DEA number renewal needs (non-existant) MCSR expiration date SOLUTION

OK, so I went to renew my DEA number… maybe I let it go a little longer than I should have.  (Are a lot of these posts starting with “OK”?  A little anxiety there, maybe?)

In addition to wanting to know your state controlled substance number (in Massachusetts, the MCSR), they (now) need to know the expiration date of your state certificate.

The only problem: there is no expiration date printed on the MCSR certificate.  The other only problem: when you search the web and get to the Mass DPH “FAQ” page, you are told that the certificates do not actually expire, they are “recalled” every few years at the pleasure of the Mass DPH.

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Update to 2013 CPT Codes for Psychiatry

I tweaked the ROS section of history to have a complete list of systems, and better prompts.

I also modified the file names so that they have the date on them.  I will leave old versions up, to reduce possible confusion.  I’ll try to remember to update the original post (at so that it links to the blog entry for the latest update.

I’m making progress on the form for sessions/encounters and I hope to post it soon.

2013 CPT Codes for Psychiatry pdf version
2013 CPT Codes for Psychiatry .doc version for revision/remixing; more info with original post at

New Psychiatry CPT Codes: Don’t Panic

If you’re a psychiatrist (or psychiatric RNCS) in the US reading this, you are almost certainly aware that all of our billing codes changed on Jan 1, 2013.  If you are like most of the psychiatrists I know—at least in private practice—you are at least somewhat freaked out by this.  If so, keep reading.  If not—for example, if you’re not a psychiatrist in the US—stop reading this immediately and go do something more interesting, like… well, like just about anything other than memorizing a phone book.  (There used to be things called phone books…  never mind.)

I made up a one-sheet reference, which I think can help with the codes.  There are links to it at the bottom.

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Affect Defenses and Relationship Defenses: a Unifying Approach to ISTDP

I just got home from the UK where I attended the three-day IEDTA meeting and a three-day ISTDP immersion course taught by Jon Frederickson and Rob Neborsky.  Both were excellent.

Over the past several years, I have been watching a spectrum of ISTDP practice and trying to understand their common elements and differences are.  Other than at conferences, most of the work I’ve been exposed to so far has been from Allan Abbass and Jon Frederickson.  The immersion was the first chance I had to see Rob Neborsky’s work in the style that he and Josette ten Have-de Labije have developed.

Trying to fit their work together with what I already understood led me to a new way of thinking about it, which I found helpful, and which I’ll describe here.  There are no new concepts here, but I think it’s simple, direct terminology that can help us understand what people are doing from a unified standpoint.

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If I’d known baking bread was so easy…

Added later: I never completed this post, but it lets me know when I first got involved in no-knead baking. Lots more posts on bread later.

My aunt was a great, adventuresome cook (and author of the carefully-historically-researched, critically well-received Little House on the Prairie Cookbook).  When I was around 8 years old, she taught me how to make bread.  Maybe five years after that, at Christmastime, I made bread for friends and dropped it at their house (for a number of years after that, I was known to some grandparents only as “the boy who made the bread”).  It was a great project for a kid to spend a day doing: combine the ingredients, let it rise, knead, rise more, punch down, etc etc. Most people I know don’t have that much time on their hands.

My wife has been a Mark Bittman fan for some time and I was interested when she pointed out his no-knead bread recipe.  I looked at it and noticed that you need to bake the bread in an enameled Le Creuset-style dish.  I didn’t have one and wasn’t keen to invest that much to find out whether I like something or not.  But I think it was looking through the comments to that article that I was eventually led to “Artisan Bread in Five Minutes a Day”

Final comment on Errol Morris’s series

Added later: at the time I wrote this, I was able to provide links to the individual comments on Morris’s series that I was responding to; sadly, they were not “permalinks” but “ephemalinks,” and  I did not think to preserve the text of the comments themselves.

I can’t resist taking one last stir at the dying embers here.  @LG #6: I join many others in thanking you for what seems to me to be a very able and cogent summary.  And as you say, it has been an interesting week, certainly very different from just reading a series in the newspaper.  @Skoorby #66: thank you for your very interesting description of the process of following this and other writings and discussion; I can relate to pretty much all of what you said, and I think it’s a valuable contribution as we adapt to this brave new world (in small letters, i.e. Shakespeare more than Huxley) of the web.

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My comment on Errol Morris’s 4th installment of “The Ashtray” ran over 5,000 characters


I finally hit my limit today, and I had some time, so I wrote a comment on Errol Morris’s 4th installment of his  “Ashtray” series on the Times web site.  Comments are limited to 5,000 characters and the site cheerfully informed me that I had minus 1520 characters remaining.  So here it is in its entirety:

There is apparently yet another Thomas Kuhn here, one I don’t think he would have ever anticipated: the Thomas Kuhn who threw the ashtray.  Speaking as his son I have to say that, try as I might, I just can’t get myself to believe that he threw that ashtray.

I am not someone to take the ramparts to defend my father against every allegation.  He was a complicated guy and he did a lot of things.  Many were admirable.  Some were absolutely indefensible.

What we’re seeing here is not a rejection of his views; it’s a rejection of a caricature of his view.  He never believed in any sort of relativism that says there is no truth other than the point of view people take on it.  He believed very much in truth, but he also knew that understanding what it is to be true is much more complicated than it might first appear.

He certainly made mistakes, and I certainly heard him say things that I knew to be false but that he believed based on his own distorted point of view.  But I don’t believe I ever saw him say anything that he knew to be untrue.  He believed in truth, and he believed in truthfulness.  He had a bad temper at times.  He could be angry, he could yell, he could behave quite badly, but I never, ever saw him be violent, threaten violence, or throw anything, not even the pencil that was perpetually tucked behind his ear.  I’m prepared to believe quite a few unflattering things about him, and to say some myself (though mostly in private), but I just can’t get myself to believe that he threw that ashtray, and neither can anyone I’ve talked to who knew him well—among whom there is quite a spectrum of overall opinion about him.  (I should say here that, as a few commenters have noted, he could also be generous, helpful, understanding, encouraging, and more.)

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“The Legacy of Thomas Kuhn”


Errol Morris, whom I otherwise greatly respect, is in the midst of posting a five-part series on the New York Times web site entitled “The Ashtray” about my father, their vexed relationship, the nature of truth, etc.  The series is by turns…  well, I’m hoping to write more about it here later—we’ll see whether that happens.

In the meantime, it reminded me of some remarks I made at a November 1997 “Symposium on the Legacy of Thomas Kuhn,” at MIT’s (late) Dibner Institute, in response to another former student of his who had suggested in a presentation that the most sensible way to account for the widespread dissemination of Kuhn’s ideas was because he had Narcissistic Personality Disorder (as defined by the by-then-already-outdated revised 3rd edition of the American Psychiatric Association’s DSM [Diagnostic and Statistical Manual of…]). Never mind the fact that most people with Narcissistic Personality Disorder don’t get their ideas disseminated very far. Continue reading ““The Legacy of Thomas Kuhn””

The first armband!

Well, I did wear the armband to Fenway.  Many thanks to my wife, without whom this would not actually have happened.

Somewhat the worse for wear at the end of the day, but you get the idea.

There was a long line for blood donations, so I was there for about two hours.  No one said a word to me about it.  But I’m guessing some people did notice it, and thought about it.

I heard a chunk of Tom Ashbrook’s On Point today, which was a show on Islam in America.  It included a good discussion on the diversity of opinions and beliefs among muslims in the US and around the world.