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. The year is up, and I have had to weigh the effects of my participation.
It's been a good run. I've enjoyed the chance to comment on events as they occur and to hear back from readers. To my regulars especially: thanks. On the downside, blogging intruded on my long-term writing projects as other activities, like hosting a weekly radio show, had not.
Blogging can be relentless. You're your own producer, setting your own topics and doing your own research. The temptations are something like addictive. You can think about postings every day. Also, I had a habit of refining essays once they were up. A piece I had online by ten AM was still not in final form at noon. And then I was always taking on other journalistic projects, like book reviews for Slate and the Washington Post. In the wake of the recession (I think that's the cause) my clinical practice expanded, generally through the return of patients who already had a claim on my attention. Increasingly, solid blocks of time for planned books became hard to find.
That's my main reason for pulling back - to give my other writing space. The Website has made organizational changes as well, but that factor is less critical. I urge my patients to take control of their schedules. I have wanted to "do as I say."
The end of a project is an occasion for assessment. I have not been fully satisfied with my performance as a blogger. In an opening essay, I wrote "The best blogs, it seems to me, have a personal voice and an element of edge, part humor, part grumpiness." I committed myself to "a certain looseness of focus, as regards subject matter" and a tolerance for variety and idiosyncrasy. I don't know that I got there. Many of my blogs were as carefully researched as my print essays, and more conventional in their form. I rarely got loose - nor did I have a sense that my audience wanted me to. When I strayed, into notes about Alain Robbe-Grillet or bicycling or my experience as a cub writer for Newsweek, those postings attracted fewer readers. The highest click rates were for essays about brain biology.
Invariably, posts about psychotherapy, the field I have taught (and written about) the longest, were less popular than ones about drugs. I wondered about my audience. In effect, readers wrote to say, "You overemphasize psychopharmacology" - but would they spend time with my postings about alternative treatments, such as talk, bright lights, and exercise? Mostly, no.
I sensed, and sometimes read explicitly of, resistance to my approaching health care politics, medical ethics, public health, and the history of psychiatry. Here, I sometimes thought it was a matter of my having failed to introduce myself properly: I should have detailed my prior work in those arenas. (And - my own training and background aside - what is the basis of the objection to doctors' discussing medical ethics? Philosophers are the johnnies-come-lately. From Hippocrates through Osler and on, doctors have debated the proper use of their techniques.) Perhaps some more formal process was called for - when I was aiming for more informality.
Looking at my list of postings, I see that my most frequent function was correcting science writing by the mainstream media, often reporters' sloppy readings of new research. I criticized big Pharma often; but because debunking drug companies is a comfortable activity for journalists, generally when I clarified research results, the reassessment was in the direction of saying, no, that practice was not deceptive, and, yes, that positive effect was more marked than has been reported. I saw my role as merely corrective. I would have undertaken it as gladly for a psychotherapy or form of meditation not given its due. But because the press was so one-sided, often I found myself defending ordinary psychiatric diagnosis and the like.
To clarify science, its tools and its categories, is to protect patients and to strenghthen certain useful cultural perspectives as well. That stance is honorable and necessary. But the role conflicts with my sense of myself as a maverick commentator whose hope is to stand apart and, on occasion, to make radically original observations. Yes, as the writerly consensus moves to oppose industry and the professions, conventionality becomes rebellious - but finally the paradox does not satisfy me. I might leave that honorable undertaking to someone else and move on to other causes. Also, I worry over a word that has recurred in this overview, clear, or clarity; in other writing, my additional aim has been to leave room for paradox, ambiguity, uncertainty, and double-mindedness; short pieces are ill-suited to that posture.
