The new Diagnostic and Statistical Manual Fifth Edition [DSM-V] has a new diagnosis for frequent and severe anger outburts and underlying irritability, Disruptive Mood Dysregulation Disorder[DMDD].  This diagnosis targets children and adolescents who have problems with anger control that do not seem to be related to moods and do not seem to respond to medications…

When I was on the faculty at the University of Pittsburgh School of Medicine, some of my research regarding the effectiveness of medication for ADD/ADHD utilized a single subject research design.  This design uses each person in the study as their own control.  This helps eliminate the uncontrolled variables in large n [number of subjects…

Starting in the 1980s, there was a focus on identifying risk factors for developing disease and yet it was clear that risk factors such as smoking, alcohol abuse and sexual behaviors were not evenly [randomly] distributed across the population. It was also found that risk factors for chronic diseases clustered with many people having more…

After the terrorist attacks in Paris, I heard a priest give a sermon where he said that we are being consumed by fear, that we are like vultures, and the fear is like carrion. This sounds like we are consuming fear and can’t get enough of it. My patients have shown me that their fear…

Recently I received a call from one of my patients who told me that he was running out of his aripiprazole [Abilify] medication.  I had recently increased his dose fom 7.5 mg to 15 mg and I remembered feeling surprised that he was requiring a dose above 7.5 mg.  He told me that he was…

I recently saw a Michael Jordan poster that pointed out all the shots that he had missed [thousands] including game winning shots that he missed.  It ends by saying that he failed repeatedly and that was why he succeeded. Do you believe that?  Does failure lead to success? Right after seeing the poster, I met…

David Brooks had an opinion piece in the New York Times on January 21, 2014 that he entitled “The Art of Presence.” He describes how a victim of trauma have times when they feel overwelming despair and paralyzed by fear. These victims have experienced what is helpful from other people who interact with them. One…

I’ve been helped by my patients to see patterns of brain functioning in people who have difficulty concentrating and focusing.  They seem to rely on stress and deadlines to help them focus.  They also seem to be able to focus if they are excited about something and find it novel and stimulating.  So, concentration and…

I’ve had several requests to write another blog about grief.  A number of my patients have lost pets, mostly dogs.  Some have had to make the decision to euthanize their pets.  We have had discussions about how to prepare for the death of a pet.  This includes whether to create a shrine to their pet.…

Empathy is good and shame is bad.  So why is this a big deal?  It may be because shame is so destructive and empathy is so helpful. What makes shame so destructive? If you have ever experienced shame [and it is possible that everyone has experienced shame] then you know how bad it feels.  Shame…