I am ready to plant myself for a while at 1 Denbigh Rd, Constantia. For many years my practice was in a “treehouse in the forest.” It was a confidential, calm space, connected to the nourishment of nature. My practice 2012- 2022 In 2023, I decided to try to do something a little differently. I moved into Crescent Mediclinic. The reasoning was that it would be convenient to be on-site for my inpatients, which it was. However, my work lost an important component. I acutely felt the loss of Nature’s help in healing and destressing. I did not anticipate how being in a clinic would cha ..read more

I have seen my patients with OCD tortured by intrusive thoughts. Violent images, contamination fears, magical thinking, taboo thoughts; their brains find a million repetitive ways to torture. In an attempt to control these thoughts, to prepare against the potential outcomes of these intrusive obsessions, my patients often have neutralising behaviours. They compulsively wash, or pray, or create symmetry, or count, or avoid a letter of the alphabet. Any action to try to reduce the anxiety. These behaviours add to the problem. Patients end up late because their clothes have to be “just right”. Or ..read more

It is an transformative time in psychiatry. We have new options in managing difficult to treat depression. There is always hope ..read more

It is always a privilidge to connect with those at the cliff face of mental health care ..read more

I recently started treating a very depressed patient. He had been struggling for some time. His world was a grey landscape where nothing stood out. The days just merged from one to the other. The only thing he looked forward to, with desperation, was his evening routine of wine and cannabis which helped him relax and fall asleep. He would have restless, anxious nights. He dreaded mornings, when he would get up exhausted and just have to grit his teeth and face the day again. When I told him that he was very depressed, tears filled his eyes. He hadn’t thought that he had an illness. He just cam ..read more

When I first heard of Transcranial Magnetic Stimulation, I must admit, I was a bit sceptical. I struggled to believe that a giant magnet held to your head could help patients struggling with Treatment Resistant Depression. But, as study after study came in, with extremely positive results in traditionally hard to treat patients, I became increasingly frustrated. Why wasn’t TMS treatment available to my patients, here in Cape Town? Depression is a horrible illness that robs people of their joy, their ability to connect, their ability to function. Antidepressants came out in the 50’s and have sa ..read more

Day million of the lockdown and no end in sight. This week has felt particularly rough, with many of my patients really struggling. I think that part of the reason, as we settle in for the long haul, is that previous effective coping strategies have not been useful our current situation. A salient feature of my most robust and resilient patients is the sense that they can make effective future plans. They can make a adjust for any of life’s challenges. Part of my job has always been to help my patients get control in their lives, to help them make a plan. One lady came to me, trapped in an abu ..read more

I have been doing online consultations since March 16. I have had the unique privilege of seeing how a few of us have been handling this lockdown thing. On the whole, my patients have understood the reasoning for the lockdown and have been committed to doing their part. Some have responded energetically. They baked bread, joined online courses, built puzzles and relished the family time. These super busy responders expounded on what a relief it was not to be running around all the time… and then promptly filled their hours with a similar busyness. They have been a little miffed with others, li ..read more

On 16 March President Ramaphosa declared a state of emergency. A full lockdown followed soon after. In South Africa you cannot walk your dog, nor pop out to buy alcohol or cigarettes. Psychiatrists have responded by being as freaked out as everyone. For the last 200 years, psychiatrists have used “The Container” as the boundary for their work. It is the committed time and a safe space within which my patients and I explore the hard stuff. A safe space is as important to a psychiatrist’s work, as a sterile environment is to a surgeon. It can be done in other ways, but the risk of contagion is ..read more

In keeping with best clinical practice, I will be doing online consultations for the period of the lockdown. Contact 021 7941321 to book an appointment ..read more