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Archive for the 'Psychology' Category

Tuesday, May 26th, 2015

Book Giveaway! The Seventh Sense, by William Duggan

This week our featured book is The Seventh Sense: How Flashes of Insight Change Your Life by William Duggan.

In addition to featuring the book and the author on the blog, we will also be posting about the book on twitter, and facebook.

We are also offering a FREE copy of The Seventh Sense to one winner. To enter the contest please e-mail pl2164@columbia.edu and include your name and address. The winner will be selected Friday, May 29th at 1:00 pm.

For more on the book you can read the introduction:

Friday, May 22nd, 2015

The Journey Ahead

The Thirteenth Step

“[F]or now at least, any promise of “cure” is somewhere between naïve and dishonest, depending on who makes it and why. But it is equally true that these chronic relapsing disorders can now be managed so that most people with such disorders can decrease their risk for relapse, allowing them to live productive, good lives.” — Markus Heilig

This week our featured book is The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig. For the final day of our giveaway, we are happy to present an excerpt from “The Journey Ahead,” the final chapter of The Thirteenth Step.

Don’t forget to enter our book giveaway of The Thirteenth Step!

Thursday, May 21st, 2015

PTSD and addiction

The Thirteenth Step

“Here’s a dream: A future in which every patient with alcohol problems, man or women, is thoroughly evaluated for PTSD, treated with evidence based behavioral interventions, and given the opportunity to benefit from synergistic effects of psychotherapy and pharmacology. Wouldn’t that be something?” — Markus Heilig

This week our featured book is The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig. In today’s post, Heilig discusses the deep connection between PTSD and substance addiction which scientists are still trying to fully understand.

And don’t forget to enter our book giveaway of The Thirteenth Step!

PTSD and addiction
By Markus Heilig

The public is clearly waking up to the fact that much of the toll of PTDS comes from substance use. Hard drinking may appear as the only way to temporarily escape the intrusive memories of traumatic events, face people at the grocery store, or fall asleep without the torment of nightmares. Up to 75% of combat veterans with PTSD also have alcohol problems. Conversely, between a third and half of patients seeking treatment for alcohol problems have PTSD.

But here’s something else to think about: The vast majority of PTSD patients are actually not veterans of wars. Firefights or explosive devices are not the most common causes of PTSD. Rape, sexual assault, or intimate partner violence are. Even with the recent wars, PTSD is twice as common among women as it is among men, affecting 8 – 16% of adult females in the US. Yet women suffering from PTSD are not much talked about. When they seek treatment for alcohol problems, the questions that would allow a PTSD diagnosis to be made are rarely asked. And even if the diagnosis is obvious, people look the other way. Traumatic events are so hard to talk about. Excuses are plentiful. Maybe bringing back traumatic memories will trigger cravings and relapse? So this difficult material is left for a “later” that never comes. (more…)

Wednesday, May 20th, 2015

Us and Them

The Thirteenth Step

“In this book I will share some of the amazing advances the neuroscience of addiction has made over the years I have been in the field. I will offer a personal take on what addiction is: a malfunction of some of the most fundamental brain circuits that make us tick, and a disease that is not much different from other chronic, relapsing medical conditions. I trust it will be clear what addiction is not: a moral failing, a simple inability to say no, or a condition that can be cured by mystic incantations.” — Markus Heilig

This week our featured book is The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig. Today, we are happy to present an excerpt from “Us and Them,” the first chapter of The Thirteenth Step, in which Heilig explains his experiences working with addiction, and lays out his hopes for what his book will accomplish.

Don’t forget to enter our book giveaway of The Thirteenth Step!

Tuesday, May 19th, 2015

Why breakthroughs in addiction research have not changed addiction treatment

The Thirteenth Step

“But the size of the addiction research enterprise is dwarfed by a $35 billion a year or so treatment industry in this field. This is a booming entrepreneurial world, where treatment centers charge people tens of thousands of dollars for various offerings. And despite all the investment in science, few of those treatments make much use of the scientific advances in the area of addiction. In fact, treatment approaches have not changed much at all over the past quarter century.” — Markus Heilig

This week our featured book is The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig. To open the week’s feature, Heilig has written a powerfully argued guest post in which he contrasts the advances in the science of addiction and the stagnation in the way that addiction is actually treated.

Don’t forget to enter our book giveaway of The Thirteenth Step!

Why have breakthroughs in addiction research not changed addiction treatment?
By Markus Heilig

The US taxpayers fund the overwhelming majority of addiction research in the world. Every year, Congress channels about $1 billion to the National Institute on Drug Abuse (NIDA). An additional almost 0.5 billion is separately given to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), my own workplace for the past decade. That may sound impressive, and in many ways it is. With the help of these resources, there have been truly amazing advances in the understanding of how addiction works. “Brain reward systems” have become part of the general parlance. The NIDA director has become a celebrity who has appeared on 60 Minutes. New findings on how alcohol and drugs get people hooked have shown a rare ability to fascinate people far outside the circle of scientists. And there has been perhaps a more modest, but still significant progress in figuring out better treatments.

But the size of the addiction research enterprise is dwarfed by a $35 billion a year or so treatment industry in this field. This is a booming entrepreneurial world, where treatment centers charge people tens of thousands of dollars for various offerings. And despite all the investment in science, few of those treatments make much use of the scientific advances in the area of addiction. In fact, treatment approaches have not changed much at all over the past quarter century. If someone were to be pulled out of a 12-step meeting then and transported through time to one today, he or she would probably not notice much of a difference. Here is, perhaps unsurprisingly then, something that the investment in research has not bought us: Any measurable dent in the damage done by addictions.

Some basic facts: Alcohol continues to kill about 80,000 Americans each year. Death from prescription pain killers adds almost 20,000 more, and has been on the rise for over a decade. As we have begun clamping down on these prescriptions, heroin has become resurgent instead. Why is it that all the passionate research efforts by dedicated scientists have such a hard time producing much of a change in the lives of real people with addictions? Only about one in 10 people with alcoholism ever receive treatment. For most of those, that is synonymous with joining Alcoholics Anonymous (AA), a movement formed three-quarters of a century ago, when medicine had little to offer addicts beyond perhaps treating the shakes of acute alcohol withdrawal. (more…)

Monday, May 18th, 2015

Book Giveaway! The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig

The Thirteenth Step

“Heilig makes the science accessible to both lay and professional audiences alike by using a strong, conversational tone interspersed with humor and illustrative vignettes. He draws the reader in and effectively consolidates complex concepts. I applaud his efforts to bring the plight of the addicted to the attention of others and for calling upon the field to do its very best to help.” — Valerie J. Slaymaker

This week our featured book is The Thirteenth Step: Addiction in the Age of Brain Science, by Markus Heilig. Throughout the week, we will be featuring content about the book, its subject, and its editors on our blog as well as on our Twitter feed and our Facebook page.

We are also offering a FREE copy of The Thirteenth Step. To enter our book giveaway, simply fill out the form below with your name and preferred mailing address. We will randomly select our winners on Friday, May 22nd at 1:00 pm. Good luck, and spread the word!

Thursday, January 15th, 2015

Discouraging North American and European Citizens from Foreign Jihad

Mental Health in the War on Terror

This week our featured book is Mental Health in the War on Terror, by Neil Krishan Aggarwal. Throughout the week, we will be posting content from and about the book and it’s author. In today’s guest post, Aggarwal discusses a recent New York Times article on efforts to keep Western citizens from “traveling to fight in war zones in Muslim countries,” and how the War on Terror has been and is being shaped by sometimes troubling stereotypes.

Don’t forget to enter our book giveaway for Mental Health in the War on Terror!

Discouraging North American and European Citizens from Foreign Jihad
By Neil Krishan Aggarwal

A New York Times article dated January 13, 2015 and titled “West Struggles against Flow to War Zones” describes North American and European officials struggling to “stem the flow of their citizens traveling to fight in war zones in Muslim countries.” The article comes after last week’s tragic attacks in France and reflects major themes from my book Mental Health in the War on Terror: Culture, Science, and Statecraft. In my book, I analyze questionable claims of Orientalist stereotypical scholarship and de-radicalization programs, some of which appear in this article. By scrutinizing this article, I hope to show how such claims recur in an influential newspaper and shape public discussions of the War on Terror. Only by inspecting such claims one at a time can we discern how the War on Terror has permeated popular culture.

1. The “West/Rest” fallacy. The authors begin: “For more than a decade, Western governments have struggled to stem the flow of their citizens traveling to fight in war zones in Muslim countries.” This assertion implies a rigid division among Muslims and non-Muslims. Where does the West begin and end? What is the standard for “Muslim countries”? Is a Muslim country defined on the basis of political system (Saudi Arabia), population (Indonesia), or Orientalist notions of the Middle East? Are we not comparing apples and oranges by contrasting entities based on geography (“Western”) and religion (“Muslim”)? (more…)

Tuesday, January 13th, 2015

National Security Above Mental Health — Neil Aggarwal

Mental Health in the War on Terror

“We need novel solutions for hierarchical organizations such as the CIA and the armed forces that erect institutional safeguards for psychiatrists, psychologists, and whistleblowers warning of misuses in mental health knowledge and practice.”—Neil Krishnan Aggarwal

This week our featured book is Mental Health in the War on Terror, by Neil Krishan Aggarwal. Throughout the week, we will be posting content from and about the book and it’s author. Today, we are happy to repost an article on the Senate Select Committee on Intelligence’s report on American use of torture, written by Aggarwal and originally posted in mid-December.

Don’t forget to enter our book giveaway for Mental Health in the War on Terror!

The Senate Select Committee on Intelligence’s release of the report Committee Study of the Central Intelligence Agency’s Detention and Interrogation Program marks a signature moment for government accountability in the War on Terror. The report acknowledges that “the CIA’s use of its enhanced interrogation techniques was not an effective means of acquiring intelligence or gaining cooperation from detainees” and “the CIA’s justification for the use of its enhanced interrogation techniques rested on inaccurate claims of their effectiveness.”

Politicians have debated release of the report. Former Vice-President Dick Cheney has claimed that enhanced interrogation techniques were “absolutely, totally justified” and were the “right thing to do, and if I had to do it over again, I would do it.” In contrast, Senator Dianne Feinstein, committee chairwoman, defended the release: “Releasing this report is an important step to restoring our values and showing the world that we are a just society.” Similarly, President Barack Obama declared: “The report documents a troubling program involving enhanced interrogation techniques on terrorism suspects in secret facilities outside the United States.”

In Mental Health in the War on Terror: Culture, Science, and Statecraft, I investigate how the government uses mental health professionals to advance national security interests and how mental health professionals serve such ends. I examine bioethical debates on whether mental health professionals should do no harm or participate in interrogations. I examine debates among prosecution and defense teams on the meanings of detainee mental health symptoms in Guantanamo tribunals. I conclude that the War on Terror has pushed American government officials to treat terrorism as a military problem requiring new forms of mental health knowledge, practice, and institutions rather than a law enforcement problem handled through extant institutions.

The Senate committee’s report reinforces this conclusion. After capture of militant Abu Zubaydah, a psychologist-contractor proposed in July 2002 that SERE (Survival, Evasion, Resistance and Escape) techniques from the American military could be “novel interrogation methods” for the CIA. These techniques include walling, facial holding and slapping, cramped confinement, stress positions, sleep deprivation, waterboarding, and mock burial. One CIA official clarified that “personnel will make every effort possible to insure [sic] that subject is not permanently physically or mentally harmed but we should not say at the outset of this process that there is no risk.” The psychologist-contractors normalized these techniques, responding, “The safety of any technique lies primarily in how it is applied and monitored.”

(more…)

Tuesday, January 13th, 2015

Mental Health, Culture, and Power in the War on Terror

Mental Health in the War on Terror

This week our featured book is Mental Health in the War on Terror, by Neil Krishan Aggarwal. Throughout the week, we will be posting content from and about the book and it’s author. In today’s post, we have an excerpt from the first chapter of Mental Health in the War on Terror, in which Aggarwal introduces his project, takes a close look at the causes and symptoms of PTSD, and examines the effects that the War on Terror had on an American veteran and a detainee at Guantánamo Bay.

Don’t forget to enter our book giveaway for Mental Health in the War on Terror!

Monday, January 12th, 2015

Book Giveaway! Mental Health in the War on Terror, by Neil Krishan Aggarwal

Mental Health in the War on Terror

“Very few people are able to synthesize the disciplines of anthropology, mental health, cultural studies, political theory, religious studies, bioethics and forensics as Aggarwal does in this book. He offers a balanced and insightful account of the challenges of forensic psychiatry in assessing and managing terrorism suspects.” — Hamada Hamid, Yale University

This week our featured book is Mental Health in the War on Terror, by Neil Krishan Aggarwal. Throughout the week, we will be featuring content about the book and its author on our blog as well as on our Twitter feed and our Facebook page.

We are also offering a FREE copy of Mental Health in the War on Terror. To enter our book giveaway, simply fill out the form below with your name and preferred mailing address. We will randomly select our winners on Friday, January 16th at 1:00 pm. Good luck, and spread the word!

Wednesday, December 17th, 2014

How Expectations and Uncertainty Affect the Economy — An Interview with Eric Barthalon

Uncertainty, Expectations, and Financial Instability

The following is an interview with Eric Barthalon, author of Uncertainty, Expectations, and Financial Instability: Reviving Allais’s Lost Theory of Psychological Time.

Question: What is your book about?

Eric Barthalon: Uncertainty, Expectations and Financial Instability is about what we call “expectations” and the pro-cyclical responses they trigger. I argue that, under uncertainty, we infer the future largely from our experience of the past, and I show how Allais’s lost theory of psychological time gives an operational and testable content to this intuition or hypothesis.

Q: What exactly do you mean by uncertainty?

EB: When we throw four dices repeatedly, we cannot tell the outcome of each throw, but experience as well as mathematics tell us very precisely what we should expect: there will not be many instances where the sum of the four dices is either 4 or 24; most of the throws will yield a result close to 14. This is a situation of “known unknowns” or risk, in which it would be insane to expect a throw to yield either a 2 or a 30, and—even if the first throws are not close to 14—it would be equally insane not to expect the average of the throws to converge toward 14. In such risky situations, our expectations should be identical to the model’s forecasts. This is the very definition of rational expectations. (more…)

Friday, November 14th, 2014

Francisco Varela and Waking, Dreaming, Being

Waking, Dreaming, Being

This week our featured book is Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson, with a foreword by Stephen Batchelor. In today’s post on the final day of our feature, we are happy to post an excerpt from a fascinating interview of Thompson conducted by Joy Stocke at the Wild River Review. In the interview, Stocke and Thompson discuss the importance of his upbringing to his work, the influence of Francisco Varela, and the Dalai Lama, among many other topics, though we’ve chosen to focus on the discussion of Francisco Varela for this excerpt.

Don’t forget to enter our book giveaway for a chance to win a free copy of Waking, Dreaming, Being!

WRR: Your book, ultimately, is a meditation on consciousness. Is consciousness wholly dependent on the brain or does it transcend the brain

Thompson: That’s the fundamental question of the book. I felt compelled to write about it because it kept coming up for me in different ways, some of which were personal and some intellectual. On a personal level I thought about the question a lot when I was working intensely with my friend and mentor, Chilean neuroscientist, Francisco Varela, just before he died. He was terminally ill and we knew that at some point soon he was going to die.

I write about the last real conversation I had with him, how it centered on consciousness and the question of its transcendence. It was fall of 2000 and Cisco and I were in my dad’s apartment in New York on the Upper West Side, writing a scientific article about consciousness and the brain. We weren’t raising that question at all in the article but we were talking about it a lot when we weren’t working. Cisco was a Buddhist, and knew that he was going to die soon, so transcendence was something he was contemplating. From a Tibetan Buddhist perspective, consciousness is the most fundamental luminous nature of awareness, underlying more ordinary cognitive forms of the mind, and it’s not considered to be brain dependent. Cisco took this perspective very seriously, but he was a neuroscientist, so he was also skeptical and doubtful.

The experience of talking to Cisco about this and watching him die and feel the loss intensified the question for me. It was a question that I had always thought about, having studied Asian and Western philosophy, but also having grown up in the New Age and yoga world where it was just taken for granted that people had multiple lives and that consciousness carried on after physical death. (more…)

Thursday, November 13th, 2014

Waking, Dreaming, Being

Waking, Dreaming, Being

This week our featured book is Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson, with a foreword by Stephen Batchelor. Dreaming is one of the key parts of the human experience that Thompson examines in his book (it’s right there in the title, after all), and in today’s post, crossposted from the Huffington Post Blog, Thompson discusses the importance of dreaming to his work as a scholar, and to understanding what the concept of a “self” actually means.

Don’t forget to enter our book giveaway for a chance to win a free copy of Waking, Dreaming, Being!

Waking, Dreaming, Being
Evan Thompson

Dreaming and waking up have puzzled and fascinated humanity since prehistoric times. Paleolithic cave paintings, according to some art historians, depict mental images from dreams and the borderland between sleep and wakefulness. The ancient Indian texts called the Upanishads describe three states of the self — waking, dreaming, and dreamless sleep. The early Chinese Daoist philosopher, Zhuang Zi (Chuang Tzu, 369-298 B.C.E.), wrote that only after one is “greatly awakened” does one realize that it was all a “great dream,” while the fool thinks that he is awake. The word “Buddha” means “Awakened One.”

Lucid dreaming — being aware of dreaming while you’re dreaming — is a vivid way to experience waking up and dreaming at the same time. You wake up within the dream without waking up from the dream. In the 1980s scientists showed that lucid dreaming is a real and unique state of consciousness in sleep. In the past four years, brain-imaging experiments have been done with lucid dreamers. Instead of cave art depicting the dream world, we now have images of the dreaming brain. (more…)

Wednesday, November 12th, 2014

Evan Thompson talks to Tricycle Magazine

Waking, Dreaming, Being

This week our featured book is Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson, with a foreword by Stephen Batchelor. Recently, Thompson spoke to Tricycle Magazine about his book, his view of the mind, and mindfulness as an object of scientific scrutiny. We’ve excerpted parts of this interview below.

Don’t forget to enter our book giveaway for a chance to win a free copy of Waking, Dreaming, Being!

Almost two and a half decades ago, in The Embodied Mind, you critiqued a notion of mind that was already prevalent then and that continues to frame much of the current neuroscience research on meditation. What is that view, and what is wrong with it?
We criticized the view that the mind is made up of representations inside the head. The cognitive science version says that the mind is a computer—the representations are the software, and the brain is the hardware. Although cognitive scientists today don’t think the brain works the way a digital computer does, many of them, especially if they’re neuroscientists, still think the mind is something in the head or the brain. And this idea shows up in the neuroscience of meditation. But this idea is confused. It’s like saying that flight is inside the wings of a bird. The mind is relational. It’s a way of being in relation to the world. You need a brain, just as the bird needs wings, but the mind exists at a different level—the level of embodied being in the world.

What’s your alternative view of the mind?
The alternative view we put forward is that cognition is a form of embodied action. “Embodied” means that the rest of the body, not just the brain, is crucial; “action” means that agency—the capacity to act in the world—is central. Cognition is an expression of our bodily agency. We inhabit a meaningful world because we bring forth or enact meaning. We called this view “enaction” or the “enactive approach.”

In the enactive approach, being human is a matter of inhabiting the human world of culture and shared bodily practices. Of course we need our brain to do this, but we also need that world to be in place in order for the human brain to develop properly. The brain is what philosophers call a necessary “enabling condition” for mind and meaning, while enculturation is a necessary enabling condition for the brain. What’s important is not just what is inside the brain but what the brain is inside of—the larger space of the body and culture. That is where we find mind and meaning. (more…)

Tuesday, November 11th, 2014

The Dalai Lama’s Conjecture

Waking, Dreaming, Being

This week our featured book is Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson, with a foreword by Stephen Batchelor. Thompson’s prologue was recently excerpted at the Mind & Life institute, and we are happy to present the final section of that excerpt here.

Don’t forget to enter our book giveaway for a chance to win a free copy of Waking, Dreaming, Being!

Staying with the Open Question
Evan Thompson

Shortly before his death, Francisco Varela talked about the Tibetan Buddhist notion of “subtle consciousness” in an interview with Swiss filmmaker Franz Reichle (see Reichle’s film, Montegrande: What Is Life?, and also the Mind & Life Institute). Subtle consciousness isn’t an individual consciousness; it’s not an ordinary “me” or “I” consciousness. It’s sheer luminous and knowing awareness beyond any sensory or mental content. It’s rarely seen by the ordinary mind, except occasionally in special dreams, intense meditation, and at the very moment of death, when one’s ordinary “I” or “me” consciousness falls apart. It’s the foundation for every other type of consciousness, and it’s believed to be independent of the brain. Neuroscience can’t conceive of this possibility, while for Tibetan Buddhists it’s unthinkable to dismiss their accumulated experience testifying to the reality of this primary consciousness.

Varela’s position is to suspend judgment. Don’t neglect the Buddhist observations and don’t dismiss what we know from science. Instead of trying to seek a resolution or an answer, contemplate the question and let it sit there. Have the patience and forbearance to stay with the open question. (more…)

Tuesday, November 11th, 2014

Stephen Batchelor’s Foreword to Waking, Dreaming, Being

Waking, Dreaming, Being

This week our featured book is Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson, with a foreword by Stephen Batchelor that we are proud to present below as the first post of the feature.

Don’t forget to enter our book giveaway for a chance to win a free copy of Waking, Dreaming, Being!

Monday, November 10th, 2014

Book Giveaway! Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson

Waking, Dreaming, Being

This week our featured book is Waking, Dreaming, Being: Self and Consciousness in Neuroscience, Meditation, and Philosophy, by Evan Thompson, with a foreword by Stephen Batchelor. Throughout the week, we will be featuring content about the book and its author on our blog as well as on our Twitter feed and our Facebook page.

We are also offering a FREE copy of Waking, Dreaming, Being. To enter our book giveaway, simply fill out the form below with your name and preferred mailing address. We will randomly select our winners on Friday, November 14th at 1:00 pm. Good luck, and spread the word!

Friday, October 31st, 2014

Preface to Losing Tim: How Our Health and Education Systems Failed My Son with Schizophrenia

Losing Tim, Paul Gionfriddo

“But I think [Tim] under­stood that if his story could help change the way we think and move us to action, it was worth telling. Plus, he loves me, and I love him.”—Paul Gionfriddo

We conclude our week-long feature on Losing Tim: How Our Health and Education Systems Failed My Son with Schizophrenia, with an excerpt from the book’s preface in which Paul Gionfriddo discusses why he decided to write about his son. For more of the book you can also read the book’s first chapter, Tim Brings a Gun to School.

When my son Tim was a very young boy, he knew that I was an elected official, and he understood that elected officials made many of the “rules” by which people live. “My dad is important,” he used to volunteer to people when we were introduced to them. The prob­lem was that he pronounced the word as “impotent,” which typically elicited a giggle that puzzled Tim. Giggles aside, he had no idea how apt a description that would become when it came to my helping to make his own life more tolerable.

This book is in part a reflection on public policy and the way public policy decisions I made in good faith affected Tim’s life….

As i imagine is the case for most parents of children with serious chronic illnesses, in the course of over two decades I amassed hundreds of hard-copy and electronic documents relating to tim. they traveled with me from Connecticut to Texas and then to Florida. I saved all that I could, although there were plenty of times I wanted to burn the whole pile of paper or smash the computer in frustration. but after twenty years of storing them I decided it was time to make sense of them. So I began to do what I had been wanting to do for a long time— piece them into a narrative. I had no idea what the ending would be. I just wanted to understand better what had happened to Tim and me as we traveled his path of serious mental illness.

This book is the result. At first, it was all about Tim and not at all about me. But then i realized that I needed to describe better how iI felt about what was happening to Tim. When I started to do this, it dawned on me that I also needed to write more about the role I played as a policy maker in determining what happened to him….

Tim did something i found to be very courageous. He graciously gave his permission in writ­ing for his story to be told. when he did so, I don’t think that he ad­mired policy makers as he once had or had much respect for the rules they’ve created that affected him most directly. But I think he under­stood that if his story could help change the way we think and move us to action, it was worth telling. Plus, he loves me, and I love him.

(more…)

Thursday, October 30th, 2014

Paul Gionfriddo — “The Dangers of Stage 4 Thinking about Serious Mental Illnesses”

Losing Tim

“Until we take a different approach and move upstream in the disease process, we’re going to continue to put our resources in all the wrong places, and we’re going to continue to fight about all the wrong things. And people will still cycle between homelessness and hospitalization, outpatient treatment and incarceration, and crisis and stability.”—Paul Gionfriddo

The following is a post by Paul Gionfriddo, President/CEO of Mental Health America and the author of Losing Tim: How Our Health and Education Systems Failed My Son with Schizophrenia, originally published on Mental Health America. In the post, Gionfriddo argues for the importance of early detection and treatment of mental illness:

During my first hundred days at Mental Health America, I have frequently made the case that mental health policymakers and practitioners are too often mired in “Stage 4” thinking when they think about serious mental illnesses.

Here’s what I mean—they use an “imminent danger to self or others” as a standard for determining who gets care. That near-death time typically only comes during the latest stages of a chronic disease process, or Stage 4.

There are several dangers in using such a standard. The first is that it furthers the myth that mental illness causes violence. The second is that it leads to the over-incarceration of people with mental illnesses. The third – and perhaps most dangerous – is that it deflects our attention away from intervening early in the disease process, when we can do the most good and get the best results.

We don’t treat any other chronic diseases this way. Imagine the outcry if we waited until Stage 4 to treat cancers, cardiovascular diseases, or diabetes!

I haven’t come across anyone who thinks there’s a clinical basis for using the “imminent danger to self or others standard” to determine eligibility for care. But this hasn’t stopped us from using it for decades.

Until we take a different approach and move upstream in the disease process, we’re going to continue to put our resources in all the wrong places, and we’re going to continue to fight about all the wrong things. And people will still cycle between homelessness and hospitalization, outpatient treatment and incarceration, and crisis and stability.

At Mental Health America, we believe that it is past time for investing heavily in early identification and intervention. That’s one of the reasons we launched a new mental health screening program this year, with screening tools available on our website or at www.mhascreening.org.

And we’re pretty sure that people agree with us. After all, in just four months, the first 100,000 screens will have been taken, typically by people who are experiencing early symptoms of what may become over time severe depression, anxiety, or bipolar disorder.

They’re concerned about their mental health now, and so are we.

And they don’t want to wait ten years or more, and be forced to progress to Stage 4, for everyone else to take notice.

Wednesday, October 29th, 2014

Losing Tim, Losing Time — Paul Gionfriddo

Losing Tim, Paul Gionfriddo

“We created a system that neglected our children when we could have made a difference and inevitably led them to homelessness, hospitalization, and incarceration.”—Paul Gionfriddo

The following post is by Paul Gionfriddo, author of Losing Tim: How Our Health and Education Systems Failed My Son with Schizophrenia. For more on the book, you can also read an interview with Paul Gionfriddo.

I’d like to travel back in time. Just twenty-five years would do. Because if I knew then what I know now, I don’t think I would ever have to have written Losing Tim.

Because public policy matters in the lives of people like Tim.

I’m sure this won’t come as a shock to anyone, but policymaking isn’t a perfect science. As I write in Losing Tim, a very wise Connecticut legislator—a college professor by trade—once remarked that when she arrived in the state legislature, she assumed that the best proposals coupled with the best-reasoned arguments would lead to good public policy. Then the legislative session began, and she learned that gut feelings and emotion often carried the day, and the policy that resulted was as much a reflection of these as it was of logic and reason.

Imagine what this did in the area of mental health. We were faced with a huge challenge in the 1980s. We were closing the doors of expensive and ineffective institutions, and were returning thousands of people to their families and communities.

But their families and communities weren’t ready to receive them. This was in part because they were afraid of the way they looked and acted, and in part because they didn’t really know what to do for them. Still, I write, we believed that anything that happened to people in the community would be preferable to what had happened to them behind the locked doors of those large psychiatric facilities.

Except that it wasn’t, because we just moved folks from behind one set of locked doors—state psychiatric hospitals—to another—county jails and state and federal prisons.

This was not our intention, but we didn’t know any better.

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