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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and Narrative Medicine.
SHARE Sunday, March 4, 2012 Day 12 of the Australian Journey (13043 views)
Day 12 of the Australian cross cultural exchange journey consisted in our leading an inipi ceremony (sweat lodge) for people associated with Mission Australia. We also learned much about some very exciting projects being conducted by Mission Australia, including the Michael Project, which is an intensive effort to assist homeless people in Sydney, and the Catalyst-Clemente Project, which provides education for disadvantaged.
SHARE Monday, April 22, 2013 To Do and Not To Be (10929 views)
I reflect upon the importance of doing, what is called behavioral activation. In order to change, we need to do things differently, and not just think about doing things differently. Unfortunately, conventional medicine has supported a narrative which tells us that we do not have to make an effort to change our behavior, so people who are depressed or anxious don't believe they need to do anything. We need to change this.
SHARE Sunday, May 20, 2012 Narrative Concepts (10673 views)
I attempt to say what a narrative is. It is a telling of something to someone by someone. It may reflect the basic means by which our brains work, the result of a co-evolution of brain and story to allow us to recall the myriad of details necessary for negotiating a social life with the 500 people whom we are capable of knowing. Its shortest form consists of two action clauses that can be sequenced and one orienting clause.
SHARE Wednesday, August 1, 2012 The Inflammatory Theory of Depression (9074 views)
In this article, I describe a way of thinking about depression that makes sense of how we collapse from too much stress and from unremitting anxiety and misery. In this theory, eventually life overwhelms our capacity to resist inflammation and it runs away. From August 16th through the 19th, catch me in Hartford, Connecticut, to further discuss these ideas. For details, see
SHARE Monday, December 10, 2012 Pain, Part 2 (8922 views)
I continue to reflect upon chronic pain, beginning with some comments from my colleague, Peter Blum, who is a hypnotherapist and all around healer-guy in Woodstock, NY, and then leading into some brain science that shows that our brains are changed by the experience of pain and begin to link all kinds of unrelated experiences to that pain so that pain becomes multiply determined by more than just the sensations.
SHARE Monday, April 30, 2012 Single Payer Health (8592 views)
In this article, I look at possible difficulties of implementing single payer health care in the United States. We review studies that show that the difference in health care costs between the U.S. and Canada are due almost entirely to administrative costs. We look at the administrative inefficiencies that already exist in the U.S. and amply them to start a single-payer system, supporting local control of health care.
(1 comments) SHARE Sunday, September 1, 2013 Avatars and Hearing Voices Therapy (8176 views)
Recently we've learned about a computer assisted process for dialogue with disembodied, persecutory voices. In this process, developed by Dr. Julian Leff, a psychiatrist at University College, London, voice hearers pick a sound for their voice and a face which becomes an avatar on the computer screen. Then the facilitator helps them to dialogue with the avatar to oppose it. The results are very impressive. Series: Hearing Voices (1 Articles, 8176 views)
(1 comments) SHARE Sunday, September 4, 2011 Accountability (7745 views)
This essay is about accountability. In the community mental health center where I have been working, most of the patients lack any sense of self-agency or accountability. Most see themselves as helpless victims of diseases over which they have no influence. They expect me to provide them with a drug that will regulate their moods and emotions and make them feel normal again. What does it take to restore a sense of agency?
SHARE Monday, April 9, 2012 The Debate Over Obamacare (7631 views)
I offer my views on health care financing. I suggest that we have reached a point as a society in which we are not willing to let people die in hospital waiting rooms who do not have insurance. We even have laws that require hospitals to care for whoever appears regardless of ability to pay even if we do not have any means to remunerate those hospitals. It's time to wake up to the reality that this kind of reality costs.
(1 comments) SHARE Friday, November 18, 2016 Heroes, Joseph Campbell, and Jordan Peterson (5936 views)
The hero's journey begins with the call to adventure. Jordan Peterson writes that life exists within explored and unexplored territory both inside and outside of the mind. A narrative crisis occurs when our story (map of meaning) is inadequate to explain an anomaly. Heroism sets the hero apart from the group. Identification with the hero serves to decrease the unbearable motivational valence of the unknown.
(1 comments) SHARE Monday, September 7, 2015 Working to Recover, or Adjusting to Illness? (5172 views)
Existing research is pessimistic about the value of our currently dominant biomedical paradigm for treating mental illness. Long-term antipsychotic use appears to make people worse rather than better. While the research continues to accumulate, practice does not change. Doctors continue to practice as if psychosis comes from lack of medication. People recover without medications. How do we reconcile these two models?
SHARE Thursday, May 6, 2010 What is a traditional healer? (4893 views)
I address the question of what is a traditional healer and define a category of hybrid healers -- people who have studied with traditional healers but are also steeped in the modern culture. Those of us who are hydrid healers can "never go home again". We can't go back and claim to be traditional healers because we have been influenced by too many other stories?
(2 comments) SHARE Sunday, January 18, 2015 Talking to Animals; what's the point? (4824 views)
We reflect on the winter buffalo hunt ceremonies of the Northern Plains and the ways in which humans communicated with animals, negotiating with them to cooperate in being hunted. This leads us to modern day attempts to communicate with animals, including studies from Northern Arizona University that decode the meaning of prairie dog chirps and efforts to talk to the great apes. We ask what is the point? What do learn?
(1 comments) SHARE Sunday, December 19, 2010 Hearing Voices and Seeing Visions: What to do? (4478 views)
Once upon a time, in most of the world's societies, hearing voices and seeing visions was honored and desired. In contemporary, modern culture it has become the one symptom that allows an immediate diagnosis of a psychotic disorder. In this essay, I write about the downside of pathologizing voices, while still acknowledging that many people suffer enormously from voices and negative visions. I describe how to be healing.
(1 comments) SHARE Monday, September 7, 2015 The difficulty of practicing narrative medicine (4354 views)
I look at the stories that people hold about their lives that sometimes work against them. I tell the story of a driven man whom I warned 25 years earlier that he might drop dead if he didn't take a break, and discover that he did, in his fifties. I discuss the problems we face in medicine, how to help people change their stories that are leading them toward illness. This is one of the hallmarks of narrative medicine.
(1 comments) SHARE Friday, October 10, 2014 Bringing Magic Back to a Muggle World (4321 views)
We need to bring magic back into our modern, materialistic world. While ultimately magic will have a scientific description, it will probably take place at the quantum level, which few of us can understand. Therefore, we are left to marvel at the way energy moves matter, at how our participation in each others electrical fields of our hearts creates coherence and even health and well-being. We are left to wonder and awe.
(3 comments) SHARE Friday, December 19, 2014 Finding Magic in a Muggle World (4314 views)
What is magic in a muggle world? We recently conducted a workshop to explore that question. First, what arose was the idea our thoughts could influence the future to which we are headed. What if our visualizations could change the direction in which we are headed. What is really magic is the power we have to influence others. We have power to uplift. We have power to give hope when there is none. This is real magic.
(1 comments) SHARE Sunday, November 2, 2014 Defining Coyote Psychotherapy (4120 views)
In the recent meetings of the Institute for Psychiatric Services in San Francisco, Barbara Mainguy and I presented material on how we work with psychosis. We are exploring what it is that we do, and we know that it is inspired by indigenous elders, that it is centered on the body, which registers our traumas and stresses, that we are wedded to the idea of story occurring in a social context so that we are embedded with others.
SHARE Monday, June 7, 2010 Community Revisited (4092 views)
Each of us is a neuron in a social brain. We need connectedness to each other to regulate our moods. I propose that the current explosion in the rates of diagnosis of anxiety disorders, depression, and bipolar disorder is relted to our lack of connectedness. We no longer have other people to regulate our moods and emotions. Alternatives to isolation are available and desirable but require us to relinguish some freedom.
SHARE Monday, December 3, 2012 Chronic Pain and Opiates (3931 views)
I describe my struggle with prescribing opiates for people in chronic pain. My observation has been that my patients on opiates don't seem to be in any less pain than my patients not on opiates, and sometimes they are more grumpy. I explore the literature and learn that prolonged opiate use sensitizes people to feel more pain and that it can also act as a neurotoxin producing neuropathic-like pain, so perhaps not a good idea
(2 comments) SHARE Sunday, February 22, 2015 Can We Reinvent Ourselves? (3801 views)
I ask the question, can we reinvent ourselves? I believe we can by becoming aware of the stories that we have absorbed which tell us how to live our lives. Through our interaction with others, we can modify those stories to become more effective and satisfying. We absorb stories through being born into a family, a place, a culture. We habitually perform those stories because we don't know better.
(2 comments) SHARE Tuesday, May 27, 2014 How we treat is more important than the treatment! (3799 views)
The way we relate to people is more important than what we do in both medicine and psychiatry. Randomized, clinical trials of the drug, citalopram, for geriatric depression, for example, showed that where a patient got treated mattered more than what drug they received. The response rate to citalopram varied from 16% to 82% among 15 hospitals. The time is nigh to improve the human elements in what we do be more helpful.
SHARE Sunday, April 24, 2011 Sweat Lodge, Prayer, and Community (3647 views)
Prayer and community have been stripped away from contemporary health care. Both are sorely needed. I talk about the sweat lodge ceremony as being a laboratory for exposing mainstream healthcare practitioners to the perspective on health and the world of Native American people and show how it produces the kind of connectedness and sense of belonging that we desperately need and which is associated with greater health.
SHARE Sunday, October 2, 2011 Excerpt from Coyote Wisdom Chapter 10 (3620 views)
This excerpt tells the story of my work with Tiffany, a young woman with cancer who was from the Christian faith and how we used Meister Eckhart as a way to bridge my Native American philosophies with Christianity to create a healing dialogue throughout the course of her cancer. this seems like an important story to me because it shows how we can create healing (meaning and purpose) even when the patient dies.
SHARE Sunday, May 20, 2012 More about Single Payer (3548 views)
In this article, I continue my musings about single-payer health systems. I share my experiences of working within the Canadian health care system as a physician (family medicine and psychiatry). I describe the back logs we did have and how we got around them, the lack of utilization review, how I could hospitalize anyone at anytime so long as there was a bed open, and how no one pushed me to discharge patients too early.
SHARE Monday, July 23, 2012 The High Cost of Medically Unexplained Symptoms (3436 views)
I write about how the search for the diagnosis for medically unexplained symptoms is an important aspect of what is bankrupting our health care system. We have to solve this problem for manage costs no matter what health care system we have. I acknowledge that some diseases are missed and that some diseases are yet to be found, but suggest that we are much better at findings serious and life threatening illnesses than before.
(1 comments) SHARE Sunday, March 17, 2013 Day 7 of Australia 2013: Hearing Voices and Mind Mapping (3351 views)
Day 7 found us working with the Prahran Mission's Hearing Voices Victoria about indigenous and narrative approaches to voices. We demonstrated the use of what I call mind mapping with the various voices we hear inside our minds. This technique works for everyone, voice hearers or not, for we all hear talk inside our heads, the question being where we think it's coming from. In mind mapping we identify the talk and talkers.
SHARE Tuesday, March 12, 2013 Day 6 of Australia 2013: Hearing Voices 1 (3282 views)
Day 6 finds us in Melbourne and back from the bush. I include some pictures from the bush. In Melbourne we are doing a presentation with the Hearing Voices Group of Victoria about indigenous approaches to voices. We started the day by explaining our approach to voices which is to give them full ontological status and dialoging with them to learn why they have come and what they want. We did experiential exercises after.
SHARE Monday, March 26, 2012 Problem Based Learning (3242 views)
Problem-based learning has become the norm for much of medical education, yet other disciplines are slower to adopt it. I muse about how to integrate PBL (as if is called) into the on-line psychology teaching environment and consider student objections. This essay was prompted by the comments of two students who were strongly opposed to PBL and gave me the opportunity to reflect upon its strengths and weaknesses.
(2 comments) SHARE Tuesday, March 12, 2013 Day 5 of Australia 2013: Indigenous Energy Healing 3 (3156 views)
This third day of our presentations on North American energy medicine was all about energy. We practiced how to move energy through hands on the body, hands above the body, feather fanning, sucking, blowing smoke, drumming, rattling, placing rocks and crystals, and more. We had lunch and then we began our healing free for all. Rocky taught everyone a chant that we sang for three hours. All 49 people got doctored.
(1 comments) SHARE Sunday, September 13, 2015 Suicide Prevention -- Does it Work? (3104 views)
Are psychiatric services successful in preventing suicide or do we actually cause more suicides than would otherwise happen. We create a culture of helplessness in which people expect rescue and do not believe they are in control of their actions. They can attempt suicide thinking they will be saved, but can miscalculate and accidentally die. An Australian man stopped 160 suicides by giving people breakfast. Is this better?
SHARE Sunday, December 4, 2011 Reflections on Teaching Statistics Again (3044 views)
I have the role of being the statistics teacher for a graduate psychology program in which students don't like statistics. I discover my hidden assumptions about students which may be relevant to life and to psychotherapy also. I reflect upon our attitudes toward math in North America and how different that is from Asian cultures. I reflect upon some students' resistance to problem-based learning and what that means.
(1 comments) SHARE Monday, March 18, 2013 Day 8 of Australia 2013: Bairnsdale (2982 views)
On the next to the last day of our Australian cross-cultural journey we visit our friend Wayne, who's now the Koorie Liaison Officer for AdvanceTAFE, an educational concern in Victoria. Our focus for the workshop that Wayne arranged for us was to consider how to better use culture to address problems in the community. The problems were the usual suspects -- drugs, alcohol, violence, gambling. What happens under colonization
SHARE Thursday, February 23, 2012 Medical Writing: the Healing Power of Narrative (2905 views)
This article represents the start of my annual trek to Australia to work with an aboriginal cooperative in Southeastern Australia. The goal is to help them to incorporate their culture into their health care and other human services through cultural exchange with aboriginal North Americans, aboriginal people from the North of Australia where culture is less disrupted, and others from the area. More to come of my 2 weeks!
(1 comments) SHARE Monday, March 11, 2013 Day 4 of Australia 2013: Indigenous Energy Medicine 2 (2806 views)
During the fourth day of our Australian cross-cultural journey we continued to present our form of indigenous (Cherokee) bodywork/osteopathy and energy medicine ("doctoring"). The second day focused on how anyone can feel energy differences in other people and within those areas of energy differences, can find points that need rubbing or holding. We showed how these intuitively discoverable points are the same as TCM.
(1 comments) SHARE Thursday, July 12, 2012 Health Care Costs and Schizophrenia (2768 views)
I reflect on the cost of care for people who are diagnosed with schizophrenia. I muse about a moving lecture by Eleanor Longdon, PhD, who was once a schizophrenic and now is a clinical psychologist. She spoke about her own process at the Hearing Voices Conference in Melbourne, Australia. Eleanor echoed my observations, that the way we manage people who hear voices and suffer this kind of distress is costly and ineffective.
SHARE Saturday, August 11, 2012 Healing Camp Day 1: Introduction to the Concept (2662 views)
In this article, I write about our invention -- Healing Camp. For the next seven days, I am going to describe what we do and how we do it so that others can (hopefully) replicate it. The concept is simple, that people from all levels of training and walks of life can come together and be healing for each other. We will be doing a similar but shorter event in Hartford, CT, the weekend of August 17th. Check Sukhasala website.
(1 comments) SHARE Monday, March 11, 2013 Day 3 of Australia 2013: Indigenous Energy Medicine (2640 views)
On day 3 of our cross-cultural journey in Australia we are at a camp where we are sharing Native North American concepts of energy medicine, particularly Cherokee bodywork/osteopathy and energy medicine and psychology (aka "doctoring"). We discover again how similar these concepts and practices are to those of indigenous Australia and New Zealand and how all people heal through touching the body and its energy.
SHARE Wednesday, March 30, 2011 Nanglyala Mental Health Center (2566 views)
I write about the composite mental health center I have created in previous essays which comes from my and others' experiences working in mental health in New York State. I call it Nanglyala Mental Health Center, in honor of the Russian word for Valhalla, which one can't use, for it actually exists. I propose a thought experiment in changing the culture at NMHC, which I hope someone somewhere will be inspired to do.
SHARE Sunday, March 4, 2012 Day 11 of the Australian Journey 2012 (2475 views)
Today is Day 11 of the Australian cultural exchange adventure for 2012. We interacted with Mission Australia in Sydney and were deeply impressed with their services for young people and for homeless adults. They have managed to integrate shelter with education and skills training so that homeless people become able to transition into the work force. One person told us, "I came here a prostitute, and I left an artist."
SHARE Saturday, December 31, 2011 The Narrative Paradigm and the New Year (2404 views)
I write about my enthusiasm for the narrative paradigm for psychotherapy as we enter into 2012. Within this paradigm, we understand that we don't necessarily know the reasons for our actions, but rather we look for the stories that create the roles that guide us to do what we do. We find that people mostly know what needs to change in their lives but have stories that stop them from making those changes.
SHARE Sunday, March 4, 2012 Day 13 of the Australian Journey 2012 (2339 views)
Today is Day 13 of the Australian Cultural Exchange Journey for 2012. After a quick morning run, we went to Mission Australia's Youth Forum 2012. We met Nancy Ingram, an elder from the area who attended Harvard University and knew about Vermont. I have a talk about the importance of heroism for adolescents and finding ways for them to be heroic or to save face when they feel they have not been heroic.
(1 comments) SHARE Saturday, March 9, 2013 Day 2 of Australia 2013: Story is Healing (2291 views)
Today we considered how story can save people's lives. When people are filled with negative stories about being inferior and worthy of humiliation and contempt, they respond accordingly often with substance misuse and violence. The traditional cultural stories of all of our peoples are antidotes to this negativity. By immersing ourselves in our cultural stories, we can turn victimization into recovery and transformation.
(1 comments) SHARE Saturday, March 9, 2013 Day 1 of Australia 2013: The Autobiographical Narrative (2224 views)
Each year we make a cross-cultural tour to Australia, though one of our Coyote colleagues comes twice a year to make an impact on incorporating culture in health care for aboriginal people. This year we began with a lecture in a writing conference on the topic of the autobiography in which I describe my experience of writing Coyote Medicine. I finish with a description of what has been accomplished in five years of coming.
(1 comments) SHARE Thursday, January 24, 2013 NIMH and its Biologic Emphasis (2195 views)
I respond to Dr. Thomas Insel's blog about his views of the top ten advances for mental health for 2012. What saddens me is that all of these advances are heavily biological and that biological medicine hasn't really succeeded very well in improving our mental health. While these advances are very interesting, I argue that what we need is more understanding of how our social relationships form our brains and behavior.
SHARE Sunday, February 26, 2012 Day 1: Australia 2012 (2009 views)
This article begins my 2012 Australian journey. I briefly describe my presentation for the day and then go to the meat of what I learned, which is about aboriginal health and disparity statistics in Australia today. Generally, as anyone can imagine, aboriginal people are in terrible shape in Australia -- to my surprise, worse than their counterparts in the USA and Canada. We know the sad state of Indians in the US.
SHARE Friday, March 2, 2012 Day 10 of the Australian Journey 2012 (1952 views)
Today was Day 10 of the journey and was a day for reflection and preparation for the Sydney portion of our trip. We reflected upon what culture camp had meant for people and confirmed that we would come again next year. Then we flew to Sydney and ate a marvelous fish dinner.
SHARE Wednesday, February 29, 2012 Day 8 of the Australian Journey 2012 (1896 views)
This is Day 8 of the Australian cross cultural adventure. Today we went to the heart of the community where the elders from the Northern Territories demonstrated some of their ceremonies and procedures to the community. That included the burning ceremony for healing pain, the smoking ceremony for purification, and spear throwing. On the way back to the island, I interviewed a patient advocate from Western Australia.
SHARE Thursday, February 2, 2012 On the Nature of Afflictions (1873 views)
In this article I wonder about what illness has to offer us. What is the nature of affliction. Is it a thing or is it a doorway, an invitation to make meaning. All illnesses offer us this opportunity.
SHARE Monday, February 27, 2012 Day 5 of the Australian Journey 2012 (1845 views)
I describe the fifth day of our journey for cross-cultural exchange. Today was primarily a day of our teaching. The days vary from receiving mostly to giving mostly. We focused on the importance for everyone, regardless of ethnicity or indigenous status to participate in ceremony in such a way as to feel closer to the spiritual dimension and to celebrate what's good and positive about one's life instead of tales of misdeeds.
SHARE Wednesday, February 29, 2012 Day 7 of the Australian Journey 2012 (1789 views)
Today is Day 7 of the Australian journey 2012. We are on Boole Poole in the Lake District of Gippsland. Our sweat lodge ceremony had been rained out the day before, so we prepared to do the ceremony as soon as the rain stopped which happened around 8am. I've written about sweat lodge before, as have others, most notably Bucko, author of The Lakota Sweat Lodge. It was a wonderful experience and then we hear crocodile tales.
SHARE Sunday, February 26, 2012 Day 4 of the Australian Journey 2012 (1781 views)
Day 4 of the Australian Journey finds us in Warburton with Auntie Jennie, an aboriginal elder from Queensland. I discuss the workshop we did together and explore further the concepts that integrate indigenous theories of mind and mental health with the Hearing Voices movement, showing that its founders were thinking indigenously as they approached voices, which appears much more effective than the biomedical approach.
SHARE Tuesday, February 28, 2012 Day 6 of the Australian Journey 2012 (1779 views)
Today is Day 6 of the 2012 Cultural Exchange Adventure in Australia. It was also the first day of culture camp at Boole Poole with the aboriginal coop. The driving rain prevented our crew from Northern Australia from doing much outside. We had planned a sweat lodge ceremony but that was cancelled also due to the rain. So instead, while we tried to stay dry, I interviewed the new doctor at the Coop.
SHARE Sunday, February 26, 2012 Day 2 of the Australian Journey 2012 (1766 views)
Day 2 of the Australian Journey for 2012 finds me in Melbourne at the International Hearing Voices conference, attended by aboriginal and non-aboriginal people alike. I present the highlights of the conference including aspects of my keynote address. The conference is unique in that it is organized hy voice hearers and not professionals who treat voice hearers. It is also unique in being upbeat, positive, and full of hope.
SHARE Tuesday, March 6, 2012 Day 14 of the Australian Journey 2012 (1763 views)
Today is the end of the Australian cross cultural adventure. I fly back to the U.S. today and resume ordinary life. I write about the people I met whom I appreciate and what I learned and where we might go next.
SHARE Wednesday, February 29, 2012 Day 9 of the Australian Journey 2012 (1741 views)
Today is Day 9 of the Australian Cultural Exchange Journey for 2012. Related to the constant, driving rain, we mostly talked today We talked about the health care system to which we wished to move and how to get there, especially through changing the socialization of students and giving them new stories about what to expect from others.
SHARE Monday, January 9, 2012 Reflections after a Hypnosis Workshop (1613 views)
I describe some reflections after co-teaching a hypnosis workshop. Particularly, we look at a person whose story is too large, as big even as the whole United States. How do we work with someone whose story is that large. I describe ways to extract smaller stories, short stories from the large novel, stories that can work within an hour time frame, the usual length of time for mental health or hypnosis encounters.
SHARE Friday, January 6, 2012 Mind, body, and unexplained symptoms (1557 views)
I describe a woman with a "mystery illness" who has defied the efforts of conventional physicians to diagnose her. She has also been unsuccessful at gaining help from alternative medical practitioners. I show how inflammation is an integrative process which can affect a variety of organs and can be provoked by stress, including the stress of worrying too much. We we can change the underlying process, we can reduce it.
SHARE Sunday, February 26, 2012 Day 3 of the Australian Journey 2012 (1435 views)
This is Day 3 of the Australian Journey. It's also the second day of the Hearing Voices International Conference in Melbourne in which aboriginal elders and their wisdom for managing voices (and giving the voices full ontological status as potential beings) were showcased. I write about some of the techniques I demonstrated in my workshop for managing voices including guided imagery, dialogue, and theatre.
(1 comments) SHARE Tuesday, July 5, 2011 Thoughts after Sundance 2011 (1419 views)
I reflect upon Sundance 2011 and what I have learned. I realize that Sundance is about love and compassion and following this red road that leads to these directions. Sundance gives us an opportunity to rise to become spiritual warriors, to find all the benefits and none of the detriments of battle, to create a community of fellow warriors within which we can feel strong, and to transcend our natural limits to become more.
(1 comments) SHARE Tuesday, November 23, 2010 Why Learn Neuroscience? (1417 views)
A student asked me why she needed to know neuroscience. Here is my answer. I argue that science is the new story with which we must contend. If we do not know the contemporary stories of science, they will be used against us. The actual stories being told today about the brain are quite uplifting, full of hope. They include neuroplasticity and epigenetics. If we know these stories we can fight against bad neuroscience.
(1 comments) SHARE Wednesday, September 7, 2011 Reflections upon transitioning to private practice (1394 views)
Just over 2 months ago I left the public mental health sector in New York to transition into private practice in Vermont. This article reflects upon those two months of changes and wonders what we can learn from the type of care available in Vermont compared to New York and from New York's apparent discrimination against paying private practitioners in favor of community mental health centers.
(1 comments) SHARE Friday, April 16, 2010 Psychology and Health Care Reform (1384 views)
A lunch meeting with Dr. Martin Johnson, a Honolulu psychologist, taught me much about how mental health coverage will change under health care reform. Insurance companies will have to provide mental health coverage on par with their coverage of medical conditions. But, who will be credentialed to provide these services? remains a question. Credentialing could limit access to services by limiting the numbers of providers.
SHARE Monday, April 4, 2011 Adolescent Addictions and Las Vegas (1361 views)
This weekend I attended an addictions and mental health conference focused upon adolescents in Las Vegas, Nevada. What an appropriate venue! I spoke about narrative practices in relation to addictions -- how we have to counter the dominant stories about magical potions and find other heroic stories that work equally well.
(1 comments) SHARE Monday, March 21, 2011 Beyond Narrative Therapy: Day 11 of the Australian Journey (1343 views)
On Day 11, we engaged in dialogue about the narrative therapy of Michael White, which is what most people in Australia and the United States index, when we say narrative practices, and the narrative practices of indigenous people. While we deeply respect Michael White's contributions to psychology and humanity, we present him as one branch on a tree of narrative in which indigenous people live in the trunk and the roots.
(1 comments) SHARE Sunday, September 4, 2011 Sundance No. 2, 2011 (1336 views)
Barbara and I write this following our second sundance of the season. In this article we contemplate the idea of the sundance as an embodied metaphorical struggle in which the suffering and deprivation encountered are physical metaphors for the suffering of life. The mindset we use to embrace uncertainty matters in everyday life. We do best when we abandon the idea that we can know what is going to happen next.
(1 comments) SHARE Wednesday, March 16, 2011 Still More Similar Than Different -- Day 7 of the Australian Journey (1263 views)
Today finds us in Day 7 of our Australian Cross-Cultural Mental Health Journey. They lessons of these week have been very consistent -- indigenous from anywhere in the world is more similar than different. An elder proposed an answer for this. He said, "When you listen to the spirits and to nature and show respect, you get the same guidance 'cause spirits talk to each other. They know how the world should go!"
SHARE Saturday, March 19, 2011 Approaches to Trauma in the Indigenous Community -- Day 10 of the Australian Journey (1208 views)
Today is Day 10 of the Australian Cross-Cultural Mental Health Journey. Today we talked about trauma in aboriginal communities and how to address that trauma. We collaboratively arrived at some ideas to propose. We agreed that narrativizing is necessary. We need to hear the stories of woundedness that people have to tell and to celebrate their resistance to abuse and to focus more on the resistance than on being a victim.
SHARE Wednesday, March 23, 2011 Narrative and Science: Day 13 of the Australian Journey (1205 views)
Today was our last full day in Australia and the occasion for a lecture and series of discussions at the University of Melbourne's Center for International Mental Health and School of Population Health. We explored the bridges between science and the indigenous world view of narrative. Particularly we were impressed with how neuroscience is completely supporting indigenous knowledge about narrative and its importance!
(1 comments) SHARE Thursday, March 17, 2011 Narrativizing is the first step at becoming indigenous friendly -- Day 8 (1202 views)
On Day 8, we asked how do we transform health care to become more indigenous friendly, whether it's mental health care of general medical care. The answer that jumped out was to implement narrative practice. Indigenous cultures are virtually uniformly cultures of story in which stories matter greatly. Being heard means having the opportunity to tell one's stories. "Treatment" begins by hearing and acknowledging stories.
SHARE Tuesday, March 22, 2011 The Power of Community: Day 12 of the Australian Journey (1156 views)
Day 12 of our Australian Journey for cross-cultural exchange in mental health was a low-key day of exchanges about healing in community. We explored the concept that healing cannot occur so easily without involvement of the entire community. Those people to whom we are accountable must agree to allow us to change, or we will not change. We must be invited by the important others in our life to perform a different story.
(1 comments) SHARE Saturday, March 12, 2011 Imaging and doing are not as different as they sound (1128 views)
Contemporary neuroscience has shown us that imagining an act and performing an act are virtually the same. We can strength our muscles almost as much by imagining exercising as by exercising. If mind is so powerful, why aren't we harnessing it for the good. I fear that mostly we allow it to run for the bad, imagining ourselves in any number of dire straights and illnesses, instead of imagining ourselves hale as we should.
SHARE Friday, March 18, 2011 Implementing Narrative Practices: Day 9 in Australia (1092 views)
The highlight of Day 9 in our Australian cross-cultural mental health journey was a workshop for indigenous mental health and human service providers on how to make their services more indigenous friendly. This involves, of course, conscious decolonization of our clinical practices. We talked about the need to become more narrative, to listen longer and more deeply to the stories people tell us and to hear stories of others.
SHARE Saturday, March 12, 2011 Eqalitarian Healing: or What can we Learn from Vygotsky (1076 views)
Vygotskyan ideas are useful to explain a concept my colleagues and I are developing for egalitarian healing. We are working to undermine the expert professional/defective client model and to put those who help people and those who are helped on a more equal footing. Vygotskyan theory helps us understand how to do this. Vygotsky describes a More Knowledgeable Other concept in which this Other can teach learner missing skills
(1 comments) SHARE Wednesday, June 16, 2010 More Indian Than Thou (1011 views)
More Indian Than Thou is a current artefact of blood quantum discussion. It disenfranchises many, and seems to contain some of the same political aspects as our oppressors. This article addresses the question of Indian identity. Can a person be an Indian without being enrolled in a tribe. Can a person claim Native American heritage without tribal enrollment and endorsement? What are the politics of "Indianness"?
(1 comments) SHARE Friday, March 11, 2011 Suicide and Mental Health: Australia Journey Day 2 (995 views)
Lewis and Coyote Institute are on Day 2 of an Australian journey which is a cross-cultural exchange about ideas for mind and mental health. Today we focused upon suicide which elders told us was rare in Australia prior to European contact, but now, all to common. We focused upon suicide as a modern non-indigenous template for the communication of suffering which sometimes backfires leading to accidental death.
(1 comments) SHARE Monday, August 9, 2010 NICABM and MInd-Body Medicine (968 views)
I reflect upon the contributions of the National Institute for the Clinical Advancement of Mind-Body Medicine toward furthering the field. At their upcoming conference this December, prominent are newer ideas of neuroplasticity and chronic pain. Through the understanding that pain circuitry in the brain are remodeled by the experience of pain so as to make people feel more pain, we can refute old ideas of pain.
(1 comments) SHARE Monday, March 14, 2011 Indigenous People are more Similar than Different -- Day 5 of the Australian Journey (860 views)
Today is Day 5 of our Australian cross-cultural mental health adventure. We traveled from Melbourne to an aboriginal owned island which has ancient sites and is in the Gippsland Lakes. The take home message for the day came from a Gunnai-Kurnai aboriginal man at the end of the day, who said, "Indigenous people are more similar all over the world than they are different." He had the final word for the day, which is so true.
SHARE Tuesday, June 22, 2010 Why do we need Stories? (842 views)
Making up story is what are brains do best. In fact, the default mode of the brain is to idly invent what if and if only stories to so that we can run simulations of our social world. We are designed to fill in gaps in our perception. We must reject much environmental information in order to maintain a stable world map.
(1 comments) SHARE Monday, March 29, 2010 Integrative Mental Health and Health Care Reform (813 views)
A recent conference in Arizona on Integrative Mental Health highlighted how poorly our current mental health care system is working. The conference was full of passion for changing our system and for incorporating nutrition, exercise, yoga, and psychotherapy into our work to improve effectiveness. More time with people is necessary and health care reform needs to reimburse that time. Indigenous mental health ideas show us...
(1 comments) SHARE Sunday, March 13, 2011 Intergenerational and Historical Trauma: Day 4 of the Australia Journey (736 views)
We continue our Australian cross-cultural mental health journey for day 4. Today's topic was intergenerational and historic trauma. In an inter-faith context we talked about the need for the suppressed stories to be told. We talked about epigenetics, which is the way in which the trauma of the ancestors are genetically transmitted across as many as four generations, if not more. We discussed the need to tell these stories.
(1 comments) SHARE Sunday, August 15, 2010 Psychiatrists in Community Mental Health (692 views)
This article explores the role of the psychiatrist in community mental health. I find myself working in this setting and realizing that almost everyone sees my role as the writing of prescriptions. Medication has become the core of community mental health with twice monthly, 25 minute "therapy" visits. I ask how psychiatrists working in such settings can push back. How can we reclaim psychiatry as the medicine of the soul?
SHARE Sunday, September 19, 2010 Explanatory Plurarlism (673 views)
I ask the question, what if all knowledge existed in the form of stories and all stories were true? If we practiced in this manner, as advocated by Uncle Albert, an aboriginal elder, how would we act? The notion of explanatory pleuralism argues that explanatory stories on any particular level do not have to relate to any other level of explanation; rather they must correspond to the level of which they are explaining.
SHARE Wednesday, June 2, 2010 Modern Day Shamanism (663 views)
Summary: The word "shamanism" has become very popular. But what does it mean and why do traditional North American deplore this word. Traditional healers are accountable to their communities. Others in the anonymous society must face regulation and must prove that they are more beneficial than harmful. The word shaman is no doubt here to stay, but there is an advantage to resisting it in that it brings to attention the di
(4 comments) SHARE Wednesday, September 1, 2010 Cancer and Coyote Magic in Woodstock (651 views)
I reflect upon the stories people create to explain their cancer and how some of these stories can be used to make them suffer even further. I wrote about Sarah, a woman with lung cancer who attended a workshop I co-led with my friend, Peter Blum. Sarah suffered enormously from believing that if she did everything "right", she would get well and her cancer would go away. It wasn't. Therefore, she was bad. What do we do?
(1 comments) SHARE Tuesday, January 18, 2011 What we can learn from Tucson and why not to overreact! (627 views)
The recent tragedy in Tucson has led some commentators to demand more inpatient beds, easier commitment laws, and forced treatment with medication. I argue that none of this would have stopped Mr. Loughner, since he had not come to anyone's attention yet. We need to refrain from overreacting and further stigmatizing the mentally ill, who are, by and large, not violent, and we need to think about ways to reach out more.
SHARE Saturday, September 4, 2010 Ethics for Mental Health (617 views)
The history of the mental health industry involves the management of people who are socially unacceptable, who are defined as excessively different from the rest of us, who live at the extremes of emotions and behaviors. How we treat these people depends upon the stories we carry about how they came to be the way they are. Contemporary stories are impoverished and lead to mistreatment of those who suffer.
(1 comments) SHARE Friday, April 9, 2010 Crossroads (609 views)
This weekend I attended a conference called Crossroads in Topanga Canyon, California. We met together to think about bringing healing circles and talking circles to ever corner and intersection in America. We experienced a healing circle together, which inspired us to think more about what it would mean for health care if all of us to belonged to one. Health care costs will only soar unless people begin to take ca
(1 comments) SHARE Wednesday, June 30, 2010 More on the Politics of Indian Identity (595 views)
Based upon comment on last weeks, "More Indian than Thou" essay, I continue my musings about the politics of Indian identity. I explore the fundamentalist response which argues that pure bloods are more Indian than mixed bloods and that non-status Indians have no business reading about, participating in, or even being interested in aboriginal culture. I argue that this would, in fact, allow the U.S. government to succeed.
SHARE Tuesday, April 27, 2010 Using Creation Stories In Healing (594 views)
Creation stories are important, because the final story about how you or I got well must be compatible with the story about how we got sick, or the treatment will never work. In my studies of remarkable healings, I found that every person had a plausible story (to them) for how their illness occurred and how they got well
(1 comments) SHARE Wednesday, March 17, 2010 Health Care and Alternative Health in France (591 views)
I recently had the opportunity to speak at a conference in Paris, France. The conference was about what we call CAM, or Complementary and Alternative Medicine, in the United States, and particularly about the basis for some CAM practices in advanced physics. I had a chance to get an idea about the French health care system as well as check out new research on homeopathy
SHARE Thursday, February 11, 2010 The Miracle of Peacefulness (588 views)
Unfortunately, miracles cannot be guaranteed or produced on demand. What is more certain is our ability to cultivate a sense of peacefulness and meaning even in the face of illness. This is miraculous in itself given today's world and medical culture. So many people sit namelessly, faceless and alone on nursing home floors, passing the time before death.
SHARE Thursday, July 8, 2010 One Road, Many Branches (588 views)
This article builds upon my past two weeks of talking about Indian identity. It is written on the sundance grounds as I prepare for purification and for this season's sundance. I talk about the way that the drug and alcohol treatment movement brought ceremony and ritual into the lives of both Indians and non-Indians. People discovered the power of the Red Road. Ethnic boundaries disappeared in the welcome for all people.
SHARE Wednesday, June 2, 2010 Reflections on the American Psychiaatric Association's annual meeting (566 views)
This past week we attended the annual meeting of the American Psychiatric Association in New Orleans, Louisiana. The high point was the amazing food that New Orleans offers. Besides that, we dialogue about the myths that psychiatry has created that now need to be changed. These myths include the idea that a perfect pill exists to make people feel "normal" and that a pill exists that can change unpleasant affect in happiness
(1 comments) SHARE Tuesday, March 15, 2011 More Indigenous Similarities Despite Differences -- Day 6 of the Australian Journey (563 views)
This is Day 6 of the Australian cross-cultural mental health exchange journey. Today we all experienced a form of healing used in the Northern Territories called "burning". They correct usage appears to be, "I burned her and she got well." One doesn't actually get burned, but palm bark is ceremonially placed in the area of an injury or sickness after having been made warm in a fire, accompanied by touch therapy and prayer.
SHARE Friday, March 5, 2010 Tapping Creation Stories For Healing and Energy (560 views)
Creation stories are ubiquitous in life. Our families tell us stories of our birth. Cultures also tell stories about their own creation, and people tell stories about how they got sick and how they got well. The story about how an illness arose is particularly powerful and has multiple versions. People's own stories about how they got sick may or may not parallel the official medical story...
SHARE Thursday, March 10, 2011 Coyotes and Reclaiming Indigenous Knowledge (555 views)
Three of us from Coyote Institute have journeyed to Australia to consult with a local aboriginal group on how to incorporate local culture into their health care and other services. This is the first in a series of daily blogs about the trip. I begin by wondering about coyote as a symbolic muse, an animal who lives at the margin and is currently expanding its territory. We discuss templates for the expression of pain.
SHARE Monday, February 15, 2010 Treatment Programs -" Do they work? (553 views)
we consider the question of treatment -" does it work? Treatment is a billion dollar industry in America. So many people go for treatment and so many experts purport to tell people how to reform. The question -" does it work? Does treatment actually help anyone?
(1 comments) SHARE Thursday, April 22, 2010 Learning from Native North America for Health Care (550 views)
The traditional healing of North America is slowly findings its way into conventional clinical settings. Not everyone (Native and non-Native) agree with its entry there. Some people believe that traditional healing should be restricted to Native people and kept away from Non-Natives. Others believe it should be openly shared with all. Even knowing what is a traditional healer is a debated question. Some people call themse
(1 comments) SHARE Saturday, March 12, 2011 The Narrative Interview: Day 3 of the Australian Journey (545 views)
Today finds us on Day 3 of our Australian cross-cultural journey. Our focus today is on the narrative interview. How would we interview people if our focus was to elicit their story instead of making a conventional DSM diagnosis. I interview a woman who has been suffering for 12 years and who has finally been offered an antidepressant medication. I show how her suffering can be rendered intelligible through narrative.
SHARE Sunday, March 21, 2010 Insurance Should Pay For Healing, Not Treating (539 views)
Numerous studies have shown that 80% of primary care visits to health care practitioners involve the ordinary suffering of daily life and not diseases that need treatment, yet we throw pills and potions at these woes as if that is their solution.
(1 comments) SHARE Saturday, March 12, 2011 Rescue: When is it Unethical? (525 views)
An under explored ethical area is that of what Michael Ortiz Hill, in his marvelous new book, The Craft of Compassion, has called professional narcissism. This is when we need our clients to get well for our own needs. Of course, we want to think that we are effective and can help people, but the more we think this way and the less we think of dialogical resolution where each contributes to the outcome, the more harm we do.
(1 comments) SHARE Sunday, November 7, 2010 Narrative Interviewing and Behavioral Change (480 views)
In this article, I talk about the importance of finding the stories behind behaviors that are adverse to health. Health behavior is not rational, but is guided by stories that people have about how life should be lived. Many times they do not realize what these stories are, since they are from their earlier years and are so ingrained as to be outside awareness. I show how changing story allows people to change diet.
(1 comments) SHARE Monday, July 26, 2010 Why can't the sundance feeling last all year long? (479 views)
I reflect on my experience of coming out of sundance, which is always a powerful, personally transformative experience for me and those others with whom I dance. Because of its deep embodiedness, sundance is simultaneously mental, physical, spiritual and communal. This and the prayers brought to sundance and the examples provided by the dancers of transcending our physical limits, explains in part the amazing healings seen.
SHARE Friday, July 2, 2010 Community -- Why is it hard? (476 views)
Belonging to community has huge benefits. It's hard because true community includes annoying and irritating people who don't agree with us. It includes people who sometimes act bizarre or socially inappropriately. It doesn't exclude and it minimizes power imbalances. Having true community takes work, because it's easier to be anonymous and let other people be in charge. But the effort pays off, and it's worth it.
(1 comments) SHARE Thursday, February 10, 2011 The Larger Stories of Education (476 views)
Art and play are important in psychology and psychology education. I use the opportunity of attending the National Council of Schools of Professional Psychology annual meeting to speculate about the future of psychology education and to ponder the effects of for-profit institutions on education. I suggest that for-profit education can only be mediocre because real education aspires to creativity and for-profit standardizes.
(1 comments) SHARE Sunday, August 1, 2010 Walking with Dementia (456 views)
Unexpectedly I find myself visiting a friend for the weekend who is helping his mother place his father into a long-term care facility. My friend's father has vascular dementia, the result of a series of strokes, each one of which rendering him progressively less capable. Nevertheless, we have a marvelous walk in which he demonstrates the unassailable curiousity of human beings for describing the motivations of others.
SHARE Tuesday, January 18, 2011 Clinic Restructuring (452 views)
I work part-time in a community mental health center in New York. Recently New York's Office of Mental Health has restructured clinical services. I write about what that has meant for quality of care, which inevitably goes down. I argue that this is inevitable in a "fee-for-service" system. I argue that the alternative is to pay physicians to care for panels of people and to do the best job as they see fit for these people.
SHARE Sunday, May 23, 2010 Who's in Charge Anyway? (419 views)
To what degree do we control our lives? Advocates of The Secret claim we have complete power to create whatever we wish. A more realistic world view is that of the Lakota who believe we are thrown into a universe of vast forces and influences over which we have no control. Within that context, we do what we can. I believe we need a philosophy that recognizes our embeddedness in a world that we didn't create and our capacit