Psychotherapy and Chronic Pain: An Interview with Alison Bowles

Here’s an online interview with my wife (and PoT blogger) Alison Bowles, conducted by Raymond Barrett of the Telehealth Certification Institute in Canandaigua, New York. Alison is a psychotherapist in private practice with an on-ground presence in Manhattan, and a developing online practice.

The interview focuses on an under-discussed issue in therapy–therapy with people suffering from chronic pain. We hear so much about the “opioid crisis” that we forget that it’s overshadowedby a long shot–by a chronic pain crisis. There’s also a dangerous trend in mental health of pretending that chronic pain conditions can be managed and resolved by the magic of mindfulness and meditation. Though many studies suggest that such claims are nonsense, that hasn’t stopped the mindfulness gurus from making them: Continue reading

Against HIPPster Regulation

Consider this post a rant-by-proxy: I owe the basic idea for it to my therapist wife, Alison, but the issue occurred to me independently (though not with such clarity) a few years ago, after I took a professional ethics course for my counseling degree.

Psychotherapy is an odd vocation that’s hard to categorize in a straightforward way. A therapist is in some respects like a teacher, in some respects like a friend, in some like a parent, in some like a religious minister, and in some like a physician. But at the end of the day, therapy is a sui generis activity with its own internal standards and internal goods. Therapy may resemble pedagogy, friendship, parenting, spiritual counseling, and medicine in some respects, but isn’t any of those things. Nonetheless, the powers-that-be have decided nowadays that psychotherapy is a form of medicine, or if that strains credulity, that it ought to be medicalized as much as possible.    Continue reading

Questions About the Parkland Shooting (1): Whatever Happened to Patient Confidentiality?

The Parkland shooting seems to be one of those “tipping point” events that–like Ferguson in the case of the abuse of police power–may well change the trajectory of the debate over guns and gun control in the United States. At this point, it seems premature to come to any definite conclusions, whether about the shooting, or about what follows from its having happened the way it did. What seems more obvious to me is that far too many questions are going unasked. Here’s the first of several posts devoted to questions provoked by the shooting and the response to it–this first one provoked by the ease with which journalists seem to have gotten their hands on psychiatric or quasi-psychiatric reports having to do with the shooter’s state of mental health.

A question for people in social work/law enforcement: is there a legal/ethically legitimate way of getting hold of an adult welfare report by some equivalent of a Department of Children and Families as described in the article linked to just above? Or is journalistic reporting on the Florida DCF report on Nikolas Cruz based on a confidentiality-violative leak? Here’s some typical reporting on the release of the report, which is described as “confidential” in the same breath as it’s described as a matter of public record. Continue reading

The first thing we do, let’s criticize all the lawyers

I stick it to the lawyers’ guild at this discussion at I’m responding to Sam Glover (and others), “Why Are Lawyers So Expensive? I’ll Tell You Why.” As far as I’m concerned, he doesn’t.

Ironically, I’m the Pre-Law Advisor at Felician College.

I might add that some of my best friends are lawyers. Seriously.

Postscript, November 2, 2014: I was away for most of the weekend, so I didn’t visit to see how the Expensive-but-So-Totally-Worth-It lawyers had responded to my criticisms of their special pleading for their inflated fees. I just did.

In four days, the author of the piece, Sam Glover, who conspicuously “LOL’d” my initial comment, has backed off, shut up, and moved on without responding to anything I said. I’ve now asked another commenter, who admitted to increasing his fees on the basis of snap judgments of his clients’ “unrealistic expectations,” whether he’d be willing to universalize that judgment and allow service providers in other fields–doctors, therapists, mechanics, plumbers, educational institutions, insurance companies–to do the same without legal interference, oversight, or regulation. I’m morbidly curious to hear the answer.

It’s not that I lack respect for the legal profession as such. It’s a necessary and valuable profession with many noble practitioners. Nor do I much mind that such people have large incomes and live accordingly. What I mind is how many others of them are arrogant, misologistic sophists who thrive on the undeserved deference they get in our society, and who, despite their inflated egos, six-figure incomes, and delusional self-conceptions, cannot argue their way out of a paper bag. There are plenty of lawyers out there fitting that description, and a great number of them seem to congregate at I wouldn’t be surprised if some of them billed for being there–in which case I don’t mind giving them a run for their money. Unfortunately, I can’t bill for it, but philosophers don’t live by bread alone.

By the way, I should probably add that not only are some of my best friends lawyers, but so are some of my best former students!