What produces mental illness: genes, environment, both,neither? The answer can be found in memes-replicable units of information linking genes and environment in the memory and in culture-whose effects on individual brain development can be benign or toxic. This book reconceptualizes mental disorders as products of stressful gene-meme interactions and introduces a biopsychosocial template for meme-based diagnosis and treatment. A range of therapeutic modalities, both broad-spectrum (meditation) and specific(cognitive-behavioral), for countering negative memes and their replication are considered, as are possibilities for memetic prevention strategies. In this book, the author outlines the roles of genes and memes in the evolution of the human brain; elucidates the creation, storage, and evolution of memes within individual brains; examines culture as a carrier and supplier of memes to the individual; provides examples of gene-meme interactions that can result in anxiety, depression, and other disorders; proposes a multiaxial gene-meme model for diagnosing mental illness; identifies areas of meme-based prevention for at-risk children; and defines specific syndromes in terms of memetic symptoms, genetic/ memetic development, and meme-based treatment.

Consultation-liaison psychiatry is an important interface between psychiatry and the rest of medicine as well as psychology, social work, nursing, and other behavioral science disciplines. This book is a practical, up-to-date handbook providing a biopsychosocial, integrative perspective and drawing the expertise of two renowned psychiatrists in the field. It is organized in five major sections addressing the fundamentals of the field as well as including an assessment of where the field is today. Chapters also address specific pathologies and populations.

ConsultationLiaison Psychiatry on the Threshold of a New Century (H. Leigh). Legal and Ethical Changes in Consultation Psychiatry (L. Tong, C. Van Dyke). Chronic Pain (J. Streltzer, B. Eliashof). Chronic Pain and Addiction (J. Streltzer). Psychiatric Consultation with Chemically Dependent Patients (S. Griffith). The Dementia Syndrome in ConsultationLiaison Psychiatry (R. Hanowell). Psychotherapy Solutions in the Medical Setting (S. Eisendrath). Physical Factors Affecting Psychiatry Condition (H. Leigh). Training in Medical Psychiatry (S. Ahles). ConsultationLiaison in Child Psychiatry (D. Fox). ConsultationLiaison 19801990 (J. Streltzer). ConsultationLiaison Funding (J. Strain et al.). Computerization and ConsultationLiaison Psychiatry in the 1990's (S. Powsner). A Computerized Database System for Psychiatric and Consultation Records (H. Leigh). Databasing in CLP Psychiatry (J. Hammer, J. Strain). Index.

This revised and updated edition incorporates new developments that have emerged since the publication of the second edition in 1985.

This authoritative reference surveys mind-body healing concepts and psychosomatic medicine in diverse countries and regions of the world. It provides practical insights on the Western division between medical and mental healing and useful information concerning recent efforts to bridge that enduring divide, particularly in the use of ancient and indigenous healing knowledge in psychosomatic practice. Coverage compares and contrasts current applications of psychosomatic medicine and/or consultation-liaison psychiatry as conducted in such representative countries as France, Britain, China, India, Argentina, Canada, and the United States. And the book predicts how this synthesis of traditions and advances will progress as it: Traces the history and development of psychosomatic medicine. Reviews contributions of traditional healing methods to psychosomatic medicine. Analyzes national styles of psychosomatic medicine as practiced in specific countries. Compares the status of psychosomatic medicine / consultation-liaison psychiatry in various countries. Considers the future of psychosomatic medicine as the field, and the world, evolves. Global Psychosomatic Medicine and Consultation-Liaison Psychiatry expands the knowledge base for psychiatrists, primary care physicians, psychiatric and primary care residents, medical students, behavioral medicine specialists, and others who are interested global and regional perspective on providing biopsychosocial care. It is also relevant for advanced students in health psychology and behavioral medicine, and for professionals in related health fields.

This updated resource refines and expands on both the core concepts and the real-world practice of consultation-liaison psychiatry in medical settings. New and revised chapters provide background and basics and describe CL psychiatry approaches to managing a wide array of common conditions, including heart disease, dementia, anxiety and depressive disorders, alcohol and substance use problems, and chronic pain. Besides the fine points of practice in varied chronic and acute care settings, specific patient populations such as children, elders, ob/gyn patients, and the immunocompromised are discussed. The latest information and insights on pharmacology, interviewing, and ethical and cultural issues round out the book's highly accessible coverage. A sampling of topics in the Handbook: Basic foundations of diagnosis, psychiatric diagnosis, and final common pathway syndromes. An integrative care model of psychiatry in the primary care setting. Patient personality, personality types and traits, and disorders. The chronic patient and the palliative care setting. Trauma- and stressor-related disorders. Somatic symptoms and related disorders. The Second Edition of the Handbook of Consultation-Liaison Psychiatry ably follows its predecessor by presenting the diverse state of the specialty to enhance the work of psychiatrists, clinical psychologists, and primary care physicians.

This updated resource refines and expands on both the core concepts and the real-world practice of consultation-liaison psychiatry in medical settings. New and revised chapters provide background and basics and describe CL psychiatry approaches to managing a wide array of common conditions, including heart disease, dementia, anxiety and depressive disorders, alcohol and substance use problems, and chronic pain. Besides the fine points of practice in varied chronic and acute care settings, specific patient populations such as children, elders, ob/gyn patients, and the immunocompromised are discussed. The latest information and insights on pharmacology, interviewing, and ethical and cultural issues round out the book's highly accessible coverage. A sampling of topics in the Handbook: Basic foundations of diagnosis, psychiatric diagnosis, and final common pathway syndromes. An integrative care model of psychiatry in the primary care setting. Patient personality, personality types and traits, and disorders. The chronic patient and the palliative care setting. Trauma- and stressor-related disorders. Somatic symptoms and related disorders. The Second Edition of the Handbook of Consultation-Liaison Psychiatry ably follows its predecessor by presenting the diverse state of the specialty to enhance the work of psychiatrists, clinical psychologists, and primary care physicians.

The essential role of the psychiatrist as consultant and educator of primary care physicians is increasing in importance as the American health care system faces fundamental restructuring. In a recent workshop during the annual meeting of the American Psychiatric Association, a number of prominent consultation-liaison psychiatrists reviewed major developments in consultation-liaison psychiatry during the past decade and looked toward the future. This book is based on these presentations, but it is not simply a proceedings book. A number of additional experts have contributed important chapters, and all the chapters based on the presentations are expanded and updated. Thus, this book reviews the current state of consultation-liaison psychiatry and anticipates future challenges. It also informs the reader about the state-of-the-art knowledge and skills in consultation-liaison psychiatry as of 1994. This book should be a valuable up-to-date overview/refresher for both consultation liaison psychiatrists and general psychiatrists who wish to update and formulate his/her consultant role. It should be especially valuable for psychiatric residents for whom the role as consultant to primary physicians assumes increasing importance, and for primary physicians and medical students who are interested in learning about commonly encountered complex biopsychosocial problems of their patients and integrating these dimensions in patient care. I am grateful to Mary Safford and Eileen Bermingham of Plenum for their help with the preparation and production of this book. I am also thankful to Anita Shaw for her secretarial help. Hoyle Leigh, M. D.

The old-fashioned doctor, whose departure from the modern medical scene is so greatly lamented, was amply aware of each patient's per sonality, family, work, and way of life. Today, we often blame a doctor's absence of that awareness on moral or ethical deficiency either in medical education or in the character of people who become physicians. An alternative explanation, however, is that doctors are just as moral, ethical, and concerned as ever before, but that a vast amount of additional new information has won the competition for attention. The data available to the old-fashioned doctor were a patient's history, phys ical examination, and "personal profile," together with a limited number of generally ineffectual therapeutic agents. A doctor today deals with an enormous array of additional new information, which comes from X-rays, biopsies, cytology, electrographic tracings, and the phantas magoria of contemporary laboratory tests, and the doctor must also be aware of a list of therapeutic possibilities that are both far more effective and far more extensive than ever before."

Consultation-liaison psychiatry interfaces between psychiatry and the rest of medicine as well as psychology, social work, nursing, and other behavioral science disciplines. This is a practical, up-to-date handbook providing a biopsychosocial, integrative perspective and drawing of the expertise of two renowned psychiatrists in the field. The book offers five major sections addressing the fundamentals of the field as well as an assessment the current status of the field.

ST MEDICINE IN A CHANGING UNIVERSE AT THE THRESHOLD OF THE 21 CENTURY Hoyle Leigh, M. D. I Professor ofPsychiatry San Francisco, University ofCalifornia, and Fresno VAMedical Center INTRODUCTION During my lifetime, the universe has changed beyond recognition. The universe into 111 which I was born, in the first halfofthe 20 century, was still infinite, permanent, orderly, and tranquil --- a universe that worked like a masterfully constructed clock. Matter and energy followed Newton's lawsofconservation. Shortly after my birth, Hiroshima proved, with a big bang, that matter was no longer permanent, everything was relative. Einstein had also shown thateverything that happened was local, that is, there was an event horizon beyond which no information could reach as nothing can travel faster than light. When I was growing up, the moon was for lovers, and going there was an impossible dream. Cosmologically, the Big Bang theory that postulates that the universe was born out ofan explosion some 10-15 billion years ago from a primordial point won over steady state. Ithas been expanding ever since, although the ultimate fateofthe universe is still unknown whetherit will keep on expanding resulting in aperpetual stateofheat death, or will at some point startcontracting, resulting in a big crunch ofgravitational collapse ending in a single black hole out ofspace, time, and existence. Quantum theory has defeated even Einstein's genius and proven that God indeed plays dice."

ST MEDICINE IN A CHANGING UNIVERSE AT THE THRESHOLD OF THE 21 CENTURY Hoyle Leigh, M. D. I Professor ofPsychiatry San Francisco, University ofCalifornia, and Fresno VAMedical Center INTRODUCTION During my lifetime, the universe has changed beyond recognition. The universe into 111 which I was born, in the first halfofthe 20 century, was still infinite, permanent, orderly, and tranquil --- a universe that worked like a masterfully constructed clock. Matter and energy followed Newton's lawsofconservation. Shortly after my birth, Hiroshima proved, with a big bang, that matter was no longer permanent, everything was relative. Einstein had also shown thateverything that happened was local, that is, there was an event horizon beyond which no information could reach as nothing can travel faster than light. When I was growing up, the moon was for lovers, and going there was an impossible dream. Cosmologically, the Big Bang theory that postulates that the universe was born out ofan explosion some 10-15 billion years ago from a primordial point won over steady state. Ithas been expanding ever since, although the ultimate fateofthe universe is still unknown whetherit will keep on expanding resulting in aperpetual stateofheat death, or will at some point startcontracting, resulting in a big crunch ofgravitational collapse ending in a single black hole out ofspace, time, and existence. Quantum theory has defeated even Einstein's genius and proven that God indeed plays dice.

The old-fashioned doctor, whose departure from the modem medical scene is so greatly lamented, was amply aware of each patient's personality, family, work, and way of life. Today, we often blame a doctor's absence of that awareness on moral or ethical deficiency either in medical education or in the character of people who become physicians. An alternative explanation, however, is that doctors are just as moral, ethical, and concerned as ever before, but that a vast amount of additional new information has won the competition for attention. The data available to the old-fashioned doctor were a patient's history, physical examination, and "per sonal profile," together with a limited number of generally ineffectual therapeu tic agents. A doctor today deals with an enormous array of additional new information, which comes from X rays, biopsies, cytology, electrographic tracings, and the phantasmagoria of contemporary laboratory tests; and the doctor must also be aware of a list of therapeutic possibilities that are both far more effective and far more extensive than ever before."

What produces mental illness: genes, environment, both,neither? The answer can be found in memes-replicable units of information linking genes and environment in the memory and in culture-whose effects on individual brain development can be benign or toxic. This book reconceptualizes mental disorders as products of stressful gene-meme interactions and introduces a biopsychosocial template for meme-based diagnosis and treatment. A range of therapeutic modalities, both broad-spectrum (meditation) and specific(cognitive-behavioral), for countering negative memes and their replication are considered, as are possibilities for memetic prevention strategies. In this book, the author outlines the roles of genes and memes in the evolution of the human brain; elucidates the creation, storage, and evolution of memes within individual brains; examines culture as a carrier and supplier of memes to the individual; provides examples of gene-meme interactions that can result in anxiety, depression, and other disorders; proposes a multiaxial gene-meme model for diagnosing mental illness; identifies areas of meme-based prevention for at-risk children; and defines specific syndromes in terms of memetic symptoms, genetic/ memetic development, and meme-based treatment.