Sacramento Street Psychiatry

More than just meds.

by Steven Reidbord, MD

Movie Review: "A Dangerous Method"

Tonight I was invited to an advance screening of "A Dangerous Method," a film about the early days of psychoanalysis. It stars Keira Knightley, Michael Fassbender, and Viggo Mortensen, and will be in wide release by Sony Pictures Classics this month. The invitation was extended to Psychology Today bloggers, among others, in the hope we'll publicize the release. Read More

Do You Analyze Everyone You Meet?

People sometimes wonder whether I "analyze" everyone I meet. This is usually asked with some fear that as a psychiatrist I can "see right through them" and instantly know things about their innermost thoughts they'd prefer to keep hidden. Although this is true (just kidding), I try to reassure them with the following analogy. Read More

Therapy for Therapists

Tara Parker-Pope of the New York Times blog Well featured my prior post, on the feelings some patients have as they imagine whether their psychotherapists have been in therapy themselves. My post was about patients' fantasies, not the reality of therapy for therapists. Read More

“Have You Seen a Therapist Yourself?”

Recently a patient asked whether I'd ever been in therapy myself. Without answering his question directly (see my thoughts on psychotherapist disclosure and privacy), I replied that many of us have, and asked what it meant to him. Read More

Do Antidepressants Work?

There is an active debate underway in the popular literature about whether antidepressant medications actually do anything chemically helpful for depressed patients. No one doubts that many patients report feeling better, and that most evidence less depression on standardized rating scales, following treatment. Read More

The lure of rapture

Fundamentalist Christian minister Harold Camping of Oakland, California, has widely publicized that today is the day of the Rapture, when according to some interpretations of the New Testament true believers ascend to heaven to escape impending misery and turmoil on Earth. I am writing in the afternoon, and can't guarantee just yet that Camping is mistaken. Read More

Talk doesn't pay: Comments on the NY Times article

Commentary on an article about a psychiatrist who gave up therapy for a medication only practice. Read More

Embracing psychiatric uncertainty

I always get troubled looks from psychiatry residents when I point out that our field is the domain of the uncertain and the not-well-understood - and that it will always remain so. As soon as the cause of a disease is known, it automatically leaves psychiatry for another specialty. Read More

Should therapists accept holiday gifts?

December brings the annual pleasures and challenges of holiday gifts and how to deal with them in dynamic psychotherapy. Although it is relatively easy to follow a simple rule about this, ideally a good deal of thought goes into a therapist's decision about whether to accept a patient's holiday gift. Read More

Diagnostic alphabet soup

Why some psychiatrists — and patients — embrace a growing avalanche of diagnoses. Read More

If I accused you of being a Martian...

In dynamic psychotherapy, patients often say how hurt and victimized they feel as a result of unkind judgments or criticisms by others:

"My coworker called me a hypocrite!"

"My mother told me I neglect her by not visiting enough."

"My husband complains I'm too self-centered." Read More

Bull in a China Shop

A bull in a china shop is a risky proposition. But how did it end up there? When this phrase is applied to human relationships, sometimes the bull isn't the problem. Read More

Countertransference, an overview

I attended a very good lecture last week on contemporary views of countertransference. It inspired me to write a brief overview of the concept here, with more to follow. Read More

Would You Trade Years of Life for Happiness?

Fully half of top athletes surveyed say they would take a drug that guaranteed sports success even if it killed them five years later. Surveyed non-athletes overwhelmingly reject this Faustian bargain. Yet nearly everyone engages in activities that potentially sacrifice years of life for short-term happiness or satisfaction. How are we comfortable with this? Read More

"I Don't Want to be in Therapy Forever!"

Traditional therapy is open-ended. So when does it stop? Read More

Sailing between support and insight in therapy

For more than a decade I've taught a seminar in dynamic psychotherapy to psychiatry residents. One tricky issue that arises every year is the apparent choice between conducting a "supportive" psychotherapy, versus an "analytic" or "insight-oriented" one. I developed a sailing analogy to clarify this issue, and to teach an important point about it.

Recently I evaluated a new patient, a young woman who wondered whether medication might ease her depression. She was in therapy elsewhere, and although seeing me was her idea, she was apprehensive about adding an antidepressant. I did end up recommending one, at which point she asked: "Aren't antidepressants just a crutch?" Read More

What Happens on Sacramento Street?

Sacramento Street is a pleasant east-west boulevard that runs north of Golden Gate Park in San Francisco. One section of Sacramento, together with adjoining side streets, forms a neighborhood in which many of the city's private-practice psychiatry offices have been located for generations, many fashioned from subdivided and re-purposed Victorian homes. Read More

Steven Reidbord, MD, is a psychiatrist and chair of the Continuing Medical Education Committee at California Pacific Medical Center, as well as a consultant to the California State Bar.

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