In these seven lessons for young therapists, a practising psychiatrist and psychotherapist with more than 40 years' experience surveys what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy. Ranging from what to read and how to begin therapy, the lessons cover therapeutic temperaments and technique, the myth of independence and individual psychology, the nature of change, the evolution of therapy, the search for meaning and relational ethics, and finally, when therapy is over.
Overview:
1. People come into therapy in order not to change - When does therapy begin?
2. Therapeutic temperaments - Who conducts therapy and why?
3. The family as a unique culture - Relational psychology and relational therapy.
4. Changing the subject - How does therapy work?
5. One hundred years of invisibility - The evolution of therapy from the 19th-century discovery of the unconscious to the 21st-century values of diversity, decolonization and change.
6. Making meaning - Making sense, technique, and doing good: Relational ethics.
7. "And on the seventh day, the Lord rested" - When therapy is over: The myth of closure, flow, and slowness in therapy.
This workshop integrates the author's model of working with families across cultures presented in "A Stranger in the Family: Families, Culture, and Therapy" (1997) and elaborated in his "Letters to a Young Therapist" (2011) with more recent work on trauma-informed therapy in "Trauma and Transcendence" (Capretto & Boynton, eds., 2018), and his "Slow thought manifesto" (2019).
TAKE YOUR TIME: Seven Lessons for Young Therapists
Vincenzo Di Nicola
1. In these seven lessons for young therapists, based on practising clinical psychology, child psychiatry and psychotherapy for almost 50 years, I will survey what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy
2. These lessons integrate my work in psychiatry and psychotherapy with my Slow Thought Manifesto and my call for Slow Therapy
3. With these seven lessons for young therapists in this technocratic time of pressure and speed, I commend young therapists – eager to embrace change and to make a difference – to “Take your time”
4. By opening a space for reflection by every party in the therapeutic encounter, the possibility of an event – something surprising, unpredictable and new – may emerge
DOI: 10.13140/RG.2.2.32747.55841
"Take Your Time: Seven Lessons for Young Psychiatrists"
Vincenzo Di Nicola
Inaugural Lecture 2023
Psychotherapy Special Interest Group
Department of Psychiatry & Behavioral Medicine
College of Medicine & Philippine General Hospital
University of the Philippines Manila
28 July 2023
In these seven lessons for young therapists, a practising psychiatrist and psychotherapist with more than 40 years’ experience surveys what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy. Ranging from what to read and how to begin therapy, the lessons cover therapeutic temperaments and technique, the myth of independence and individual psychology, the nature of change, the evolution of therapy, the search for meaning and relational ethics, and finally, when therapy is over.
1. People don’t want to change (resistance, homeostasis)
2. Different therapeutic temperaments see different tasks, seek different ways of doing therapy
3. Families are unique cultures that require a relational approach
4. Therapy opens new vistas of life in a holding environment
5. Therapy makes visible the invisible – as social animals, we thrive in social contexts, suffer in isolation – Independence is a myth!
6. People seek meaningful lives
7. Slow Therapy respects the flow & rhythms of life, takes time to integrate change, and knows when to stop
This address integrates the author’s model of working with families across cultures presented in "A Stranger in the Family: Families, Culture, and Therapy" (1997) and elaborated in his "Letters to a Young Therapist" (2011) with his more recent work on trauma in Trauma and Transcendence (Capretto & Boynton, eds., 2018), and “Take Your Time,” his Slow thought manifesto (2019).
"Take Your Time: Seven Lessons for Young Therapists"
23rd World Congress of Psychotherapy
Casablanca, Morocco, February 11, 2023
In these seven lessons for young therapists, a practising psychiatrist and psychotherapist with more than 40 years’ experience surveys what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy. Ranging from what to read and how to begin therapy, the lessons cover therapeutic temperaments and technique, the myth of independence and individual psychology, the nature of change, the evolution of therapy, the search for meaning and relational ethics, and finally, when therapy is over.
1. People don’t want to change (resistance, homeostasis)
2. Different therapeutic temperaments see different tasks, seek different ways of doing therapy
3. Families are unique cultures that require a relational approach
4. Therapy opens new vistas of life in a holding environment
5. Therapy makes visible the invisible – as social animals, we thrive in social contexts, suffer in isolation –
Independence is a myth!
6. People seek meaningful lives
7. Slow Therapy respects the flow & rhythms of life, takes time to integrate change, and knows when to stop
This plenary address integrates the author’s model of working with families across cultures presented in A Stranger in the Family: Families, Culture, and Therapy (Norton, 1997) and elaborated in his Letters to a Young Therapist (Atropos, 2011) with his more recent work on trauma in Trauma and Transcendence (Fordham, 2018), and “Take Your Time,” his Slow thought manifesto (Aeon, 2019).
I am convinced that your efforts will bring us closer to the day when psychiatry will, at last, become a truly human psychiatry.
– Philosopher Jean-Paul Sartre, Preface to Laing & Cooper’s Reason and Violence
Nothing is closer to the heart of therapists across all our clinical professions than the notion of change. Like the title of my first book, A Stranger in the Family (Di Nicola, 1997), “changing the subject” is a polysemous phrase that invokes several layers of change. Family Therapy (FT) changed the subject by changing the frame of therapy, placing the individual in a family context, invoking systems theory. My model of cultural family therapy (CFT) changed the subject by placing the family itself in the larger context of culture. These approaches also changed the subject of our work – both the identified patient (IP) and the family system or culture. Now, I propose to change the subject again, identifying three gaps in relational theory and therapy: a theory of the subject (how we define persons), a theory of therapy (how to conduct therapy), and most important, a theory of change (how change or innovation occurs). While we have many competing theories of these tasks, there no consensus among therapists. To address these gaps, I invoke the event as a new model, based on the philosophy of Alain Badiou (Badiou & Tarby, 2013). Faced with a predicament (crisis, rupture), two potential outcomes arise: trauma or event. Trauma closes down the possibilities of life, while event opens them up. By drawing a clear line, marking a before and after, the event changes a world – as an individual (subject), a family (system, culture), or an entire community (the world). Thus, the Event speaks to the very definition of being – beyond attitudes, behaviour, cognitions, and emotions – to what being-in-the-world means. The three conditions for the Event are: (1) being there to witness the event, (2) naming it, and (3) fidelity to the event, which radically changes the subject by identifying with the event. Recalling the story of Antonella (Di Nicola, 2021), an Italian immigrant to Canada referred by an Italian family therapist, I conduct an evental analysis to examine her lifeworld (Lebenswelt in German), her search for meaning and identity. Then through evental therapy (individual, couple, and family meetings), I bear witness to the event of her life. Reaching beyond the human world to become a dog breeder, Antonella resolves her ambivalent attachments to become – “at last,” as Sartre said – a genuinely human subject with an identity and a purpose in life.
References:
Badiou A, Tarby F. Philosophy and the Event. Cambridge, UK: Polity Press, 2013.
Di Nicola V. A Stranger in the Family: Culture, Families, and Therapy. New York: Norton, 1997.
Di Nicola V. Antonella – “A stranger in the family”: A case study of eating disorders across cultures. In: DS Stoyanov, et al. (Eds), International Perspectives in Values-Based Mental Health Practice. Springer, 2021.
Multiples, Multiplicity & The Multitude - Stokes Endowment Lecture - George W...Université de Montréal
This invited lecture for the Stoke Endowment dedicated to families and family therapy at GWU udpated my model of cultural family therapy published 15 years earlier in "A Stranger in the Family: Culture, Famlies, and Therapy" (NY: WW Norton, 1997).
Attachment, Family & Social Systems : London’s ‘Cradle to Grave’ Contribution...Université de Montréal
Address of the Incoming President of WASP
Conference: “Recovery from Mental Illness: Challenges and Solutions from Across the Globe”
Joint Congress of the World Association of Social Psychiatry (WASP) and the Faculty of Rehabilitation and Social Psychiatry, Royal College of Psychiatrists (RCPsych, UK)
London, UK, January 17, 2023
TAKE YOUR TIME: Seven Lessons for Young Therapists
Vincenzo Di Nicola
1. In these seven lessons for young therapists, based on practising clinical psychology, child psychiatry and psychotherapy for almost 50 years, I will survey what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy
2. These lessons integrate my work in psychiatry and psychotherapy with my Slow Thought Manifesto and my call for Slow Therapy
3. With these seven lessons for young therapists in this technocratic time of pressure and speed, I commend young therapists – eager to embrace change and to make a difference – to “Take your time”
4. By opening a space for reflection by every party in the therapeutic encounter, the possibility of an event – something surprising, unpredictable and new – may emerge
DOI: 10.13140/RG.2.2.32747.55841
"Take Your Time: Seven Lessons for Young Psychiatrists"
Vincenzo Di Nicola
Inaugural Lecture 2023
Psychotherapy Special Interest Group
Department of Psychiatry & Behavioral Medicine
College of Medicine & Philippine General Hospital
University of the Philippines Manila
28 July 2023
In these seven lessons for young therapists, a practising psychiatrist and psychotherapist with more than 40 years’ experience surveys what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy. Ranging from what to read and how to begin therapy, the lessons cover therapeutic temperaments and technique, the myth of independence and individual psychology, the nature of change, the evolution of therapy, the search for meaning and relational ethics, and finally, when therapy is over.
1. People don’t want to change (resistance, homeostasis)
2. Different therapeutic temperaments see different tasks, seek different ways of doing therapy
3. Families are unique cultures that require a relational approach
4. Therapy opens new vistas of life in a holding environment
5. Therapy makes visible the invisible – as social animals, we thrive in social contexts, suffer in isolation – Independence is a myth!
6. People seek meaningful lives
7. Slow Therapy respects the flow & rhythms of life, takes time to integrate change, and knows when to stop
This address integrates the author’s model of working with families across cultures presented in "A Stranger in the Family: Families, Culture, and Therapy" (1997) and elaborated in his "Letters to a Young Therapist" (2011) with his more recent work on trauma in Trauma and Transcendence (Capretto & Boynton, eds., 2018), and “Take Your Time,” his Slow thought manifesto (2019).
"Take Your Time: Seven Lessons for Young Therapists"
23rd World Congress of Psychotherapy
Casablanca, Morocco, February 11, 2023
In these seven lessons for young therapists, a practising psychiatrist and psychotherapist with more than 40 years’ experience surveys what therapy is about and how it works, from behaviour therapy and family therapy to psychodynamic psychotherapy. Ranging from what to read and how to begin therapy, the lessons cover therapeutic temperaments and technique, the myth of independence and individual psychology, the nature of change, the evolution of therapy, the search for meaning and relational ethics, and finally, when therapy is over.
1. People don’t want to change (resistance, homeostasis)
2. Different therapeutic temperaments see different tasks, seek different ways of doing therapy
3. Families are unique cultures that require a relational approach
4. Therapy opens new vistas of life in a holding environment
5. Therapy makes visible the invisible – as social animals, we thrive in social contexts, suffer in isolation –
Independence is a myth!
6. People seek meaningful lives
7. Slow Therapy respects the flow & rhythms of life, takes time to integrate change, and knows when to stop
This plenary address integrates the author’s model of working with families across cultures presented in A Stranger in the Family: Families, Culture, and Therapy (Norton, 1997) and elaborated in his Letters to a Young Therapist (Atropos, 2011) with his more recent work on trauma in Trauma and Transcendence (Fordham, 2018), and “Take Your Time,” his Slow thought manifesto (Aeon, 2019).
I am convinced that your efforts will bring us closer to the day when psychiatry will, at last, become a truly human psychiatry.
– Philosopher Jean-Paul Sartre, Preface to Laing & Cooper’s Reason and Violence
Nothing is closer to the heart of therapists across all our clinical professions than the notion of change. Like the title of my first book, A Stranger in the Family (Di Nicola, 1997), “changing the subject” is a polysemous phrase that invokes several layers of change. Family Therapy (FT) changed the subject by changing the frame of therapy, placing the individual in a family context, invoking systems theory. My model of cultural family therapy (CFT) changed the subject by placing the family itself in the larger context of culture. These approaches also changed the subject of our work – both the identified patient (IP) and the family system or culture. Now, I propose to change the subject again, identifying three gaps in relational theory and therapy: a theory of the subject (how we define persons), a theory of therapy (how to conduct therapy), and most important, a theory of change (how change or innovation occurs). While we have many competing theories of these tasks, there no consensus among therapists. To address these gaps, I invoke the event as a new model, based on the philosophy of Alain Badiou (Badiou & Tarby, 2013). Faced with a predicament (crisis, rupture), two potential outcomes arise: trauma or event. Trauma closes down the possibilities of life, while event opens them up. By drawing a clear line, marking a before and after, the event changes a world – as an individual (subject), a family (system, culture), or an entire community (the world). Thus, the Event speaks to the very definition of being – beyond attitudes, behaviour, cognitions, and emotions – to what being-in-the-world means. The three conditions for the Event are: (1) being there to witness the event, (2) naming it, and (3) fidelity to the event, which radically changes the subject by identifying with the event. Recalling the story of Antonella (Di Nicola, 2021), an Italian immigrant to Canada referred by an Italian family therapist, I conduct an evental analysis to examine her lifeworld (Lebenswelt in German), her search for meaning and identity. Then through evental therapy (individual, couple, and family meetings), I bear witness to the event of her life. Reaching beyond the human world to become a dog breeder, Antonella resolves her ambivalent attachments to become – “at last,” as Sartre said – a genuinely human subject with an identity and a purpose in life.
References:
Badiou A, Tarby F. Philosophy and the Event. Cambridge, UK: Polity Press, 2013.
Di Nicola V. A Stranger in the Family: Culture, Families, and Therapy. New York: Norton, 1997.
Di Nicola V. Antonella – “A stranger in the family”: A case study of eating disorders across cultures. In: DS Stoyanov, et al. (Eds), International Perspectives in Values-Based Mental Health Practice. Springer, 2021.
Multiples, Multiplicity & The Multitude - Stokes Endowment Lecture - George W...Université de Montréal
This invited lecture for the Stoke Endowment dedicated to families and family therapy at GWU udpated my model of cultural family therapy published 15 years earlier in "A Stranger in the Family: Culture, Famlies, and Therapy" (NY: WW Norton, 1997).
Attachment, Family & Social Systems : London’s ‘Cradle to Grave’ Contribution...Université de Montréal
Address of the Incoming President of WASP
Conference: “Recovery from Mental Illness: Challenges and Solutions from Across the Globe”
Joint Congress of the World Association of Social Psychiatry (WASP) and the Faculty of Rehabilitation and Social Psychiatry, Royal College of Psychiatrists (RCPsych, UK)
London, UK, January 17, 2023
Panel Discussion:
"What Can Psychotherapists Learn From the Social Sciences?"
Chair: Césare Alfonso
Panelists:
Vincenzo Di Nicola
Arvind Rajagopalan
Renato Antunes dos Santos
International Federation for Psychotherapy
23rd World Congress of Psychotherapy
Casablanca, Morocco
10 February 2023
Points covered:
My first contribution was my model of Cultural Family Therapy (CFT)
A Stranger in the Family: Families, Culture, & Therapy (1997)
Next, I articulated overarching principles of the psychotherapies
Letters to a Young Therapist (2011)
Now, we are re-visioning psychotherapy through philosophy
Alain Badiou’s philosophy of the Event
CULTURAL FAMILY THERAPY: The Theory and Practice of Cultural Psychiatry with ...Université de Montréal
Society for the Study of Psychiatry and Culture
“Transforming Policy and Practice for
Culturally Competent Mental Health Care”
37th Annual Meeting
Minneapolis, MN – May 5-7, 2016
CULTURAL FAMILY THERAPY:
The Theory and Practice of Cultural Psychiatry with Families
Vincenzo Di Nicola, MD, PhD
Université de Montréal
and
Steven J. Wolin, MD
George Washington University
This interactive workshop presents Cultural Family Therapy (CFT), a synthesis of family therapy and cultural psychiatry based on Di Nicola’s book, A Stranger in the Family: Culture, Families, and Therapy (1997).
Three key processes for CFT will be demonstrated:
1) Cultural coherence: Each family coheres as and maintains it own culture, reflecting deep parallels between the functions of the family and culture, so that family culture supersedes the notion of family system;
2) Cultural transmission: Each family is the bearer of the larger culture(s) it is embedded in;
3) Cultural adaptation: CFT’s unique mission is to facilitate cultural adaptation for families undergoing culture change.
These processes will be illustrated with case examples.
In Part 2, participants will divide into two groups for discussion of CFT theory and practice, illustrated by two family cases in treatment with Wolin (a couple in continuous conflict whose battle concerns which family of origin will rule current family life) and Di Nicola (a young adult of mixed heritage whose core identity, sense of belonging, and symptomatic distress are in constant flux). Participants will apply the key CFT processes to these cases.
Part III will conclude by reconvening the participants for an interactive discussion, with a focus on applying CFT treatment strategies to their own clinical work with families undergoing culture change.
Learning objectives for this workshop are:
1. Identify three key processes that CFT employs to characterize today’s family and understand their functions in creating a unique culture for its members.
2. Formulate a clinical role for the family and cultural psychiatrist by specifying three clinical tools for conducting CFT with families undergoing culture change.
References:
Di Nicola, Vincenzo. A Stranger in the Family: Culture, Families, and Therapy. New York & London: W.W. Norton & Co., 1997.
Di Nicola, Vincenzo. Family, psychosocial, and cultural determinants of health. In: Sorel, Eliot, ed., 21st Century Global Mental Health. Burlington, MA: Jones & Bartlett Learning, 2012, pp. 119-150.
This PowerPoint Presentation by Dr Werner Sattmann-Frese outlines key aspects of a complexity oriented and ecologically and somatically (body-centred) aware approach to counselling and psychotherapy. Werner is a senior lecturer and program manager at the Jansen Newman Institute in Sydney.
What Is Called Therapy? Towards a Unifying Theory of Therapy Based on the EventUniversité de Montréal
This presentation addresses the question, “What is called therapy?”
Echoes the question posed by Martin Heidegger (1954), Was heißt Denken? about the nature of thinking
Q: “What is called therapy?”
We will survey three topics to answer it:
I. Accidental therapy
II. What is called therapy?
III. Changing the subject
From the Threshold to the Event: Thirty Years of Cultural Family Therapy - Al...Université de Montréal
Dr. Di Nicola presents Cultural Family Therapy (CFT), a synthesis of two approaches pioneered in the McGill University Dept. of Psychiatry where he trained: family therapy and transcultural psychiatry. Key influences include Maurizio Andolfi (1989) and Mara Selvini Palazzoli (1988) in family therapy and Raymond Prince (2010) and Henry Murphy (1982, 1986) in transcultural psychiatry. In numerous publications and international workshops over the last 30 years, Dr. Di Nicola has elaborated a model of CFT, beginning with a monograph published while he was a Fellow in Family Therapy at the Institute of Community and Family Psychiatry (Di Nicola, 1985) and a key article while he was Chief Resident at the AMI (Di Nicola, 1986). A model of CFT was presented in greater depth in his book, A Stranger in the Family: Culture, Families, and Therapy (1997) and updated in Letters to a Young Therapist (2011).
CFT weaves together family stories that express their mental and relational predicaments and conceptual tools for conducting clinical work. CFT is an ongoing update of our notions of “family” and “therapy,” on one hand, and of “culture” and “psychiatry,” on the other. From the beginning, CFT was constructed to deal with threshold people undergoing rapid cultural change.
Three basic principles and processes for CFT will be reviewed:
1) the deep parallels between the notions of “family” and “culture,” mean that “culture” supersedes the notion of family “system”;
2) each family is the bearer of the larger culture(s) in which it is embedded and creates a culture of its own, so the family is the vehicle for intergenerational cultural transmission, for maintaining culture (cultural coherence), and for generating its own small-scale cultural adaptations, yielding three yoked family functions: cultural transmission, cultural maintenance/coherence, and cultural adaptation;
3) at the heart of systemic family theory and sociocultural psychiatry is a relational psychology that inverses theorizing from self to society by redefining the notions of identity and belonging through relations.
With its relational and sociocultural approach, CFT is exquisitely responsive to working with threshold people – families undergoing culture change within and across cultures. In a world with huge global flows of migrants and refugees instigated by conflict, disasters, or economic and social reasons, CFT offers clinical tools to understand and treat families experiencing severe stress due to rapid and massive culture change.
CFT grew/unfolded by examining families in different cultures and in invisible or otherwise discounted/ignored social circumstances, from invisible minorities to undocumented migrants and refugees (Di Nicola, 1998, 2012a, 2016).
“A Social Psychiatry Manifesto”
Vincenzo Di Nicola , MPhil, MD, PhD, FRCPC, DFAPA
Psychiatric Grand Rounds
VA Boston Mental Health Care System
Harvard South Shore Psychiatry Residency
April 4, 2020 at 12:00 PM Eastern Time
Purpose Statement
To give an overview of the history and current status of Social Psychiatry with some applications of relevance Veterans and their families
Several sentences that describe the training.
• What is the current knowledge deficit, or gap?
A better understanding of the contributions of social psychiatry
• How does the information you are presenting fill that gap?
By providing the broader context of social psychiatry to understand veterans and their families
• How will it benefit Veterans?
By providing a broader context, the presenter hopes to inform clinicians and policy-makers of the importance of social context and family and social relationships
Objectives
The objectives are what the learners will be able to do after attending the training. It is best that each objective has only one item being focused on.
At the conclusion of this educational program, learners will be able to:
1. Describe and define Social Psychiatry;
2. List the three main branches of Social Psychiatry;
3. Name two major public health projects of Social Psychiatry;
4. Give at least two examples of the clinical and policy relevance of Social Psychiatry for Veterans and their families.
Social Psychiatry Comes of Age - Inaugural Column in Psychiatric TimesUniversité de Montréal
In this inaugural column on “Second Thoughts… About Psychiatry, Psychology, and Psychotherapy,” I want to express second thoughts about my profession in a warm and constructive way.
https://www.psychiatrictimes.com/view/social-psychiatry-comes-of-age
Family & Culture SIG Workshop - Di Nicola & Al-Baldawi - WACP Congress - 17....Université de Montréal
Title: “Culture, Families & Psychosis: How the Culture of the Family Affects How It Deals with a Psychotic Member”
Abstract
Since the pioneering studies of Bateson and associates on their “double bind” hypothesis of schizophrenia, there has been a veritable industry of work on the family and schizophrenia. This included many family therapists as well as psychiatrists who were dissatisfied with the medical model of psychosis such as RD Laing. With the “expressed emotion” (EE) model of schizophrenia, which followed on the footsteps of sociological research by George Brown, Vaughan and Leff (1976) created a paradigm to examine the family, social and cultural context of psychosis. When EE was applied to immigrant families in London and exported to other cultures (see Di Nicola, 1988), for the first time a question was seriously posed about the interactions among three key variables: culture, families, and psychosis. One way of examining the relationships is to ask how the culture of the family affects how they deal with a psychotic member.
Humanistic approach talks about human potential which can only be harnessed by an individual by focussing on internalization and subjective knowledge for this world for the attainment of self-actualization or true potential by fulfilling the needs as per the hierarchy of importance.
Turning "Vystopia" into Powerful Action for ChangeVegFund
“Vystopia” is defined as the anguish of being vegan in a non-vegan world. With more than 30 years of experience, Clare Mann provides vegans with language and a toolbox to work through their anguish and unite with others to examine the biggest social justice challenge of our time.
Clare Mann, is a psychologist, existential psychotherapist, author, and communications trainer. She is also an active member of the Anonymous for the Voiceless Sydney chapter. She runs a part-time private vegan psychology practice in Sydney and works with vegans worldwide via Skype and Facetime.
In this webinar, Clare will empower you to:
-Work through your vystopia
-Learn strategies to maintain hope and direction
-Develop powerful communication techniques
-Turn your anguish into powerful action for animals
-Become a healthier, happier, and hopeful vegan
For more resources like this please visit: vegfund.org/resources
The Social Determinants of Health – Social Psychiatry’s Basic ScienceUniversité de Montréal
Psychiatric Times
Home page teaser: From populations to patients.
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/-the-web-of-meaning-family-therapy-is-social-psychiatrys-therapeutic-branch
The Social Determinants of Health – Social Psychiatry’s Basic Science
May 29, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No disciple of the wise may live in a city that does not have a physician, a surgeon, a bathhouse, a lavatory, a source of water, a synagogue, a school teacher, a scribe, a treasurer of charity funds for the poor, a court that has authority to punish.
—Moses Maimonides1
In this column, I want to highlight our first, foundational branch of social psychiatry – psychiatric epidemiology and public mental health by focusing on the Social Determinants of Health (SDoH). I consider SDoH the basic science of social psychiatry.
Psychiatric Times
Home page teaser: Embracing movement as theory
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/migration-maps-of-meaning-maps-of-belonging
Migration – Maps of Meaning, Maps of Belonging
May 22, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
The migrant has become the political figure of our time.
– Thomas Nail, The Figure of the Migrant
Migration. A hot topic in politics with implications for economics, education and housing, and not the least for global health and mental health. With passionate debates about the US southern border, the porous border between North Africa and southern Europe, claims about migration motivated the referendum that led to Britain leaving the European Union (“Brexit”), while European countries from Hungary to the Netherlands elected anti-immigrant leaders. And let’s not forget about massive internal migrations such as Brazil experienced in the 20th century and the flow of refugees from war, crime and famine all over the world, with Ukraine, the Middle East, and Haiti in the headlines, to name just three places.
In this column, I want to move away from the polarizing and unproductive politics of migration to talk about human migration through three different lenses: (1) my work with refugees and migrants as a social and cultural psychiatrist; (2) how literature can illuminate the human stories behind migrations; and finally, (3) American philosopher Thomas Nail’s bold new theory of migration and mobility, offering a kinopolitics and kinopsychology along with a veritable “ontology of motion” with his masterwork, Being and Motion.
Psychiatric Times Home page teaser:
Experience is an end in itself, not measured in time or goals.
Column: "Second Thoughts ... About Psychiatry, Psychology and Psychotherapy"
Link: https://www.psychiatrictimes.com/view/slow-thought-in-a-fast-city
Slow Thought in a Fast City
May 15, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
More Related Content
Similar to Lessons for Young Therapists: Getting Started and Staying on Track in Your Psychotherapy Practice
Panel Discussion:
"What Can Psychotherapists Learn From the Social Sciences?"
Chair: Césare Alfonso
Panelists:
Vincenzo Di Nicola
Arvind Rajagopalan
Renato Antunes dos Santos
International Federation for Psychotherapy
23rd World Congress of Psychotherapy
Casablanca, Morocco
10 February 2023
Points covered:
My first contribution was my model of Cultural Family Therapy (CFT)
A Stranger in the Family: Families, Culture, & Therapy (1997)
Next, I articulated overarching principles of the psychotherapies
Letters to a Young Therapist (2011)
Now, we are re-visioning psychotherapy through philosophy
Alain Badiou’s philosophy of the Event
CULTURAL FAMILY THERAPY: The Theory and Practice of Cultural Psychiatry with ...Université de Montréal
Society for the Study of Psychiatry and Culture
“Transforming Policy and Practice for
Culturally Competent Mental Health Care”
37th Annual Meeting
Minneapolis, MN – May 5-7, 2016
CULTURAL FAMILY THERAPY:
The Theory and Practice of Cultural Psychiatry with Families
Vincenzo Di Nicola, MD, PhD
Université de Montréal
and
Steven J. Wolin, MD
George Washington University
This interactive workshop presents Cultural Family Therapy (CFT), a synthesis of family therapy and cultural psychiatry based on Di Nicola’s book, A Stranger in the Family: Culture, Families, and Therapy (1997).
Three key processes for CFT will be demonstrated:
1) Cultural coherence: Each family coheres as and maintains it own culture, reflecting deep parallels between the functions of the family and culture, so that family culture supersedes the notion of family system;
2) Cultural transmission: Each family is the bearer of the larger culture(s) it is embedded in;
3) Cultural adaptation: CFT’s unique mission is to facilitate cultural adaptation for families undergoing culture change.
These processes will be illustrated with case examples.
In Part 2, participants will divide into two groups for discussion of CFT theory and practice, illustrated by two family cases in treatment with Wolin (a couple in continuous conflict whose battle concerns which family of origin will rule current family life) and Di Nicola (a young adult of mixed heritage whose core identity, sense of belonging, and symptomatic distress are in constant flux). Participants will apply the key CFT processes to these cases.
Part III will conclude by reconvening the participants for an interactive discussion, with a focus on applying CFT treatment strategies to their own clinical work with families undergoing culture change.
Learning objectives for this workshop are:
1. Identify three key processes that CFT employs to characterize today’s family and understand their functions in creating a unique culture for its members.
2. Formulate a clinical role for the family and cultural psychiatrist by specifying three clinical tools for conducting CFT with families undergoing culture change.
References:
Di Nicola, Vincenzo. A Stranger in the Family: Culture, Families, and Therapy. New York & London: W.W. Norton & Co., 1997.
Di Nicola, Vincenzo. Family, psychosocial, and cultural determinants of health. In: Sorel, Eliot, ed., 21st Century Global Mental Health. Burlington, MA: Jones & Bartlett Learning, 2012, pp. 119-150.
This PowerPoint Presentation by Dr Werner Sattmann-Frese outlines key aspects of a complexity oriented and ecologically and somatically (body-centred) aware approach to counselling and psychotherapy. Werner is a senior lecturer and program manager at the Jansen Newman Institute in Sydney.
What Is Called Therapy? Towards a Unifying Theory of Therapy Based on the EventUniversité de Montréal
This presentation addresses the question, “What is called therapy?”
Echoes the question posed by Martin Heidegger (1954), Was heißt Denken? about the nature of thinking
Q: “What is called therapy?”
We will survey three topics to answer it:
I. Accidental therapy
II. What is called therapy?
III. Changing the subject
From the Threshold to the Event: Thirty Years of Cultural Family Therapy - Al...Université de Montréal
Dr. Di Nicola presents Cultural Family Therapy (CFT), a synthesis of two approaches pioneered in the McGill University Dept. of Psychiatry where he trained: family therapy and transcultural psychiatry. Key influences include Maurizio Andolfi (1989) and Mara Selvini Palazzoli (1988) in family therapy and Raymond Prince (2010) and Henry Murphy (1982, 1986) in transcultural psychiatry. In numerous publications and international workshops over the last 30 years, Dr. Di Nicola has elaborated a model of CFT, beginning with a monograph published while he was a Fellow in Family Therapy at the Institute of Community and Family Psychiatry (Di Nicola, 1985) and a key article while he was Chief Resident at the AMI (Di Nicola, 1986). A model of CFT was presented in greater depth in his book, A Stranger in the Family: Culture, Families, and Therapy (1997) and updated in Letters to a Young Therapist (2011).
CFT weaves together family stories that express their mental and relational predicaments and conceptual tools for conducting clinical work. CFT is an ongoing update of our notions of “family” and “therapy,” on one hand, and of “culture” and “psychiatry,” on the other. From the beginning, CFT was constructed to deal with threshold people undergoing rapid cultural change.
Three basic principles and processes for CFT will be reviewed:
1) the deep parallels between the notions of “family” and “culture,” mean that “culture” supersedes the notion of family “system”;
2) each family is the bearer of the larger culture(s) in which it is embedded and creates a culture of its own, so the family is the vehicle for intergenerational cultural transmission, for maintaining culture (cultural coherence), and for generating its own small-scale cultural adaptations, yielding three yoked family functions: cultural transmission, cultural maintenance/coherence, and cultural adaptation;
3) at the heart of systemic family theory and sociocultural psychiatry is a relational psychology that inverses theorizing from self to society by redefining the notions of identity and belonging through relations.
With its relational and sociocultural approach, CFT is exquisitely responsive to working with threshold people – families undergoing culture change within and across cultures. In a world with huge global flows of migrants and refugees instigated by conflict, disasters, or economic and social reasons, CFT offers clinical tools to understand and treat families experiencing severe stress due to rapid and massive culture change.
CFT grew/unfolded by examining families in different cultures and in invisible or otherwise discounted/ignored social circumstances, from invisible minorities to undocumented migrants and refugees (Di Nicola, 1998, 2012a, 2016).
“A Social Psychiatry Manifesto”
Vincenzo Di Nicola , MPhil, MD, PhD, FRCPC, DFAPA
Psychiatric Grand Rounds
VA Boston Mental Health Care System
Harvard South Shore Psychiatry Residency
April 4, 2020 at 12:00 PM Eastern Time
Purpose Statement
To give an overview of the history and current status of Social Psychiatry with some applications of relevance Veterans and their families
Several sentences that describe the training.
• What is the current knowledge deficit, or gap?
A better understanding of the contributions of social psychiatry
• How does the information you are presenting fill that gap?
By providing the broader context of social psychiatry to understand veterans and their families
• How will it benefit Veterans?
By providing a broader context, the presenter hopes to inform clinicians and policy-makers of the importance of social context and family and social relationships
Objectives
The objectives are what the learners will be able to do after attending the training. It is best that each objective has only one item being focused on.
At the conclusion of this educational program, learners will be able to:
1. Describe and define Social Psychiatry;
2. List the three main branches of Social Psychiatry;
3. Name two major public health projects of Social Psychiatry;
4. Give at least two examples of the clinical and policy relevance of Social Psychiatry for Veterans and their families.
Social Psychiatry Comes of Age - Inaugural Column in Psychiatric TimesUniversité de Montréal
In this inaugural column on “Second Thoughts… About Psychiatry, Psychology, and Psychotherapy,” I want to express second thoughts about my profession in a warm and constructive way.
https://www.psychiatrictimes.com/view/social-psychiatry-comes-of-age
Family & Culture SIG Workshop - Di Nicola & Al-Baldawi - WACP Congress - 17....Université de Montréal
Title: “Culture, Families & Psychosis: How the Culture of the Family Affects How It Deals with a Psychotic Member”
Abstract
Since the pioneering studies of Bateson and associates on their “double bind” hypothesis of schizophrenia, there has been a veritable industry of work on the family and schizophrenia. This included many family therapists as well as psychiatrists who were dissatisfied with the medical model of psychosis such as RD Laing. With the “expressed emotion” (EE) model of schizophrenia, which followed on the footsteps of sociological research by George Brown, Vaughan and Leff (1976) created a paradigm to examine the family, social and cultural context of psychosis. When EE was applied to immigrant families in London and exported to other cultures (see Di Nicola, 1988), for the first time a question was seriously posed about the interactions among three key variables: culture, families, and psychosis. One way of examining the relationships is to ask how the culture of the family affects how they deal with a psychotic member.
Humanistic approach talks about human potential which can only be harnessed by an individual by focussing on internalization and subjective knowledge for this world for the attainment of self-actualization or true potential by fulfilling the needs as per the hierarchy of importance.
Turning "Vystopia" into Powerful Action for ChangeVegFund
“Vystopia” is defined as the anguish of being vegan in a non-vegan world. With more than 30 years of experience, Clare Mann provides vegans with language and a toolbox to work through their anguish and unite with others to examine the biggest social justice challenge of our time.
Clare Mann, is a psychologist, existential psychotherapist, author, and communications trainer. She is also an active member of the Anonymous for the Voiceless Sydney chapter. She runs a part-time private vegan psychology practice in Sydney and works with vegans worldwide via Skype and Facetime.
In this webinar, Clare will empower you to:
-Work through your vystopia
-Learn strategies to maintain hope and direction
-Develop powerful communication techniques
-Turn your anguish into powerful action for animals
-Become a healthier, happier, and hopeful vegan
For more resources like this please visit: vegfund.org/resources
Similar to Lessons for Young Therapists: Getting Started and Staying on Track in Your Psychotherapy Practice (19)
The Social Determinants of Health – Social Psychiatry’s Basic ScienceUniversité de Montréal
Psychiatric Times
Home page teaser: From populations to patients.
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/-the-web-of-meaning-family-therapy-is-social-psychiatrys-therapeutic-branch
The Social Determinants of Health – Social Psychiatry’s Basic Science
May 29, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No disciple of the wise may live in a city that does not have a physician, a surgeon, a bathhouse, a lavatory, a source of water, a synagogue, a school teacher, a scribe, a treasurer of charity funds for the poor, a court that has authority to punish.
—Moses Maimonides1
In this column, I want to highlight our first, foundational branch of social psychiatry – psychiatric epidemiology and public mental health by focusing on the Social Determinants of Health (SDoH). I consider SDoH the basic science of social psychiatry.
Psychiatric Times
Home page teaser: Embracing movement as theory
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/migration-maps-of-meaning-maps-of-belonging
Migration – Maps of Meaning, Maps of Belonging
May 22, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
The migrant has become the political figure of our time.
– Thomas Nail, The Figure of the Migrant
Migration. A hot topic in politics with implications for economics, education and housing, and not the least for global health and mental health. With passionate debates about the US southern border, the porous border between North Africa and southern Europe, claims about migration motivated the referendum that led to Britain leaving the European Union (“Brexit”), while European countries from Hungary to the Netherlands elected anti-immigrant leaders. And let’s not forget about massive internal migrations such as Brazil experienced in the 20th century and the flow of refugees from war, crime and famine all over the world, with Ukraine, the Middle East, and Haiti in the headlines, to name just three places.
In this column, I want to move away from the polarizing and unproductive politics of migration to talk about human migration through three different lenses: (1) my work with refugees and migrants as a social and cultural psychiatrist; (2) how literature can illuminate the human stories behind migrations; and finally, (3) American philosopher Thomas Nail’s bold new theory of migration and mobility, offering a kinopolitics and kinopsychology along with a veritable “ontology of motion” with his masterwork, Being and Motion.
Psychiatric Times Home page teaser:
Experience is an end in itself, not measured in time or goals.
Column: "Second Thoughts ... About Psychiatry, Psychology and Psychotherapy"
Link: https://www.psychiatrictimes.com/view/slow-thought-in-a-fast-city
Slow Thought in a Fast City
May 15, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
“The Trouble with Normal”: Reading 2 Canadian Bestsellers - Gabor Maté’s "The...Université de Montréal
This column in my series, "Second Thoughts" in Psychiatric Times reviews the books and careers of 2 Canadian bestselling public intelectuals - Jordan Peterson and Gabor Maté
I am writing this column in Marrakesh, Morocco where I am participating in the 20th World Congress of Dynamic Psychiatry, which took place from April 16-20th, 2024, sponsored by the World and the Moroccan Associations of Dynamic Psychiatry. And isn’t that a story in itself? Psychoanalysis and psychodynamic psychiatry once so powerfully present in the USA and the Global North are now being rescued and reinvigorated beyond their cloistered institutes by the Global South in psychiatric and psychological practices as well as in academic departments.
Émile Nelligan - poète québécois, pris entre deux solitudes : la poèsie et la...Université de Montréal
Cette présentation passe en revue le cas d’Émile Nelligan, le poète le plus célèbre du Québec et le patient le plus célèbre de l’Hôpital St-Jean de Dieu (aujourd’hui l’Institut universitaire en santé mentale de Montréal) dont nous fêtons le 150e anniversaire. Nous retraçons le parcours de Nelligan en tant que prodige poétique jusqu’à son internée dans un asile de Montréal, tout cela avant qu’il n’ait 20 ans. Les arguments sont examinés pour Nelligan en tant qu’étude de cas de la tension entre la psychiatrie et l’antipsychiatrie ; les déterminants développementaux, familiaux et sociaux de la santé mentale ; sa vie et sa maladie en tant que personne liminale vue à travers la psychiatrie culturelle ; la relation entre la créativité et la folie ; la société québécoise déchirée entre « deux solitudes » de la culture et de la langue française et anglaise et perçue comme répressive.
This column approaches trauma from three perspectives-child and family psychiatry, trauma-informed care, and social psychiatry and philosophy. The tragedy of King Lear is briefly introduced as the framework for understanding tragedy and trauma. In closing, I argue for a nuanced approach to trauma that is selective but responsive to the ruptures that create trauma and tragedy in our lives.
"You do me wrong to take me out o' the grave. Thou art a soul in bliss; but I am bound Upon a wheel of fire, that mine own tears Do scald like molten lead."
- King Lear, Act IV, sc 7
Sin Magia ni Maestros: Para las prácticas sistémicas y sociales mexicanasUniversité de Montréal
Es hora de que los terapeutas y activistas sociales mexicanos sigan esperando mejores prácticas mientras aceptan los límites de los modelos importados. Ya es hora de que los mexicanos formen a sus propios líderes a través de su propia pedagogía produciendo nuevas soluciones a sus propios problemas, sin magia ni maestros foráneos o locales.
This is a follow-up to my first column in Psychiatric Times on "The Gaza-Israel War: 'A Major Poetic Emergency.'" That emergency has become a full-blown crisis cascading into a catastrophe. There are two sides, multiple competing allegiances, many losers, and no winners.
Polarization: On the Threshold between Political Ideology and Social RealityUniversité de Montréal
This is my 4th column in my new series in Psychiatric Times, "Second Thoughts About ... Psychiatry, Psychology and Psychotherapy" This column is about polarization in social and political life and the slippery slope from what is to what ought to be, from facts to values.
https://www.psychiatrictimes.com/view/polarization-on-the-threshold-between-political-ideology-and-social-reality
“The Web of Meaning” – Family Therapy is Social Psychiatry’s Therapeutic BranchUniversité de Montréal
My third column in the series, "Second Thoughts ... About Psychiatry, Psychology, and Psychotherapy" in Psychiatric Times is called, “The Web of Meaning”: Family Therapy is Social Psychiatry’s Therapeutic Branch and explores family therapy as one of the three branches of social psychiatry
Against “The Myth of Independence” – For a More Convivial and Interdependent...Université de Montréal
Psychiatric Times
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/against-the-myth-of-independence-for-a-more-convivial-and-interdependent-society
Against “The Myth of Independence” – For a More Convivial and Interdependent Society
March 27, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No more fiendish punishment could be devised … than that one should be turned loose in society and remain absolutely unnoticed by the members thereof. – William James
Lead: Some of the most divisive notions in the Western world and the Global North: individualism and independence. Are they a myth?
DOI: 10.13140/RG.2.2.32192.14086
“Atado a una rueda de fuego”: Reflexiones sobre una vida en los estudios de t...Université de Montréal
V Di Nicola, “Atado a una rueda de fuego”: Reflexiones sobre una vida en los estudios de trauma. Boletín CRISOL (Centro de Posgrado en Terapia Familiar), Febrero 2024, 1: pp. 3-6.
Abstracto
Este breve ensayo aborda el trauma desde tres perspectivas: psiquiatría infantil y familiar, atención informada sobre el trauma y psiquiatría y filosofía social. Se presenta brevemente la tragedia del Rey Lear como marco para comprender la tragedia y el trauma. Para terminar, el autor aboga por un enfoque matizado del trauma que sea selectivo pero que responda a las rupturas que crean trauma y tragedia en nuestras vidas.
Palabras clave: trauma, tragedia, Determinantes Sociales de la Salud (DSS), Experiencias Adversas en la Infancia (EAI), Trastornos de Estrés Postraumático (TEPT), historia de trauma
"El Evento Como Desencadenante del Cambio Ontólogico"
por Vincenzo Di Nicola
MASTER CLASS Practicum Internacional 2024
CRISOL Centro de Posgrado en Terapia Familiar Ciudad de México, México
8 y 9 de Marzo de 2024
DOI: 10.13140/RG.2.2.27104.90887
From Populations to Patients: Social Determinants of Health & Mental Health i...Université de Montréal
Abstract:
The overall objective of this webinar is to harness the powerful data of populational studies to patients in clinical practice.
This is effectively a plan for applying social psychiatry to the clinic –a call for “Clinical Social Psychiatry.”
This objective will be addressed through three goals with seven steps:
(A) Review social psychiatry’s powerful populational studies on psychiatric epidemiology and Social Determinants of Health & Mental Health (SDH/MH)
1. Adverse Childhood Experiences (ACE) Studies
2. Global Mental Health (GMH) – Treatment Gaps
3. Epidemiology to reflect the burden of disease
(B) Promote translational research of social psychiatric studies – redefining health in social terms
4a. Translational research to redefine health
4b. Mental health in a social context (C) Provide ground-level prescriptions aimed at prevention, promotion, intervention, and adaptation
5. Mental health services to be delivered where people live
6. Shared care/integrated care/collaborative care
7. We can’t do everything – address common and pressing problems
Keywords: Populational studies, social determinants of health & mental health (SDH/MH), translational research, ground-level prescriptions
Borders, Belonging, and Betrayals: A Poetic Conversation Among a Palestinian ...Université de Montréal
Borders, Belonging, and Betrayals: A Poetic Conversation Among a Palestinian Israeli Psychologist, an Italian Canadian Psychiatrist, and a Canadian United Church Pastor in a Time of War
Psychiatric Times Magazine
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS
H. Steven Moffic, MD
November 20, 2023
https://www.psychiatrictimes.com/view/the-gaza-israel-war-a-major-poetic-emergency
The Gaza-Israel War: “A Major Poetic Emergency”
A Poetic Conversation Among a Palestinian Israeli Psychologist, an Italian Canadian Psychiatrist, and a Canadian United Church Pastor in a Time of War
November 20, 2023
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS
H. Steven Moffic, MD
Columnist’s Introduction
Get ready for something unique and extraordinary, more than I even could have wished for! It
caught my breath and brought me to tears. Take these lines from Dr. Di Nicola’s piece:
· “Not poetry of war, but poetry of life.”
· “The words I might have spoken are now a choking silence as I think of you and your loved ones, of all the families and remnants of families, trapped within the maelstrom.”
...
Now we have another most moving example, full of depth, involving a Jewish psychiatrist,
a Palestinian Israeli psychologist, and a Christian pastor, all also poets. In an earlier parallel process, over the last few years I’ve been involved in editing books on Islamophobia, Anti-Semitism, Christianity and Psychiatry (all for Springer). If I imagined those volumes talking to one another, I would wish it would be in an interaction just like these writers have had—a reflection of their religions, professions, and themselves at their very best complementary essence.
This symposium convenes three leaders from across Canada to discuss their concerns, values and visions for Canadian psychiatry in the next decade.
Douglas Urness considers continuing professional development (CPD), advocacy and collegiality as the starting point for continuity and renewal. Professional and public polarizations now make collegiality crucially important.
Gary Chaimowitz addresses key issues facing psychiatry in the next decade, ranging from critical challenges in health care organization and delivery (access to care, privatization, quality of care, human resources) and Canadian psychiatry’s collegial relationships among ourselves (including work stress and physician burnout) and with others (clinical psychologists, allied professions, interdisciplinary and international collaborations) to social issues (e.g., environmental anxiety) and advocacy (i.e., equality, diversity and inclusiveness).
Hygiea Casiano values resiliency and using positive psychiatry techniques to build healthier institutions and communities. This value orientation is particularly impressive given her role in forensic child and adolescent psychiatry, working with youth confronting trauma and self-harm.
The chair & moderator, Vincenzo Di Nicola, a socially-oriented child and adolescent psychiatrist, offers bridging comments on these perspectives in Canadian psychiatry and animates a discussion with symposium participants.
References
Canadian Institute for Health Information. Measuring access to priority health services [Product release]. Accessed February 6, 2023.
Centre for Addiction and Mental Health. The Crisis is Real. https://www.camh.ca/en/driving-change/the-crisis-is-real. Accessed February 6, 2023.
Di Nicola V, Stoyanov D. Psychiatry in Crisis: At the Crossroads of Social Science, The Humanities, and Neuroscience. Foreword by KWM Fulford, MD, Afterword by A Frances, MD. Cham, Switzerland: Springer Nature, 2021.
Jeste DV, Palmer BW, Rettew DC, Boardman S. Positive psychiatry: its time has come. J Clin Psychiatry. 2015 Jun;76(6):675-83.
A poem from my new collection -
"TWO KINDS OF PEOPLE:
Poems from Mile End"
(Singapore: Delere Press, 2023)
Republished along with a review of my poetry collection in Capital Psychiatry
A Collection of Poems that Refutes the Binary in Favor of Imaginative PluralityUniversité de Montréal
"A Collection of Poems that Refutes the Binary in Favor of Imaginative Plurality"
TWO KINDS OF PEOPLE: Poems from Mile End by Vincenzo Di Nicola
Reviewed by Dennis Palumbo, M.A., MFT
Capital Psychiatry, Fall 2023, 4(4): 44-45.
Accompanied by a poem from this collection, "The Sufi Tavern."
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Surgical Site Infections, pathophysiology, and prevention.pptx
Lessons for Young Therapists: Getting Started and Staying on Track in Your Psychotherapy Practice
1. Workshop
Lessons for Young Therapists:
Getting Started and Staying on Track
in Your Psychotherapy Practice
Vincenzo Di Nicola
73rd Annual Conference
Vancouver, British Columbia
October 21, 2023
2. Professor Vincenzo Di Nicola
MPhil, MD, DipPsych, FRCPC, PhD, FCAHS, DLFAPA, DFCPA
Professeur titulaire, Université de Montréal
President, World Association of Social Psychiatry
Email: vincenzodinicola@gmail.com
4. Learning Objectives
1. Discern the patterns in psychotherapeutic practice based on a
survey of the evolution and current practices of psychotherapy
2. Answer such basic questions as to what to read and how to begin
therapy and what motivates both the patient and therapist
3. Avoid theoretical riddles and practical traps and focus on the
therapeutic relationship and its ethical conduct
5. Introduction
• In these seven lessons for young therapists, based on
practising child psychiatry and psychotherapy for almost 40
years, I will survey what therapy is about and how it works,
from behaviour therapy and family therapy to
psychodynamic psychotherapy
6. Workshop: Questions
• What kind of psychotherapy practice do you have or plan?
• Do you have or plan ongoing supervision, advanced training, and access
to mentors and a peer group of therapists?
• What changes are you planning for your practice?
• What more resources do you need to accomplish your practice goals?
• Are you practising adequate self-care and work-life balance?
7. Workshop: Resources
• Kids: American Academy of Child& Adolescent Psychiatry (AACAP)
• Link: https://www.aacap.org/
• Trauma-informed care: Harvard Program in Refugee Trauma(HPRT)
• Link: https://hprt-cambridge.org/
• Psychodynamic Psychotherapy & Psychoanalysis: American Academy of PsychodynamicPsychotherapy&
Psychoanalysis(AAPDPP)
• Link: https://www.aapdp.org/
• Webinar: https://members.aapdp.org/upcoming-events?reload=timezone
• Culture & Families: World Associationof CulturalPsychiatry (WACP)
• Webinar: WACP Family & Culture Special Interest Group
• Link: https://waculturalpsy.org/wacp-news/family-culture-special-interest-group/
8. Introduction
These lessons integrate my work in psychiatry and psychotherapy:
• A Stranger in the Family: Families, Culture, and Therapy (1997)
• Letters to a Young Therapist (2011)
• “Two trauma communities” in Trauma and Transcendence (2018)
• “Slow Thought: A Manifesto” in Aeon Magazine (2019)
• Psychiatry in Crisis: At the Crossroads of Social Sciences, the
Humanities, and Neuroscience (2021)
11. Peoplecome into therapy not to change
Systems theory
the basis of Systemic family therapy
calls this homeostasis
12. What is the task of therapy?
Freud wrote that the task of psychoanalysis is
to make the unconscious conscious
13. What is the task of therapy?
To give structure and meaning to the predicament of
an individual, a couple or a family,
a group or a community
14. What is the task of therapy?
This exploration of predicaments is done in therapy
when it is not possible elsewhere
or otherwise
15. What to read, whereto start?
•Read Freud first, don’t read about Freud
•Start with The Interpretation of Dreams (1900)
•After Freud, read Winnicott’s Playing and Reality (1971)
19. Who conducts therapy and why?
The therapist you are now, or will be - and that you
were meant to be – was determined long before you
started your professional training as a therapist
20. Who conducts therapy and why?
• Phenomenological temperament
Understanding – What? Why?
• Technocratic temperament
Intervention – How?
23. Family Sayings
There are five of us children.… When we meet, we can be indifferent and
aloof. But one word, one phrase is enough; one of those ancient phrases,
heard and repeated an infinite number of times in our childhood … would
make us recognize each other in the darkness of a cave or among a
million people. These phrases are our Latin, the vocabulary of our days
gone by …. They are the evidence of a vital nucleus which has ceased to
exist, but which survives in its texts salvaged from the fury of the waters
and the corrosion of time. These phrases are the foundation of our family
unity which will persist as long as we are in this world, and which is
recreated in the most diverse places on earth …
—Natalia Ginzburg, Family Sayings (1963, pp. 23-24)
25. Families
• Salvador Minuchin (1921-2017)
• Articulated a coherent approach with a
model of family functioning, a theory
of change, and techniques for therapy
• Psychoanalysis,he argued, sees
“Man out of context”
27. Families
• Mara Selvini Palazzoli (1916-1999)
• The Milan Team: Systemic family
therapy
• “Family therapy is the starting point for
the study of ever wider social units.”
—Mara Selvini Palazzoli
28. Families
• Maurizio Andolfi (b. 1942)
• Relational psychology and therapy
• This represents nothing les than a
rethinking of psychology based on
relationships and therapies that
follow from such a psychology
31. How therapy works
Therapists do three simple things with information:
• Enhance uncertainty (that doesn’t seem to be working out
so well for you)
• Introduce novelty (there may be other ways to look at it)
• Encourage diversity (let’s try a different approach)
Reference: Di Nicola, V. A Stranger in the Family (1997)
32. How therapy works
• Freud’s psychoanalytic method uses introspection to arrive
at insight
• Yet Freud never used the word “insight”
• He wrote about “working through”
33. Donald Winnicott
(1896-1971)
•The “holding environment”
•Allows both child and parent,
patient and therapist to play
Reference: Winnicott, D.W. Playing and
Reality. London: Tavistock (1971)
34. Louise Glück
(1943-2023)
We look at the world once, in childhood.
The rest is memory.
– “Nostos” in Meadowlands (1996)
• American poet, Nobelist in Literature
(2020)
36. One hundred years of invisibility
The evolution of therapy
19th century – symptoms
20th century – schools of therapy
21st century – change
And yet, people remain invisible – the most vulnerable –
children, other minorities
37. Making visible what was invisible
•Freud said that psychoanalysis aims to make the
unconscious conscious
•The story of therapy is the story of making visible
what was invisible
39. We are social animals
No more fiendish punishment could be devised …
than that one should be turned loose in society and
remain absolutely unnoticed by the members thereof….
We are gregarious animals with an innate propensity to
get ourselves noticed favorably by our own kind.
—William James (1890)
42. What is said and what is unsaid
• People will tell you or show you what you need to
know
• Anthropologist Gregory Bateson (1972) said that
sometimes people speak in “metaphors that are
meant”
• “I am a rug – my husband walks all over me”
43. What is said and what is unsaid
• Sylvia Plath (1932-1963) – American poet
• Patient at McLean Hospital – The Bell Jar (1963)
• Committed suicide in London
• In “Lady Lazarus” (1965) she wrote,
Dying
Is an art, like everything else.
I do it exceptionally well.
44. What is said and what is unsaid
•Haitian therapist to a Haitian mother in Montreal:
“I have understood everything that you have NOT said.”
“If you do not witness what cannot be said,
you will shatter what can be said.”
—al-Niffari (cited by Adonis, 2005)
45.
46. The fox’s lesson
Les hommes ont oublié cette vérité, dit le renard. Mais tu ne dois pas l’oublier. Tu
deviens responsable pour toujours de ce que tu as apprivoisé.
—Antoine de St-Exupéry, Le Petit Prince (1943)
“Men have forgotten this truth,” said the fox. “But you must not
forget it. You become responsible, forever, for what you have tamed.”
—Antoine de St-Exupéry, The Little Prince (1943)
47. Face-to-face encounter
• Psychotherapy of all types is a face-to-face encounterwith
other human beings
• Response and responsibility begins with that
• Emmanuel Levinas asserted that “Philosophy is first ethics”
• Healing, holding, caring in psychotherapy must be founded
on the ethics of face-to-face
48. The gurū-chelā relationship
• Each society has the resources to construct
psychotherapy in accord with its values and traditions
• In India, JS Neki used the gurū-chelā (master-disciple)
relationship as a paradigm for Indian psychotherapy
Reference: Di Nicola, V. The Gurū-Chelā Relationship Revisited: The Contemporary
Relevance of the Work of Indian Psychiatrist Jaswant Singh Neki. World Soc Psychiatry
2022;4:182-6.
49. Forget Maslow’s hierarchy of needs
The people need poetry like
they need bread.
—Osip Mandelstam (1891-1938)
Russian poet
50. Seventh Lesson
“And on the seventh day, the Lord rested …”
When therapy is over:
The myth of closure, flow, and slowness in therapy
51. The myth of closure
•Freud said that therapy is over when the patient
realizes that it could go on forever
•There is no closure, just a choice to get on with it
•Asymptote: the point of diminishing returns
52. Sabbatical
Do your work for six years; but in the seventh, go into
solitude or among strangers so that the memory of
your friends does not hinder you from being what you
have become.
—Leo Szilard (1992)
53. Take your time
Question: “How does one philosopher address another?”
Answer: “Take your time.”
—Ludwig Wittgenstein (1980)
54. Slowness in therapy, flow
We need a philosophy of Slow Thought to ease thinking
into a more playful and porous dialogue
about what it means to live
—Di Nicola, “Slow thought manifesto” (2018)
56. Belonging
Belonging is to social psychiatry
what attachment is to child psychiatry
Belonging is the glue that holds together
the social determinants of health and mental health
and gives them structure and meaning
57. Holding
Holding is the glue that binds introspection to insight in a
relational act of empathy and witnessing (Mollica, 2006)
or, as philosopher Martha Nussbaum (2011) put it,
“the highly particular transactions that constitute love
between two imperfect people”
58. Seven Lessons: Summary
1. People don’t want to change (homeostasis)
2. Different therapeutic temperaments see different tasks,
seek different ways of doing therapy
3. People live in social contexts, not isolated worlds
4. Therapy creates new views of life through a holding
environment
5. Therapy makes visible the invisible
6. People need and want to have meaningful lives
7. Therapy respects the flow & rhythms of life, taking time
to integrate change, knowing when to stop
60. Acknowledgements
I would like to express my gratitude to:
• Accademia di Psicoterapia della Famiglia (Rome)
• American Academy of Psychodynamic & Psychoanalysis
• World Federation for Psychotherapy
• John Farnsworth, PhD (New Zealand)
61. References
• Adonis. Sufism and Surrealism. London: SAQI, 2005.
• Andolfi, M., Angelo, C., de Nichilo, M. & Di Nicola, V. The Myth of Atlas: Families &
the Therapeutic Story. New York: Brunner/Routledge, 1989.
• Bateson, G. Steps to an Ecology of the Mind. New York: Ballantine Books, 1972.
• Di Nicola, V. A Stranger in the Family: Culture, Families and Therapy. New York &
London: W.W. Norton & Co., 1997.
• Di Nicola, V. Letters to a Young Therapist: Relational Practices for the Coming
Community. New York & Dresden: Atropos Press, 2011.
62. References
• Di Nicola, V. “Take your time: Seven pillars of a slow thought manifesto.” Aeon
(online magazine). February 27, 2018. https://aeon.co/essays/take-your-time-
the-seven-pillars-of-a-slow-thought-manifesto.
• Di Nicola, V. Two trauma communities: A philosophical archaeology of cultural
and clinical trauma theories. In: PT Capretto & E Boynton (Eds), Trauma and
Transcendence: Limits in Theory and Prospects in Thinking. New York: Fordham
University Press, 2018, pp. 17-52.
• Di Nicola, V. The gurū-chelā relationship revisited: The contemporary relevance of
the work of Indian psychiatrist Jaswant Singh Neki. World Social Psychiatry
2022;4:182-6.
63. References
• Freud, S. The Interpretation of Dreams. 1900. Available at:
https://en.wikisource.org/wiki/The_Interpretation_of_Dreams
• Ginzburg, N. Family Sayings. New York: Arcade Publishing. 1963.
• Glück, L. Meadowlands. New York: The Ecco Press, 1996.
• James, W. Principles of Psychology. New York: Henry Holt, 1890.
• Minuchin, S. Families and Family Therapy. Cambridge, MA: Harvard U Press, 1974.
• Mollica, R.F. Healing Invisible Wounds: Paths to Hope and Recovery in a Violent
World. New York: Harcourt International, 2006.
64. References
• Nussbaum, M.C. PhilosophicalInterventions: 1986-2011.Oxford: Oxford
University Press, 2011.
• Selvini Palazzoli, M., Boscolo, L., Cecchin, G. & Prata, G. Paradox and
Counterparadox:A New Model in the Therapy of the Family in
Schizophrenic Transaction. New York: Jason Aronson, 1978.
• Szilard, L. The Voiceof the Dolphins & Other Stories. Stanford, CA: Stanford
University Press, 1992.
• Winnicott, D.W. Playing and Reality. London: Tavistock,1971.
• Wittgenstein,L. Culture and Value. Oxford: Basil Blackwell, 1980.