Category Archives: Precipitants

Decoupling ‘psychotic symptoms’ from “schizophrenia” can help improve treatment

Phenomenon(sic) such as hallucinations and delusions can be independently examined in their own right,rather than subsuming their study within the context of diagnostic categories such as
‘schizophrenia’,which is a heterogeneous, disjunctive construct

Childhood adversity and psychosis: generalised or specific effects?. Available from: [accessed Sep 17, 2015].

E. Longden, M. Sampson and J. Read – Childhood adversity and psychosis: generalised or specific effects?. in Epidemiology
and Psychiatric Sciences, Available on CJO 2015 doi:10.1017/S204579601500044X

Association of Child Poverty, Brain Development, and Academic Achievement

“Our work suggests that specific brain structures tied to processes critical for learning and educational functioning (eg, sustained attention, planning, and cognitive flexibility) are vulnerable to the environmental circumstances of poverty, such as stress, limited stimulation, and nutrition.” Freely available….

▶ Nadine Burke Harris: How childhood trauma affects health across a lifetime – YouTube

▶ Nadine Burke Harris: How childhood trauma affects health across a lifetime – YouTube.

Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. An impassioned plea for pediatric medicine to confront the prevention and treatment of trauma, head-on.

Australasian Psychiatry Feature on Psychotherapy –

Edwin Harari 2104 Ghost Busting: Re-introducing psychotherapy for the psychiatrist


Objective: The purpose of this paper is to provide a clinically relevant historical and conceptual overview of psychotherapy as an introduction to a forthcoming series of papers on specific models of psychotherapy. The author offers a selective review of some key ideas in the history and practice of psychotherapy.

Conclusion: The principles of psychotherapy should inform all psychiatric practice, including the doctor– patient relationship, multidisciplinary teams caring for patients with complex or ‘treatment resistant’ problems, and patients who are non-compliant with psychotropic medication.

Keywords: psychotherapy, doctor–patient relationship, treatment resistance, psychotherapy and medication

Australasian Psychiatry 2014, Vol 22(5) 433–436 © The Royal Australian and New Zealand College of Psychiatrists 2014 Reprints and permissions:

Australasian Psychiatry – Signposts DOI: 10.1177/1039856214546673

Ghost Busting: re-introducing psychotherapy for the psychiatrist

Edwin Harari Consultant Psychiatrist, St. Vincent’s Hospital Area Mental Health Service, Fitzroy, VIC, Australia

Psychotherapy (‘healing the mind’) is a particular type of interpersonal influence, wherein one person, acknowledged by society as possessing relevant skills (the psychotherapist) seeks to change the thoughts, feelings, attitudes, behaviours, relationships or personality of a suffering other (the patient):

If one posits that the relation between doctor and patient has been critically wounded, how are we to understand whether, and on what basis, that relationship may be reasserted ? AI Tauber

The pedagogy for engaging hidden values and divided selves is the moral building of the clinician as a full developed human being. A Kleinman

I do not favour the way Descartes ontologically screwed up a reasonable search for mind-brain docking during the past four centuries yielding life-denying monstrosities like radical behaviourism and an emotionless information processing cognitivism… J Panksepp

The possibility of intersubjective knowledge offers a welcome relief from a forced choice between pure subjectivity (Descartes) and true objectivity (Kant). EM Hundert

The outcome of the game is to convert what would otherwise be a nameless trauma into a loss. J Lear

As a general rule throughout Asia, the more patriarchal the society, the more the Buddha looks like a woman: the more egalitarian the society, the more the Buddha looks like a man. L Shlain

Psychotherapists, especially, appreciate [that]… this painful ambivalence is as old as the ice-age, a hallmark of Cro-Magnon man, torn between his craving for consolation and his fear of revenge. J Cawte

Each of the above quotations may serve as a conceptual signpost or creative condensation of the argument each of the authors’ advances in their respective texts which bear on the nature, subject matter and practice of psychotherapy.

Read more here

 Tauber AI. Confessions of a medicine man: an essay in popular philosophy. Cambridge, MA: MIT Press, 2002, p.103.
 Kleinman A. The divided self, hidden values and moral sensibility in medicine. Lancet 2011; 377: 804–805.
 Panksepp J. The self and ‘its’ vicissitudes. Critique of commentaries. Neuropsychoanaly-sis 2002; 4: 50.
 Hundert EM. Philosophy, psychiatry and neuroscience. Three approaches to the mind. Oxford: Clarendon Press, 1990, p.297.
 Lear J. Happiness, death and the remainder of life. Cambridge, MA: Harvard University Press, 2000, p.92.
 Shlain L. The alphabet versus the goddess. New York: Penguin, 1998, p.200.
 Cawte J. Aboriginal healing: psychotherapy in ancient society. Aust J Psychother 1988; 7: 14.
 Doidge N. The brain that changes itself. Melbourne: Scribe, 2007, p.216.
 Wolff HH. The therapeutic and developmental functions of psychotherapy. Br J Med Psychol 1971; 44: 117–130.
 Markowitz JC and Milrod BL. The importance of responding to negative affect in psycho-therapies. Am J Psychiatr 2011; 168: 124–128.
 Frank JD and Frank JB. Persuasion and healing: a comparative study of psychotherapy (3rd edition). Baltimore: Johns Hopkins University Press, 1991.
 Kernberg OF. Severe personality disorders: psychotherapeutic strategies. New Haven, CT: Yale University Press, 1984.
 Gabbard G and Kay J. The fate of integrated treatment: whatever happened to the biopsychosocial psychiatrist? Am J Psychiatr 2001; 158: 1956–1963.

“If one gram costs $1 in the black market, then we’ll sell the legal product for $1. If they drop the price to 75 cents, then we will to.

Ex President Mujica of Uraguay – an increase in drug-related murders prompted him to act against the dealers in 2013 by destroying their competitiveness in the biggest illegal market: marijuana, because this is the heart of the drug problem… Uruguay’s likely cannabis law could set tone for war on drugs in Latin America
In places where an increase in the incidence of schizophrenia has been reported, these can be attributed mainly to substance abuse (eg Drug Induced Psychosis). However, there are additional explanations for psychosis differential diagnoses. The most important of these is stress, and especially complex or traumatic stress – presenting as depressive psychosis in both its unipolar and bipolar forms.

Emotional health in childhood ‘is the key to future happiness’ | Society | The Guardian

Proving the good economics of supporting vulnerable kids (never mind the morality of this…)

Schizophenia Is Not What It Used to Be | Psychology Today

Does schizophrenia have genetic roots? …the best that geneticists have done is to identify 128 gene alleles (variants) that are “associated” with schizophrenia. This means that these gene variants might be “risk factors” for schizophrenia at most, but they scarcely can be thought of as causes.

Schizophenia Is Not What It Used to Be | Psychology Today.

I am amazed by the strength of the human spirit and never give up hope | Healthcare Professionals Network | The Guardian

It’s often quite easy to see why someone might be low in mood, or panicky, or hearing voices telling them they are worthless. Sometimes the reasons are less obvious, and we arrange to meet again once we know the client better…

A typical person might have been bullied, neglected or abused as a child; subjected to domestic violence as an adult; and now be on benefits and struggling to feed and clothe their children.

I am amazed by the strength of the human spirit and never give up hope | Healthcare Professionals Network | The Guardian.

Home – Hearing Voices Network USA

Help for people who understand that one key to recovery is understanding the meaning voices have in the context of lived experience, and that as suppressing voices  with medication only works for some, other ways, more ethical of working are crucial in modern mental health work.

Home – Hearing Voices Network USA.