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Licensed clinical psychologist and health care ethicist Jenny Shields discusses her article, “DSM-5 doesn’t name it, but moral distress is everywhere in medicine.” Jenny illuminates the pervasive issue of moral distress among …
What is the purpose of psychotherapy? What are the goals?
Psychotherapy is a talking process between a patient and a psychotherapist that involves looking at feelings, behaviors, impulses, and thoughts through a process of self-reflection. The purpose of psychotherapy is to explore life patterns and to learn what works and what gets in the way of feeling successful and fulfilled. The goals are to reach one’s fullest potential. This is done …
Administrative violence in medicine is often understood as harm to patients due to systemic issues; however, administrative violence in medicine is also a process used to inflict harm on physicians, destabilizing the medical field on both systemic and individual levels. While much attention is given to how institutions and governments perpetuate administrative violence, it can also be enacted by individuals toward individual physicians with great harm, particularly by other physicians …
I remember the first time I was shamed for asking a question. It was during my OB/GYN clinical rotation in PA school. I asked my attending physician something about a patient, not out of laziness, but because I genuinely needed clarity. But instead of guiding me, he shut me down. “You should be doing your research. You should be telling me about the patient, not the other way around.” I …
Gaslighting manifests in many forms. The most common may be political fights involving the extreme positions on any controversial issue (e.g., gun control, abortion, immigration, you name it). One extreme faction claims they have the truth and blames the opposing extreme faction for the problems in our world. We see this every day in news reports. Those who have experienced gaslighting know that political fights involve gaslighting on steroids.
Another common …
In medicine, we were taught to value humility over pride. To downplay our successes. To “just do our job.” Even as we achieve remarkable things, we rarely pause to acknowledge them, let alone celebrate.
Pride feels risky. Many physicians worry that being proud means being egotistical, self-important, or inconsiderate of others who may be struggling. We were trained to attribute our successes to the team, to luck, or hard work—never to …
She whispered when she said “panic attacks.”
Not because she thought I would judge her or fail to understand. But because she was a physician, and in her world, saying the wrong thing to the wrong person could cost her everything.
She found me through a colleague of a colleague. No insurance, no documentation trail, no diagnostic codes, no third-party systems. She paid in cash. She never used her full name.
“If I …
In medicine, we’ve long relied on the oxygen mask analogy to justify self-care: “Put your own mask on first before assisting others.” It’s a powerful image—but it’s not enough.
Oxygen masks drop in emergencies. Putting them on is a reactive action. They keep us alive—but they don’t help us thrive.
For many physicians, the oxygen mask has become the gold standard of wellness. In a culture that rewards self-sacrifice and martyrdom, “putting …
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Health care executive Traci Sweet discusses her article, “The role of contingency management in addiction treatment.” She makes a compelling case for the increased use of contingency management—an evidence-based approach utilizing positive …
We were taught that sacrificing ourselves is noble. That resilience is enduring. And that suffering and struggling are valiant.
We were taught rest is optional, complacent, lazy—something for other, less busy, less important people.
We were also taught to see “self-care” as somewhat indulgent.
Self-care is often thought of as something earned. A guilty pleasure.
Even the words commonly used in medicine to describe caring for ourselves—”self-care”—sound indulgent.
“Caring for ourselves as well” is not …
Lose weight and you’ll be happy,
They say …
I wasn’t happy,
I was exhausted and depleted.
You’re so disciplined,
They say …
As I starved myself
And had to earn my food.
I wish I could have your problem,
They say …
Brainwashed into thinking,
Smaller is better.
How do you always eat so “healthy”?
They ask …
While my list of “safe” foods
Grows shorter and shorter.
As I dream of being free
And escaping the prison in my mind …
They wonder how to be …
Here in the Midwest we have finally made it through the doldrums of winter, which also indicates the season that basketball fans eagerly anticipate all year: March Madness.
The annual National Collegiate Athletic Association (NCAA) single-elimination basketball tournament inspires millions of folks to fill out brackets predicting the winners, myself included. I love sports for a multitude of reasons, and witnessing these young adults experiencing some of the best—and hardest—moments of …
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Practicing internist and psychiatrist Muhamad Aly Rifai discusses his article, “How America became overmedicated—and what we can do about it.” He raises concerns about the high rate of psychotropic medication use in …
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The mental health crisis in America continues to intensify. With therapist shortages, high costs, and long waitlists, there are millions of people without access to therapy. As a cognitive scientist who analyzed therapy transcripts in grad school and now develops AI mental health applications, I’ve observed artificial intelligence emerging as a complementary solution to these accessibility challenges.
Practicing medicine today is not what most of us envisioned when we chose it as a profession. We still love science. We still love health. We still love helping patients and being healers.
But the practice of medicine has changed—and continues to evolve at an unprecedented pace. Navigating this shifting landscape requires a new mindset—one rooted in adaptability, self-awareness, and resilience. The way we were trained to practice medicine twenty or …
Since the Han Dynasty (206 BCE–220 CE), when civil service exams evaluated intellectual abilities, people have used cognitive assessments to identify special talents or, more commonly, to detect problems.
We’ve come a long way in 2,000 years! Today, neuropsychological batteries—combinations of assessments to detect dementia, learning disabilities, and cognitive impairments from chronic conditions or acute events—are widely used. Yet, far too often, these assessments are administered reactively, only after severe deficits …
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It is a routine Saturday morning—I am sitting in my office, looking at the snowflakes dropping outside my window. As I sip on my cup of Earl Grey tea preparing my psyche for a busy day of managing an on-call shift on an acute care psychiatry floor, I am suddenly washed over by grief. A very similar Saturday a year ago, I was saying goodbye to my father as he …
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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Anesthesiologist and psychotherapist Maire Daugharty discusses her article, “Why real therapy isn’t just about crisis.” She challenges the common misconception that therapy is only necessary or effective during acute crises (“crisis-hopping”), explaining …
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Kim Downey:
A friend shared with me how she told someone their mutual physician was on medical leave. She heard it was serious. That person’s immediate response was concern over how it would affect their upcoming appointment. My friend said she thought of my advocacy work, initiating a conversation fostering empathy for the struggling physician.
I read a post by a surgeon, with fellow doctors commenting …
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