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zzzThe Blog of Dr. Don Kerson

  • May 3, 2016
  • By Don Kerson

STIRRING IN ATTENTIONLAND: DR. DON GOES VIDEO

Howdy one and all; long time no blog!

Once again, against my better judgment, I am going to subject myself to the harsh glare of the camera, this time to create a record of the work I am doing (and doing and doing and doing).

As the environment for stimulant prescribers has become more and more restrictive, the demand for our services here at theattentiondoctor.com has skyrocketed, up 75% since January, when new electronic prescribing laws went into effect. In 30 years of treating hyperactive adults who are also depressed I have developed some material that I think every adult with ADD who takes medicine should have, but up to this point the best way to transmit this material has been in person. The material is available in print and in audio on our site, but so far that’s no substitute, and I’m as glued to my office as I've ever been, giving the same spiels over and over.

So, we’re making an infomercial, during which I can get it done all at once, get it down, do it right; so I can stop doing it, or at least do it less, a lot less.

We will be filming at Founder’s Hall at St Francis College in Brooklyn Heights, 182 Remsen Street, 11201 at 7pm on Saturday May 7th. The hall seats about 400. Boy, we’d love to fill it up. The audience will be a mixture of old patients, current patients, prospective patients, friends and family, and anybody else who hears about it and wants to show up.

I’m hoping that this film will receive wide distribution—85 percent of psychiatric prescription are written by GP’s who certainly will never have the time nor the inclination to present this material along with their prescribing. Indeed, the vast majority of psychiatrists are not very much more likely to do so either; and yet there are literally tens of millions of us, with few trained to care for us, and even fewer coming down the pike.

If any of you can see fit to join us this Saturday evening for this filming it would be much appreciated. I expect a celebratory atmosphere; over the almost 30 years I’ve been sitting on Manhattan Avenue, taking all comers, I’d like to think we’ve created a sense of community around us, and we’ll be harvesting that investment this weekend. Come and watch!

Would you or a friend like to attend? RSVP Here, again all are welcome!

  • February 20, 2015
  • By Don Kerson

Audio: Dr. Don’s Trances

Dr. Kerson leads clients through focus-enhancing relaxation exercises and guided meditations in these audio recordings.

  • January 26, 2015
  • By Don Kerson

Medication, Meditation, Procrastination and Disorganization: The Four Step Program for Adults With ADD and Depression

Over the years since the publication of “Getting Unstuck” I have been refining and solidifying my approach to the treatment of adults with ADD, with or without depression. I have arrived at a four-pronged approach: four key topics that are addressed with both information and experience.The topics are: Medication, Meditation, Procrastination and Disorganization.

  • January 26, 2015
  • By Don Kerson

Left-Brain Selves and Right-Brain Selves

For the purposes of this discussion, when we say “left- brained” and “right-brained,” we are talking about two complementary modes of thinking that are at first primarily located as electrical activity in their respective hemispheres. They do not always stay so tightly localized. In people who develop in a healthy manner and remain relatively untraumatized, the selves become increasingly complex and increasingly able to hold both thinking styles in mind at once.

  • January 19, 2015
  • By Don Kerson

Badly Named and Poorly Defined

Context is everything. Under the proper circumstances, attention in children and adults with ADD can be more than adequate. In fact, overfocus can be as much of a problem for people with ADD as underfocus. Attention Regulation Disorder or Attention Modulation Disorder might be a more accurate name. It’s not just paying attention that is the issue, it’s facility in the shifting of attention: paying attention to the right thing at the right time.

  • January 9, 2015
  • By Don Kerson

The Doctor is ‘In’! Psychiatric Stand-Up Jan. 29

As ever, mental health threads itself through the media landscape in one form or another. A few weeks ago New York Mayor DiBlasio announced a new mental health focus at Riker's Island prison, which is much needed as everyone knows we closed our asylums and moved these unfortunate folks to prisons instead. The New York Times released a long article on the mental health treatment (or lack of it) of Adam Lanza, the Newtown shooter. 60 Minutes ran a long uplifting piece on Mindfulness, and on the same show a long far more disturbing piece about the inability of several mentally ill teenagers to find adequate care.

The thread that runs through everything I see and hear about mental health is America's woeful, tragic inattention to the antiquated way we divide and disempower our mental health professionals. When I hear about Mayor DeBlasio's intentions for the penal system I am pleased, but immediately I wonder where he expects to find and retain skilled, dedicated practitioners for this long-neglected work (Why exactly has America chosen to incarcerate rather than treat vast, vast numbers of the mentally ill? Is it really cheaper to pay prison guards and feed, clothe and house tens of thousands than to train prescriber-therapists?). I've written here already about gun violence, and this month on our site we've posted a new article, stimulated by the 60 Minutes piece, entitled "Who'll be Minding the Store? Mindfulness, Medication and the Lack of Prescriber-Therapists."

The idea behind this site, apart from the promotion of our business, is that there in fact exist very effective and efficient treatments for many mental health conditions, but that they are rarely available to most of us because they are hard to find and hard to pay for if found. We present ideas about mental health policy, but we also seek to refine and present useful psycho-educational information that displays the kind of treatments that we offer and that we think should be readily available. We are excited to also be posting on our site our treatment outline: Medication, Meditation, Procrastination and Disorganization: The Four Step Program for Adults With ADD and Depression.

This somewhat telegraphic five page article is specific and detailed, and offers, for the first time ever, the clearest picture of the program that has evolved since the publication of "Getting Unstuck" five years ago. We believe that this program offers the most comprehensive, efficient and effective approach to ADD adults and their concerns. We offer the article here for free in the hopes of stimulating discussion, at long last, about exactly how medicine and psycho-educationally skill-based therapies ought to be constructed for this huge under-served population.

Finally, we are busy here in Attentionland preparing for our newest foray:

Thursday, January 29th at Billet and Bellows (177 Grand Street)

The Doctor is In: Psychiatric Stand-Up

The Attention Doctor, Dr. Don, and sorta, kinda well known comic, Kris Tinkle, will be hosting a slew of more or less amusing guests, taking questions from the audience and generally bantering in the name of mental health.

We're holding this groundbreaking event (how long has it been since psychiatry had a sense of humor anyway) at a nifty new venue in the heart of happy hipster Brooklyn, Billet and Bellows, owned by the very talented metal worker and longtime Billyburg fixture Kristina Kozak.

What brings us here to this unusual venture/juncture? Not too many shrinks mounting stand up shows are there?

Partly, we very much want to support Kristina and her lovingly crafted speakeasy; much of what you see there was made by Kristina herself, including the chairs, the table and the bars, and it’s truly unique and peaceful. Partly, we want to inaugurate a venue where the very, very many hyperactive comedians (aren't all comedians hyperactive?) can help me to create the sense of community that I believe is necessary if we ADDers as an interest group are to assert our rights and our needs to secure the care to which I believe we are entitled.

There are 30 million adults with ADD in America, and the best America has to offer them seems to be Dr Phil and Dr Oz, both of whom are empty charlatans. It is no longer enough for me to treat as many of us as I can. There are too many of you and only one of me. I need to spread what I know, to teach what I know. I need to raise questions and seek help to get some answers. And I need your help to do it.

In a matter of months we will be offering an intensive experience of some sort presenting the program that we described above, now available on our site. Much about the format and timing of this offering is as of yet open. On the 29th we’ll be talking some more about that; if you're interested in taking our program in a seminar setting please come out to this event and help us shape that experience.

This mailing list now has 2500 people on it. Many of you know me very well, quite personally. Many of you are or have been patients. Many of you have no such connections. This event is meant to grow this mailing list; it's also meant to test this list’s ability to interest and mobilize its readers. Please share this blog post and our articles if they are of interest to you and to the many others hyperactive folks you undoubtedly know.

Come on out, it’s free and it might be funny:

January 29th at Billet and Bellows

THE DOCTOR IS IN

  • January 8, 2015
  • By Don Kerson

Who’ll be Minding the Store? Mindfulness, Medication and the Lack of Prescriber-Therapists

Complicated individuals need to be addressed with appreciation of neurophysiological differences (ADD, Asperger’s, LD), inherited depressions (bipolar and serotonin), acquired depressions (arousal and motivations), and interpersonal and occupational adjustment. Then the treatment needs to be bolstered and continued by a judicious application of mindfulness and other esoteric practices.

  • January 4, 2015
  • By Don Kerson

Audio: Improving Focus & Functioning

An hour-long talk about Dr. Don’s revolutionary new approach to managing AD/HD in Adults. Recorded live on November 3rd, 2008 at a meeting of the New York chapter of CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder).

  • January 4, 2015
  • By Don Kerson

Audio: Treating AD/HD Adults

This is an audio recording of Dr. Kerson’s live address to the 2013 New Jersey state convention of the NASW. Dr. Don describes his four-part program for treating adults with Attention Deficit and Hyperactivity Disorder (AD/HD).

  • December 24, 2014
  • By Don Kerson

Audio: Rewiring Your Brain Podcast

In this podcast, Dr. Don outlines his new approach to handling attention deficit and hyperactivity disorder in adults. This is followed by a brief question-and-answer segment.

  • December 19, 2014
  • By Don Kerson

Audio: Getting Unstuck

Audio recording of a live talk by Dr. Kerson before the Manhattan Adult ADD Support Group in January, 2008. Dr. Don discusses his approach to Adult AD/HD management, as recently published in his book, Getting Unstuck.

  • October 29, 2014
  • By Don Kerson

Gun Violence and the Death of the Prescriber-Therapist, Part II: What Should We Do?

Remember please, above all, that over and over and over it has been shown that even small amounts of psychiatric care applied consistently over time routinely pays for itself, many times over, in decreased general health care costs. If we can recognize how cost-effective enlightened mental health care can be then to me it stands to reason we should invest in creating the most skilled broadly trained cadre of mental health prescriber-therapists we can. This is of course the hardest of hard sells, a pipe dream from The Attention Doctor.

  • October 28, 2014
  • By Don Kerson

Peter Kramer in the N.Y. Times

The front page article in the Sunday review section of the Times today is by Peter Kramer, of "Listening to Prozac" fame, a fellow Brunonian, (the attention doctor was Class of ’76). He's one of us aging prescriber therapists; but I'd be surprised if you can use ObamaCare to get in to see him.

He pitches his article as a plea for the value of storytelling as a means of teaching the essentially currently un-researchable combined skills of prescribing and conversing therapeutically. What he really does, in the very mild mannered way that polite academic psychiatrists do, is to reveal the bankrupt, corrupt, useless self serving nature of "research psychiatry" and the "evidence based" CBT (cognitive behavioral therapy) which the medical schools, insurance companies and the government are currently using to suck the life out of therapy and the money away from providing mental health care or training.

The sad ugly truth is that there are only two funding sources for psych research: Uncle Sam, ever altering priorities blown by the wind of the next election, and the drug companies, whose research methods are more profit driven and distorted than even the most cynical of us would dare to believe. Neither results in lots of useful truth.

Studies are generally short and unsubtle, driven by the economics of finding and keeping patients willing to distort their care for arguable gain and by the comic "exclusion criteria" designed to purify the studies enough to be meaningful. They just aren't. Meaningful that is.

I think the real point of Kramer's plea, unspoken if you ask me, is that what is needed is the integration of therapy with prescribing, that doctors spend enough time with patients that they actually "could" tell a story, that doctor and patient know each other, and that this relationship, this knowledge of each other, really, as persons, is what needs to be taught and supported and continued, and is very, very much a part of the experience that in fact changes the brain.

Not too much of that going on out there now is there?

Izzat right, Pete?

Stay tuned ladies and gentlemen; if you like us tell your friends.

More to come.

  • October 28, 2014
  • By Don Kerson

Regulatory Juggernaut Attacks Attentionland

Many readers of this material are current or former patients of mine, and as such they have already experienced the misery of rolling stimulant shortages, shifting co-pays, unresponsive byzantine insurers whose live employees know less than their automatons. They have endured the rolled eyes and the helpless shrugs of pharmacists as they troll the city for their medicines. They have seen their doctors retire without replacement as more and more stimulant prescribers fall prey to fees that are never raised and new bureaucratic tasks that never end.

It about to get worse, at least in New York State.

In August 2013 the "tough" centrist" Cuomo administration began demanding that every doctor who prescribes any controlled substance to anyone (opiates, tranquilizers and stimulants) must go online to the PMP (prescription monitoring program) to prevent multiple prescriptions from different doctors. It adds five distracted un-therapeutic minutes to every visit, effectively lowering fees yet again.

Now, coming in March of 2015, all prescriptions are supposed to be electronically submitted. All prescriptions, including stimulants, must be electronically transmitted to one pharmacy at a time. No more written scripts at all. You used to print them yourself. Then they made you get preprinted ones from them. Now they're just going to stop printing them. No written scripts. Period.

I am planning for retirement.

Whosoever devised this plan has no idea what it is like to run a psychiatric practice that caters to busy successful people who also happen to take stimulants. I'm not going into all the ways I feel that these computer based intrusions into my work impair me, (what if my Internet goes down; that never happens to you, does it? Am I supposed to stop working for the day?) but I will say this: It's already more than difficult to find prescribers who are comfortable with and knowledgeable about stimulants, let alone willing to prescribe them at all.

Watch with me as it gets so much worse.

Our Practice Plans; Brooklyn Bound

These business-related regulatory, insurance, record keeping and IT challenges are the very reason why so few doctors who take insurance provide anything more than basic prescribing, and why there are so few of even those. For the past ten years we have had two equal offices; one in Greenpoint and another at various locations in downtown Manhattan.

Simple economics is moving us towards consolidating our offices in one location, Greenpoint, and this shift will take place very gradually over the next 6 months to a year. For the time being we will continue accepting new patients in both locations; by new year we will most likely be taking new work only in our Brooklyn office, and sometime in the spring I will move one of my Manhattan days to Brooklyn.

Just sayin’.

  • October 28, 2014
  • By Don Kerson

Bibliotherapy: The Attention Doctor’s Reading List

When I ask them to allow me to teach them personalized mental exercises, and when I ask them to perform these exercises in a disciplined manner when they are not with me, I want them to understand why I am doing what I am doing. I want them to begin to learn about their brains, as I have spent my entire life learning about mine: by reading. […] There are 18 titles here, books that reflect my need to instruct myself beyond what was available to me as a psychiatric resident 30 odd years ago, books that inform and supplement any work that one might do to develop one’s brain. I’ve divided these books as I group them in my mind. If you’ve read more than a even just a few of them, you’ll know a lot of what I know, and therapy with me (or anyone else) will be far easier and more productive than you can imagine.

  • October 23, 2014
  • By Don Kerson

October in Attentionland; Psychiatry, Our Practice, and The World

Good morning everyone; On this fine fall Sunday we at The Attention Doctor are busy preparing our next newsletter, the second in our renewed series.  In August we threatened frequent outbursts, and some specific articles on ADD and depression. As usual, for me, and for so many of my customers, reality intrudes.

The difficulties of running the small business that is our therapy practice are hard to underestimate, and I am unhappy to report that the assault on outpatient mental health services continues unabated by the less than truly progressive Cuomo administration. Many challenges, many patients, not enough time for this.

First, as ever, I'm going to talk up new articles that are going to be posted alongside this (soon to be more frequent?) blogpost.

As promised, the upcoming "Gun Violence and the Death of the Prescriber-Therapist, Part II: What Should We Do?" continues to ask how can we think about and plan for the likely mental health needs of our less and less well safety-netted shrinking middle class.

Alongside this you will find a piece entitled "Bibliotherapy; The Attention Doctor's Reading List", some ideas and recommendations that have been rattling around up there for too long, that wanted to come out.

It turns out the pieces I promised on ADD and Treatment Resistant Depression are not as well developed as I had hoped, and I am at the moment disinclined to fix them. If this is an issue for you please feel free to contact me here at the site. (See the “Contact” link above or below.)

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Contact Us

Name: Dr. Don Kerson
Phone: 718-383-3493
Address: 861 Manhattan Avenue 2nd Floor, Brooklyn NY 11222