In patients with depression, psychological pain is a risk factor for suicidal ideation. Those with borderline personality disorder may experience more prominent and temporally unstable psychological pain.
bit.ly/4aO9Ywq

'Another way of putting it is that I know I am far from alone, among mental health professionals, in carrying around my own share of proclivity for the use of borderline defenses.' - Harold F. Searles, M.D.

Mark L. Ruffalo Some between-patient reading for this afternoon

'Patients manifest, over the course of months and years of treatment, an interest, a genuine caring, as to whether the analyst himself has been growing and thriving during and as a result of their therapeutic ministrations to him.'

Francis J. Braceland was chief psychiatrist of the renowned Institute of Living in Hartford, Connecticut, from 1951 to 1965. During the Second World War, he left his position as Dean of the medical school at Loyola to join the U.S. Navy's medical staff and served for two years...

Spitzer described the psychoanalytically influenced DSM-II as - “reliability is no better than fair for schizophrenia and is poor for the [rest]”

Picture of the inter-rater reliability of the DSM-II (the degree of consistency between two of the same thing)

Many patients are so terrified of emotional intimacy that they are driven over and over again to provoke crises that allow them to distance with impunity (see Hedges, 2000).
Nancy McWilliams

#intimacy #fear #distance

I remember listening to this song on repeat with my Italian grandmother in New Jersey. We would watch Bocelli on RAI (Italian language TV). As beautiful today as when it was first recorded nearly 30 years ago. Con Te Partirò (Time To Say Goodbye).
youtu.be/TdWEhMOrRpQ?si…

Another shot of 2012 Kentucky Derby Preakness Stakes Winner I'll Have Another enjoying his days in retirement.

Classic paper from 1978 by Spitzer, Endicott, and Robins showing that there were only 14 scientifically valid psychiatric diagnoses at the time DSM-III was published. DSM-III listed 265 disorders.
pubmed.ncbi.nlm.nih.gov/655775/

New piece by Ronald Pies at Psychiatric Times on nonprescribing in psychiatry, touching also on overutilization and underutilization of some agents. Dr. Ghaemi Nassir Ghaemi is quoted on mood illness, and I am quoted on borderline disorders.
psychiatrictimes.com/view/the-fine-…

'She didn't know who would leave or stay, so she pushed them all away.'
psychologytoday.com/us/blog/from-f…

Allison Hauser Robin Carhart-Harris Nassir Ghaemi makes a convincing argument here that lithium is the only disease-modifying drug in psychiatry, and I believe that a compelling argument can be made that it is only psychotherapy that gets at the 'cause' of personality pathology.
pubmed.ncbi.nlm.nih.gov/35653111/

Tim Kaiser Max Wolff Robin Carhart-Harris When we get into discussion of 'root causes,' there are likely only two treatments in psychiatry that achieve that: lithium for bipolar mood disorder, and psychotherapy for personality disorder.

'Psychiatric disorders are, by their nature, complex multilevel phenomena. We need to keep our heads clear about their stunning complexity & realize, with humility, that their full understanding will require rigorous integration of multiple disciplines & perspectives.' - Kendler