Psychiatry = Pharmacology, Nothing More

This hits close to home, but hopefully readers will not expect me to divulge details on how close to home.

I just saw another example of "The answer is a prescribed pill." The doctor has offered behavior modification techniques, but not in a heartfelt way. And not with the doctor being involved hands-on with the patient. Instead, the recommendation was a treatment of daily drugs. There's clearly a higher return-on-effort-expended for the psychiatrist to dole out "meds" to patients than to be more active in therapy. It's the easier route, for sure.

In my opinion, a large part of the problem is the field of psychiatry itself has major "coping" issues. The field hasn't kept up with modern Western culture and typical behaviors. Major forces like social media (Facebook, Twitter) usage, cyber-bullying, etc. haven't been studied closely enough by the psychiatric profession. There are coping methodologies and practices out there, but few if any have been updated for relevance in today's hyper-connected, information-overload Western society. The average person's affiliations and beliefs are radically different than those of twenty years ago, for example ZERO twenty-somethings expect tenure with specific workplaces to be longer than a couple years and trust in institutions is lower than even in the 1960s.

The sad irony is that many of the technologies creating the newest stresses, the smartphones and Facebook accounts and Google searches, could themselves be harnessed to allow psychiatrists to handle more patients more intensively, with better information, better interactions, and better monitoring. Regarding psychological and spiritual well-being, there should certainly be "an app for that." Why isn't this happening?

Maybe I'm influenced here a little bit by the current "Occupy Wall Street" movement putting such a spotlight on corporate greed. But I think an overwhelming bias in spending and attention favors pills over practices. The big pharma companies spend billions on R&D, lobbying Washington, marketing directly to consumers via big prime-time advertising campaigns, and wooing doctors aggressively. Who is going to fund the innovation in non-pill solutions? Who is motivated to do anything like that? The answer, unfortunately, is NOBODY. You have a few "guru" types, Tony Robbins perhaps the most famous, who earn enough to spend some of the earnings on research and marketing. But this is peanuts compared to the activities of Big Pharma.

Unfortunately there's been no big philanthropic activity around mental illness, other than the Special Olympics movement (which is a very good thing, and sports are a great antidote for psychological problems, but it doesn't do the trick). There's too much of a stigma about mental illness, it's the dirty little secret families don't want out there for others to see. And it's not as "marketable" as cancer, heart disease, or AIDS (readers, PLEASE do not take this as an argument against continuing strong fundraising to fight those diseases or raise awareness about treatment and prevention; maybe there can be some room for more activity on mental health, too?).

It could be argued that, in the past, organized religions were sort of in-the-business of behavioral modification practices and treatments for psychiatric problems, and they could apply accumulated treasure and missionary zeal to helping. But the decline in church-going and the financial fortunes of religions means this isn't a viable alternative to the pill-for-everything trend either.

If there's any hope for a reversal in this unfortunate trend, it may be from increasing awareness about Eastern mind-body ties, holistic medicine, and more consumer-friendly versions of all this like Yoga (which appeals to the same vanity that causes people to want to pop pills yet is actually about something much deeper).

For now families have to do all they can to provide active daily support to those afflicted, whether medications are involved or not, to try to help modify negative behaviors in a non-judgmental way. It's called Unconditional Love.

Dear President Obama: Please Step Up

POTUS just sent out a mass email to supporters using the term "frustrated". He means his supporters are, or should be, frustrated. He blames Congress, obviously Republicans, for recent problems like the S&P downgrade. But it comes across as Obama himself expressing frustration. Well, you know what, sir, please just LEAD!

You, President Obama, dug yourself this hole. You blame Republicans for being ridiculously partisan, making it impossible for the White House to work with them. Perhaps true. But instead of dealing with the reality of their increased power, you continued to support a Democratic congressional leadership group PROVEN to be out of touch with Americans. The mid-term election results showed that, clearly.

At many points in US history, a mid-term election signaled to the sitting President he had to move to the center politically. Making lemonade out of lemons, such events became great opportunities to demonstrate an independent leadership -- detached from Congress -- that won over a majority of the electorate and led to the presidents' re-elections. Instead of a stalemate, the sitting President could right some of his own party's wrongs, with the legitimate defense that he needed to be practical.

To the average American, the rantings of Tea Partiers seem whacko. So you Mr. President can appeal as the anti-that. But the Big Government Democrats look like Luddites given the current global economic climate. So you need to be as distanced from them as from the Tea Party. Why are you so unwilling or unable to cut ties to the Washington insiders. Either your ideology aligns with them, which guarantees you will lose the next election by a huge margin, and you don't deserve the electorate's support. Or you're getting bad political advice on how you should be positioning yourself. I hope it's the latter, but you need to recognize your mistakes and change course.

You need to show a plan for jobs and the economy that is SOLELY the White House's plan, presented in stark contrast to right-wing AND left-wing alternatives. You're misreading that you need to work some kind of anticipated political compromise into what you propose. The average citizen assumes right now, cynical and bruised, that if Speaker Boehner has an imprint on the plan, the plan won't be viable. Just as much (and probably moreso), if Rep. Pelosi or Senator Reid are OK with what you're saying, the plan is dead-on-arrival.

You need to get out of Washington. You need to focus on winning over the business leaders of America, who tend to be willing to step away from political affiliations if they see benefits to their companies of acting independently. An acid test of whether you have a credible plan would be can you get Starbucks' CEO Howard Schultz on stage with you to unveil a new direction for the economy. Not every major CEO is going to join his contribution-withholding effort, but you wouldn't find a single one who disagrees with the spirit of Schultz's stand.

As a President leading rather than constantly seeking political compromises, you would attract to your side every truly great thinker on the economy. They would work with you to fix this mess. They'd consider it an honor. But if you ask any of them to show up and Washington to join some kind of process involving incumbents who've proven incapable of taking action or even understanding our predicament, forget it.

Please, Mr. President, lead.

Back to Blogging

It's been a long time since I blogged. And even back then, I had just started before getting consumed in my gig-du-jour. A lot has transpired in my life and career since then. The world is very different, too. But my blog's theme and label has become stronger and more relevant. You only need to look at recent events in North Africa and the Middle East to see how communications and social networking have fused to change the way people organize and act. Exciting stuff, but worrying in some ways, too. I believe I have some thoughts to contribute to the understanding of what's going on and what could be on the horizon. Plus, I think it's simply therapeutic to try to write something every day, and go on record fearlessly in a public forum. So let's see how it goes.