A patient in psychoanalytic psychotherapy reported to the analyst that the patient recently had been forced by satanic cult members to commit a murder. After discussion, the patient and the analyst agreed to inform the police. The police could not find evidence for the occurrence of the crime. Continued psychoanalytic work revealed that it was not a contemporary murder but a flashback of a childhood horror. Because flashbacks of past traumatic experiences are not an uncommon phenomenon, they would account for some of the gruesome events reported by patients but which law enforcement officers cannot validate as having recently occurred.

Who am I to treat this person? That is what came to mind every time I treated a seriously disturbed patient. I do not know enough, and I have hang-ups. But no one knows enough, and every therapist has hang-ups, although our own analysis helps. We may feel confused, frightened, angry, or hopeless because these are the patient’s feelings. Discussed are creating rational hope, dealing with feelings (including terror), depression, delusions, hallucinations, and suicidal and homicidal dangers. Theory is helpful, but it is not enough. Tolerating not knowing often leads to effective improvisations. Best results were obtained with psychoanalysis or psychoanalytic therapy without medication. Next best was psychoanalytic therapy with initial medication withdrawn as rapidly as the patient can tolerate. Electroconvulsive therapy is discouraged.

In this article, a document presenting a planned psychiatric building in Sweden was analyzed using critical discourse analysis. Focus was on how biomedical perspectives, administration, logistics, and efficiency is materialized in the building. The building is planned without personal consulting rooms or office places. Text and images were understood with reference to Augé's concept of nonplaces; places that are void of meaning. Outpatient practice is portrayed as equal, neglecting power imbalances, diversity, and context. Clinicians and clients are expected to be in transit in an environment centered on transparency and technology, enabling surveillance and control. Encounters and dialogues are never mentioned, while electroconvulsive therapy has its own place both in the document and in the building. Technology is central and presented as necessary for future needs. The idea that current psychiatry represents a story of constant progress, providing precise diagnosis and effective treatment is materialized in the building.

Persuasive design, the use of behavioral psychology in digital devices and applications to alter human behavior, is employed in entertainment and educational technologies that occupy a great proportion of the lives of children and adolescents. A primary purpose of persuasive design is to increase the time spent using social media, video game, and other entertainment technologies in order to increase business revenue. This adds to children's and adolescents' health risks, as excessive recreational screen time has been associated with both physical (sleep, weight) and mental health (depression, anxiety, compulsive use, and inattention) issues for children and adolescents. Given the potential for negative health outcomes, it is necessary for the field of psychology to acknowledge, educate, and take action against the use of persuasive design in platforms typically used by children and adolescents.

Clinical studies carry with them a paradox: The more obviously efficient an intervention is, the more ethical problems its trials pose. This article discusses the ethical problem of breached equipoise principle because of the perceived effectiveness of a nonblindable verbal technique, crisis dialogue (CD). CD is designed to help establish a therapeutic relationship with persons in a suspected psychotic state. In a pilot randomized controlled study in Yverdon, Switzerland (usual treatment vs. usual treatment + CD), after inclusion of 30 patients, clinicians expressed a consensual opinion that CD was effective in most cases. Following their opinion, the joint clinical and research team decided that the study had to be discontinued and that CD should be tried with all patients for ethical reasons. This poses an ethical problem with potential far-reaching consequences: In this interrupted study, differences between groups in terms of clinical outcome (Brief Psychiatric Rating Scale, Clinical Global Impression), therapeutic alliance (Working Alliance Inventory, Difficult Doctor–Patient Relationship Questionnaire), and patient satisfaction were consistent in favoring CD, but these differences did not reach statistical significance in most measurements. The early interruption of the study because of perceived effectiveness of the intervention can be seen as unethical as well because chances were high that a larger sample would have shown more conclusive results, allowing for faster introduction of CD in various clinical settings with corresponding improvement of patient care.

The Diagnostic and Statistical Manual of Mental Disorder (5th ed.; DSM-5) Task Force’s recommendation to reduce the limit of normal bereavement to 2 weeks has provoked a wave of negative public and professional reaction not seen since the 1960s and 1970s. I argue that the Task Force is correct to insist that excuses have no place in medicine, which is how psychiatry promotes itself, and therefore for the sake of consistency, bereavement should not count as the only exception to what would otherwise be diagnosed as a mental disorder. But the reclassification of bereavement as mental disorder should focus attention on psychiatry’s overall inability to clearly say what they are talking about when they refer to mental disorder and to provide objective evidentiary grounds for detecting “its” presence. Detecting something is illusory (think of witches) if there is no way to distinguish between true-positive detection and false-positive detection.