@awaisaftab.bsky.social
Psychiatrist with philosophical interests | Conversations in Critical Psychiatry (Oxford University Press, 2024) | Psychiatry at the Margins www.psychiatrymargins.com
Congratulations! 👏
01.12.2025 20:36 — 👍 2 🔁 0 💬 0 📌 0Reposting for the Monday crowd
01.12.2025 14:51 — 👍 3 🔁 1 💬 0 📌 0
Brains on Brains podcast with guest Awais Aftab, USA
Are biology-based explanations enough?
🎧 In our latest ECNP podcast, @awaisaftab.bsky.social & Stefan Jerotic explore pluralism, patient perspectives & conceptual clarity in psychiatry.
Listen on your preferred platform
Spotify: ow.ly/IZ7j50XzXOP
Apple: ow.ly/93pg50XzXOO
YouTube: ow.ly/sBiX50XzXOR
Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz
Exploring medication effects mediated symbolically
www.psychiatrymargins.com/p/meaning-me...
love his book! thanks so much for this interview, it was a wonderful back and forth that resonates with so many parts of my training
29.11.2025 17:01 — 👍 2 🔁 1 💬 0 📌 0
Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz
Exploring medication effects mediated symbolically
www.psychiatrymargins.com/p/meaning-me...
circling p-values right below .05 to infer something about the invalidity of inferences (or even research misconduct) is conceptually no different from calling p-values right above the threshold marginally significant. makes no sense to deride one of these practices while upholding the other.
23.11.2025 17:56 — 👍 41 🔁 9 💬 2 📌 0
The Clinical Craft of Psychiatric Medication Tapering: Q&A with Anders Sørensen
“Withdrawal teaches you, as the clinician, that you don’t control the process. Successful tapering is inherently patient-led, and there’s a kind of humility in accepting that.”
www.psychiatrymargins.com/p/the-clinic...
“RCTs or STFU” is its own form of fundamentalist dogma in medicine that is ultimately incoherent and self-serving.
22.11.2025 20:33 — 👍 17 🔁 1 💬 1 📌 0
6 Suggestions for DSM-6
Making the next DSM look less like a house of mirrors
www.psychiatrymargins.com/p/6-suggesti...
"what we need from DSM-6 is transparency about what evidence, if any, supports the particular thresholds for the conditions included in the manual, and why that particular threshold is what it is" 👏🏻
21.11.2025 16:01 — 👍 7 🔁 3 💬 0 📌 0
@awaisaftab.bsky.social is amazing, as usual. Loving this post.
Regarding DSM diagnostic criteria: "A best guess is fine as a starting point, but it cannot be treated as something special or sacred..." as it is basically a "pulled-out-of-the-ass threshold"
www.psychiatrymargins.com/p/6-suggesti...
More like a house of broken glass that traps us and slices us open. :(
21.11.2025 01:40 — 👍 7 🔁 1 💬 1 📌 0
6 Suggestions for DSM-6
Making the next DSM look less like a house of mirrors
www.psychiatrymargins.com/p/6-suggesti...
I am truly honored by the piece Daniel Oppenheimer (a wonderful writer & podcaster) wrote about me for Psychotherapy Networker, a generous profile (with kind comments from Frances & Aviv) & many apt observations by Daniel about the state of psychiatry
www.psychotherapynetworker.org/article/psyc...
For the Monday crowd 👇🏽
17.11.2025 14:59 — 👍 2 🔁 0 💬 0 📌 0
In Search of the Unclassified Residuum: Q&A with Rachel Aviv
The author of “Strangers to Ourselves” on diagnostic stories, iatrogenic narratives, explanatory pluralism, humility, and more.
www.psychiatrymargins.com/p/in-search-...
As @rachelaviv.bsky.social put it in her interview with @awaisaftab.bsky.social, "the iatrogenic harm story can involve a simplification that, oddly, mimics the chemical imbalance one." This dynamic––to which I also pointed in this essay below––is enormously consequential.
undark.org/2025/08/21/o...
In Search of the Unclassified Residuum: Q&A with Rachel Aviv
The author of “Strangers to Ourselves” on diagnostic stories, iatrogenic narratives, explanatory pluralism, humility, and more.
www.psychiatrymargins.com/p/in-search-...
The sexual impact of SSRIs in adolescents is poorly understood and we know even less about instances of protracted sexual difficulties. An important call to action — more research and more mindful clinical practice — by Daniel Bergner in @nytimes.com
www.nytimes.com/2025/11/12/m...
Relatively stable, yes. Personality structure doesn't change dramatically, but the maladaptive behavioral patterns can change. In long-term studies of BPD, for example, more than 80% of people no longer meet criteria over 15-20 years, but their Big 5 traits probably haven't changed that much.
11.11.2025 17:38 — 👍 0 🔁 0 💬 0 📌 0
>> they respond generally to appropriate clinical care and competent psychotherapy, one that is empathetic, compassionate, and attuned to relational difficulties.
Some relevant thoughts in this post:
www.psychiatrymargins.com/p/borderline...
A lot of controversies around BPD are about a) the best way to frame, label, or talk about the relevant experiences and behaviors, b) the misuse, stigmatization, and weaponization of the BPD label. There is no doubt that the experiences exist (regardless of what label you use) and >>
11.11.2025 16:07 — 👍 2 🔁 0 💬 1 📌 0
Table comparing different types of psychotherapies for borderline personality disorder
Consider, for example, the psychotherapies that have empirical support for borderline personality. They are generally long-term, and they focus on things like transference, mentalization, dialectical behaviors, etc. [The table is from here: psychiatryonline.org/doi/10.1176/...
11.11.2025 14:46 — 👍 0 🔁 0 💬 1 📌 0So psychotherapy isn't really a unitary thing. While different types of psychotherapies are generally similar in benefit for depressive episodes or anxiety exacerbations, it appears that the core features of personality disorders are fairly unresponsive to short-term CBT or supportive therapies. >>
11.11.2025 14:46 — 👍 0 🔁 0 💬 1 📌 0
Understanding Detransition(s) in Transgender Healthcare
The diversity of detransition experiences in the DARE study
Guest post by Kinnon Ross MacKinnon
www.psychiatrymargins.com/p/understand...
“detransition is not a monolithic experience… it can span changes in self-concept, mental health-related factors, gender minority stressors, treatment satisfaction or dissatisfaction, and healthcare access barriers.”
www.psychiatrymargins.com/p/understand...
A blue book cover with plain colors and the text “Acute Religious Experiences: Madness, Psychosis, and Religious Studies” by Richard Saville-Smith. Bloomsbury
Re-reading “Acute Religious Experiences” by @dranamorphosis.bsky.social this weekend, and God — what a bloody brilliant book!
09.11.2025 19:17 — 👍 9 🔁 2 💬 0 📌 1The 4 classes:
* Detransitioning with regret (Class A)
*Identity evolutions (Class B)
* Transition ambivalence (Class C)
* Interrupted gender transitions (Class D)
