Too Much Freedom, pt II

So, let me try to summarize the previous entry (this a just a running thought, folks, and if it seems to be directionless I’ll pull the plug): I’m attempting to invert the notion of “too much freedom,” which is typically aimed towards people seeking acknowledgement of social justice issues, seeing as in reality if there’s going to be an argument for “too much freedom” it’s in the much more serious and widely documented actions by right-wing extremism.

Part of what I’m musing on are questions of how we got here. How, for example, we have so many people who are poorly informed.

There’s an interesting piece in the Globe & Mail, by columnist David Parkinson, pointing out the chasm that can exist between what a populace thinks they know, and what the more complicated truth may be. In this case, some myths that Canadians seem to have come to believe about our economy. We think our interest rates are the highest compared to other countries, but the opposite is true; we think the carbon tax is hurting our wallets but its overall effect is practically negligible on the average person. An easy takeaway from this is the need for better public education about how the parts of the economy work. But even the best education can’t save us from our own psychology.

We’re easily influenced by phenomena which can seem to draw its own conclusions. The sight of a street person sitting on the sidewalk, drinking from a bottle a sherry distracts from the many possible reasons, likely spanning many years, how that sight came to be. If we were able in that moment to step back, we’d begin to see how factors such as socio-economic status, childhood instability, and mental health issues probably contributed to this outcome. Were we magically to have access to this information, it’s likely we would conclude the street person we see on the sidewalk probably didn’t choose to be where they are, which is where our minds might go if we don’t know any better, or don’t wish to know any better.

A very interesting piece of data is the prevalence of brain injury in homeless populations. We know through research data that street people suffer from a host of unfortunate situations. While data may not tell the full (read: nuanced) story, more and more it provides a scaffolding to better understanding, potentially leading to better social outcomes. The problem is that, to the average person a) data is invisible, and b) because most of us just want our individual lives to go well, and don’t have the time or capacity to understand everything else, we rely on a combination of news, friends, social media, suspicion, projection, transference, you name it. So, even before treading into the topic of intentional disinformation, there are many ways in which we can unintentionally lull our way into thinking we know more about things than we do.

All of this said, a defining issue, which I touched on previously is one of severity. There’s a significant degree of difference between someone who mistakenly believes the federal government is responsible for the Bank of Canada’s decisions to hike interest rates, and someone who is spreading hatred against LGBTQ+ individuals on public channels. The consequences to the former are few and isolated. To the latter other people’s lives may be at stake.

And this is where disinformation makes everything worse. It’s the difference between someone having strong feelings against a politician or member of society, and that same someone wanting to storm the Capital building or intimidate drag storytime at the local library.

And I should take a break and come back to this…to be continued.


An Impossible Essay: “The Movement Against Psychiatry”

I’ve been wondering whether to respond to an essay that was posted on VICE Magazine a couple of weeks ago, and so this is my meagre attempt. The hesitation you are picking up is based upon the fact that it’s an almost impossible essay for anyone to attempt to write; impossible because its subject matter contains so many perspectives — ground level, professional, clinical; historical, academic, unacknowledged — that one would need to write a thick book in order to begin to encompass just a notion of the territory that is being covered. The fact that I’m blogging about it means it’s stirred up some feelings (some conflicted) that need to be put on paper. Mostly this reflects well on the piece, despite the fact I’m not exactly a fan of VICE in general.

The essay, The Movement Against Psychiatry, by Shayla Love, lays itself out from the beginning with a profile of two people with two very different mental health challenges: one of whom, it’s argued, might have been helped by being institutionalized (even if against her will) in order to prevent her downward spiral; the other sought psychiatric assistance but found herself over-prescribed with various medications, without a sense of there being an overarching logic or consideration for the underlying causes of her situation, or the side effects of what she was prescribed. In this comparison we are presented with an outline of the challenges facing mental health in general and modern psychiatry specifically.

We are then presented with three groups: the psychiatric orthodoxy, those who belong to what is known as the anti-psychiatry movement, and those who belong (or fall into) what is referred as “critical psychiatry.” The first glimpse of the impossibility the author faces — if using those two persons’ examples off the top didn’t do it — is that, if you stop and consider it, there are inevitably going to be many voices within each of these three groups, ranging from the open-minded to the downright neglectful. For my purposes, it is specifically with how those who belong to the last two groups are separated from each other that I think the piece finds its greatest challenge. A key problem is that there are those who are self-declaratively anti-psychiatric — ranging from wanting to abolish psychiatry altogether to those wanting to revolutionize the foundations upon which patients’ conditions are considered — and those whose philosophy might be considered by the establishment as anti-psychiatric, in a pejorative sense, but who for all intents fall into the “critical psychiatry” group.

To her credit, the author touches early upon the detractive nature of the term anti-psychiatric, however my criticism is that the essay misses an opportunity to convey the power those in the psychiatric establishment have who wield this term, compared to those who are not medical doctors (perhaps researchers, perhaps academics, or clinicians) but who nonetheless have pointed questions about the prevailing logic of certain psychiatric interventions (whether it be about overprescription of drugs, or the use of ECT). That term and its connotations, in other words, can be weaponized, whether or not it is used accurately or as an attempt to discredit or dismiss the person in question entirely.

But I want to be fair where fair is relevant: the author also correctly exposes the fact that the waters of the anti-psychiatry movement are muddied by the more than passive involvement of the Church of Scientology. They have a stake, albeit a selfish one, which is fitting for a cult. This does no one any favours in this debate, and only makes it easier (see last paragraph) to punch down from the psychiatric establishment with only the briefest mention that a critic may have ties to Scientology.

And I will admit that there are a host of well-respected voices who, if pressed, I might put in the “critical psychiatry” camp, who do themselves no favours by using only the most self-serving, one-sided Mad in America articles to labour their (otherwise respectable) arguments. I find by contrast that my professional perspective ends up being more nuanced (which gives me pause given my comparative lack of academic credentials). I believe in a biopsychosocial approach to mental health (whereby causation might be one, or a mix of all). I can tell you anecdotally that, yes, there are people who are temporarily helped by medication, who are able to use that stabilization to pursue non-biomedical interventions like talk therapy. It’s good to question the underlying chemical imbalance hypothesis of depression, but if someone achieves stability enough to be able to advocate for themselves (and to make choices such as tapering off said medication) then so be it.

I think what gets lost in the debate, which can often pit two highly qualified individuals speaking in terms that are highly specialized and often theoretical — and again, I think the author does their best to come back to this point — is that, at ground level, regular people who need help are harmed. Harmed, because their GP likens depression to something like diabetes, insisting that their patient will need to be on drugs for the remainder of their life, or puts their patient on a high dosage of a toxic anti-anxiety med like clonazepam without mandating regular check-ups in order to potentially lessen the dosage. Or they are harmed because community organizations are often ill-equipped to provide consistent space for people who suffer from psychotic episodes. Or they are harmed by an untrained psychotherapist who operates in a province or state where the profession is unregulated, thus allowing practically anyone, regardless of credentials, to see clients.

I keep hearing the word “patchwork” when the mental health support system is mentioned. That is what the average person faces: a patchwork of often disconnected resources with no sense of guidance about what is best for them and their situation. Moving closer to a system that has the capability to provide continuity for each individual within a public health system should be the priority. While there is a need for debate, the largely sectarian nature of it only seems to put that possibility further away.



A Different World


I’m sometimes in the habit of cross-posting from this blog to my professional blog, but this time it’s the other way around. I think it fits.


The COVID-19 pandemic has laid bare the human face behind our central idea of how an economy works — something we have long needed reminding of, lest those of us who are able to pay our rents and leases become too comfortable with abstract terms such as “supply chains” and “stakeholders”. We are reminded that we are a society of interdependent people — individuals, families, communities — and it’s overdue that we see our economies the same: people require support when tragedy makes their livelihood untenable.

And just as the pandemic has made us humbly pause to consider the society we have constructed (or, if I am feeling cynical, we have  allowed others to manage so long as it doesn’t affect our ability to pay too much for our livelihood), so too has the tragic, preventable deaths of George Floyd, and Breonna Taylor in the U.S. and in this country, Regis Korchinski-Paquet and Chantel Moore to name just two from each country in the last two months, forced us (and not without the persistence of the Black Lives Matter movement) to reckon with our society’s implicit racism and how that directly affects the lives (not just livelihoods) of Black and Indigenous individuals in particular.

We are reckoning not with the isolated actions of “a few bad apples” but with the concept of systemic racism, that is, when racist or white supremacist notions are baked into the very structure of certain communities, businesses, and government agencies. This is particularly evident within policing organizations.

I’ve previously written about the idea of social justice, and my own path from a place ignorance. There is a great sense of exhaustion I’ve heard from members of the BIPOC (that is, “Black, Indigenous, [and] People of Colour”) community. The exhaustion of having white friends and colleagues continually approach them to ask for resources to help them understand racism (imagine asking a victim of gun violence to help explain the problems with firearms licensing). The exhaustion that comes with wondering whether this will be yet another blip of media interest in which hopes are raised only to be let down.

A different world is possible, but the time is past due for white folk like myself to do the heavy lifting, to seek out and reference the many (many) resources out there already written by the BIPOC community that will help people like me contextualize and understand how racism is systemic, and — just as importantly — to help others like me better understand this situation. As a therapist and active member of society it’s the least I can do. 

For anyone who is curious, here are some resources I have no hesitation recommending:

Between the World and Me, by Ta-Nehisi Coates (book)

Black on Bay Street, by Hadiya Roderique (Globe and Mail essay)

The New York Times’ 1619 Project

The Inconvenient Indian, by Thomas King (book)

A last thought for you: there are no slow news days, only barriers to other peoples’ experience.


The “patchwork”

Note: this was originally a letter to the editor at The Globe & Mail, which in turn was published April 26th. It was in response to two articles posted in the G&M, the first a featured essay by Norman Doidge MD, a psychiatrist and psychoanalyst, and the second an op-ed by Ari Zaretsky, chief of the department of psychiatry at Sunnybrook Health Sciences Centre. Each of these were responding to cuts by the province of Ontario to the provision of psychotherapy. I have expanded upon my original letter, which was edited for publication.

Every few months I’m asked by someone seeking information on the process of finding a psychotherapist to describe what the landscape and rules are. The word “patchwork” is the first to come up in my attempt at an answer, what with it being a maze of publicly funded dead ends and privately available add-ons. But to call the mental health system in Canada a “patchwork” is to insult quilt-making. One only needs to scan the pieces by Norman Doidge and most recently Ari Zaretsky to discover how confusing this might be for the average person seeking support.

If this average person exists let’s attempt to make sense of the road ahead from their angle: a day devoted to research will show there are psychiatrists and psychologists, who, as it turns out, may or may not have extensive training in psychotherapy. Then you have psychotherapists, whose profession may or may not be regulated depending upon the province you live in. Assuming our average person isn’t privately wealthy we must then ask: which profession — psychiatrist, psychologist, psychotherapist, social worker — is covered by what public or private health plan, and for whom is this available? Imagine being in the midst of a panic attack then trying to find support when you most need it only to discover that, to use Ontario as an example, despite being the only profession covered by OHIP, more and more psychiatrists are less and less interested in delivering psychotherapy versus managing prescriptions where, coincidentally, they can see more clients in a day and make a larger income. Meanwhile social workers enjoy vastly more private health benefits coverage than do psychotherapists.

Both Doidge’s and Zaretsky’s pieces are coming from a perspective that seems to make things more about the therapist, justifying their modal belief system or cost benefit analysis over the basic needs of those who are not privately insured. They rightly hail the benefits and importance of psychotherapy, but in their own ways go on to mount a self-interested defence of their turf: psychodynamic vs cognitive delivery methods. This battle over which therapeutic approach is more quantitatively or qualitatively effective than the other reeks of the privilege of those who have probably never been in long-term individual therapy themself.

The cart before the horse is that there is too little public access to trained professionals — particularly those who don’t have the MD designation of psychiatrists or the PhD of a clinical psychologist, but nonetheless have specialized training in psychotherapy — while we are in the midst of a steadily growing demand, with grave consequences for some who aren’t able gain access to professional assistance. Let individuals decide on the right approach for them. To qualify for the College of Registered Therapists of Ontario (CRPO) I cannot practice psychotherapy in this province without qualifying for membership, which means being a graduate of (or currently in training with) one of the approved training institutes registered with the college. Given this thorough certification process why should we then disregard the diverse modalities the CRPO explicitly acknowledges and pretend that this can be boiled down to a binary choice between a conservative interpretation of psychoanalysis or the limitations of CBT? In my experience as both a therapist and someone who has been in long-term personal therapy as part of my training program’s ethos — an ethos I feel should be obligatory for anyone training to be a psychotherapist — therapy works best when the “fit” is good, not about which style is supposedly better than the other.

The most important point — and one lost in both Doidge’s or Zaretsky’s articles — is the primacy of allowing Canadians the ability to gain access to psychotherapy in the first place.

[I would also recommend reading Heather Weir’s contribution to the G&M letters to the editor]



The Brain & Science – The Problem With Wanting It All

As a psychotherapist, I have taken an interest in the rise of neurobiological research being applied to my field. At first, particularly upon hearing about “interpersonal neurobiology” (or IPNB), I was excited — I was seeing the intrapsychic and biological converge into what appeared to be a fascinating model of understanding human behaviour. But here’s the thing: while I have a deep reverence for the subjective life of the individual, I’m also interested in looking at things empirically, where applicable. Without this latter aspect, I feel we fall prey to magical thinking.

The more I looked into some of the new ideas permeating my field, I became aware of a few things. While certain concepts, such as the idea of neuroplasticity, were taken from science, the more I looked at who was writing about this, the more I noticed that the people applying these complicated concepts to psychotherapy weren’t neurologists or geneticists. One of the oft-referenced authors in the field of IPNB is Allan N. Schore, who is a psychologist and researcher. His books are popular with those looking to harmonize neurology and psychotherapy. And while I respect his multidisciplinary work, I have difficulty with binary conceptions of how the left and right brains work (whereas, supposedly, the right brain is responsible for emotional attunement, the left brain for insight and analysis). Why do I have difficulty with this? Because many neuroscientists would contend that this is too simplistic a way to look at the brain.

This is a blog post and not a long-form essay. I could go on. I suppose what irks me is the amount of material being written about a myriad of complex neurobiological research findings that skip over the necessary cautions that are the hallmarks of science. Correlation is not causation. How big was the sample size? Continue reading “The Brain & Science – The Problem With Wanting It All”


Essay in Humber Literary Review #6

I’m happy to say that the latest issue of Humber Literary Review (#6) is out, and I have an essay included. This is their first themed issue, and it’s about mental health. Because I’m a psychotherapist who is deeply reflective about the way in which we choose to see the world, I saw this as a golden opportunity to submit a pertinent perspective; my essay, On Madness Within Imagination, confronts a cultural blindspot – the depiction of madness in fiction.











It is available at the following Toronto bookstores:

Another Story (on Roncesvalles)
Book City on the Danforth
Book City on Queen
Book City on St Clair
Book City in the Village
Presse Internationale on Bloor
Presse Internationale in the Beaches
Type Books (on Queen)

It is available elsewhere, of course, but I have no clue where. You can also purchase a subscription from HLR.


The Trouble With The Trouble With Physics

I’m on my second attempt reading Lee Smolin’s 2006 book The Trouble With Physics. I am reminded of a similar situation with another book, Joyce’s Ulysses. And, similarly, my second attempt with The Trouble With Physics is not a reappraisal but a confirmation: this is hard to read.

Smolin’s book is making a case for the fact that string theory is a failure; a spectacular failure that its adherents defend with a most byzantine theoretical web; that, because string theory is de rigueur in so many of the top schools, with so many reputations at stake, no one wants to recognize the fact that string theory — an attempt to harmonize the ideas of quantum theory and relativity so that we might understand the foundation of the universe more clearly — is a dead end.

The problem I’m (still) having with the book is that Smolin is writing to an audience that is willing to take a steep (try 90 degrees upward) climb in order to understand the various concepts and theories which not only formed the foundation of string theory, but the issues that weren’t resolved through the original work of Newton, Einstein, etc. Smolin lays out in the beginning various fundamental aspects of how things work that we simply don’t know — instilling early that scientific inquiry is, if anything, about the need for curiosity. However, given Smolin’s densely described approach to get us ready to understand his arguments, and while I don’t doubt the necessity, I think he would need to double the length of his book to do so effectively for interested readers who are not physicists.

What is more successful, and the reason I continue to read it, is how Continue reading “The Trouble With The Trouble With Physics”


Author Profile in the December Issue of Quill & Quire Magazine

My year-of-years continues with blessings – I was profiled in the December issue of Quill & Quire, the major trade publication for publishers and booksellers in Canada. Although the feature isn’t likely to be posted online, I’m attaching a photo below taken from my smartphone. The December issue is still on newstands if you are interested in picking up a copy.


SARS Essay in Torontoist

Torontoist just posted an essay I wrote about this being the 10th anniversary of the SARS breakout in Toronto (which went on to kill 44 people and cost the country $2 billion), and the fact that nothing is being done to commemorate it. That is to say that commemorations are not necessarily celebrations, but can be sober remembrances of mistakes made in our past.

Read it here.