Yousuf Raza – Neurotransmitters & Hormones or more
AI: Summary ©
The speakers discuss the complex field of neuropthic psychiatry, where patients are the first to notice problems with their hormones and their disorders. They discuss the importance of an expert in prescribing medications for patients who need them, but it is not possible to keep a space open for patient needs. The speakers also discuss the use of psychotherapy and psychotherapy, including psychotherapy, psychotherapy, and psychotherapy, and how they can help patients change their circumstances. They also mention the use of psychotherapy for patients, including psychotherapy, psychotherapy, and psychotherapy, and how they can help them change their circumstances. They also mention a new guest, Walay volume, and a guest guest, Walay---
The speakers discuss the complex field of neuropthic psychiatry, where patients are the first to notice problems with their hormones and their disease. They explore the use of psychotherapy, including psychotherapy, psychotherapy, and psychotherapy, and how they can help patients change
The speakers discuss the complex field of neuropthic psychiatry, where patients are the first to notice problems with their hormones and their disease. They explore the use of psychotherapy, including psychotherapy, psychotherapy, and psychotherapy, and how they can help patients change
AI: Summary ©
Assalamu alaykum.
everybody and Assalamu alaykum.
I'm sorry.
I think I'm so there's a little bit
of a discrepancy between the two of us.
Go ahead, please one of the pioneers in
Pakistan in establishing psychiatry across the country, and
I'm sorry.
I think I'm so there's a little bit
of a discrepancy between the two of us.
Go ahead, please one of the pioneers in
Pakistan in establishing psychiatry across the country, and
I'm sorry.
I think I'm so there's a little bit
of a discrepancy between the two of us.
Go ahead, please one of the pioneers in
Pakistan in establishing psychiatry across the country, and
I'm sorry.
I think I'm so there's a little bit
of a discrepancy between the two of us.
Go ahead, please one of the pioneers in
Pakistan in establishing psychiatry across the country, and
I'm sorry.
I think I'm so there's a little bit
of a discrepancy between the two of us.
Go ahead, please one of the pioneers in
Pakistan in establishing psychiatry across the country, and
I'm sorry.
I think I'm so
there's
a little bit of a discrepancy between Institute
of Psychiatry.
Institute of Psychiatry.
and stage as a VC of University of
and stage as a VC of University of
and stage as a VC of University of
Health Sciences.
Institute of Psychiatry Hospital.
Institute of Psychiatry Hospital.
he basically laid the he basically laid the
he basically laid the foundations of that Institute.
he could have stayed in England.
he could have stayed in England.
he could have stayed in England.
Work there done whatever he Work there done
whatever he wanted to in psychiatry.
He had a wanted to in psychiatry.
He had a What?
he wasn't allowed to have a he wasn't
allowed to have a he wasn't allowed to
have a room to see the psychiatric room
to see the psychiatric patients?
and that's the beginning of one of the
greatest institutes of this country and most of
the psychiatrists serving in Pakistan are a product
of that institute.
Mr. Mubasher used to say that other departments
wouldn't shake hands with him because he was
a doctor for mad people.
and everywhere that psychiatry is being practiced in
Pakistan and around the world, the things they
have contributed to it, it's unparalleled.
It is unparalleled.
Should we begin then with today's program?
Yes, Dr. Yusuf.
Our guest today, I feel very strange to
call him our guest because he is a
very good friend of both of us.
Dr. Ali Hassan, he is in New York
at the moment and he is doing a
residency in psychiatry and training in psychoanalysis.
Our primary concern to call Ali is that
our general public and especially those people who
are associated with psychiatry and psychology in Pakistan,
why is a person sitting in a US
hub doing a good residency in psychiatry?
After all, why did he go to training
in psychoanalysis?
Although we had heard that this is not
the case in America.
In America, there is a new medicine and
this happens in America and that happens in
America.
So, Dr. Ali Hassan.
Drum roll and there he is.
Assalamu Alaikum, Ali.
Assalamu Alaikum.
Walaikum Assalam, Yusuf Bhai, Azam Bhai.
Thank you very much for respecting me.
It looks very difficult.
Very difficult.
I am sorry, now he is in the
middle.
I just wanted to bring you in the
middle.
Okay.
Before we begin, my condolences to the both
of you.
You both were professors and mentors, at least
distantly.
Professor Bashir, indeed he is a great loss.
But I hope the two of you will
be able to build on what he was
able to do.
Yes, Inshallah.
All of us, the psychiatry community in Pakistan
hopes to be able to carry on his
legacy, Inshallah.
Ali, like Azam said, what is your need
in America, in New York?
You are training in such a good department
of psychiatry.
You are doing residency.
You are learning from the best of people.
Why complement that with psychoanalysis of all things?
Psychoanalysis, which is not taught in any university.
They have their own dedicated centers.
Universities do not treat it that way.
So, what do you care?
You go at 8 in the morning and
come back at 5.
And after that, even after your psychiatric training,
you rest and practice.
What is the need for psychoanalysis?
There are some personal reasons.
I will speak in both Urdu and English.
Because that is what I am comfortable with.
I think our audience will be similar.
We get such pieces from Shifa who do
not know English or Urdu.
It takes one to know one.
For those of you watching, Shifa, Ali and
I share the same Alumnus Alma Mater.
Please, I am sorry.
Go ahead.
That's okay.
Psychiatry is a very interesting and complicated field.
History is filled up with different controversies.
This treatment is right, this is wrong, etc.
It seems, as it happens in other fields,
it is assumed that the new is always
better.
I think we should be a little cautious.
And most people are cautious.
When they go into their field, they realize
that what is new does not necessarily replace
the old.
That can add to it, but it does
not certainly replace it.
Today's psychiatry in America, and I would safely
assume in Pakistan as well, is predominantly regarding
psychopharmacology.
On the complex interactions of serotonin and dopamine
and norepinephrine.
And how we can get that mixture right.
Ultimately, it's that question.
Many psychiatrists want to call themselves neuropharmacologists.
Meaning that neurons are wired in a certain
way in your brain.
And you can affect those neurons through certain
medications that the psychiatrist prescribes.
Psychotherapy, psychoanalysis, Freud.
To get on these newer drugs and be
very precise in their interventions.
They're moving towards these medications.
The problem is that they find that the
more they're doing this, the more mechanical and
the more technician-like they're becoming.
And their patients are the first to notice
that.
A patient comes to a psychiatrist.
He has a lot of problems.
He has to understand himself.
He has to understand his society.
He has to understand his disease.
He is given that explanation.
That there is a problem with your hormones.
There is no other problem.
And this is, I know I'm making some
gross generalizations here.
But you have to understand without that.
Your hormones are the problem.
And essentially there is nothing else.
And even if they say there is something
else, that means there are difficulties in your
relationships.
Ultimately, it's because of your hormones.
So, in a sense, it takes away a
lot of control from a person.
And patients don't like it.
Their medications, in turn, don't work as effectively
as they hoped and imagined it would.
Now, those things are slowly being revealed in
their research and data.
Some people would acknowledge that.
And some people would be like, this data
is not that solid.
We need more studies.
We need more studies.
But there's good enough data which is pointing
towards that by simply prescribing medications, we won't
make our patients better.
So, on the other side, they started to
notice that psychotherapy, and by psychotherapy I mean
that you talk to your patients, understand their
problems, their ways of relating with other people,
understand that.
That ultimately has an effect on your neurons,
on how your brain is wired.
So, they were able to capture that using
CT scans and MRIs.
There's good research in that sense coming out.
It's preliminary.
So, when they came across this data, they
realized that, oh, we have a history of
psychoanalysis and psychotherapy, which we had forgotten because
it was something very old.
And we thought medications was the real deal.
Ultimately, if we were just to find this
one transmitter, one hormone, the ultimate pill, it
would take our depressions and anxieties away.
But they found out that therapy has something
very useful to offer.
And ultimately, the playground on which all these
changes are taking place is your neurons, your
brain.
They were like, maybe we need to revisit
the psychiatric history and learn from that.
And of course, that doesn't mean we go
back into classical, traditional Freudian psychoanalysis.
That's come a long way.
That's developed quite a bit.
So, I think that's something that the field
is struggling with, is coming to terms with.
And that's something that I also realized because
of my own personal experiences and having good
company of academics and people who are honest
in academia.
So, that's why I thought if I am
just going to prescribe medications, I would be
doing a grave injustice to my patients and
myself as well.
Because there's no fun in speaking with people
if we really cannot understand and relate with
them.
So, Ali.
So,
So, if I can answer that.
They have nothing good to offer.
Every scientist, every technician, carpenter, any human being
has many tools for different problems.
It's not going to work for all.
Some people, yes, they do need medications.
And some people actually don't need medications.
And they won't get better on medications.
But it's not going to get better.
And some people need both.
Absolutely.
And some people need both.
Some people need more than either of these
two.
Some people need more than either of these
two.
The idea is to keep a space open
for what is needed by the patient.
And this is the job of an expert.
This is the job of a psychiatrist.
This is the job of a psychologist to
identify what the patient needs.
Medications, psychotherapy, both, one or the other or
something else.
Unfortunately, in psychiatry, all of us are convinced
by all these fancy journals out there that
there is only one way of treating patients.
And that's through medications.
I know it's a gross generalization again, but
that's the general academic attitude and psychiatry within
itself is struggling with it.
And this intimately ties in also to your
first question about data.
Yes, you can find more data.
Maybe we all can wait to have enough
data.
But the problem is that the prophets of
psychiatry, the big giants of psychiatry who are
leading this field, they have come to realize
that there is good enough data for us
to look somewhere else.
And the history of psychopharmacology is from the
1950s to 2020.
So it's a good 70 years.
It's at least three generations.
So we could either keep pursuing that same
track or we could look elsewhere.
When we start running into hitting walls, we
need to look elsewhere.
If we don't, then there are problems and
questions ultimately come to life and death.
Ali, you mentioned in the beginning that there
are certain tendencies within psychiatrists that they prefer
to call themselves neuropharmacologists or psychopharmacologists for that
matter.
When I hear that, I feel like that's
actually pretty honest.
When you label yourself as a neuropharmacologist or
a psychopharmacologist, at least the absolutist claim that
we got you covered in every domain of
your mental health needs.
And then all we ever end up doing
is prescribing medications.
At least as a neuropharmacologist, they're outrightly saying
this is our domain.
There may be other domains and so be
it.
I hear what you're saying.
Psychiatry encompasses sociological aspects of the patient's living
environment, their psychological makeup and structure, and then,
of course, their neurobiology.
The psychiatrists wanted to cut themselves off in
a sense from psychosocial factors.
But they're not as important and that's not
something we do.
So we just rather focus on the biological
part.
And then they are trying to rebrand themselves
as neuropharmacologists as well.
It's sort of a distancing maneuver in certain
ways from what psychiatry was and where they
hope it to be or where they see
it to be.
We can choose to overlook it.
I think it was Kenneth Kendall, he's a
big geneticist or neurobiologist.
He published a paper in the 90s called
Psychotherapy and the Single Synapse.
And if I recollect, the idea was the
spoken word.
Of course, we do it technically.
We establish therapeutic relationships with our patients.
We explore that in a way where one's
brain is wired.
It's quite powerful.
Now they're finding out a very famous psychopharmacologist
in the US.
His textbook is taught in every residency.
His name is Stephen Stahl.
He recently wrote an editorial in which he
says that psychotherapy is an epigenetic drug.
What does this mean?
Genetics was thought to be fixed and rigid.
There's a code in it that cannot be
changed.
Ultimately, that is responsible for human psychology and
behavior.
This was a popular criticism against that was
the search for the suicide gene, for example.
What is that gene that is responsible for
people that makes them commit suicide?
If we just target that, we'd be able
to address suicidality in our patients.
But later they found out.
Our genes can change with time and with
their interactions with the environment and society.
Azam, can you hear me?
Yes, I can hear you.
I think there are some.
So, Ali.
They found out ultimately that genes, you know,
they're not fixed.
Of course.
You're training in analysis.
Sorry, I think there's a little video lag
on my end.
That's why you're getting the audio late.
Uh, uh, uh, uh, uh, uh,
uh, uh, uh, uh, uh,
uh, uh, there's a whole unit called family.
where the roots of psychopathology come from.
And I don't think that any psychotherapeutic school
neglects the family or other social factors.
So, regarding this, your analysis training says that
how can mental health professionals take this forward?
How the pathology is rooted not only in
the person, but also in the whole unit
or the habitat in which the person is
living.
I don't know.
That's a challenge.
Because it's a challenge academically, it's a challenge
conceptually, it's a challenge in the clinics.
I think a lot of our patients who
come in, the problem is within them, like
you've identified.
While some part of that, and I say
that very carefully, some part of that, so
they're sort of enmeshed in that social network.
The patient doesn't know that.
So I think establishing a good sense, which
are coming from outside of him, his social
environment, household, wife, children, economic factors, job stressors.
Are they real?
Are they unreal?
Are they being feigned by the patient?
Are they being exaggerated or embellished?
Or if it is a real problem on
the outside, how is the patient contributing towards
that?
It is possible that the patient is, and
we cautiously introduce that idea.
That's one.
A patient is sitting in our room, we
can't change the outside world for him.
Ultimately, the patient has to do it him
or herself.
So certainly we can inculcate and nurture certain
habits and ways of looking at things.
And it's a long, long process.
And ultimately enable the patient to change those
things that are external to him.
It's different from the effects of the external
environment.
Because many people will overlook that these problems
are real on the outside of the patient.
They're unhealthy.
But if you take medicine, you won't feel
bad about what's happening with you on the
outside.
On the other hand, in psychotherapy, if the
idea is you can help the patient impart
certain skills, he can change their external circumstances.
Not only that, if they can't change their
external circumstances, they can cope with it better.
But with understanding.
It's not just a numbing away of feelings.
And I'm not saying that psychopharmacology does that.
But sometimes there are tendencies for us to
do that.
And if I were to take the conversation
slightly in a different direction, we spoke earlier
on that this tendency has started developing in
psychiatry.
From psychology, psychoanalysis, Freud, post Freudian.
It's like baggage that we're carrying.
Ironically, psychiatry's daddy issues have started.
Which pills will probably not take care of.
But if we were to look deeply into
that, how much of a role does the
progress in internal medicine, neurology, surgery, other medical
specialties.
How much of that do you think is
contributing to this attitude?
Yes, I think it's obvious.
Psychiatrists are not real doctors.
That's the popular phrase that goes.
I think that's what you started off from
as well.
Why are you wearing a psychiatrist's scrubs?
I'm a psychiatrist's fan.
And it's there within psychiatrists themselves.
If they want to be as medical as
other fields, they want to be as precise
as other fields.
Hence, we need criterias.
Hence, we need imaging.
Hence, we need biomarkers and genetic testing.
So we actually know to catch depression confidently.
It's my opinion and it's based on the
work of others.
There's a medical aspect in psychiatry.
But there's also a very relational aspect of
psychopathology.
Which is ignored the more you medicinalize psychiatry.
So the problem is not that medications are
not important in psychiatry.
They are.
But they're not the only thing.
Psychiatry has, over the past many decades, focused
with psychopharmacology mostly.
And they had their reasons for that.
I think they need to get over with
these reasons at this point.
And they need to consider the relational aspects
of it as well.
Obviously, in medicine, surgery, neurology, you can overlook
the relational aspects.
Because they don't impact your patient as much.
They do.
But they're not the source of the dis
-ease that our patients have.
Psychiatry may.
Many forms of depression are problems of relating
with other people.
So essentially, you're annoyed, you're angry, you're irritated.
You find a poor sense of self-esteem.
Or ultimately, they end up to the psychiatrist's
office.
And the psychiatrist says, Take this pill.
Don't tell me I'm okay with knowing that
you have a poor sense of self.
That's all I want to know.
I don't want to know why it originated.
I need to know.
What you alluded to just now.
If you want to dig deeper, the way
psychiatry is treated in medical fraternity, the way
psychiatrists are looked upon, we can go deep
into how that results in the predominantly psychopharmacological
practice.
We can go even deeper than that.
Intellectually, the way science is developing, the way
the university is structured, the way the ideology
of materialism as Sheldrick calls it, as Volvitz
alludes to, we can go into all those
things.
But the last sentence you used, I don't
want to hear about it.
It does offer a lot of convenience.
It takes less time.
You don't have to hear a lot of...
It's very emotionally taxing.
You have to hear about people's traumatic experiences,
facilitate them, working through them.
It's draining.
Medicine is just so much simpler.
Absolutely.
Unfortunately, unfortunately, that's the case.
The medicalization of psychiatry, that has that flavor
to it as well.
And of course, there's a whole spectrum to
the practice of psychiatry.
But the whole idea of med checks, in
15 minutes you'll get the patient's medication right
and you'll send them out of their office
and they're happy.
Sometimes your patients are happy because they don't
want to talk about it in detail.
It works for both of us.
It works.
It's a deal that works for both the
psychiatrist and the patient.
And there's nothing bad in that, if it
works that way.
But definitely, it's much quicker.
You make much more capital if you're dealing
with medications.
And sitting down with a patient, trying to
understand them, not only takes a lot of
time, it also eventually might lead to you
earning less money.
Which hurts, honestly.
But also, more importantly, I think it's emotionally
very taxing and draining.
And the reason for that is you have
to relate with your patient.
The psychiatrist, the psychologist has to relate with
the patient.
They have to share their sadness.
They have to share their anger.
They have to bear their annoyance that patients
oftentimes do make us feel annoyed.
And why would anyone want to do that?
So let's take the easy route.
Here's the pill, which is backed up by
science.
And some of it is.
It's being misused.
So you have to be really damaged and
wounded to actually want to do that.
Who needs to be damaged?
The psychiatrist?
Yeah, if the psychiatrist doesn't want to just
do the pill and he wants to go
into this therapy and he wants to talk
long, analysis.
Are you trying to say that I'm damaged?
Maybe the psychiatrist needs treatment.
If I take a jab at you, I
take a jab at myself as Azam.
Hopefully, we're not the psychopharmacologists that psychiatry tried
to make out of us.
But yeah, that's the gratification, right?
It's harder work.
But at the end of the day, the
mutual enrichment when you are able to genuinely
help someone through those difficult corners in their
life or you have to dig deep and
you have to go into painful memories and
events and you have to make yourself vulnerable,
right?
All that happens.
But then when it actually pays off, when
it works, when they grow, they don't necessarily
become happier, but they grow.
They become better people.
You become a better person.
Isn't it worth it?
I think that's an answer that every individual
has to ask themselves.
A lot of time, people, when they start
off their psychiatric practice and X number of
years, let's say 15 or 20, they often
use this term, I became disillusioned.
And when you ask, what does that mean?
They're like, I'm not happy with where psychiatry
is going.
My work doesn't give me as much satisfaction.
I think there's a lot to explore there
for the psychiatrist.
Why is it that you feel unsatisfied with
your work?
And essentially, you're putting the psychiatrist on the
couch or on the seat.
First, you said that psychiatrists have daddy issues.
Now you're saying they have existential issues.
Without being facetious, without pointing fingers at any
of them, either the therapists or the psychiatrists,
I think the patients are human beings.
And the psychiatrist is also a human being.
We as a profession and as professionals often
have a tendency to forget that.
We're treating so much suffering and illness.
I cannot lose a sense of purpose in
life, a sense of meaning in life, a
sense of disconnectedness from my work.
And when it happens to them, it's quite
disturbing.
So just like a psychiatrist or psychiatrists like
to be listened to, the patients also like
to be listened to and like to be
understood.
Oftentimes, when psychiatrists go for the treatment of
their own depression and anxieties and whatever, they
don't turn towards psychopharmacology.
They turn towards therapy.
That's always interesting.
I'm not saying that's across the board.
Again, I'm not saying medications don't have a
part.
But the idea is that psychiatrists are subject
to the very same laws that their patients
are subjected to.
When we are depressed, we have this tendency
of saying, Oh, you know, I'm burnt out.
Psychiatry or medical professionals use this term.
This is chronic fatigue syndrome or passion fatigue
or burnout.
We reserve the word depression or unspecified mood
disorder for our patients, not for ourselves.
This is what Azam-e-Jula says.
Azam-e-Tommy.
Which one?
The one with Tommy?
Yes.
Psychiatric medicines have a discontinuation syndrome, but drugs
have withdrawal.
Just like our dog Tommy.
Right.
So, in a sense, the
positional or academic conflicts in psychiatry and psychology,
unfortunately, they turn out to be very tribal.
And no offense to the people of the
tribes.
I think they're very holistic at times.
But, you know, a better word would be
archaic or childish or immature.
Even sectarian.
I think they have a lot more in
common, but they stick to differences.
And there's many reasons for that.
Money is one of them.
Fair.
Ali, a familiar name.
Dr. Anam J.
Nawaz, I believe it is.
Money and the way our societies are structured.
Ali, if you want to answer a couple
of questions before we wrap up.
I see that we have some difficulty with
the connection.
I don't know if you can hear me.
I can't hear the both of you.
You can't hear either of us?
Okay, now we've lost Ali.
Remove him.
Remove him?
What's wrong with this internet in New York?
I thought he was...
he is gone.
He has left.
Maybe he's in Kamooki.
We were told about New York, but we
logged in from Kamooki.
We'll wait for Ali to join us back.
Until then.
Azam, would you like to address a couple
of questions or should we wait for Ali
to come back?
I think we'll take questions and if Ali
can join.
Ali is back.
Ali, can you hear us?
I can hear you, yes.
Okay, now we've, in your absence, decided to
move over to the Q&A.
So, Dr. Anam is asking this question.
Do you think recommending a particular modality for
a certain diagnosis could depend on the severity
of illness a patient is experiencing?
It depends on modalities, medications or psychotherapy.
I think it...
I think that is the time this question
came up when we were talking about psychotherapy
and psychopharmacology.
I see, I see.
I think how significantly the symptoms are impairing
our patients.
Because our patients, we don't want to put
our patients through undue suffering.
Saying that I will do therapy because I
dislike medications.
Therapy is often like watching the grass grow.
It takes time.
And for those six months, a patient is
suffering unnecessarily.
So, there's...
On a case-to-case basis, it's not...
I think it's not okay to withhold medications
when they can be useful.
And if our patients are severely ill, yes,
we start medications and we then try to
understand what the origins of their symptoms are.
And then we try to address that.
And continue medications or discontinue medications.
And do you think there would be like
a general trend that the more severe...
And many times, not all.
That the more severe an illness is, that's
when medications would be warranted or that's when
a combination would be warranted or that's when
therapy is definitely indicated.
That severity is an index of the choice
that we make.
Severity, how long it has been for.
Someone might come to you in an acute
state of distress for three days.
And there was nothing else in the past,
right?
It's a severe stress, yes.
By talking to them, you can acutely bring
down their stress.
There are panic attacks happening a lot.
They can't go to work.
And they're the only working member of the
family.
At that time, you may want to intervene
with...
So, therapy does not fit all.
Medications do not fit all.
You have to spend time.
It has to be tailored.
It has to be individualized as much as
possible.
You can only do that if you listen
to them.
All right.
Dr. Anam wants more.
In your practices, do you find yourself ruling
out or having enough resources to medical neurological
disorders prior to diagnosing a psychiatric illness?
Is this question for you or for me?
Peace be upon you.
Anam herself is a psychiatry resident.
Anam herself is a psychiatry resident.
I would imagine, Anam, you know the answers
to these questions.
But sometimes we do, sometimes we don't.
Oftentimes...
This is all the people from Shikha going
into psychiatry, man.
It was all after you.
Sometimes very real medical illnesses are overlooked by
medical practitioners because our patients also have psychiatric
illnesses.
They might think this is because of depression
or this is because of psychosis and it's
not a real disease.
In that sense, the psychiatrist should have a
basic enough understanding of medical illnesses as well
so that he or she can catch them
for themselves.
As far as I can say, most of
the population that I'm dealing with is university
students.
There's a particular demographic that I have greater
access to and they have an access to
me.
So yes, in this particular population, in their
20s, even early 30s, usually neurological medical illnesses
are not that much of a priority that
they require to be excluded.
Yes, in a more senior population, a more
elderly population, that does become an important differential
to entertain.
So particularly what I have to do in
my daily practice, that's usually a younger client.
Azam?
Yes, I think it's been 50 minutes.
We should wrap it up.
And we have some questions from the vacuum
anesthesia.
But for that, I think we'll have to
give different answers.
Azam, please answer the question about your practice.
Do you find yourself ruling out neurological medical
disorders often?
Sorry, you asked this question to me.
Yes, they should be ruled out, of course.
And many neurological disorders and even many medical
disorders can mimic and their symptoms can overlap
with the psychiatric disorders.
Yes, they can.
So, yes, they should be ruled out, but
they should be ruled out with some sense
of, I would say, sanity.
Yes, CT scan, MRI, EEG is in his
own clinic and everything gives him a cut.
Okay, thank you so much, Ali, for joining
us.
It was an absolute pleasure having you here
on Psych Bhatak.
We hope to be bothering you ever so
often.
On better days.
On better days, on less short of a
notice.
Ali is the only guest, ladies and gentlemen,
who we did not ask if he wants
to come on Psych Bhatak, or if he
is available to come on Psych Bhatak.
We told him that we need you to
be on Psych Bhatak.
And he was very kind enough to consent.
And so here he is.
Thank you so much.
Azam, Maryam is asking, why are you always
in a hurry to wrap up?
First of all, I would like to know
which Maryam she wrote on her head.
I will answer accordingly.
No, no.
Now, if she has given you such respect
on your head, won't you be upset?
I have no answer to this question.
Come on, Azam has a life, people.
Okay, Ali, any last words before I take
you off screen?
Just this, I think the two of you,
what you're doing over here, which is basically
distilling down psychiatric concepts, practice.
Ali, we don't need studies.
Please don't say that again.
Azam, let him speak.
I'm taking Azam out of the frame.
Ali, say something.
You know, you see how Yusuf Bhai was
interested in getting appreciation.
I think it's very important for the understanding
of the general public.
I think this is good.
We are trying to tell them difficult things
in simple words.
I think this is great.
And I think you should keep doing this
carefully and intelligently.
Azam's health is so bad that he has
to tell difficult things in simple words.
You have no idea how painful this is
for him.
Thank you very much, Ali.
Thank you, Azam.
Thank you, everyone, for being here, for watching,
for your questions, Dr. Annam in particular.
We will all see you again next week
on another interesting topic and another interesting guest,
hopefully, on Psych Baitak, next Wednesday, 8 p
.m. I'll see you all then with Azam
Khalid.
Thank you all.
As-salamu alaykum, sir.
As-salamu alaykum.
Walaykum as-salam.
Walaykum as-salam.