Shrink Rappers at the American Psychiatric Association's Annual Meeting in Toronto, May 2015

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APA starts today and I'm updating the list of talks we'll be giving.  Roy is already in Toronto for the APA assembly.  We will  be doing the same talks as I had previously posted, but some of the other speakers in our symposia/workshops have had to cancel, so here is the updated schedule.  Any suggestions for restaurants or fun sights in Toronto will be much appreciated!


I'd like to invite you to come here us speak at this year's annual meeting in Toronto.

We will be speaking at the following symposia and workshops:

Value in Mental Healthcare: What Does It Mean, and Who Decides? - Symposium

 Toronto Convention Centre - South, Level 800, Room 801 A,  

 2:00 PM - 5:00 PM, Monday May 18th

Speakers:

Robert Roca, MD, MBA, MPH

  --Value: Medicine's Holy Grail

Benjamin Liptzin, MD

   --Value: Perspectives on Outcomes and Costs

Henry Harbin, MD

   --Measuring Outcomes Using Standardized Tools: Why It's    

      Important and How To do It

Dinah Miller, MD

 --Value: What Matters to the People We Treat?

Sunil Khushalani, MD
  -- Eliminate Waste, Improve Value
Steven Sharfstein, MD
   --Discussant 
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- Are You a Sitting Duck Online? What You Can (and Can't, or Shouldn't) Do About Negative Reviews Your Patients Post About You-Workshop

Toronto Convention Centre - South, Level 700, Room 711, 9:00 AM - 10:30 AM, Tuesday May 19, 2015;

SCHEDULED AGENDA

 Introduction to review sites: John Luo, MD

 Personal experience of negative review: Dinah Miller, MD

 Small group exercise
 Constructive responses by individual psychiatrists and the    

    psychiatric profession:  Paul Appelbaum, MD 

 Future directions: Laura Roberts, MD
 Q and A

_________________________________________________________________

Practical Privacy Issues 

Wed, 5/20: 11:00 AM  - 12:30 PM
11:00 A.M. Sessions

Metro Toronto Convention Centre -Level 800, South Building 

Room: Room 802 A-B 

Chair: Zebulon Taintor, M.D. /Co-Chair: Paul Appelbaum, MD 

Presenters:  

~Paul Appelbaum, M.D.,  NY State Psychiatric Institute 

~ Erik Vanderlip, M.D.,M.P.H. University of Washington

~Lori Simon, M.D.

~Steve Daviss, M.D.    FUSE Health Strategies LLC

Objectives:

• List issues related to electronic health records and HIPAA and other laws and regulations and how to cope with them.
• Describe how to avoid computer and technology operations that increase the risk of confidential data being stolen.
• Take steps to limit risks of financial data being stolen apart from other steps to safeguard patient-specific sensitive data.
• Describe how to use psychotherapy notes to maintain privacy. 

___________________________________

National Action Alliance for Suicide Prevention: Recommendations for Prevention From the Suicide Attempt Survivors Task Force Report--Symposium

 Toronto Convention Centre - South, Level 800, Room 803 A/B, 2:00 PM - 5:00 PM

ABSTRACT:
The stigma around suicide is often associated with whispers or silence, despite the fact that prevention of suicide is a national priority. The National Action Alliance for Suicide Prevention
convened a national task force of suicide attempt survivors last year, releasing a groundbreaking, federally funded report called The Way Forward. The goal of this report is to provide a framework for national, state, and local stakeholders to use when developing resources and initiatives to prevent suicide as part of the National Strategy for Suicide Prevention.
This groundbreaking report identified eight Core Values and seven Recommendations that are helping to catalyze major changes in the national approach to suicide prevention and response. The
speakers will discuss ways in which clinicians and others can bring the report's recommendations to life and open channels of communication and awareness around the topic of suicidal thinking.

Chair: Steven Daviss, MD
Discussant: Dinah Miller, MD

THE NATIONAL SUICIDE PREVENTION LIFELINE: John Draper, Ph.D. : Project Director for the National Suicide Prevention Lifeline


LIVED EXPERTISE: INNOVATIVE PROGRAMS, INTERVENTIONS AND SUPPORTS FOR PEOPLE EXPERIENCING SUICIDAL INTENSITY INFORMED BY LIVED EXPERIENCE
Presenter: Eduardo Vega, MA




Finally, Dr. Hanson will not be presenting at APA, but she will be presenting at the American Academy of Psychiatry and the Law meetings in Toronto earlier in May.  We will post her schedule once it is finalized.   

Per Twitter: Dear Dr. Lieberman and others.....

 Oh my. So over on my Twitter account, I tweeted a tweet that has now been favorited, retweeted, mentioned, ?distorted, and tagged such that I've received over 30 notifications on all sorts of stuff I'd rather have nothing to do with. 

So let me start the story at the beginning.  Earlier in May, the New York Times ran a column called This is My Brain on PMS.   It was a first person account of someone's mental anguish and emotional instability during the premenstrual time.  

Jeffrey Lieberman is a former APA president, the chairman of psychiatry at Columbia, and author of a new book on the history of psychiatry called "Shrinks."   Dr. Lieberman has previously tweeted sentiments that indicate that he wishes the NY Times would publish more science-oriented psychiatry articles and devote less precious space to these "opinionator" pieces or to anything with a sentiment that is critical of psychiatry, although I understand his book is rather critical of psychoanalytic practice.   It's hard to know what is in someone's heart in 140 characters, and Dr. Lieberman posted the following tweet:

Jeffrey A. Lieberman @DrJlieberman  ·  May 5

I guess the #narcissist introspections repeatedly published by @nytimes do provide 1st person accts of #DSM disorders http://nyti.ms/1OWHyo2 

I  read this and thought "Really?"  Did this esteemed psychiatrist really just publically refer to an introspective piece about a patient's distress with the hashtag "narcissist"?  Why?  I assumed (but I don't know) that Dr. Lieberman never evaluated the author of the article and that this was not a clinical diagnosis, but a diagnostic term used in it's street meaning, so a hurled insult or name calling.  To my uninformed read, the past president of the APA was calling a patient names!  I felt protective of the author and I felt a bit embarrassed for my profession, though perhaps I misunderstood the intent here.  I just don't know.  

Bless social media, you get to be impulsive, and I tweeted a reply:

@DrJlieberman Why is a patient's narrative of their difficulties 'narcissism'? #insulting. Perhaps public accounts are destigmatizing.

Dr. Lieberman responded that he did not mean to be insulting but that the NYTimes never publishes serious scientific stuff about psychiatry. Gracious enough for Twitter. This was all on May 5th.

Let's be real here: I don't know Dr. Lieberman, and I don't know Diana Spechler, the author of the PMS article.  This had nothing to do with me and these people are all entitled to their opinions.  Why did I stick my 2 cents in here?  I don't need any more enemies (Shrink Rap comes with it's own set of haters).  I should have resisted the urge to comment.

I would not have given it another thought, but today my Notification marker was popping up numbers again and again.  I was retweeted, favorited, and tagged on a bunch of posts I didn't understand.  Dr. Lieberman was being insulted -- tagged as a symbol for all that is wrong with academic psychiatry, among other things.  My account was tagged along with some other psychiatry bloggers, a Forbes health writer, Ms. Spechler, and The Lancet to name a few linked on to these less-than-friendly tweets.

Since it was beyond me to respond in 140 characters, I'm doing it here.

To @Dr. Lieberman: Forgive my intrusion to your twitter feed. 

To @boringyoungman who likes to stir things up from an anonymous handle: as per my tweets, you need to add your name.  There's no credibility in someone who provokes with no clear identity.  

To @Matthew Harper perhaps you'd like to write an article comparing Shrinks to Shrink Rap.  I haven't read Shrinks so I don't know if it would work, but scream if you want a copy of our version of Telling-it-Like-it-is-Psychiatry.

To all involved, Tweet what you like, but please don't tag me on anything that insults someone.  I am retracting my #insulting hashtag.

Writing about Patients -- or Not

Novelist and psychoanalyst Lisa Gornick has an article in today's NYTime Opinionator, Why I Never Write About My Patients.  She talks about how she ended her career as a psychoanalyst when her novels became successful.  First a leave of absence, then the separation became a divorce.

Gornick writes:

During the years when my stories appeared only in obscure literary journals, never seen by any of my patients, the marriage between my occupations was comfortable. With the publicity that accompanied the publication of my first novel, in 2002, however, many patients became aware of my writing. I knew that whatever responses they might have were “grist” for the therapy mill, but I also knew that just as dreams are transformations of the unconscious of the dreamer, literary works plumb their authors’ inner lives. Analytically oriented therapists such as myself use our responses in sessions as a way of understanding our patients — in a sense, lending our unconscious for the purposes of the treatment. But adding my patients’ responses to my novel into the mix — having my characters, with their links to other corners of my unconscious, in the treatment room — risked, I feared, both clogging the therapeutic mill with too much grist and inhibiting my writing work out of concern for its impact on my patients.

I stopped taking new patients, gave my current patients 18 months notice (sufficient time for nearly all to complete their treatment) and commenced an extended leave.

Eight years later, I tested the waters for returning to my practice — only to discover that the separation should be a divorce. With many of my stories and essays and interviews now available online, and with new mores in which there is no hesitation about looking up anything about anyone, I felt too exposed.

 I'm not one for writing about my own patients, it just doesn't seem either necessary or right, so I can relate to Gornick's concerns.  But when it comes to the analytic belief that the psychoanalyst must be a blank slate whose personal life remains hidden from the patient, then I drift off.  Times have changed and it's hard to remain obscure.  I like social media, and the Internet makes us all so much more more exposed than we'd like to be.  It takes a rare person to ward off every activity that might show up online.  When I think about it, I feel smothered.  In the office, I'm mostly me, but modified to meet the needs of my patients.  In my free time, I'm all me and fortunately the 'me' who lets loose has no criminal convictions.