Sponsor Shrink Rap for NAMI Walkathon

The National Alliance on Mental Illness is dedicated to improving the lives of individuals and families affected by mental illness, by grassroots advocacy for public health policy and funding that supports awareness, education, and advocacy for mental illness.

So I just realized that the annual NAMI Walks fundraising event in Baltimore is tomorrow morning. While the other shrinkrappers are still having fun and sun in Hawaii, I'll be leading the Shrink Rap team here at home tomorrow morning. Please support NAMI by sponsoring my walk. You'll be supporting a good cause, will feel great after doing it, and maybe even lose weight vicariously! (It's also tax-deductible.) NOTE: you can donate even after the event is over.

Click on the logo above to sponsor, or go to http://www.nami.org/namiwalks11/BAL/drdaviss. I'll be happy to mention your name and/or link if you like in a follow-up thank you post next week (just include your info in the Message To Me window after making your donation). Even $5 will be greatly appreciated!

Thank you,
~Roy

Please Go To Amazon and Write a Review!

Aloha! Clink and I are still in Hawaii on opposite ends of the same island. Gorgeous here, and oh,how I love vacation! I am having some technical difficulties posting from an iPad, and maybe Roy could add a photo for me.

You're used to hearing us say on our podcast, "Please go to iTunes and write a review!"

Now, I'd like to ask, if you've read our new book, Shrink Rap: Three Psychiatrists Explain Their Work,
Please go to Amazon and write a review!

Thank you so much, and I am going back to my vacation now. See you next week. Roy, hold down the blog-- you're doing a great job.

Results from Our Survey on Attitudes Towards Psychiatry

Aloha from the American Psychiatric Association's Annual Meeting in Honolulu! The weather is gorgeous here and it's been a great meeting. Yesterday, I heard Archbishop Desmond Tutu speak, and today, I listened to "Conversations" with Lorraine Bracco--also known as Dr. Melfi from The Sopranos. The beach is nice, too, and Clink has been scuba diving. Should I tell you she just learned to swim this past winter? She is amazing!

In a few hours, we will be giving our workshop, The Accessible Psychiatry Project: The Public Face of Psychiatry in New Media. We are telling the audience that the survey we did was not validated, was not statistically analyzed, and is not real science. Mostly, it was about how cool it is that we can even do this at all (ask questions, interact with readers, have an impact). I thought I'd share the survey results with everyone here. If you took the survey, thank you, again.

702 responses

Summary 

Who are you?

A professional who treats psychiatric disorders (for example, a mental health professional, a primary care physician/ nurse practioner, or pediatrician) 129 19% Someone who works in a field connected to psychiatry, for example a researcher, health writer, clergyman, patient advocate, support staff in a mental health facility 100 15% Someone who is or has been in treatment for a mental illness 410 60% The family member or close friend of someone with a psychiatric disorder 256 38% The family member or close friend of a mental health professional 96 14% An innocent bystander with no direct relationship to the mental health profession 63 9% Other 79 12% People may select more than one checkbox, so percentages may add up to more than 100%.

My age group - Choose one
	Under 20 20 3% 21-35 251 36% 36-50 225 32% 51-65 163 23% Over 65 20 3% People may select more than one checkbox, so percentages may add up to more than 100%.

My perception of psychiatry has been primarily shaped by . . .
	My personal experiences as either a professional in the field or as a patient 550 81% The experiences of those close to me 291 43% The portrayals I see in the media 117 17% Information I have read about psychiatry 337 49% I don't have any preconceived ideas about psychiatry 17 2% Other 32 5% People may select more than one checkbox, so percentages may add up to more than 100%.

I believe that psychiatry . . .

more often than not helps people with mental health problems 448 66% more often than not harms people with mental health problems 77 11% encourages people to use diagnostic labels to explain their bad behavior or laziness 119 18% provides explanations for behavior in a way that is ultimately helpful 338 50% is a field that is about controlling others and is basically evil 36 5% is a field that is about helping those with mental disorders to live better lives 467 69% Other 181 27% People may select more than one checkbox, so percentages may add up to more than 100%.

Psychiatric patients, in general, ...

are just regular people 524 78% are more creative and/or interesting than the average person. 125 19% are uncomfortable to be around 79 12% are often dangerous or scary 32 5% are unreliable 55 8% should not be permitted to work in certain professions, such as medicine, child care, or law enforcement 33 5% live better lives if they hide the fact that they suffer from mental illness 151 22% live better lives if they are open with the fact that they suffer from mental illness 221 33% Other 157 23% People may select more than one checkbox, so percentages may add up to more than 100%.

Psychiatrists are . . .

interesting people 284 43% weird people 146 22% intimidating because they may analyze me in public settings or know what I'm thinking 49 7% on the whole, no different than any other group of professionals 317 47% pawns of the pharmaceutical industry 159 24% interested in knowing and understanding their patients as complete human beings 280 42% just interested in symptoms and medications 215 32% troubled people looking to cure themselves 64 10% I have no opinion about psychiatrists 26 4% Other 166 25% People may select more than one checkbox, so percentages may add up to more than 100%.

Have you ever been evaluated or treated by a psychiatrist? -
	Yes 447 64% No 215 31% People may select more than one checkbox, so percentages may add up to more than 100%.

Psychotherapy . . .

more often than not helps people recover from or manage mental illness 417 62% more often than not helps people to better understand themselves and negotiate their lives 457 68% encourages a detrimental, self-centered perspective 50 7% more often than not makes people feel or behave worse than they did before they entered treatment 23 3% is for people who don't have friends to talk to 56 8% is more often than not inferior to medication as a treatment for mental disorders 54 8% is more often than not superior to medication as a treatment for mental disorders 176 26% does nothing 29 4% I have no significant opinion about psychotherapy 45 7% Other 154 23% People may select more than one checkbox, so percentages may add up to more than 100%.

Have you ever been in psychotherapy? -
	Yes 486 69% No 176 25% People may select more than one checkbox, so percentages may add up to more than 100%.

Psychiatric medications . . .

more often than not help people recover from, or cope with, their difficulties 368 55% more often than not cause problems that are worse than the ones they treat 140 21% have saved lives and helped people to function better 490 73% are a quick fix for people who don't have the inner strength to deal with adversity 63 9% treat illnesses that can strike anyone 388 58% are the creation of a greedy pharmaceutical industry that has deceived the public 138 21% I have no opinion about psychiatric medications 15 2% Other 223 33% People may select more than one checkbox, so percentages may add up to more than 100%.

Have you ever taken psychiatric medication? -
	Yes 458 65% No 210 30% People may select more than one checkbox, so percentages may add up to more than 100%.

Sometimes, patients are seen for brief visits by a psychiatrist for management of their medications and if they need psychotherapy, they see a social worker, psychologist, nurse therapist, or counselor (so-called "split treatment"). What do you think of this practice?

Brief visits with a psychiatrist for medication management typically work well 154 23% Psychiatrists should spend more time than this with their patients to manage medications 348 52% When possible, psychiatrists should provide both psychotherapy and medication management to their patients 377 56% Patients should not see psychiatrists at all: medications should be managed by other professionals such as primary care physicians, nurse practitioners, or specially-trained psychologists 38 6% I have no significant opinion on this topic 52 8% Other 161 24% People may select more than one checkbox, so percentages may add up to more than 100%.

Electronic Health Records (EHRs or EMRs) . . .

should not contain any records of psychiatric illnesses and treatments (including medications) even though that means my primary care doc or ER doc wouldn't know about my meds or condition unless I tell them 89 13% should have separate and higher protections for mental illness than for other health problems 218 32% should exist for psychiatry exactly as all other medical records do, with the same protections as for other health condition, because adding special protections increases stigma against mental illness 275 41% should allow patients to control which information they wish to be shared and with whom for all medical specialties 290 43% facilitate better communication and improve psychiatric care 261 39% negatively affect communication and detract from psychiatric care 49 7% I have no significant opinion about electronic health records in psychiatry 74 11% Other 94 14% People may select more than one checkbox, so percentages may add up to more than 100%.

Direct-to-Consumer (DTC) advertising (commercials/magazine ads) of medications . . .

decreases the stigma associated with taking psychiatric medications and is therefore good for psychiatry 142 21% scares prospective patients too much with the lists of side effects 109 16% provides incomplete medical information and the suggestion that patients should demand specific treatments without individual consideration of the patient and their problems 497 74% provides useful information to patients and increases awareness about treatment options 128 19% should be allowed to continue 90 13% should be no longer be allowed 304 45% I have no opinion about direct-to-consumer advertising 43 6% Other 109 16% People may select more than one checkbox, so percentages may add up to more than 100%.

Psychiatric blogs by mental health professionals . . .
	more often than not are useful sources of information 300 45% more often than not are biased and unhelpful 36 5% are entertaining or interesting to me 401 60% I have no opinion on psychiatry blogs by mental health professionals 176 26% Other 53 8% People may select more than one checkbox, so percentages may add up to more than 100%.

Blogs about psychiatry in general -- including those by patients and those who may be disenchanted with psychiatry -- have . . .

provided encouragement for me to get treatment or to recommend treatment to others 110 17% discouraged me from getting treatment or recommending psychiatric treatment to others 28 4% had no influence on my attitudes towards psychiatric treatment 216 33% had a positive influence on how I view psychiatry 133 20% had a negative influence on how I view psychiatry 55 8% I have no opinion on psychiatry blogs in general 211 32% Other 97 15% People may select more than one checkbox, so percentages may add up to more than 100%.

Do you feel this survey is balanced and fair? -
	Pretty much 431 61% In the middle 198 28% Not really 40 6% People may select more than one checkbox, so percentages may add up to more than 100%.

Comment box for additional comments or suggestions . . .

You're missing the large portion of the population who doesn't read blogs like this. My close friend has very different attitudes toward psychiatry (they are wierd, controlling, just want to push meds, etc.) and she may be more the typical person.You surely didn't think this was a balanced or fair survey. did you? Was that part of your plan?You have to find a way for members of the same family (spouse/parent) who are on the same insurance policy not to see each other's medication/psychiatric treatment records.Lawyers take the name of a medication and then create an attack on the person for ...

Number of daily responses

Guest Post from Eric Stevenson: Caring for a chronic illness patient: A difficulty on its own

This Guest Post is from Eric Stevenson, a health and safety advocate who resides in the South Eastern US.

Having a chronic illness can be extremely tough, not only for the patient themselves but also for those who care for them. The process of loving and supporting someone with a chronic illness can be very difficult and challenging. Many times caregivers don’t want to speak up about their own stress because they may feel guilty or that it doesn’t matter as much than the patient’s problems. Luckily, there are a few ways to be prepared and help in the difficult situation of caring for a person with a chronic illness. 

There’s a great amount of social factors and possible coping strategies involved with care giving, as some things can influence stress levels in a positive or negative direction. Financial instability can cause major stress and mental issues for caregivers. In many times a chronic illness can lead to major financial problems as hospital bills continue to stack up. Financial factors can influence the mental state of caregivers in either direction. With more financial support, caregivers are often able to delegate some of their responsibilities, thus lowering stress and improving mental health. 

Social support also plays a huge role in the process of caring for a chronic illness patient. The help of family, friends, or even neighbors can play both a positive and negative part in the mental state. Not allowing for any support for the patient can often cause problems, but so can minimal support for yourself or a care giver. The stress and difficulty of taking care of someone with a chronic illness can be a major burden. Not having anyone to talk to or vent is often a major cursor to stress. 

Many people deal with side effects of coping strategies. Some may take to avoidance, but in many cases that will lead to further health problems. Avoidance as a coping strategy has been known to bring on many cases of depression. Many caregivers with low self esteem will use emotionally charged coping strategies, while those with high self esteem may turn to task centered coping methods. In the end, research has shown a large connection in self esteem and depression within caregivers. 

Factors such as the type of illness and location will also play a large part in the process. Some diseases like mesothelioma (a cancer forming from asbestos exposure) will have a severely low life expectancy. When compared to a patient that may be expected to live many years longer, the care giving situation will be extremely different. 

In the end, there are certainly a few factors that will play a large part in the role of a caregiver for those with chronic illnesses. The value of a support system and being educated on the disease will remain important. Caring can end up being extremely difficult and stressful, thus caregivers should also be looked out for in the future.

We Got Our Duck!

Jackie, our wonder editor, told me there was a duck surprise. Oh, good. I like surprises. And Shrink Rap likes ducks. And then I forgot.

So this morning I went to check out the Johns Hopkins University Press booth at the Exhibit Hall here in Honolulu at the APA. Lots of books, lots of people, and they have a poster up for Shrink Rap in a corner. And a big screen with images that change. Then I noticed it: the Shrink Rap stuff all has ducks on it! This, after they denied us a duck on our cover and said it made us look like quacks.

Ok, so it's beautiful here in Oahu and I'm off to soak up some sun.
I woke up at 5:20 this morning and have been learning about psychiatry all day!

Just a quick note to myself and a to-blog-about list. We've been so busy lately that time has been short for blogging and podcasting, but I still have ideas, so coming posts will (some day!) be:

--Response to the med student who wanted to know how to deal with negativity when she says she wants to be a psychiatrist.
--What is anti-psychiatry and why does it bother me. (Please pray for me if I go there).
--The chapter I wish I'd written, inspired by Jesse's comments.
--We got a request to talk about how autism may mimic psychiatric symptoms on our next podcast. Maybe we'll respond to the medical student on a podcast instead.

Ever feel like life gets just too busy? Okay, having fun at APA, gotta catch some rays now.
--

Come Visit Us at APA In Honolulu!

So glad Blogger is back. I was starting to go into withdrawal despite Roy's reassurance that it would be okay!

Aloha! Do come meet us at APA. I've never been to Hawaii before, I'm looking very forward to this.

On Monday, Morning, May 16th at 11 AM, we will be doing a book signing in the Exhibition Hall at the Johns Hopkins University Press at Booth 1424. The Press will be discounting our book to a mere $12, cheaper than you will find it anywhere! Let me further remind you that this may be a tax deductible business expense. Oh, come visit even if you don't want a book! ClinkShrink will be wearing a duck necklace.

On Wednesday morning at 7 AM, we will be giving our workshop called The Accessible Psychiatry Project: The Public Face of Psychiatry in New Media in Room 326B in the Hawaii Convention Center. If all goes well with the technology, we promise an entertaining multi-media event. It's an early hour, but do bring popcorn anyway.

---

NOTE FROM CLINK:
Ignore what it says on the APA iPhone app about our presentation (they have it listed as 'withdrawn'). We ARE giving it!! I talked to the APA people and they're supposed to fix this.

ANOTHER NOTE FROM CLINK IN HAWAII:
Dinah just texted me that our presentation info was left out of the conference program! Augh, are we cursed?? We ARE giving the Accessible Psychiatry Project presentation on Weds morning at 7:00 am in room 326b.

On the positive side, the iPhone app is fixed and our presentation is listed correctly there.

---

Today's Shrink Rapper News

1) Our book is now out on Kindle. Apparently, you can get it in a minute for $10.

2) One of my old posts is up on KevinMD, Predicting How Much Impact Mental Illness has in a Person's Life.

3) In June, we hope to have another component blog up and running---Shrink Rap News-- we will be doing weekly posts on the Clinical Psychiatry News website. Those posts will target an audience of psychiatrists. Oh, we started with that idea here at Shrink Rap, but the readers we found, both shrinks and non-shrinks, have proven to be so much fun!

4) Aloha! We're getting ready to go to Hawaii for APA-- Roy will give you details about where to find us shortly.

5) Frazzled and frizzled, I did what I've never before done today: I blew off my hair stylist! Not on purpose, but I thought my appointment was 3 hours after she thought it was. Ah, you ask, did she charge me? Do hair stylists charge for No Shows? (They should). No, she had time for me later in the day, and Yes, if I can reschedule a patient who has forgotten an appointment on the same day, I don't charge for the 'missed' session. Someone would have asked that, right?

Those Privacy-Invading Pediatricians, Silenced!

A while back, Roy blogged about proposed legislation in Florida that would make it illegal for physicians to ask patients if they own guns. What the??? Since when do we legislate what people can ask each other, outside of discrimination issues for jobs? And is there any precedent for legislating the conversation that occurs between a doctor and patient? So apparently this is going to pass, and Greg Allen writes in "Florida Bill Could Muzzle Doctors on Gun Safety,"

Florida Gov. Rick Scott is expected to sign a bill that will make the state the first in the nation to prohibit doctors from asking patients if they own guns. The bill is aimed particularly at pediatricians, who routinely ask new parents if they have guns at home and if they're stored safely.

Pediatricians say it's about preventing accidental injuries. Gun rights advocates say the doctors have a political agenda.

Ah, it's not about us shrinks, it's okay to ask if there is a question of danger. It's about the pediatricians. Personally, I think the pediatricians should fight back: if they can't ask who owns a gun and target their gun safety remarks, they should give extensive gun safety instructions and literature to every parent at every visit. Perhaps as a statement of unity, all pediatricians in all states should discuss gun safety with every patient, no questions asked.

Happy Mother's Day to All

A Cry for Help

When Roy and I were on Talk of the Nation this past week, a called phoned in to ask about her sister. The question was about care in the Emergency Room/Department, so it was a perfect Roy question and he fielded it. I've been playing with it since, and wanted to talk more about this particular scenario, because the scenario was very common, and the question was more complicated than it seems.

From the transcript of the show:

ANN (Caller): Hi, thank you very much. I would like to ask Dr. Roy (oh, I gave him his blog name here) a question: My sister was admitted to emergency when she cut her wrists, and the doctor on call pulled me aside and said, do you think she was trying to kill herself?

And I said - because my sister is very intelligent - I said, if my sister really wanted to kill herself, she would have done it. I think she's asking for help.

And so he said - and so he had her see the psychiatrist who was on call, or on duty. And she spoke with him for a while. And he sent her home, saying: Well, if you need me, I'm here.

What I would like to ask Dr. Roy is, what protocol was going on there? Why did they allow that to happen? And what would you change, if you could?

----
Roy did a great job touching on issues of voluntary versus involuntary hospitalization and the importance of hooking someone who is looking for help in to outpatient care.

If this were more of a two-way conversation, I'd want to ask more questions. What did the caller think should have happened? Was the sister given a referral for outpatient care? Was she asked if she wanted one? Was she already in treatment? My sense --and I could easily be wrong-- was that the caller thought the patient should be admitted to the hospital. She was desperate and ready now for help. The doctor asked the sister if she thought the patient wanted to commit suicide; hopefully the patient was asked that as well.

So if the caller thought her sister should have been hospitalized, there are things about the 'system' she isn't aware of. Hospital inpatient units are a place that people go to be kept safe. In many ways, they are a holding place and the goals there do not include treatment back to wellness, but treatment back to safety. It's a very low bar, and it ends up that only those who are imminently dangerous, or so disorganized as to be at risk, get admitted from an ER. There are some exceptions: if the ER doc doesn't believe a patient who says he's not suicidal/homicidal, he may err on the side of safety and admit the patient, or if the patient's behavior seems unpredictable, he may get admitted. At a community hospital, a typical length of stay is only a few days, very little actual psychotherapy occurs in the hospital, and while medications may be started, people are generally discharged before those medications can take effect or even be brought to steady-state levels. Gone are the days of long-term hospitalizations. And because of the acuity of illness in those people who are admitted to the hospital, psychiatric inpatient units are often not very restful places. If you want peace and quiet, you're better off in a hotel where you can order room service, have a massage, sleep peacefully, and it costs a whole lot less.

Sometimes people are admitted to specialty units where more intensive treatment does take place which may take longer and may have a goal that goes beyond imminent safety. There are special mood disorder units, eating disorder services, pain units, trauma disorder services, or inpatient stays for ECT...but one doesn't typically get admitted to these from the Emergency Room and often issues of payment limit who can be admitted and for how long. Of course, there is Clink's favorite place, The Retreat, where you can get help in a very pleasant environment, and I imagine they would be happy to have the sister of the caller from the radio, but that is self-pay.

"Getting help" usually means going to an outpatient therapist/psychiatrist and it's not something that necessarily gets started while the moment is ripe. If there is a clinic associated with the hospital, they may have emergency slots for the ER to offer fast appointments, but other times, it can take many weeks to get a first appointment. Private practice varies a good deal-- I know shrinks who can get you in within the week, and others with a 6 week wait, and many who are simply too booked to take new patients.

I didn't write these rules, I'm just letting you know what they are. How do you think it should all work?

Our Book That Was...Then Wasn't....

The official "pub date" on our Shrink Rap book is June 1st. It's a nice date. It's been moved back a couple of times....there was that incident where Roy's hard drive exploded with the index on it that threw things off just a little. Then there's the timing about how it takes about a month from the time the books come in to the warehouse until they get to the store shelves. I guess Harry Potter gets a more precise "pub moment." Amazon, we were told, has it's own release date, based on when the books get to them.

On Friday, we were excited to see that Amazon listed the book as "in stock" with a May 4th delivery date! If you ordered then, it went, no "wait...wait...wait." This was exciting as it meant we could tell people the book was "out." The copy I ordered back in January arrived on Tuesday. So last night, I take a look at Amazon, and the after days of 'only 3 left in stock'..."only 20 left in stock"...up and down with no rhyme or reason-- they are now sold out. Not available now, ships in 1 to 3 weeks. Two days and they sold out? I wonder if they sold one to the person who went on after our NPR interview and gave the book a one-star review on May 4th because it "Sounds like more drug promotion" with no indication that he ever read it. And you wonder why I'm tired of being dissed.

Okay, so Barnes and Noble online still has Shrink Rap, same low price of $12.92.

Here's what the publisher and editorial reviewers have to say about our book. Please note that the "hugely popular" designation was not ours!

Editorial Reviews

Review

One of the most useful books I've read about mental illnesses -- and as the father of a son with a severe mental disorder, I've read just about all of them. It demystifies our complicated medical and legal system, explaining everything from 'chemical imbalances' to involuntary commitment procedures to the most recent advances in brain mapping. If you have a mental disorder, love someone who has one, or are a doctor, therapist, social worker, lawyer, judge, or criminal justice professional, you need to read this book.

(Pete Earley, New York Times bestselling author of CRAZY: A Father's Search through America's Mental Health Madness )

In the too-often confusing and fractured world of mental health services, Shrink Rap is a ready resource for patients and their families looking for more insight into the range of services available and how they are delivered.

(Keith Ablow, M.D., psychiatrist, Fox News contributor, and coauthor of The 7: Seven Wonders to Change Your Life )

Product Description

Finally, a book that explains everything you ever wanted to know about psychiatry!

In Shrink Rap, three psychiatrists from different specialties provide frank answers to questions such as:

• What is psychotherapy, how does it work, and why don't all psychiatrists do it?• When are medications helpful?• What happens on a psychiatric unit?• Can Prozac make people suicidal?• Why do many doctors not like Xanax?• Why do we have an insanity defense?• Why do people confess to crimes they didn't commit?

Based on the authors' hugely popular blog and podcast series, this book is for patients and everyone else who is curious about how psychiatrists work. Using compelling patient vignettes, Shrink Rap explains how psychiatrists think about and address the problems they encounter, from the mundane (how much to charge) to the controversial (involuntary hospitalization). The authors face the field's shortcomings head-on, revealing what other doctors may not admit about practicing psychiatry.

Candid and humorous, Shrink Rap gives a closeup view of psychiatry, peering into technology, treatments, and the business of the field. If you've ever wondered how psychiatry really works, let the Shrink Rappers explain.

Our Fifteen Minutes of Fame!

Can I tell you about our interview on NPR?

If you'd like to read about it on NPR's website or listen to the interview: Click HERE

So the story starts before today. We're shrinks, bloggers, not seasoned media folks, and so it was pretty exciting a couple of months ago when Kathy, the wonder publicist at the Hopkins Press told us that Talk of the Nation wanted to have us on! Only not ClinkShrink because the call in format doesn't allow for more than two guests, and they could use her at another time for a forensic story. Roy and I chatted, Clink chimed in with all sorts of good suggestions from her years of testifying in court and teaching newbie forensics folk to testify, and Kathy wanted to meet to give us some pointers. There were approximately 243 emails involved. And when we met with Kathy last week, she did let us know that if we messed this up, our book-related interviews were finish. Not that I was feeling any pressure, which always mixes well with that pre-interview anxiety.

I picked Roy up at his hospital. I did this because it was on the way and there was no other way to be sure that Roy would make it on time and that I wouldn't have a heart attack if he didn't show up. We got to Washington early and obsessed about where to park, finally opting to park in the NPR building. There were all these people lined up outside waiting for Popsicles from a truck, which we later learned was in honor of the 40th anniversary of All Things Considered. There were no Shrink Rap Popsicles involved, but in the car, I did hand Roy a 'good luck duck.' I have a whole box of them, in case you ever need any.

So we sign in and we're meeted-and-greeted and escorted to a room where we can listen to the radio, wait, and be nervous. We talk about the characters in our book---we'd been warned they might want to mention them, and I had skimmed the book because these people aren't real, they were just vehicles to make all the facts more palatable. Everyone had hated them but me, but even I had forgotten who was who and who did what, and I'm not sure that Roy ever really knew.

Another gentleman joined us. He looked famous, but what do I know. I asked him his name. Peter Bergen. He looked at me like I'd just popped out of a cave and I figured he was famous so I mumbled about how I'm missing a pop culture gene. What are you here to talk about, I asked. I guess that was a really dumb question, because in the last two days, Roy and I may have been the only people in the world on the radio not talking about this. "Osama bin Laden," he said. Right. He asked us why we were there and we told him we'd written about psychiatry. What's it about? We both tripped over our words and had no real clue what our book was about. Funny, but when I got home tonight, my husband was watching that same Peter guy on CNN! Amazing.

So Mr. Bergen goes off to meet Neal Conan, we listen to him on the radio, and we scramble to figure out what we say if we're asked what our book is about. Roy thinks I wrote it in an email once and he searches old documents. I start from scratch: "People don't understand what psychiatry is all about and they make all sorts of assumptions. Shrink Rap explains the nuances and logistics of the practice of psychiatry without all the jargon." Sounds good. Of course, no one else asked what our book was about.

We meet Neal Conan. I'm excited. Roy is oh-so-cool. I ramble because I'm nervous. We sit down and Neal says something about the green button. "I press the green button every time I talk?" I ask. No No No, he'd said, "Press the green button if you have to cough." It's the mute button. Right. Got it. I don't have to cough. Stay away from the green button.

It's like a podcast, and the show itself was a lot of fun. We weren't nervous once we started just talking. I did not faint. I did not vomit. Roy can say the same!

On the way out, I felt like a balloon that had been blown up a little too full and then a pin prick was letting the air seep out. I told Roy that for once he talked more than I did. He said I talked more than he did. We laughed. I let him drive back because my driving makes him seasick.

I check emails. Some nice messages from Sarebear who tried to call in (Thank you!) and Carrie. Barb said we sounded good. One review on Amazon--one star-- and they clearly hadn't read the book. The NPR site already had comments about toxic psychiatric drugs and how psychiatrists don't listen to their patients. Oy, but hey, I've come to expect it. My rant on the subject will be re-posted momentarily .

Kathy called to say we sounded good. Yes!
Thank you for letting me talk about this for way too long!

The Shrink Rappers With Neal Conan on NPR's Talk of the Nation

On Tuesday, May 3rd at 3 PM Eastern time, tune in to NPR for Talk of the Nation with Roy and Dinah as guests (and Clink in spirit). It's a call-in show, and we'd love to hear from you. (Listen to the the 31 minute segment on NPR)

And while we're at it:

Shrink Rap: Three Psychiatrists Explain Their Work
is now available on Amazon at
http://amzn.to/shrinkrap.







If that's not enough:

Please click here to take our short survey on Attitudes Towards Psychiatry.

NPR listeners are invited to take the survey, no mental health experience needed.

To find Talk of the Nation on your radio, click HERE. Please note that some stations do not air both hours of the show (ours is during the second hour). We will post the Internet link after the program airs!
Guidelines for NPR callers can be found by clicking HERE.

Shrink Rap Survey on Attitudes Towards Psychiatry

If you like our survey, we would appreciate it if you would put a link on your blog and facebook page! And, of course, please check back soon for the results!
The link to this post is:
http://bit.ly/shrinkrapsurvey

Podcast #58: I Need a New Drug and Happy Five Years of Shrink Rap and Still Blogging

(Belated) Happy Blogiversary to Us!

Five Years and Still Blogging

Shrink Rap quietly turned Five on April 21st. We chatter about this while we podcast. We kept it short again and talked about some new medications. Roy mentioned a new antidepressant, Viibryd that's a bit like a combo of an SSRI + buspirone. Dinah talked about a conference she went to on psychopharm update and she read some of the slides that were presented by Dr. Neil Sandson. This led us to talk about some other new medications, including long-acting antipsychotic medications that are administered by injection.

We then talked about Silenor, a sleep medication which is the re-packaging of an older medication, Doxepin, in a lower dose. A phone call to the pharmacy revealed some interesting information about the cost of these medications, but you'll have to listen, or call the pharmacy yourself, if you want the answer.

This all led us to a discussion of the combination medication for the treatment of obesity, Contrave, that did not get FDA approval, and Steve's post on his psychiatry blog, Thought Broadcast, on Contrave compared to Swiffer floor cleaning system. Huh? Oh, listen and maybe we make sense.


Thank you for listening.
We invite you to go to iTunes and write a review.

And our Shrink Rap book should be available in the next few weeks: our review copies have arrived. Our next line will be "Go To Amazon and write a review!"

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This podcast is available on iTunes or as an RSS feed or Feedburner feed. You can also listen to or download the mp3 or the MPEG-4 file from mythreeshrinks.com. Thank you for listening. Send your questions and comments to: mythreeshrinks@gmail.com.