Episodes

  • Corrigan IPU patients deserve a real, substantive right to access the outdoors. The current supposed access is a sham and a scam.

    Corrigan IPU patients deserve a real, substantive right to access the outdoors. The current supposed access is a sham and a scam.
    Feb 21 2025
    It is gross really to see the Corrigan IPU patients staying inside day after day, week after week, and in some cases month after month. And it is still more alarming when Corrigan staff blithely and complacently point to the four times a day when a minority subset of patients (youthful patients) can go outside. (Roughly 25% to 50% of patients [depending on the patients on unit at a particular time) can access the outdoors because, for example, they do not suffer neither obesit], paranoia exacerbated in groups, social anxiety, catatonia, or dementia, and do not present fall risks). For the other patients (the majority [especially when weighted by length of stay]). they are inside constantly, and it is disgusting to see. Their skin can be as white as white-out. The outdoors breaks are valued by the employees, but the employees aren't able to extend the courtesy to their fellow humans. It is a case of domination of the medical professionals over the neurodiverse. Some Corrigan staff no doubt get off on this. Most would get off on it indirectly and subliminally. Maybe a few get off on it consciously and directly. On the other hand, there is also another factor at play: the way we can get used to things that are odious, simply because others aren't clamoring about it, and we simply stop paying attention. If you went to Corrigan IPU, you would be appalled by the majority of patients who never go outside. But I venture if you shunned it for a year or so, you would eventually get used to it. You would be able subconsciously to suppress how disgusting it is for these humans (who happen to be patients) to be tortured by not having a real substantive, right of access to the outside. How does this happen? Rousseau in his Confessions said it was human nature. “I have derived an important moral principle, perhaps the only one of any real practical use, which is that we should avoid situations that bring our duty into conflict with our interests … since I am certain that in such situations, … we will sooner or later weaken, without noticing it, and become unjust and wicked in deed without having ceased to be just and good in spirit” I first raised this issue with Corrigan in October 2024 to Larry Weiner who is the Director of Human Rights at Corrigan. He simply ignored me. Danielle Keogh, LICSW, actively resisted my efforts. I then decided to make a formal Human RIghts Complaint. I assumed this would get a response. However no one from Corrigan would even acknowledge they received it. I sent it to: Jose Afonso ("provider" where a "provider" is sometimes called a "prescriber". It is essentially someone who can prescribe, so it is a nurse practitioner, DO, etc.) Maxwell I. Mayer (provider) Larry Weiner and Jeanne Crespi, social worker. Nb: I have invited each of these people to come on to this podcast or contact me in writing to correct me where I am wrong. To work at Corrigan you need to develop the ability to shun. You shun recognition of how many patients don't get to go outside. You shun the nausea you probably had when you first saw this. You also learn, it seems, to shun other people, people such as me who are raising the issue. A social worker or mental-health counselor would in fact claim that such shunning constituted "self care" or "an adaptive coping mechanism." Until they correct me, I would attribute Afonso and Mayer's non-response to their occupational or characterological contrariness and sense of superiority. They are "providers." They also have a vested interest (which is subliminal [see Rousseau]) as they possess the big swinging dicks at Corrigan IPU, are used to being kowtowed to, and, on information and belief, seem to use the Corrigan IPU as the IPU for their personal (presumably middle-class, white) patients. (The nurses will hold a bed open when they know that one of the providers' patients will soon be needing a bed. On information and belief, they also keep their own patients there longer ceteris paribus. Also as the golden goose: Corrigan IPU apparently requires an MD be on call all the time in case of an admission. The upshot is that it is good to have one of them as a provider. From the perspective of their patients' families, keeping this small (16-bed) unit open is a godsend. It only starts to look sketchy when you think of the anonymous payers of taxes and insurance premia. Why did I send it to Jeanne Crespi? She is the interim "Person in Charge," meaning she is the person you are supposed to contact with a Human Rights Complaint. It was thus quite surprising to me that neither she nor Larry Weiner even acknowledged my Complaint, or were willing to indicate to me that my Complaint would be taken seriously. I mean: that is one of their official, professional duties, as the Human Rights Officer and Person in Charge. In each case I was specifically--and increasingly plaintively--asking that they person ...
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    24 mins
  • philosophy of substance use disorder

    philosophy of substance use disorder
    Feb 16 2025

    Owen Flanagan [Duke University]

    James B. Duke University Professor Emeritus of Philosophy & Professor of Neurobiology Emeritus

    What Is It Like to Be an Addict?: Understanding Substance Abuse

    "A brilliant and unparalleled synthesis of the science, philosophy, and first-person phenomenology of addiction. Owen Flanagan is a distinguished philosopher who ... is also an ex-addict. This book is beyond excellent. It is wise. Everyone who wants to understand addiction must read it." -- Hanna Pickard, Bloomberg Distinguished Professor of Philosophy and Bioethics, Johns Hopkins University "This elegant and clear book ... deserves to be a landmark in the study of addiction." -- Carl Erik Fisher, M.D., Assistant Professor of Clinical Psychiatry, Columbia University, author of The Urge: Our History of Addiction

    Owen Flanagan is an internationally acclaimed philosopher of mind, consciousness, ethics, and comparative philosophy and author of 12 books translated into many languages.

    A powerful and important exploration of how addiction functions on social, psychological and biological levels, integrated with the experience of being an addict, from an acclaimed philosopher and former addict.

    What is addiction? Theories about what kind of thing addiction is are sharply divided between those who see it purely as a brain disorder, and those who conceive of it in psychological and social terms. Owen Flanagan, an acclaimed philosopher of mind and ethics, offers a state-of-the-art assessment of addiction science and proposes a new ecumenical model for understanding and explaining substance addiction.

    Flanagan has first-hand knowledge of what it is like to be an addict. That experience, along with his wide-ranging knowledge of the philosophy of mind, psychology, neuroscience, and the ethics and politics of addiction, informs this important and novel work. He pairs the sciences that study addiction with a sophisticated view of the consciousness-brain/body relation to make his core argument: that substance addictions comprise a heterogeneous set of "psychobiosocial" behavioral disorders. He explains that substance addictions do not have one set of causes, such as self-medication or social dislocation, and they do not have one neural profile, such as a dysfunction in dopamine system. Some addictions are fun and experimentation gone awry. Flanagan reveals addiction to be a heterogeneous set of disorders, which are picked out by multifarious cultural, social, psychological, and neural features.

    Flanagan explores the ways addicts sensibly insist on their own responsibility to undo addiction, as well as ways in which shame for addiction can be leveraged into healing. He insists on the collective shame we all bear for our indifference to many of the psychological and social causes of addiction and explores the implications of this new integrated paradigm for practices of harm reduction and treatment. Flanagan's powerful new book upends longstanding conventional thinking and points the way to new ways of understanding and treating addiction.
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    45 mins
  • socrates

    socrates
    Feb 11 2025

    Agnes Callard

    Open Socrates

    This is the the most impressive book I have ever read. What a mind! I was more nervous than usual, and I think I kept pronouncing her name wrong, but I feel honored, really, to have been able to talk with Agnes about this stunning work.
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    37 mins
  • madness

    madness
    Jan 11 2025


    Wouter Kusters

    A Philosophy of Madness: The Experience of Psychotic Thinking

    MIT Press: https://mitpress.mit.edu/9780262044288/a-philosophy-of-madness/
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    44 mins
  • Corrigan Mental Health Center in Fall River, MA.

    Corrigan Mental Health Center in Fall River, MA.
    Dec 14 2024
    The IPU at Corrigan Mental Health Center. This is a psychiatric IPU in Fall River, MA. It's a DMH facility. Best parts: 1) there are some excellent staff members (excellent both for patients and for co-workers), (e.g., OT Kyle, providers Max and Allison, nurses Christian and Jill, tech Sean, Social Worker Nicole). 2) As a public-sector, unionized shop, the staff can be their authentic selves. For those who don't like their jobs, they can express that openly. They are not pressured to dissimulate. 3) for patients, if you are looking for a place to stay a while, (i.e., if you are okay with being detained longer than the usual 72 hours), and if you are young and hence able to access the outdoors space, it may be a good place. If you are a patient of one of the Corrigan doctors (like Mayer, then an advantage of having Mayer as a doctor is that he is able to use this unit as an IPU for his regular outpatient clients. He can keep them there in an emergency and thus provide a respite for the patient and their family, a chance to return to stabilization) Worst parts: (a) Approximately half of the patients do not have actual access to the outside. The staff will tell you they provide four outdoor opportunities per day. But for practical purposes, many of the patients cannot--orwould not be reasonably expected to--access the outdoors as provided by Corrigan. (To go outside requires negotiating a steep set of stairs [it can be possible to take elevators but the elevators are difficult to operate, the techs don't make them readily available, and even when the techs are asked to take someone down in the elevator, they may choose not to. ). In addition, accessing the outside can only be done in a large group. Many of the patients are anxious in groups and would love to access the outside if they were able to do so individually, but prefer not to go down in the crowded group, long-stair, way with chains and locks, and authentically depressed staff). (b) Taxpayers lose big time. This is an extremely cost inefficient IPU. It is staffed 24/7/365, (including always an on-call provider apparently), and the staffing levels are such that, during the day shift alone, there are more staff than patients!!! At one time, Corrigan IPU had 40 patients. The folklore is that a patient there hung themself and, as a result, the beds were dropped all the way to 16. But there are more than 16 staff working the day shift alone (not even counting the evening shift or nighttime shift). During the daytime, there are 5 nurses (a charge nurse, another unit nurse, a med nurse, and two nurses in an administrative role (not on unit). 2 occupational therapists 2 providers 4 techs and 3 social workers That is for 16 beds, and often a bed or two is empty, so let's say 15 patients on average. In addition, there are other staff who are not full time (or who work full time, but divide their time across the IPU and other operations): a pharmacist, a nutritionist (she may be full time), a peer advocate, a human rights officer, and more layers of admin. In addition, Corrigan tends to keep people longer than other inpatient units--- much longer (e.g., instead of 72 hours, one stays for months or even, for two patients, 2 years and counting). Because of this, there are more court proceedings compared to units which churn more on a 72 hour cycle. Few if any patients bring their own counsel. So whenever there is a hearing, the taxpayers are paying for the DMH attorney, the Corrigan Staff, the patient's attorney, and the judge or magistrate. (c) Danielle Keogh, LICSW is a reckless individual. You would think that social workers would be people who will talk directly to anyone they have issues with. SW Keogh was incapable of doing this and, instead, recklessly tries to railroad subordinates by going behind their back and trying to squeeze them. You would think that she, as a social worker, would be patient-centered. In fact, she claims the patients at Corrigan are not well enough for a patient-centered approach. Her priority appears to be her career and her title / her status. (How, one might ask did she get promoted to her current position after only a few years on the job? Pretty privilege? Who was making the hiring decision? Why do they like working with her?) Her focus is entirely on appearances and, in particular, looking good to bureaucrats. Her direction to her subordinates is to lie on MIS because her main priority is to do well in audits. That is, she wants to do well when she is evaluated from above. Her going behind subordinates' back and trying to clamp them down is the sign of someone who thinks that social work is about being a tool in a hierarchy. You would think that she, as a social worker, might view social work as a place to create change and fight social injustice. But in reality, she deals with personnel matters unprofessionally--as a matter for gossip. Her ...
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    45 mins
  • disavowal

    disavowal
    Dec 11 2024

    Alenka Zupančič

    Disavowal

    This book argues that the psychoanalytic concept of disavowal best renders the structure underlying our contemporary social response to traumatic and disturbing events, from climate change to unsettling tectonic shifts in our social tissue. Unlike denialism and negation, disavowal functions by fully acknowledging what we disavow. Zupancic contends that disavowal, which sustains some belief by means of ardently proclaiming the knowledge of the opposite, is becoming a predominant feature of our social and political life. She also shows how the libidinal economy of disavowal is a key element of capitalist economy.

    The concept of fetishistic disavowal already exposes the objectified side of the mechanism of the disavowal, which follows the general formula: I know well, but all the same, the object-fetish allows me to disregard this knowledge. Zupancic adds another twist by showing how, in the prevailing structure of disavowal today, the mere act of declaring that we know becomes itself an object-fetish by which we intercept the reality of that very knowledge. This perverse deployment of knowledge deprives it of any reality.

    This structure of disavowal can be found not only in the more extreme and dramatic cases of conspiracy theories and re-emerging magical thinking, but even more so in the supposedly sober continuation of business as usual, combined with the call to adapt to the new reality. To disrupt this social embedding of disavowal, it is not enough to change the way we think: things need to change, and hence the way they think for us
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    51 mins
  • psychosis

    psychosis
    Nov 28 2024

    Stijn Vanheule

    Why Psychosis Is Not So Crazy

    A Road Map to Hope and Recovery for Families and Caregivers

    An expert’s guide to humanizing psychosis through communication offers key insights for family and friends to support loved ones during mental health crises.

    Are we all a little crazy? Roughly 15 percent of the population will have a psychotic experience, in which they lose contact with reality. Yet we often struggle to understand and talk about psychosis. Interactions between people build on the stories they tell each other—stories about the past, about who they are or what they want. In psychosis we can no longer rely on these stories, this shared language. So how should we communicate with someone experiencing reality in a radically different way than we are?

    Drawing on his work in psychoanalysis, Stijn Vanheule seeks to answer this question, which carries significant implications for mental health as a whole. With a combination of theory from Freud to Lacan, present-day research, and compelling examples from his own patients and well-known figures such as director David Lynch and artist Yayoi Kusama, he explores psychosis in an engaging way that can benefit those suffering from it as well as the people who care for and interact with them.
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    47 mins
  • turkeys

    turkeys
    Nov 10 2024

    Peter Singer

    Consider the turkey

    Why this holiday season is a great time to rethink the traditional turkey feast.
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    45 mins