott famously coined the term 'holding environment' to describe the experience of safety and support that constitutes a good therapeutic alliance with a patient. Psychological space is a phrase I have been using in recent years to capture the capacity of a patient to bear psychological tension long enough to resolve or find creative pathways to deal with matters that are troubling him or her. The following is a little vignette that emerged during a Ketamine-enhanced ther

When I was three, I was taken to the hospital in the afternoon for a tonsillectomy the next day. This was almost 70 years ago, a time when parents didn't remain overnight, preoperative sedatives were limited, and anesthesia consisted of ether delivered through a mask. I have limited memories of this experience. I was an adventurous little fellow and don't remember missing my parents. Rather, the staff were friendly, and I assume I responded to their kindness. The morning of m

Effectively providing therapy to patients with a history of trauma and PTSD depends on being guided by theoretical principals. I've recently noted a convergence of ideas that leads me to put a lot of credence in what follows. One idea comes from the emerging psychedelic movement; the idea that the mind has a natural tendency to self-heal. Other thoughts derive from the writings of Abraham Maslow, an author whose fame had led me to know of his 'hierarchy of needs,' but littl