I wish the symptoms were called "additive" and "subtractive" symptoms rather than "positive" and "negative ones. It would cause so much less confusion on the part of pretty much everyone

I've seen quite a lot of these old psychiatric "interviews" (I don't know a better word for it in English), and I've always wondered how they hold up today. So this is very interesting to see, I would love to see more reactions like this

I loved this guy from the first day I saw him. I am 31, and spent some days in a mental facility in 2012 over a psychotic outbreak. The respect that you, doctor, show for this guy in this video is what is warranted from every doctor but not always found. I learned from this video, aside from many interesting facts, that my autism is not the worst scenario as I so selfishly pitied myself and blamed doctors for it. Time to keep growing. Great video ❤ greetings from Argentina

This is so interesting. I'm a psych BA who now just deals cards at a casino so I enjoy living my dream vicariously through the real deal ones pft. It's very interesting to hear about things like this, and it helps that it's more media-directed. You seem very sympathetic and thoughtful as you discuss it, too.

THANK YOU, I have been Catatonic and it is so rare to see anything about Catatonia at all and I loved your comments about understanding what helps a person stay well as opposed to just understanding their risk factors. A little about my story for anyone interested in the Catatonic experience: I suffered through Catatonic "stupor" for about 2 weeks in 2020. My disgnoses was/is Major Depressive Disorder & Catatonia. I was given put on an antidepressant and Lorazepam, which I have since learned is referred to as the "Lorazepam challenge". Eventually, it was decided my condition warranted an emergency ECT treatment, emergency in the sense that it began immediately on a weekend, instead of the regular ECT treatment days. ECT was decided on by my Dad and a team of Psychiatrists after my condition deteriorated to the point I wasn't eating, barely drinking water and often needed to be moved into position, eg on one occasion lifted out of a wheelchair into my bed and I had kept the posture and body positioning of someone seated, needing to be pushed into a laying position and have my legs straightened out. My experience was almost entirely negative symptoms. Waxy Flexibility, Catalepsy, slowed speech if any speech at all; with the occasional positive symptoms, almost exclusively Echolalia. Please do more Catatonia content. It's a devastating disorder that many nurses and Doctors have zero experience with.

The analysis of this man's speech reminded me that, many years ago, I knew a linguist who did some really interesting studies regarding the psychiatric diagnostic criteria relating specifically to speech. The work she was presenting at the time involved testing the speech patterns of hospitalized schizophrenic patients, using both patients hospitalized with major depression and a group with no known psychiatric disorders as controls (sadly, due to how long ago this was, I can't remember the specific methods she used to test the speech patterns of the subjects). Anecdotally, in that particular study, I remember she found one patient diagnosed with schizophrenia whose linguistic abnormality did not fit with the rest of the subjects, which caused her to suspect they might have been misdiagnosed. Sadly, that patient committed suicide soon after, and we'll never know whether or not she was correct or if her methods might have helped them. Still, I believe that having scientists whose field of study is (in this case) language take their specifically created tools and attempt to apply them to this one aspect of psychiatry (or, really, any field where language plays a part in diagnoses) could potentially really help professionals in that field fine tune the process. I haven't been in academia in many years now, but I hope more people are doing such work, as it really was in its infancy at the time.

My daughter has schizophrenia, it is an awful illness that affects the whole family and friends of the sufferer. We need a cure; keeping the symptoms somewhat at bay with anti-psychotics and their devastating side effects is not good enough.

This is so interesting. There's a similar video of that time about bipolar I believe. Really fascinating as well. Both illnesses are so severe and often misunderstood. I have bipolar.

This was incredibly educational! Thank you

I really want you to react to the psychiatrist in Terminator 1 & 2, the scenes are great, especially in Terminator 2, but when I watched T1 recently I was like, man, he's awful. Yea he thinks he's delusional, but he's mocking him to his face, which is probably the worst way to approach that.

Thanks, I really like your takes on these sorts of "old interviews". I have severe depression, AVPD, cPTSD, chronified eating disorder and lots of anxiety. About thoughts, I rather have the opposite issue, often having them bombarding me mercilessly. I sometimes stuggle with speak blockage though (meaning I have the words in my brain but I just can't say them for a while) and/or word finding problems. I hate it with a passion. I am generally really bad at "tolerating the silence", which does not help me at all, because stressing myself makes it only harder to get these words out. If it gets really bad all that comes out is "eh...eh". It's like watching myself from outside and wanting to madly push myself to get things going. Just watching this video and the poor man makes me only gain more respect for the profession of the psychiatrist. To tell the difference between a brain that is overflown with thoughts or a barin that has thought blockages, when from outside you just see a person taking a lot of time to say something must need very good observation skills. Not even to mention the patience and ampathy with patients. ABout the lack of movement, rather recently (since a few monts) I found to have moments where I cannot move a single muscle for a while. It somehow similar to the thought blockage in the way that its light obeserving myself from outside, yelling at myself and calling me names. Like "Just move that arm NOW...". It most often happens when getting up from bed, where I'm half sitting, sometimes in uncomfy positions and just need to shout at me internally for severel seconds until I finally get to move. Often then it's sudden, like "hep" and the whole body "overmoves" almost. I guess it's linked to my depressive state, but it's annoying. And scary too. Also, as I live alone, I don't really know how long they last. The watch hardly helps, since I can't predict them I have no "starting point" for a reference. I can't help but wonder how is the psychological strain for the patient in the video about his symptoms? As I said, I am painfully aware of my "mute" and "immobile" moments and they freak me out. Sorry for digressing. I did not know of that sort of complete absence of thoughts before. So I learned that exists too.

Wow. What you described re: catatonia sounds very much like an autistic shutdown with selective mutism. I describe it as being blank - it’s just like a white page with a blinking cursor in my brain. The internal narrator is gone and words are gone as well. Fascinating!

I really enjoy these types of videos , we can learn so much about mental health and the symptoms people experience with these type of illnesses. Truly educational and to understand the workings of the mind. ❤ very very complex and we need to get better at understanding mental health in general. ❤

I recognize a part of the symptoms that I sometimes have when I have a lot of stress and anxiety. I am then unable or have a hard time moving, also speaking is very hard or just not possible. so far I had it just for a short period of time and human contact seems to help to get out of it. I don't have psychosis and never had but am autistic and have ocd

We watched this video in a lecture about Schizophrenia recently, so it's super cool to see you reacting to it! I'm also writing my bachelor's project on Schizophrenia, so this is a gold mine for general understanding😊

Your enthusiasm and general demeanor makes me want to have a beer with you and discuss life! Hope you're well and keep up making the world a better place ❤

Very interesting. Thank you doc! ❤

Fascinating, what really stands out to me as an amateur, is how well spoken and articulate this individual is, yet its still hard to follow his reasoning. I was really impressed how quickly you were able to dissect his behaviour, and the therapists as well. I noticed in your videos, you spoke quite often of delusions. In the show 'Legion' they have this great narration by Jon Hamm on the nature of delusion, reality and madness. There even are compilations of all the monologues on KZfaq. I really like the one 'facets of delusion', a 16 min video, I think it would provide some great topics to talk about on your channel.

I learned that there is such a thing as catatonic schizophrenia, I learned that thought blocking is a thing, and a thing which I (and probably most people) have experienced to a tiny degree

Please do more of these videos.

These videos are truly fascinating. Thank you Elliot. I wish I was 20 years younger as this field would be great to work in. I’m currently helping a friend who is struggling with severe personality disorder and off his meds. Found it so interesting how the symptoms seem like bipolar. When I actually get thru to my mate ( it’s like he has masks ) he has so much disgust for himself. Doesn’t understand why we all love him. He was adopted, so I guess this would have been attachment disorder as a child?

I learned something! Thanks for the SAPROF recommendation keen to look into this more A little addition - something I've seen a few times in our MH service is catatonia which is later diagnosed as severe burnout related to ASD (level 2). Curious whether the same pattern emerging in the UK

Pleb here, but I watch this video before and was not aware of the symptoms of this diagnosis. Therefore I was left thinking he was an odd fellow but nothing overtly concerning and was confused where schizophrenia was on display. I also thought catatonic was similar to being in a coma.

Can thought blocks be due to absent seizures? I deal with these regularly and I’ve always wondered whether it was my epilepsy or my mental health

It always sticks out to me when I hear MH professionals talk about chlorpromazine no longer being commonly used in the UK. I was given it a decade ago when I was 17 to treat psychosis/ mania during an inpatient admission and was shocked later to hear that is rarely reached for nowadays. I find it a little uncomfortable that they were so quick to treat me with it when I was under 18 and would be interesting to know if anyone has had similar experiences

I was wondering if this was an actor for the training video, because the presentation seemed a bit off when comparing it to when my mum was dealing with these symptoms. But based on the comments, it seems this is a real patient, and I realise I'm a) comparing it to literally just one other person, and b) my mum was never treated with benzos, she just cycled out of it, and I'm assuming a medication that strong would definitely affect the presentation. A good lesson for me to not generalise too much. Thanks for these videos. I'm ashamed to say encountering depictions or discussions of schizophrenia/psychosis is triggering for me because of my mum, but I'm working on it by giving myself the choice to engage when I'm feeling safe. If you're doing any more videos on the topic, it might be interesting to look at neologisms/word salad, because I think that that's a symptom a lot of people aren't aware of if they haven't experienced or seen it. Separately, I saw several comments on this video from people about the similarity of thought-block and inactivity symptoms during periods of high stress, so maybe it would be interesting to have a video on how executive dysfunction and dissociation and/or overwhelm can manifest during the fight-or-flight response and why these are different from catatonia? Will I ever write a short comment? Deep sigh :P

I get thought block often, typically while under any kind of stress.

It is very interesting the overlap between conditions. I have FND. When I have a dissociative episode or after a seizure by behaviour is very similar to what you can see in the video. I am sat very still and very stiff. Often my upper lip will curl up. My speech is very delayed and strained if I am able to talk at all.

Fascinating. On a complete aside, what's your thoughts on Prophet Song and The Bee Sting. I met both authors in Dublin recently and have finished Prophet Song and working my way through the other. I assume you're a fan as they're prominent behind you!! :)

as a doctor is it easy to differentiate between thought block and being guarded or paranoid?

As a forensic psychiatrist it would interesting to hear your opinions on video by channels like Explore With Us or School of Life.

I used an audio clip from that video once to mash up with a song from Chris Bear/Daniel Rossen from the "Past Lives" soundtrack

Please react to the episode "Fishes" from the second season of The Bear!

Hahah here (The Netherlands) Haldol is still the first go to drug for many inpatients. Hopefully we also soon are moving on from that medication as first option.

i love these videos! I upload them to create an archive for people to be able to watch and learn from the past

I've watched heaps of these apparent training vids & its so much better watching you explain them. For example, i didn’t know the psych was probing this guy to suss out the delusions. I thought he just didn't understand what was being said 😂 My autistic ability to understand what's actually happening in any given moment is so subpar 😂 I hope you do many more of these! It's great having the education on what's going on in the educational vids 😁

Feel bad for this gentleman this is no way to live a life... thank God for the injections I take

I just did me a learn: At first I thought it strange describing some of these symptoms as “positive”, I’d never heard symptoms which are additional to normal neurotypicality described as “positive” and the the reverse as “negative”

i have seen this long time ago. and thought since he is catatonic when he plays piano to sit he thinks he is play the piano, but actually just sits in front of piano and do nothing. does anyone know what he did to get the diagnosis? or is it just him talking and acting that way defines him as catatonic?

You've possibly answered this somewhere else but where's the yellow guy in your lego display? is he missing or taken away?

Totally unrelated, but your hair looks awesome.

These videos were made to present a 'standard" patient for medical students to learn from. So the interview wasn't necessarily what you would expect in actual therapy, but simply to elicit the behavior and responses that are diagnostic of the illness. Thought blocking, slow response, paranoid and grandiose beliefs, rigid posture. Benzos were known as the treatment for catatonia since the 30s, so it is safe to assume after 3 months in hospital his catatonic symptoms would be significantly improved, while the antipsychotic medications were still very new at this time so the patient is still dealing with significant symptoms of his schizophrenia.

I know thought block isnt a positive thing for a human being, but as someone who suffers from cPTSD and ADHD, my brain is LOUD! Like, constantly filled with hundreds of different disjointed thoughts, varying from light and happy interest to dark moments from trauma. Constantly. All day. All night. I only get a mild break when sleeping, but that comes with its own issues (night terrors). I'd love just a day of silence in my brain. I wish meds were an option, but my insurance has made it a struggle. They have many steps before they'll test me, which is hell considering the ADHD x_x

I wondered if the long pauses could be related to hallucinations being distracting and he's attempting to separate reality from hallucinations

really? I treated a tire catatonic schizophrenia pt in Philly when I was an intern, really smart human wanted to go to medical school. They were mute for the longest time till there ws like 3 weeks of 15 mg of Ativan daily.

Once upon a time, schizophrenia was just a convenient diagnosis for a host of conditions that today are better understood and more elegantly categorized.

The truth is a lot of people in those days would of probably not liked how he behaved. It isn’t him been delusional thinking that.

The guy's skin is phenomenal.

Benzo’s and anti psychotics. He’ll be a cool ass piano instructor I’ll give you that.

The approach was so cold back then. No bedside manner at all.

Thanks, doc! This was a really interesting video. I also think you’d love ‘Please Like Me’! It’s very queer, has many portrayals of mental illness, and is quite short :$

I learned.. that my psychiatrist may be paying attention to the cadence of my speech 0_0

I have catatonic schizophrenia

Hello Doctor, Was this mans' name Christopher? Regards, L.R. Update: indeed. Christopher is mentioned at 08:00 in the free documentary Pennhurst Asylum on KZfaq.

This is a little longer interview for funsies kzfaq.info/get/bejne/bNuAisSl0Mjeeqc.htmlsi=gYIeMpuaEtk-010z

Poor guy. Whoever started spreading these videos online clearly had no regard for privacy.

And as a doctor you have never seen like one patient even with catatonia?

Hello!

So… I’m being hypothetical with this. And I’m not suggesting there isn’t some underlying condition or untreated mental illness here… but, given that this interview happened in 1961, and that homosexuality was only just removed from the US medical book of mental illnesses in the 1970s (yes?), my speculative side kind of has to wonder; was this guy really, in fact, gay, or closeted? Was he outed, or had he attempted to come-out on his own as gay/bisexual, and that didn’t go over so well, thus leading to a dramatic situation and tense argument with family/friends? What if all of the drama surrounding his outing/coming-out is what caused his “treatment” and detention? He could’ve tensed up and been deemed "psychotic", due to being unable to process the fact that he was outed. We didn’t have the same knowledge or vocabulary back then, let alone sensitivity. As I said, homosexuality was included on the mental illnesses list! Now this young man is being asked-on camera, no less, in a very conservative era-to discuss "why" he’s there and "what" events led to that moment. He’s likely in shock. Keep all of this in the back of your mind as he gives his answers. He’s carefully plotting the answers he gives, because it was a hateful and potentially dangerous, vitriol-laced situation that led to his detainment in the first place! Again, I’m just theorizing. But this is 1961: an era on the cusp of social change, pre-Woodstock, pre-Stonewall, pre-sexual liberation movement. Nearly a decade prior to all of that, really, the decades post WWII were no doubt culturally/socially revolutionary in their own ways, and fueled the decades to come. Imagine a time when gay bars were raided routinely, and the patrons who didn’t escape successfully were arrested for the night, had their photos, names, and identifying information printed in the papers the next day. And here, this guy is being asked on camera "why"? I would imagine he’s nervous to respond due to the fear surrounding his very detainment. And due to homosexuality being considered a mental illness at the time, it was very easy to lump gays into "other" categories of mental health. Looking at his "reactions", it was very easy to claim he was "catatonic schizophrenic". Which, as you said, is RARE. Yeah, because the doctors are potentially pulling at straws to diagnose him in some way. The reality being that he was simply gay, outed, came out, etc. and had a negative response from those around him, leading to that detainment. The doctors could potentially say anything if someone were accused of being gay back then. They’d use any little twitch or hesitation to say "Oh, yes, there we go. He’s catatonic. And it’s all recorded, so you can’t deny it, sir." He’s tensing up, not wanting to say anything more for fear of the repercussions. Not providing clear answers. He’s being baited by the interviewer into saying, "well, I’m a homosexual. And that’s why I’m here," but he’s also been shocked into submission, essentially a cornered animal under duress. Very fine line between actual mental illness and reality when homosexuality is on the agenda… the patient naturally is reluctant to reveal too much, once hospitalized, thus leading to a rare, catatonic "diagnosis". We lacked the modern vernacular, vocabulary, sensitivity to and awareness of homosexuality back then (and again, it was listed as a mental illness until 50 years ago), so imagine being a gay person and being interviewed on camera, after being potentially hospitalized FOR THAT REASON. But I digress.

I bet they gave him ECT.

There is actually a comment on that video from somebody who claims that this was their uncle. Comment is below. This is an old comment about this man that seems to have been lost: "This man was my uncle. I'm not going to give any names, but for those of you who are concerned with how things turned out for him, not well. There's so much to address here. First let me say that he was being treated in this video with meds. Without the medication his mood ranged from complete delusion to catatonic. As for being gay, I don't think he had much of a sex drive at all. With or without meds. As for the idea that he was put here because he was gay by some unloving family, that's ridiculous. I don't have time to say all the things my family tried just to make his existence somewhat peaceful just for his own sake. My family had a couple of openly homosexual and lesbians in it even back in the sixties and with the exception of my mother's father no one gave a shit. My uncle suffered with meds and even more without. After forty some odd years, most of which he spent in institutions, he took his own life by way of drug overdose. By the way, the comment about the plot twist, he never had a piano was funny because he didn't. His seeming obsession with piano came and went as did obsessions with religion, especially the Catholic Church and government. As far as I know he couldn't play a lick. He was very ill at his best and a living shell at his worst. I hope that answers some questions because that's all I have to say on the matter. He's been gone since the late eighties and I really hope that other members of my family don't see this video, mostly because of the comments from people that somehow think they understand him better than the people who suffered with him. One last thing, I think people thought that he was talking about sitting or standing effeminately or something. No, he was talking about sitting or standing motionless for hours. Usually not even his facial expression would change but when it did it was usually related to something in his mind only. I really can't begin to tell you all how heartbreaking the whole thing was. He did seem intelligent and with meds he did remind me of a high functioning guy with autism I once met."

I feel that looking over presentations such as this with a more contemporary outlook of modern presentations and how this would be formulated if the case was presented today - and how that would be assessed, would lead to different patient outcomes and this case is a perfect example. For the context of my argument, i would pose that this case if assessed today could indicate autistic traits as we explore further the presentation of catatonia in autism thanks to Amitta Shah, the social communication difficulties displayed, the difficulties observed with eye contact and limited tone of voice added to the robotic structure of sentences and posture. Although given this appears to be American and taking into account the likelihood of there been strong sedation for compliance. I would love to see a video of these old recorded interviews or review of well documented clinical cases as a reformulation for entertainment purposes of closed cases. And especially reflecting on the development of the treatments offered.

Sheldon's father?

💖

They also had one of a woman with DID. That one was fascinating.

As a forensic psychiatrist it would interesting to hear your opinions on video by channels like Explore With Us or School of Life.