While no one doubts that body, brain, and mind comprise an integrated system; modern psychiatry is increasingly practiced in an organ and symptom-specific manner. Integrative Psychiatry attempts to unify this fragmented approach in a responsible, scientific and clinically useful manner.


Integrative Psychiatry offers to optimize current available treatments, since the rush for scientific progress marginalizes proven treatments and age-old wisdom.


By using available knowledge, based on solid scientific data, TIIPS highlights the benefit of merging complementary aspects of medicine and psychiatry.


We want to identify conditions where integrative approaches to body, mind, and treatment are essential to recovery and maintenance of good health.


In fact, far from being revolutionary, the body/mind connection is intuitively grasped by all, and has been that way throughout human history.


The Institute consists of renowned physicians, academicians and healthcare professionals, all of whom are committed to making a positive contribution to the way we treat our patients.


Our guiding principle is ‘Optimizing currently available treatments’ rather than looking for new ones.

July 5 2017 by Dr. Kaminski

Closure and other unhelpful memes

Definition of Meme: an idea, behavior, style, or usage that spreads from person to person within a culture.

Memes (discrete units of knowledge, gossip, jokes and so on) are to culture what genes are to life. Just as biological evolution is driven by the survival of the fittest genes in the gene pool, cultural evolution may be driven by the most successful memes. — Richard Dawkins

Years ago, in my time as unit chief at Mount Sinai Medical Center in New York, I sat in many team meetings. Those were comprised of different disciplines typically present on a psychiatric in-patient unit. One day in discussing a certain patient on the team I asked a colleague how she intended to go about treating him. Her answer, given with firm certitude, was: “We have to strengthen his ego”.  I looked around me, earnest intelligent faces of dedicated professionals, all beamed with a certain satisfaction: We have a strategy for this patient! I could not help myself: “and how do you suggest we go about strengthening his ego? I asked half facetiously. I am still waiting for the answer. 

I view the use of memes as an expression of mental laziness akin to driving the four blocks to the dry cleaners. We slip each other words that describe whole concepts, unexamined and painfully inaccurate. “strengthening the Ego” “love”,” hate”, “happiness”, “overreaction”, “too much”,  “not enough” and so many others - some hip, some lame but all products of the “thinking in a nutshell” mentality.  We package dried essence of complex notions into convenient and easy to swallow capsules.  We say words to describe particular emotions without context (Next time you are angry, stop and think at what or with whom before you say it. You’d be surprised how discovering a context - however superficial -  can help in dealing with your unpleasant feelings).

Granted, in everyday parlance we are not concerned that our conversant might miss the depth and breadth of our connotations. Listening to random conversations, or watching TV makes it easy to assume that most people simply don't care what weight their words carry, have nothing special to say, or both:  so the vagueness of their statements is not an obstacle to most discussions.  In fact, those who labor to make themselves clear and precise are often seen as pretentious or tiresome bores. 

An area where the lazy use of vague memes is unacceptable is in the medical and psychiatric dialogue. Therapeutic conversation cannot be based on vagueness. The internist would ask you where does it hurt, and the psychiatrist would ask you what do you mean by the expression/word you just used. Whereas most people can pinpoint a pain to a certain area, one discovers that in psychiatry the situation is completely different. Even when pressed, most people identify the “good” reason rather than the “real” reason for their emotional pain. I do not suggest that people are intentionally obfuscating how they truly feel, or why, from their psychiatrists. We have emulated memes to such an extent, that we use them even in our private of privates, even in our inner world. You may be tormented for a long time by a certain meme of a concept that can be proven false and needlessly injurious, and be freed from it in one or two sessions. 

The word “closure” is one of my pet peeves. Its basic definition is: “an often comforting or satisfying sense of finality.”  The meme’s connotation, especially in romantic disappointment, goes something like this: understanding the relationship, why and what went wrong, and what happened around the breakup (before during and after).  However, the meme does not say who gives the sense of closure.  And many feel they need to “get closure” from the ex-romantic partner.  That of course is a catch 22 since as long as you feel you need closure from someone, especially from an ex romantic partner, you cannot really “get closure”.  Instead of cutting this painful branch of your life, you continue to need the person who hurt you, if only for “a closure”.   When you actually stop and think about what is a closure, why do you need it and who should grant it, the burden of “waiting for a closure” becomes vastly more manageable.

To paraphrase Socrates “The unexamined meme is not worth keeping”. read more
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