Category: Reading

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Medicine Policy Reading Systems

The Word is Not the Thing, And…

This past week I finished reading McCloud’s Understanding Comics: The Invisible Art.[1. I purchased Understanding Comics to learn a different perspective about storytelling. I am not a routine reader of comics. Regardless, I do recommend this book. It is a thoughtful and fun read, and it’s a comic book.] The second chapter, “The Vocabulary of Comics”, reiterates a major point in Hayakawa’s Language in Thought and Action:

The first of the principles governing symbols is this: The symbol is NOT the thing symbolized; the word is NOT the thing; the map is NOT the territory it stands for.

McCloud uses René Magritte’s “The Treachery of Images” to welcome the reader to “the strange and wonderful world of the icon”:

I’m using the word “icon” to mean any image used to represent a person, place, thing or idea.”

This idea that “the word (or icon) is not the thing” is relevant to a recent opinion piece, “Beware the Word Police“, in the academic journal Psychiatric Services:

Frequent calls for changing diagnostic labels to decrease stigma may result in unintended consequences. Condemning incorrect language by policing word choice oversimplifies the depth of work involved to increase opportunities for people with mental illness. This Open Forum reviews three unintended consequences of using scolding language.

The author of that opinion piece, Patrick Corrigan, lists these three unintended consequences:

  1. the word police’s focus on “just changing terms” misrepresents the depth and persistence of bias and bigotry
  2. word police are a major barrier to the essential goals of stigma change
  3. word police may undermine stigma change at the policy level

I’m One of Those People who avoids using the words “addict”, “schizophrenic”, or “diabetic”. I instead say “individual with a substance use disorder”, “person with a diagnosis of schizophrenia”, or “someone with diabetes”.

While I agree with all the authors above—words and icons aren’t the thing, they only represent the thing; the use of different words does not equate to actual reduction in discriminatory behaviors—I also believe that, as a society, The Royal We have come to agree that certain words have certain meanings.

For example, if I describe a person as a “diabetic”, what comes to mind? Perhaps you think of a family member who has diabetes and has excellent management of her blood sugars. Maybe you think of the person who goes to the emergency department multiple times a month due to high blood sugars and non-healing wounds. Or maybe you’re thinking about the growing number of people who struggle to pay for insulin to treat their diabetes. The range of ideas that come to mind with the word “diabetic” is broad.

But if I say someone is an “addict”, what comes to mind? Maybe you think of a senior vice president of a major business who wears tailored suits, but most people don’t. When I teach and ask audiences—comprised of health care professionals or otherwise—to list what comes to mind when I say “addict”, the list always includes things like

  • dirty
  • mean
  • desperate
  • selfish
  • etc.

(When the audience is comprised of health care professionals, I remind them that, right now, they are likely working with someone with a substance use disorder… and that person won’t disclose how much s/he is suffering because they feel shame about the presumed characteristics of “addicts”.)

It is true that the word “addict” is NOT the person with a substance use disorder. However, we, as a society, have somehow arrived at the agreement that the word “addict” describes someone who is dirty, has no self-control, etc.

Even though a different word doesn’t change the actual thing, the different word can change the idea about the thing. A different word can have a different definition, different associations.

Again, if I describe someone as “schizophrenic”, what characteristics comes to mind?

But what if that person with schizophrenia is your neighbor? works as a barber? works at Microsoft? is raising two kids? just earned her graduate degree? volunteers at the animal shelter? is the owner of that plot in the community garden that is overflowing with flowers and vegetables?

If different words can change the idea about the thing, then different words can help people change their behaviors about the thing.[2. To be clear, insight does not always result in behavior change. Even if the psychoanalysts argue otherwise.] In regards to the “word police” piece above, shifts in ideas and behaviors can drive improvements in health and social policy. This can lead to a reduction in stigma. The Royal We can develop new agreements for these different words. And using different words is sometimes easier than changing definitions for the same word (e.g., consider racial slurs).

Maybe I am falling into the “word police” camp. However, I do agree that behavior change is the ultimate goal, since what we do matters more than what we say. As with many things, the solution is somewhere in-between: Let’s work on word choice to help shift ideas and behaviors, but also remind ourselves that the word is not the thing.

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Reading

Interesting Reads.

Here are some things I’ve read recently that you may also find interesting:

1. When Going to Jail Means Giving Up The Meds That Saved Your Life. “Pesce worried that while he went through withdrawal from methadone in jail, someone would offer him drugs, and he wouldn’t be able to refuse. He turned to the courts for a solution: Pesce sued the Essex County sheriff on the grounds that his addiction was a disability and that denying him treatment was a violation of the Americans with Disabilities Act, as well as cruel and unusual punishment.”

2. Though I do not follow sports, I enjoy sports writing. Here is a pair of articles related to baseball and economics: Why Isn’t Anyone Bidding for Bryce Harper and Manny Machado? (“… and now owners are squeezing players on either end like so many papayas in a juicer”) and Baseball Doesn’t Need Collusion To Turn Off The Hot Stove.

3. I recently saw the play M. Butterfly (and was one of the few apparent Asians in the audience…) and wanted to learn more about the curious events that inspired this work: The True Story of M. Butterfly; The Spy Who Fell in Love With a Shadow. “… Bernard Boursicot, as he has always wanted to be, becomes a man of extraordinary distinction: the man who made love to another man for 18 years and did not know.”

4. I much prefer prose to poetry, though occasionally a poem will catch my attention. Here’s David Whyte’s Everything Is Waiting For You.

5. I only learned of Donella Meadows after her death. Here’s one of her columns where she discusses “What Makes a Great Leader?” One wonders what she would say about the current President.

6. The first book I finished reading in 2019 is Language in Thought and Action. This is one of the best books I have read in my life. Many of the ideas are familiar to me from my clinical training, but Mr. Hayakawa discusses the impacts of language and word choice from a non-clinical perspective that is more accessible. The first edition was published in 1941; it still has potent relevance today.

Categories
Consult-Liaison Education Medicine Observations Reading

Hoping for Hope for Psychosis.

The American Board of Psychiatry and Neurology (ABPN) is running a pilot project: Psychiatrists and neurologists can read a set of articles and answer mini-quizzes over the course of a year instead of taking a multiple-choice exam. If the physician answers enough questions correctly in either activity, then this supports the application for board recertification.[1. To be clear, I feel frustration with the American Board of Psychiatry and Neurology and their board recertification procedures. This “read articles and take mini-quizzes” is an encouraging improvement, but there are other aspects of board recertification that give me heartburn. This is why I am also a member of the National Board of Physicians and Surgeons.]

I am enrolled in the “read articles and take mini-quizzes” pilot. One of the mandated articles is “Improving outcomes of first-episode psychosis: an overview“. One of my professional interests is psychotic disorders (e.g., conditions wherein people report hearing voices and beliefs that do not appear rooted in reality). If you share that interest, you may find this article informative, too.

Note I said “informative”, not “encouraging”. Here are a selection of statements I found notable in the article:

Psychotic disorders such as schizophrenia are common, with 23.6 million prevalent cases worldwide in 2013. One in two people living with schizophrenia does not receive care for the condition. The recovery rates… and associated disability… following a first episode of psychosis have not improved over the past seventy years under routine clinical care. Although existing psychopharmacological treatments alone can reduce some symptoms, they have little impact on the outcome of the illness.

Oof. This is the first paragraph of the article! None of the statements surprise me, but when they are all put together like that… well, it makes me wonder: “When are we going to get better at this? When will we consistently help individuals with these conditions?”

At the moment, there are no approved [prevention interventions for individuals who are clinical high risk for psychosis] that have been shown to reliably alter the long-term course of the disorder.

Sigh. This speaks to population-level data. This means that we—the individual at high risk, the family and friends of this person, and any professionals involved at the time, if we happen to meet this person—grope around as we try to minimize the risk of illness. Maybe our efforts will work for This Person, but maybe they won’t for That Person. So we continue to work and hope.

The detrimental impact of illicit substance abuse on the long-term outcome of psychosis is well known, with a dose-dependent association.

Here in Washington State, we see a lot of people with psychotic symptoms who have used or are using methamphetamine. It ruins minds. I wish people would stop smoking/snorting/injecting it.

Marijuana is legal in this state and there is some evidence that cannabidiol (CBD), a compound found in marijuana, may reduce psychotic symptoms. Delta-9-tetrahydrocannabinol (THC), also found in marijuana, can induce psychotic symptoms. This is problematic. Companies sell CBD on the internet and I have concerns about how people will run with this preliminary data.

[There is a] lack of stringent evidence for a robust effect of antipsychotics on relapse prevention in the long term….

The article summarizes evidence that suggests that antipsychotic medications may simply delay the relapse of psychotic symptoms, rather than prevent them from reappearing.

One of my early jobs was working in a geriatric adult home. My work there taught me that people with psychotic disorders can and do get better. The burdens of antipsychotic medications—paying for medications, the actual act of swallowing the pills every day, the side effects, some mild, some intense—add up. I was fortunate to work with some people to successfully reduce the doses of their antipsychotic medications and, in some cases, stop them completely! (There were also at least one instance when tapering medications was absolutely the wrong thing to do; that person ended up in the hospital. I felt terrible.)

When I reflect on that time, there were no guidelines about this. These decisions to taper medications—always with ongoing discussion and with the individual’s consent—were just an effort to “first, do no harm”. Context matters: I used as much data—from the individual, family and caregivers, and the literature—as I could find before embarking on deprescribing. Was I naive and reckless? Maybe. Was I just lucky? Maybe? Was I doing the best that I could with the information I had? I think so.

Schizophrenia features are strong predictors of poor long-term outcomes… when communicating with patients, it may be preferable to use the broader term psychosis rather than schizophrenia….

As far as I know, schizophrenia is the only psychiatric diagnosis that includes the criterion “Level of functioning… is markedly below the level achieved prior to the onset“. Even the neurocognitive disorders (dementias) don’t explicitly comment on a decline of “level of functioning”.

One wonders if the long-term outcomes in schizophrenia might be even just a little bit better if those of us who give the diagnosis of schizophrenia believed that people with this condition could get better. Do we, as a group, give this diagnosis out of resignation? And what message does that send to individuals experiencing these symptoms?

And what about that recommendation that we don’t discuss “schizophrenia” with individuals with psychotic symptoms? Indeed, for individuals presenting with “first episode psychosis”, this counsel is prudent. People with psychosis do get better. But, again, do we avoid using the term “schizophrenia” because of the connotations associated with that word? “… we don’t think you will ever get better.”

Maybe this is a circular argument: The reason why a decline in function is part of the definition of schizophrenia is because there is a decline in function in people diagnosed with schizophrenia.

But what about the people who meet all criteria for schizophrenia who get better?

The people who discern the pathophysiology of schizophrenia shall win the Noble Prize, for they will have figured out how the brain works. And perhaps, by that time, the articles about psychosis will give us all hope.

Categories
Policy Reading Systems

About that APA Statement on “Toxic Masculinity”…

Several people asked me about the American Psychological Association’s (APA) statement about “toxic masculinity”. You can find the statement, which is actually a practice guideline, here.

I read the entire guideline. My reactions and opinions follow:

1. The title of the practice guideline is not “Toxic Masculinity”. The title is “APA Guidelines
for Psychological Practice with Boys and Men”. The word “toxic”, let alone the phrase “toxic masculinity”, does not appear anywhere in the document.

2. This APA practice guideline, like other clinical practice guideline, is a “statement[s] that suggest or recommend specific professional behavior, endeavor, or conduct for psychologists”. Psychologists are the intended audience. On page one of the document, it states:

These guidelines serve to (a) improve service delivery among populations, (b) stimulate public policy initiatives, and (c) provide professional guidance based on advances in the field. Accordingly, the present document offers guidelines for psychological practice with boys and men.

3. The introduction to the document includes a section of definitions. Language is how we communicate with each other, but, wow, can words get in the way. I suspect some readers had strong reactions to the definitions (and, perhaps, to the legitimacy of some of the words defined). And if those readers do not agree with the definitions (or question the validity of the words themselves), then the rest of the document will seem like a pile of poo.

My guess is that the phrase “traditional masculinity ideology”, tucked into the “masculine ideology” section, and the accompanying definition made some people clutch their pearls. I myself did not react one way or another to the phrase “traditional masculinity ideology”, which the APA defines as

anti-femininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence.

This phrase has apparently been in use since 2007. This definition gets more attention later in the document, which may have caused the strands holding the pearls to rip, thus sending hundreds of pearls clattering to the floor.

So many words. So many opportunities to develop heartburn over words.

4. The practice guideline includes ten specific guidelines. Here they are:

Psychologists…

  1. strive to recognize that masculinities are constructed based on social, cultural, and contextual norms.
  2. strive to recognize that boys and men integrate multiple aspects to their social identities across the lifespan.
  3. understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others.
  4. strive to develop a comprehensive understanding of the factors that influence the interpersonal relationships of boys and men.
  5. strive to encourage positive father involvement and healthy family relationships.
  6. strive to support educational efforts that are responsive to the needs of boys and men.
  7. strive to reduce the high rates of problems boys and men face and act out in their lives such as aggression, violence, substance abuse, and suicide.
  8. strive to help boys and men engage in health-related behaviors.
  9. strive to build and promote gender-sensitive psychological services.
  10. understand and strive to change institutional, cultural, and systemic problems that affect boys and men through advocacy, prevention, and education.

Lots of striving happening here.

While I can understand why some people might hurl spittle at their electronic screens at a few of these guidelines, most of them are reasonable and want to improve the well-being of boys and men. Don’t we want boys and men to successfully integrate various aspects of their identities? Who objects to helping men become better fathers? Why would anyone get upset about reducing the problems that boys and men are more likely to encounter in both behaviors and health?

4. I took the most notes for the first three guidelines:

Guideline 1: Psychologists strive to recognize that masculinities are constructed based on social, cultural, and contextual norms.

And this is where the pearls spilled all over the floor.

Recall that the APA’s definition of “traditional masculinity ideology” refers to “anti-femininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence”. In this section, APA asserts that this ideology “can be viewed as the dominant… form of masculinity” that “strongly influences what” people in a culture assume is normal.

APA goes on to assert that this “dominant masculinity” has historically excluded men “who were not White, heterosexual, cisgender, able-bodied, and privileged”.

So many words in there that induce emotional reactions, right?

I argue, however, that this definition is fair. Let’s go through a thought experiment together:

In the United States, the image of a cowboy easily comes to mind upon hearing the word “masculine”. Picture a cowboy in your mind’s eye, if you will:

  • What color is his skin? Does he look like this or this?
  • When he is riding off into the sunset, who does he want to make sweet love to? Why was Brokeback Mountain so scandalous?
  • Did you even consider that your cowboy could be a trans man?
  • Does your cowboy wear glasses? hearing aids? a prosthetic limb?
  • And does your cowboy push the saloon doors open with bravado? Or does he brush off all the dust from his face and clothes, ensure that he has proper identification on him, and knock on the wall of the saloon?

APA never states that this definition of “dominant masculinity” is “toxic”. Instead, APA asserts that the “ideal, dominant masculinity is generally unattainable for most men”. As a consequence, men “who depart from this narrow masculine conception by any dimension of diversity… may find themselves negotiating between adopting dominant ideals that exclude them or being stereotyped or marginalized”.

Because it’s too hard to reach that ideal, “men not meeting dominant expectations often create their own communities”.

APA then recommends that psychologists work with individuals in their care to “become aware of how masculinity is defined in the context of their life circumstances”. More importantly, APA advises that “psychologists strive to understand their own assumptions of, and countertransference reactions toward, boys, men, and masculinity”. Because if I think Mr. Doe should be like a cowboy and refrain from crying after the death of his child, Mr. Doe is going to pick up on that, even if he wants to weep. And, thus, I’m a jerk and I’m not helping him.

Guideline 2: Psychologists strive to recognize that boys and men integrate multiple aspects to their social identities across the lifespan.

This guideline delves more into the intersection of things like race, age, sexual orientation, etc. and being a boy or man. And these intersections aren’t limited to these “social justice warrior” flavors: A man who has served in the military has a social identity that many others lack. Military service is its own culture and affects how men interpret and define masculinity.

As such, APA recommends that psychologists “working with boys and men strive to become educated about the history and cultural practices of diverse identities” and

[w]hile attempting to understand, respect, and affirm how masculinity is defined in different cultures, psychologists also try to avoid within-group stereotyping of individuals by helping them to distinguish what they believe to be desirable and undesirable masculine traits and to understand the reasons upon which they base these beliefs”.

This recommendation is easiest to understand through a lens of race or ethnicity (e.g., a black man or a refugee from Somalia), though has other applications.

Guideline 3: Psychologists understand the impact of power, privilege, and sexism on the development of boys and men and on their relationships with others.

More words that have the power to launch spittle across the screen.

My overall read of this guideline suggests that the ostensible privilege that boys and men have can also trap them. If boys and men are trying to fit into a masculine ideal that is unattainable, and that masculine ideal includes behaving in ways that are intended to restrict resources and power from others, that pursuit impairs their abilities to have effective and meaningful relationships with human beings. This leads to suffering for all involved. This ties into Guideline 4:

Psychologists strive to develop a comprehensive understanding of the factors that influence the interpersonal relationships of boys and men.

The recommendation is that psychologists

can discuss with boys and men the messages they have received about withholding affection from other males to help them understand how components of traditional masculinity such as emotional stoicism, homophobia, not showing vulnerability, self-reliance, and competitiveness might deter them from forming close relationships with male peers.

For me, the punchline of the practice guideline is actually tucked in the section that defines “masculine ideology”. The last sentence in that section is:

acknowledging the plurality of and social constructionist perspective of masculinity, the term masculinities is being used with increasing frequency. (emphasis mine)

If there are multiple definitions of “masculinity”, and knowing that those definitions can change over time, even within the same person, then we can use those changing definitions to help improve the psychological and physical health of boys and men.

Do I think the moral fiber of our nation will disintegrate if a boy or man chooses to wear nail polish? No.

Do I want boys and men to stop trying to achieve things? No.

Do I want them to avoid risks and adventure? No. (Do I want them to avoid stupid risks and pursue noble adventures to make great achievements? Yes.)

Do I want boys and men to engage in less violence? Yes, because I want everyone to engage in less violence. I value cooperation over conflict… and that’s the only way we’re going to survive as a species.

Do I think men should feel comfortable crying in public when they feel heartbroken? Given what some (many?) of them have experienced, yes. I want them to know we don’t think less of them when they need help… because we all do.

The “anti-femininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence” of “traditional masculine ideology” is not “toxic” or evil. There were assumptions behind that definition and it’s outstanding that we can now challenge those assumptions. It means that we’re growing and learning, and don’t we want people and societies to change for the better as time passes?

Categories
Education Nonfiction Reading

Books I Read in 2018.

I know this post is late (i.e., “These are the things I did in 2018” posts usually appear in December), but perhaps some of the books I read in 2018 will make it onto your reading list for 2019.

Radical Dharma: Talking Race, Love, and Liberation. I didn’t know what to expect when I picked up this book. Because the authors are people of color, they bring a different perspective to Buddhist thought and practice. In some ways, this was a refreshing change from much of published the Buddhist literature (i.e., written by white authors, or written by Asian authors who seem to have a white audience in mind). The authors also share personal anecdotes about their journey in Buddhism that may resonate with readers of color.

The Nonviolence Handbook: A Guide for Practical Action. This was the most compelling book I read in 2018. This slim book offers both concrete suggestions about how to practice nonviolence in daily living and how individuals (often Gandhi) applied nonviolence principles in history. I found this book inspiring, challenging, and meaningful. It also reminded me that I should not take cooperation for granted.

On Tyranny: Twenty Lessons from the Twentieth Century. This book is definitely a “handbook”: It is small and to the point. The table of contents alone provide useful guidance on what we all can do every single day to support our democratic society. I appreciated that the book does not rely on fear alone; it empowers the reader to take action in the face of uncertainty.

Dreams from My Father: A Story of Race and Inheritance. This book pairs well with the next book (Hillbilly Elegy). Obama’s writing reveals a thoughtful and idealistic perspective. He wrote this years before he served as President and I found myself recognizing elements of his character as President in this book. It is a story of a man trying to learn about himself and his beliefs in a world that passes judgment on him because of his heritage and skin color. It also highlights the importance of his relationship with his mother.

Hillbilly Elegy: A Memoir of a Family and Culture in Crisis. I read this after Dreams from My Father and, in many ways, I felt like I was reading the same tale with different details. Vance also tells the story of his efforts to learn about himself and his beliefs in a world that passes judgment on him because of where he was born and raised. Vance, too, highlights the importance of his relationship with his grandmother. Because Vance and Obama have different political ideologies, these two books show how, despite our beliefs, we share more in common than we allow ourselves to believe.

Silence: The Mystery of Wholeness. I picked up this book with hopes of learning more about how to find or create silence in a world that seems full of sonic garbage. This was the most “woo woo” book I read all year. I often wrote question marks in the margins. I intend to re-read this book at some point; I may always find it esoteric. I found the ideas of different silences (e.g., the silence within our hearts versus the “big” silence of the universe; how silence is always with us) useful for my own application.

The Girl on the Train. I rarely read fiction, so this was a treat. I picked this up on a public bookshelf for airplane reading. The story was engrossing, though I couldn’t help but think about the lack of coping skills the characters demonstrated. I also discerned the identity of the villain early on, so the “twist” not surprise me. The book nonetheless makes for fine brain candy.

Falling Leaves: The Memoir of an Unwanted Chinese Daughter. This book was also a selection for airplane reading. The intercultural issues of the memoir are familiar to me and the storytelling is satisfactory. This memoir seemed to lack the depth of self-reflection as seen in the Obama and Vance memoirs. I wanted to learn more about how she grew and understood herself as an individual as a result of her experiences with her stepmother.

Silence: The Power of Quiet in a World Full of Noise. This was yet another effort to apply more silence in my life. This text is similar to other works by Thich Nhat Hanh, though does comment more on cultivating silence within (which, in some ways, paired nicely with the Sardello book above on silence). Did I learn anything new? No. Did it nonetheless bring me comfort? Yes. This book was another reminder to me that we often have to generate our own silence, particularly when there is a lot of noise “outside” that we cannot control.

Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. I read this in anticipation of a talk from the author, Laura van Dernoot Lipsky. Many of the examples in her book come from her previous clinical work in Seattle, so the book felt particularly familiar. The book offers validation to all of us who work in clinical settings. I was hoping for more commentary on how we can adjust or shift systems to better support people who work in human services; the book focuses chiefly on what the individual can do. I also hoped that the book would offer a more evidence-based framework for these individual interventions, though also appreciate that there are spiritual aspects of trauma work that are difficult to measure. Laura is a compelling and energetic speaker. You can watch her TED talk.

Extreme Government Makeover: Increasing Our Capacity to Do More Good. I received this book from a colleague, who received it from the author for free! (My colleague and I both work in local government and when she asked him if he could provide the books at a discount for the staff, he sent a stack of books to us at no charge.) The major premise of the book is the reduction of waste: Reducing the amount of time between tasks (much of which is waiting, with no action happening); eliminating bottlenecks (e.g., where only one person is the “decider”); and minimizing processes that only serve to prevent lawsuits. I suspect that selection bias is at play, though: The people who choose to read this book are probably already aware of how to make things more efficient.

Here are all the books I started in 2018, but did not finish:

A People’s History of the United States. I’m actually over halfway through this book. I found myself getting angry while reading it, though, given the current context of the federal administration in the United States. Some of the events described in the book were similar to the ideas coming out of the current White House. I like reading and don’t need to experience more anger than necessary. I do want to finish this book, just not now.

The Making of Asian America: A History. I found myself getting angry while reading this one, too, so I put this one down. I like that the author discusses the experiences and events of different Asian groups, as, indeed, Asians are not all the same. I will get back to this one, too.

The Art of Memoir. I want to write a book, and that book is a memoir. Writing is already difficult, but the writing for this memoir presents particular challenges. I hope to learn from the mistakes and experiences of others. However, reading about memoir writing takes time away from actual memoir writing. Sometimes we fool ourselves into thinking we need to learn from others when, in fact, we just need to do the work.

The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are. I had never read a book by Brene Brown, though I enjoyed listening to Krista Tippett interview her on the podcast On Being. The book is like a personal cheerleader, which is fine, though that’s not what I needed or wanted.

Good Prose: The Art of Nonfiction. I enjoy reading good sentences. I continue to strive to craft clear, meaningful sentences because I want to write stellar stories. As I noted above, though, sometimes we just need to do the work.

Chinese Culture and Mental Health. While Western psychiatry is getting better at acknowledging the role of culture in the manifestation of thoughts, emotions, and behaviors, it still ain’t great. This book is an academic textbook, so while it is informative, it isn’t the most exciting reading. I will finish this one, too, though it may take a while.

How to Measure Anything: Finding the Value of Intangibles in Business. I picked this up primarily to help me think about my clinical and administrative work in a different way. I have already learned interesting perspectives about measuring seemingly immeasurable things in the first quarter of the book. This book requires a level of concentration that I often did not have by the end of the day. This is a book I want to finish, but it will take time.

If you want to share with me what books have changed your life for the better or made you think about the world in a different way, let me know (e-mail, Twitter, Facebook).