Consider these a necessary addendum to the Laws of Mount Misery by Samuel Shem:
- Beware the hyphenated last name.
- Bad therapy is far more damaging than no therapy.
- Alcoholism may have a genetic component, but that doesn’t make it inherently a disease.
- CBT is the ideal therapy for patients who don’t want to get better.
- Psychiatry is prone to fads: vpa, ketamine, TMS, CBT, neurontin, etc.
- Some of the best psych drugs aren’t initially intentioned as psychiatric (eg. imipramine, thorazine, propranolol)
- The nurses wield far more power over you than the doctors do on an inpatient psych unit.
- If a patient and their therapist agree on the brand name medication they want you to prescribe, there can be no true clinical indication there.
- Collusion between patients and therapists is rampant, particularly amongst the social workers.
- P = MD applies to most psychiatrists.
- If your new patient openly reports, nay, brags, that she has a history of multiple personalities she only has one and it starts with the letter B.
- If your psychiatrist is writing the note for your session during your session, they hate a) you, b) their spouse, c) themselves, or d) all of the above.
- No therapist can guide you towards a healthier place in life which they haven’t already been to/through themselves.
- SSRIs absolutely do numb your affect and that’s why you won’t taper down off of them.
- Humans foremost fear death. Our second greatest fear is change. All other fears are noise.
- Most intense moods are unconsciously intentional, a defense mechanism.
- Therapy you get for free is utterly worthless.
- Therapy you get for the price of your copay is worthless.
- Therapy you get at a sliding scale discount is mostly worthless.
- Therapy you pay full price for is hit or miss.
- The precontemplation phase is filled with people who are certain alcoholism is a disease.
- Shame leads to rage leads to violence. (h/t Alone)
- Anyone claiming to have less than two vices is either a liar or autistic.
- Patients get better, change, and grow only when they want to.
- The greatest healer is time. Get out of the way.