There are some pretty sobering statistics on men’s mental health. About half of all men will experience a mental illness in their lifetime, which is more than women. Worryingly, males are more than three times as likely as females to die by suicide, and more than twice as likely to develop substance use disorders. And yet, over seven in ten men don’t seek help for mental illness. Think about that. Let those numbers sink in, especially the last one.

Whenever I have a patient with PTSD who has a dog, I always make a point to ask how the dog is going, which helps me gauge progress. I’ve been involved with the charity Whiskey’s Wish for a few years now. They provide service dog training for veterans, first responders, and corrections officers who have PTSD. They’ve done some tremendous good in this world, but sadly they’ll be closing their doors later this year. Around the time that I started working with Whiskey’s Wish, some colleagues and I scoured the scientific literature on the benefits of using canines to compliment treatment for PTSD. In this blog post I discuss the research on service dogs in treating PTSD.

Treating PTSD is a profound experience. Helping someone battle their monsters is rewarding and difficult. But it also requires creativity in your approach and careful attention to your own countertransference. In the right environment there is hope. It provides a safe and containing space in which recovery can occur. In this blog post I focus on the pharmacological management of PTSD and draw upon the neuroscience to shed light on why certain medications are used.

Anxiety is more than feeling nervous. There’s a whole constellation of anxiety disorders, ranging from Specific Phobias to Generalised Anxiety Disorder to Panic Disorder. The common thread among all of these disorders is excessive fear and anxiety with associated behavioural disturbances. The underpinning neuroscience of Anxiety is fascinating and has significant therapeutic implications.

In its common usage, the Dark Night of the Soul is an existential crisis. To fully understand the Dark Night of the Soul it is important to consider the roots of the concept and how it relates to Jung’s concept of the Self. In Jung’s Alchemical process of psychological recovery, the Dark Night allows for the most basic parts of our Self to emerge and it is where we meet our Shadow. Jung famously asks us to befriend the Shadow and it is through this befriending that the deeper parts of our Unconscious reveal themselves.

We live in exciting times for psychiatry. Over the last decade, there’s been increasing interest in integrating neuroscience and psychotherapy. Advances in neuroscience have led to a deeper understanding of the link between neuroscience and psychotherapies, and has informed the development of a number of new therapies. But scholars working in the main form of therapy that I use (psychodynamic psychotherapy) haven’t exploited these advances in the same way. This doesn’t mean that psychodynamic theory does not have a neurobiological basis. Instead, it raises the important question of whether psychodynamic theory can utilise neuroscience to expand the art of psychodynamic psychotherapy.

Moral Injury presents of the biggest challenges emerging in the trauma literature. Whilst it overlaps with PTSD, it has some distinct aspects and is very difficult to treat. Psychotherapy alone cannot repair moral injuries, and so a holistic approach must also include social and spiritual interventions. The common thread among the psychological treatment strategies that do show benefit may essentially reduce the “injustice gap”. This returns the question of therapy to earlier conceptions of Moral Injury as a betrayal of justice and raises the question of how to restore that injustice.

Trauma is widely represented across cultural practices. But there is surprisingly very little clinical evidence in the academic literature on the impact of theatre on trauma despite the rich field of dramatherapy; to date the only published review found no clinical benefit in PTSD. I think that this is an indication that we’re looking at this the wrong way and that theatre is an immensely powerful approach to catharsis.

In any given year, about one in five Australians will experience symptoms of mental illness, and two in five in their lifetime. Anxiety disorders and affective disorders are the most common groups of mental illness. In all its hues, depression is a dynamic and complex interplay of genes, environment and neurobiology. All of these can be changed, but it’s slow and a hard won.

Stress and trauma are common human experiences. While stress is a normal response to new and challenging situations, trauma involves an overwhelming response to life-threatening situations, injury, or sexual assault. Stress is not always harmful, but trauma almost always is.

It seems fitting to start my practice and my blogs with the hottest topic in Psychiatry right now: psychedelic-assisted therapy.