What state do you practice in?

Every night when I get ready for bed, I say my prayers and one of them is to express three things I am grateful for that happened to me that day. One thing I am always grateful for is that I live and practice Psychiatric Social Work in New York State, one of the states with the best social policies in the nation in supporting a high quality of life.

I have often thought about what it is like to practice in a state with repressive and regressive social policies? I wonder, being more blessed than others, how I can help my colleagues? 

As you probably are already aware, the social indicators of quality of life are quite different between the red and the blue states. I don’t intend this comment to be political but sociological. I often wonder what it would be like to practice in a red state where social policies are often out of line with Social Work values and human rights?

What state do you practice in and how does it make a difference?

What techniques do you use?

I had a potential client call yesterday, Friday, 08/07/26, to ask “Are you taking new patients?”

I said, “Yes, I am, What are you looking for?”

He said, “I have a lot of stuff I want to talk about with somebody?”

I said, “Have you been in therapy before?”

He said, “Oh yeah, 5 or 6 times since I was a teenager.”

I said, “What was that like for you? What did you find helpful and not helpful?”

He said, “My last therapist was very sweet and kind and she was really into CBT and she kept asking me about my symptoms and then giving me a lecture and worksheets. I need more than that, What kind of therapy do you do? What kind of techniques do you use?”

I said, “I am not a technique guy. I listen to people’s stories about their situation and what they want to change and happen positively in their life and then we go from there.”

He said, “That sounds great. Can we set up an appointment?”

We did. I’ll be meeting with him on Monday.

We now have two adulthoods in 2026.

 

In 1900 the life expectancy in the US was 49. In 2026 life expectancy is about 80. We have almost doubled about adult life expectancy.

I share with my clients the idea that we now get two adulthoods: the first being 20-50 and the second being 50-80. The first adulthood we are hormonally programed by Mother Nature to mate and procreate to fulfill our evolutionary, biological obligations to our species, and then the second adulthood we are left in existential conternation about what do to with our second adulthood.

This transition from the first to the second adulthood has sometimes be called a "midlife crisis" and/or the "empty nest syndrome."

Extending the human life expectancy has been biologically very successful, but psychologically and socially brings challenges.

Should community based psychiatric services be publicly funded?

Should community based psychiatric services be publicly funded?

08/07/26

Should mental health services be publicly funded as they have historically been with the old State Hospital System? In the 60s deinstitutionalization of services for people with psychiatric disorders occurred moving the required services to Community Mental Health Centers.

States promised that the money saved from closing their psychiatric hospitals would be reinvested in community based services and then reneged on their promise and used the saved money for other purposes. The costs of psychiatric services were shifted to health insurance.

Health insurance, though, said they would only reimburse for services that were “medically necessary.” Health insurance would not pay for what came to be called “wrap around services,: which many people with psychiatric disabilities need. Case management services were not “medically necessary” and so people with psychiatric problems were left to navigate an increasingly complex service system on their own and there was a rise in the criminalization of people’s behavior and homelessness.

A return to State Hospitals is not the answer, but state legislators keeping their original promise to fund community based services not covered by health insurance is.

Authoritarian parenting contributes to the development of lying and cheating in children.

Authoritarian parenting is a major factor in contributing to children lying and cheating. The lying and cheating is a coping mechanism to deal with shame, low self esteem, and sense of failure.

It is my observation in my professional and personal life that this coping mechanism extends into adulthood and can become quite dysfunctional interfering with the development of healthy interpersonal relationships. 

Lying and cheating undermine trust, credibility, and reliability.

It can take years to overcome this habitual response to dealing with situations in which there is a fear of disappointment and punishment from others from telling the truth and acting fairly.

I had a client who told me she had found and bought a book titled, The Courage To Be Disliked. Besides lying and cheating the fear of dissappointing and being punished by others for not living up to the external expectations is a major contributor to symtoms of anxiety, depression, and in the extreme homicidal and suicidal ideas. To overcome lying and cheating it does take courage to stand up for oneself and be honest.

There are many ways to change these habitual behavor patterns and perhaps one of the best is psychotherapy with a trusted nonjudgmental psychotherapist

For more click here.

Discussion book of the month, A World Appears by Michael Pollan

This month, August 2026,  the Allnonfiction book dsicussion group is discussing Michael Pollan’s book, A World Appears

You can join the Allnonfiction book discussion group by going here.

Talk therapy provides enduring relief from depression years after treatment, study finds

From PsyPost on 07/19/26

Talk therapy provides lasting relief from depression, with the benefits persisting for several years after treatment ends. A new, large meta-analysis evaluating tens of thousands of patients tracked these mental health improvements over time, mapping exactly how long people feel better. The research was published in the journal World Psychiatry.

For more click here.

A few note worthy points:

1. Talk therapy may be more helpful than medication.
2. Talk therapy benefits are long lasting over several years.
3. In general, maximum benefit is achieved at about 3 months.
4. "Talk therapy" is professionally referred to as "psychotherapy" and colloquially as "counseling."]
5. "Psychotherapy" is much different than simple conversation because the therapist knows the most helpful questions to ask to explore areas that will be most helpful to the client and is ethically bound to put the client's needs ahead of their own.