Jackie Rakov

Forensic & general psychiatrist. From fixated threat to psychotherapy. Retweets are not my opinion.

[Jackie Rakov @psychwrite]

For some light hearted fun, i.e. don’t at me… (not exhaustive, everyone is valued, etc)

#MetGala2022 attendees as #mentalhealth staff; a thread 🧵;

[Jackie Rakov @psychwrite]

There’s something everyone needs to know.

You can’t all have ADHD.

#psychiatry

[Jackie Rakov @psychwrite]

@Democra23125849 @tigertuffmark I think it’s wise to be careful differentiating Muslim or Islamic, from Islamist! They are not the same.

[Jonathan Shedler @JonathanShedler]

The benefits of psychotherapy don’t come from self-disclosure. They come from working through inner obstacles (like shame and fear of judgment) to self-disclosure.

This work must happen in the therapy relationship. Take it outside the relationship and it’s no longer therapy.

Psychotherapy works because there is skin in the game. In all relationships, including psychotherapy, there is vulnerability and risk. You may feel shamed. You may be judged. You may be rejected.

Remove these risks and you remove the therapy. It becomes a meaningless illusion.

It’s the illusion that there is such a thing as connection without vulnerability. There isn’t. It’s the illusion of understanding, without risk of misunderstanding. It’s the illusion of facing emotional risks, without actual bravery.

It’s buying into a comforting lie.

Real psychotherapy is never a game of pretend. It’s never about comforting illusion in place of difficult truth. It’s about facing ourselves honestly, in a real relationship that comes with real risk.

This is how emotional change and growth happen.

The core defining feature of real psychotherapy is facing the truth, and telling the truth, and living the truth. Not living in illusion.

So many want a bypass. There is no bypass.

[Jonathan Shedler @JonathanShedler]

“Good psychotherapy creates the conditions for its own expiration because the patient will no longer need us. As Winnicott noted, ‘We all hope our patients will finish with us and forget us, and they will find living itself to be the therapy that makes sense.’”
—Nancy McWilliams

[Interesting things @awkwardgoogle]

The Ukrainian actress Tania Galakhova portrayed what it's like to live with depression 😢

[Glenn Sullivan @drglennsullivan]

Read along with my Intro to Psychotherapy students!

[Jonathan Shedler @JonathanShedler]

Some therapists speak of

trauma work / shadow work / family of origin work / dream work / parts work / attachment work / etc. etc.

as if they were separate things or special skill sets

Psychodynamic therapist don’t use these terms. Frankly, they sound silly to us. They’re the bread and butter of what we do, day in day out

We also have a special term for this kind of work. We call it “psychotherapy”

[Jackie Rakov @psychwrite]

@gayatri_d @Ahpra I think there should absolutely be scrutiny on prescribers. I had a doctor contact me about my own patient asking if I was “happy with” her proposed dose. She didn’t know he had major mental illness and was just happy to pull the trigger.

[Jackie Rakov @psychwrite]

https://t.co/VxQZY39U9e
@Ahpra warns against businesses that prioritize profits > patient welfare, particularly those prescribing a single class of drug w/o thorough assessments. A surge (18K users in ‘19 to >1M million by Jan ‘24) raised concerns re: de facto recreational market

[Edward A. Perin - Psychologist @DoctorPerin]

Where do you think the most talented therapists are found?

[Jackie Rakov @psychwrite]

@emilysnowau @Mr_Fireside @TopherField The ubiquitous exploiters of the scheme ruin it for the genuinely deserving, who oftentimes have trouble accessing it. Infuriating.

[Jackie Rakov @psychwrite]

State & territory governments have outlined their measures to address the issue. These include infrastructure upgrades, removal of ligature points & enhanced mental health support. However, concerns persist over the pace & completeness of these efforts.
https://t.co/5nNatDAooN

[Jackie Rakov @psychwrite]

A Guardian Australia investigation has uncovered that 57 inmates died by suicide using known ligature points in prisons. This negligence spans multiple states and highlights systemic failures in addressing preventable deaths.

#forensicpsychiatry

https://t.co/7wa5opcFcL

[Jackie Rakov @psychwrite]

@BigRedCeltTT @drruthmitchell Calling it “kidnapping” is absurd. Under international law, states can enforce naval blockades (even in international waters) if properly declared. Boarding a ship attempting to breach that blockade isn’t criminal, it’s lawful enforcement. Humanitarian or not, clearance matters.

[Jackie Rakov @psychwrite]

@PatMcGorry The Age is right: mental health support is failing. But the Vic Royal Commission isn’t the solution it’s part of the problem. It sidelined clinical judgment, gutted secure care, and deprioritised compulsory treatment. Reform must start with reality, not ideology.

[David Puder M.D. @DavidPuder]

Highly recommend getting this book or audiobook by Nancy McWilliams. Reading each chapter 3-4 times is required to really grasp the depth.

This chapter on depressive personality is articulate, nuanced, and the best I have found written on it.

[Stephen Cicirelli @SteveCicirelli]

I just failed a student for submitting an AI-written research paper, and she sent me an obviously AI-written email apologizing, asking if there is anything she can do to improve her grade. We are through the looking-glass, folks.

[Jackie Rakov @psychwrite]

@SimonKatterl I’m limited by characters as I don’t pay for X. Feel free to enter a dialogue any time, before casting aspersions. Cheers.

[Jackie Rakov @psychwrite]

@SimonKatterl While it’s true that some individuals with lived experience have successfully discontinued antipsychotics, one should acknowledge that outcomes can vary greatly depending on diagnosis, context, support systems, and personal circumstances. I don’t think that was schizophrenia.