Alexandre Khoury

Psychiatry should not begin with "what can I prescribe?" It should begin with a serious, multidimensional assessment of the person's medical condition, psychological state, and socioeconomic reality. The first question should be: is this person in real danger of physically harming themselves or others, directly or indirectly, and if so, what is the path of least harm? That path may include medication, including substances whose legal status varies by place. But in many cases, less invasive and more holistic approaches may better address the roots of distress, especially when the long-term effects of a medication are not fully understood. Sometimes people just need grounding, meaning, structure, challenge, accountability, hard truths, or simply a loving slap in the face. Our society is intolerant of distress, quick to pathologize emotional pain, and eager for immediate relief from the natural frictions of the human condition. Patients then suffer the consequences of this collective immaturity through overmedication, dependency, and side effects that ruin lives.

in case you missed it: - gödel's incompleteness theorem, - the halting problem, - tarski's undefinability of truth, - cantor's diagonal argument, etc. are all corollaries of lawvere's fixed point theorem:

@OnlyFormHolds Could you please expand step 4?

My route to Catholicism - World is crazy - Saw the problem is metaphysical - Landed on truth, beauty & goodness - Found flaws - Discovered Aristotle - Found it incomplete - Found Aquinas - It made complete sense - Saw Aquinas must lead to Catholicism - Reverted to Catholicism

@VirgilMSW All I'm saying is, maybe try nature's ancient medicine first before jumping to capitalism's latest products..

@AEKhoury I have seen spotty evidence for these treatments. It seems they might have a place, but I would also caution against just using the drugs. My understanding is that integration of the experience is vital, or you are just doing drugs.

One thing I want to hear more of from the anti-psychiatry crowd, what is your positive alternative? I hear the rage, I do not hear actual solutions to real and significant suffering that doesn't go away if Psychiatry goes away.

@VirgilMSW On top of that, there is a deep spiritual difference between the mushroom that possibly co-evolved with Homo for a million years, versus molecules synthesized a few decades ago (including Ketamine)

@VirgilMSW Also all the ones I mentioned are one time treatments. Not something you take every single day for years.

@AEKhoury More drugs? To me this sounds like trading one magic pill for another.

@VirgilMSW One can numb your clit.. not the others.

@angelaramblings Many illegal substances can enhance life. A lot of recent medical studies were published on this.

@Tomano_1 Maybe but mushrooms also can with way less risks.

I think a lot of people who actually think anti-depressants are useless or shouldn’t be used have never actually experienced something as terrible as being moderately to severely depressed. The meds are flawed through and through, but they work and are life-savers, literally

@longjumping_yak @Aella_Girl The slave owners in history seemed to be doing quite well, healthy, comfortable. Seems like those internal reasons were not sufficient to maintain the practice.

@AEKhoury @Aella_Girl In what way is the human body evolved to be slave owners? Please elaborate, smarty pants.

a great test of "would you have been chill with owning slaves, if you'd been born into a slave-owning family" is whether or not you're vegetarian today

@longjumping_yak @Aella_Girl Their body also evolved to be perfectly capable and comfortable slave-owners/masters.

@Aella_Girl Humans are omnivores. Their body has evolved to process both plant and animal matter. It is simply not immoral for an animal to eat its natural diet.

@samhall404 Expanded on this here: x.com/aekhoury/statu…

The collapse of trust was not caused by "anti-psychiatry". It was caused by years of patients reporting harm and being told their suffering was just the illness returning. A serious profession should be able to defend medication where it helps while honestly accounting for where it harms.

For the first time in the history of modern antidepressants, psychiatry and the pharmaceutical industry have lost control of the dominant narrative. The long standing consensus, anchored in claims of dangerous and unscientific favourable risk benefit profiles, negligible withdrawal liability and the reflexive assertion that symptoms of withdrawal syndromes merely represent relapse of the underlying disorder, is now fracturing. Decades of accumulated evidence on neuroadaptation increasingly align with thousands of patient reports of protracted withdrawal syndromes, delayed onset symptoms, kindling and persistent post SSRI sexual dysfunction (PSSD). These phenomena were systematically minimised, pathologised as “underlying illness” or dismissed as anecdotal for years. This represents a profound epistemic rupture. For over three decades, the profession maintained near hegemonic authority over the interpretation of clinical data, trial design (where withdrawal was rarely a primary outcome) and the framing of adverse effects. That monopoly is visibly disintegrating as high visibility accounts disseminate mechanistic explanations and lived experience data that the old paradigm could no longer suppress. The gatekeepers’ standard responses, labelling critics as “anti psychiatry,” invoking Scientology guilt by association, labelling as “pill shamers”or issuing ‘reassuring’ guidelines without addressing the full spectrum of neurobiological evidence and patient experience, are losing their potency. Go to the accounts of any of the well known biological psychiatry defenders and iatrogenic harm minimisers, @ompsychiatrist, @ProfRobHoward , @tylerblack32, @DrAnnieHickox , @JRBneuropsiq, @AhmadRehanKhan, @pash22, @mgoldingmd, @patmcgorry, @jonathanstea, @m_aadil and others, and you’ll witness a live action scramble unfolding in real time. It would almost be fascinating if it weren’t so disturbing. This is exactly how psychiatry has been able to inflict incomprehensible levels of harm for decades: a coordinated mix of denial, deflection, patient/critic smearing and institutional self protection, all while the human cost continues to mount. History is rarely kind to medical establishments and clinicians that prioritise institutional self preservation and pharmacological optimism over rigorous accounting of iatrogenic harm. The old paradigm is cracking, and no amount of rhetorical deflection can restore the former consensus.

When even serious psychiatrists are warning about careless prescribing, it is no longer "anti-psychiatry" to ask whether the default model has gone too far. x.com/AllenFrancesMD…

Psychiatry should not begin with "what can I prescribe?" It should begin with a serious, multidimensional assessment of the person's medical condition, psychological state, and socioeconomic reality. The first question should be: is this person in real danger of physically harming themselves or others, directly or indirectly, and if so, what is the path of least harm? That path may include medication, including substances whose legal status varies by place. But in many cases, less invasive and more holistic approaches may better address the roots of distress, especially when the long-term effects of a medication are not fully understood. Sometimes people just need grounding, meaning, structure, challenge, accountability, hard truths, or simply a loving slap in the face. Our society is intolerant of distress, quick to pathologize emotional pain, and eager for immediate relief from the natural frictions of the human condition. Patients then suffer the consequences of this collective immaturity through overmedication, dependency, and side effects that ruin lives.

@lexi_trades1 @bomtafriski I'm reusing this, shorter to type and funny.. I gree

@bomtafriski I gree

Why do women seem to value you more when you start pulling away?👀

Two years ago, I witnessed a Christian miracle, but I did not convert. Not because I thought the miracle was fraudulent — I think it was genuine — but because of the existence of other genuine miracles in competing religious traditions. Even more frustrating, these traditions give the same unconvincing explanations of the others’ miracles: demons, fraud or, at best, lesser revelations. Christian holy men tell me Buddhism has been hijacked by Satan. Buddhist monastics tell me Christ is a Bodhisattva for a lesser civilization not ready for the ultimate truth. I don’t find any of these answers compelling. So how is one to decide between competing religious claims? This is the burning question that has motivated my seeker’s journey for the past few years and my guest Rice University’s Jeff Kripal has given me the most compelling response yet. After two years of talking with every religious scholar/practitioner/monastic I could find, it is this interview that I find most convincing by far. He figured it out. Now let me be clear, what I find so compelling is less so Jeff’s answer, and more his method. Jeff takes seriously 1. the miraculous claims of all orthodox religions, but also 2. the modern critiques of those religions: biblical criticism, science, Freud, Feuerbach. And last but not least he also integrates 3. the contemporary supernatural: near death experiences, remote viewing, UAPs, telepathy, reincarnation research. Jeff is the only religious scholar I know who not only takes these three seemingly incompatible spheres seriously but has integrated them into a unifying theory. And if you are at all curious about the religious question I cannot recommend Jeff’s work enough for both scholars and seekers. Timestamps: 4:07 Against Western Monotheism 33:58 Against Eastern Religion 52:50 Against Materialism 1:23:11 Fraudulent Miracles? 1:31:52 Dual Aspect Monism 1:49:47 The Historicity of Miracles 1:55:39 The Ethics of Mysticism

A superaligned model would NOT give you what you think you want. Talking to it might be an uncomfortable experience.