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Therapist in the Wry

Therapist in tne Wry

A delightful peek into the mental health underworld! Michael Szilagyi mixes dark humor with an endearing compassion for humanity in his breakout publication. A must-read for clinicians, students, and anyone seeking to understand the inner workings of the mental health field. — Dr. Jennifer M. Durham, D. Min., LPCC-S, CTT, CTS

While psychotherapy is not recognized as a particularly amusing career choice, Therapist in the Wry delivers a hilarious blow-by-blow account of daily life as a counselor in a community mental health facility in Middle America.

After surviving his colorful half-Hungarian family and facing personal tragedies, gross injustices and many minor mishaps, Michael Szilagyi discovered he suffered from attention deficit disorder and other assorted ailments. But his most serious life-long affliction is dark humor syndrome, activated by almost any therapeutic incident, family occasion or domestic ordeal.

Pigeonholed as an underachiever through his school years, he proceeded to ace college and qualify as a licensed clinical counselor. Not being entirely normal himself, he had an intuitive feel for what his clients must be experiencing. From behind his nom de plume Szilagyi takes a fond swipe at everything – vacuous team leaders, incompetent administrators, eccentric co-workers, exotic family members, even his pet cats. The people he identifies most readily with are usually his patients – the isolated and lonely, the weird and the lovable, sometimes the violent and felonious.

By turns deadly serious and gently mocking, at times totally outraged, often laughing uncontrollably, the author brings home the absurd reality of working on the front line of America’s crisis-ridden mental health system.

Reviews

Anyone who has worked in non-profit mental health will love this book. The descriptions are vivid and at times wrenching. Szilagyi’s words paint images that I, as a therapist, have seen over and over. Those who have worked with the downtrodden or hope-lacking will find affirmation and hope throughout these pages. The end point – at which one arrives via light humor, gallows humor, Szilagyi’s vulnerability, and notes on the history of a profession – is a poignant reminder that all helpers are there to help those who come seeking help and that such connections are sacred and meaning-making for all involved. —Yvette R. Tolbert, MFA, MA, PCC-S, ATR-BC, NCC

As a mental health professional, I found reading Therapist in the Wry thoroughly affirming. Szilagyi’s writing communicates the experience of honoring those we serve while working in a challenging mental health system. Humor lightens the read as Szilagyi relays his own family stories, historical pieces of the profession, and aspects of this career choice, including education, research and funding concerns. His humanity is present as he describes the suffering and joy his clients experience in their healing process. I recommend this book for therapists, interns and anyone interested in the mental health field. It is both a realistic and hopeful read. — Heidi Larew, PCC-S, LICDC-CS, ACS, NCC, ATCS

Szilagy’s sardonic portrayal of a flailing community mental health agency is sure to ring true for those who have ever been on the payroll of non-profit organizations. Szilagy uses a pleasant mix of dark humor and insightful observations in an attempt to make sense of the absurdities that are part of his everyday life as a counselor. But through all of the frustrations and downright scary stories, Szilagy is able to bring to light the real reason anyone would choose to work in the mental health field – and that this is a belief that we can be a positive influence on people who need it the most. — Michelle Culley, LPC

‘Happy pills’ from Denmark

cartoonThis cartoon was posted on Facebook by the Silje Benedikte Foundation, named for a young Norwegian woman who took her own life at 20 after two years of treatment with 20 different psychotropic drugs. The joke seems to be that, since a big debate is finally raging in neighboring Denmark over their health system’s misuse and overuse of psychotropic medications, there’s now a surplus available for export! We see a Norwegian dad emptying a mega-jar of antidepressants down his kid’s throat, saying, “Just got these in from Denmark earlier today.”

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Psychiatry Gone Astray

Here’s an English translation of “Psychiatry Gone Astray,” an op-ed piece by Prof. Peter Gøtzsche in the Copenhagen daily Politiken that has caused quite a stir in Denmark. His book, Deadly Medicines and Organised Crime: How Big Pharma has Corrupted Healthcare, came out last year. The article is posted on the website of Dr. David Healy, a professor of Psychiatry in Wales and an internationally respected psychiatrist and psychopharmacologist. His book Pharmageddon tells how pharmaceutical companies have hijacked healthcare in America – with life-threatening results.

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Death in Psychiatry – Dorrit Cato, author of “Dear Luise”

“For the first time ever the Danish mental health system has been found guilty of causing the death of one of its patients,’ writes Dorrit Cato Christensen, author of Dear Luise. “This is important news. One hopes that far more psychiatric healthcare providers will be found guilty of causing death with their dangerous treatment. The psychiatric ward where this patient was treated I know very well. My daughter Luise died there from overmedication.

“After the verdict the Clinic Manager claimed that they have learned from the sad story so treatment will be safer, with less medication. I don’t believe them at all,” says Dorrit. “They said exactly the same eight years ago when my beloved Luise died in their care. In our organization Death in Psychiatric Care we see how bad psychiatric treatment really is. People contact us constantly to tell us how a beloved relative who sought psychiatric help suddenly ends up as a dangerously ill zombie. Many report that a relative has died from overmedication.”

Translation of a January 9, 2014 article in Politiken, a leading Copenhagen-based daily newspaper, covering the ruling on Adel’s suicide:

Gross medical negligence led to suicide

Psychiatric Hospital in Amager harshly criticized for overmedicating 26-year-old man. Clinical Manager claims that incidents involving medicine in large doses have led to ‘cultural change’ in psychiatric treatment.

Overmedicinering

MANIC DEPRESSIVE. His brother says psychotropic drugs changed Adel from a vigorous 26-year-old to looking like “a 90-year-old patient in a hospice.” – Photo: PRIVATE PHOTO

By HANS DRACHMANN

A 26 -year-old psychiatric patient who committed suicide by throwing himself in front of a subway train in June 2011 had been so heavily medicated at the Psychiatric Center in Amager that the side effects were ‘unbearable.’

After two years of deliberations, the Patient Safety Commission has severely criticized the psychiatric hospital for providing treatment to the patient, Adel Saidane, which ‘did not meet generally accepted professional standards.’

Upheld all complaints

‘My older brother suffered so many side effects that were so unbearable that any human being might commit suicide in that situation.’ said the patient’s brother, Hafed Amin Saidane , who brought the case before the Patient Safety Commission.

The report criticized the Psychiatric Center on five specific points. The 26-year-old was overdosed with medication. The doctors did not given any reason for the high doses, as they should have. They failed to take proper care of the patient and were not sufficiently focused on side effects. The hospital ward should have provided Adel Saidane with an individual caretaker so he could not leave the center unaccompanied.

‘All our complaints have been upheld. We were in no doubt that he committed suicide because of the medication’s side effects,’ says Hafed Saidane.

His brother was bipolar but had not been hospitalized for two and a half years. Then in May 2011 he felt distressed and checked himself into the hospital. Over the next four weeks he was treated with several antipsychotics combined with sedatives in amounts that, in his brother’s words, changed him from a vigorous 26-year-old to looking like ‘a 90-year-old patient in a hospice.’

The case has consequences

At Copenhagen Metro Mental Health Services they’re deeply apologetic over the incident. ‘I take this very personally. We are so sorry and my heart goes out to the relatives. It’s a terrible thing and I feel awful about it,’ says Inger Merete Terp, Clinical Manager at Amager Psychiatric Center.

The case is an example of the wide-ranging practice of overmedicating psychiatric patients, which was prevalent in the Copenhagen area until mid-2012, when Politiken began covering the situation.

Overmedication, among other things, led to the dismissal of a Clinical Manager in Glostrup and a reprimand to a deputy director of Copenhagen Metro Mental Health, prompting the adoption of an action plan mandating close monitoring of medication to prevent overdoses.

Subsequently the proportion of patients treated with heavy doses of the antipsychotic Zyprexa was reduced from almost 25 percent to about 5 percent.

‘I think we’ve got a good grip on it and we’ve now ensured that action can be taken on the same day if any mental health center starts prescribing excessive doses,’ says Svend Hartling , vice president of Metro Mental Health.

He describes the Amager incident as ‘highly irregular’ and will now ask the executive board of Metro Mental Health whether enough has been done to prevent this from happening again.

Paradigm shift

The Patient Safety Commission’s report is also being sent to the National Board of Health and to chief medical officers in Copenhagen, who will address the issues at a meeting next week.

‘We are discussing whether there should be consequences, so other patients are not put at risk,’ said National Health Board oversight manager Anne Mette Dons. She is generally satisfied that the Metro region has taken effective action against overmedication. ‘There really a has been a paradigm shift.’

Clinic Manager Inger Merete Terp says that the overmedication case has resulted in a ‘culture change.’

‘We need to focus not only on medication but also on patients’ daily lives. We must look at patients’ daily life, see that they can wash dishes or take a walk and do things that contribute to quality of life,’ she says.

The Commission’s ruling will now be taken up with doctors at Amager Psychiatric Center and with other mental health center managers in the Metro Area.

Death in Psychiatry – Dorrit Cato, author of “Dear Luise”

AsEverWas

As Ever Was

When the counterculture was busy being born in Los Angeles and San Francisco in the mid-1960s, Hammond Guthrie found himself in the midst of hipster heaven, somewhere between late Beat and early Hippie. A budding painter and writer, he quickly made friends with many of the musicians, poets, performance artists and street people who were blazing trails into new lifestyles.

Realizing that life was meant to be a total trip, a non-stop adventure, he left the West Coast with his wife for England and immersed himself in the alternative scene in London – the world of International Times, the UFO Club, Arts Lab, inner-city squats – with a writing gig at Time Out magazine.

Moving on to Amsterdam, he befriended Provos and free-living bohemians, while building a promising career in the art world – the Stedelijk Museum even bought his paintings for their collection. But in the early 1970s the trip took a surreal turn. His wife started taking free love far too literally, and her amorous escapade with a drug dealer entangled them both in a nerve-racking intrigue in the twilight zone of Tangier. Hammond’s Moroccan mission was to spring five Americans, including his wife’s lover, from 60-year prison sentences for wholesale hashish smuggling.

Here he tells it all in his playful style, with a keen eye for absurd detail and an unflagging sense of humor. Among the hundreds of famous and not-so-famous personalities he encountered along the way were the Buffalo Springfield, Del Close, Max Crosley, Richie Havens, Nico, Carmen McCrea, Allen Ginsberg, John “Hoppy” Hopkins, William Burroughs, Simon Vinkenoog, Kenneth Alsop, Pete Townshend, and Emmet Grogan.

Reviews

AsEverWas, along with Ed Sanders’ Tales of Beatnik Glory are the two most important tomes I’ve seen recounting those decades of the twentieth century. — Larry Sawyer, Editor, Milk Magazine

Hammond takes you places you want to linger and others that cause you to shudder with fears you might not know you had. It was the sixties, but you haven’t read this story before. — Comment on Amazon.com from a reader in Sioux Falls, South Dakota

Hammond’s book may be one of the quintessential freak histories. — Michael Simmons, LA Weekly columnist

It brought back memories I’ve never had! — Gary Fulkerson, singer/songwriter

I laughed, I cried. It’s a marvelous book written in intriguing conversational style, bringing back wonderful memories from a wonderful time. — Herbert Gold, novelist and journalist

AsEverWas captures the story of countless others who lived on the fringes during an era when the country was at an important crossroads. Anyone who was alive during these turbulent times and who gives a damn about just how we got here should read this book — John Aiello, poet and journalist

Helps you see, feel and understand the moods, people and places that shaped an extraordinary decade. For its style and its lessons, Hammond Guthrie’s memoir is a rare and important achievement. — Stew Albert, co-founder of the Yippies

I’m blown away by the stories – [he] really [has] seen and done it all. Just fascinating and, unlike so many of the other accounts I’ve seen, [Hammond] actually does remember. — Jeff Tamarkin, author of Got a Revolution

What a marvelous surprise lurking beneath the cover of this one.Jacket Magazine