mkdir -p /home/daytona/workspace/psychiatry-questions

~/psychiatry-questions/build.js

const {
  Document, Packer, Paragraph, TextRun, HeadingLevel,
  AlignmentType, LevelFormat, BorderStyle, ShadingType
} = require('docx');
const fs = require('fs');

// ── colour palette ──────────────────────────────────────────────
const DEEP_BLUE   = "1B3A6B";
const MID_BLUE    = "2E5FA3";
const LIGHT_BLUE  = "D6E4F7";
const TEAL        = "1A7A8A";
const LIGHT_TEAL  = "D4F0F4";
const GOLD        = "B8860B";
const LIGHT_GOLD  = "FFF8DC";
const DARK_GREY   = "2C2C2C";
const MID_GREY    = "555555";
const LIGHT_GREY  = "F5F5F5";
const WHITE       = "FFFFFF";

// ── helper: horizontal rule ──────────────────────────────────────
function hrParagraph(color = "CCCCCC") {
  return new Paragraph({
    border: { bottom: { style: BorderStyle.SINGLE, size: 6, color } },
    spacing: { before: 60, after: 60 }
  });
}

// ── helper: spacer ────────────────────────────────────────────────
function spacer(pt = 120) {
  return new Paragraph({ spacing: { before: 0, after: pt }, children: [] });
}

// ── question block factory ────────────────────────────────────────
function questionBlock(num, category, question, context, bgColor = LIGHT_GREY, borderColor = MID_BLUE) {
  const paragraphs = [];

  // number badge + category label
  paragraphs.push(
    new Paragraph({
      spacing: { before: 200, after: 40 },
      children: [
        new TextRun({ text: `Q${num}  `, bold: true, size: 22, color: MID_BLUE, font: "Arial" }),
        new TextRun({ text: `[${category}]`, bold: true, size: 18, color: TEAL, font: "Arial" }),
      ]
    })
  );

  // the question itself
  paragraphs.push(
    new Paragraph({
      shading: { type: ShadingType.SOLID, color: bgColor },
      border: { left: { style: BorderStyle.THICK, size: 12, color: borderColor } },
      spacing: { before: 60, after: 60 },
      indent: { left: 240, right: 240 },
      children: [
        new TextRun({
          text: question,
          bold: true,
          size: 24,
          color: DARK_GREY,
          font: "Arial",
          italics: false,
        })
      ]
    })
  );

  // context / why it matters
  paragraphs.push(
    new Paragraph({
      shading: { type: ShadingType.SOLID, color: WHITE },
      spacing: { before: 40, after: 120 },
      indent: { left: 240, right: 240 },
      children: [
        new TextRun({ text: "Why it matters: ", bold: true, size: 20, color: TEAL, font: "Arial" }),
        new TextRun({ text: context, size: 20, color: MID_GREY, font: "Arial" }),
      ]
    })
  );

  return paragraphs;
}

// ── section header factory ────────────────────────────────────────
function sectionHeader(title, subtitle, bgColor, textColor = WHITE) {
  return [
    new Paragraph({
      shading: { type: ShadingType.SOLID, color: bgColor },
      spacing: { before: 360, after: 60 },
      indent: { left: 200, right: 200 },
      children: [
        new TextRun({ text: title, bold: true, size: 30, color: textColor, font: "Arial" })
      ]
    }),
    new Paragraph({
      shading: { type: ShadingType.SOLID, color: bgColor },
      spacing: { before: 0, after: 200 },
      indent: { left: 200, right: 200 },
      children: [
        new TextRun({ text: subtitle, size: 20, color: textColor, font: "Arial", italics: true })
      ]
    })
  ];
}

// ════════════════════════════════════════════════════════════════
// DOCUMENT CONTENT
// ════════════════════════════════════════════════════════════════

const children = [];

// ── COVER ────────────────────────────────────────────────────────
children.push(spacer(600));
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 0, after: 120 },
    children: [
      new TextRun({ text: "PSYCHIATRIC CONVERSATION", bold: true, size: 52, color: DEEP_BLUE, font: "Arial" })
    ]
  })
);
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 0, after: 80 },
    children: [
      new TextRun({ text: "Reference Guide", size: 36, color: MID_BLUE, font: "Arial", italics: true })
    ]
  })
);
children.push(hrParagraph(MID_BLUE));
children.push(spacer(80));
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 0, after: 40 },
    children: [
      new TextRun({ text: "20 Profound Questions for a Psychiatrist", size: 26, color: TEAL, font: "Arial", bold: true })
    ]
  })
);
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 0, after: 400 },
    children: [
      new TextRun({ text: "Positive Psychotherapy  |  AI & Psychiatry  |  General Psychiatry", size: 22, color: MID_GREY, font: "Arial" })
    ]
  })
);
children.push(spacer(200));
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 0, after: 40 },
    children: [
      new TextRun({ text: "July 2026", size: 20, color: MID_GREY, font: "Arial" })
    ]
  })
);
children.push(spacer(800));

// ── HOW TO USE ───────────────────────────────────────────────────
children.push(
  new Paragraph({
    shading: { type: ShadingType.SOLID, color: LIGHT_BLUE },
    border: { left: { style: BorderStyle.THICK, size: 16, color: DEEP_BLUE } },
    spacing: { before: 200, after: 60 },
    indent: { left: 240, right: 240 },
    children: [
      new TextRun({ text: "How to use this guide", bold: true, size: 24, color: DEEP_BLUE, font: "Arial" })
    ]
  })
);
children.push(
  new Paragraph({
    shading: { type: ShadingType.SOLID, color: LIGHT_BLUE },
    spacing: { before: 0, after: 200 },
    indent: { left: 240, right: 240 },
    children: [
      new TextRun({
        text: "Each question is designed to be open-ended and philosophically loaded. The goal is not a right answer but to reveal how a psychiatrist thinks — their assumptions, blind spots, and values. Read the \"Why it matters\" note before asking so you can follow up with precision. You do not need to ask all 20; choose 5-7 that resonate most with your conversation.",
        size: 20, color: DARK_GREY, font: "Arial"
      })
    ]
  })
);

children.push(hrParagraph(DEEP_BLUE));

// ════════════════════════════════════════════════════════════
// SECTION 1 — POSITIVE PSYCHOTHERAPY
// ════════════════════════════════════════════════════════════
children.push(...sectionHeader(
  "SECTION 1 — POSITIVE PSYCHOTHERAPY",
  "Questions 1 – 5: Strengths, meaning, flourishing, and the limits of positive reframing",
  DEEP_BLUE
));

children.push(...questionBlock(
  1,
  "Positive Psychotherapy",
  "How do you balance treating pathology with actively cultivating a patient's strengths and sense of meaning — and do you think psychiatry has historically neglected the positive side of mental health?",
  "Cuts to the core tension between the disease model and the flourishing model (Seligman's PERMA framework vs. DSM categorization). The answer reveals whether the clinician sees their role as fixing what is broken or building what is strong.",
  LIGHT_BLUE, MID_BLUE
));

children.push(...questionBlock(
  2,
  "Positive Psychotherapy",
  "In positive psychotherapy the therapeutic relationship itself is considered a healing force — how do you personally navigate the boundary between genuine human connection and clinical distance, and do you think that boundary should exist at all?",
  "Touches on countertransference, authenticity, and whether professional \"neutrality\" is a clinical stance or a myth. Forces the clinician to reflect on their own humanity as a therapeutic instrument.",
  LIGHT_BLUE, MID_BLUE
));

children.push(...questionBlock(
  3,
  "Positive Psychotherapy",
  "Can post-traumatic growth be intentionally facilitated, or does forcing a positive reframe risk minimizing genuine suffering — and where is the ethical line between encouragement and toxic positivity?",
  "Challenges whether positive psychology techniques can become a form of emotional bypassing. The tension between Tedeschi & Calhoun's PTG model and the right to sit with pain without being coached out of it.",
  LIGHT_BLUE, MID_BLUE
));

children.push(...questionBlock(
  4,
  "Positive Psychotherapy",
  "Psychedelic-assisted therapy is showing remarkable efficacy for treatment-resistant depression — but its mechanism involves dissolving the ego and radically altered states of consciousness. Does that challenge the core assumption in psychiatry that a stable, continuous self is necessary for mental health?",
  "Bridges positive psychotherapy with neuroscience and philosophy of self. Forces examination of whether \"stability\" is the goal of treatment or whether transformation through dissolution is a valid healing path.",
  LIGHT_BLUE, MID_BLUE
));

children.push(...questionBlock(
  5,
  "Positive Psychotherapy",
  "If a patient's depression is a rational, proportionate response to genuinely terrible life circumstances — poverty, chronic illness, discrimination — is medicating them ethical, or are you chemically adjusting them to accept an unjust situation?",
  "The political edge of positive psychotherapy: does focusing on individual resilience inadvertently absolve structural systems of responsibility? Referenced in Peter Kramer's \"Listening to Prozac\" and critiqued by Joanna Moncrieff.",
  LIGHT_BLUE, MID_BLUE
));

// ════════════════════════════════════════════════════════════
// SECTION 2 — AI & PSYCHIATRY
// ════════════════════════════════════════════════════════════
children.push(spacer(200));
children.push(...sectionHeader(
  "SECTION 2 — AI & ITS INFLUENCE ON PSYCHIATRY",
  "Questions 6 – 10: Algorithms, empathy, bias, prediction, and the future of the therapeutic encounter",
  TEAL
));

children.push(...questionBlock(
  6,
  "AI & Psychiatry",
  "AI models can now conduct conversations that patients rate as more empathetic than those with human clinicians — what does that tell us about what patients are actually seeking, and what does it mean for the future of the therapeutic relationship?",
  "Forces reflection on whether \"feeling heard\" requires a conscious listener, or whether it is a pattern-matching experience the brain cannot distinguish from genuine understanding. References Woebot efficacy data and Kuyken's work on therapeutic alliance.",
  LIGHT_TEAL, TEAL
));

children.push(...questionBlock(
  7,
  "AI & Psychiatry",
  "Mental health algorithms trained on population data will inevitably encode historical biases — over-diagnosing certain communities, under-diagnosing others. Who bears moral responsibility when an AI-assisted diagnosis causes harm?",
  "Sharp ethics question about accountability distribution in the AI-clinician loop. Is liability with the developer, the institution that deployed it, or the clinician who relied on it? Connects to Obermeyer's landmark bias study in health AI.",
  LIGHT_TEAL, TEAL
));

children.push(...questionBlock(
  8,
  "AI & Psychiatry",
  "If an AI system could predict a psychotic break or a suicide attempt with 90% accuracy days before it happens, should a psychiatrist act on that prediction even when the patient shows no clinical signs — and what does this do to patient autonomy and the presumption of wellness?",
  "Probes predictive psychiatry, pre-emptive intervention, and civil liberties. Raises the pre-crime problem: can you ethically intervene on a statistical risk rather than a present state? Relevant to DARPA-funded mental health prediction research.",
  LIGHT_TEAL, TEAL
));

children.push(...questionBlock(
  9,
  "AI & Psychiatry",
  "Do you think large language models will eventually replace the diagnostic interview, or is there something irreducibly human in the act of listening that no pattern-matching system can replicate?",
  "Invites a philosophical answer about what diagnosis actually is — data extraction or an intersubjective encounter. Connects to Karl Jaspers' \"General Psychopathology\" and the phenomenological tradition that insists meaning cannot be computed.",
  LIGHT_TEAL, TEAL
));

children.push(...questionBlock(
  10,
  "AI & Psychiatry",
  "If an AI chatbot demonstrably reduces suicidal ideation in a patient more effectively than a human therapist does, but the patient develops an emotional dependency on it — should you encourage or discourage that relationship?",
  "Sits at the intersection of clinical pragmatism and ethical concern about parasocial digital attachment. No clean answer exists, which is precisely the point. Tests whether the clinician prioritizes outcomes or process.",
  LIGHT_TEAL, TEAL
));

// ════════════════════════════════════════════════════════════
// SECTION 3 — GENERAL PSYCHIATRY (Original)
// ════════════════════════════════════════════════════════════
children.push(spacer(200));
children.push(...sectionHeader(
  "SECTION 3 — GENERAL PSYCHIATRY",
  "Questions 11 – 15: Diagnosis, power, identity, coercion, and the meaning of recovery",
  GOLD, DARK_GREY
));

children.push(...questionBlock(
  11,
  "General Psychiatry",
  "The DSM was designed as a descriptive, atheoretical classification system — yet it profoundly shapes how society understands suffering. Do you think having a diagnostic label liberates patients or imprisons them in an identity?",
  "Gets at the performative power of psychiatric nosology. Once labeled, the label shapes behavior, self-perception, and social treatment. Draws on Ian Hacking's concept of \"looping effects\" and Erving Goffman's stigma theory.",
  LIGHT_GOLD, GOLD
));

children.push(...questionBlock(
  12,
  "General Psychiatry",
  "Psychiatry is the only medical specialty where a physician can legally deprive a patient of liberty against their will — how do you personally reconcile that coercive power with a commitment to patient autonomy, and has the field done enough to examine its own history of misuse?",
  "Raises involuntary commitment, institutional abuse, and the politics of mental illness. Connects to Foucault's \"Madness and Civilization,\" the anti-psychiatry movement, and ongoing debates about community treatment orders.",
  LIGHT_GOLD, GOLD
));

children.push(...questionBlock(
  13,
  "General Psychiatry",
  "If a patient achieves full symptom remission through medication but reports feeling like a blunted version of themselves — whose definition of recovery should take precedence, the clinician's or the patient's?",
  "Cuts to the heart of what psychiatry is for: biological normalization vs. subjective flourishing. Connects to the neurodiversity movement, recovery-oriented care, and Pat Deegan's \"personal medicine\" concept.",
  LIGHT_GOLD, GOLD
));

children.push(...questionBlock(
  14,
  "General Psychiatry",
  "Psychiatry relies almost entirely on self-report and observable behavior — there are no reliable biomarkers for most diagnoses. Does that make psychiatric diagnosis a scientific act, a clinical art, or a social negotiation?",
  "Forces epistemological honesty about the status of psychiatric knowledge. Connects to the Rosenhan experiment, the NIMH's RDoC project (an attempt to build biology-based diagnosis), and ongoing debates about diagnostic validity vs. reliability.",
  LIGHT_GOLD, GOLD
));

children.push(...questionBlock(
  15,
  "General Psychiatry",
  "The placebo effect in psychiatry is among the largest of any medical specialty — some antidepressant trials show barely significant drug-vs-placebo differences. Does that undermine the biological model of psychiatric illness, or does it reveal something profound about the healing power of expectation and relationship?",
  "Irving Kirsch's meta-analyses on SSRI efficacy sparked intense controversy. The answer reveals whether the clinician can hold the biological and relational models simultaneously without defensiveness.",
  LIGHT_GOLD, GOLD
));

// ════════════════════════════════════════════════════════════
// SECTION 4 — TRICKY ADDITIONAL QUESTIONS
// ════════════════════════════════════════════════════════════
children.push(spacer(200));
children.push(...sectionHeader(
  "SECTION 4 — THE TRICKY TEN",
  "Questions 16 – 20: Edge cases, ethical traps, and genuinely hard problems",
  "4A0000", WHITE
));

children.push(...questionBlock(
  16,
  "Tricky",
  "Psychiatry diagnoses conditions like narcissistic or antisocial personality disorder — but these traits are often highly adaptive and rewarded in corporate leadership or politics. Are you treating pathology, or are you treating a poor fit between a person and their environment?",
  "Challenges the universality of psychiatric norms. What is disordered in one context is fitness in another. Draws on evolutionary psychiatry and the work of Randolph Nesse on how emotions like anxiety and depression can be adaptive signals.",
  "FDECEA", "4A0000"
));

children.push(...questionBlock(
  17,
  "Tricky",
  "Psychiatric medication is increasingly prescribed by primary care physicians with minimal psychiatric training. Is that democratizing mental healthcare, or is it creating a generation of patients on psychotropics with no real understanding of what is being treated?",
  "Tests the clinician's willingness to critique their own profession's boundaries. Touches on the commercialization of psychiatry, the role of pharmaceutical marketing, and the chronic underfunding of specialist services.",
  "FDECEA", "4A0000"
));

children.push(...questionBlock(
  18,
  "Tricky",
  "The concept of \"insight\" in psychiatry — the ability of a patient to recognize they are ill — is used to justify overriding patient refusal of treatment. But insight is assessed by the clinician. How do you guard against using \"lack of insight\" as a tool that conveniently eliminates the need for consent?",
  "One of the most ethically fraught concepts in psychiatry. Xavier Amador's LEAP model tries to work around it, but the structural power imbalance remains. Forces the clinician to confront how easily a subjective judgment becomes a legal mechanism.",
  "FDECEA", "4A0000"
));

children.push(...questionBlock(
  19,
  "Tricky",
  "As psychiatric genetics and neuroscience advance, the deterministic view of mental illness grows stronger — genes load the gun, environment pulls the trigger. If mental illness is largely biological fate, what is the philosophical role of psychotherapy at all?",
  "The hard problem of agency in psychiatry. If symptoms are downstream of fixed biology, is therapy changing the mind or just rearranging thoughts around an immovable structure? Connects to epigenetics research showing environment can modify gene expression.",
  "FDECEA", "4A0000"
));

children.push(...questionBlock(
  20,
  "Tricky",
  "Burnout, loneliness, and existential dread about geopolitical instability are rational responses to the world as it is. At what point does psychiatry risk becoming a machine that pathologizes normal human responses to abnormal conditions — and who decides where that line is?",
  "Perhaps the most important question in contemporary psychiatry. The DSM-5 removed the bereavement exclusion from major depression, signaling that even grief is now a candidate for diagnosis. Forces reflection on medicine's relationship with suffering as a social phenomenon.",
  "FDECEA", "4A0000"
));

// ── FOOTER NOTE ─────────────────────────────────────────────────
children.push(spacer(300));
children.push(hrParagraph(DEEP_BLUE));
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 120, after: 60 },
    children: [
      new TextRun({ text: "These questions are designed to provoke reflection, not to trap. The best conversations will leave both parties with more questions than answers.", size: 18, color: MID_GREY, font: "Arial", italics: true })
    ]
  })
);
children.push(
  new Paragraph({
    alignment: AlignmentType.CENTER,
    spacing: { before: 0, after: 40 },
    children: [
      new TextRun({ text: "Generated by Orris  |  July 2026", size: 16, color: "AAAAAA", font: "Arial" })
    ]
  })
);

// ════════════════════════════════════════════════════════════════
// BUILD
// ════════════════════════════════════════════════════════════════
const doc = new Document({
  styles: {
    default: {
      document: { run: { font: "Arial", size: 22, color: DARK_GREY } }
    }
  },
  sections: [{
    properties: {
      page: {
        margin: { top: 1080, bottom: 1080, left: 1080, right: 1080 }
      }
    },
    children
  }]
});

Packer.toBuffer(doc).then(buf => {
  fs.writeFileSync("/home/daytona/workspace/psychiatry-questions/Psychiatry_Questions_Reference.docx", buf);
  console.log("Done: Psychiatry_Questions_Reference.docx");
}).catch(err => { console.error(err); process.exit(1); });

cd /home/daytona/workspace/psychiatry-questions && node build.js 2>&1

python /home/daytona/skills/docx/scripts/office/validate.py /home/daytona/worksp…

ls -lh /home/daytona/workspace/psychiatry-questions/Psychiatry_Questions_Referen…