In Practice

A Practicing Doctor's Views on Psychiatry and Contemporary Culture.

by Dr. Peter Kramer

Reassessments

Another look at serotonin, genetics, and happiness Read More

Racism, Politics, and the Unconscious

Clearly consciousness is layered. But not every thought we might want to disown occurs outside awareness. Read More

Just to say that I've put a detailed essay up on XX about the recent news on antidepressants: the claim that they don't work for minor depression, the claim that they do more to change personality than to moderate mood disorder, and the claim that depressed people rarely get a full course of them anyway. Judith Warner has a similar, less technical piece appearing as a New York Times op-ed. Read More

Nobelobama: Yes, You Can!

What do these Scandinavians have in mind?

I heard the news this morning as I drove out to my usual bicycling route. On NPR, Elie Wiesel was sounding gracious but befuddled, as if it were he who had been wakened with incomprehensible news. Then I was off pedaling, so I got to digest the announcement without exposure to commentary. Read More

Due for a Comeback?

What future for the serotonin transporter gene? Read More

No Joints: How Psychiatry Carves Up Nature

Just a note to say that I have a piece posted at double X on the latest dust-up about DSM-V. My topic is the blg-picture question, whether we can "carve nature at the joints." I'm reseaching a book-in-progress on diagnosis and its counterpart, normality, so there will be more notes along these lines. Read More

Nice Work If You Can Get It

Just a note to say that I have an essay in the Wall Street Journal "Culture" section about good work and its effect on identity and private life. Read More

FWIW

I'm always curious about what the New York Times considers news. Read More

One Patient, One Doctor, One Year

I'm back to recommend another book by a medical colleague who is also a good friend. Today sees the publication of The Addict, by Michael Stein. Michael is an internist specializing in the treatment of infectious disease, but his work with drug addicts displays the sensitivity and insight of the best psychotherapy. Read More

Ave atque Vale

I have received a number of emails from readers asking about the disappearance of my postings to "In Practice." I am grateful for the expressions of concern and encouragement, but I have decided to set this blog aside - at the least, to stop contributing to it regularly. From the start, the blog was a one-year experiment. Read More

Fuhgeddaboudit

If we had a drug that could erase bad memories, should we use it? That was the question the press extracted from an arguably limited set of observations reported in an on-line article in Nature Neuroscience. Read More

As They Say on Facebook: Status Update

Just a note to let readers know that shortly (morning West Coast, afternoon, East) I will be participating in "AirTalk with Larry Mantle," on public radio. The topic is the ethics of memory modulation - via medications, such as propranolol, that may be able to interfere with the consolidation of fearful associations. Read More

Why Ski

The family took a trip to the mountains this weekend. Skiing is an impossible sport. From where we start, the drive north takes four and a half hours, if you don't hit bad weather or traffic, but you always do. This time, on our way up black ice slowed the interstate to thirty, allowing for a leisurely view of the spinouts. Then there's the equipment. Read More

More Naked Emperors

Readers of this blog will be familiar with the skeptical stance that holds the efficacy of psychiatric interventions—medication, psychotherapy, magnetic stimulation, and the rest—to be largely unproven. Readers may be less aware of doubts about placebos. Read More

His Own Country

Abraham Vergehese's new novel, Cutting for Stone, raises the question: can a page-turner be high art? Read More

Antidepressants and Suicide: WHO Scientists Weigh In

On the question of new antidepressants and suicide, the evidence we have has been synthesized, and the results are in: the medications prevent suicides in adults, and especially in the elderly. For children and adolescents, we simply don't know - and the gap in our knowledge has had dangerous effects. Read More

Lexapro and Zoloft in a Cloud of Dust

Is one antidepressant more effective than another? A new summary of "horse race" studies favors Zoloft and Lexapro -- but the real winner is . . . Read More

In Memoriam, John Updike, 1932 - 2009

What a dear and rewarding companion John Updike has been. As a teenager, I must have come across a story of two of his in the New Yorker, but my first substantial encounter came in the summer of 1966, when The Centaur was assigned as reading for incoming Harvard and Radcliffe freshmen. Read More

Perversion, and the Mystery of Sexual Desire

Today's Slate features my review of The Other Side of Desire, by Daniel Bergner. In yesterday's magazine section, the New York Times showcased Bergner's reporting on scientific explorations of women's sexuality. The book deals mostly with a different topic, perversion, and here the contributions of formal research are limited, a fact that signals a major change in the psychiatric paradigm. Read More

We've Gotta Crow

As I did with yesterday's posting, I apologize in advance for distraction from the main event - today, the glorious inauguration. (Did anyone else find Reverend Joseph Lowery's benediction to be the sentimental high point? Michelle Norris did a touching interview with him yesterday.) But a phrase in Richard A. Friedman's essay in the Science Times reminded me of a wild goose chase I once enjoyed. Read More

A Fortunate Man

Today we should all be revisitng the "I have a dream" speech. Anthony Lewis contributed a wonderful essay yesterday about what sounds to be a thoughtful book, King's Dream, by Eric J. Read More

The Major Scourge of Humankind

A milestone was reached toward the end of last year, and the press made no note of it. In October, the World Health Organization declared that now, among all the illnesses and forms of injury it measures, "depression is the leading cause of years lost due to disability."

I have a personal stake in this announcement.

You might as well read Stephen Pinker's cover story in this morning's New York Times Magazine on his genes and yours; it's reasonably entertaining. But for an author like Pinker, who usually packs his essays with fascinating factual nuggets, the piece is also surprisingly content-free. The fault is not Pinker's. Read More

Freebies, Farewell

It seems there will be no more Zyprexa pen-knives, Prozac mugs, or Zoloft soap dispensers. Drug companies have agreed to a moratorium on branded goodies for doctors. Will the ban on freebies lead to better prescribing? Read More

On the Bright Side, Again

I'm always amazed at how resistant depressed patients are to trying bright light therapy. The treatment may help; and even when it doesn't, people who try it tend to like it. Read More

On Who Can't Write What

In today's New York Times, David Brooks celebrates a magazine piece that appears to show that private college undergrads can't write coherent prose. But with journalism, as with students' essays, it's buyer beware. Read More

Looking on the Bright Side

In the face of the economic crisis, patients' outlooks may be oddly upbeat. For some, the recession offers justification. In their business, they were the ones who counseled prudence. More broadly, financial setbacks accord with the melancholic worldview. Read More

Relevant to Nothing

It was one of those timely coincidences that lead to long rants. An old friend who's a college history professor came for coffee and dessert last night, and he started complaining about the way undergraduates write. "The admissions staff must all be incompetents!" he roared. Read More