Two psychiatrists conduct an adversarial review of Adam Kay's 'This Is Going To Hurt,' debating whether his NHS memoir represents institutional failure causing PTSD or a self-inflicted martyr complex, while examining the book's comedy, structure, and impact on healthcare discourse. Longer summary

This book review examines Adam Kay's 'This Is Going To Hurt,' a medical memoir documenting his career as an NHS obstetrician from 2004-2010, written as an adversarial collaboration between two psychiatrists: one who sees it as a textbook case of moral injury and PTSD, and another who views Kay as suffering from a martyr complex. The review explores the book's comedic brilliance, analyzes accusations of misogyny, and ultimately argues that the book documents the systematic institutional failure that broke a competent doctor rather than representing a heroic escape from dysfunction. Shorter summary

Scott Alexander proposes that political hyperpartisanship might be a form of trauma, comparing PTSD symptoms to behaviors observed in political extremists. Longer summary

Scott Alexander explores the idea that political extremism might be a form of trauma. He compares symptoms of PTSD to behaviors observed in politically hyperpartisan individuals, such as triggers, distorted cognitions, and hypervigilance. The post discusses how trapped priors in the brain might explain both cognitive and emotional aspects of political extremism. Scott also considers the implications of framing political partisanship as trauma, including potential risks of expanding the concept of trauma. Shorter summary

Scott Alexander discusses reader comments on his 'Geography of Madness' review, revising views on culture-bound syndromes and exploring various mental health topics. Longer summary

This post discusses various comments on Scott Alexander's review of 'The Geography of Madness'. It covers topics like culture-bound syndromes, the prevalence of brief psychotic disorder, the history of school shootings, the universality of PTSD, the rise of transgender identities, and the correlation between believing in ghosts and experiencing PMS. Scott revises some of his previous views, becoming more skeptical about many traditional culture-bound syndromes and acknowledging the complexity of cultural influences on mental health conditions. Shorter summary

Scott reviews a book on culture-bound syndromes, expanding the discussion to how all mental illnesses are influenced by culture to varying degrees. Longer summary

Scott Alexander reviews 'The Geography of Madness' by Frank Bures, which explores culture-bound syndromes like koro (belief in penis theft by witches). The book traces the history and spread of these syndromes across cultures. Scott expands on the idea, discussing how all mental illnesses exist on a spectrum of biological vs. cultural influence. He argues that even conditions considered 'real' in Western psychiatry, like anorexia or PTSD, have significant cultural components. The review touches on complex issues around gender dysphoria and cultural beliefs, concluding that there is no truly 'neutral' culture free from influence on mental health presentations. Shorter summary

Scott discusses reader comments on his 'Crazy Like Us' book review, covering topics like PTSD, cultural influences on mental illness, and cross-cultural prevalence of schizophrenia. Longer summary

This post discusses several comments on Scott's review of 'Crazy Like Us', touching on topics like PTSD in ancient vs modern soldiers, cultural influences on mental illness, childhood sexual abuse, and cross-cultural prevalence of schizophrenia. Scott reflects on these comments, providing additional context and sometimes revising his views based on new information presented. Shorter summary

Scott Alexander reviews 'Crazy Like Us', exploring how Western mental health concepts spread globally and whether raising awareness of mental health problems might make them worse. Longer summary

Scott Alexander reviews 'Crazy Like Us' by Ethan Watters, which explores how Western mental health concepts are spreading globally. The book presents case studies on anorexia in Hong Kong, depression in Japan, PTSD in Sri Lanka, and schizophrenia in Zanzibar. While Scott finds the book's main thesis only moderately interesting, he's intrigued by a recurring sub-theme: whether raising awareness of mental health problems might actually make them worse. He discusses each case study, offering his own insights and critiques, and concludes by imagining a culture that runs 'Mental Health Unawareness Campaigns'. Shorter summary

Scott Alexander reviews 'The Body Keeps The Score', a book on PTSD, praising its historical context but criticizing its outdated science and uncritical embrace of alternative therapies. Longer summary

Scott Alexander reviews 'The Body Keeps The Score', a book about post-traumatic stress disorder (PTSD) by Bessel van der Kolk. The review covers the book's historical context, its insights into PTSD symptoms and neurobiology, and its treatment recommendations. Scott praises the historical accounts of PTSD recognition but criticizes the book's outdated scientific claims, lack of consideration for genetic factors, and uncritical enthusiasm for alternative therapies. He notes the book's emphasis on bodily disconnection in PTSD patients and the importance of reconnecting with the body in treatment. Overall, Scott finds the book less helpful than expected for guiding clinical practice, but acknowledges its potential value in highlighting the importance of trauma screening and specialized trauma clinics. Shorter summary

Scott Alexander explores why recreational drugs like ketamine and MDMA have shown more promise in treating mental health conditions than intentionally developed pharmaceuticals, suggesting a new direction for drug research. Longer summary

Scott Alexander discusses the surprising effectiveness of ketamine and MDMA in treating depression and PTSD respectively, noting that these recreational drugs have shown more promise than intentionally developed pharmaceuticals. He speculates on why this might be, suggesting that drugs with strong effects on the brain, even if originally used recreationally, might be more likely to have significant therapeutic benefits. Scott proposes that pharmaceutical research might be more productive if it focused on chemicals with powerful psychoactive effects, rather than prioritizing minimal side effects. He acknowledges potential counterarguments, including the possibility that ketamine's antidepressant effects may come from a non-psychoactive metabolite. Shorter summary

Scott Alexander discusses a study challenging the idea that childhood abuse lowers IQ, and explores its implications for understanding the effects of child abuse on various outcomes. Longer summary

This post discusses a study by Danese et al. challenging the assumption that childhood abuse lowers IQ. The study found that after adjusting for pre-existing factors, there was no significant difference in IQ between abused and non-abused children. Scott Alexander explores the implications of this study in the context of shared-environment-skeptical psychiatry and discusses other studies showing limited effects of child abuse on various outcomes. He notes that while these findings are interesting, they may understate the dangers of severe abuse due to sample size limitations. The post concludes by suggesting that child abuse likely causes PTSD-like symptoms but may not have effects drastically different from normal PTSD. Shorter summary

Scott Alexander defends trigger warnings as tools for informed choice, not censorship, and criticizes arguments against them, especially those based on non-consensual exposure therapy. Longer summary

Scott Alexander argues in favor of trigger warnings, stating they are not censorship but rather provide information for informed choices. He suggests a compromise for implementing warnings unobtrusively, and criticizes arguments against trigger warnings based on exposure therapy, emphasizing that therapy should not be forced on people without consent. The post has an ironic tone when discussing social justice and media criticism, but becomes more serious when addressing mental health considerations. Shorter summary