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Cake day: June 16th, 2023

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  • I’m trying to think about a good medical analogy for what therapists and psychiatrists (that both prescribe meds and do therapy).

    The best analogy I can come up with is thinking about mental health in 2 categories, and using medical treatment as an analogy like a previous user mentioned. You can have low level mental health issues where a little therapy is needed to reset your approach maybe using therapy every couple weeks for 6 months. Or you can have a serious condition that results in a threat to your or others life. That that doesn’t have to be death, it could be serious illness or physical injury.

    It’s like the difference between someone needing a physical trainer at the gym to get back into shape, where you can white knuckle the process on your own but it’s WAY more efficient to get outside guidance. That example is someone with low level mental health problems. Then there’s the severe stroke victim in a coma for 3 months, this person will NOT benefit from a physical trainer, they need a medically trained physical therapist. This example is someone suicidal and non socially functional with MDD, or bipolar disorder that is cutting themselves, and other severe mental health issues. They need significant help, maybe PHP, or skilled weekly or even twice weekly therapy. And an individual can process through both low level and extreme states over the decades.


  • This is the best description of what short term hospitalization is like. The severe car accident analogy is great. In patient hospitalization is like being in the ICU to stabilize, and then you have to do the thousands of hours of physical therapy afterwards to get back to full functionally. I’ve been in a US PHP program twice in the last 25 years and the second time in 2007 started with 11 days of in patient hospitalization after a suicide attempt. The folks that hate in patient hospitalization most likely are early in their mental health journey (2000-3000 hours of various therapies, workshops, and PHP for me so far).

    Being early in your mental health awareness makes the lack of control in an in patient hospitalization terrifying.

    For me the 11 days were a godsend, and I needed the doc to stabilize me on my new meds. They weren’t going to release me until they’re saw me improve on the SSRIs and that took 11 days. I was then put into an outpatient program for 3 months. I will say the outpatient programs and my workshops are where I did the heavy lifting wrt emotional learning, learning CBT and DBT, etc. Those two PHP stints laid the foundation for my recovery.


  • Sorry, I don’t know how complex your team’s role is, but in our environment of oncology research this individual is not improving their behavior, is disruptive, using your niceness, and I would put them on a PIP to improve or let go. The folks on the spectrum that I’ve worked with do not react with kicked puppy face, instead they’re profoundly grateful for the social guidance and try to improve. This guy honestly sounds a little manipulative.