Psychiatry – Page 3 – Go Retire Psychiatrist

Svengoolie Show Movie: “The Bad Seed”

I watched the Svengoolie show movie, “The Baddest Seed on the Planet” yesterday on the Internet Archive because I wanted to see the Iowa Hawkeye vs UMass football game last night. Hey, the Iowa Hawkeyes and the Iowa State Cyclones both won yesterday!

Actually, I thought “The Bad Seed” was a pretty good movie, just to let the shrilling chicken out of the bag. It’s a good break from the rubber mask, stop motion animation, shlocky howlers. It does run long, a little over 2 hours and at times there’s a little too much lofty psychoanalytic dialogue. At times it seemed like a play.

It’s a 1956 Warner Bros. Pictures production. There was a Perry Mason regular on it; William Hopper played Col. Kenneth Penmark (father of Rhoda). Henry Jones played Leroy, the really creepy sociopath handyman who had a lot in common with Rhoda (played by Patty McCormack), the psychopathic 8-year-old daughter of Kenneth and Christine Penmark (played by Nancy Penmark). Eileen Heckart played the heck out of her role as the tipsy Hortense Daigle, mother of her unfortunate murdered child Claude—who is never seen.

The main underlying theme is the question of whether psychopaths are born bad or victims of bad environments.

How this gets treated in the film is fascinating. When Rhoda saws through a fawn with a dull straight razor while singing Elvis Presley’s “Don’t Be Cruel,” it really doesn’t leave much to the imagination.

Things start to go bad early when Claude wins a penmanship award instead of Rhoda who is thinking, “OK bud, over your dead body!” I’ve got to tell you; I got chills just looking at her after a while.

The handyman Leroy pegs Rhoda for a bad seed right away, mainly based on the idea that bad seeds think alike. He keeps telling her he’s got her number until he has a close encounter of the excelsior kind, and “excelsior” means ever upward only in the sense that burning wood shavings used for packing fragile items tend to be carried by the wind.

Just to gloss over the scientific psychiatric literature on psychopathy, the most recent paper I could find on the web suggests that structural and functional brain abnormalities of psychopathic persons contribute substantially to the observed behavioral patterns of callousness and poor adaptability to prosocial motivations beginning early in life and which tend to be resistant to change as one gets older. The younger the person, the more plastic the antisocial traits may be to change via behavioral modification, hopefully leading to greater empathy. (Anderson NE, Kiehl KA. Psychopathy: developmental perspectives and their implications for treatment. Restor Neurol Neurosci. 2014;32(1):103-17. doi: 10.3233/RNN-139001. PMID: 23542910; PMCID: PMC4321752.)

By far, Hortense Daigle has the most awkwardly comical role as she combines grief, inebriation and eerie suspicion of Rhoda in her own son’s death. Every time she shows up to the Penmark house, she’s roaring, dramatically staggering drunk. She helps herself to the booze in the house, even making it clear which bourbon she prefers (Never mind my grief! I said I wanted that martini in a dirty glass!).

Other than the movie being a bit too long, I thought it was very good. I could have done without the theater like credits with all the actors coming out to take a bow (or curtsy in Rhoda’s case), a slapstick bit between Christine and Rhoda, and the warning to the audience not to reveal the ending to anyone.

Connecting the Dots between Kintsugi and the Blues

Since I wrote the blog about the Big Mo Pod Show, Hickory Smoked Blues, I’ve been trying to remember how I connected the dots between Kintsugi and blues music, which is said to be healing even though often it sounds like it could make you hurt.

I had a devil of a time tracking this down. The image of Kintsugi or Kintsukuroi, which is the Japanese art of repairing broken pottery by mending the broken parts a mixture which contains powered gold.

The main idea is that repairing something broken using something like gold (read blues music here) can be healing.

You could also apply this to some other process, including psychotherapy.

The writing of a couple of people helped me make the connection. One of them is now a child psychiatrist named Jenna, who used to write the blog The Good Enough Psychiatrist, a link for which is still on my blog menu. Her post entitled “Amae” (a Japanese concept meaning cherished) caught my attention. Amae has both positive and negative aspects. In a way blues music is similar. It can be nourishing as long as it isn’t too focused on trauma.

About a month later, I found an essay by another child psychiatrist, Dr. Ashmita Banerjee, MD, entitled “The Power of Reflection and Self-Awareness,” actually mentions kintsukuroi at the end of the essay following her poem, called “Not A Poem.”

So, I think what I was getting at was pain and suffering can be reduced in healing ways, which can include art forms, like music. Some blues music can be repetitious, negative and even demoralizing when the emphasis is only on the pain. The other side of the blues can be uplifting, especially when there is the element of cherishing the tender, the wise, and the healing notes—the golden glue.

Both essays were the inspiration for my post, “Food for Thought.” The image of the kintsugi bowl is on both that post and “Big Mo Pod Show: Hickory Smoked Blues.” I still think the Robert Cray Band version of “I’ll Always Remember You” is a reminder of Kintsugi, at least for me.

Rounding@Iowa Podcast: “When to Suspect Atypical Recreational Substances”

There’s a new podcast in town from The University of Iowa Health Care and the title is “When to Suspect Atypical Recreational Substances.”

89: Tick-borne Illnesses – Rounding@IOWA

Join Dr. Clancy, Dr. Appenheimer & Dr. Barker as they discuss prevention, diagnosis and treatment of various tick-borne illnesses. CME Credit Available: https://uiowa.cloud-cme.com/course/courseoverview?eid=82296 Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Ben Appenheimer, MD Clinical Associate Professor of Internal Medicine-Infectious Diseases Assistant Director, Infectious Diseases Fellowship Program Associate Clinical Director, Infectious Diseases Co-Medical Director, TelePrEP, University of Iowa Health Care University of Iowa Carver College of Medicine Jason Barker, MD Associate Professor of Internal Medicine-Infectious Diseases University of Iowa Carver College of Medicine Financial Disclosures: Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.0 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 1.0 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-038-H01 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.)

This is a fascinating topic and the discussion ran for close to an hour, which is longer than usual because there’s a lot to say about it. The substances include a lot of chemicals that are not illegal and, in some cases, easily available in convenience stores and gas stations. In fact, the name for one of them is gas station heroin, which is tianeptine, approved in other countries as an antidepressant.

The discussion also included substantial information (or maybe better said, lack of enough information) about bath salts (usually cathinones), kratom, and something I’ve never even heard of: diamond shruumz (chocolate bars which can contain various substances not limited to psilocin). Remember that guy who chewed the face off of somebody in Miami in 2012? That was attributed to intoxication with bath salts.

This is way beyond the 1970s stuff like window pane or blotter (LSD) and pot. Many people end up in emergency rooms for evaluation of what looks like poisoning from multiple drugs. The stickler is the possibility that they got poisoned from something bought at a convenience store. Often it’s difficult to tell what the person ingested.

One of the takeaways from this podcast is that, whenever possible, try to get a history from the patient. They might just tell you what you need to know.

Community Psychiatry Podcast: Shelter House Iowa City, Iowa

I just discovered this Community Psychiatry Podcast site today. A couple of days ago Dr. Emily Morse, DO, of The University of Iowa Health Care gave a 20-minute interview that outlines how the psychiatry department leverages community psychiatry outreach to address the challenges those experiencing homelessness face.

Introduction: “Emily Morse, DO, is a Clinical Associate Professor of Psychiatry at the University of Iowa where she was first drawn to community-based care during her residency training. Her current clinical work spans a variety of settings which include outreach clinics embedded within local permanent supportive housing programs in partnership with Shelter House in Iowa City—an organization that provides comprehensive support services to help individuals move beyond homelessness. She also works as part of interdisciplinary teams that reach patients across Iowa, including one focused on individuals with intellectual and developmental disabilities, and another providing reproductive and perinatal mental health care. Along with her clinical work, she is active in medical education as a psychiatry clerkship co-director, and she enjoys working alongside residents and fellows while aiming to provide accessible, collaborative, and relationship-centered care.”

Dr. Morse provides a view of psychiatry that goes beyond the idea of scheduled appointments in the psychiatry clinic.

This is also a great way to get beyond the politicization of this issue we typically hear about in the national and local news almost every day.

Svengoolie Show Upcoming Movie: “The Curse of Frankenstein”!

Svengoolie Show Intro: “Calling all stations, clear the air lanes, clear all air lanes for the big broadcast!”

The Svengoolie show movie coming up this Saturday is Hammer’s 1957 production of “The Curse of Frankenstein”! Guess what? This time, Christopher Lee plays Frankenstein’s monster and—he has no lines at all. The movie is loosely based on Mary Wollstonecraft Shelley’s classic novel, “Frankenstein; or The Modern Prometheus.”

There’s lots of blood and gore, so wear goggles because the film was shot in SpatterVision. Don’t look for screws on the monster’s neck. I guess they were loose and fell off.

Big Mo Pod Show: The Yellow Butane Curse and Other Fun Things

I got off my schedule last week on listening to the Big Mo blues show, but as it turns out, he was gone last Friday. I heard last night’s blues show and heard Stevie Ray Vaughn’s Riviera Paradise.

So, of course that was not on the list of songs for the pod show today, but Big Mo did mention that Riviera Paradise and the name of the collection, which was In Step was related to Stevie Ray Vaughn’s having been successful at staying sober from substance use disorder for a year. The name In Step was evidently related to his going through a 12-step program to achieve sobriety. I learned about Stevie Ray Vaughn early in my residency (if I recall correctly) from a University of Iowa psychiatrist who is now the chair of the psychiatry department.

Big Mo Pod Show 072 – “The Yellow Butane Curse”

The name of today’s pod show was “The Yellow Butane Curse” which is about superstition. I’m not sure if this means that blues music enthusiasts are prone to being superstitious, but Big Mo did admit to believing that yellow butane lighters were unlucky for him.

This is probably going to seem like a disconnected transition but I missed last week’s pod show (“He plays what can’t be written down” see below), which was not the usual format of song talk but an interview with a successful local musician, Merrill Miller. I don’t know anything about him except what I learned in the podcast. I got a kick out of listening to a couple of musicians just more or less shooting the breeze about living the musician’s life.

Merrill mentioned playing in places like Strawberry Point, Iowa. I don’t have a musical connection to Strawberry Point, and I never went anywhere there that was connected with music like Merrill did. In fact, the only reason I was in Strawberry Point was because I was part of a survey crew staking Highway 13 between there and Elkader to straighten out some of the many curves in the road. We didn’t have much time to listen to music.

One piece of Iowa history they talked about was the issue of black musicians not being able to find a place to stay in this area because of racism. They had to find somebody they knew who would put them up while they were in town for a gig. Funny where a rambling, relaxed conversation will sometimes lead you.

I had few connections to music while I was growing up. My mother tried to teach my little brother and I how to play piano. It was an old out of tune piano. I managed to learn where the “middle C note” was—and that’s about all I recall about it. I took guitar lessons and got pretty good at making buzzing notes with it. Man, I could make that guitar buzz, although my teacher got a good laugh out of it—and couldn’t get me to break the habit. I could blow into a harmonica (what real musicians like Merrill and Big Mo call a harp), but I couldn’t kidnap any notes out of it. I tried picking notes on a banjo for a short while, had a second stab at the guitar, and got not much more than callouses on my fingers before moving on to non-music making careers.

You can be glad about that. Now about that suggestion that I have for a tee shirt design about my favorite faux sponsor created by Big Mo, Mayree of the legendary Mayree’s hand battered catfish; it’s better because it’s battered. I wonder if there’s any movement on that.

Pride or Rhetoric? What Would Dr. Melvin P. Sikes Say?

I noticed the headlines about the DEI flap at The University of Iowa, the one with the official apparently spilling the beans about University of Iowa’s DEI program not going away despite being illegal while maybe being unaware of being filmed. I’m not going to retell the story.

However, it does remind me of a time back in the 1970s in the days of affirmative action when I was a freshman student at Huston-Tillotson College (now Huston-Tillotson University) in Austin, Texas.

I learned about tenacity to principle and practice from a visiting African American professor in educational psychology from the University of Texas. It was 1975. Dr. Melvin P. Sikes paced back and forth across the Agard-Lovinggood auditorium stage in a lemon-yellow leisure suit as he talked about the importance of bringing about change in society.

He was a scholar yet decried the pursuit of the mere trappings of scholarship, exhorting us to work directly for change where it was needed most. He didn’t assign term papers, but sent me and another freshman to the Austin Police Department. The goal evidently was to make them nervous by our requests for the Uniform Crime Report, which Dr. Sikes suspected might reveal a tendency to arrest blacks more frequently than whites. He wasn’t satisfied with merely studying society’s institutions; he worked to change them for the better. Although we were probably just as nervous as the police were, this real-life lesson about the importance of applying principles of change directly to society was awkward.

Nothing like confronting social issues head on, right?

We would have preferred a term paper. We sat in the police station looking at the Uniform Crime Report, which was the only resource we could get. I think we were there a couple of hours; it felt a lot longer than that. The officer who got us the paperwork was polite, but a little stiff and wasn’t really open to anything like an interview or anything close to that. I can’t remember what we came up with as a write-up for what felt like a fiasco. I’m pretty sure we didn’t bring about anything even close to change. It was a humbling experience. Maybe that was the point but I’ll never know.

Dr. Melvin P. Sikes was a member of the Tuskegee Airmen although he didn’t see combat. He was the dean of two historically black colleges, a clinical psychologist, and a University of Texas professor. He died in 2012 after a long and successful career as a psychologist, teacher, and author.

I found a podcast about him which was sponsored by the Hogg Foundation for Mental Health and which aired February 15, 2024. It’s an hour long, but there are segments of interviews of him in 1972 that I consider fascinating. A couple of times he says something which I wish the interviewer had allowed him to expand on. The gist of it is that we need to have a system of education which allows people to speak from the standpoint of pride rather than rhetoric. I think what he might have meant is that it would be wonderful if we felt secure and confident in ourselves to express our minds sincerely. The word “rhetoric” makes me think of talk that is persuasive, even impressive, but maybe insincere. I think it still fits today.

Success of Johnson County Civil Mental Health Court in its First Year

I’ve been looking for other ways that Iowa addresses mental illness and its impact on homelessness and other adverse outcomes since my last post on the issue.

It turns out that, despite Iowa ranking 51^st out of all U.S. states for the low number of psychiatric beds according to the Treatment Advocacy Center statistics (in 2023, it had just two beds per 100,000 patients in need), a new mental health court established in in May of 2023 has made substantial progress in reducing the number of crisis contacts, psychiatric hospitalizations, and days in the hospital. Arrests, jailings, and days in jail were also reduced.

Participants in the new program include the University of Iowa Health Care, Iowa City VA Hospital, the Abbe Center, Guidelink Center, National Alliance for the Mentally Ill (NAMI), Shelter House, and several other mental health service agencies in Johnson County.

The Johnson Mental Health Court continues to operate since June of this year when the pilot program’s funding from the East Central Iowa Mental Health Region was supposed to have ended on June 30, 2025, due to the change in mental health regions. This is a program for patients under involuntary mental health commitment that avoids incarceration and placement in a state psychiatric hospital.

This civil mental health program didn’t exist until well after I retired and I hope for its continued success.

Luett, T. (2024, April 24). Civil Mental Health Court in Johnson County finds success in first year. The Daily Iowan. https://dailyiowan.com/2024/04/24/civil-mental-health-court-in-johnson-county-finds-success-in-first-year/ Accessed July 30, 2025

Mehaffey, T. (2024, April 14). News Track: ‘Challenging, rewarding’ first year of Johnson County mental health court. The Gazette – Local Iowa News, Sports, Obituaries, and Headlines – Cedar Rapids, Iowa City. https://www.thegazette.com/crime-courts/news-track-challenging-rewarding-first-year-of-johnson-county-mental-health-court/ Accessed July 30, 2025.

It Takes a Village to Tackle Homelessness: What’s Iowa Doing?

After I read Dr. Dawson’s post today “More on homelessness and violence as a public health problem,” it got me thinking about what the situation on homelessness of people with mental illness and substance use disorder is here in Iowa.

First, I looked at the 2024 Iowa Homelessness Needs Assessment, which is a thorough report you can download if you need it. It’s a 23-page pdf document which doesn’t mention the intersection with the homeless mentally ill until almost the very last page. It gets mentioned in the section subtitled “Improve Coordination With Adjacent Systems”:

To end or substantially reduce homelessness, a coordinated response is needed that aligns the resources in adjacent systems with CoC resources and housing. Homelessness is often caused by and/or exacerbated by the inability of public support systems to address the complex needs of people in extreme poverty experiencing housing crises. These systems include education, hospitals, behavioral health, criminal justice, and child welfare. Engagement and service delivery approaches need to be responsive to the particular needs of people at imminent risk or experiencing literal homelessness. More responsive adjacent systems will provide specialized engagement, enrollment supports, discharge planning, and coordination with CoCs in each region.

Typically, this kind of document makes me thirsty for a more granular, human connected account of what kind of person actually becomes homeless. Are they always dangerous? The answer is “no.”

Actually, there’s this human-interest Iowa’s News Now story published December 27, 2024, “A Closer Look: U.S. and Iowa homelessness reach record highs” (accessed July 28, 2025). It’s about a real person who became homeless despite being a University of Iowa graduate.

People become homeless for many reasons. I just want to mention resources that are available in Iowa that could be helpful. The website Homeless or At-Risk of Homelessness presents the idea that “Sometimes, life takes an unexpected turn. People face hardships and turn toward their communities for support.”

There are some people who struggle with mental illness and substance abuse and as a consequence of those challenges become homeless, as the Iowa Homelessness Needs Assessment above points out.

One resource I think is important is The University of Iowa’s Integrated Multidisciplinary Program of Assertive Community Treatment or PACT program. It’s an evidence-based treatment model that’s been around for decades in many locations in the U.S.

There’s also an Iowa Health and Human Services program called PATH (Projects for Assistance in Transition from Homelessness) to help homeless adults with mental illness, substance abuse and trauma.

This was just a quick and admittedly superficial summary of what Iowans have been doing about the homelessness crisis. It really takes a village.

Shout Out to Dr. George Dawson for Post “The Autocratic Approach to Homelessness”

I want to give a shout out to Dr. George Dawson for his post today “The Autocratic Approach to Homelessness” in reference to President Trump’s most recent executive order, “Ending Crime and Disorder on America’s Streets.” As a retired psychiatrist, I look back and remember seeing the problem of the homeless mentally ill a lot. You can read my take on it from last summer’s posts: