New Clinical Tips - 1 & 2

1. Restore, http://restore4life.com/, is a liquid supplement that helps reduce leaky gut syndrome in the face of glysophate (Roundup) exposure.  Glysophate is found in common herbicides and is highly toxic to humans.  When one introduces Restore to the gut, the gut is able to withstand the way glysophates dissolve the tight junctions between the cells in the gut.  I believe that this product not only does so in the gut, but probably benefits the entire body in many profound ways. 

I highly recommend this supplement as part of recovery in mental health.  I have had great success in using a variety of nutritional supplements in the past, but it was only when I started using Restore that certain “difficult patients” began to also benefit from the functional approach with surprisingly good speed and results.  Take a look at this supplement on their website and see if you can benefit from taking it too.


 

2. I just attended the International Conference on Nutrition in Medicine (ICNM), July 29 ad 30, 2016.  I was astounded by the information presented and very moved by Rich Roll’s beautiful retelling of his recovery from alcoholism and drug abuse to become an ultra endurance athlete through a whole foods, plant based diet.  He went to Stanford for college and has a law degree from Columbia University.  Also, he is very handsome!  Oh dear, am I digressing? 

Anyway, I am going to implement what I learned at the conference, into my own life.  I was truly inspired by the presenters and convinced that their messages are not only important to my personal, long-term health, but also to the health of my patients, and globally, for our planet.  I will still be taking my supplements, but I know that as I improve my diet, they will become less central to maintaining my health.  I am so grateful for their leadership in nutrition and their heartwarming efforts to educate all of us in doing what is good, right, and healthy nutritionally. 

I would highly recommend anything that Dr. Neal Barnard recommends!  I bought his book, “Breaking the Food Seduction.”  It is an easy read.  I am enjoying it so far and would recommend others who are struggling with cravings for unhealthy foods to buy it and read it!
 

A Psychiatrist's Perspective: Syrian Refugees and the Middle East

Just the evening before, I had asked someone to explain to me, what is going on in the Middle East, to create the Syrian refugee crisis.  The person was not clear about it either. The very next day, the NY Times devoted their entire issue to help clarify the multitude of factors, in the Middle East, that culminated in our current global crisis. The headline reads:

TOP STORIES

The New York Times Magazine has dedicated an entire issue to a single story: the Arab world’s undoing since the invasion of Iraq

It took all evening for me to read through it the first time. I decided to read it again, because the conflicts were so many, the names so unfamiliar, and the incidents so incredible, that it was difficult, to absorb it initially. 

As a psychiatrist, I see things through the heart and in holistic, philosophical strokes.  In viewing politics, idealism and the inner examination of the soul are fragile and delicate instruments, when faced with the guns of war. So, I will humbly apologize for my ignorance, beforehand, on matters in the Middle East. I will simply explore my personal reaction and experience, as I read their recent history.

What I found, as I read the overview, was a conflict of my own. On the one hand, I felt great compassion for the suffering, homeless citizens. I wished they could be housed properly, that they could be given a chance to work as refugees, and that they would find kindness from their neighboring countries. On the other hand, I lacked the ability to empathize with how they arrived at their situation. I could not empathize or understand their need to destroy each other, to fight over property, and the cycle of narcissistic despotism, which destroys their hope for peace.

The words that came to mind, to describe what fueled the endless killings were: selfishness, pride, need to control, secrecy, and lies. These words describe the nature of evil, and of course, at its root: fear. So, it came down to this for me: that evil and fear, like a fire, inflamed and magnified suffering, until it boiled over, like an overheated pot of soup.

The answer to the evil that overruns the area, from the forces that try to contain it, is to kill it. Beat it to death. Destroy a little more. Kill a little better.

Could that be the way to establish peace? It seems rather paradoxical to expect peace to come through violence, don't you think?

For example, what would I think of a parent who slaps a child and says, "Don't hit your brother!"? It may be a quick way to stop the child from hitting their brother, but ultimately, that child knows that it is okay to hit someone, because his/her parent had demonstrated exactly how it is acceptable.

If selfishness, pride, need to control, secrecy, and lies fueled the endless wars in the middle east, then would it not make sense that what would restore peace would require just the opposite energies?  That is: unselfishness (unconditional love, sharing), humility, empowerment of all, transparency, and the truth. Could there be a short cut to peace through any other path? Perhaps through the altruism, sharing, and unconditional caring of the neighboring nations, a model of peace could provide a short cut to creating greater peace within the middle east.

I think of the great leaders of all time--those who lived and breathed peace--all became martyrs, without exception.  Is peace and strength mutually exclusive? Must a leader of peace succumb to the forces of violence? Must peace be powerless in its defense against attacks? I don't think so.  

But a leader of peace uses different "weapons," do they not? Their weapons create rather than destroy, enlighten rather than annihilate, unify rather than segregate. Their skills come from a different source: love. With regard to politics, the players of peace create as a group, unified and guided through love without boundaries. Such groups would not think it strange to be inclusive of different religions, backgrounds, gender, and education, as long as each voice is furthering the cause of peace, unity, and understanding; and the means (how to achieve something) towards the end (achievement) are consistent and in harmony with each other.  

In other words, more than social and religious affiliations, players of peace worship love, peace, and truth before all else.  They ask themselves, "Is this in the service of love, peace, and truth?" When faced with a task, they look for a way to meet the task lovingly, peacefully, and truthfully. Life is not about "us vs. them", because it is not driven by material things one can touch or own, but about living in that state of love, peace, and truth with one another. 

Perhaps some may think of such a perspective as poetic imagination, impossible to achieve. Others may think of it as threatening their way of life and the cohesion among their allegiances. But, when faced with the goliath of war, why not have faith in a pebble, aimed by a force greater than self? Let it not be about a war between David and Goliath, or even a struggle between life and death, but about who and how we choose to be while we yet live.  

The usefulness, of learning from current history and politics, is to glean, vicariously, the lessons we need to learn for our daily conduct with ourselves, with each other, within the family, and in the community.  Be what we would want our world leaders to be, but be that, in our own sphere of influence, however small we may perceive it to be. Remember to respond from a place of love, generously and without fear.

When we are attacked, take a breath, and allow that attack to go no further than where we stand. And then, in our next breath, breathe out peace and strength. That is my wish for us and for the world.  

Alice W. Lee, MD

A Psychiatrist's Response to Khizr Khan's Speech and Trumps Reaction to Mr. Khan

The battle for the presidency of the United States currently unfolds before us, as living history. I am profoundly moved, to add my voice, to those who have spoken for the continuance of our beautiful country, and the unifying principles that bring us together, as a social network that supports, not only ourselves, but each other.

In reading about Khizr Khan and the criticism and coldness he received from Donald Trump, I wish to support Mr. Khan, not secretly or privately through email or letter, but publicly, through my blog. He is such a brave and heart-centered man.  To speak to the point, to say what is true, to appeal to both mind and heart, is central to the preservation of our democracy. 

What I like, about Mr. Khan and his spirit, is that he is not intimidated by Trump, who has more money and social status than he does. Mr. Khan has a moral compass, and he unapologetically proclaims it.  He has the boldness to say: 

“What he (Trump) said originally — that defines him . . . people are upset with him. He realizes, and his advisers feel, that [his original statement] was a stupid mistake. That proves that this person is void of empathy. He is unfit for the stewardship of this great country. You think he will empathize with this country, with the suffering of this country’s poor people? He showed his true colors when he disrespected this country’s most honorable mother. . . . The snake oil he is selling, and my patriotic, decent Americans are falling for that. Republicans are falling for that. And I can only appeal to them. Reconsider. Repudiate. It’s a moral obligation. A person void of empathy for the people he wishes to lead cannot be trusted with that leadership. To vote is a trust. And it cannot be placed in the wrong hands.”

In response to Trump’s attack on his wife, Khan said that the Republican nominee’s words were “typical of a person without a soul.” (The Washington Post, Stephanie McCrummen, July 31, 2016 1:00 a.m.)  

As a psychiatrist, I am not an expert on politics, and normally, I do not write any commentary about the political process.  But this year is different, I am drawn to the political process, not because of any interest in, or experience with, politics, but because I am an expert on empathy, the mind, and the heart of an individual.  It is very clear to me that our country is divided into two groups, with strikingly different values and priorities, symbolized by our current presidential candidates.

One group uses fear, blame, anger, and promises, to appeal to the masses. The other group uses hope, mutual responsibility, tolerance, and dedication to hard work, to appeal to the masses.  One inflames. The other inspires. One says, "I, alone, can fix your problems." The other says, "We can do it together."

Of course, there is plenty of fear, in even the best of us, and when we hear Trump make his promises, so convincingly, there is a child in us that wants to believe him and wants to shift our responsibilities onto his shoulders. We hope, in our hearts, that he could fix our problems and save us. 

However, responsibility is the other side of the coin for freedom.  If one does not have any responsibility, one has lost one's freedom.  Therefore, to give our responsibilities away, is the same as giving away our freedoms.

Empathy, also, is the price we pay for true power.  It is easy to block our painful feelings (shame, fear, or resentment) and shift the blame for our suffering to our neighbor, a foreigner, or another country.  But when we do, we are saying, "I do not have the power. They do. Because they do, I will reclaim my power, by eliminating my enemy." Power has never been reclaimed this way, and it never will. 

In reality, when we look at ourselves honestly and, with humility say, "I can and will do better." We begin to reclaim our innate power, which had been waiting beyond the door of authentic suffering, without needing the fantasy of an enemy.  Not only do we start to use our innate power to help ourselves, but through compassion, we are motivated to help others.

In this election process, the allegiances of certain political leaders tell me a great deal about who they are. When one candidate condemns Trump vociferously and, in the next moment, endorses him, what does it tell me, of who they are beneath their rhetoric? It tells me that they do not have the strength, to be a living example of their words, through real action.  It tells me that they lack integrity.  It tells me that they are afraid of being their own light in the darkness.

Being a light in the darkness means that, when the whole world might choose what is mean spirited and an easy way out, one chooses to remain compassionate and true to one's moral compass. I honor those Republican candidates who have remained a light in the darkness.  I see their light shine, as the darkness deepens around them.  I hope that they will remain brave and honest, when challenged to be otherwise.

Like Mr. Khan, I have something to say to those candidates who have aligned with Mr. Trump: we see you, as you are, through your choices. Don't be the fools that paraded along with the king, in the story, "The Emperor's New Clothes." In the end, you will share the sting of shame, as the truth reveals his vanity. Mr. Trump is the Emperor without clothes. But you don't have to march down the street, celebrating his new wardrobe, pretending you see something, when you know well enough there is nothing there.

Ten Clinical Tips on Antipsychotic Withdrawal

When an individual becomes psychotic, typically an antipsychotic medication is used to ameliorate symptoms. However, there are many side effects associated with the use of antipsychotics, and often no clear method for coming off the medication once symptoms are under control. In addition, withdrawal from an antipsychotic medication, after taking it for several years, may often result in withdrawal symptoms that mimic the original psychotic illness, sometimes several months later.

Is it possible to withdraw from antipsychotic medications safely and successfully, without the recurrence of psychotic symptoms? I believe it is possible, though not easy. Knowing how to lessen the stress of tapering will improve your ability to experience a smooth, safe, and successful outcome.

Over the years, in the process of learning about medication withdrawal in general and antipsychotic withdrawal in particular, I have found that, in addition to supporting the body with proper nutritional support through diet and supplements, there are aspects of the withdrawal process that are valuable to know beforehand, for a smooth and safe withdrawal process. They are as follows:

  1. Carefully follow sleep patterns: Do not reduce antipsychotic medications until sleep has increased through nutritional and energy medicine support to at least 9 hours per day. Lowering antipsychotic medication when sleeping 8 hours or less would lead to insomnia--one of the early symptoms of stress during withdrawal.  I have found that ultra CBD, a hemp oil extract, can be helpful to patients for supporting sleep and appetite, when needed.
  2. Use liquid antipsychotics if available: It is easier to taper down in small amounts when using liquid antipsychotics. Of course, this principle applies to antidepressants or anxiolytics as well. If liquid antipsychotics are not available, they can be specially compounded through certain compounding pharmacies, especially through pharmacies that also sell nutritional supplements.
  3. Antioxidant and anti-inflammatory support: typically I use a combination of whole food powders such as acai, goji, and maqui powder to lower oxidative stress.  I also highly recommend an anti-inflammatory diet and restricting wheat, dairy, and white, refined sugar.  Among the anti-inflammatory supplements I use are Restore (a supplement for the gastrointestinal system), probiotics, vitamin C, and omega-3 fatty acids.
  4. Strengthen the GABA neurotransmitter system: The GABA system provides the physical message of tranquility.  By increasing the neurotransmitter that is central to creating calmness and peace, people are able to rely less on the effects of an antipsychotic. I often recommend GABA rice (about half a cup twice daily) or liposomal GABA. Zojirushi makes GABA rice cookers and can make GABA rice from organic, brown rice. Organic, germinated brown rice cooked in a regular rice cooker will also make GABA rice.
  5. A "step-down process of withdrawal":Although there are many factors that can make antipsychotic withdrawal difficult, different antipsychotic medications have different levels of difficulty during withdrawal, based on their psychopharmacology alone. Consider Zyprexa, it affects approximately 17 different subtypes of receptors, while Haldol affects two dopamine receptor subtypes. In between, we have Abilify, which affects 10 different receptor subtypes, while Seroquel affects seven different receptor subtypes. When these medications are lowered, the body has to adapt to the number of receptors that become unblocked.  It follows that it is easier for the body to adapt to changes, when there are fewer changes to adapt to.  When lowering an antipsychotic medication that affects many different neurotransmitter subtypes, such as Zyprexa, it may be helpful to use a "step-down process," tapering down the antipsychotic through the use of another antipsychotic that affects fewer receptor sites. For example, when tapering down on Zyprexa, gradually increase the dosage of Seroquel. Once the individual is only on Seroquel and has safely and completely weaned off of Zyprexa, then gradually taper the dosage of Seroquel while gradually increasing the use of liquid Haldol. Once the individual has transitioned to Haldol and has completely been weaned off Seroquel, then very gradually lower Haldol. All the while, the individual should be using supplements and energy medicine to facilitate the recovery process. Tapering off Haldol, the last step of the "step-down process" may be easier to achieve successfully than coming directly off of Zyprexa.
  6. Treatment of contributing causes:  Infection, toxicity (heavy metals, pesticides, and herbicides), genetic mutations, and traumas all contribute to oxidative stress and inflammation, which affect mental health.  Treatment of these underlying causes will be critical to a successful withdrawal.
  7. Minimize social stressors:  Abrupt changes and demands, losses and traumas can undermine the ability to come off an antipsychotic medication.  It is important to consider the social context and to support a calm, predictable, and yet, rewarding set of circumstances for optimal healing to occur.  Psychotherapy is often a critical and central part of the healing process, by strengthening insight, forgiveness, presence, and healthy coping strategies.
  8. Guided Visualization/Meditation:  I recommend to my patients the use of an audio track called "Minimizing Withdrawal Problems" to listen to once per week.  It uses meditation and intention to support the body's ability to adapt to dosing changes.  This track is available on my website to download from the digital products section.
  9. Collaboration with other integrative health practitioners: It is helpful to create a treatment team of integrative practitioners who can work together to help the patient heal.  Each can bring to the process a special set of skills that can support the patient during this difficult process.
  10. Give it time: the journey is just as important as the end goal of being off a medication.  It is often better to give oneself more time to heal, on a medication, than to force the process and experience physical discomfort from withdrawing too quickly.  Medications are helpful in many ways and should not be viewed as an enemy in this process.  Improvements in health will naturally result in a need to rebalance the dosage of medications to a lower amount.

A Psychiatrist’s Personal Opinions of Donald Trump

As I listen to Mitt Romney and the Republican party speak up against Donald Trump today (Transcript of Mitt Romney’s Speech), I feel compelled by civil duty to express my personal opinions on Donald Trump’s rise in politics.

It has been an interesting, incredible, and horrifying experience to see the rise and success of Donald Trump over the course of the Republican primary elections. When I first saw him during a Republican debate, I was greatly entertained by his theatrics and dramatic dialogue. It really was like watching a comedy show, but a reality comedy show. I had no doubt in the beginning that the American public would be able to see through his bluster, insults, and sales job.  But no.

The whole progression of Trump’s appeal to the public reminds me of the rise in power of Hitler. Before Hitler came into power, he promised a lot of things to the downtrodden, and he used the Jews as a scapegoat for the country’s problems. Hitler arose from an environment where fear and anger could be used to gain power.  People felt disillusioned with the government, and they hoped for a savior. Hitler had the narcissistic grandiosity to say, “Here I am. I will save you.” I see Trump using the same carrot to entice the public. Hitler thought of himself as above the law. I heard Trump tell Jeb Bush, during a debate, that if he had wanted to have a casino built in Florida, he would have. Meaning, he thought of himself as above the governing powers of that state. In other words, his wealth/power makes him above the rule of law. A leader of a democratic or republican nation does not think of himself as above the law or government. Monarchs and dictators, however, do. When Bush responded, “You would not have.” Trump replies, “Oh, yes I could!” Narcissism in action.

When I read books or watched movies about the Holocaust, I wondered what I would have done under the circumstances. Would I try to keep my head down and stay out of trouble, or would I have the courage to speak up about it? Would I try to bring some light and sanity into the country, or would I shrug my shoulders and retreat into a state of powerlessness? When I see what is going on right now in politics, I feel as if I am reliving the beginnings of an old, horrifying chapter of history that I thought would never, ever be allowed to repeat. And certainly not in the United States of America. And I am challenged to speak up, rather than avoid the issues confronting our nation.

Everyone I know thinks Trump is ridiculous and unworthy to be president. It is obvious, isn’t it?  It’s like saying the Emperor has no clothes. Don’t you see he’s naked, parading around like that? If it is not obvious, then here are just a few reasons why Trump would be ridiculous and unworthy to be president:

  1. He lacks the ability to be civil to his opponents. That is the whole point of politics, being able to work in a social setting without offending everyone you bump into.  Trump has the opposite ability.  He is an expert at bumping into people and offending everyone.  These are not helpful characteristics for the president of a dog food shop, much less the president of the United States.
  2. He does not use logical reasoning to persuade. He uses insults. In any given debate, I lose count of all the times he insults someone. How can such an illogical, abusive person ever hope to work with anyone in relative harmony?
  3. He projects all his anger towards another person or group, calls them names, and blames them for problems.  And he has a lot of anger and a lot of blame.  A president of a free nation does not behave in this manner. Dictators do.
  4. He has no experience as a law maker or working in government.  He does have a lot of experience bossing people around. He tried to boss around a television network, regarding who would have the right to interview during the debate, and he refused to attend the debate, when he didn’t get his way. This is how he will behave, if he becomes president, but in a larger context. Can you imagine how he will handle volatile nations whose leaders think he’s lower than the dirt on the bottom of their shoes? How do you think he will treat the issues of freedom of speech and the press, if he were to be elected?
  5. He denigrates people for their sex, race, and appearance.  These are extremely immature defense mechanisms.  But, in a political leader, this quality would be disastrous.  Hitler denigrated people, and then he acted on his feelings.
  6. He ridicules politicians for being the puppet of millionaire donors, claiming that donors control the way lawmakers make decisions in government, missing the point entirely that he is essentially a donor running for president, holding the same mind set. To elect him would be similar to eliminating other competing special interest groups that attempt to influence government, and electing the head of one special interest group as president of the United States. Do you think that will improve our government?

I hope as the election season progresses that Trump’s tax returns and more information will surface to make him more transparent to the public, as if what we know about him isn’t enough already to help us see him as he truly is. Could the Emperor be more naked than he already is?

Let us hope we can let go of our desires and fantasies for a savior enough to let us see Trump’s true nature. As disappointing as it may be to see him as a narcissist with grandiose and empty promises, it is far less painful than to face the nation the United States will become under his reign.