“A typical neuron makes about ten thousand connections to neighboring neurons. Given the billions of neurons, this means there are as many connections in a single cubic centimeter of brain tissue as there are stars in the Milky Way galaxy.” David Eagleman

This short, accessible, and frequently amusing book opens with “The Half Lesson: Your Brain Is Not for Thinking.” It’s not? Already my mind boggled. Then what’s it for? Wipe your mind of whatever you were thinking (ha) and prepare for a shock.

I bet you are asking yourselves: Doorknob bombshells? Doorknob bombshells in therapy? What is that?

A doorknob bombshell, also known as a doorknob moment, is a clinical phenomenon that occurs in a wide variety of settings. That’s when a patient drops distressing personal information critical to the treatment on their way out the door, hand on the doorknob, and then breaks down.                                 

What should a caring clinician do when a patient does that? It’s a near universal dilemma for clinicians.

Since its inception in 1949, Mental Health Awareness Month has been all about making public, in a spirit of advocacy, the many, many challenges faced by millions of Americans living with mental health conditions.

But there’s not much out there about the working and personal lives of mental health providers. And what there is, is inaccurate, being based on fiction, such as the television sitcom Frasier. Let me make you aware of what my life as a psychiatrist is like.

Let me make you aware of what my life as a psychiatrist is like.

Yes! Not only that—I met my deadline. I am amazed.

You know what’s weird? I can’t remember writing it. Wait, that’s not accurate. I do remember the experience of writing it.

Ideas are everywhere, with two caveats. First, you have to notice them. Second, they’re not all good. By that I mean, worth developing.

What is a good idea?

Writing used to be my happy place. I used to be disciplined, reliable, and productive. Not anymore.

“How’s the book coming?” asks my friend Kristin, best-selling author and major procrastinator. She’s referring to the book W.W. Norton, major publisher of books essential to the practice of psychiatry and neurology, has advanced me actual money to write: 50,000 words, completed manuscript due October 2023.

“Terrible,” I say. “I oversleep, dawdle away the delegated time, then feel relieved when the time runs out. I don’t recognize myself!!!” 

I was invited—out of the blue— to write an academic book by W. W. Norton, a publisher of books essential to the practice of psychiatry and neurology.  I’ve been writing and practicing psychiatry for decades in obscurity and felt like a long-time actor might feel who gets “discovered overnight”— Disbelieving. Thrilled. Validated.

Thinking through how it happened makes me believe that you, too, can write an article that leads to a book deal.

On average I read eight to ten books a month, fiction and non-fiction, for a couple hours at the end of my day in bed. Since July, after landing the book deal with W.W. Norton, I’ve also been reading one book—The Master and His Emissary: The Divided Brain and the Making of the Western World by Ian McGilchrist, MD, a British psychiatrist and philosopher—for a couple hours most mornings at the desk after a few cups of coffee.

How many pages do I read in two hours? About ten. The material is so dense, I have to take notes to stay focused. (More on that in a few paragraphs.) I haven’t worked this hard since medical school!

Harvest lust—what is it? You know how it is when you go to an orchard to pick your own apples. The trees are heavy with fruit and the air smells sooo sweet from the apples and you take a bite of one and it’s delicious and you lose your mind and pick waaaayyy more than you intended. That’s u-pick lust. Harvest lust is u-pick lust on steroids.

Every fall, harvest lust grabs me because

I have a book deal! With W.W. Norton! For an academic book!

That’s amazing all by itself given I’m a rural shrink toiling in the back forty of upstate New York untethered from academia. But here’s what totally blows my mind.

The National Society of Newspaper Columnists: Organization for writers of serial essay, including columnists and bloggers, in any medium awarded me a third place in the General Interest: Online category of their 2022 contest. I am so delighted!

When I submitted two 2021 posts from this blog, I wasn’t fully aware of the level of competition.

According to Google, Imposter Syndrome is “loosely defined as doubting your abilities and feeling like a fraud. It disproportionately affects high achieving people who find it difficult to accept their accomplishments.” Is this you? Me too. The wordsmith who coined the term probably did so ironically. Though, as a shrink, I would include the syndrome as a legitimate diagnosis in the DSM, the Diagnostic and Statistical Manual of Mental Disorders. It’s real, with real consequences.