Tag: TALES FROM SMUKLER’S COUCH

Trust A Liar? by Art Smukler, MD, author & psychiatrist

by artsmuklermd, posted in Politics, Psychiatry, Self Examination, World events, a psychological view, Writing

Decades ago as a young psychiatrist, my patient Jeremy, a 16 year-old boy who I hospitalized on an adolescent unit because of rampant drug use, running away from home, and stealing, was doing well. He participated in group, individual, and family therapy, did his school work, followed the adolescent unit rules, and told me how he was “a changed person”.

His mom warned me numerous times that whatever came out of Jeremy’s mouth was a lie. Nevertheless, after 4 weeks of excellent behavior, I made plans to discharge Jeremy and see him as an outpatient.

That night I got a call at 4 AM. Jeremy was in full restraints because he had tried to burn down the hospital and then violently attacked staff members.

To sum up a frustratingly long story, after many months of intensive inpatient therapy I again believed that Jeremy was improving and transferred him from the closed unit to the open unit. The next day, a few hours after a therapy session with Jeremy in which I silently congratulated myself on how well my approach was going, I got an emergency call from the hospital. Jeremy had run away.

Months later he was caught robbing a convenience store and placed in Juvenile Detention.

Years later I ran into his mother. She reported that he never returned home and was currently in prison for assault and breaking and entering. She said that from the beginning she hoped that I could help Jeremy but deep down knew that it was hopeless. He was a liar from the time he was a little boy and that never changed.

So, my honest and focus-on-the-positive readers, what is the moral of this true Tale From Smukler’s Couch?

Don’t trust liars.

Whether they are spouses, politicians, investment counselors, or “friends”, liars lie. One important characteristic of sociopaths (people with no conscience) is that many of them are really likable. They are great con men and their lies are very, very believable.

Most of us want to see the best in our fellow humans, but that doesn’t work with liars.

Does this remind you of anyone I’ve been railing against?

Happy reading.

Art

#conmen, #liars, #sociopaths, #sociopathicpoliticians, #treatingsociopaths

Locking Up The Mentally Ill – Good or Bad? by Art Smukler, MD, author & psychiatrist

by artsmuklermd, posted in Writing

Back in the early seventies we still had plenty of homeless people bunking out over subway grates and sleeping in doorways. But, not nearly as many as we have today – all over the US.

Thousands and thousands of the homeless are mentally ill or suffering from an addiction.

As a first year psychiatric resident in Philadelphia, at PGH, Philadelphia General Hospital, the mentally ill were brought in for evaluation by the police. To place someone on a psychiatric hold, the law was clearcut, two psychiatrists needed to sign the admission papers. Once that was done, the patient was admitted to the inpatient unit and treated, most commonly for psychotic thinking secondary to schizophrenia, bipolar disorder, paranoid disorder, addiction etc.

Then what happened?

After treatment, they were discharged to return to their families, homes, or given appointments to attend sessions at a community health center. Their psychotic thinking was under control.

Yes. You read that correctly. THEY WERE DISCHARGED.

Then we closed the state hospitals, lost funding for Community Mental Health Centers and ignored the problem.

Well, you see where that got us.

Liberals who think that placing someone who is overtly psychotic in a treatment center is unfair and wrong don’t sufficiently understand the problem. When a psychotic person is adequately treated, they are often no longer psychotic! They can return to being a productive member of our society.

If Prop 1 doesn’t pass, and it’s very, very close to whether it will or not, we’re back to watching our mentally ill sleep under freeways, yell obscenities, and even attack innocent people. Delusional thinking can’t be reasoned with. More about that in another post.

Thanks, Art

#Prop1, #Delusionalthinking, #homelessness, #mentallyill