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

Melbourne, Australia
Joined July 2009
For some light hearted fun, i.e. don’t at me… (not exhaustive, everyone is valued, etc) #MetGala2022 attendees as #mentalhealth staff; a thread 🧵; – at Melbourne, Victoria
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Would you like lives with that? If rehabilitation means fewer people get hurt, I think we can all survive the disappointment of an offender’s life improving A forensic psychiatrist asks some irritating questions about “tough on crime”. psychwrites.substack.com/p/w… #vicpol #crime
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Expert Witness Testimony: Do as I say, not as I do... psychwrites.substack.com/p/e…
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So, what the heck is a forensic pyschiatrist? psychwrites.substack.com/p/s…
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There’s something everyone needs to know. You can’t all have ADHD. #psychiatry
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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.
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“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
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The Ukrainian actress Tania Galakhova portrayed what it's like to live with depression 😢
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Read along with my Intro to Psychotherapy students!
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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”
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abc.net.au/news/2025-07-09/m… @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
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Where do you think the most talented therapists are found?
2%Insurance network
11%Community Health
80%Private practice
6%Universities
731 votes • Final results
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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 theguardian.com/australia-ne…
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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. theguardian.com/australia-ne…
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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.
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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.
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Building more jails is a short-sighted response that focuses on punishment and NOT addressing the root causes. This is not how to rehabilitate people & reduce crime! Investing in education, mental health support, addiction services, & community programs would be more effective.
Replying to @JacintaAllanMP
It's why we're opening more prison beds and hiring hundreds of new staff, to deal with the increasing number of alleged offenders being denied bail.
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"Dr A said Cauchi was not showing symptoms of a relapse while his dose of clozapine was gradually being lowered. In her opinion, this meant he was “in full remission” from the condition." Until relapse. Sorry but no. This just means clozapine was working. thenightly.com.au/australia/…
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Serious mental illness is chronically underrated by systems, by the public, even by individual clinicians. Untreated it doesn’t just just go away, it invariably escalates. Forensic psychiatric hospitals exist for what happens when we look away; we can't afford to. #psychtwitter
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What is the most poorly understood concept by therapists? I will go first: Reflective function
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