“The Retrievals” is a podcast series hosted and written by Susan Burton and presented in cooperation with the New York Times that focuses on the failure of a Yale fertility clinic to address uncontrolled pain during procedures. As it turns out this was the result of a nurse surreptitiously replacing the pain medication fentanyl with saline to support her addiction. This apparently unfolded over the course of a year or …

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Locums can be a very challenging space, at least for anesthesiologists. Environments are frequently disrupted. There is often animosity between clinicians coping long-term with turmoil and inadequate staffing, and the temporary locums who fill a gap and are often paid substantially more for their intrusion. In anesthesia, the quality of the relationship between clinician and the total environment is essential. This includes nuances of the culture, scheduling structure and expectations, …

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The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines mental health, including depression, in terms of pathology or a deviation from normal that is reliably exhibited in observable behaviors. It describes genetics and risk factors, differences in gender, and considers cultural perspectives. Limitations of the DSM diagnostic criteria are acknowledged and recognize that human experience, or interaction between genetics and environment, cannot be captured completely. While the underlying neurobiology …

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Professional coaching can contribute to personal growth and development by providing encouragement and support using a handful of simple techniques designed for deepening exploration in a co-created working relationship. Focuses can be wide ranging and include development and clarification of goals, refining communication, boundary setting, and conflict management skills. A coaching stance typically seeks improved performance, for example increased efficiencies at work or navigating executive function more effectively. It can …

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In his book Ways of Attending, McGilchrist (2016) discusses a difference in attention—one that seeks organization and one that any attempt at organizing subverts. A bit like Schrödinger’s cat, just by looking, it is disturbed. In differing translations of Tranströmer’s poem Prelude from 17 Dikter (1954), about the moment upon wakening from a dream, he captures the infinite possibility that slides one fully awake into a new day, and which …

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Current studies identify the negative impacts of failing to diagnose and treat attention deficit hyperactivity disorder (ADHD), which contributes to well-described impairment, morbidity, and mortality. Timely diagnosis, acceptance, and treatment do, in fact, improve outcomes. Benefits include a decrease in negative impacts on self-esteem, depression and other mood disorders, substance use disorders, suicidality, motor vehicle crashes, and criminality. These consequences result from easy distractibility and impulsiveness, which can be damaging …

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I read with great interest the recently published article in The New York Times by Paul Tough, who has reported on child development and education over the last twenty years. He outlines statistics, specifically the rise in diagnosis of children and adults since the 1990s, and then discusses implications, including questioning a current understanding of the disorder and its treatment.

Neurodevelopmental disorder

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder …

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Maybe you’ve struggled to put the shattered mirror of yourself back together, and you don’t want to unearth what you’ve been able to put to rest. Plenty of people decide that psychotherapy is not for them, and we are, as our own individual, sovereign self, the best judge of our needs. As someone looking from the outside, we can only know a fraction of the depths of another person and …

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Language is the architecture of our perception. It impacts the way we experience ourselves in relation to others, the moments that make up our daily lives, and why we emphasize one input while ignoring others. I first learned this in a linguistics course that explored the difference between, for example, “I dropped the book” in one language versus “the book fell from me” in another. This shows up in intimate …

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Situations that trigger a call for assistance with couples counseling are generally described as a need for improved communication, chronic conflict, lack of physical or emotional intimacy, or a desire to better understand the impacts of past trauma. Therapeutic work can evolve into tackling more specific long-standing disappointments in emotional and physical intimacy. Disconnection is often exacerbated incrementally by increased responsibility with children, aging parents, and cultural differences, among other …

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The therapeutic modality developed by Francine Shapiro and referred to as eye movement desensitization reprocessing or EMDR, when embedded in the context of a wider lens, focuses on specific events and feelings with a view to overarching goals. We become who we are in a relationship, and specifically in our earliest relationship with a primary caregiver who shapes our worldview before we can give this active consideration. Subsequently, we develop …

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In 1987, Francine Shapiro went for a walk and discovered eye movement desensitization reprocessing (EMDR) as a therapeutic technique for traumatic experiences with lasting impact. Some thirty years later, with a substantial body of research confirming its efficacy, the mechanism of action remains a mystery. However, the treatment has expanded to focus on chronic pain, addictions, attachment trauma, among other areas. So, what is EMDR exactly? First and foremost, like …

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I’ve been conceptualizing this for several years now – ideas about what I would like to do with perspectives from my long-time practice as a physician and those always developing as a psychotherapist. I love both; each brings a unique skill set and way of being in the world, and I am well-immersed in the confusions one has for the other. I am an adult therapist with a deep love …

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It was some time into practice before I understood how being a therapist contributes to one’s own growth. I found this assurance from my best mentors rather mysterious. Sure, I’m a better listener, but what did they really mean? From my vantage point now, it seems obvious, and it is more than being attuned. On the surface, it is about being able to hear stories of suffering and watch someone …

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