Awais Aftab
Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific debates inside psychiatry and the psy-sciences.
Awais Aftab did not write this page.
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Their wordsThe problem with medical and psychiatric care is not necessarily that we do too much but that we do too much of some things because we have constrained the supply of all the other things.
↗I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com 1st of 3 in this piece
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Their wordsIt is relatively easy to ask for and be prescribed medications, but quite difficult to see a physician who actually cares and listens and thoughtfully attends to diagnostic work-up and treatment risks and patient concerns.
↗I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com 2nd of 3 in this piece
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Their wordsWhen a patient has ready access to a full range of options, then medication becomes one tool among many, chosen deliberately, not defaulted to out of desperation.
↗I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com 3rd of 3 in this piece
- 7 days earlier
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Their wordsWe have highly imperfect tools at our disposal, and more and more we rely on these tools in situations where their use is less-than-necessary.
↗Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com 1st of 3 in this piece
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Their wordsAnyone selling you anything better than 'highly imperfect' in the realm of mental healthcare is a fool or a grifter.
↗Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com 2nd of 3 in this piece
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Their wordsWhen we start treating weak norms of consultation as strong norms, when we assign preemptive authority in areas where only contributory authority is justified, when we destroy traditional cultural means of support to shunt people into medical treatment, we erode people's capacity to meet suffering with the resources they already have or could have had outside medicine.
↗Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com 3rd of 3 in this piece
- 7 days earlier
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Our reading
Psychiatry's confidence in its theories of mind and brain exceeds the evidence supporting them.
Their wordsPsychiatry has unearned confidence in both its theories of mind and its theories of brain.
↗The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com 1st of 3 in this piece
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Their wordsBut not knowing is not a license to do nothing - to tell patients, well, come back in a decade and maybe we can help.
↗The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com 2nd of 3 in this piece
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Our reading
In providing care, there are no ideological sides — only the patient and what actually helps them.
Their wordsWhen it comes to providing care that helps patients, there are no sides. There is only the patient; the illness or disorder disrupting the patient's life and the lives of loved ones; and, in the case of mental illness and infectious disease, the question of whether that illness adversely affects the broader community.
↗The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com 3rd of 3 in this piece
- 8 days earlier
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Their wordsThe only thing stopping the DSM is a bunch of self-imposed rules and conventions.
↗Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com 1st of 3 in this piece
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Their wordsThere is no consistency, no respect for evidence, no clear bar for when downstream implications matter and when they don't.
↗Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com 2nd of 3 in this piece
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Their wordsI do not believe that DSM deserves the respect and authority we bestow on it.
↗Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com 3rd of 3 in this piece
- 6 weeks earlier
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Their wordsThe Rumpelstiltskin effect is not a claim that receiving a diagnosis is a net benefit or a net positive. It is a claim that the mere act of receiving a diagnosis can be beneficial.
↗The Principle of Rumpelstiltskin: Psychiatrists and Witchdoctorspsychiatrymargins.com
- 3 weeks earlier
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Their wordsThe emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself.
↗The Fantasy of Being "Just" a Psychiatric Prescriberpsychiatrymargins.com
- 10 months earlier
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Their wordsTheir experiences highlight a striking, neglected and unchristened medical phenomenon: The therapeutic effect of a clinical diagnosis, independent of any other intervention, where clinical diagnosis refers to situating the person's experiences into a clinical category by a clinician or the patient.
↗The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org All 3 from this paper
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Their wordsIf a clinical diagnosis can have a therapeutic effect, then, at least in some instances, diagnoses are medical interventions in themselves and ought to be treated and researched as such, with an eye to both positive effects and potential iatrogenic harms.
↗The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org All 3 from this paper
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Their wordsLikewise, self-diagnosis should be understood as an attempt to secure the therapeutic effect of a medical intervention to which patients do not have official access.
↗The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org All 3 from this paper