Lucy!

Yesterday I was on a speaker on a panel at The Annapolis Book Festival.  There were a few glitches--one of the panelists had a family emergency and couldn't make it (--oh, I still have to meet Pete Earley, I was looking very forward to this after all the wonderful things I've heard about him), and the A-V equipment didn't fly and part of my talk begins with a slide show set to music called The Public Face of Psychiatry, that I like to use as a set up for why psychiatry needs blogs and books and an image re-do.  It all went fine despite the missing panelist and AV issues--I showed the slideshow on my computer and it was worked fine. 

The most notable part of the event, however, was that my Co-panelist, Joani Gammill, author of The Interventionist,  came with her emotional support chihuahua, Lucy.  What a sweet little dog!  She also came with her beautiful, charming, and very mature 13-year-old daughter, but the daughter remained in the audience, in charge of the never-used dog carrier.  Lucy, however, was front and center on the panelist's table.   And to think, I actually ironed my shirt that morning.  If I knew there would be a dog to focus all the attention, I would gone wrinkled.  


Joani  and Lucy spoke first while four men worked on the projector on my behalf.  After I spoke, I asked for questions.  The first question, influenced I'm sure by Lucy-- was from someone who wanted to know how I used animals in my practice of psychiatry.  Oh my.  I really can't compete with a chihuahua.  I thought of my dogs, Kobe, the incredibly high strung Pomeranian who appeared in my back yard two-and-half years ago, and Max, the wonderful mutt-from-the-pound who hated closed spaces and died of cancer last year.  I told what few pet stories I had: I'd brought Max to my office once on a weekend.  He panicked in the elevator (we left by the stairs).  He couldn't even sleep in a bedroom with us, he scratched at closed doors.  No therapy for Max.  And Kobe doesn't sit still and would be an amazing distraction.  Kobe, sad to say, is all about Kobe.  And once upon a time I was medical director of a clinic.  One day I looked outside my first floor office window and there was a man on the sidewalk outside the clinic with a 10-foot-long albino python wrapped around his neck.  He wasn't a patient, and I asked him A) what does it eat and B) to leave.  Snakes and community psychiatry clinics don't mix.  A patient once brought a dog to a session with another psychiatrist in her handbag (I don't recall this being a problem).  And another patient brought his pet ferret in.  I asked him not to because there were children in the waiting room petting the ferret and I didn't think it was fair for some poor mom to have to explain to the pediatrician that her kid got bitten by a ferret while she was waiting to see her psychiatrist.  The member of the audience suggested I get a fish tank-- not a bad idea, my dentist has an amazing one--but I struggle to keep the plants alive, arrange separate coverage for them while I'm away, and....well, I'll think about the fish idea.

Okay, so Joani has been to rehab compliments of Dr. Phil, and has continued to work with him in her own role as an interventionist.  You can see why she'd be good, and I put a Dr. Phil clip with her up above.  The Shrink Rappers have an funny fondness for Dr. Phil after  ClinkShrink and Roy tricked me into  believing we were talking to him on the phone during a podcast.   And while, I'm plugging other people, I hope all is well with our missing panelist, Pete Earley, and do check out his wonderful book Crazy: A Father's Search Through America's Mental Health Madness.   


It was a very fun morning.  They gave me a nice gift bag for speaking and told me to take two for my co-authors, so Clink and Roy, I have gifts for you (note to Clink, includes T-shirt and coffee...)  We even sold a few books and I got to be on a panel with a chihuahua.

And if you've never listened to the Dr. Phil prank that my co-bloggers played on me, you can find it here.  Hard to believe I'm advertising how gullible I am.

Found on My Facebook Page

We talk about ducks here on Shrink Rap, but in my 'real' life, I like giraffes. I was very excited when today's American Journal of Psychiatry arrived in the mail and there were two giraffes on the cover! And if that wasn't wonderful enough, Henry put the cover up on my Facebook page with the cover of Shrink Rap in the background and mama giraffe saying to baby giraffe, " Because I'm your mother, no playtime until you finish reading!" How'd he do that? Well, I liked it, so I thought I would share it with you.

If you didn't catch it, our book was reviewed in The Johns Hopkins Magazine by Kristen Intlekopher. Three authors couldn't ask for a better review, so please do read it! You'll need to scroll past oysters, cell phone radiation, and political order, but this review made my day.

Someone asked if I would friend Jesus if he were on Facebook. I can't imagine I would ask to be his friend and I'm not sure what I would do if Jesus sent me a Friend request. Who thinks of these questions?

i before e, except after w?

I mean we're shrinks, we deal with the weird everyday. If anyone knows weird, it's us.

So I get this email from Roy. Stop spelling it "wierd" it's "weird" you have it stuck in your head wrong. He's right and he gave me a long list of places on Shrink Rap where weird is misspelled as 'wierd.' Only they weren't all me. Clink did it a couple of times. Sarebear did it in our comment section. I did it a bunch. This is weird. But it is "i before e except after c"...right? Why is weird spelled weirdly?

Maybe I need a new word. Strange. Unusual. Unconventional. Odd. That's a good one, even I can't spell "odd" wrong.

From Wikipedia:

Old English wyrd is a verbal noun formed from the verb weorþan, meaning "to come to pass, to become". The term developed into the modern English adjective weird. Adjectival use develops in the 15th centrury, in the sense "having the power to control fate", originally in the name of the Weird Sisters, i.e. the classical Fates, in the Elizabethan period detached from their classical background as fays, and most notably appearing as the Three Witches in Shakespeare's Macbeth. From the 14th century, to weird was also used as a verb in Scots, in the sense of "to preordain by decree of fate".

The modern spelling weird first appears in Scottish and Northern English dialects in the 16th century and is taken up in standard literary English from the 17th century. The regular modern English form would have been wird, from Early Modern English werd. The substitution of werd by weird in the northern dialects is "difficult to account for".^[1]

The now most common meaning of weird, "odd, strange", is first attested in 1815, originally with a connotation of the supernatural or portentuous (especially in the collocation weird and wonderful), but by the early 20th century increasingly applied to everyday situations.^[2]

Enough. It's all too weerd. The chinchilla is for Jesse because his preoccupation with the little rodents is kind of ....different.

The Sunday Morning Shrink Rapper Update.

I've decided to start reading the Sunday New York Times in bed--- no electronic distractions and I actually sort of read. I love the internet, but I think it makes me crazy.

The NY Times has a feature on Debra Winger and talks about her acting come back in the role of Frances on In Treatment. Click here if you'd like to read it.

I'm reading a wonderful book, a memoir by Dr. Mark Vonnegut called Just Like Someone With Mental Illness Only More So. When I was a kid, I loved Kurt Vonnegut's novels. Unusual family with lots of genius and mental illness. I will write more about the book when I finish it, maybe later today?

Tried a great new pizza place last night. Trouble parking and I thought I'd never go there again, and then we ordered a boring pizza because we have topping-issues in my marriage. Great spinach salad, and as we waited for the pie, I coveted the pizza's around us with sausage, veggies, mushrooms, oh.... but then our Four Cheese Pizza arrived and it was amazing. We didn't even mind that we were by far the oldest people in the place, and I will definitely go again, maybe on a weekday. So here's a plug for Iggy's.

As for the rest of my day? Roy wanted me to go to lunch with him so he could convert me into someone who fully understands the details of an issue that has come up in our state with hospital reimbursements. The restaurant he chose isn't open on Sundays. Oh, and he's decided he's busy with one of his many other projects. Clink wanted to work on posting another podcast with me, but got a last minute invite to a birthday party and has blown me off. I've pointed out to her that she was on my "A" list as a first-choice friend for a Sunday afternoon. The day-before birthday party invite and she was clearly on that person's "B" list. Apparently, my company doesn't compare to the prospect of birthday cake.

Our little dog, Kobe, the hyperactive one, was shaved down yesterday in an event called grooming. I suggested husband take him to the Ravens Game (Kobe would like that) but was told, "As a comfort dog? Kobe is the farthest thing from a comfort dog."

Psychiatry Is For The Birds (Or: Prozac For Polly)

Don't ask me how I stumbled across this story, but I thought it was fun enough to put up on the blog. It's a study done by a parrot rescue organization in Minnesota that describes a kind of trauma recovery program for birds, using human development models. See the full article: "Avian Affective Dysregulation: Psychiatric Models and Treatment for Parrots in Captivity".

The group has a clinical psychologist and trained volunteer caregiver "therapists" while the parrots are known as "clients" (not "patients"). The five cockatoos described in this study are even given pseudonyms to protect their anonymity. The team develops individualized treatment plans for each bird that are supposed to help them recover from traumatic rearing through gradual exposure and de-sensitization.

In this paper the researchers classify the birds according to one of four attachment styles: secure, insecure-avoidant, insecure-ambivalent and disorganized-disoriented. Each attachment style is thought to be the result of certain early and juvenile caregiver experiences. Birds exposed to frequent changes of caregivers, or caregivers who were abusive or unpredictable, developed insecure or unstable attachments to other birds and to human caregivers. These birds had a number of bird "symptoms" or behavior problems such as withdrawal, lack of affect (unh...how can they tell if a bird has a flat affect?), attacking or biting behavior or a "flat crest" (I think that's the bird equivalent of a dog with it's tail between it's legs).

The paper really doesn't go into detail about how the birds were treated except to say they were given opportunities to "exercise autonomy, agency, and social and physical competence". They were also gradually reintroduced (or introduced for the first time) to other birds. The cockatoo which came from a stable, secure and consistent human family was surprised by the other birds (since he had never been around them before), but he adapted quickly to the flock and didn't show any maladaptive behaviors. The bird from the violent and substance abusing family had unpredictable and sometimes violent reactions to other birds. One bird was given a "social facilitator"---another bird who supposedly modeled appropriate bird behavior and taught him how to adapt to the flock---his own emotional support animal.

They also tried giving the most unstable cockatoos psychiatric medication such amitriptyline, clomipramine and Prozac, but the results were inconsistent. (And yes, they even figured out a way to give informed consent.)

I thought people might enjoy reading about "transpecies psychiatry". You might find it interesting to read about elephant PTSD as well as EMDR therapy for traumatized horses.