Board Certified Psychiatrist from Maryland practicing more than 20 years.  Working in private practice and community mental health.


39 thoughts on “About”

  1. Been reading your site (actually found my way here via Steveofcaley; bugged out when he reverted to his mother tongue which is all but unintelligible to me). So, just curious – what’s the answer, in your opinion? From reading your blog, I get the following impressions: Single Provider (as in NHS, aka “Socialized Medicine”) – bad; Single Payer ( as in universal Medicare, aka “Socialized Medicine”) – maybe bad; Obamare (as in more of the same, but with lots more government control, aka “Socialized Medicine,” but with lots of opportunities for corporate profit) – very, very bad. That being the case, what is recommended? The Invisible Hand of the Market? That seems about as exciting as a trip to Victorian England. I’m very curious to hear your thoughts on the subject (maybe I just need to read more). Cheers – Jack

    • Sorry for the delay in posting, have to say there really isn’t a good plan as saving everybody is not exactly what the planet had in mind when it allegedly allowed evolution to include Homo Sapiens.

      Natural Selection was nuked once the evolution of health care interventions allowed people to live to be 85 with some frequency never seen before.

      Cue the line from Colonel Blake to Hawkeye in M*A*S*H, “rule number 1, people die, and rule number 2, doctors can’t change rule #1”. Tell that to average Americans who unfortunately are not going to live further…

      Thanks for reading here, hope it is worth the while.

      Joel H

  2. David Newnes said:

    Hi what is your perspective on psychosis, schizophrenia and purported spiritual emergencies: I am really really really curious do you deal with patients claiming to have a “kundalini awakening” and if so what are the procedures, guidlines and protocols put in place for such patients with these claims and complaints that psychiatrists have to use (given that if certain psychiatrists want to take the subjectivity of the patient very seriously and honestly and recognizes each sign and symptom of the “awakening” as definitive evidence of such an awakening)?? Statistically how many patients each year have these specific experiences and seek help in psychiatry?? What is your personal view on this subject in regards to the patients you personally treat?? (unless you want to keep this private). If a patient was to walk into your office and complain they are having a full blown kundalini awakening, along with all the typical “signs and symptoms” that they report, and needed your help what do you say to them?? If all the evidence of the patient having this kundalini awakening is undeniably there do you decide that this patient is having a genuine spiritual numinous experience or do you reduce the signs and symptoms to a common biological cause that all patients having these so called awakenings must be experiencing?? It must be obvious that different psychiatrists have different views on this subject but I want to know yours.

    Thanks in advance :))

    • Sorry, never heard of Kundalini awakening, have no opinion about it. Psychosis is like Shortness Of Breath or Headache to me, it is a presentation and could be due to several possible primary causes, hence why a responsible psychiatrist would not label it anything more than Psychosis NOS at first and eliminate possible factors, be it Schizophrenia, or Mood Disorder, or acute Psychotic Break, or just a delirium from a medical or substance abuse cause.

      Good luck in your pursuits in defining this phenomena/disorder.

      Joel H

  3. Do you have an email adress you are willing to share? I cannot find your name listed. I came across your blog following links from a story in the Appelbaum report to DHMH And was curious about your CV, and was hoping to have a discussion about your perspective on certain commitments.

  4. Perhaps see the ever-irascible “Theodore Dalrymple” who wrote Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy..oh dear, he’s not very politically correct either, is he?

    • I missed the part where that was my problem, and I don’t write for opiates, as they are not psychiatric medication. But, thank you for noting the link option, and to readers, this person also commented at another post, “The fastest growing demographic in the addiction population ain’t junkies and boozers, folks”, who seems to be “sick of you (me, Joel H?)”.

      Two rules to the addiction population, at least, deny, and project. Let’s see how that legalization of pot goes in Colorado for a year or so, and get back to us how wonderful and without complications it is going.

      Still say Decriminalization is a fine first change in policy, but, extremists run these debates, and only the public loses in the end.

      Joel H

  5. I find your site interesting. Most likely because I have always been fascinated by the mind; it is something more complex than the entire universe but as close as us. My exposure to psychology and to meds has been minimal, although in the ‘80s I earned a B.S. in psych. followed by a semester of Master’s level counseling courses. However, since my interest was always more in research and less towards therapy, I dropped that pursuit and I ended up spending the next 11 years working as a pharmacy technician at a local hospital. You see a lot working the evening shift in a hospital.

    Yet, what I find most intriguing about your site is why you write it. Lately I have come across a number of articles and comments by medical professionals and I ponder the motivation.

    Is it looking for absolution [H. Steven Moffic], defensiveness [Ronald Pies], upset at the direction of the business [1BoringOldMan], irrational exuberance for meds [Leo Pozuelo], guano-crazy [Simon Wessely/E Fuller Torrey], bridge with other providers, bridge b/t patients and providers [Sandra Steingard], a passion for writing or all of the above? [Note that every mention in brackets is pure speculation on my part and some are tongue-in-cheek. It is not my intent to defame anyone.]

    So, if you don’t mind my asking why do you write, and why do write about your occupation? If you have already answered this here, my apologies; I am still reading through your most recent articles.

    • RB:

      Fair question you ask at the end, I think I have noted it in the past, somewhere, but, it is about educating, enlightening, advising from a distance, and for me uniquely an outlet for my enraging.

      Too much BS out there, in the profession, from too many patients these days, outside intrusions that have no business telling mental health providers what to do, and, this general quick fix mentality that just has to be put out to pasture. My advice to readers is pay attention to the tags I use, that usually directs what the point of each post is directed to.

      My weakness is my profound hate for PPACA, I know it will ruin health care, psychiatry most specifically, and I hate politicians intruding into medicine. It is wrong, they have no clue what the hell they are doing, and I truly think there is a sizeable element of antisocial/sociopathy growing in various elements of this country, and across the world, and the indifference, tolerance, and sheer rote approval is beyond appalling.

      So I hope to get back to more pure psychiatry posts this year, but, as long as we continue to read what is in PPACA/Obamacare, I may have to relapse and write about it. I get a lot of flack about saying Obama and politicians are antisocials, even if just traits, but, I’d rather say it and be proven wrong by the correct and well intended acts by our politicians, but, ain’t happening to now.

      Thanks again for reading and commenting, appreciate the interest and any inputs.

      Joel H

      • Your writing is cathartic then?

        You are not alone on your thoughts about healthcare. Over 15 years ago a couple of conversations with my Pharmacy Director showed me where we were headed. He talked for years of retiring, and once when I asked him why he wanted to retire so badly, he said because healthcare is becoming more like business every day. I didn’t really understand it as I was young and naïve. Now older, I realize whether business or gov’t, both are a bad influence, except that maybe gov’t is worse since it pretends it is helping people.

        In a more chilling encounter, I entered his office one day to ask him a question and before I said anything, he sort of stared at me, but past me like he was deep in thought and said “Always do what’s best for the patient.” In my head I am like, “Ok, I don’t know what conversation you just had but that is always a good point…and why would I do anything other than that?” Oh, I was so very naïve.

        Just know this, I appreciate what you are doing here and as long as you do what’s best for the patient (in the moral sense), you’re alright by me, doctor. I look forward to reading your thoughts on psychiatry and on PPACA.


      • Again, thanks for reading and commenting. It is about doing what is best for the patient. Sometimes “No” is a good thing, when it comes to requesting controlled substances without indication.

        Be safe, be well.

        Joel H

      • Ok, I don’t know what conversation you just had but “Sometimes ‘No’ is a good thing, when it comes to requesting controlled substances without indication” is always a good point…and why would I think anything other than that? Or in other words, I agree with you completely.

        No need to approve this comment, it was just for you. OT – Have you ever considered adding email to this blog?

      • My apologies if the reference to my last reply was vague or misdirected. I am in a place right now where most cannot say “No” in a therapeutic way, and it is frustrating with all the overmedicating I have had to assume from a prior provider.

        Not sure what you mean by adding email to the blog, I know some people “follow”, I don’t really do that with other sites, but if there is an email process separate from that, I keep the site simple, which it probably shows. So I hope readers will come by a couple of times a week to see what is new. I don’t usually post as often as I have these past 3 months, so, as I get back to normal frequency, I would read here every Wed and Sat/Sun, that is my normal routine.

        Thanks again for the interest.

        Joel H

      • No worries!

        I wasn’t exactly clear when I asked about email either. What I meant was an email contact form (with no personal email address connection), like here http://www.tomahaiku.com/contact-me/. It helps for one-off conversations. However, I won’t be offended if you don’t implement it; this is your sandbox, play in it whatever way you like.

        Thanks for the info on the posting schedule regardless. And, your site is fine. Simple carries a visual appeal and elegance all its own.

        Drive on.


  6. Wow!!!

    I have to tell you how eye opening this site was!!

    I have been overly prescribed benzos and sleeping pills for years…started with zopiclone (told I could take it every day for the rest of my life) later Ativan and now Clonazepam…was never told about the tolerance or withdrawal issues and am now struggling to get off.

    Crazy story for you from the realms of my own wacko psychiatrist…

    Told me today that benzos (specifically clonazepam in my case) are like using antibiotics for an infection…you have to keep using them/increasing them until the “infection” goes away.

    Crazy stuff.

    I think any pdoc that prescribe these beasts should have to try them out first!

    • Thanks for relating your experience. Yes, benzos are prescribed like pez by some docs, and it is frightening and irresponsible, in my opinion.

      Hope you are with a doctor now who is listening, not dictating.

      Be safe, be well.

      Joel H

  7. I am sure the plethora of out of balance and painful commentary is overwhelming. You may view the article here:


    The version I prepared for your site included a great many references (in APA form) as well. Ask and I will forward.

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