iiinova — where your digital self keeps evolving

Leonard Fein | Cognivox @cognivox.bsky.social · 01/09/2026

"Psychiatry is a pathology of freedom: it is medicine applied to the diminishments of freedom." — Henri Ey, 1948 Ey is using the word "pathology" here to mean the study of pathological conditions, rather than as a synonym for "disease" itself. (My translation from the original French.)

000

Leonard Fein | Cognivox @cognivox.bsky.social · 13/08/2026

I take psychiatric medications. They help me. This is why I get angry when I see psychiatrists portrayed as frauds. If psychiatrists are frauds, then I am a dupe. I am not a dupe. Neither are the millions like me. #Psychiatry

020

Leonard Fein | Cognivox @cognivox.bsky.social · 13/08/2026

When you hear the name of a psychiatric drug, what comes to mind? For me: Vraylar is a Norse god. Caplyta is a sports drink. And bupropion is an animatronic purple gummy bear cheerfully urging me to seize the day. What are your associations?

000

Leonard Fein | Cognivox @cognivox.bsky.social · 29/07/2026

Not all the letters after a mental health practitioner's name tell you the same kind of thing. Some point to licensure. Others describe education, certification, membership, or recognition. Sort first. Decode second.

000

Leonard Fein | Cognivox @cognivox.bsky.social · 14/07/2026

The other day I searched the Library of Congress catalog for print books with “psychiatry” in the title. Of 3,437 results, the very first was David Cooper’s “Psychiatry and Anti-Psychiatry” (1967). The catalog has a sense of humor.

000

Leonard Fein | Cognivox @cognivox.bsky.social · 11/07/2026

From my psychiatry shelves. Volume 2 was more cooperative for the camera. G. N. Christodoulou and colleagues, Ψυχιατρική [Psychiatry], vol. 2. Athens: ΒΗΤΑ Medical Arts, 2006. #Psychiatry

Photograph of the cover of a Greek-language psychiatry textbook lying on a wooden surface. The gray cover bears the large Greek title “Ψυχιατρική” (“Psychiatry”) and identifies the book as volume two. A yellow-and-blue geometric design frames two colorful brain-scan images near the center.

010

Leonard Fein | Cognivox @cognivox.bsky.social · 04/07/2026

After a U.S. congressman earlier this week announced his recent hospitalization for depression, the NYT published an explainer on why someone with depression might need inpatient care, and what treatments they might be offered during their stay. Gift link below.

nytimes.com

For Many Americans, Depression Is Familiar. Here’s What We Know.

240

Leonard Fein | Cognivox @cognivox.bsky.social · 03/06/2026

We call them antidepressants. An older word was thymoleptics. “Antidepressant” names the medication by what it opposes: depression. “Thymoleptic” names it by what it acts on: temper, emotion, mood. One term names the enemy. The other names the terrain. #Psychiatry

010

Leonard Fein | Cognivox @cognivox.bsky.social · 27/05/2026

Depression is hard to describe. The novelist William Styron called it "so mysteriously painful and elusive ... as to verge close to being beyond description." #Psychiatry #Depression

100

Leonard Fein | Cognivox @cognivox.bsky.social · 25/05/2026

Most depression treatment guidelines mention the patient’s family. But few make it central, and fewer still recognize that family members can depend on the patient, not just the other way around. Spain’s 2014 national guideline is a welcome exception. #Psychiatry #Depression

100

Leonard Fein | Cognivox @cognivox.bsky.social · 24/05/2026

In debates over psychiatric “deprescribing,” the term has become an amalgam. It can refer to dose reduction, stopping one drug, consolidating a crowded regimen, managing withdrawal, or rethinking long-term treatment. Same neighborhood, different questions. Blurring them muddles the discussion.

100

Leonard Fein | Cognivox @cognivox.bsky.social · 22/05/2026

Psychiatry and Religion in Two Textbooks: ‘[…] ministers often feel qualified to offer information and advice about how to handle “psychiatric problems” even though they may be unaware of distinctions as fundamental as the difference between psychiatry and psychology.’ (2021) #Psychiatry

100

Leonard Fein | Cognivox @cognivox.bsky.social · 22/05/2026

What’s the most accurate metaphor for the DSM? a) Tool b) Bible c) Manual d) Dictionary e) Reader’s Digest f) None of the above #Psychiatry

100

Leonard Fein | Cognivox @cognivox.bsky.social · 20/05/2026

“Treatment-resistant depression” collapses distinctions that matter. Its close cousin, “difficult-to-treat depression,” fares no better. Treatment is not a monolith. Resistance is not necessarily absolute. Nor is it a property of the disease alone. #Psychiatry #Depression

010

Leonard Fein | Cognivox @cognivox.bsky.social · 14/05/2026

Humble Beginnings “Lithium salts have found a wide application in some countries (particularly England and Scandinavia) for the treatment of psychotic excitement, especially in manic patients.” – Comprehensive Textbook of Psychiatry, 1967 #Psychiatry #Lithium #BookSky

140

Leonard Fein | Cognivox @cognivox.bsky.social · 16/03/2026

When the first Academy Awards were held in 1929, effective depression treatments did not exist. Today dozens do, and millions have benefited. Yet the image of psychiatry in cinema still mirrors that shown in Cuckoo’s Nest. The therapies have changed. The story has not. #Psychiatry #Oscars

001

Leonard Fein | Cognivox @cognivox.bsky.social · 12/03/2026

Lothar Kalinowsky (1899–1992) was a doyen of 20th-century psychiatry, a pioneer of somatic treatments, and co-author of a major clinical textbook. He was not shy about biological therapies. #Psychiatry · #PsychShelf

Quote card with cream background and black serif text reading: "Psychiatry is still … limited to purely empirical treatments of diseases whose origin remains shrouded in mystery." Attributed to Lothar Kalinowsky & Hanns Hippius (1969).

100

Reposted by Leonard Fein | Cognivox

Leonard Fein | Cognivox @cognivox.bsky.social · 05/03/2026

→ Marginalia: Five psychiatry textbooks, five different conceptions of where the field begins. Each revealed by a single choice: what to put first. What do you think should come first – and why? a) The patient b) The encounter c) The examination d) The diagnosis e) The brain #Psychiatry

001

Leonard Fein | Cognivox @cognivox.bsky.social · 02/03/2026

[1/4] Cocktail Hour 🍸 The rule: cocktails and antidepressants don’t mix. The exception: when the cocktail is pharmacologic.

100

Leonard Fein | Cognivox @cognivox.bsky.social · 28/02/2026

[1/3] Book Route The other week, I bought a Polish psychiatry book from a seller who wouldn’t ship to the US. My only option was to set up a forwarding address in Germany. The seller ships to Germany; a forwarder reships to me. It felt vaguely clandestine. (Now it feels mundane.)

110

Leonard Fein | Cognivox @cognivox.bsky.social · 26/02/2026

[1/10] Of Bibles, Constitutions, and DSM The DSM is often called “psychiatry’s bible.” The metaphor is vivid, and it captures how the manual shapes lives, governs institutions, and informs culture. But it is incomplete. DSM is less a bible than a constitution.

110

Leonard Fein | Cognivox @cognivox.bsky.social · 25/02/2026

⚠ Not a medical professional. General information only, not medical advice. Always consult a qualified medical provider. If you need support now: (USA) Call/text 988 - TTY: 711 then 988 | (Global) findahelpline.com

020

Leonard Fein | Cognivox @cognivox.bsky.social · 24/02/2026

A line catches. The page won’t let go. Psychiatry, in its own words. (Mostly.) #Psychiatry #PsychShelf #booksky

000

Leonard Fein | Cognivox @cognivox.bsky.social · 23/02/2026

[1/5] Beyond the Opening Chapter In the previous threads, I looked only at opening chapter titles – what a textbook announces before it says anything else. Here, I relax that rule. These titles sit further inside their books. Let's dig deeper.

100

Leonard Fein | Cognivox @cognivox.bsky.social · 20/02/2026

Reading my way through psychiatry textbooks from around the world, comparing how they begin. A US textbook begins with the brain. An Indian one with the clinical examination. A British one with the patient's perspective. What comes first is rarely accidental. #booksky

141

Leonard Fein | Cognivox @cognivox.bsky.social · 20/02/2026

[1/5] Where Does Psychiatry Begin? Part 2 Five contemporary non-Anglophone psychiatry textbooks; five languages. All begin the same way. Before addressing what psychiatry does, they ask what it is. Where did it come from? What has it become? Where is it going?

100

Leonard Fein | Cognivox @cognivox.bsky.social · 20/02/2026

[1/4] Where Does Psychiatry Begin? Part 1 Five contemporary Anglophone psychiatry textbooks; five different answers. The patient The encounter The examination The diagnosis The brain

200