Health and Medicine

The mind gym is open

Week XXVI, MMXXV
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Recently: Why is production declining in Hollywood? Patrick Adler on the short-term disruptions and long-term trends transforming an industry.

Today: Why are millions more Americans turning to talk therapy—and sticking with it? Carlos Blanco on the decline of a stigma, a shift in health coverage, and the individualization of treatment.

+ Is political violence in America really getting worse? Iran, Israel, and what we’re tracking for this week’s member’s despatch. & New music from Neggy Gemmy

FEATURE

Help wanted

Kelly Sikkema
The United States, the Centers for Disease Control and Prevention says, is in the middle of a mental-health crisis—with roughly 60 million American adults suffering from some kind of mental illness. Meanwhile, more and more people are turning to talk therapy. The practice has become so common that it can now seem like everyone has a therapist—or knows a close friend, neighbor, or family member who has one. When The Sopranos debuted in 1999, it was a surprising conceit that the main character was a mob boss who’d entered therapy; today, no one would find it the least bit unusual.

Between 2018 and 2021, the number of Americans receiving outpatient talk therapy increased from 16.5 million to almost 22 million. That means about 8.5 percent of the American adult population is in talk therapy. And people are increasingly sticking with it, going to repeated sessions rather than just trying it once or twice.

Why?

Carlos Blanco is a psychiatrist specializing in both talk therapy and psychopharmacology. Blanco sees several factors at play. U.S. legislators have passed a number of laws ensuring that people with mental-health problems can get the same level of treatment that people with physical problems do. And as Americans have become more and more conscious of the efficacy of talk therapy, it’s become less and less stigmatized. Plus, the rise of online therapy has made therapy altogether more accessible than it’s ever been before.

Meanwhile, the way psychiatrists practice talk therapy has changed. An older, more paternalistic mindset—according to which the psychiatrist more or less simply gives the patient a standardized treatment protocol—is on its way out; today, psychiatrists and patients tend to work together to tailor treatments to the patients’ distinctive circumstances and needs. Which, Blanco says, seems to have changed people’s relationship to therapy on a whole other level …

Read on—with membership
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From Carlos Blanco, in The Signal:

  • “If you have two or three jobs just to make a living, it’s very difficult to find time to go to therapy. And of course, you don’t just need the time; you also need the money. Therapy can be expensive—and is still too expensive for too many.”
  • “One advantage of virtual treatment is, you can now access expert therapists much more easily than you could in the past. A lot of therapists have specialized ability in treating depression, for example, but relatively few know how to treat less common issues like, say, a gambling disorder. You’re just not going to have a specialist on that in every town. But now, virtual therapy is spreading access to expert treatment.”
  • “It might sound strange, but going to a therapist should in a sense be like going to a restaurant: The customer should be free to choose whatever they want from the menu, but the restaurant should make sure that everything on the menu is good. You can ask the server what they’d recommend, but in the end, it’s your choice.”
Read on
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CONNECTIONS / FROM THE MEMBER’S DESPATCH
A history of political violence
Early in the morning on Saturday, June 14, a man drove a black SUV with flashing police lights to the home of Minnesota state Representative Melissa Hortman, a top Democrat in the state legislature. He was wearing a badge and tactical vest and carried a taser. When she answered the door, he introduced himself as a police officer—and then shot and killed her and her husband, Mark.

Now infamously, he wasn’t a cop. He was planning a killing spree in Minnesota and Wisconsin. Before assassinating the Hortmans, he shot state Senator John Hoffman and his wife, Yvette. When the true police caught him the next day, they found a list of about 70 intended targets—mostly Democratic politicians but also doctors and officials at Planned Parenthood centers.

On the same day as the killings in Minnesota, Arthur Folasa Ah Loo was shot and killed while demonstrating in Salt Lake City as part of the nationwide protests against U.S. President Donald Trump. At another demonstration, in Culpepper, Virginia, a man drove an SUV into a crowd of protesters.

Neither are these the only recent examples of political violence in America. Just in the last three months, Pennsylvania’s Governor Josh Shapiro’s house was set on fire while he and his family were asleep inside; two Israeli Embassy workers were shot and killed in Washington, D.C.; protesters in Boulder, Colorado, calling for the release of Israeli hostages were set on fire; and in New Mexico, the Republican Party headquarters was firebombed—along with a Tesla dealership.

It seems political violence in America is getting worse.

Is it?

Read on
DEVELOPMENTS
Meanwhile …
U.S. President Donald Trump announced a “complete and total cease-fire” between Israel and Iran on Monday evening; Iran confirmed the deal, conditional on Israel stopping its attacks; earlier on Monday, Iran had launched retaliatory missile strikes against a U.S. air base in Qatar, though Washington says it intercepted them all. … Iran’s Parliament voted on Sunday to close the Straits of Hormuz, which about 20 percent of the world’s oil supply passes through. … Canada and the EU have signed a defense-partnership pact, in response to an American withdrawal from shared-security arrangements. … Belarus freed the opposition leader Sergey Tikhanovsky and 13 other political prisoners on Saturday after direct talks with the U.S. … & The Vera C. Rubin Observatory in northern Chile, a U.S.-funded site with the world’s largest digital camera, has released the first-ever images of more than 10 million distant galaxies.
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Coming soon: Ashley Finan on how Russia and China got so far ahead of the U.S. and the West in nuclear energy/power.

See you Thursday …

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