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June 16, 2019 by MARIA POPOVA |

The Healing Power of Gardens: Oliver Sacks on the Psychological and Physiological Consolations of Nature

“In forty years of medical practice, I have found only two types of non-pharmaceutical ‘therapy’ to be vitally important for patients with chronic neurological diseases: music and gardens.”

( – “I work like a gardener,” the great painter Joan Miró wrote in his meditation on the proper pace for creative work.

It is hardly a coincidence that Virginia Woolf had her electrifying epiphany about what it means to be an artist while walking amid the flower beds in the garden at St. Ives.

Indeed, to garden — even merely to be in a garden — is nothing less than a triumph of resistance against the merciless race of modern life, so compulsively focused on productivity at the cost of creativity, of lucidity, of sanity; a reminder that we are creatures enmeshed with the great web of being, in which, as the great naturalist John Muir observed long ago, “when we try to pick out anything by itself, we find it hitched to everything else in the universe”; a return to what is noblest, which means most natural, in us.

There is something deeply humanizing in listening to the rustle of a newly leaved tree, in watching a bumblebee romance a blossom, in kneeling onto the carpet of soil to make a hole for a sapling, gently moving a startled earthworm or two out of the way.

Walt Whitman knew this when he weighed what makes life worth living as he convalesced from a paralytic stroke: “After you have exhausted what there is in business, politics, conviviality, love, and so on — have found that none of these finally satisfy, or permanently wear — what remains? Nature remains; to bring out from their torpid recesses, the affinities of a man or woman with the open air, the trees, fields, the changes of seasons — the sun by day and the stars of heaven by night.”

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June 13, 2019 by Knvul Sheikh | The New York Times

How Much Nature Is Enough? 120 Minutes a Week, Doctors Say

Researchers have now quantified the ideal amount of time needed to reap the health benefits of the great outdoors.

(The New York Times) – It’s a medical fact: Spending time outdoors, especially in green spaces, is good for you.

A wealth of research indicates that escaping to a neighborhood park, hiking through the woods, or spending a weekend by the lake can lower a person’s stress levels, decrease blood pressure and reduce the risk asthma, allergies, diabetes and cardiovascular disease, while boosting mental health and increasing life expectancy. Doctors around the world have begun prescribing time in nature as a way of improving their patients’ health.

One question has remained: How long, or how frequently, should you experience the great outdoors in order to reap its great benefits? Is there a recommended dose? Just how much nature is enough?

According to a paper published Thursday in the journal Scientific Reports, the answer is about 120 minutes each week.

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June 13, 2019 by Rachel H. Tribe | BJPsych Open

Open dialogue in the UK: qualitative study

Rachel H. TribeAbigail M. FreemanSteven LivingstoneJoshua C. H. Stott and Stephen Pilling

Open dialogue is an integrative approach to the organisation of specialist mental health services and therapeutic meetings.

This qualitative study sought to explore service users’ and clinicians’ experiences of network meetings during the implementation of open dialogue in a modified version, for a UK-based mental health service.

In total 19 participants were interviewed (8 service users and 11 clinicians) and an inductive thematic analysis of the data was conducted.

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June 12, 2019 by Dr John Read |

Making Sense of Madness

What causes psychosis, and what can help? Psychotherapy, with its interest in life history and circumstance, and its emphasis on the transformative power of the therapeutic relationship, has more to offer in this area than we are often trained to think. Ahead of an upcoming conference on the origins and meaning of psychosis, Dr John Read, Professor of Clinical Psychology, explains why the psycho-social model must be hauled back into view

( – During the 15 years or so that I worked as a nursing assistant, clinical psychologist and manager of mental health services, I was always struck by the fact that even the seemingly weirdest of behaviours and experiences (‘psychotic symptoms’) made sense once I knew a bit about the person’s history and circumstances. And much of what I heard about the early lives of these people was none too pleasant. Of course the trick, the hard bit, was gaining the trust of people so that they felt like telling me about themselves in the first place. I had entered the field, nearly 50 years ago, full of Ronnie Laing’s ideas about the meaning of madness, and my experience proved to me, over and over again, that he was right.

I was also repeatedly struck by the lack of interest in history and circumstances from many of my colleagues, including most (but not all) psychiatrists. But they had entered the field with a psychiatry textbook and the DSM in their heads. And their inability to reach the person in front of them, to form a ‘therapeutic relationship’ – partly because all they did was ask about symptoms and drug them – proved to them that what they had read about ‘schizophrenia’ being a devastating and intractable illness was right.

When I eventually left mental health services to return to academia I was determined to research what so many ‘psychotic patients’ had taught me about the origin of their distress, despair and confusion. It is more than 20 years ago now that I published the first of many reviews of the literature on childhood adversities and psychosis. The pivotal one, however, was eight years later, which we managed to get some media coverage for. The Guardian wrote, ‘The psychiatric establishment is about to experience an earthquake that will shake its intellectual foundations’.

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June 10, 2019 by René Keet | BMCPsychiatry

Recovery for all in the community; position paper on principles and key elements of community-based mental health care

(BMC Psychiatry) – René Keet, Marjonneke de Vetten-Mc MahonLaura Shields-ZeemanTorleif RuudJaap van WeeghelMichiel BahlerCornelis L. MulderCatherine van ZelstBilly MurphyKoen WestenChris NasIonela Petrea and Guido Pieters


Service providers throughout Europe have identified the need to define how high-quality community-based mental health care looks to organize their own services and to inform governments, commissioners and funders. In 2016, representatives of mental health care service providers, networks, umbrella organizations and knowledge institutes in Europe came together to establish the European Community Mental Health Services Provider (EUCOMS) Network. This network developed a shared vision on the principles and key elements of community mental health care in different contexts. The result is a comprehensive consensus paper, of which this position paper is an outline.
With this paper the network wants to contribute to the discussion on how to improve structures in mental healthcare, and to narrow the gap between evidence, policy and practice in Europe.

Main text
The development of the consensus paper started with an expert workshop in April 2016. An assigned writing group representing the workshop participants built upon the outcomes of this meeting and developed the consensus paper with the input from 100 European counterparts through two additional work groups, and two structured feedback rounds via email.
High quality community-based mental health care: 1) protects human rights; 2) has a public health focus; 3) supports service users in their recovery journey; 4) makes use of effective interventions based on evidence and client goals; 5) promotes a wide network of support in the community and; 6) makes use of peer expertise in service design and delivery. Each principle is illustrated with good practices from European service providers that are members of the EUCOMS Network.

Discussion among EUCOMS network members resulted in a blueprint for a regional model of integrated mental health care based upon six principles.

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June 6, 2019 by Michael P. Hengartner | Acta Neuropsychiatrica

Scientific debate instead of beef; challenging misleading arguments about the efficacy of antidepressants

(Acta Neuropsychiatrica) – In a recent commentary with the polemic title ‘Antidepressnats; what’s the beef?’, Goodwin and Nutt argued that the benefit-risk ratio of antidepressants had been questioned inappropriately (Goodwin & Nutt, 2019). Personally I think it is a great achievement that our medical system can offer pharmacological treatments to people who suffer from serious clinical depression, and like Goodwin and Nutt I accept that antidepressants may be useful in some patients (Hengartner & Ploderl, 2018). Nevertheless, and this is where my position deviates from Goodwin and Nutt, I am also concerned about the overestimation of efficacy and the minimisation of harm (Hengartner, 2017). There are many misrepresentations in the commentary by Goodwin & Nutt, all of which systematically inflate the apparent benefits of antidepressants, and in this letter, I will discuss five of them.

Full article

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June 6, 2019 by Miranda Sawyer | The Guardian

Shane Meadows: ‘For many years I didn’t remember it… but it caused me a lifetime of anguish’

The director speaks for the first time about the horrific event from his childhood that inspired his new TV drama The Virtues

(The Guardian) – I’ve interviewed director Shane Meadows a few times now, and it’s always been fun. He’s an entertaining person to spend an hour with: enthusiastic, emotional, funny, a natural talker. Plus there’s lots to talk about, as his work is great. From his first features, Small Time (1996) and A Room For Romeo Brass (1999), through Dead Man’s Shoes, into 2006’s This Is England and the three TV spin-off series that came out of that (This Is England 8688 and 90), as well as his Stone Roses comeback documentary, Made of Stone, Meadows makes brilliant British films and telly. He calls himself “kitchen sink”, but he’s a rare combination of artist, storyteller and near-documentarian who often uses his life growing up in Uttoxeter in Staffordshire as inspiration. His methods – lengthy casting process, lots of rehearsals – mean that he helps actors, and people who have never acted before, to give authentic and award-winning performances. His work leaves me in bits.

So I’m looking forward to seeing him again. Except that this interview turns out to be far from fun. It goes very dark, very quickly. If I were a continuity announcer, I’d say something like: the following contains content that some people might find upsetting.

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June 5, 2019 by Ruth E. Cooper et al | Schizophrenia Research

Psychosocial interventions for people with schizophrenia or psychosis on minimal or no antipsychotic medication: A systematic review

Ruth E.Cooper, Neelam Laxhman, Nadia CrellinJoanna MoncrieffStefan Priebe


Antipsychotics are the first-line treatment for people with schizophrenia or psychosis. There is evidence that they can reduce the symptoms of psychosis and risk of relapse. However many people do not respond to these drugs, or experience adverse effects and stop taking them.

In the UK, clinical guidelines have stressed the need for research into psychosocial interventions without antipsychotics. This systematic review examines the effects of psychosocial interventions for people with schizophrenia or psychosis who are on no/minimal antipsychotics.

Databases were searched for empirical studies investigating a psychosocial intervention in people with a schizophrenia spectrum disorder who were not taking antipsychotics or had received an antipsychotic minimisation strategy.

We identified nine interventions tested in 17 studies (N = 2250), including eight randomised controlled trials. Outcomes were generally equal to or in a small number of cases better than the control group (antipsychotics/treatment as usual) for Cognitive Behavioural Therapy (CBT), Need Adapted Treatment and Soteria. The remaining interventions provided some encouraging, but overall inconsistent findings and were Psychosocial Outpatient Treatment, Open Dialogue, Psychosocial Inpatient Treatment, Psychoanalysis/Psychodynamic Psychotherapy, Major Role Therapy, and Milieu Treatment.

Study quality was generally low with little recent research. In conclusion, nine psychosocial interventions have been studied for patients on no/minimal antipsychotics. The majority of studies reported outcomes for the intervention which were the same as the control group, however, study quality was problematic. Given the adverse effects of antipsychotics and that many people do not want to take them, high quality trials of psychosocial treatments for people on minimal/no antipsychotics are needed.


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June 3, 2019 by Andrew Anthony | The Guardian

Stephen Porges: ‘Survivors are blamed because they don’t fight’

The psychiatry professor on the polyvagal theory he developed to understand our reactions to trauma

(The Guardian) – Stephen Porges is professor of psychiatry at the University of North Carolina and “Distinguished University Scientist” at Indiana University, where he has created the Traumatic Stress Research Consortium. He is best known for developing polyvagal theory, which describes how visceral experiences affect the nervous system and our resulting behaviour. On Monday 10 June, he will be giving a talk at Love vs Trauma, the Body & Soul charity’s day-long symposium in London, which aims to tackle issues surrounding childhood adversity and trauma. Other participants include Peter Fonagy and Lemn Sissay.

Can you explain polyvagal theory in layperson’s terms? 
Polyvagal theory articulates three different branches of the autonomic nervous system that evolved from very primitive vertebrates to mammals. And it’s quite interesting how the sequence evolved. First, you have a system that is really an ancient one, which is death feigning or immobilisation. Then it has a fight or flight system, a mobilisation system. Then finally, with mammals, you have what I call a social engagement system, which can detect features of safety and actually communicate them to another. When you trigger feelings of safety, the autonomic nervous system can help health restoration. In terms of dealing with a life threat, you most likely go into this feigning death, dissociative state.

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May 29, 2019 by Matt Shipman | NC State University

The Message That Addiction Is a Disease Makes Substance Users Less Likely to Seek Help

(NC State University News) – Research finds that people with substance-use problems who read a message describing addiction as a disease are less likely to report wanting to engage in effective therapies, compared to those who read a message that addiction behaviors are subject to change. The finding could inform future public and interpersonal communication efforts regarding addiction.

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