Category Archives: Anxiety

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.

How Cannabis Causes Paranoia: Using the Intravenous Administration of ∆9-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia

“… it was definitively demonstrated that the drug triggers paranoid thoughts in vulnerable individuals. The most likely mechanism of action causing paranoia was the generation of negative affect and anomalous experiences”

How Cannabis Causes Paranoia: Using the Intravenous Administration of ∆9-Tetrahydrocannabinol (THC) to Identify Key Cognitive Mechanisms Leading to Paranoia.

Amy Cuddy: Your body language shapes who you are – YouTube

Here are practical steps to self empowerment – simple lessons from the neuro-science of posture. Amy’s self disclosure and empathy around 16 minutes in make this a real gem! (Show this to your clients!!!)

Amy Cuddy: Your body language shapes who you are – YouTube.

Research – Anxiety symptoms in adolescents at risk for psychosis: a comparison among help seekers

Early publication online:

Granö, N., Karjalainen, M., Edlund, V., Saari, E., Itkonen, A., Anto, J., & Roine, M. (2012). Anxiety symptoms in adolescents at risk for psychosis: a comparison among help seekers. Child and Adolescent Mental Health doi: 10.1111/camh.12012

Key Practitioner Message

  • Anxiety has previously been related to psychosis and an at-risk state for psychosis. In the present study, help-seeking adolescents differ significantly in terms of their level of total anxiety symptoms, because adolescents at risk for psychosis had more anxiety symptoms
  • Item-by-item analysis scores in items such as feeling relaxed, feeling nervous, losing control and feeling faint were statistically significantly higher in adolescents at risk for psychosis
  • The anxiety subfactor of cognitive anxiety explained significantly at-risk state for psychosis
  • In clinical practice, the possibility of persisting anxiety symptoms should be considered when working with help-seeking adolescents at risk state for psychosis

Background Several studies have reported on how anxiety disorders and anxiety symptoms are already present before the onset of psychosis. However, anxiety disorders are typically studied in these studies at diagnosis-level.

The aim of present study was to investigate the profile of anxiety symptoms in subjects at risk of developing psychosis and to compare the anxiety profile with those who are not at risk.

Method Data were collected at Helsinki University Central Hospital (HUCH) by an early detection and intervention team. Of 185 help-seeking respondents, between 12 and 18 years of age, 59 adolescents were classified as being at risk of psychosis and 126 as not being at risk via an interview conducted by a validated at-risk assessment tool (PROD). Anxiety was measured using the Beck Anxiety Inventory (BAI).

Results The anxiety total sum score was higher in the at-risk group for psychosis (mean 8.33 vs. 13.34, p = .000). Both subfactors of the anxiety scale, cognitive anxiety (p = .000) and somatic anxiety (p = .000), differed significantly by risk status. After using the Bonferroni correction for multiple analysis, items of relax (p = .000), nervous (p = .002), losing control (p = .000) and faint (p = .002) had statistically significant higher mean scores in the group at risk of psychosis. In logistic regression analysis, being female (p = .015) and the subfactor relating to cognitive anxiety (p = .044) significantly explained the at-risk status for psychosis.

Conclusions Adolescents at risk for psychosis have a higher level of anxiety compared with other help-seeking adolescents. These results should be considered in clinical practice.