Awais Aftab
Psychiatrist with philosophical interests | Conversations in Critical Psychiatry (Oxford University Press, 2024) | Psychiatry at the Margins www.psychiatrymargins.com
- Reposted by Awais AftabI posted this to reddit, it received a lot of attention before being removed by mods (?) I guess the uncomfortable realities presented were too much for them.
- What Do We Owe the Insufferable? When mental illness exhausts our emotional capacities www.psychiatrymargins.com/p/what-do-we...
- Reposted by Awais AftabReading @awaisaftab.bsky.social's new blog post instead of listening to a psychoanalytic podcast. Check it out here:
- What Do We Owe the Insufferable? When mental illness exhausts our emotional capacities www.psychiatrymargins.com/p/what-do-we...
- Dan Stein's obituary in the Lancet www.thelancet.com/journals/lan...
- Reposting for the Monday crowd 👇🏽
- Your brain on stimulants vs your brain on ADHD There is more to what ADHD is than what stimulants do, and there is more to the clinical use of stimulants than the boundaries of ADHD www.psychiatrymargins.com/p/adhd-beyon...
- Your brain on stimulants vs your brain on ADHD There is more to what ADHD is than what stimulants do, and there is more to the clinical use of stimulants than the boundaries of ADHD www.psychiatrymargins.com/p/adhd-beyon...
- Reposted by Awais AftabWorth the read, and jargon explained. Nice!
- I feel like sharing this post again… Antirealism Will Not Save the DSM From Empirical Inadequacy What does the DSM say about the unobservable structure of psychopathology? www.psychiatrymargins.com/p/antirealis...
- I feel like sharing this post again… Antirealism Will Not Save the DSM From Empirical Inadequacy What does the DSM say about the unobservable structure of psychopathology? www.psychiatrymargins.com/p/antirealis...
- Reposted by Awais Aftab"Can a Psychiatric Crisis Save Your Life?" Texto interessante e bem equilibrado do @awaisaftab.bsky.social www.psychiatrymargins.com/p/can-a-psyc...
- Reconsidering Lithium as the Gold Standard for Bipolar Disorder: A Personal History “Lithium is one of our tools but has no special status.” A guest post by Robert Haim Belmaker www.psychiatrymargins.com/p/reconsider...
- The latest in nominative determinism 😃
- Reposted by Awais AftabMadness gifted me the most precious things, things from the forbidden realm beyond the veil where we aren't meant to go & can't stay for long while maintaining function in this world. Most mad people will say that though it's suffering it has imparted us with things we're grateful for.
- Can a Psychiatric Crisis Save Your Life? Madness as breakdown and breakthrough www.psychiatrymargins.com/p/can-a-psyc...
- Reposted by Awais AftabA great weekend read. As with previous interviews with the likes of Wouter Kusters, it's useful to ask whether MH episodes, in a counter-intuitive way, can serve a purpose for some people.
- Can a Psychiatric Crisis Save Your Life? Madness as breakdown and breakthrough www.psychiatrymargins.com/p/can-a-psyc...
- Reposted by Awais AftabOnly partially read so far but PSYCHED to see my absolute fave talking about the unspoken positives of “bad mental health” bc I’ve wanted to put this into words/explore this for years
- Can a Psychiatric Crisis Save Your Life? Madness as breakdown and breakthrough www.psychiatrymargins.com/p/can-a-psyc...
- Can a Psychiatric Crisis Save Your Life? Madness as breakdown and breakthrough www.psychiatrymargins.com/p/can-a-psyc...
- Reposted by Awais AftabClaudenfreude: the feeling you get when someone gets busted for using AI when they shouldn’t h/t @ssweatt.bsky.social for coining it
- Reposted by Awais AftabJust learned I've won the APA Distinguished Scientific Award for Early Career Contributions to Psychology in the area of psychopathology, and am feeling pretty delighted!! So grateful to @aidangcw.bsky.social for nominating me, and very proud of the work it's based on.
- My periodic round-up of interesting stuff I’ve read (And some personal media favorites from 2025) www.psychiatrymargins.com/p/notable-li...
- Reposted by Awais AftabI když Freud položil základy psychoanalýzy a dodnes je v psychoanalytických kruzích velmi důležitou figurou, současná psychoanalýza není pouze o něm. Akademická psychologie to bohužel nebere moc v potaz. @awaisaftab.bsky.social toto téma rozebírá v přiloženém textu.
- It just occurred to me that this juxtaposition is almost an illustration of what Dan Oppenheimer had identified as the dynamic between the Scientist and the Survivor is his profile of me, except in this case both the Scientist and the Survivor were able to grow beyond the limitations of their roles.
- The All of Thine That Cannot Die: Farewell to Two Friends In memory of Dan J. Stein and Lisa Wallace www.psychiatrymargins.com/p/the-all-of...
- The All of Thine That Cannot Die: Farewell to Two Friends In memory of Dan J. Stein and Lisa Wallace www.psychiatrymargins.com/p/the-all-of...
- Reposted by Awais AftabStories like this this make me realise how difficult public health progress can be. Inertia is a powerful force! Each story stresses a different mechanism for inertia Here, health progress was curiously lost due to technical progress. /1
- How the Citrus Cure for Scurvy Was Lost, and Lessons for the Science of Psychopathology The copper-lined containers and the contexts that neutralize treatment www.psychiatrymargins.com/p/how-the-ci...
- How the Citrus Cure for Scurvy Was Lost, and Lessons for the Science of Psychopathology The copper-lined containers and the contexts that neutralize treatment www.psychiatrymargins.com/p/how-the-ci...
- Cool study in JAMA Psychiatry confirms what many have suspected for a while: PHQ (depression questionnaire) instructions are widely misinterpreted by patients. It is unfortunate that a questionnaire as shitty as PHQ-9 has become so ingrained & ubiquitous jamanetwork.com/journals/jam...
- I should note though: if we created a version of PHQ-9 that didn’t have these interpretation issues, it will in all likelihood still correlate very highly with the current PHQ-9. Imperfect measures can still index symptom burden and track change with meaningful utility… (/1)
- … but that is no excuse to tolerate imperfection, esp at this large scale of implementation, when we can easily do better. (/2)
- Why I'm Trying Psych Meds Again and how I've changed my mind about their critics An excellent post by Jesse Meadows www.sluggish.xyz/p/why-im-try...
- Reposted by Awais AftabWell. The only hope remains for research programs that try to find the cause of psychotic disorders. If not us, then, maybe younger folks will have the chance to be free of this.
- Antipsychotic tapering appears to help long-term in a new trial but not for the obvious reason… And considerable uncertainty remains My discussion of the HAMLETT study by Sommer et al. (October 2025, JAMA Psychiatry) www.psychiatrymargins.com/p/antipsycho...
- Antipsychotic tapering appears to help long-term in a new trial but not for the obvious reason… And considerable uncertainty remains My discussion of the HAMLETT study by Sommer et al. (October 2025, JAMA Psychiatry) www.psychiatrymargins.com/p/antipsycho...
- A review of “Conversations in Critical Psychiatry” by Daniel Cohrs for the AJP Residents’ Journal. “The field’s conceptual terrain is rich, multifaceted, and contentious; the dialogue format allows for its exploration in a way that is both thoughtful & precise” psychiatryonline.org/doi/full/10....
- If you’re convinced the cure is worse than the disease, it’s awfully tempting to also convince yourself that there was never an illness in the first place. Nowhere is this impulse more evident than in debates about psychopathology.
- Mixed Bag #25: Kinnon MacKinnon on Trans Identity and Medicine MacKinnon explores the topic using a book, a concept, a person, an article, and a surprise item www.psychiatrymargins.com/p/mixed-bag-...
- What Other Diagnoses Could Learn From Autism’s Diagnostic Appeal The role of cognitive-perceptual mechanistic explanations A response by Riva Stoudt to my autism differential diagnosis post www.psychiatrymargins.com/p/what-other...
- Reposted by Awais Aftabwww.news.uct.ac.za/article/-202... an amazing colleague, too young
- Reposted by Awais AftabBlog post: Within family prediction of psychopathology: Bad prediction is bad prediction. ericturkheimer.substack.com/p/within-fam...
- Dan J. Stein passed away on Dec 6, 2025, after a reportedly short illness. An unexpected death, we had emailed just 2 weeks ago! He was brilliant and wise, a distinguished psychiatrist, a true intellectual, a good friend. He was really gracious to me, I owe him a lot. Rest in peace. I will miss you.
- The picture is from Oct 2023 when we presented together at ECNP in Barcelona.
- Reposted by Awais AftabI think @awaisaftab.bsky.social suggestions are worth giving serious consideration.
- 6 Suggestions for DSM-6 Making the next DSM look less like a house of mirrors www.psychiatrymargins.com/p/6-suggesti...
- Reposted by Awais Aftab@awaisaftab.bsky.social your articles always lead to the most interesting discussions! Thank you so much for sharing
- Reposted by Awais Aftabimpaired social cognition is a huge bucket of different things. i am not a clinician but it might be less about the extent and more about the *how*.
- Reposted by Awais Aftab"the choice is not between autism or nothing, but rather between autism and about a dozen other diagnostic possibilities". This is very relevant for discussions of overdiagnosis and self-diagnosis. #autism
- Autism’s Confusing Cousins A differential diagnosis for the weird and the awkward www.psychiatrymargins.com/p/autisms-co...
- Reposted by Awais AftabUma introdução interessante e bem equilibrada à confusão diagnóstica relacionada ao autismo.
- Autism’s Confusing Cousins A differential diagnosis for the weird and the awkward www.psychiatrymargins.com/p/autisms-co...
- Reposted by Awais AftabThe most recent article I saw was "Social cognition deficits in borderline personality disorder: Clinical relevance" by Galvez-Merlin et al. (doi.org/10.1016/j.ps...). There's also some older work by Roepke et al. (DOI: 10.3389/fnins.2012.00195) and Preißler et al. (doi.org/10.3389/fnbeh.2010.00182)
- Reposted by Awais Aftab
- Autism’s Confusing Cousins A differential diagnosis for the weird and the awkward www.psychiatrymargins.com/p/autisms-co...
- Autism’s Confusing Cousins A differential diagnosis for the weird and the awkward www.psychiatrymargins.com/p/autisms-co...
- Reposting for the Monday crowd
- Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz Exploring medication effects mediated symbolically www.psychiatrymargins.com/p/meaning-me...
- Reposted by Awais AftabAre biology-based explanations enough? 🎧 In our latest ECNP podcast, @awaisaftab.bsky.social & Stefan Jerotic explore pluralism, patient perspectives & conceptual clarity in psychiatry. Listen on your preferred platform Spotify: ow.ly/IZ7j50XzXOP Apple: ow.ly/93pg50XzXOO YouTube: ow.ly/sBiX50XzXOR
- Reposted by Awais Aftablove his book! thanks so much for this interview, it was a wonderful back and forth that resonates with so many parts of my training
- Meaning, Medications, and Psychodynamic Psychopharmacology: Discussion with David Mintz Exploring medication effects mediated symbolically www.psychiatrymargins.com/p/meaning-me...
- Reposted by Awais Aftabcircling p-values right below .05 to infer something about the invalidity of inferences (or even research misconduct) is conceptually no different from calling p-values right above the threshold marginally significant. makes no sense to deride one of these practices while upholding the other.
- The Clinical Craft of Psychiatric Medication Tapering: Q&A with Anders Sørensen “Withdrawal teaches you, as the clinician, that you don’t control the process. Successful tapering is inherently patient-led, and there’s a kind of humility in accepting that.” www.psychiatrymargins.com/p/the-clinic...
- “RCTs or STFU” is its own form of fundamentalist dogma in medicine that is ultimately incoherent and self-serving.
- 6 Suggestions for DSM-6 Making the next DSM look less like a house of mirrors www.psychiatrymargins.com/p/6-suggesti...
- Reposted by Awais Aftab"what we need from DSM-6 is transparency about what evidence, if any, supports the particular thresholds for the conditions included in the manual, and why that particular threshold is what it is" 👏🏻
- 6 Suggestions for DSM-6 Making the next DSM look less like a house of mirrors www.psychiatrymargins.com/p/6-suggesti...
- Reposted by Awais Aftab@awaisaftab.bsky.social is amazing, as usual. Loving this post. Regarding DSM diagnostic criteria: "A best guess is fine as a starting point, but it cannot be treated as something special or sacred..." as it is basically a "pulled-out-of-the-ass threshold" www.psychiatrymargins.com/p/6-suggesti...
- Reposted by Awais AftabMore like a house of broken glass that traps us and slices us open. :(
- 6 Suggestions for DSM-6 Making the next DSM look less like a house of mirrors www.psychiatrymargins.com/p/6-suggesti...
- 6 Suggestions for DSM-6 Making the next DSM look less like a house of mirrors www.psychiatrymargins.com/p/6-suggesti...
- I am truly honored by the piece Daniel Oppenheimer (a wonderful writer & podcaster) wrote about me for Psychotherapy Networker, a generous profile (with kind comments from Frances & Aviv) & many apt observations by Daniel about the state of psychiatry www.psychotherapynetworker.org/article/psyc...
- For the Monday crowd 👇🏽
- In Search of the Unclassified Residuum: Q&A with Rachel Aviv The author of “Strangers to Ourselves” on diagnostic stories, iatrogenic narratives, explanatory pluralism, humility, and more. www.psychiatrymargins.com/p/in-search-...
- In Search of the Unclassified Residuum: Q&A with Rachel Aviv The author of “Strangers to Ourselves” on diagnostic stories, iatrogenic narratives, explanatory pluralism, humility, and more. www.psychiatrymargins.com/p/in-search-...
- The sexual impact of SSRIs in adolescents is poorly understood and we know even less about instances of protracted sexual difficulties. An important call to action — more research and more mindful clinical practice — by Daniel Bergner in @nytimes.com www.nytimes.com/2025/11/12/m...
- Re-reading “Acute Religious Experiences” by @dranamorphosis.bsky.social this weekend, and God — what a bloody brilliant book!
- “detransition is not a monolithic experience… it can span changes in self-concept, mental health-related factors, gender minority stressors, treatment satisfaction or dissatisfaction, and healthcare access barriers.” www.psychiatrymargins.com/p/understand...
- The 4 classes: * Detransitioning with regret (Class A) *Identity evolutions (Class B) * Transition ambivalence (Class C) * Interrupted gender transitions (Class D)
- Understanding Detransition(s) in Transgender Healthcare The diversity of detransition experiences in the DARE study Guest post by Kinnon Ross MacKinnon www.psychiatrymargins.com/p/understand...
