Independent and autonomous are incongruent traits to work in CMHCs.


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I give up, I will never be able to work for any clinic for a prolonged period ever again in my life.  Nope, these places just want providers to be eager to prescribe and willing to conform to agendas that don’t practice by a biopsychosocial model.

Every damn psychiatrist I have followed in the past 2 years as a Locum doc, and now this current job I hoped to take on as a permanent doc, were just a bunch of nice, compliant prescription sources who couldn’t say no to a script demand, never annoy an administrator eager to maintain the business model, and truly believed that quantity trumped quality every freakin’ moment of the day.

Anyway, after yet another draining week, I come home and find this sample issue of The Brown University Psychopharmacology Update (August 2015 issue), and what is in there to just piss me off?  First, the lower cover story of “Extended-release mixed Amphetamine salts effective for Comorbid ADHD & cocaine use”.  Really?!  Let me advise readers here, that is such a joke and profound lie at the same time, ADD patients do not use cocaine for two reasons over 90% of the time:  they don’t get a high from it as cocaine is a stimulant so the effect is therapeutic, and, if they really want to push the odds then they have to use a lot of it, so cost ends up making use fairly much prohibitive within a few months at most.  That’s if the large quantity to use doesn’t have serious morbidity or mortality, a nice way of saying if it doesn’t hurt or kill them, then they are lucky.

So, there really is not a sizeable cohort of ADD patients who are coke users, thus the frank ridiculousness of this article in the first place.

The second loser in the issue was this, on page 3:  “SSRIs and Venlafaxine show no Major risk of Cardiac birth defects”, umm, this study was based on live births in five Nordic countries between 1996 and 2010, so did they either avoid Paxil or just ignored the truth plainly out there?

You can google “Is paxil safe to use in pregnancy” and find whatever articles you want, I think this one sums it up fine for me, and was updated this month:

In there this:  “There is one SSRI that the FDA and its manufacturer warn women not to take during pregnancy— paroxetine (Paxil), which carries a grade D. Drugs that are labeled as D have been shown to be a risk to a human fetus.”

And yet, at the end of the article is this little gem:  “a growing body of evidence from animal studies has suggested that the neurotransmitter serotonin is important as a signaling molecule in a variety of cells and tissues during embryogenesis, including heart development.  Disruption of the serotonin signaling cause by exposure to SSRIs may thus result in disturbances of cardiac development….”

Huh?  The title says there are no major risks of cardiac birth defects, yet this ending seems to contradict that very premise.  WTF am I missing here?!?!

So, once again this lame publication that is trying to sell meds are safe in pregnancy, well, when can a lawyer use this to drag Brown’s Psychopharmacology Update into court as a complicit co-conspirator in a lawsuit by a damaged child?

Remember, if you are pregnant and feeling depressed and end up in a psychiatrist’s office being offered meds, just ask the doc this question:  “would you as a woman, or if a man and married, take or advise your wife this medication you are offering me now?”  Watch the stammering or frank denial blossom before you!

Just incredible what I have to endure these last several years…

“Prescriptions for all, come and get ’em!!!”

We really do live in the U.S. of A.!


Gotta love acronyms, well, if you use them right, I guess.  I think it is becoming painfully obvious that the real meaning of U.S. of A. means, to me at least, the

Unwavering State of Antisocialism.

I know readers think I am being extreme and overgeneralizing, but, I don’t think most Americans are antisocial, however, the percentage is much greater than what the DSM thinks it to be here.  I think there is at least a 10% or more of this culture that is insidiously or overtly antisocial, in all venues of our travels in this society.

Certainly it is pervasive in business and politics, growing in health care, and I see enough patients coming into my office these past 10 years or so who aren’t antisocial, but struggling to deal with antisocial cretins in these patients’ lives to a point it is causing heartache and “headache” per psychological distress.

I leave readers with this:  for me, it is painfully obvious that Hillary Clinton is a dysfunctional person who is not fit to be President of the United States, yet, poll after poll these past 2 or so months, since it is fairly obvious she is hiding things by deleting her emails (forget her history the prior 20 years for a minute) and how disingenuous and demeaning she is caught at times in public venues, how does she have a persistent 30-35% who say they support her and find her trustworthy???

That is the foundation to my hypothesis:  it isn’t the politicians who suck, but, the public who are beyond ignorant and clueless anymore, just reflexively agreeable because they identify with these candidates.

I have met people who say they think she is antisocial, in some form, and would still vote for her.  WTF does that say to you?!?!

Think about it the next time you hear chants for “USA, USA!!!”

The drug seeking really is getting old, and, obnoxious



Know what ADD stands for to me these days?  Annoying Drug Demanders, specifically for those alleged ADD patients over 40 years old coming in and almost honestly demanding I write for Adderall or other stimulants, and in general, those patients who want controlled substances, and even if not meds of abuse potential, meds to literally fix their psychosocial issues NOW!

I have a drop out rate in my private practice these last 6 months of over 40% from these very folks coming in and demanding I submit to their drug seeking issues.  Really, I am closing about 7 or so charts a month for people who don’t come back after I set limits in the first 1-2 visits.  This is private practice mind you, not Community Mental Health Care clinics.

Is it me?  I will say yes to that, to a point.  Is it them too?  Yeah, it is.  The boldness and frank expectation to get what people want, I’ll just end this brief post with this simple perspective:  health care is not a business, the patient is not a customer or consumer, and they are not always right.

And frankly, there are plenty of psychiatrists who want your money, so they will give you what you want, if you are just looking to get high or “fixed” today.  I am not one of those doctors, I focus on needs, not wants, and I would like to see people be healthy and functional, not just better or feeling good.

There is a difference between those two endpoints, thinks about it.

“You can’t always get what you want, but if you try sometimes, you just might find, you get what you need…”

Standards of care, no, physicians now live “stranded from care”.


This is going to be a short post, I just want to note to anyone out there either as provider or patient, do you really think the care being provided and received really is the standard of care?  I can tell you after the last 2 plus years alone as Temp Doc, nope, what is going on in clinics, private practice offices, and fairly much any other mental health care venue, it is almost solely stranded from care.  The intrusions, micromanagement, lack of accountability in administrative decisions is just beyond astounding and astonishing, it is becoming brutal and brusque.

And so many doctors just tolerate it, minimize the damages, and some actually try to rationalize and defend it!  Who the f— are these people masquerading as advocates and supporters of health care?  If you know the answer or answers, please let me, and readers who peruse the threads, know ASAP.

Stoker wrote “there are worse things than death”, yep, it is called a caring and invested psychiatrist circa 2015.  ISIS is more merciful than the crap I have endured of late.  Outrageous?  No, outstanding, per those who succeed in chipping away at the fabric of responsible and appropriate mental health care.

All you out there still silent, you are pathetic!

Not a fan of House, but the image works for me here.

“A faith of convenience is a shallow faith.” Believe it, you are watching it across this country of late!



Once again, The Week Magazine comes through, reading in the Book Review section on page 21 about “Black Earth:  The Holocaust as History and Warning” this quote noted at the end of the review:

“In a period of fear and panic, it is the easiest thing in the world to talk ourselves into the idea that bad things we do are necessities of human nature.”

Lots of reviews, I chose this one for readers to get an idea:

I know there are readers out there who just roll their eyes and say, “Here we go again, Hassman is railing away using an extreme example as his analogies for poor choices and actions”, but, hey, it is valid history, and how much did Nazi Germany do to disrupt and erode the trust and expectations of humans across the planet, hmm???

At the end of the review above is this:

“Snyder pinpoints many miscalculations made by Hitler, but also highlights how many of his calculations were, amazingly, entirely accurate. Hitler knew what beasts humans could be turned into, and he knew how to do it. The lessons of Hitler’s effectiveness, are available today and have been put to use in such places as Rwanda, Somalia, and Ukraine. Though Snyder honors those who resisted the beast within and without and who even rescued or otherwise brought aid and comfort to the oppressed Jews, he is not sanguine about humanity’s better selves prevailing. In comparing the facts of the Holocaust against the patterns of more recent history, Snyder reveals the blueprint of genocide lurking beneath current events, at once astoundingly complex and frighteningly simple.”

Yeah, it is human nature to panic and just turn into a mob, and I think that is the outright agenda of those who prey as failed leaders and people of alleged influence on the human condition .  Gotta love the scapegoat mentality that I think was rewritten from American behaviors and examples these last 60 or so years, eh?

And now Obama turns to Putin to lead in taking out ISIS.  Am I the only person in this country who is paying attention and writing about it repetitively how this cretin in the Blight House on Pennsylvania Avenue in DC is continuously eroding the fabric of this country in so many levels, it is beyond astounding and outrageous.

It is criminal.  And yet a pervasive 30% of citizens not only support him endlessly, they cheer him on.  Frightening…

Go back to the first post and read if I am correct, or just hopeless lost:

I give you the picture that is timeless, to me at least…

Ironic, from The Week Magazine over 2 & 1/2 years ago…

Identifying Characterological issues is very important, especially in people who crave positions of power and influence!



Think about this for one minute, please.  Who benefits from dumbing down boundaries and definitions of basic rights/wrongs?  No one who intrinsically does what is right, responsible, and respectful.  So, who does that leave in this pursuit of diminishing, demeaning, and disrupting fabrics of society?

Yep, the characterological individual, the Axis 2 person, the guy/gal who just like to divide and conquer.  And most reading here know this, but, I wonder if the ones who do read here who have struggles interpersonally can gain some insight, and practice some appropriate judgment, and see the folly of their ways…

At another blog, I was yet again attacked by a certain individual who just repetitive utters that anyone who is a psychiatrist and does not continuously and repetitively spew absolute detraction and rejections of anything psychiatric is a complicit supporter of legitimate inappropriate practices by psychiatric hierarchy diminishing the value of the profession.  The last sentence was appropriately run on and voluminous, to reflect the ideology and attitude of these commenters that are infinitely antipsychiatry.  These people will stop at nothing to rail away that anyone who does not genuflect to their ideology and zealotry are against them.

Pretty pathetic, hmm?  This same person I note above said this in the last comment at the thread, which I played a role in closing, I admit that freely and honestly:

“…Psychiatric diagnosis- labeling employed as a means to denigrate those whose opinions and perceptions threaten the status quo. Here, (above) this practice can be viewed as a venue to express open hostility toward those in a specific diagnostic category, (Axis II) which, by written accounts from this author (above) comprises most of our society, and all of those who oppose status woe that is psychiatry.

I can’t think of a single example from any other medical specialty , of a doctor who uses his professional credential as a weapon of mass destruction…”

Yeah, I am that doctor who uses my credential as a psychiatrist as a weapon of mass destruction.  Wow, any more over the top and Everest is a mole hill.

I leave readers to consider reviewing these three prior posts I wrote about Axis 2 issues, the first one of my first posts almost 3 years ago now, and the other two more recent entries, and think about what I offer as opinion to what the Axis 2 individual brings into the community as nothing less than immature and primitive efforts at redefining societal boundaries and expectations , until proven otherwise mind you as there are exceptions to rules and observations.


I finish with this from that last link, and hope readers will think about these rigid, inflexible people who think their framework is the only opinion that not only matters, but should be embraced and maintained for the rest of time:

“addendum later tonight:  Gee, on cue this from Dr John Grohol at Psychcentral blog, and you gotta admit, ironic?:

the end is just so perfect:  “It’s good to know that trolls online have a personality type that fits with what most of us view them as being — sadistic, deceptive and in it for themselves. Trolls just want to have fun? Sure… but who doesn’t?” “

Hey, just my imperfect opinion, true?


What I want for Christmas, er, Hanukkah.

I will keep this post simple and to the point. It’s been quite the lousy last couple of months between my private practice work and this new job which I will leave unnamed. People, whether it be patients, or other colleagues, just want it popular easy and convenient.

So, what I want for the holidays in the next few months, is simply this: I would like the winning numbers for Powerball, no big payout, maybe after taxes about 5 to 10 million dollars tops.  What I would do with it after I gave my family some money and pay off my debts in full is simply this: I would open my own private practice, just on my own, and ask potential patients who would come to see me, after I put an advertisement in the various media sources, just this:

I would ask patients to pay $100 an hour, and for that I would provide them a full complement of mental health services. I would see them for a full hour evaluation and then advise them to consider follow ups to include medication where applicable, one hour therapy visits, and access other adjunct services that would provide them a complete complement of services. Besides paying $100 an hour, I would ask them to commit to the following: agree to meet with me weekly for the first 6 weeks, then at least bi-weekly for another 6 visits. After that, depending on where they’re at, I would ask them to meet with me every 2 to 4 weeks and hopefully in the space of the first 6 months to 9 months, I would see them have improvement.

Furthermore, I would be able to meet with 30 to 50 patients with this formula, and I’ll be conducting my own study. I will call it the “1 two 1”,  & I would show people who were interested that those who commit to what are the standards of care for responsible and efficacious mental health should see improvement.

The patients certainly have to spend time, money, and energy, and I would hopefully be able to provide them an opportunity to improve.

Think about it for one minute. I’m at least contributing half the cost for their care, and all I’m asking of them is to commit to a standard of care which I think would make a difference in their lives.

At the end of the day, how many people would honestly make this kind of commitment?   I mean yes, I am obviously coming in with some income stream of my own, but, I am agreeing to provide them care and see them have an opportunity to improve themselves.

Yeah, like this opportunity is really going to happen. But, I asked readers, if you have your own set of five digits between 1 to 59, and then the bonus ball being 1 – 25, I think that range in numbers, and, God forbid I actually win, I’ll give you the 10% pay off for your contribution, and then we’ll see if my commitment actually impacts for the better!

Hey, we all can dream, right!!,??


( note: this is my first post using my tablet, as my home computer has been in the shop and it has been completely frustrating to not be able to do a post of late!)

Maybe this pattern of divisive leaders really is representative of what American citizens want?


You read these poll numbers of what people are allegedly looking for in a President, and if you are not a partisan hack or special interest player, you have to step back and ask yourself, how is there a pervasive 30-40% of poll responders who continue to say they want Trump or Hillary Clinton to be President?

My take?  I think there is a pervasive and growing characterological element in society that is really redefining rigidity and inflexibility across the country.  I can only say it is astounding, and asinine at the same time, that people can say in one breath they want the above very flawed people to be our next President, after watching this horror show from our current “leader” play out as it has, and then 72% claim they have no trust of current politicians who are just the trend setters for the Trumps and Clintons these two, from the one party system of Republocrats, reflect as the ongoing agenda.

Just remember this, I firmly believe that consistency is the hallmark of success, but, I guess that adage or affirmation can be corrupted.

Also remember what George Carlin said 19 years ago, it really aren’t the poliiticans who suck at the end of the day, but, the public who vote these incompetent and corrupt people in and keep them entrenched for decades.

So, who will follow my lead as the candidates present as of now?  Do not vote, as things stand as of now, and then you will have the honest right to complain about the mess all the morons and incompetent voters will again put us in who vote reflexively like they are pushing down the toilet lever in the voting booth.  Because if you vote for a candidate who only espouses divisive and inflexible agendas and goals, well, you are complicit at the very least.

Divisiveness, now there is a new American tradition!!!

Obama America

Oh, and Bill O’reilly is the exclamation point to this post:

Watch it all if you have the strength.

Hell, I’ll be the only person in the room to speak the truth…


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I am ashamed to be an American citizen.  If this is the best we have had the past 20 years as Presidents that allegedly represent us as a country, first Bill Clinton, then George W Bush, and the complete scum bag that is Barack Obama, with what, at least 33-50% of alleged electorate citizens who supported or still support these cretins for what they have done to demean, diminish, and destroy any possible healthy and responsible morals and values, then this country deserves to crumble.

People first rallied around a philanderer and liar, then went on and supported an agenda to start a war and defend torture, then with the pervasive erosion of so many elements of American foundation principles both domestic and foreign by what I know to be an Anti-American agenda by the Antisocial in Chief in the Blight House now, I have to live among these people who have no clue to what is inherently right versus wrong?!

I just hope these partisan hacks who are hopeless apologists and defenders for all this bogus BS by these Presidents alone are harmed as badly as those Americans who know better and have been trying to fight these horrendous insults and disruptions by these failed leaders these past 20 years.  ‘Cause that is the only way people either learn or are removed from the equation for all the idiocy, cluelessness, and frank hideous complicity they have contributed to letting these cretins rule us as they have done.

Hey, read up on how Rome fell.  You’ll all be living it front and center these next, what, 4 years or less.  All of you who honestly care about your children under 25 years old, I honestly and sincerely advise you to hug them close before they are gone from your protective concerns.  We are doomed, what with Trump the narcissistic windbag and Clinton the bitch wife that are the main characters of the Republocrat agenda now.

“The story of its ruin is simple and obvious; and, instead of inquiring why the Roman empire was destroyed, we should rather be surprised that it had subsisted so long. The victorious legions, who, in distant wars, acquired the vices of strangers and mercenaries, first oppressed the freedom of the republic, and afterwards violated the majesty of the purple. The emperors, anxious for their personal safety and the public peace, were reduced to the base expedient of corrupting the discipline which rendered them alike formidable to their sovereign and to the enemy; the vigour of the military government was relaxed, and finally dissolved, by the partial institutions of Constantine; and the Roman world was overwhelmed by a deluge of Barbarians.”

Sound familiar?   Nah, truth is too painful to too many.

Just remember this if you have any interest, personality disorders are now beyond pandemic in this country, they are the rule of what runs leadership in the various facets of this society; and rigid, inflexible, self serving people do not create growth nor productivity or promote improvements in future generations.

Yeah, Rome will be the lesson.  Feel the heat yet, or do you really think being passive, indifferent, and uninterested is going to save your lives?  Cue Carlin’s last show to bring it back home:

Yep, you are owned, and not valued.  And it is beyond having you by your gonads, they have you by your throats now.  And you voted, encouraged, or just tolerated their pervasive presence.

And, you’re welcome to be reminded of your failure.  Think of what the thank you is for, the end of that above rant…

America burns

Or, maybe this brief video is a bit closer to home as an image, after all, art does imitate life, eh?

Too dark a post for readers?  How do you watch the news these days, I ask myself that very question these past few months.  It is getting darker each day of late, are you ready for the coming winter?


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